despite numerous efforts to revive tourism, recovery has been slow.With no immediate recovery in sight, governments have nonetheless been trying to support battered tourism industries. Various countries have tried to promote domestic tourism. Other measures included, but are not limited to providing subsidies, relaxing taxes, and issuing travel coupons and vouchers. For example, Japan launched the "Go To Travel" Campaign in July 2020, which offers discounts and subsidies up to 50% on domestic travel to boost domestic demand. Promotion of domestic tourism and "travel bubbles" allowing travel to resume between certain destinations have been highlighted as potential strategies for driving recovery in the short term. However, where tried, these strategies have not been enough to bring travel back to pre-pandemic levels. Particularly for domestic tourism, situations remain volatile, as movement of people depends highly on the number of new COVID-19 cases. Further, domestic tourism is not enough to fill gaps left by international tourists, especially for countries that are highly tourism-dependent.Added to the previously implemented strategies, vaccine passes seem to be an emerging solution to restart tourism.On 8 December 2020, the first ever jab of the COVID-19 vaccine in the world was delivered in the United Kingdom. Even before the launch of COVID-19 vaccines, the idea of introducing "vaccine passes" was discussed and considered as a possible strategy to accelerate recovery of travel and tourism. necessarily reflect the views and policies of ADB or its Board of Governors or the governments they represent. ADB encourages printing or copying information exclusively for personal and noncommercial use with proper acknowledgment of ADB. Users are restricted from reselling, redistributing, or creating derivative works for commercial purposes without the express, written consent of ADB.

Understanding factors affecting the susceptibility of organisms to thermal stress is of enormous interest in light of our rapidly changing climate. When adaptation is limited, thermal acclimation and deacclimation abilities of organisms are critical for population persistence through a period of thermal stress. Holobionts (hosts plus associated symbionts) are key components of various ecosystems, such as coral reefs, yet the contributions of their two partners to holobiont thermal plasticity are poorly understood. Here, we tested thermal plasticity of the freshwater cnidarian Hydra viridissima (green hydra) using individual behavior and population responses. We found that algal presence initially reduced hydra thermal tolerance. Hydra with algae (symbiotic hydra) had comparable acclimation rates, deacclimation rates, and thermal tolerance after acclimation to those without algae (aposymbiotic hydra) but they had higher acclimation capacity. Acclimation of the host (hydra) and/or symbiont (algae) to elevated temperatures increased holobiont thermal tolerance and these effects persisted for multiple asexual generations. In addition, acclimated algae presence enhanced hydra fitness under prolonged sublethal thermal stress, especially when food was limited. Our study indicates while less intense but sublethal stress may favor symbiotic organisms by allowing them to acclimate, sudden large, potentially lethal fluctuations in climate stress likely favor aposymbiotic organisms. It also suggests that thermally stressed colonies of holobionts could disperse acclimated hosts and/or symbionts to other colonies, thereby reducing their vulnerability to climate change.

Approximately 5% of patients with IgA nephropathy (IgAN) exhibit mild mesangial lesions with acute onset nephrotic syndrome and diffuse foot process effacement representative of minimal change disease (MCD). It is not clear whether these unusual cases of IgAN with MCD (IgAN-MCD) are variant types of IgAN or coincidental deposition of IgA in patients with MCD. In a retrospective multicenter cohort study of 18 hospitals in Korea, we analyzed 46 patients with IgAN-MCD. Patients with endocapillary proliferation, segmental sclerosis, and crescent were excluded, and the clinical features and prognosis of IgAN-MCD were compared with those of pure MCD. In addition, we performed galactose-deficient IgA1 (KM55) staining to characterize IgAN-MCD. Among the 21,697 patients with glomerulonephritis enrolled in the database, 46 patients (0.21%) were diagnosed with IgAN-MCD, and 1610 patients (7.4%) with pure MCD. The 46 patients with IgAN-MCD accounted for 0.6% of primary IgAN patients (n = 7584). There was no difference in prognosis between patients with IgAN-MCD and those with only MCD. IgA and KM55 showed double positivity in all patients with IgAN-MCD (n = 4) or primary IgAN (n = 5) under double immunofluorescent staining. However, in four patients with lupus nephritis, mesangial IgA was deposited, but galactose-deficient-IgA1 (Gd-IgA1) was not. These findings suggest that IgAN-MCD is a dual glomerulopathy in which MCD was superimposed on possibly indolent IgAN. We confirmed by KM55 staining that IgAN-MCD is true IgAN, enabling better characterizations of the disease. Furthermore, IgAN-MCD shows a good prognosis when treated according to the usual MCD treatment modality.

PURPOSE: The study aimed to examine whether handgrip strength (HGS) expressed as absolute or relative to body weight is associated with fasting glucose (FG), hemoglobin A1c (HbA1c) and the prevalence of diabetes mellitus (DM) in different age categories.METHODS:A total of 28,129 adults from the Korea National Health and Nutrition Examination Survey of 2014-2018 was analyzed. To examine the relationship between HGS and variables related to DM, participants were categorized into three groups according to their HGS (Tertile). Then, participants were further categorized into six groups according to their age. One-way ANOVA and logistic regression analyses were performed.RESULTS: Compared with participants in the upper tertile of absolute handgrip strength (AHGS), those in the lower tertile were older, shorter and heavier and also had higher FG and HbA1c. When age was adjusted, the prevalence of DM was 1.19 times (95% CI: 1.03-1.38) higher among men in the lowest tertile of AHGS. On the other hand, compared with participants in the highest tertile of relative handgrip strength (RHGS), those in the lowest tertile had 2.10 times (95% CI: 1.87-2.41) and 2.42 times (95% CI: 2.08-2.81) higher prevalence of DM in men and women, respectively. When the associations were examined according to age subcategories, significant associations between AHGS and the prevalence of DM were seen only in men in their 50s and 60s, but not seen in women in all age groups, with the exception of the 60s. However, significant associations between RHGS and the prevalence of DM were seen in all age subcategories.CONCLUSIONS:We concluded that the association between HGS and the prevalence of DM was dependent on age and RHGS is a stonger measure than AHGS.

Background and Aims BK virus nephropathy (BKVN) is one of the significant contributors to allograft dysfunction in kidney transplantation. Because of the lack of effective anti-viral medication, early detection of BKV replication and preemptive management is vital to preserving allograft function. Herein, we investigated the predictive value of urinary exosomal BKV-microRNA for BKVN in the kidney transplantation cohort. Method ARTKT (assessment of immunologic risk and tolerance in kidney transplantation) is a prospective observational cohort in which a total of 420 kidney transplant recipients were enrolled from 7 teaching hospitals in South Korea since 2015. Urine samples were collected at 0.5, 3, 6, 12, and 24 months after kidney transplantation in this cohort. All enrolled patients were reviewed to identify the patients diagnosed with BKVN histologically (biopsy-proven BKVN) and those experienced BK viremia defined as plasma BKV DNA load > 4 log10 copies per mL (presumptive BKVN). Urinary exosomal miR was quantified using real-time reverse transcription PCR. Results 10 patients and 14 patients developed biopsy-proven BKVN and presumptive BKVN, respectively. Because of unavailable urine samples, urinary exosomal BKV-microRNA was investigated in 8 patients with biopsy-proven BKVN and 13 patients with presumptive BKVN. 61 patients with no evidence of BKVN were selected as a negative control. Most of BKVN was developed in a median time of 3.4 months after transplantation. In line with this pattern, urinary exosomal BKV-microRNA peaked at 3 months after transplantation and decreased thereafter in biopsy-proven BKVN and presumptive BKVN, keeping higher value in biopsy-proven BKVN compared to presumptive BKVN after 3 months. At 2 weeks after transplantation, half of the patients with biopsy-proven BKVN showed an early rise of urinary exosomal BKV-microRNA, whereas patients with presumptive BKVN and no evidence of BKVN did not. However, plasma BK virus DNA was not detected in all groups at 2 weeks after transplantation. In multivariate cox proportional hazards model, urinary exosomal BKV-microRNA was significantly associated with biopsy-proven BKVN. Conclusion A urinary exosomal BKV-microRNA increase as early as 2 weeks after kidney transplantation predicts future BKVN development, enabling early intervention.