Background N6-Methyladenosine (m6A) is the most common RNA modification and regulates RNA splicing, translation, translocation, and stability. Aberrant expression of m6A has been reported in various types of human cancers. m6A RNA modification is dynamically and reversibly mediated by different regulators, including methyltransferase, demethylases, and m6A binding proteins. However, the role of m6A RNA methylation regulators in thyroid cancer remains unknown. The aim of this study is to investigate the effect of the 13 main m6A RNA modification regulators in thyroid carcinoma. Methods We obtained clinical data and RNA sequencing data of 13 m6A RNA methylation regulators from The Cancer Genome Atlas (TCGA) THCA database. We performed consensus clustering to identify the clinical relevance of m6A RNA methylation regulators in thyroid carcinoma. Then we used LASSO Cox regression analysis to generate a prognostic signature based on m6A RNA modification regulator expression. Kyoto Encyclopedia of Genes and Genomes, Gene Ontology and Gene Set Enrichment Analyses were performed to explore differential cellular processes and signaling pathways between the two groups based on risk signature. Results We found that most of the m6A RNA modification regulators are down-regulated in 450 patients with thyroid carcinoma. We derived a three m6A RNA modification regulator genes-based risk signature (FTO, RBM15 and KIAA1429), that is an independent prognostic biomarker in patients with thyroid carcinoma. Moreover, we found that this risk signature could better predict outcome in male than female. Functional research in vitro demonstrated that the m6A RNA methylation regulators involved in the model acted significant role in the proliferation and migration of thyroid cancer cells. Conclusions Our study revealed the influence of m6A RNA methylation regulators on thyroid carcinoma through biological experiments and three-gene prognostic model.

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Background: The increasing opportunities for medical students to participate in international, supervised and structured electives have been shown in our recent study, which enhanced students’ professionalism, cultural competence and clinical reasoning skills in preclinical years. However, evidence is scant in achieving the specific learning objectives and improving clinical reasoning during clinical years. This study aims to demonstrate how the short-term supervised elective can improve students’ clinical reasoning skills, skills of case report writing and satisfactory academic performance.Results: We recorded daily discussions on the demonstrated skills and cases collection with six Curtin Medical School students from Australia during a 19-day supervised elective at the First Affiliated hospital, Sun Yat-sen University, China. The daily clinical reasoning discussions, case collection and bedside demonstrations in different disciplines became the main content of the reflections discussed in this article. Their feedback was recorded post-elective to examine the impact of the exchange in their ongoing case report writing, clinical reasoning skills development and academic performance. The main themes of case-based clinical reasoning identified in the daily discussions and feedbacks were described by the students in two frameworks. Learning through clinical reasoning is well demonstrated during students-supervisors daily debrief. The students have used these clinical reasoning skills in their ensuing clinical placement with satisfactory academic performances. The students have completed two case reports individually with cases for publication in both Australian Doctor and BMJ case report. The supervisors obtained students’ feedbacks at the time of the elective, 6-month and 12-month post-elective, and feedback summary is highlighted in three aspects including improved clinical reasoning skills, scientific writing skills and satisfactory academic performance.Conclusions: These reflections provide insight into how this exchange elective may improve students’ clinical reasoning, enhance scientific writing skills and strengthen academic performance.