According to a Prognoscan database, upregulation of Bruton's tyrosine kinase (Btk) is associated with low overall survival in ovarian cancer patients. We found that spheroids-forming ovarian cancer cell, which highly expressed cancer stem-like cell (CSC) markers and Btk, were cisplatin resistant. We next treated CSCs and non-CSCs by a combination of ibrutinib and cisplatin. We found that chemoresistance was dependent on Btk and JAK2/STAT3, which maintained CSC by inducing Sox-2 and prosurvival genes. We suggest that addition of ibrutinib to cisplatin may improve treatment outcome in ovarian cancer.

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Current standard chemotherapy for late stage ovarian cancer is found unsuccessful due to relapse after completing the regimens. After completing platinum-based chemotherapy, 70% of patients develop relapse and resistance. Recent evidence proves ovarian cancer stem cells as the source of resistance. Therefore, treatment strategy to target both cancer stem cells and normal stem cells is essential. In this study, we developed a novel chalcone derivative as novel drug candidate for ovarian cancer treatment. We found that methoxyphenyl chalcone was effective to eliminate ovarian cancer cells when given either as monotherapy or in combination with cisplatin. We found that cell viability of ovarian cancer cells was decreased through apoptosis induction. Dephosphorylation of Bcl2-associated agonist of cell death protein was increased after methoxyphenyl chalcone treatment that led to activation of caspases. Interestingly, this drug also worked as a G2/M checkpoint modulator with alternative ways of DNA damage signal-evoking potential that might work to increase response after cisplatin treatment. In addition, methoxyphenyl chalcone was able to suppress autophagic flux and stemness regulator in ovarian spheroids that decreased their survival. Therefore, combination of methoxyphenyl chalcone and cisplatin showed synergistic effects. Taken together, we believe that our novel compound is a promising novel therapeutic agent for effective clinical treatment of ovarian cancer.

BACKGROUND Medical education is not only gaining theoretical knowledge, but also achieving clinical experiences as clinical skills. Currently, robust development of technology in the digital era has evolved medical learning modalities, such as simulation tools and open-access medical education. Augmented reality is one potential modality that may improve clinical skills learning effectiveness. OBJECTIVE This scoping review aimed to describe the existing research on the use of augmented reality for improving skills in medical students. METHODS This study conducted searches utilizing electronic databases such as PubMed, Embase, and Web of Science in June 2022, and identified articles involving the use of augmented reality for improving skills in medical students. The Rayyan website was used to filter the articles that had met the keywords to be screened with the inclusion criteria which was the use of augmented reality as a learning method in medical students. RESULTS A total of 37 articles met the inclusion criteria. More than 80% of the studies included in this review described that the use of augmented reality (AR) could improve clinical skills of medical students. Articles were classified into two research methods: randomized control trial (RCT) and non-RCT; also, into three topics, AR system, the use of AR in improving various skills, and the use of AR in lumbar facet-related skills. CONCLUSIONS Augmented reality could be used in medical education to improve clinical skills. However, due to limited databases, further studies about the use of augmented reality for improving skills in medical students are still needed.