Anatomical perspectives of brow-lifting using threads: Clinical cases with techniques.

INTRODUCTION: Tailoring surgical interventions to target age-related transformations is paramount. Many candidates seeking blepharoplasty commonly exhibit eyebrow ptosis, underscoring the necessity for surgeons to possess a comprehensive understanding of techniques for brow and forehead rejuvenation. METHODS: Various surgical techniques are available for eyebrow and forehead enhancement, contrasting the standardized approaches in upper and lower blepharoplasty. Thread lifting has gained popularity for forehead lifting, although a more precise term would be eyebrow lifting. The thread lifting methods using V and I techniques with floating-type threads (Secret Line, Hyundai Meditech., Inc., Wonju-si, Republic of Korea) are used. RESULTS: The natural aging process often causes the forehead and eyebrows to sag under the influence of gravity, leading to the appearance of heavy eyelids. Elevating the eyebrows can mitigate droopiness, enhance vision clarity, and rejuvenate the facial aesthetic. While non-surgical methods like Botulinum Toxin A can weaken muscles and potentially aid in brow elevation, their visible effects may be somewhat constrained. DISCUSSION: Surgical methods encompass endoscopic forehead lift, eyebrow lift techniques, and scalp excision-based forehead reduction surgery, each with specific advantages and drawbacks. Thread lifting bridges the gap between surgical and non-surgical modalities. Forehead areas often lack subcutaneous fat, requiring precise anatomical understanding for effective thread lifting. Cannula usage with partial tunneling ensures efficacy even in patients with strong adhesions. Presented cases showcase successful eyebrow lifting using cog threads, illustrating immediate and gradual post-procedure changes. CONCLUSION: Eyebrow thread lifting demands periodic procedures, offering subtler improvements than surgery. Anatomical knowledge is crucial, and the technique presents discomfort. Effects last about 6 months, requiring re-treatment as effects regress. Thread lifting, a middle ground between surgical and non-surgical methods, can rejuvenate brows with less downtime.

Obesity is associated with incident chronic kidney disease in individuals with normal renal function.

Background/Aims: Obesity has known to be a modifiable risk factor associated with worse outcomes in chronic kidney disease (CKD), but few studies have examined the impact of obesity on CKD incidence in the general population. The purpose of this study was to investigate the role of body mass index (BMI) and waist-to-hip ratio (WHR) as predictors of incident CKD and to evaluate the impact of weight reduction on CKD prevention. Methods: A total of 2,711 participants from a community-based cohort with normal renal function were prospectively analyzed. Among participants with obesity, we analyzed the change in WHR to evaluate the association of obesity reduction with CKD development. Results: During a mean follow-up of 11.03 ± 4.22 years, incident CKD occurred in 190 (7.0%) participants. In the fully adjusted multivariable Cox proportional hazard models, the risk of incident CKD increased with higher BMI (hazard ratio, 1.06; 95% confidence interval, 1.00-1.11; p = 0.033) and higher WHR (hazard ratio, 1.33; 95% confidence interval, 1.07-1.66; p = 0.009). In the Kaplan-Meier analysis, cumulative adverse renal events were significantly more common in the maintained obesity group than in the reduced obesity group (p = 0.001). Conclusions: Both higher BMI and WHR were associated with development of CKD, but the magnitude of the effect of WHR was higher than that of BMI. Moreover, reducing obesity would be beneficial for renal prognosis.

Standardization of an antimicrobial resistance surveillance network through data management.

Introduction: The rapid spread of COVID-19 worldwide within 2 months demonstrated the vulnerability of the world's population to infectious diseases. In 2015, the Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched to combat antimicrobial resistance (AMR). However, there has been no comprehensive assessment of the decade-long global battle against AMR based on GLASS data. Methods: South Korea established Kor-GLASS (Korean-GLASS) to proactively monitor data quality and enable international collaborations. A unique feature of Kor-GLASS is the quality control center (QCC), which uses network hubs and ensures standardized, high-quality data through interlaboratory proficiency testing (IPT) and external quality assessment (EQA). In addition, the QCC multifaceted endeavors for integrated data quality management. Results: Since 2020, high-quality AMR data have indicated fluctuating antibiotic resistance rates in South Korea. This trend does not align with the decrease in antibiotic usage seen in humans but coincides with non-human antibiotic sales, indicating a need for greater monitoring of non-human antibiotic resistance. Comprehensive and robust management taking account of the intricate interplay among humans, animals, and the environment is essential. Kor-GLASS has been expanded into a "One Health" multiagency collaborative initiative. Discussion: Although a standardized solution is not suitable for all countries, it must align with the local context and international standards. A centralized top-down management structure such as that of the QCC is essential to ensure continuous data quality coordination. Sustained efforts and surveillance systems are crucial for monitoring and managing AMR and safeguarding human health.

Efficacy and Safety of Lurasidone vs. Quetiapine XR in Acutely Psychotic Patients With Schizophrenia in Korea: A Randomized, Double-Blind, Active-Controlled Trial.

OBJECTIVE: This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. METHODS: Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. RESULTS: Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35-4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. CONCLUSION: Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.

BAG3 Mediated Down-regulation in Expression of p66shc has Ramifications on Cellular Proliferation, Apoptosis and Metastasis.

Redundancy of cancer cells towards ROS-mediated apoptosis despite expressing proline-rich p66shc abundantly needs to be investigated properly. P66shc, an adapter protein, is indispensable both for initiating ROS-mediated apoptosis and subsequent ROS generation through Rac-1 activation. P66shc gets phosphorylated at Ser-36 that triggers its translocation to the mitochondria and subsequent release of Cytochrome c in response to oxidative stress. It also aids in Rac-1 dependent NADPH oxidase activation, leading to the generation of cytosolic ROS that can perform diverse functions depending on its concentration. This study has identified the multi-faceted anti-apoptotic protein BAG3 as an interacting partner of p66shc. BAG3 utilizes its WW domain to bind to the proline-rich motifs of p66shc. BAG3, through its WW domain, antagonizes p66shc mediated apoptosis, by inhibiting both the expression and phosphorylation of p66shc under normal and oxidative stress conditions. This results in significant protection against ROS-mediated apoptosis. BAG3-mediated reduction in p66shc expression increases cell proliferation and metastasis. The increase in cell proliferation is attributed to the impact of BAG3 on Rac-1 activation and ROS production under normal conditions. This study has unraveled an interactor of p66shc that enhances pro-survival role while simultaneously suppressing its apoptotic role.

Analysis of Active Components and Transcriptome of Freesia refracta Callus Extract and Its Effects against Oxidative Stress and Wrinkles in Skin.

Freesia refracta (FR), a perennial flower of the Iris family (Iridaceae), is widely used in cosmetics despite limited scientific evidence of its skin benefits and chemical composition, particularly of FR callus extract (FCE). This study identified biologically active compounds in FCE and assessed their skin benefits, focusing on anti-aging. FR calli were cultured, extracted with water at 40 °C, and analyzed using Centrifugal Partition Chromatography (CPC), Nuclear Magnetic Resonance (NMR), and HCA, revealing key compounds, namely nicotinamide and pyroglutamic acid. FCE significantly increased collagen I production by 52% in normal and aged fibroblasts and enhanced fibroblast-collagen interaction by 37%. An in vivo study of 43 female volunteers demonstrated an 11.1% reduction in skin roughness and a 2.3-fold increase in collagen density after 28 days of cream application containing 3% FCE. Additionally, the preservation tests of cosmetics containing FCE confirmed their stability over 12 weeks. These results suggest that FCE offers substantial anti-aging benefits by enhancing collagen production and fibroblast-collagen interactions. These findings highlighted the potential of FCE in cosmetic applications, providing significant improvements in skin smoothness and overall appearance. This study fills a gap in the scientific literature regarding the skin benefits and chemical composition of FR callus extract, supporting its use in the development of effective cosmeceuticals.

Deep Network Regularization for Phase-based Magnetic Resonance Electrical Properties Tomography with Stein's Unbiased Risk Estimator.

Magnetic resonance imaging (MRI) can extract the tissue conductivity values from in vivo data using the so-called phase-based magnetic resonance electrical properties tomography (MR-EPT). However, this procedure suffers from noise amplification caused by the use of the Laplacian operator. To counter this issue, we propose a novel preprocessing denoiser for magnetic resonance transceive phase images, operating in an unsupervised manner. Inspired by the deep image prior approach, we apply the random initialization of a convolutional neural network, which enforces an implicit regularization. Additionally, we introduce Stein's unbiased risk estimator, which is the unbiased estimator of the mean square error for optimizing the network without the need for label images. This modification not only tackles the overfitting problem inherent in the deep image prior approach but also operates within a purely unsupervised framework. In addition, instead of using phase images, we use real and imaginary images, which aligns with the theoretical model of the risk estimator. Our generative model needs neither the preparation of training datasets nor prior training procedure, and it maintains adaptability across various resolutions and signal-to-noise ratio levels. In testing. our method significantly diminished residual error remaining in phase maps, quantitatively as well as qualitatively, for both phantom and simulated brain data. Furthermore, it outperformed other denoising methods in reducing noise amplification and boundary error. When applied to healthy volunteer and patient data, the proposed method revealed reduced error in the reconstructed conductivity maps, with conductivity values aligning well with established literature values. To the best of our knowledge, this is the first blind approach using a purely unsupervised denoising framework that can implement a 2D phase-based MR-EPT reconstruction algorithm. The source code is available at https://github.com/Yonsei-MILab/Implicit-Regularization-forMREPT-with-SURE.

Enhancing mutation detection in multiple myeloma with an error-corrected ultra-sensitive NGS assay without plasma cell enrichment.

BACKGROUND: Risk stratification in multiple myeloma (MM) patients is crucial, and molecular genetic studies play a significant role in achieving this objective. Enrichment of plasma cells for next-generation sequencing (NGS) analysis has been employed to enhance detection sensitivity. However, these methods often come with limitations, such as high costs and low throughput. In this study, we explore the use of an error-corrected ultrasensitive NGS assay called positional indexing sequencing (PiSeq-MM). This assay can detect somatic mutations in MM patients without relying on plasma cell enrichment. METHOD: Diagnostic bone marrow aspirates (BMAs) and blood samples from 14 MM patients were used for exploratory and validation sets. RESULTS: PiSeq-MM successfully detected somatic mutations in all BMAs, outperforming conventional NGS using plasma cells. It also identified 38 low-frequency mutations that were missed by conventional NGS, enhancing detection sensitivity below the 5% analytical threshold. When tested in an actual clinical environment, plasma cell enrichment failed in most BMAs (14/16), but the PiSeq-MM enabled mutation detection in all BMAs. There was concordance between PiSeq-MM using BMAs and ctDNA analysis in paired blood samples. CONCLUSION: This research provides valuable insights into the genetic landscape of MM and highlights the advantages of error-corrected NGS for detecting low-frequency mutations. Although the current standard method for mutation analysis is plasma cell-enriched BMAs, total BMA or ctDNA testing with error correction is a viable alternative when plasma cell enrichment is not feasible.

The Circadian Clock of Müller Glia is Necessary for Retinal Homeostasis and Neuronal Survival.

Biological processes throughout the body are orchestrated in time through the regulation of local circadian clocks. The retina is among the most metabolically active tissues, with demands depending greatly on the light/dark cycle. Most cell types within the retina are known to express the circadian clock in rodents, however, retinal clock expression in the human has not previously been localized. Moreover, the effect of local circadian clock dysfunction on retinal homeostasis is incompletely understood. We demonstrate an age-dependent decline in circadian clock gene and protein expression in the human retina. Using an animal model of targeted Bmal1 deficiency, we identify the circadian clock of the retinal Müller glia as essential for neuronal survival, vascular integrity, and retinal function. These results suggest a potential role for the local retinal circadian clock within the Müller glia in age-related retinal disease and retinal degeneration.

Reverse and antegrade vector thread lifting techniques: Correcting nasolabial and marionette lines.

BACKGROUND: This study evaluates the efficacy of reverse and antegrade thread lifting vectors in conjunction with thread selection for correcting nasolabial folds and marionette lines, aiming to enhance treatment precision and effectiveness. METHODS: Three female patients aged 43, 48, and 53, presenting with primary concerns regarding nasolabial folds, underwent distinct treatment regimens utilizing various types of threads and vectors. Additionally, video demonstrations were recorded to showcase the procedural techniques employed in each case. RESULTS: The outcomes of the thread lifting procedures demonstrated significant improvements in the correction of the nasolabial fold and marionette line. CONCLUSION: Innovative thread insertion techniques involve entry points above the zygomatic arch and threading toward the temple hairline for lateral face lifting. These utilize barbs to pull skin and underlying tissues. The reversal technique involves inserting threads in a criss-cross pattern, forming a fibrous structure that may prolong the duration of results. Various thread combinations, considering factors such as composition, thickness, and barb size, provide customized procedures. This research introduces clinical applications, including temple area hairline lifting for nasolabial fold and marionette line correction, reverse vectors targeting nasolabial folds and marionette lines, and antegrade approaches from the lateral side.

Scapula position test reliability and comparisons of scapula position and shoulder function among individuals with and without adolescent idiopathic scoliosis.

BACKGROUND: An evaluation of scapula position is important to predict spine curvature and shoulder function in patients with adolescent idiopathic scoliosis (AIS). Therefore, a reliable scapula position is required to assess posture in patients with AIS. OBJECTIVE: This study investigated the reliabilities of scapula position tests and differences in scapula position and shoulder function between individuals with and without AIS. METHODS: The study compared 18 patients with AIS and 18 healthy controls to identify differences in scapula position and shoulder function. The acromion-table distance, lateral displacement of the scapula, acromion depression, winged scapula, upward rotation of the scapula, and anterior tilt of the scapula were measured. Scapula position test reliabilities were assessed using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum clinically important difference (MCID). Shoulder function was measured using the Shoulder Pain and Disability Index. RESULTS: The reliabilities of scapula position tests (ICC 0.85-0.93, SEM 0.1-1.2, and MCID 0.2-2.5) were good. There were significant differences in scapula position and shoulder function between patients with AIS and healthy controls (p< 0.05). CONCLUSION: Scapula position tests were highly reliable in patients with AIS; they can be used to evaluate scapula position during clinical assessment of posture in patients with AIS.

Impact of Serum Creatinine- and Cystatin C-Based Sarcopenia Index on Renal Outcomes in Non-Dialysis-Dependent Chronic Kidney Disease Patients: Results From the KNOW-CKD Study.

OBJECTIVE: To evaluate the impact of the serum creatinine- and cystatin C-based new sarcopenia index (SI) on renal outcomes in non-dialysis-dependent patients with chronic kidney disease (CKD). METHODS: In this observational Korean Cohort Study for Outcome in Patients With CKD (KNOW-CKD), 1957 patients with CKD stage 1 to stage 4 were analyzed from 2011 to 2019. Men and women were separately assigned to quartile groups according to their SI. The primary outcome was a composite renal outcome consisting of 50% reduction in estimated glomerular filtration rate or end-stage kidney disease. With use of Fine and Gray subdistribution hazard models, the association between the SI and the primary outcome was analyzed. RESULTS: During a median follow-up of 6.0 (4.2 to 7.7) years, the primary composite renal outcome occurred in 528 (28.6%) patients within a median of 3.0 (1.8 to 5.0) years. In unadjusted and adjusted models, lower SI groups had a poor primary outcome compared with the highest group (quartile 4). The hazard ratios for quartiles 1, 2, and 3 compared with quartile 4 in the fully adjusted model were 4.47 (95% CI, 3.05 to 6.56; P<.001), 3.08 (95% CI, 2.13 to 4.48; P<.001), and 2.09 (95% CI, 1.45 to 3.01; P<.001), respectively. Restricted cubic spline regression analyses found a relatively inverse linear relationship between the SI and the composite renal outcome. CONCLUSION: The new SI is an independent predictor of renal outcomes. A low SI is associated with poor renal outcome.

Proteomics Profiling of Bilirubin Nanoparticle Treatment against Myocardial Ischemia-Reperfusion Injury.

In myocardial infarction, ischemia-reperfusion injury (IRI) poses a significant challenge due to a lack of effective treatments. Bilirubin, a natural compound known for its anti-inflammatory and antioxidant properties, has been identified as a potential therapeutic agent for IRI. Currently, there are no reports about proteomic studies related to IRI and bilirubin treatment. In this study, we explored the effects of bilirubin nanoparticles in a rat model of myocardial IRI. A total of 3616 protein groups comprising 76,681 distinct peptides were identified using LC-MS/MS, where we distinguished two kinds of protein groups: those showing increased expression in IRI and decreased expression in IRI with bilirubin treatment, and vice versa, accounting for 202 and 35 proteins, respectively. Our proteomic analysis identified significant upregulation in the Wnt and insulin signaling pathways and increased Golgi markers, indicating their role in mediating bilirubin nanoparticle's protective effects. This research contributes to the proteomic understanding of myocardial IRI and suggests bilirubin nanoparticles as a promising strategy for cardiac protection, warranting further investigation in human models.

Recurrent fever of unknown origin and unexplained bacteremia in a patient with a novel 4.5 Mb microdeletion in Xp11.23-p11.22.

Fever of unknown origin (FUO) remains a formidable diagnostic challenge in the field of medicine. Numerous studies suggest an association between FUO and genetic factors, including chromosomal abnormalities. Here, we report a female patient with a 4.5 Mb Xp microdeletion, who presented with recurrent FUO, bacteremia, colitis, and hematochezia. To elucidate the underlying pathogenic mechanism, we employed a comprehensive approach involving single cell RNA sequencing, T cell receptor sequencing, and flow cytometry to evaluate CD4 T cells. Analysis of peripheral blood mononuclear cells revealed augmented Th1, Th2, and Th17 cell populations, and elevated levels of proinflammatory cytokines in serum. Notably, the patient exhibited impaired Treg cell function, possibly related to deletion of genes encoding FOPX3 and WAS. Single cell analysis revealed specific expansion of cytotoxic CD4 T lymphocytes, characterized by upregulation of various signature genes associated with cytotoxicity. Moreover, interferon-stimulated genes were upregulated in the CD4 T effector memory cluster. Further genetic analysis confirmed maternal inheritance of the Xp microdeletion. The patient and her mother exhibited X chromosome-skewed inactivation, a potential protective mechanism against extensive X chromosome deletions; however, the mother exhibited complete skewing and the patient exhibited incomplete skewing (85:15), which may have contributed to emergence of immunological symptoms. In summary, this case report describes an exceptional instance of FUO stemming from an incompletely inactivated X chromosome microdeletion, thereby increasing our understanding of the genetics underpinning FUO.

A Randomized, Multi-Center, Open Label Study to Compare the Safety and Efficacy between Afatinib Monotherapy and Combination Therapy with HAD-B1 for the Locally Advanced or Metastatic NSCLC Patients with EGFR Mutations.

BACKGROUND: Lung cancer, especially non-small cell lung cancer (NSCLC), poses a significant health challenge globally due to its high mortality. Afatinib, a second-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), has shown superior efficacy over traditional chemotherapy in NSCLC treatment. However, issues like secondary resistance and adverse effects call for alternative therapies. HAD-B1, comprising 4 herbal medicines, has shown promise in lung cancer treatment in both preclinical and clinical settings. This study assesses the combination of HAD-B1 and Afatinib in advanced NSCLC patients to potentially improve outcomes by addressing the limitations of current EGFR-TKI therapies. METHOD: A randomized, open-label trial evaluated the efficacy and safety of HAD-B1 with Afatinib in 90 EGFR-mutation-positive NSCLC patients. Participants were divided into treatment and control groups, receiving Afatinib with or without HAD-B1. The study focused on the initial dose maintenance rate and disease control rate (DCR) of Afatinib, alongside secondary outcomes like survival rates and quality of life, under continuous safety monitoring. RESULTS: Among the 90 participants, no significant difference was found in initial dose maintenance (60.98% in the treatment group vs 52.50% in the control, P = .4414) or DCR (80.49% vs 90.00%, P = .2283). Secondary outcomes like PFS, TTP, and OS showed no notable differences. However, physical functioning significantly improved in the treatment group (P = .0475, PPS group). The control group experienced higher rates of adverse events of special interest and adverse drug reactions (P = .01), suggesting HAD-B1 with Afatinib might enhance physical function without increasing adverse effects. CONCLUSION: Combining HAD-B1 with Afatinib potentially improves quality of life and reduces adverse events in advanced NSCLC patients. Further research is necessary to confirm the long-term benefits of this combination therapy, aiming to advance NSCLC treatment outcomes. TRIAL REGISTRATION: Clinical Research Information Service (CRIS) of the Republic of Korea, https://cris.nih.go.kr/ (ID: KCT0005414).

Association between sleep patterns and alcohol use disorders in workers.

Alcohol use among workers that is intended to aid sleep may lead to alcohol use disorders. This study aimed to explore the association between sleep patterns and alcohol use disorders in workers. Data from the Korea National Health and Nutrition Examination Survey conducted in 2014, 2016, 2018, and 2020 were used for this study. We included only workers aged 19 years and older. The final analysis comprised 11,972 respondents (6,472 male and 5,500 female). Multiple logistic regression analysis was used to investigate the relationship between sleep patterns and alcohol use disorders. Workers with poor sleep patterns were more likely to develop alcohol use disorders compared to those with good sleep patterns (male: adjusted odds ratio [OR] 1.22, 95% confidence interval 1.07-1.39; female: adjusted OR 1.21, 95% CI 1.03-1.41). Workers with both poor sleep quality and less than seven hours of sleep had the highest odds of alcohol use disorders in both male (adjusted OR 1.73, 95% CI 1.38-2.17) and female (adjusted OR 1.44, 95% CI 1.13-1.84). Poor sleep patterns were associated with alcohol use disorders in male who work night shift (OR: 1.74, 95% CI: 1.25-2.42) and in female who worked more than 52 hours per week (adjusted OR: 1.71, 95% CI: 1.04-2.80). Customized sleep management programs should be provided to workers in sleep-deprived working environments to prevent them from developing alcohol use disorders.

Association between stress types and adolescent suicides: findings from the Korea Youth Risk Behavior Survey.

Objective: This study aims to explore the association between types of stress and suicidal behaviors-ideation and attempts-among Korean adolescents in two distinct years: 2015 and 2020. Methods: Data were acquired from the Korea Youth Risk Behavior Web-based Survey conducted in 2015 and 2020. Participants' desire for suicide was evaluated by asking questions about suicidal ideation and attempts, during the past year. Types of stress were divided into five categories: none, home, school, academic achievement, and appearance. Multiple logistic regression was used to investigate the association between variables of interest and dependent variables. Results: Among the 77,363 adolescents included in this study, 8.8% male and 13.2% female participants had seriously thought about committing suicide, and the rate of male and female participants who tried committing suicide was 1.6% and 2.5%, respectively. While every type of stress was highly associated with suicidal ideation, family and home types of stress had the highest odds ratio (OR), that was statistically significant for both sexes (Male: OR 3.81, 95% Confidence Interval [CI] 2.81 to 5.15; Female: OR 3.64, 95% CI 2.42 to 5.50). Moreover, the OR increased in order of: appearance; academic achievement; school and friends; and family and home, compared to the group that perceived no stress. Suicidal attempts were statistically significant and higher in likelihood, only amongst the female group that experienced stress from family and home (OR 2.48, 95% CI 1.08 to 5.67). In comparison to year 2015, suicidal ideation and attempts decreased in year 2020, but participants experiencing stress from family and home had a higher tendency of attempting suicide, though not statistically significant, regardless of their sex (Male: OR 1.03, 95% CI 0.74 to 1.44; Female: OR 1.06, 95% CI 0.81 to 1.4). Conclusion: Adolescents who experience stress from family and home, or school and friends, are more likely to think about suicide, or carry it out, as compared to those having different causes of stress.