A Novel Mock Oral Curriculum for Senior Surgery Residents: Results of a Pilot Study.

INTRODUCTION: The oral general surgery certifying examination (CE) is required for board certification. A curriculum was designed to improve CE passage rates at an academic residency program. Limited literature exists that evaluates a long-term mock oral curriculum for senior residents. This study aims to evaluate the impact of this curriculum on essential elements for clinical practice and CE preparedness. METHODS: The curriculum consisted of weekly meetings with postgraduate year four and postgraduate year five residents (n = 10). Two residents were selected for a video-recorded board-style mock examination with a faculty examiner and peer audience. Each attendee completed a standard evaluation form that assessed score, anxiety, confidence, and medical knowledge. Blood pressure, pulse, and unused time were assessed. A postcurriculum survey was conducted. RESULTS: Medical knowledge had the greatest correlation with overall scores (R2 = 0.733). Positive correlations were seen between confidence and case number for faculty, self, and peer scores (R2 = 0.671, R2 = 0.566, and R2 = 0.729, respectively). There was a positive correlation between confidence and medical knowledge (R2 = 0.575). There was a significant difference between the overall score of nontachycardic versus tachycardic residents (P = 0.00994). CONCLUSIONS: Residents demonstrated increasing confidence as they progressed through the curriculum by self-reported and objective measures. Residents demonstrated improvements in overall scores. Future directions will examine results of the 2-y curriculum experience and CE passage rates to verify that a standardized, structured, weekly, longitudinal curriculum is beneficial for CE preparedness and clinical practice.

Effects of Intermittent Fasting and Physical Activity on Salivary Expression of Reduced Glutathione and Interleukin-1ß.

Previous research has consistently demonstrated that regular exercise promotes antioxidant production and decreases the expression of inflammation markers. However, there is very little research examining the effects of intermittent fasting (IF) on oxidative stress and inflammation. The present study investigated the hypothesis that a combination of IF and physical activity will reduce the need for glutathione (GSH) production by decreasing oxidative stress. In addition, it was hypothesized that a combination of IF and physical activity will significantly reduce inflammation, as indicated by a decrease in interleukin-1ß (IL-1ß) concentration. For three months, subjects practicing IF (n=7) ate only during an eight-hour window each day and fasted for the next 16 hours. A standard diet control group (n=18) maintained a normal, balanced diet spread out over the course of 14-18 hours each day. Based on data obtained from fitness-tracking devices, subjects were placed into one of three activity level groups: minimum, moderate, and maximum physical activity. Subjects provided fasting saliva samples monthly. The samples were subjected to a glutathione microplate assay and an interleukin ELISA test to determine salivary concentrations of GSH and IL-1ß, respectively. For GSH concentration, there were no significant differences between the diets at any physical activity level. However, moderate to maximum physical activity, in conjunction with fasting, led to significant decreases in IL-1ß concentration. In summary, results suggest that a combination of moderate physical activity and intermittent fasting promotes the maintenance of antioxidant function while inhibiting the inflammatory process.

Iodine-mediated hydration of alkynes on keto-functionalized scaffolds: mechanistic insight and the regiospecific hydration of internal alkynes.

An iodine-mediated hydration reaction of alkynes serves as a green alternative to metal-catalyzed procedures. Previous work has shown that this method works well with terminal alkynes on keto-functionalized scaffolds, including 1,3-dicarbonyls and their heteroatom analogues. It was hypothesized that the reaction proceeds through a 5-exo-dig neighboring group participation (NGP) cyclization and an α-iodo intermediate. The work described herein probes the existence of the intermediate through NMR investigations and explores the scope of the hydration process with internal alkynes. The NMR experiments confirm the existence of the α-iodo intermediate, and methodology studies demonstrate that alkyl-capped, asymmetric, internal alkynes undergo a regiospecific hydration, also via the 5-exo-dig NGP pathway.