Fooyin University

Enhancing clinical competence in postgraduate year (PGY) trainees is crucial for effective patient care, especially in emergency medicine. This study investigated the impact of a well-designed, group-developed, peer-assessed learning approach combined with high-fidelity simulations on clinical skills and teamwork of PGY trainees. PGY trainees participated in a one-month program featuring team development, clinical training, scenario design, simulation, peer-assisted debriefing, and post-course evaluations at one week and three months. Trainees were divided into two groups, engaged in clinical practice, group discussions, and developed critical scenarios under mentor guidance to challenge the other group. Teamwork performance was assessed using the TEAM scale, Ottawa Global Rating Scale, and reflective essays. Follow-up evaluations employed the PGY Clinical Proficiency Evaluation scale. Trainees identified deficiencies in situation monitoring and maintaining composure, noting difficulties in effectively monitoring and reassessing situations. Despite having passed ACLS training, participants recognized their lack of clinical experience in managing critically ill patients, handling dynamic situations, low self-confidence, and limited leadership opportunities in resuscitation teams. However, team morale was high, and performance in communication and leadership was relatively strong due to the similar hierarchical levels of the trainees and initial team dynamics established during their training. Follow-up questionnaires indicated significant improvements in clinical confidence, reasoning abilities, familiarity with ACLS resuscitation guidelines, and team dynamics across various subspecialty training areas. The integration of peer-assisted learning with high-fidelity simulation significantly enhanced clinical competence, teamwork, and confidence in PGY trainees. This innovative approach provides a structured, supportive learning environment that effectively prepares trainees for real-world clinical challenges. Future research should explore long-term outcomes and broader applications of this method.

3-Hydroxy-1-(3',5'-dimethoxy-4'-hydroxy-phenyl)-hexan-5-one (3-HDM), a novel ginger Zingiber officinale-derived compound, lacks anti-cancer investigation, especially for oral cancer. This study addresses the antioral function and mechanism of 3-HDM against oral cancer cells (Ca9-22 and CAL 27).

MTS, flow cytometry, and western blotting were used to determine cell viability and antioral function and mechanism.

3-HDM inhibits oral cancer cell viability without normal cell (S-G) toxicity. This selective antiproliferation relies on oxidative stress validated by N-acetylcysteine (NAC), a reactive oxygen species (ROS) remover. 3-HDM upregulates subG1 and annexin V proportions, enhances caspases 3 and 8 activation to a greater extent in oral cancer than in normal cells, reverted by NAC. This process demonstrates the ROS-dependent selective apoptotic character of 3-HDM. 3-HDM also upregulates more ROS and mitochondrial superoxide and downregulates the mitochondrial membrane potential and glutathione in oral cancer than in normal cells in a ROS-dependent manner. Moreover, 3-HDM suppresses antioxidant signaling mRNA expressions such as NFE2L2, NQO1, and TXN and inhibits NFE2L2 phosphorylation in oral cancer cells compared to normal cells. NAC also downregulates the 3-HDM-induced γH2AX and 8-hydroxy-2-deoxyguanosine DNA damage markers.

3-HDM shows selective antioral cancer effects and mechanisms without toxicity to normal cells via oxidative stress regulation.

Kawasaki Disease (KD) is a multisystemic vasculitis of unknown aetiology in children. The incidence of KD varies by geographic area and correlates with differences in gut microbiota patterns, with the highest incidence in Asian. This study aimed to investigate alterations in faecal microbiota and assess their relationship with systemic inflammation in KD patients. A total of 59 patients and 55 matched controls were included. Fecal samples were collected at the onset of KD. The V3/V4 regions of 16S rDNA were sequenced using the MiSeq platform. PICRUSt 2 was used to analyse the potential functional pathways involved in gut dysbiosis. Alpha (p < 0.042) and beta (p < 0.001) diversity in KD were significantly decreased when compared to the control group. After multivariate regression, among the seven critical microbes, increased Eggerthella lenta (p = 0.016) and decreased Bacteroides ovatus (p = 0.014) could also predict KD risk using receiver operating characteristic curve (ROC) analysis (Eggerthella lenta: area under the ROC curve, AUC = 0.841, odds ratio = 23.956; Bacteroides ovatus: AUC = 0.816, odds ratio = 31.365). Notably, Bacteroides ovatus was positively correlated with blood segment cells (p = 0.006), but negatively correlated with blood lymphocytes (p = 0.013). After multivariate regression, flavone and flavonol biosynthesis decreased in children with KD (p < 0.001). Our results indicated that both Bacteroides ovatus and Eggerthella lenta may deregulate flavone and flavonol biosynthesis, consequently modulating immune cells and potentially triggering KD. This study suggests that alterations in the gut microbiota are closely associated with immune responses and provides a new perspective on the aetiology, pathogenesis, and treatment of KD.