Antiphotoaging effects of solvent fractions isolated from Allomyrina dichotoma larvae extract.

Skin aging is affected by a variety of factors, including ultraviolet rays, oxidative stress, medications, smoking, and genetics. Among them, photo-aging accounts for about 80% of skin aging. The present study was evaluated to verify the potential of Allomyrina dichotoma larvae, which has recently been attracting attention as an edible insect, as an anti-aging substance. UVB irradiation at 100 mJ/cm2 was sufficient to induce photo-aging of fibroblasts within 24 h, which was alleviated after treatment with 70% ethanol extract of Allomyrina dichotoma larvae extract (ADLE). To obtain an extract from ADLE, which has a relatively high content of polyphenol compounds containing physiological activity, fractional solvent extraction was carried out using organic solvents such as hexane, chloroform, ethyl acetate, and butanol. Additionally, ethyl acetate and butanol fractions contributed to the inhibition of UVB-induced ROS production, cell damage, and senescence of fibroblasts. It was also confirmed that the two fractions can regulate the expression of MMP-1 and AP-1. In particular, the ethyl acetate fraction showed an excellent effect in recovering collagen decomposed by UVB. Therefore, these results suggest that ADLE has potential as a natural insect-derived biomaterial to inhibit UVB-induced photo-aging.

Multilevel Reset Dependent Set of a Biodegradable Memristor with Physically Transient.

The electronic device, with its biocompatibility, biodegradability, and ease of fabrication process, shows great potential to embed into health monitoring and hardware data security systems. Herein, polyvinylpyrrolidone (PVP) biopolymer is presented as an active layer, electrochemically active magnesium (Mg) as a metal electrode, and chitosan-based substrate (CHS) to fabricate biocompatible and biodegradable physically transient neuromorphic device (W/Mg/PVP/Mg/CHS). The I-V curve of device is non-volatile bipolar in nature and shows a unique compliance-induced multilevel RESET-dependent-SET behavior while sweeping the compliance current from a few microamperes to milliamperes. Non-volatile and stable switching properties are demonstrated with a long endurance test (100 sweeps) and retention time of over 104  s. The physically transient memristor (PTM) has remarkably high dynamic RON /ROFF (ON/OFF state resistance) ratio (106 Ω), and when placed in deionized (DI) water, the device is observed to completely dissolve within 10 min. The pulse transient measurements demonstrate the neuromorphic computation capabilities of the device in the form of excitatory post synaptic current (EPSC), potentiation, depression, and learning behavior, which resemble the biological function of neurons. The results demonstrate the potential of W/Mg/PVP/Mg/CHS device for use in future healthcare and physically transient electronics.

Faculty perceptions and use of e-learning resources for medical education and future predictions.

PURPOSE: This study aims to investigate medical faculties' perceptions and current practice of using e-learning resources, needs and suggestions for more effective use of such resources, and future directions of e-learning in medical education. METHODS: This descriptive study was conducted on full-time faculty members who were registered users of the e-learning portal of the consortium of Korean medical schools. Participants were invited to an online survey containing 45 items that addressed their perceptions and use of e-learning resources, and their predictions of future use. Descriptive analysis and reliability analysis were conducted as well as a thematic analysis of qualitative data. RESULTS: Ninety faculty members from 31 medical schools returned the questionnaires. Participants positively perceived e-learning resources and that they predicted their use would become increasingly popular. Still, only half of the respondents were using e-learning resources for teaching and agreed that they were willing to share their e-learning resources. Our study illustrates several barriers inhibit faculty use and sharing of e-learning resources, and a need for a more comprehensive, better-organized resource repository. Participants also pointed out the needs for more resources on multimedia assessment items, clinical videos, and virtual patients. CONCLUSION: Our study sheds light on medical faculty needs for institutional support and faculty development programs on e-learning, and institutional policies that address faculty concerns regarding ownership, intellectual property rights, and so forth on creating and sharing such resources. Collaborations among medical schools are suggested for creating a better organized around learning outcomes and more comprehensive repository of resources.

Copper nanoparticles/polyaniline/molybdenum disulfide composite as a nonenzymatic electrochemical glucose sensor.

A Cu@Pani/MoS2 nanocomposite was successfully synthesized via combined in-situ oxidative polymerization and hydrothermal reaction and applied to an electrochemical nonenzymatic glucose sensor. The morphology of the prepared Cu@Pani/MoS2 nanocomposite was characterized using FE-SEM and Cs-STEM, and electrochemical analysis was performed using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and chronoamperometry techniques. Electrostatic interaction between Cu@Pani and MoS2 greatly enhanced the charge dispersion, electrical conductivity, and stability, resulting in excellent electrochemical performance. The Cu@Pani/MoS2 was used as an electrocatalyst to detect glucose in an alkaline medium. The proposed glucose sensor exhibited a sensitivity, detection limit, and wide linear range of 69.82 µAmM-1cm-2, 1.78 µM, and 0.1-11 mM, respectively. The stability and selectivity of the Cu@Pani/MoS2 composite for glucose compared to that of the potential interfering species, as well as its ability to determine the glucose concentration in diluted human serum samples at a high recovery percentage, demonstrated its viability as a nonenzymatic glucose sensor.

Evaluation of Durability Performance for Chloride Ingress Considering Long-Term Aged GGBFS and FA Concrete and Analysis of the Relationship between Concrete Mixture Characteristic and Passed Charge Using Machine Learning Algorithm.

In this study, accelerated chloride diffusion tests are performed on ordinary Portland cement (OPC), ground granulated blast furnace slag (GGBFS), and fly ash (FA) concretes aged 4-6 years. Passed charge is evaluated according to ASTM-C-1202 for 12 mixtures, considering water-binder (W/B) ratios (0.37, 0.42, and 0.47), GGBFS replacement rates (0%, 30%, 50%), and FA replacement rates (0% and 30%). The effects of aged days on passed charge reduction behavior are quantified through repetitive regression analysis. Among existing machine learning (ML) models, linear, lasso, and ridge models are used to analyze the correlation of aged days and mix properties with passed charge. Passed charge analysis considering long-term age shows a significant variability decrease of passed charge by W/B ratio with increasing age and added admixtures (GGBFS and FA). Furthermore, the higher the water-binder ratio in GGBFS and FA concretes, the greater the decrease in passed charge due to aged days. The ML model-based regression analysis shows high correlation when compressive strength and independent variables are considered together. Future work includes a correlational analysis between mixture properties and chloride ingress durability performance using deep learning models based on the time series properties of evaluation data.

Single-cell phenotypes revealed as a key biomarker in bacterial-fungal interactions: a case study of Staphylococcus and Malassezia.

IMPORTANCE: Evaluating bacterial-fungal interactions is important for understanding ecological functions in a natural habitat. Many studies have defined bacterial-fungal interactions according to changes in growth rates when co-cultivated. However, the current literature lacks detailed studies on phenotypic changes in single cells associated with transcriptomic profiles to understand the bacterial-fungal interactions. In our study, we measured the single-cell phenotypes of bacteria co-cultivated with fungi using Raman spectroscopy with its transcriptomic profiles and determined the consequence of these interactions in detail. This rapid and reliable phenotyping approach has the potential to provide new insights regarding bacterial-fungal interactions.

Pinostilbene inhibits full-length and splice variant of androgen receptor in prostate cancer.

Prostate cancer is the most prevalent cancer in men worldwide and is promoted by the sex hormone androgen. Expression of androgen from the testis can be significantly reduced through castration. However, as most prostate cancer patients acquire castration resistance, additional therapeutic solutions are necessary. Although anti-androgens, such as enzalutamide, have been used to treat castration-resistant prostate cancer (CRPC), enzalutamide-resistant CRPC (Enz-resistant CRPC) has emerged. Therefore, development of novel treatments for Enz-resistant CRPC is urgent. In this study, we found a novel anti-androgen called pinostilbene through screening with a GAL4-transactivation assay. We confirmed that pinostilbene directly binds to androgen receptor (AR) and inhibits its activation and translocalization. Pinostilbene treatment also reduced the protein level and downstream gene expression of AR. Furthermore, pinostilbene reduced the protein level of AR variant 7 in the Enz-resistant prostate cancer cell line 22Rv1 and inhibited cell viability and proliferation. Our results suggest that pinostilbene has the potential to treat Enz-resistant CRPC.

Molecular features, antioxidant potential, and immunological expression assessment of thioredoxin-like protein 1 (TXNL1) in yellowtail clownfish (Amphiprion clarkii).

Thioredoxin-like protein 1 (TXNL1) is a redox-active protein belonging to the thioredoxin family, which mainly controls the redox status of cells. The TXNL1 gene from Amphiprion clarkii (AcTXNL1) was obtained from a pre-established transcriptome database. The AcTXNL1 is encoded with 289 amino acids and is predominantly localized in the cytoplasm and nucleus. The TXN domain of AcTXNL1 comprises a34CGPC37 motif with redox-reactive thiol (SH-) groups. The spatial distribution pattern of AcTXNL1 mRNA was examined in different tissues, and the muscle was identified as the highest expressed tissue. AcTXNL1 mRNA levels in the blood and gills were significantly increased in response to different immunostimulants. In vitro antioxidant capacity of the recombinant AcTXNL1 protein (rACTXNL1) was evaluated using the ABTS free radical-scavenging activity assay, cupric ion reducing antioxidant capacity assay, turbidimetric disulfide reduction assay, and DNA nicking protection assay. The potent antioxidant activity of rAcTXNL1 exhibited a concentration-dependent manner in all assays. Furthermore, in the cellular environment, overexpression of AcTXNL1 increased cell viability under H2O2 stress and reduced nitric oxide (NO) production induced by lipopolysaccharides (LPS). Collectively, the experimental results revealed that AcTXNL1 is an antioxidant and immunologically important gene in A. clarkii.

Gossypetin Prevents the Progression of Nonalcoholic Steatohepatitis by Regulating Oxidative Stress and AMP-Activated Protein Kinase.

Nonalcoholic steatohepatitis (NASH) is a severe liver metabolic disorder, however, there are still no effective and safe drugs for its treatment. Previous clinical trials used various therapeutic approaches to target individual pathologic mechanisms, but these approaches were unsuccessful because of the complex pathologic causes of NASH. Combinatory therapy in which two or more drugs are administered simultaneously to patients with NASH, however, carries the risk of side effects associated with each individual drug. To solve this problem, we identified gossypetin as an effective dual-targeting agent that activates AMP-activated protein kinase (AMPK) and decreases oxidative stress. Administration of gossypetin decreased hepatic steatosis, lobular inflammation and liver fibrosis in the liver tissue of mice with choline-deficient high-fat diet and methionine-choline deficient diet (MCD) diet-induced NASH. Gossypetin functioned directly as an antioxidant agent, decreasing hydrogen peroxide and palmitate-induced oxidative stress in the AML12 cells and liver tissue of MCD diet-fed mice without regulating the antioxidant response factors. In addition, gossypetin acted as a novel AMPK activator by binding to the allosteric drug and metabolite site, which stabilizes the activated structure of AMPK. Our findings demonstrate that gossypetin has the potential to serve as a novel therapeutic agent for nonalcoholic fatty liver disease /NASH. SIGNIFICANCE STATEMENT: This study demonstrates that gossypetin has preventive effect to progression of nonalcoholic steatohepatitis (NASH) as a novel AMP-activated protein kinase (AMPK) activator and antioxidants. Our findings indicate that simultaneous activation of AMPK and oxidative stress using gossypetin has the potential to serve as a novel therapeutic approach for nonalcoholic fatty liver disease /NASH patients.

A Comparative Analysis of Pain Control Methods after Ankle Fracture Surgery with a Peripheral Nerve Block: A Single-Center Randomized Controlled Prospective Study.

Background and Objectives: Patients experience severe pain after surgical correction of ankle fractures. Although their exact mechanism is unknown, dexamethasone and epinephrine increase the analgesic effect of anesthetics in peripheral nerve blocks. This study aimed to compare the postoperative pain control efficacy of peripheral nerve blocks with ropivacaine combined with dexamethasone/epinephrine and peripheral nerve blocks with only ropivacaine and added patient-controlled analgesia in patients with ankle fractures. Materials and Methods: This randomized, controlled prospective study included patients aged 18-70 years surgically treated for ankle fractures between December 2021 and September 2022. The patients were divided into group A (n = 30), wherein pain was controlled using patient-controlled analgesia after lower extremity peripheral nerve block, and group B (n = 30), wherein dexamethasone/epinephrine was combined with the anesthetic solution during peripheral nerve block. In both groups, ropivacaine was used as the anesthetic solution for peripheral nerve block, and this peripheral nerve block was performed just before ankle surgery for the purpose of anesthesia for surgery. Pain (visual analog scale), patient satisfaction, and side effects were assessed and compared between the two groups. Results: The patients' demographic data were similar between groups. Pain scores were significantly lower in group B than in group A postoperatively. Satisfaction scores were significantly higher in group B (p = 0.003). There were no anesthesia-related complications in either group. Conclusions: Dexamethasone and epinephrine as adjuvant anesthetic solutions can effectively control pain when performing surgery using peripheral nerve blocks for patients with ankle fractures.

Microwave-assisted rapid synthesis of nitrogen-enriched amphibious carbon quantum dots for sensitive detection of ROS and multiple other applications.

Carbon quantum dots (CQDs) have gained tremendous attention due to their pertinence in diverse application fields. Herein, we report the application of nitrogen-doped CQDs (N-CQDs) for the sensitive detection of reactive oxygen species (ROS) in vitro. The N-CQDs were synthesized via a rapid, one-pot, cost-effective and environmentally friendly approach, and exhibited amphibious solubility in solvents with a wide range of relative polarities from 1 to 0.4. Spectroscopic and microscopic techniques were used to accomplish the functional, morphological, and optical characterization of these nanoparticles. The as-synthesized luminous N-CQDs reproducibly demonstrated an average size distribution with a diameter of 5-6 nm. Their suitability for multiple other applications, such as metal sensing, confidential information inscription, hosting on cellulose materials with long-standing stability, designing polysaccharide molds flashing bright fluorescence, fingerprint imprinting, and in vitro bioimaging has also been exhibited. The plausible mechanism of peroxide induced fluorescence quenching of CQDs is presented. Treatment of human neuroblastoma cells SH-SY5Y with 1000 µg mL-1 N-CQDs demonstrated excellent (∼100%) cell viability. An empirical relation between fluorescent intensity of N-CQDs as a function of the concentration of oxidants inside single-cells has been established for the first time.

Standardized Suicide Prevention Program for Gatekeeper Intervention of North Korean Defectors in South Korea.

OBJECTIVE: North Korean defectors (NKDs) have experienced substantial difficulties during the migration and settlement in South Korea. They have a high prevalence of depression, post-traumatic stress disorder, and suicidal behaviors. The high prevalence of mental disorders among NKDs can lead to a high suicide rate. However, there are no suicide prevention programs for NKDs. This study aims to customize a suicide prevention program with content suitable for NKDs' particular circumstances. METHODS: A multidisciplinary research team developed this program based on domestic and international gatekeeper training programs for suicide prevention and articles related to suicide prevention. RESULTS: We developed a multi-part gatekeeper training program, "Suicide CARE for NKDs." In the "Introduction," trainees learn about the need for the program and its importance. In "Careful observation," trainees learn to recognize linguistic, behavioral, and situational signals of suicide risk. In "Active listening," trainees learn how to ask about suicidal thoughts and to listen empathetically. In "Risk evaluation and expert referral," trainees learn to evaluate suicide risk and to connect NKDs with institutes or services. CONCLUSION: We expect this program to become useful for training gatekeepers to prevent suicide among NKD. A future follow-up study is needed to confirm the efficacy of the program.

A structural analysis of the rail unit of an indoor assistive mobility system.

BACKGROUND: Individuals with gait disturbances, such as that post-stroke, are discharged home to undergo outpatient rehabilitation. Rehabilitation in the community is not as effective as that in hospital, due to long travel times and short program duration. OBJECTIVE: This study analyzed rail unit structure, with the aim of assisting home indoor assistive mobility system (HIAMS) development, allowing patients to undergo gait-related rehabilitation training at home. METHODS: The HIAMS consists of a mobile rail running around the whole room, a turn-table for movement between rails, and a weight-supporting component. Structural analysis was performed using the Abaqus/CAE solution (Version 6.14, Dassault systems, Inc.) to verify device safety, according to the load applied to the rail and turn-table units. The load was applied vertically at 150 kg to reflect the weight of potential users. RESULTS: Structural analysis was performed on the weight-supporting components, which was consist of turn-table case, bearing components (center, left), connective bracket and rail rollers. The safety factors of each components were estimated as 1.31, 5.39 (bearing, center), 8.45 (bearing, left), 1.43 and 3.61 in sequence. CONCLUSION: We demonstrated a safety factor of ⩾ 1.3 for the key system units, suggesting this technology is safe for use in the home rehabilitation training of individuals with gait impairment post-ICU stay.

CycloZ Improves Hyperglycemia and Lipid Metabolism by Modulating Lysine Acetylation in KK-Ay Mice.

BACKGRUOUND: CycloZ, a combination of cyclo-His-Pro and zinc, has anti-diabetic activity. However, its exact mode of action remains to be elucidated. METHODS: KK-Ay mice, a type 2 diabetes mellitus (T2DM) model, were administered CycloZ either as a preventive intervention, or as a therapy. Glycemic control was evaluated using the oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) levels. Liver and visceral adipose tissues (VATs) were used for histological evaluation, gene expression analysis, and protein expression analysis. RESULTS: CycloZ administration improved glycemic control in KK-Ay mice in both prophylactic and therapeutic studies. Lysine acetylation of peroxisome proliferator-activated receptor gamma coactivator 1-alpha, liver kinase B1, and nuclear factor-κB p65 was decreased in the liver and VATs in CycloZ-treated mice. In addition, CycloZ treatment improved mitochondrial function, lipid oxidation, and inflammation in the liver and VATs of mice. CycloZ treatment also increased the level of ß-nicotinamide adenine dinucleotide (NAD+), which affected the activity of deacetylases, such as sirtuin 1 (Sirt1). CONCLUSION: Our findings suggest that the beneficial effects of CycloZ on diabetes and obesity occur through increased NAD+ synthesis, which modulates Sirt1 deacetylase activity in the liver and VATs. Given that the mode of action of an NAD+ booster or Sirt1 deacetylase activator is different from that of traditional T2DM drugs, CycloZ would be considered a novel therapeutic option for the treatment of T2DM.

Injury of the Spinothalamic Tract Following Whiplash Injury: A Diffusion Tensor Tractography Study.

OBJECTIVES: Using diffusion tensor tractography (DTT), we demonstrated the spinothalamic tract (STT) injury in patients with central pain following whiplash injury. Our primary hypothesis is that fractional anisotropy (FA) and tract volume (TV) of the STT in injured people differ from non-injured people. Our secondary hypothesis is that the direction of the collision results in a different type of injury. METHODS: Nineteen central pain patients following whiplash injury and 19 normal control subjects were recruited. The STT was reconstructed by the DTT, the FA and TV of the STT were measured. In addition, different characteristics of the STT injury according to the collision direction were investigated. RESULTS: The FA value did not differ significantly between the patient and control groups (p > 0.05). However, the significantly lower value of the TV was observed in patient group than the control group (p < 0.05). The onset of central pain was significantly delayed (13.5 days) in patients who were involved in a frontal collision, compared to patients with rear-end collision (0.6 days) (p < 0.05). In contrast, the Visual Analogue Scale was higher in the patients with rear-end collision (p < 0.05). CONCLUSIONS: We found the STT injury mild traumatic brain injury (TBI) who suffered central pain after whiplash injury, using DTT. In addition, we demonstrated different characteristics of the STT injury according to the collision direction. We believe that injury of the STT would be usefully detected by DTT following whiplash injury.

Semi-Supervised Adversarial Auto-Encoder to Expedite Human Activity Recognition.

The study of human activity recognition concentrates on classifying human activities and the inference of human behavior using modern sensing technology. However, the issue of domain adaptation for inertial sensing-based human activity recognition (HAR) is still burdensome. The existing requirement of labeled training data for adapting such classifiers to every new person, device, or on-body location is a significant barrier to the widespread adoption of HAR-based applications, making this a challenge of high practical importance. We propose the semi-supervised HAR method to improve reconstruction and generation. It executes proper adaptation with unlabeled data without changes to a pre-trained HAR classifier. Our approach decouples VAE with adversarial learning to ensure robust classifier operation, without newly labeled training data, under changes to the individual activity and the on-body sensor position. Our proposed framework shows the empirical results using the publicly available benchmark dataset compared to state-of-art baselines, achieving competitive improvement for handling new and unlabeled activity. The result demonstrates SAA has achieved a 5% improvement in classification score compared to the existing HAR platform.

The Efficacy of Treatment Intensification by Quadruple Oral Therapy Compared to GLP-1RA Therapy in Poorly Controlled Type 2 Diabetes Mellitus Patients: A Real-world Data Study.

We compared the glycemic efficacy of treatment intensification between quadruple oral antidiabetic drug therapy and once-weekly glucagon-like peptide-1 receptor agonist (GLP-1RA)-based triple therapy in patients with poorly controlled type 2 diabetes mellitus refractory to triple oral therapy. For 24 weeks, changes in glycosylated hemoglobin (HbA1c) from baseline were compared between the two treatment groups. Of all 96 patients, 50 patients were treated with quadruple therapy, and 46 were treated with GLP-1RA therapy. Reductions in HbA1c for 24 weeks were comparable (in both, 1.1% reduction from baseline; P=0.59). Meanwhile, lower C-peptide level was associated with a lower glucose-lowering response of GLP-1RA therapy (R=0.3, P=0.04) but not with quadruple therapy (R=-0.13, P=0.40). HbA1c reduction by GLP-1RA therapy was inferior to that by quadruple therapy in the low C-peptide subgroup (mean, -0.1% vs. -1.3%; P=0.04). Treatment intensification by switching to quadruple oral therapy showed similar glucose-lowering efficacy to weekly GLP-1RA-based triple therapy. Meanwhile, the therapeutic response was affected by C-peptide levels in the GLP-1RA therapy group but not in the quadruple therapy group.

A comparative study of rubber band ligation versus BANANA-Clip in grade 1 to 3 internal hemorrhoids.

PURPOSE: Rubber band ligation (RBL) for grade 1 to 3 internal hemorrhoids is a well-established modality of choice. But RBL is also a kind of surgical treatment; it is not free from complications (e.g., delayed bleeding [DB], rectal stenosis). This study aimed to investigate the results of the comparative treatment of RBL and BANANA-Clip (BC; Endovision). METHODS: Study participants were 632 consecutive patients with grade 1 to 3 internal hemorrhoids attended to Department of Colorectal Surgery at Wellness Hospital between January 2010 and May 2019. We retrospectively reviewed the incidence rate of complications, including DB between RBL and BC. RESULTS: There were 304 male and 328 female patients, whose ages ranged from 15 to 84 years, with a mean age of 45.7 years. The common symptom and cause of treatment was prolapse (70.1%). The number of ligated sites was 1.49±0.57 in the RBL group and 1.99±0.77 in the BC group. RBL showed a significantly higher incidence of DB (3.5%) compared to BC (0%) (P=0.001). The 1-year success rate was 95.9% in the RBL group and 99.7% in the BC group (P=0.005). CONCLUSION: In our study, BC was more reliable in treating grade 1 to 3 internal hemorrhoids with higher success rates and less post-ligation complications, especially DB, compared to RBL.

Vaccinia-related kinase 2 variants differentially affect breast cancer growth by regulating kinase activity.

Genetic information is transcribed from genomic DNA to mRNA, which is then translated into three-dimensional proteins. mRNAs can undergo various post-transcriptional modifications, including RNA editing that alters mRNA sequences, ultimately affecting protein function. In this study, RNA editing was identified at the 499th base (c.499) of human vaccinia-related kinase 2 (VRK2). This RNA editing changes the amino acid in the catalytic domain of VRK2 from isoleucine (with adenine base) to valine (with guanine base). Isoleucine-containing VRK2 has higher kinase activity than the valine-containing VRK2, which leads to an increase in tumor cell proliferation. Earlier we reported that VRK2 directly interacts with dystrobrevin-binding protein (dysbindin) and results in reducing its stability. Herein, we demonstrate that isoleucine-containing VRK2 decreases the level of dysbindin than valine-containing VRK2. Dysbindin interacts with cyclin D and thereby regulates its expression and function. The reduction in the level of dysbindin by isoleucine-containing VRK2 further enhances the cyclin D expression, resulting in increased tumor growth and reduction in survival rates. It has also been observed that in patient samples, VRK2 level was elevated in breast cancer tissue compared to normal breast tissue. Additionally, the isoleucine form of VRK2 exhibited a greater increase in breast cancer tissue. Therefore, it is concluded that VRK2, especially dependent on the 167th variant amino acid, can be one of the indexes of tumor progression and proliferation.

Moving forward: embracing challenges as opportunities to improve medical education in the post-COVID era.

Pandemics affect every aspect of life, and Coronavirus Disease 2019 (COVID-19) is no exception. The impact of COVID-19 might be even greater in medical education, which involves close contact with patients. This comment reviews current trends in medical education in response to COVID-19, especially in the pre-clerkship curriculum, and discusses opportunities and challenges in medical education in the post-pandemic era. COVID-19 has accelerated the adoption of online teaching and learning and is expected to boost innovation in medical education. First, blended learning, which is a mix of online and offline learning intended to incorporate the best of both worlds, is expected to become more widespread. Second, more novel approaches to learning that involve student-led initiatives likely become popular mediated by various technologies. Third, there will be more use of online learning resources and assessments. As online learning is expected to play a prominent role in the post-COVID-19 era, such transitions offer both opportunities and challenges. These challenges include faculty development on online teaching skills, creation and sharing of online resources, and effective design and implementation of online assessments. This comment calls for institutional support and collaborations for faculty development and for the development and sharing of learning resources, more models and guidelines for effective technology integration, and use of the virtual learning environment to promote student-centered learning to embrace the challenges as opportunities to improve medical education in the post-COVID era.