Background: Precision oncology is advancing, increasing the demand for comprehensive, non-invasive genomic profiling tools. Liquid biopsy using circulating tumor DNA (ctDNA) enables real-time molecular profiling, treatment monitoring, and early detection of resistance variants. We developed the PAN100 panel (Dxome), a hybridization capture panel targeting 101 genes, as a pan-cancer genotyping assay to detect clinically actionable variants across various cancer types. This study presents the first comprehensive validation of the PAN100 panel including both analytical and clinical performance across eight cancer types using reference materials and matched tissue samples. Methods: For analytical validation, we assessed accuracy, limit of detection (LoD), and precision using Seraseq ctDNA v2 Reference Materials (SeraCare, Milford, MA, USA). Clinical validation was performed using plasma samples from 27 patients with eight types of cancer and 17 matched tumor samples. Positive percent agreement (PPA) between ctDNA and tissue next-generation sequencing (NGS) results was assessed using TruSight Oncology 500 and TruSight Tumor 170 assays. The limit of blank (LoB) was evaluated in 34 healthy individuals. Results: The PAN100 panel demonstrated high precision and linearity (LoD, 0.3%; 95.0% confidence interval, 0.29–0.35) variant allele frequency. The PPA between ctDNA and tissue NGS was 73.1% for single-nucleotide variants, 80.0% for insertions/deletions, and 74.2% overall. The LoB was 0.00001%. Conclusions The PAN100 panel is a robust tool for detecting clinically significant variants with high concordance with tissue NGS. Its sensitivity for low-frequency variants enables real-time treatment adaptation, supporting precision oncology. Its comprehensive design is particularly valuable for challenging diagnoses and clonal evolution monitoring.

Objective: Suicide is a leading cause of death among adolescents, and despite the need to distinguish between suicidal consideration and suicide attempts, research focused on suicide attempts remains insufficient. Therefore, this study aims to investigate the influence of self-perceived weight on suicide attempts. Methods: This study utilized data from the Korea Youth Risk Behavior Web-based Survey for its analysis from 2005 to 2023, including a total of 1,156,728 participants. This study utilized various analytical methods to examine the influence of self-perceived weight on suicide attempts. We estimated weighted prevalence and used linear regression to assess temporal trend β coefficients and their differences (βdiff) with 95% confidence intervals (CIs), and survey-weighted logistic regression to estimate weighted odds ratios (wORs) and 95% CIs for the association between self-perceived weight and suicide attempts. Results: A comparison of suicide attempts based on self-perceived weight suggested that individuals who perceived themselves as overweight (weighted prevalence, 3.97% [95% CI, 3.89 to 4.04]) had the highest rate of suicide attempts, followed by those who perceived themselves as underweight (3.36% [95% CI, 3.28 to 3.44]), while those who perceived themselves as having a normal weight (3.20% [95% CI, 3.14 to 3.27]) had the lowest rate. Additionally, females (underweight: 4.47% [95% CI, 4.32 to 4.62]; normal weight: 3.91% [95% CI, 3.81 to 4.01]; overweight: 5.23% [5.11 to 5.35]) experienced more suicide attempts than males (underweight: 2.73% [95% CI, 2.65 to 2.82]; normal weight: 2.43% [95% CI, 2.35 to 2.51]; overweight: 2.60% [95% CI, 2.52 to 2.69]). Conclusion Findings from the present study suggest that self-perceived weight was associated with suicide attempts and interaction analyses indicated a potential sex-based difference in the impact of body image distortion. Therefore, this study suggests the introduction of programs and campaigns aimed at correcting distorted self-perceived weight.

OBJECTIVE: Despite the global decrease in influenza infections during the coronavirus disease 2019 (COVID-19) pandemic, seasonal influenza remains a significant health issue. South Korea, known for its robust pandemic response and high influenza vaccination rates, offers a unique context for examining changes in vaccination trends during the pandemic. Using nationally representative data, we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups. METHODS: We analyzed influenza vaccination rates in South Korea between 2011-2022, focusing on pandemic-related impacts. The data of 2,426,139 adults (≥ 19 years) from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors. RESULTS: We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013 (weighted prevalence: 46.68% [95% confidence interval ( CI): 46.55-46.82]) to 2017-2019 (weighted prevalence: 52.50% [95% CI: 52.38-52.63]). However, a significant decline was observed in 2022, the late-COVID-19 pandemic period (weighted prevalence: 55.78% [95% CI: 55.56-56.01]), compared with the mid-pandemic period in 2021 (weighted prevalence: 59.12% [95% CI: 58.91-59.32]), particularly among populations traditionally prioritized for influenza vaccination, including older adults (≥ 65 years) and patients with chronic diseases and low educational and income levels. CONCLUSION The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic, showing a notable decrease among vulnerable demographic groups. This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates, particularly among high-risk populations.
Humans ; Republic of Korea/epidemiology* ; COVID-19/epidemiology* ; Adult ; Middle Aged ; Influenza Vaccines/administration & dosage* ; Male ; Female ; Influenza, Human/epidemiology* ; Aged ; Vaccination/statistics & numerical data* ; Young Adult ; Pandemics ; SARS-CoV-2

The effects of atherogenic indices on kidney function remain unclear. This study evaluated the association between atherogenic indices and risk of chronic kidney disease (CKD) in adults with metabolic derangements. Methods: A total of 4,176 participants from the Gangnam Severance Medical Cohort (2006–2021), which consisted of participants who had at least one disease related to metabolic derangements including diabetes mellitus, fatty liver, and hypertension were enrolled and atherogenic indices (lipid ratios including atherogenic index of plasma [AIP]) were assessed. The study endpoint was a composite kidney outcome (estimated glomerular filtration rate [eGFR] of <60 mL/min/1.73 m2 in at least two measurements in participants with baseline eGFR of ≥60 mL/min/1.73 m2; ≥30% decrease in eGFR from baseline in participants with baseline eGFR of <60 mL/min/1.73 m2; or the initiation of dialysis or kidney transplantation). Results: During a median follow-up of 6.0 years (interquartile range, 2.5–11.0 years), 1,266 composite kidney outcomes (30.3%) occurred. The highest quartile of AIP showed a higher risk of composite kidney outcome than the lowest quartile (hazard ratio [HR], 1.31; 95% confidence interval [CI], 1.12–1.54). This association was consistent when the AIP was treated as a continuous variable (HR per 1.0 increase, 1.51; 95% CI, 1.21–1.88). However, other atherogenic indices did not show significant associations with composite kidney outcome. Adding AIP to the traditional risk model to predict composite kidney outcomes significantly improved the C-index, net reclassification index, and integrated discrimination improvement. The association between high AIP and an increased risk of composite kidney outcome was consistent regardless of subgroup. Conclusion: High AIP was associated with an increased risk of CKD in adults with metabolic derangements.

Background: Posttransplant diabetes mellitus (PTDM) complicates kidney transplant recipients (KTRs) in morbidity and mortality. This study aimed to predict PTDM risk in KTRs using machine learning and deep learning models. Methods: Data were obtained from the Korea Organ Transplantation Registry, a nationwide cohort study of KTRs. Four machine learning algorithms, including eXtreme Gradient Boosting (XGBoost), CatBoost, light gradient boosting machine and logistic regression, and deep learning were implemented on 41 pretransplant and 31 posttransplant variables to predict PTDM. Model performance was assessed using the area under the curve (AUC) of the receiver operating characteristic curve, accuracy, precision, recall, and F1 score. Results: Among 3,213 KTRs, 497 patients (15.5%) developed PTDM within 1 year. The PTDM group had higher age, body mass index (BMI), triglyceride level, and prevalence of hypertension and cardiovascular disease, and lower total cholesterol level at baseline than the No-PTDM group. The XGBoost model showed the highest AUC (0.738) and F1 score (0.42), and modest accuracy (0.86), while the CatBoost model exhibited the highest accuracy (0.87) and precision (0.79). Feature importance in XGBoost was highest for recipient age, followed by baseline BMI, triglyceride level at posttransplant 6 months, baseline glycated hemoglobin and high-density lipoprotein cholesterol level, white blood cell (WBC) count and serum uric acid level at 6 months, baseline WBC count, and tacrolimus trough level at discharge. Conclusion The XGBoost model demonstrated the best performance for predicting PTDM within 1 year, offering an accurate tool for early identification and personalized care of high-risk KTRs for PTDM.

Good’s syndrome is a rare cause of combined B- and T-cell immunodeficiency in adults with a history of thymectomy. The patients with Good’s syndrome are susceptible to encapsulated bacterial infections and opportunistic viral/fungal infections. We report a 63-year-old female patient who was diagnosed with cerebral toxoplasmosis in the middle of monthly immunoglobulin treatment for Good’s syndrome. She was referred owing to progressive dizziness for one week without any neurologic deficits. Although routine laboratory tests and toxoplasma serology exams were within the normal range, brain image studies suggested cerebral toxoplasmosis, which was confirmed by pathology of brain lesions. She was treated with pyrimethamine and sulfadiazine as well as with systemic corticosteroids, and improved without sequelae. Later, her medication was switched to trimethoprim/sulfamethoxazole as a second-line treatment due to sulfadiazine-related neuropathy.

BACKGROUND/OBJECTIVES: This study investigated the relationship between adolescent food-related lifestyles and food-related media use and eating behavior in Korea. SUBJECTS/METHODS: Participants were 392 Korean adolescents, ranging in age from 12 to 18, recruited via convenience sampling. They completed a self-report questionnaire survey consisting of questions about food-related lifestyle, food-related media use, food consumption behavior, food literacy, and nutrition quotient. Data analysis was conducted using SPSS 29.0. (IBM Co., Armonk, NY, USA). RESULTS: The factor analysis of food-related lifestyles identified four factors. Based on the cluster analysis results, participants were classified into three clusters reflecting different levels of interest: high interest in food, moderate interest in food, and low interest in food. The analysis revealed significant differences between groups in food-related liestyle factors (P < 0.05). Notably, the high-interest group demonstrated proactive engagement with food-related content, a willingness to explore diverse culinary experiences, and a conscientious consideration of nutritional labeling during food purchases. In contrast, the low-interest group reported tendencies toward overeating or succumbing to stimulating food consumption post-exposure to food-related content, coupled with a disregard for nutritional labeling when making food choices. A stronger inclination toward a food-related lifestyle was positively correlated with higher levels of food literacy and nutrition quotient. CONCLUSION This study proposes that the implementation of a nutrition education program using media could effectively promote a healthy diet among adolescents with a high level of interest in their dietary habits. For adolescents with low interest in their dietary habits, it suggests that introducing an education program with a primary focus on enhancing food literacy could be beneficial in fostering a healthy diet. Our research findings provide insight for the development of tailored nutritional education programs and establishment of effective nutrition policies.

Objective: Extrapyramidal symptoms (EPS) are common side effects of antipsychotic drugs. Despite the growing interest in exploring objective biomarkers for EPS prevention and the potential use of voice in detecting clinical disorders, no studies have demonstrated the relationships between vocal changes and EPS. Therefore, we aimed to determine the associations between voice changes and antipsychotic dosage, and further investigated whether speech characteristics could be used as predictors of EPS. Methods: Forty-two patients receiving or expected to receive antipsychotic drugs were recruited. Drug-induced parkinsonism of EPS was evaluated using the Simpson-Angus Scale (SAS). Participants’ voice data consisted of 16 neutral sentences and 2 second-long /Ah/utterances. Thirteen voice features were extracted from the obtained voice data. Each voice feature was compared between groups categorized based on SAS total score of below and above “0.6.” The associations between antipsychotic dosage and voice characteristics were examined, and vocal trait variations according to the presence of EPS were explored. Results: Significant associations were observed between specific vocal characteristics and antipsychotic dosage across both datasets of 1–16 sentences and /Ah/utterances. Notably, Mel-Frequency Cepstral Coefficients (MFCC) exhibited noteworthy variations in response to the presence of EPS. Specifically, among the 13 MFCC coefficients, MFCC1 (t=-4.47, p<0.001), MFCC8 (t=-4.49, p<0.001), and MFCC12 (t=-2.21, p=0.029) showed significant group differences in the overall statistical values. Conclusion Our results suggest that MFCC may serve as a predictor of detecting drug-induced parkinsonism of EPS. Further research should address potential confounding factors impacting the relationship between MFCC and antipsychotic dosage, possibly improving EPS detection and reducing antipsychotic medication side effects.

Purpose: There are clinical unmet needs in predicting therapeutic response and precise strategy for the patient with advanced biliary tract cancer (BTC). We aimed to identify genomic alterations predicting therapeutic response and resistance to gemcitabine and cisplatin (Gem/Cis)-based chemotherapy in advanced BTC. Materials and Methods: Genomic analysis of advanced BTC multi-institutional cohorts was performed using targeted panel sequencing. Genomic alterations were analyzed integrating patients’ clinicopathologic data, including clinical outcomes of Gem/Cis-based therapy. Significance of genetic alterations was validated using clinical next-generation sequencing (NGS) cohorts from public repositories and drug sensitivity data from cancer cell lines. Results: 193 BTC patients from three cancer centers were analyzed. Most frequent genomic alterations were TP53 (55.5%), KRAS (22.8%), ARID1A (10.4%) alterations, and ERBB2 amplification (9.8%). Among 177 patients with BTC receiving Gem/Cis-based chemotherapy, ARID1A alteration was the only independent predictive molecular marker of primary resistance showing disease progression for 1st-line chemotherapy in the multivariate regression model (odds ratio, 3.12; p=0.046). In addition, ARID1A alteration was significantly correlated with inferior progression-free survival on Gem/Cis-based chemotherapy in the overall patient population (p=0.033) and in patients with extrahepatic cholangiocarcinoma (CCA) (p=0.041). External validation using public repository NGS revealed that ARID1A mutation was a significant predictor for poor survival in BTC patients. Investigation of multi-OMICs drug sensitivity data from cancer cell lines revealed that cisplatin-resistance was exclusively observed in ARID1A mutant bile duct cancer cells. Conclusion Integrative analysis with genomic alterations and clinical outcomes of the first-line Gem/Cis-based chemotherapy in advanced BTC revealed that patients with ARID1Aalterations showed a significant worse clinical outcome, especially in extrahepatic CCA. Well-designed prospective studies are mandatory to validate the predictive role of ARID1Amutation.