Purpose: This developmental study explored the conceptual feasibility and applicability of a metaverse-based clinical assessment platform as a complementary tool to conventional objective structured clinical examinations in undergraduate medical education. Methods: A targeted literature review and expert consensus process were conducted to identify domains of clinical competence in which metaverse technologies could provide added value. Based on these findings, prototype virtual patient simulations were developed within a metaverse environment. Large language models (LLMs) were integrated to support dynamic, interactive history-taking simulations, and pilot modules for physical examination were also created. Results: Integration of LLMs into virtual patient scenarios enabled realistic, context-sensitive medical interviews, facilitating interactive dialogue between examinees and simulated patients. In contrast, physical examination modules faced technical limitations, particularly in replicating procedures requiring tactile or haptic feedback, such as palpation and percussion. Nevertheless, the metaverse environment enabled delivery of consistent and reproducible scenarios, supporting objective assessment of communication and diagnostic reasoning skills. Conclusion Metaverse-based simulations augmented by LLMs offer a promising approach to scalable and standardized clinical assessment, particularly within cognitive and interpersonal competency domains. Although current technological constraints limit the fidelity of physical examination simulations, rapid advancements in immersive and haptic technologies may help overcome these barriers in the near future. Further research is needed to evaluate the educational efficacy, validity, and feasibility of deploying such platforms in summative, high-stakes assessment contexts.

A phytochemical study of the root extract of Hemerocallis fulva var. kwanso Regel resulted in the isolation and structural characterization of four lignans (1‒4), three flavanones (5, 6, and 8), one chalcone (9), and two monoterpenes (7 and 10). Enzyme inhibition assays revealed that two flavanone glucosides (5 and 6) showed significant inhibitory effect against protein tyrosine phosphatase 1B (PTP1B), with IC50 values of 31.38 µM and 51.46 µM, respectively. Further enzyme kinetic studies demonstrated that these two compounds acted as noncompetitive PTP1B inhibitors, with Ki values of 30.88 µM and 50.38 µM, respectively.

Dystaenia takeshimana (Nakai) Kitagawa belongs to the family Apiaceae (Umbelliferae) and is a perennial herb naturally endemic to Ulleung Island, Republic of Korea. Following its successful introduction and cultivation in mainland Korea, a phytochemical investigation of this plant was carried out. As a result, thirteen compounds were isolated and structurally characterized, including one flavonoid glycoside (1), two polyacetylenes (2 and3), one caffeoylquinic acid derivative (4), one aliphatic hydroxy acid (5), four phenolic acids and their derivatives(6, 8–10), one aromatic alcohol derivative (7), two carbohydrates (11 and 12), and one phytosterol (13). The structures of these compounds were elucidated based on spectroscopic analyses and comparison with previously reported literature data. To the best of our knowledge, this study represents the first report on the isolation of falcarinol (2), trans-4-hydroxy-2-nonenoic acid (5), and sucrose (11) from D. takeshimana and the evaluation of their protein tyrosine phosphatase 1B (PTP1B) inhibitory activity. Compounds 2, 3, and 5 exhibited potent PTP1B inhibitory effects with IC50 values of 10.74, 8.31, and 25.24 µM, respectively. Enzyme kinetic studies indicated noncompetitive inhibition by 2 and mixed-type inhibition by 5 against PTP1B. Furthermore, molecular docking analysis was performed to investigate the binding interactions between the active compounds and the enzyme active site.

Phytochemical investigation of the water extract and alkaloid fraction of Areca catechu L. led to theisolation of one new methoxyflavonoid rutinoside (1), together with eleven known compounds (2−12), five of which (8−12) belong to the pyridine alkaloid class. The structure of the new compound was elucidated through extensive spectroscopic analyses, including 1D and 2D NMR experiments and high-resolution mass spectrometry.Notably, rhamnazin-3-O-rutinoside (2) is reported here for the first time from this species. The isolated compounds were evaluated for their inhibitory activity against protein tyrosine phosphatase 1B (PTP1B) using a p-nitrophenyl phosphate assay. Flavonoids (3 and 4) and stilbene (5) exhibited notable inhibitory activity, with IC50 values of 13.30 ± 0.71, 13.44 ± 0.84, and 8.68 ± 0.12 μM, respectively. In contrast, methoxyflavonoid rutinosides (1 and 2) and pyridine alkaloids (8−12) did not show significant inhibitory activity against PTP1B.These findings provide additional chemical insights into A. catechu and its constituents in relation to PTP1B inhibition.

This review article examines, from an editor’s perspective, how generative artificial intelligence (AI) can be integrated into academic writing, peer review, and editorial workflows while protecting scientific soundness.Current concepts: Editors increasingly encounter manuscripts containing fabricated or unverifiable references and receive post-publication error reports, trends that have been amplified by AI-assisted checking and meta-research. An assessment of 100 Korean medical journals (January–March 2024) found that only 18 journals provided explicit guidance on AI use. Among journals with such policies, most prohibited listing AI as an author and emphasized author accountability, while disclosure requirements, permitted uses, and sanctions varied. Reviews of top-ranked medical journals similarly reveal heterogeneous approaches to disclosure and to reviewers’ use of AI under confidentiality constraints. Some journals, such as Journal of Educational Evaluation for Health Professions, make disclosure optional because AI-detection tools are unreliable and AI-assisted and human-written text are often intermingled.Discussion and conclusion: Natural language–based vibe-coding can also enhance peer review when prompts are designed to ensure reproducible analyses. Confidentiality safeguards and options to opt out of model training should be implemented whenever manuscripts or data are uploaded. Because AI-text screening tools produce variable results and the boundary between acceptable assistance and impermissible primary generation remains unclear, detection should not be relied upon as the sole enforcement mechanism. Instead, authors, reviewers, and editors should serve as supervisors responsible for design decisions and interpretation, as well as for ensuring the availability of data and protocols, while preparing for faster, AI-enabled submission-to-publication workflows.

This review aimed to summarize the recent prevalence and epidemiological characteristics of endemic parasitic infections in Korea as reported in the literature up to 2026.Current concepts: Data were collected from national surveillance statistics of the Korea Disease Control and Prevention Agency and from studies indexed in PubMed and KoreaMed published between January 2019 and February 2026. The overall prevalence of intestinal helminth infections has decreased substantially, and infections such as ascariasis and trichuriasis (0.2%) are now rarely detected. However, clonorchiasis remains relatively prevalent in endemic river-basin regions (2.3% in 2024), reflecting persistent dietary habits involving the consumption of raw freshwater fish. Vivax malaria continues to occur near the Demilitarized Zone despite long-term control efforts (601 cases in 2025). Claims-based data showed an average of 422 cases of toxoplasmosis per year from 2007 to 2020, and the true burden may be underestimated because many infections are asymptomatic. Other parasitic diseases, including trichomoniasis (age- and sex-adjusted infection rate, >800 per 100,000 women aged 20–39 years in 2020) and scabies (age-adjusted infection rate, 43.0 per 100,000 in 2021), persist because of behavioral and demographic factors.Discussion and conclusion: Clonorchiasis still shows a relatively high infection rate in certain endemic areas. Malaria, toxoplasmosis, trichomoniasis, and scabies may continue to occur because living environments and behavioral patterns are difficult to change. These parasitic diseases should be considered in the differential diagnosis in clinical practice, and patients should be evaluated with appropriate testing and referral when indicated.

Background: The stimulatory effects of caffeine contribute to poor sleep quality. However, the relationship between caffeinated beverages and sleep quality, considering frequency or types of caffeinated beverages, were not extensively studied. Methods: Data were collected from 160 urban workers (75 men [46.9%] aged 20–69 years; with an average age of 41.8±12.3 years) using a structured, self-administered online questionnaire. Sleep quality, time, satisfaction; types and frequency of caffeinated beverages (number of cups per week; Q1: 0 cup, Q4: 14 or more cups per week), demographics, and health behaviors were asked. Sleep quality were evaluated using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). Multiple regression analysis was conducted on the association between the frequency of caffeinated beverages consumption and sleep quality. Results: The most frequently consumed beverages were unsweetened coffee (22.8%) and the most common time for caffeine was between 12 pm to 5 pm (58.2%). The average sleep quality score based on the PSQI-K was 6.0±2.0 overall, 5.3±1.6 in Q1, and 6.6±2.2 in Q4 (frequent caffeinated beverage drinkers), indicating poorer sleep quality in Q4 (P=0.022). In Q1, 13.3% rated their sleep quality as ‘very good,’ while in Q4, only 2.5% gave the same rating. Poor sleep quality was significantly associated with the frequency of caffeinated beverages per week (β=0.232, P=0.004) and self-reported stress level (β=0.256, P=0.002). Conclusions Frequent consumption of caffeinated beverages appears to be associated with poor sleep quality among urban workers. While reducing caffeine intake may contribute to improvements in sleep quality as a health promoting behavior, this hypothesis requires validation through future studies employing personalized intervention approaches.

Purpose: In Korea, the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment (LST) was implemented on February 4, 2018. We aimed to investigate relevant factors and clinical changes associated with LST decisions after law enforcement. Materials and Methods: This single-center retrospective study included patients who completed LST documents using legal forms at Asan Medical Center from February 5, 2018, to June 30, 2020. Results: 5,896 patients completed LST documents, of which 2,704 (45.8%) signed the documents in person, while family members of 3,192 (54%) wrote the documents on behalf of the patients. Comparing first year and following year of implementation of the act, the self-documentation rate increased (43.9% to 47.2%, p=0.014). Moreover, the number of LST decisions made during or after intensive care unit admission decreased (37.8% vs. 35.2%, p=0.045), and the completion rate of LST documents during chemotherapy increased (6.6% vs. 8.9%, p=0.001). In multivariate analysis, age < 65 (odds ratio [OR], 1.724; 95% confidence interval [CI], 1.538 to 1.933; p < 0.001), unmarried status (OR, 1.309; 95% CI, 1.097 to 1.561; p=0.003), palliative care consultation (OR, 1.538; 95% CI, 1.340 to 1.765; p < 0.001), malignancy (OR, 1.864; 95% CI, 1.628 to 2.133; p < 0.001), and changes in timing on the first year versus following year (OR, 1.124; 95% CI, 1.003 to 1.260; p=0.045) were related to a higher self-documentation rate. Conclusion Age < 65 years, unmarried status, malignancy, and referral to a palliative care team were associated with patients making LST decisions themselves. Furthermore, the subject and timing of LST decisions have changed with the LST act.

Background: The stimulatory effects of caffeine contribute to poor sleep quality. However, the relationship between caffeinated beverages and sleep quality, considering frequency or types of caffeinated beverages, were not extensively studied. Methods: Data were collected from 160 urban workers (75 men [46.9%] aged 20–69 years; with an average age of 41.8±12.3 years) using a structured, self-administered online questionnaire. Sleep quality, time, satisfaction; types and frequency of caffeinated beverages (number of cups per week; Q1: 0 cup, Q4: 14 or more cups per week), demographics, and health behaviors were asked. Sleep quality were evaluated using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). Multiple regression analysis was conducted on the association between the frequency of caffeinated beverages consumption and sleep quality. Results: The most frequently consumed beverages were unsweetened coffee (22.8%) and the most common time for caffeine was between 12 pm to 5 pm (58.2%). The average sleep quality score based on the PSQI-K was 6.0±2.0 overall, 5.3±1.6 in Q1, and 6.6±2.2 in Q4 (frequent caffeinated beverage drinkers), indicating poorer sleep quality in Q4 (P=0.022). In Q1, 13.3% rated their sleep quality as ‘very good,’ while in Q4, only 2.5% gave the same rating. Poor sleep quality was significantly associated with the frequency of caffeinated beverages per week (β=0.232, P=0.004) and self-reported stress level (β=0.256, P=0.002). Conclusions Frequent consumption of caffeinated beverages appears to be associated with poor sleep quality among urban workers. While reducing caffeine intake may contribute to improvements in sleep quality as a health promoting behavior, this hypothesis requires validation through future studies employing personalized intervention approaches.