Analysis of the Status and Future Direction for Digital Therapeutics in Children and Adolescent Psychiatry.

Digital therapeutics based on software, such as artificial intelligence, virtual reality, games, and smartphone applications, are in the spotlight as new therapeutic alternatives in child and adolescent psychiatry. It draws attention to overcoming conventional therapeutics' limitations, such as toxicity, cost, and accessibility, and encourages patients to participate in the treatment attractively. The growth potential of the digital therapeutics market for psychiatric disorders in children and adolescents in Korea and abroad has been highlighted. Clinical studies and Food and Drug Administration approvals for digital therapeutics have increased, and cases approved by the Ministry of Food and Drug Safety have emerged in Korea. As seen above, digital transformation in child and adolescent psychiatry will change treatment paradigms significantly. Therefore, as this new field has just begun to emerge, it is necessary to verify the effectiveness and scope of the application of digital therapeutics and consider preparing a compensation system and institutional arrangements. Accordingly, this study analyzed the development trends and application status of digital therapeutics in children and adolescents and presented limitations and development directions from the perspective of application in healthcare. Further, the study is expected to identify the utility and limitations of digital therapeutics for children and adolescents and establish effective application measures.

c-Src inhibitor PP2 inhibits head and neck cancer progression through regulation of the epithelial-mesenchymal transition.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancer, causing considerable mortality and morbidity worldwide. Although HNSCC management has been extensively studied, the treatment outcomes have not improved - the 5-year survival rate of patients with HNSCC is 40%. Recent studies on the development of a novel HNSCC treatment have highlighted proto-oncogene tyrosine-protein kinase Src (c-Src) as one of the major therapeutic targets. However, the clinical efficacy of c-Src inhibitors against HNSCC was not comparable to that obtained in vitro. Furthermore, the molecular mechanisms underlying the efficacy of c-Src inhibitors remain elusive. In this study, we assessed the efficacy of 4-amino-5-(4-chlorophenyl)-7-(dimethylethyl)pyrazolo[3,4-d] pyrimidine (PP2), a selective c-Src inhibitor on HSNCC. Nine HNSCC cell lines (SNU1041, Fraud, SNU46, SNU1076, SNU899, SCC1483, YD15, YD9, and YD10-) were screened, and the effects of PP2 were evaluated using wound healing, apoptosis, and invasion assays. Western blot analysis of downstream markers was conducted to assess the specific mechanism of action of PP2 in HNSCC. The therapeutic efficacy of PP2 was further evaluated in xenograft mice. PP2 reduced tumor cell growth both in vitro and in vivo. Furthermore, it enhanced tumor cell apoptosis in cell lines and prevented metastasis in mice. PP2 also regulated the epithelial-mesenchymal transition pathway downstream of c-Src. More specifically, in SCC1483 and YD15PP2 HNSCC cell lines, PP2 exposure downregulated Erk, Akt/Slug, and Snail but upregulated E-cadherin. These results suggest that PP2 inhibits cell growth and progression in HNSCC by regulating the epithelial-mesenchymal transition pathway.

Neuropsychological Profile of College Students Who Engage in Binge Drinking.

This study investigated the neuropsychological profile of college students who engage in binge drinking (BD) using comprehensive neuropsychological tests evaluating verbal/non-verbal memory, executive functions, and attention. Groups were determined based on scores on the Korean version of the Alcohol Use Disorder Identification Test (AUDIT-K) and Alcohol Use Questionnaire (AUQ). There were 79 and 81 participants in the BD and non-BD groups, respectively. We administered the Korean version of the California Verbal Learning Test (K-CVLT) and Rey-Osterrieth Complex Figure Test (RCFT) to evaluate verbal and non-verbal memory, respectively, and measured executive functions using the Wisconsin Card Sorting Test (WCST), Trail-Making Test, Controlled Oral Word Association Test and Stroop Color-Word Test. We administered the d2 test to evaluate attention. Neuropsychological performance was analyzed by multivariate analysis of variance. The BD group showed significantly poorer performance in the long-term free recall condition of the K-CVLT and delayed recall condition of the RCFT and completed significantly fewer categories on the WCST than the non-BD group. In addition, there were significant negative associations among the AUDIT-K total score, AUQ binge score, and long-term free recall score of the K-CVLT. There were significant negative associations between the total AUDIT-K score and delayed recall RCFT score, and between the total AUDIT-K total score and numbers of completed categories on the WCST. These results indicate that college students who participate in BD have difficulties with verbal/non-verbal memory and executive functions, and further suggest that excessive alcohol use could have detrimental effects on the hippocampal-prefrontal circuit even with a relatively short period of alcohol use.

Porcine epidemic diarrhea vaccine evaluation using a newly isolated strain from Korea.

Porcine epidemic diarrhea virus (PEDV) infects pigs and causes an enteric disease that is characterized by vomiting and watery diarrhea. PEDV outbreaks have a tremendous financial impact on the worldwide pork industry. In South Korea, the incidence of PEDV has continued despite nationwide use of attenuated and inactivated vaccines, raising questions regarding the current vaccines' efficacy and the need for new vaccine development. In the present study, we isolated a new Korean PEDV epidemic strain, PED-CUP-B2014, in Vero cells. Phylogenetic analysis of the spike gene demonstrated that the PED-CUP-B2014 belongs in genogroup G2b and is close to PEDVs currently circulating in many countries including the United States, and is distinct from many current vaccine strains. Upon serial passages into Vero cells, PED-CUP-B2014 adapted to Vero cells, which was evidenced as higher virus growth in Vero cells and confirmed lower virulence in suckling piglets. The administration of the inactivated 65-passaged PED-CUP-B2014 to sows greatly increased the survival rate of their offspring and significantly reduced diarrhea severity after PEDV challenge. Higher serum/colostrum PEDV-specific antibodies and higher neutralizing titers were shown in sows vaccinated with PED-CUP-B2014 compared to unvaccinated sows or sows administered commercial PEDV vaccine. Altogether, our data demonstrated that the newly isolated PEDV strain conferred critical passive immune protection to pigs against epidemic PEDV infection.

What do faculties need most in a faculty development program?

PURPOSE: This study examined two overarching topics: to what extent do faculties acknowledge class readiness, execution of lessons, and evaluation of the session; and what core content should be strengthened in a medical school faculty development program? METHODS: In November 2012, 37 faculties completed a detailed survey on the needs of medical school faculty development programs. The 14-item survey assessed the importance, operational frequency, difficulty in accomplishment, class readiness, execution of teaching, and evaluation of the session. RESULTS: Faculties were aware of the importance of class readiness, execution of teaching, and evaluation of the session but had a low level of accomplishment with regard to execution of the instruction and evaluation of the session. Four subitems of session evaluation were considered very important but showed low operational frequency, high difficulty in accomplishment, and low accomplishment ability. The successful discussion class item had the lowest operational frequency and accomplishment ability. The core contents that should be strengthened in medical school faculty development programs are diagnose students' class readiness (prior knowledge) (35.5%) and providing class session with suitable level/content (32.3%). CONCLUSION: Before designing faculty development programs, a needs assessment is useful in providing more tailored content for the faculty.

What kind of feedback do medical students want?

PURPOSE: Feedback in medical education is as important as developing the curriculum and choosing the right method of instruction. This study measured three overarching areas: student satisfaction rates with academic feedback, the type and helpfulness of the feedback, and the types of feedback that students want. METHODS: In December 2013, 166 students answered a student survey that consisted of 26 items. The survey asked questions on their experiences with the overall feedback that was given the previous semester, the satisfaction rate, the type of feedback that was received, the helpfulness of the feedback, and the types of feedback that were desired after examinations and learning tasks. RESULTS: Overall, 35% of the students were satisfied with the feedback that they received in the previous semester. Students wanted more systematic (61.4%) and timely feedback (30.1%). The types of feedback that were most desired were "written comment feedback from the teacher" (51.8%) for learning tasks and "item difficulty, percentile ranks feedback" for examinations (62.0%). CONCLUSION: Students found the current feedback to be helpful, but the lack of feedback that students desired indicates that we must provide more systematic feedback in a more timely manner.

Quercetin induces mitochondrial biogenesis through activation of HO-1 in HepG2 cells.

The regeneration of mitochondria by regulated biogenesis plays an important homeostatic role in cells and tissues and furthermore may provide an adaptive mechanism in certain diseases such as sepsis. The heme oxygenase (HO-1)/carbon monoxide (CO) system is an inducible cytoprotective mechanism in mammalian cells. Natural antioxidants can provide therapeutic benefit, in part, by inducing the HO-1/CO system. This study focused on the mechanism by which the natural antioxidant quercetin can induce mitochondrial biogenesis in HepG2 cells. We found that quercetin treatment induced expression of mitochondrial biogenesis activators (PGC-1 α , NRF-1, TFAM), mitochondrial DNA (mtDNA), and proteins (COX IV) in HepG2 cells. The HO inhibitor SnPP and the CO scavenger hemoglobin reversed the effects of quercetin on mitochondrial biogenesis in HepG2 cells. The stimulatory effects of quercetin on mitochondrial biogenesis could be recapitulated in vivo in liver tissue and antagonized by SnPP. Finally, quercetin conferred an anti-inflammatory effect in the liver of mice treated with LPS and prevented impairment of mitochondrial biogenesis by LPS in vivo. These salutary effects of quercetin in vivo were also antagonized by SnPP. Thus, our results suggest that quercetin enhances mitochondrial biogenesis mainly via the HO-1/CO system in vitro and in vivo. The beneficial effects of quercetin may provide a therapeutic basis in inflammatory diseases and sepsis.

Using a medical volunteer program to motivate medical freshmen.

PURPOSE: A task force identified 4 core properties of motivation-related improvement and developed a medical volunteer program for 63 medical freshmen in 2012. Three overarching topics were examined: What were the contents of the program? Did students' motivation improve? Were the students satisfied with the course? Pretest and posttest motivation levels and program evaluation forms were analyzed. METHODS: We organized a series of committee meetings and identified 4 core factors of motivation. The program was conducted for 63 medical freshmen in March 2012. The program evaluation form was analyzed using SPSS 17.0. RESULTS: The core factors of motivation were interest in medical studies, volunteer-mindedness, medical humanities, and self-management. The program was composed of lectures, medical volunteer hours, and program evaluation and feedback sessions. Students' motivation differed significantly with regard to interest in medical studies (t=-2.40, p=0.020) and volunteer-mindedness (t=-3.45, p=0.001). Ninety percent of students were satisfied with the program, 67.8% of students were satisfied with the medical volunteer activity, and the feedback session of the program was meaningful (66.1%). CONCLUSION: The medical volunteer program, held in the first month of the medical education year, was meaningful, but the reasons for dissatisfaction with the program should be examined. We should also develop a system that has lasting beneficial effects on academic achievement and career selection.