Medical Student Perceptions of the Learning Environment, Quality of Life, and the School of Medicine's Response to the COVID-19 Pandemic: A Single Institution Perspective.

PURPOSE: Responding to the COVID-19 pandemic, American medical schools made swift changes to clinical education based on guidelines provided by the Association of American Medical Colleges. The purpose of this study was to collect medical student perceptions of the solely online learning environment, their quality of life (QoL), and the pandemic response by their School of Medicine (SoM) to provide suggestions to inform medical schools' responses during the continuation of this pandemic and the next. METHODS: Between April 29, 2020 and May 16, 2020, the authors distributed a 60-item questionnaire that assessed demographics, learning environment, QoL, and the SoM response. Likert-type items were analyzed on an item-by-item basis, whereas themes were identified for open-ended questions. RESULTS: A total of 330 medical students (of 632; 52.2%) responded. Those who responded had positive perceptions of the online learning environment with moderate QoL disruptions to concentration and sleep. Although most students perceived being able to contribute meaningfully to the healthcare setting, they viewed themselves as underutilized. Three themes encapsulated both positive and negative perceptions of the SoM's response-communication, learning environment, and empathy and support. CONCLUSION: These findings provide insight into medical student perceptions of their learning environment and QoL as they acclimated to changes resulting from the COVID-19 pandemic. Results can help inform a SoM's response during the continuation of the COVID-19 pandemic as well as during future pandemics or crises. Follow-up surveys of medical students at multiple institutions across the USA and abroad will be essential to better characterize student perceptions.

SGK1 signaling promotes glucose metabolism and survival in extracellular matrix detached cells.

Loss of integrin-mediated attachment to extracellular matrix (ECM) proteins can trigger a variety of cellular changes that affect cell viability. Foremost among these is the activation of anoikis, caspase-mediated cell death induced by ECM detachment. In addition, loss of ECM attachment causes profound alterations in cellular metabolism, which can lead to anoikis-independent cell death. Here, we describe a surprising role for serum and glucocorticoid kinase-1 (SGK1) in the promotion of energy production when cells are detached. Our data demonstrate that SGK1 activation is necessary and sufficient for ATP generation during ECM detachment and anchorage-independent growth. More specifically, SGK1 promotes a substantial elevation in glucose uptake because of elevated GLUT1 transcription. In addition, carbon flux into the pentose phosphate pathway (PPP) is necessary to accommodate elevated glucose uptake and PPP-mediated glyceraldehyde-3-phosphate (G3P) is necessary for ATP production. Thus, our data show SGK1 as master regulator of glucose metabolism and cell survival during ECM-detached conditions.