In the Philippines, indigenous vegetables like ‘alugbati’ (Basella alba L.) can be utilized to address micronutrient deficiencies, such as vitamin A deficiency (VAD). This study aimed to develop fresh egg noodles with higher vitamin A content through the utilization of ‘alugbati’ leaves powder. Powder from ‘alugbati’ leaves was produced through dehydration of fully expanded leaves. The resultant powder was used to create three formulations of fresh egg noodles at 10%, 15%, and 20% substitution levels, with 100% wheat flour serving as the control. All formulations and the control were subjected to a water disintegration test and preference ranking test. The most preferred formulation was further evaluated for proximate composition, total carotenoid content (TCC), color, physical characteristics, and consumer acceptability. Data from triplicate experiments were statistically analyzed (p ≤ 0.05). Results showed that all samples were resistant to water disintegration (20 min in boiling water) and egg noodle with 15% substitution level was the most preferred. This sample had significantly higher ash (2.27 ± 0.28), fiber (1.77 ± 0.38), and protein (11.50 ± 0.11) contents than the control. A significantly higher TCC (1550 µg/g) compared to the control (610 µg/g) also signified that substituting with ‘alugbati’ leaves powder increased the vitamin A content of the noodles. From this, consuming 5–10 g of ‘alugbati’ egg noodles will be able to provide the vitamin A requirement of 400–800 µg retinol equivalent (RE). The egg noodles with a 15% substitution level also had a significantly darker green color and significantly lower elasticity. Moreover, this formulation was generally acceptable with mean Hedonic scores ranging from 7.20 (Like Moderately) to 7.80 (Like Very Much). This study demonstrated that fresh egg noodles with ‘alugbati’ leaves powder can be a good source of vitamin A. Clinical studies should be conducted to determine the role of the product in alleviating VAD especially in children and pregnant women.

Background Debriefing in the pediatric emergency department (PED) is an invaluable tool to improve team well-being, communication, and performance. Despite evidence, surveys have reported heavy workload as a barrier to debriefing leading to missed opportunities for improvement in an already busy ED. The study aims to determine the association between the incidence of debriefing after pediatric trauma resuscitations and PED crowding. Methods A total of 491 Trauma One activations in Riley Children's Hospital Pediatric Emergency Department that presented between April 2018 to December 2019 were included in the study. Debriefing documentations, patient demographics, time and date of presentation, mechanism of injury, injury severity score, disposition from PED, and length of stay (LOS) were collected and analyzed. The National Emergency Department Overcrowding Scale score at arrival, Average LOS, total PED census, total PED waiting room census, and rates of left without being seen were compared between groups. Results Of 491 Trauma One activations presented to our PED, 50 (10%) trauma evaluations had documented debriefing. The National Emergency Department Overcrowding Scale score at presentation was significantly lower in those with debriefing versus without debriefing. In addition, the PED hourly census, waiting room census, average LOS, and left without being seen were also significantly lower in the group with debriefing. In addition, trauma cases with debriefing had a higher proportion of patients with profound injuries and discharges to the morgue. Conclusions Pediatric emergency department crowding is a significant barrier to debriefing after trauma resuscitations. However, profound injuries and traumatic pediatric deaths remain the strongest predictors in conducting debriefing regardless of PED crowding status.

Introduction: While gamification of point-of-care ultrasound (POCUS) is well received by learners, little is known about the knowledge gained from material taught during these events. We set out to determine whether a POCUS gamification event improved knowledge of interpretation and clinical integration of POCUS. Methods: This was a prospective observational study of fourth-year medical students who participated in a 2.5-hour POCUS gamification event consisting of eight objective-oriented stations. Each station had one to three learning objectives associated with the content taught. Students completed a pre-assessment; they then participated in the gamification event in groups of three to five per station and subsequently completed a post-assessment. Differences between pre- and postsession responses were matched and analyzed using Wilcoxon signed-rank test and Fisher’s exact test. Results: We analyzed data from 265 students with matched pre- and post-event responses; 217 (82%) students reported no to little prior POCUS experience. Most students were going into internal medicine (16%) and pediatrics (11%). Knowledge assessment scores significantly improved from pre- to post-workshop, 68% vs 78% (P=0.04). Self-reported comfort with image acquisition, interpretation, and clinical integration all significantly improved from pre- to post-gamification event (P<0.001). Conclusion: In this study we found that gamification of POCUS, with clear learning objectives, led to improved student knowledge of POCUS interpretation, clinical integration, and self-reported comfort with POCUS.