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Purpose: Palliative whole-brain radiotherapy (WBRT) is a useful treatment modality for patients diagnosed with brain metastasis. Our study aimed to document parotid doses using a short course of 20 Gy in five fractions (SC-WBRT) and compare them with the known xerostomia parameters. Methods and materials: We retrieved dosimetric parameters for 59 patients who received SC-WBRT. The contouring of parotids was done retrospectively. The data was stratified depending on the lower edge of the planning target volume (PTV) border, up to either the first cervical vertebra (C1) or the second cervical vertebra (C2). The biologically effective dose (BED) of the parotid dose constraints from the literature was calculated and corrected to obtain the dose for a five-fraction treatment. These were used as a reference for assessing the parotid doses of our cohort. Results: With SC-WBRT, the mean doses of either gland (11.46 Gy) and of total parotids (11.48 Gy) were statistically significantly less than the BED corrected constraints of 12.82 Gy (p < 0.01) and 15.31 Gy (p < 0.01). Patients with PTV to C1, compared to those with a PTV to C2, had significantly lower mean doses of either gland (9.44 Gy vs 12.76 Gy, p < 0.01) and total parotid dose (9.44 Gy vs 12.78 Gy, p < 0.01). Patients with PTV to C1 had doses significantly lower than all the reference dose parameters. Conclusion: Routine delineation and documentation of parotid dosimetry would enable parotid sparing, irrespective of the dose regimen used. SC-WBRT provides better parotid sparing dosimetrically which may reduce the related toxicities even in palliative settings. Limiting the lower border of the PTV to C1 will further decrease the parotid doses. [ABSTRACT FROM AUTHOR]

Background: As limited antibiotic options are available for the treatment of carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections (BSIs), the optimal treatment duration for CRKP BSIs is unclear. Our objective was to investigate whether short courses (6–10 days) are as effective as prolonged courses (≥11 days) of active antibiotic therapy for CRKP BSIs. Methods: A retrospective cohort study comprising adults with monomicrobial CRKP BSI receiving a short or prolonged course of in vitro active therapy at a medical center was conducted between 2010 and 2021. Comparisons of two therapeutic strategies were assessed by the logistic regression model and propensity score analysis. The primary endpoint was 30-day crude mortality. Secondary outcomes included recurrent BSIs, the emergence of multidrug-resistant organisms and candidemia during hospitalization after completing antibiotic therapy for CRKP BSIs. Results: Of 263 eligible adults, 160 (60.8%) were male, and the median (interquartile range) age was 69.0 (53.0–76.0) years. Common comorbidities included diabetes (143 patients, 54.4%), malignancy (75, 28.5%), cerebrovascular accident (58, 22.1%), and hemodialysis (49, 18.6%). The 30-day mortality rate was 8.4% (22 patients). Of 84 propensity score well-balanced matched pairs, the 30-day mortality was similar in the short-course and prolonged-course group (6.0% and 7.1%, respectively; P = 1.00). However, there were less episodes candidemia in the short-course group (1.2% versus 13.1%; odds ratio, 0.08; 95% confidence interval, 0.01–0.63; P = 0.005). Conclusion: Short courses of active therapy for CRKP BSIs demonstrate comparable clinical outcomes to prolonged courses and are associated with a lower risk of subsequent candidemia.

As the COVID-19 pandemic caused severe disruption to education enterprises throughout the world, the main response by educational institutions was to move to online learning environments. The purpose of this study was to understand better how instructors could improve online learning for a professional-level week-long short course in a highly technical area (data analytics), which had, pre-COVID, been a hands-on computer, laboratory-based learning experience. The authors used self-study of professional practice to elicit and understand the major issues and concerns of the transition to an online learning environment. Under the guidance of a colleague in teacher education, three course instructors recorded and analyzed their experiences and, through discussion and data analysis, gained a deeper understanding of three challenging dimensions: course adaption to the online environment, personnel considerations, and technological considerations. Through the reflection that self-study provided, several of these challenges were addressed in subsequent courses. Self-study provided the instructors with an opportunity to reflect on the transition of the course to an online environment. This, in turn, provided an opportunity for course improvement and, arguably more importantly, an opportunity for the instructors to better understand each other's concerns and desires as it pertained to the course. [ABSTRACT FROM AUTHOR]

ABSTRACT Quantitative microbial risk assessment (QMRA) is a growing interdisciplinary field addressing exposures to microbial pathogens and infectious disease processes. Risk science is inherently interdisciplinary, but few of the contributing disciplinary programs offer courses and training specifically in QMRA. To develop multidisciplinary training in QMRA, an annual 10-day long intensive workshop was conducted from 2015 to 2019—the Quantitative Microbial Risk Assessment Interdisciplinary Instructional Institute (QMRA III). National leaders in the fields of public health, engineering, microbiology, epidemiology, communications, public policy, and QMRA served as instructors and mentors over the course of the program. To provide cross-training, multidisciplinary teams of 5–6 trainees were created from the approximately 30 trainees each year. A formal assessment of the program was performed based on observations and surveys containing Likert-type scales and open-ended prompts. In addition, a longitudinal alumni survey was also disseminated to facilitate the future redevelopment of QMRA institutes and determine the impact of the program. Across all years, trainees experienced statistically significant increases (P < 0.05) in their perceptions of their QMRA abilities (e.g., use of specific computer programs) and knowledge of QMRA constructs (e.g., risk management). In addition, 12 publications, three conference presentations, and two research grants were derived from the QMRA III institute projects or tangential research. The success of QMRA III indicates that a short course format can effectively address many multidisciplinary training needs. Key features of QMRA III, including the inter-disciplinary training approach, hands-on exercises, real-world institute projects, and interaction through a mentoring process, were vital for training multidisciplinary teams housing multiple forms of expertise. Future QMRA institutes are being redeveloped to leverage hybrid learning formats that can further the multidisciplinary training and mentoring objectives.

Based on multiple randomized-controlled clinical trials, shorter antibiotic courses are equally effective as traditional longer courses for many types of infections. However, longer courses are still being used widely in the clinical practice. To describe four components involved in the successful implementation of shorter antibiotic courses in our health care institutions, including an academic, public hospital and a community hospital staffed primarily by private practitioners. Clinical trials and peer-reviewed publications. We provide practical advice on how to support the change in clinical practice to shorten antibiotic duration. Specifically, we list the steps that we have successfully used to develop and implement an institutional practice change regarding the duration of antibiotic therapy: (a) establishing consensus documents outlining a data-driven expected practice for using antibiotics, (b) antibiotic stewardship programme support, (c) provider education, and (d) reinforcing behaviour through psychological and other tools. The implementation of these processes has successfully led to shorter antibiotic courses and decreased antibiotic use in our diverse practice settings. Intentional improvement in decreasing the duration of antibiotic therapy can be achieved by a specific antibiotic stewardship programme strategy and tactics. The implementation of shorter antibiotic courses has effects at individual and societal levels in an era of increasing antibacterial resistance and health care costs. [ABSTRACT FROM AUTHOR]

The location of SD Muhammadiyah Kalangan is located in Baturetno Banguntapan Village, Bantul, located within the village and not located on the edge of the highway, so that the location is less strategic to get the attention of the community. Promotion of new student admissions at SD Muhammadiyah Kalangan every year is carried out conventionally and has not used digital marketing media. This condition makes it difficult for SD Muhammadiyah Kalangan to compete with elementary schools located near the location. Based on these conditions, a special strategy is needed so that SD Muhammadiyah Kalangan can be better known by the public in general. This community service aims to provide insight and training to schools on digital marketing as a means to increase the interest of new student registrants. The method used in this community service is by conducting Short Course Digital Marketing activities as well as assisting in the creation of digital marketing media by utilizing websites and social media. The Short Course will start on August 6-10, 2021, and will be attended by 10 participants, namely teachers and employees of SD Muhammadiyah Kalangan. Community service shows a good impact seen from the pre-test and post-test scores of the implementation of the Digital Marketing Short Course, namely there is an increase in understanding and skills about Digital Marketing to be used as a strategy to increase the interest of new student registrants and be able to compete with other schools in the environment in the digital age.

Historically, osteoarticular tuberculosis (TB), including spinal TB, was treated with prolonged course of antitubercular therapy (ATT). Due to various challenges, there has been reluctance to explore the use of short-course ATT in spinal TB. However, with the success of short-course ATT being demonstrated in other forms of extrapulmonary TB, the subject is open for debate again. Therefore, we systematically reviewed various published literature to determine whether short-course treatment regimen (6 months) of ATT provides equivalent results in terms of disease healing as long-course treatment regimen (≥9 months) in the management of spinal TB. Five electronic databases (PubMed, MEDLINE, EMBASE, CENTRAL, and Web of Science) and their reference lists were searched to identify relevant randomized controlled trials with at least 1 year of follow-up that compared short-course with standard-course ATT for treatment of spinal TB. The methodological quality of included studies was assessed, and their data were extracted. A meta-analysis was used to calculate pooled effect sizes and 95% confidence interval (CI). The outcome measure was healed status of the disease at the final follow-up. Of 331 publications identified through literature search, eight publications describing six randomized studies were included. Moreover, 375 of 414 patients (90.58%) who received 6 months of ATT had healed status at their final follow-up compared to 404 of 463 patients (87.26%) who received ≥9 months of ATT. Overall, the healed status of spinal TB was equivalent in patients in both groups (pooled relative risk, 0.98; 95% CI, 0.92–1.04; p=0.439). However, there was considerable heterogeneity among the trials (I2=40.8%, p=0.149). The results suggest that the use of short-course (6 months) chemotherapy may be considered for the treatment of spinal TB in view of the similarity in the healing response achieved compared to treatment regimens of longer duration.

The manufacturing of gene therapy products is a rapidly growing industry bolstered by the tremendous potential of these therapies to provide lifesaving treatment for rare and complex genetic diseases. The industry's steep rise has resulted in a high demand for skilled staff required to manufacture gene therapy products of the expected high quality. To address this skill shortage, more opportunities for education and training in all aspects of gene therapy manufacturing are needed. The Biomanufacturing Training and Education Center (BTEC) at the North Carolina State University (NC State) has developed and delivered (and continues to deliver) a 4-day, hands-on course titled Hands-on cGMP Biomanufacturing of Vectors for Gene Therapy. The course, which consists of 60% hands-on laboratory activities and 40% lectures, aims to provide a comprehensive understanding of the gene therapy production process, from vial thaw through the final formulation step, and analytical testing. This article discusses the design of the course, the backgrounds of the nearly 80 students who have participated in the seven offerings held since March 2019, and feedback from the course participants. [ABSTRACT FROM AUTHOR]

Background The objective of this study was to compare the clinical outcomes of patients receiving a short course (SC) vs a prolonged course (PC) of antifungal therapy for uncomplicated Candida bloodstream infections (BSIs). Methods All episodes of uncomplicated Candida BSI from September 1, 2018, to August 31, 2020, were reviewed. We compared the primary (all-cause 90-day mortality) and secondary study end points (1-year recurrent Candida BSI and all-cause 1-year mortality) among patients who underwent SC (5–11 days) or PC (12–24 days) therapy using propensity score analysis with the inverse probability of treatment weighting (IPTW) method. Results A total of 114 patients with uncomplicated Candida BSI were included: 35 (30.7%) were classified into the SC group (median [interquartile range {IQR}], 9 [7–11] days) and 79 (69.3%) into the PC group (median [IQR], 14 [14–16] days). Patients in the SC group compared with the PC group had a higher rate of hospitalization in the surgical ward (40.0% vs 19.0%; P =.02) or septic shock at the time of Candida BSI onset (11.4% vs 1.3%; P =.03). The risk of 90-day mortality was not different between the SC and PC groups (n = 8 [22.9%] vs 17 [21.5%], respectively; IPTW-adjusted subdistribution hazard ratio [sHR], 0.67; 95% CI, 0.31–1.47; P =.20). The risk for recurrent Candida BSI within 1 year of completing therapy (IPTW-adjusted sHR, 1.07; 95% CI, 0.20–5.80; P =.94) or for all-cause 1-year mortality (IPTW-adjusted HR, 0.72; 95% CI, 0.35–1.50; P =.38) did not differ between groups. Conclusions Receiving a short vs prolonged course of antifungal therapy did not affect mortality or BSI recurrence in patients with uncomplicated candidemia. [ABSTRACT FROM AUTHOR]

Historically, osteoarticular tuberculosis (TB), including spinal TB, was treated with prolonged course of antitubercular therapy (ATT). Due to various challenges, there has been reluctance to explore the use of short-course ATT in spinal TB. However, with the success of short-course ATT being demonstrated in other forms of extrapulmonary TB, the subject is open for debate again. Therefore, we systematically reviewed various published literature to determine whether short-course treatment regimen (6 months) of ATT provides equivalent results in terms of disease healing as long-course treatment regimen (≥9 months) in the management of spinal TB. Five electronic databases (PubMed, MEDLINE, EMBASE, CENTRAL, and Web of Science) and their reference lists were searched to identify relevant randomized controlled trials with at least 1 year of follow-up that compared short-course with standard-course ATT for treatment of spinal TB. The methodological quality of included studies was assessed, and their data were extracted. A meta-analysis was used to calculate pooled effect sizes and 95% confidence interval (CI). The outcome measure was healed status of the disease at the final follow-up. Of 331 publications identified through literature search, eight publications describing six randomized studies were included. Moreover, 375 of 414 patients (90.58%) who received 6 months of ATT had healed status at their final follow-up compared to 404 of 463 patients (87.26%) who received ≥9 months of ATT. Overall, the healed status of spinal TB was equivalent in patients in both groups (pooled relative risk, 0.98; 95% CI, 0.92--1.04; p=0.439). However, there was considerable heterogeneity among the trials (I2=40.8%, p=0.149). The results suggest that the use of short-course (6 months) chemotherapy may be considered for the treatment of spinal TB in view of the similarity in the healing response achieved compared to treatment regimens of longer duration. [ABSTRACT FROM AUTHOR]

Tujuan penelitian: Tujuan dilakukannya penelitian ini adalah untuk mengetahui Pemberdayaan yatim dan Dhuafa melalui program short course (kursus singkat) Rumah Gemilang Indonesia Sawangan Depok. Metode penelitian, jenis penelitian ini adalah penelitian lapangan (field research), yaitu penelitian dan pengambilan datanya dilakukan di lapangan, dengan menggunakan pendekatan kualitatif dengan metode deskriptif kualitatif . Hasil penelitian, Berdasarkan hasil penelitian yang peneliti lakukan bahwa Rumah Gemilang Indonesia Sawangan Depok telah banyak melakukan aktifitasnya dalam hal pemberdayaan terhadap Yatim dan Dhuafa melalui program short course dan telah mendapatlkan dampak yang sangat positif bagi para peserta didikinya. Uapaya-upaya pemberdayaan yang dilakukan oleh Rumah Gemilang Indonesia Sawangan Depok antara lain pertama, Menyadarkan akan potensi yang dimiliki oleh para peserta, Kedua, Menfasilitasi untuk pengembangan potensi yang dimiliki oleh para peserta. Ketiga, Penanaman nilai-nilai kepada para peserta. Keempat, menumbuhkan sifat semangat Partisipasi kepada peserta, Kelima, Mengarahkan pada tempat yang tepat.

Background: There is limited access to 1 year of adjuvant trastuzumab in resource-constrained settings. Most randomized studies have failed to prove non-inferiority of shorter durations of adjuvant trastuzumab compared to 1 year However, shorter durations are often used when 1 year is not financially viable. We report the outcomes with 12 weeks of trastuzumab administered as part of curative-intent treatment.Methods: This is a retrospective analysis of patients treated at Tata Memorial Centre, Mumbai, a tertiary care cancer center in India. Patients with human epidermal growth factor receptor (HER2)-positive early or locally advanced breast cancer who received 12 weeks of adjuvant or neoadjuvant trastuzumab with paclitaxel and four cycles of an anthracycline-based regimen in either sequence, through a patient assistance program between January 2011 and December 2012, were analyzed for disease-free survival (DFS), overall survival (OS), and toxicity.Results: A total of 102 patients were analyzed with a data cutoff in September 2019. The median follow-up was 72 months (range 6-90 months), the median age was 46 (24-65) years, 51 (50%) were postmenopausal, 37 (36%) were hormone receptor-positive, and 61 (60%) had stage-III disease. There were 37 DFS events and 26 had OS events. The 5-year DFS was 66% (95% Confidence Interval [CI] 56-75%) and the OS was 76% (95% CI 67-85%), respectively. Cardiac dysfunction developed in 11 (10.7%) patients.Conclusion: The use of neoadjuvant or adjuvant 12-week trastuzumab-paclitaxel in sequence with four anthracycline-based regimens resulted in acceptable long-term outcomes in a group of patients, most of whom had advanced-stage nonmetastatic breast cancer. [ABSTRACT FROM AUTHOR]

A recent innovation to help patients adhere to daily tuberculosis (TB) treatment over many months is video (or virtually) observed therapy (VOT). VOT is becoming increasingly feasible as mobile telephone applications and tablet computers become more widely available. Studies of the effectiveness of VOT in improving TB patient outcomes are being conducted.

A recent innovation to help patients adhere to daily tuberculosis (TB) treatment over many months is video (or virtually) observed therapy (VOT). VOT is becoming increasingly feasible as mobile telephone applications and tablet computers become more widely available. Studies of the effectiveness of VOT in improving TB patient outcomes are being conducted.

Introduction: Trends in the use of short‐course radiation therapy (RT) for rectal cancer in Australia are unknown. The purpose of this study was to compare short‐course RT and long‐course chemoradiation (CRT) utilisation in the neoadjuvant treatment of rectal cancer in New South Wales (NSW). Methods: Patients who received neoadjuvant RT (2009–2014) for rectal cancer were identified from the NSW Central Cancer Registry. Univariate and multivariable analyses were performed to investigate factors associated with receipt of short‐course RT. Results: A total of 1196 (81%) patients received long‐course CRT, and 274 (19%) patients received short‐course RT. Receipt of short‐course RT was associated with older age: 54% in patients ≥80 years, and 11% in patients <50 years (P < 0.0001). Patients with T2 disease (30%) were more likely to receive short‐course RT, compared with T3 (19%) or T4 (8%) disease (P = 0.002). Patients with N0 (23%) disease were more likely to be treated with short‐course RT, compared with N+ (16%) (P = 0.03). The proportion of short‐course RT delivered to patients with Charlson Comorbidity Index (CCI) ≥ 2 (28%) was higher than patients with CCI = 0 (17%) (P = 0.002). There was wide variation in the proportion of short‐course RT used across residence local health districts (5–29%) (P < 0.0001). Conclusion: In rectal cancer patients treated with neoadjuvant RT in NSW, 19% received short‐course RT. The use of short‐course RT was associated with older age, comorbidities and less advanced disease. Wide variation across NSW was identified and future research investigating factors for the variation will be useful. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta-analysis of randomized controlled trials (RCTs) investigated whether the clinical efficacy of a 5-day antibiotic course is comparable to that of a longer (≥7 d) course for treating adults with community-acquired bacterial pneumonia (CABP). Methods: The PubMed, Web of Science, Cochrane Library, Ovid MEDLINE, and Embase. were searched before January 18, 2020. RCTs comparing the efficacy of a 5-day antibiotic course with a longer course (≥7 d) for CABP treatment were included. Primary outcomes included the clinical response, microbiological response, and risk of adverse events (AEs). Results: In this meta-analysis, 7 RCTs were included, and the 5-day antibiotic courses group, and a longer course group comprised 1499 and 1522 patients, respectively. The difference in the overall clinical response rates between the 5-day and longer courses (88.3% vs 88.8%, odds ratio [OR], 0.95, 95% confidence interval [CI], 0.70–1.28, I2 = 19%) was nonsignificant. Additionally, the microbiological eradication rates did not differ significantly between the groups, at 94.8% and 95.8% in the 5-day and longer courses groups, respectively (OR, 0.84, 95% CI, 0.38–1.87, I2 = 0%). Finally, all-cause mortality did not differ between the 2 groups (OR, 0.91, 95% CI, 0.31–2.66, I2 = 0%). Conclusions: Five-day treatment and longer antibiotic courses for CABP yield similar clinical and microbiological responses and exhibit similar safety profiles.

In order to respond more effectively to the health of young people in South Africa, in 2017 the National Department of Health of South Africa released the National Adolescent and Youth Health Policy. The Policy focused on a range of health problems and recommended interventions for delivery through multiple settings and government departments. It also included specific recommendations to empower and involve young people in policy and programme implementation. Adaptation of a short course on adolescent health in lowand middle-income countries, organized annually by the London School of Hygiene and Tropical Medicine and the World Health Organization, was piloted in 2017 as one means of contributing to the implementation of the Policy. The Adolescent and Youth Health Policy short course was subsequently offered in 2018 and 2019, attracting 96 participants working on adolescent health in various organizations at national and provincial levels throughout the country. Most participants (75%) successfully completed the course, as assessed by the completion criteria that had been defined. The range of topics for the assignments selected by the participants over the 3 years reflected both the content and intent of the Policy. The evaluations of the short course indicate that it helped to create legitimacy and strengthen the capacity of various constituencies, both of which are important prerequisites for policy implementation.

Background: The model of trauma in Vietnam has changed significantly over the last decade and requires reforming medical education to deal with new circumstances. Our aim is to evaluate this transition regarding the new target by analyzing trauma and the medical training system as a whole. Objective: This study aimed to establish if medical training in the developing country of Vietnam has adapted to the new disease pattern of road trauma emerging in its economy. Methods: A review was performed of Vietnamese medical school, Ministry of Health, and Ministry of Education and Training literature on trauma education. The review process and final review paper were prepared following the guidelines on scoping reviews and using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. Results: The current trauma training at the undergraduate level is minimal and involves less than 5% of the total credit. At the postgraduate level, only the specialties of surgery and anesthesia have a significant and increasing trauma training component ranging from 8% to 22% in the content. Trauma training, which focuses on practical skills, accounts for 31% and 32% of the training time of orientation courses for young doctors in "basic surgery" and "basic anesthesia," respectively. Other relevant short course trainings, such as continuing medical education, in trauma are available, but they vary in topics, facilitators, participants, and formats. Conclusions: Medical training in Vietnam has not adapted to the new emerging disease pattern of road trauma. In the interim, the implementation of short courses, such as basic trauma life support and primary trauma care, can be considered as an appropriate method to compensate for the insufficient competency-related trauma care among health care workers while waiting for the effectiveness of medical training reformation. [ABSTRACT FROM AUTHOR]

In order to respond more effectively to the health of young people in South Africa, in 2017 the National Department of Health of South Africa released the National Adolescent & Youth Health Policy. The Policy focused on a range of health problems and recommended interventions for delivery through multiple settings and government departments. It also included specific recommendations to empower and involve young people in policy and programme implementation. Adaptation of a short course on adolescent health in lowand middle-income countries, organized annually by the London School of Hygiene and Tropical Medicine and the World Health Organization, was piloted in 2017 as one means of contributing to the implementation of the Policy. The Adolescent & Youth Health Policy short course was subsequently offered in 2018 and 2019, attracting 96 participants working on adolescent health in various organizations at national and provincial levels throughout the country. Most participants (75%) successfully completed the course, as assessed by the completion criteria that had been defined. The range of topics for the assignments selected by the participants over the 3 years reflected both the content and intent of the Policy. The evaluations of the short course indicate that it helped to create legitimacy and strengthen the capacity of various constituencies, both of which are important prerequisites for policy implementation. [ABSTRACT FROM AUTHOR]

Over the past decade, it has become evident that the microbiome is an important environmental factor that affects many physiological processes, such as cell proliferation and differentiation, behaviour, immune function and metabolism. More importantly, it may contribute to a wide variety of diseases, including cancer, inflammatory diseases, metabolic diseases and responses to pathogens. We expect that international, integrative and interdisciplinary translational research teams, along with the emergence of FDA-approved platforms, will set the framework for microbiome-based therapeutics and diagnostics. We recognize that the microbiome ecosystem offers new promise for personalized/precision medicine and targeted treatment for a variety of diseases. The short course was held as a four-session webinar series in April 2015, taught by pioneers and experts in the microbiome ecosystem, covering a broad range of topics from the healthy microbiome to the effects of an altered microbiome from neonates to adults and the long term effects as it is related to disease, from asthma to cancer. We have learned to appreciate how beneficial our microbes are in breaking down our food, fighting off infections and nurturing our immune system, and this information provides us with ideas as to how we can manipulate our microbiome to prevent certain diseases. However, given the variety of applications, there are scientific challenges, though there are very promising areas in reference to the clinical benefits of understanding more about our microbiome, whether in our gut or on our skin: the outlook is bright. A summary of the short course is presented as a meeting dispatch.

Background: The aim of this study was to investigate the satisfaction of professors with the short-term course (fellowship) of medical education in Birjand University of Medical Sciences in the Covid 19 pandemic. The results of this study can be used to plan training courses in person and virtually in post-Corona era. Methods: Initially, needs assessment was conducted for the content of the course, after determining the content, the course was held online through Adobe Connect system and offline through Navid system. Following completing the course, evaluation was done and finally satisfaction with the course assessed based on the questionnaire of 34 items confirmed validity and reliability. The data were analyzed by SPSS software version 18 , using t-test and correlation coefficient. Results: The mean age of participants was 36.34 with a standard deviation of 5.64 years, 56.8% (25 people) were female and 43.2% (19 people) were male. In terms of academic rank, 75% were assistant professors. The average score of satisfaction is equal to 140.48, which indicates a high score of satisfaction with the course. Also, in general, the score of satisfaction is higher than average, in all fields. The average score of satisfaction in men is significantly lower than women. There was no significant relationship between degree, academic rank, age and work experience with satisfaction. Conclusion: Totally, professors' satisfaction with the online and offline medical education fellowship course in the relevant systems is at a high level, so it is suggested that in the post-corona era, combined empowerment courses in person and online should be held.

Higher education programs are rapidly transitioning online in support of a broader geographic base, working professionals, and, recently, emergency contingencies such as COVID-19. The flexibility of online courses makes them attractive to adult learners; as such, there is much academic discussion about online learning for adult learners and the conversion of courses to an online format. However, most of these discussions are based on traditional higher education courses. This article discusses some of the specific practical challenges in the conversion of professional short courses for adult learners. The challenges relate to instructor isolation, student preparedness, and student support. Proposed solutions to these challenges are drawn from direct instructor experience of converting a STEM professional short course to an online format. Solutions included increasing the number of instructors and providing pre-course sessions to help resolve some technical difficulties before each class began. [ABSTRACT FROM AUTHOR]

Introduction: Majority of the patients in low-to-middle income countries (LMICs) have no access to adjuvant trastuzumab due to financial constraints. Short-course (9 weeks) schedule of trastuzumab is a feasible alternative in this setting. The objective of this study was to assess the feasibility and outcomes of adjuvant short-course trastuzumab in patients with breast cancer treated at our center. Materials and Methods: This was a retrospective study conducted in a tertiary cancer center in South India. Case records of all patients who received short-course (9 weeks) adjuvant trastuzumab from June 2014 to December 2016 were reviewed. Baseline characteristics, treatment details, and outcomes were analyzed. Results: During the study, 129 patients received short-course trastuzumab. The median age was 50 years (range, 30–74 years). Majority of the patients were postmenopausal (64%). The most common histology was infiltrating ductal carcinoma; 57% had Grade 2 disease. The most common chemotherapy regimen used was doxorubicin + cyclophosphamide (AC), followed by weekly paclitaxel (n = 110, 86%) and docetaxel + cyclophosphamide (TC) (n = 17, 13%). Majority of the patients (n = 120, 93%) had T1 or T2 disease and were node-negative (n = 62, 57%). Sixty-two patients (48%) had hormone receptor-positive disease. One hundred and eight patients (84%) underwent modified radical mastectomy, and the rest had breast conservation surgery. At a median follow-up of 29 months, the 3-year overall survival (OS) was 98%; the median OS was not reached. The 3-year disease-free survival (DFS) was 97.4%; the median DFS was not reached. The regimen was well tolerated and none of the patients developed symptomatic cardiac failure. Conclusions: Our study shows that a 9-week short course of trastuzumab is a feasible strategy in a resource-limited setting and can lead to promising outcomes, especially in early breast cancer.

Objective: To compare the efficacy of short course versus standard course oral co-trimoxazole in the management of children presenting with lower urinary tract infections. Study Design: Randomized Controlled Trial. Setting: Department of Paediatric, Federal Government Polyclinic, Islamabad. Period: 6 months from January 2017 to June 2017. Material & Methods: Patients were randomly allocated to two therapy groups by lottery method i.e. oral co-trimoxamole for 3 days (Group A) and oral co-trimoxazole for 10 days (Group B). The antibiotic course was started according to child weight and stopped after 3 and 10 days according to study group allocation. The patients were followed up after 7 days in the short course group and 10 days in the standard therapy group to assess for clinical resolution of UTI. The outcome was noted as clinical cure or relapse/recurrence of UTI. The children with recurrence were sent home after change of therapy to next generation of antibiotic therapy and in case of severe condition, patient was admitted for parenteral therapy. Results: In this study efficacy of short course was seen in 41(85.4%) patients while patients who were given standard course among they m efficacy was seen in only 14(29.2%) patients only. Efficacy of short course treatment was significantly higher as that of that of standard course i.e. p-value=0.000. Efficacy of both treatment regimens was seen in terms of age, gender and duration of symptoms. Stratification of these variables showed that short course efficacy was significantly higher as that of standard course for all these stratified variables. Conclusion: Results of this study demonstrated that short course of oral co-trimoxazole is more effective than standard course in the management of children presenting with lower urinary tract infections. However short course is not only beneficial in terms of cost as well as it cures in a short time span and minimal side effects. [ABSTRACT FROM AUTHOR]

Background: The Primary Trauma Care (PTC) course was originally developed to instruct health care workers in the management of patients with severe injuries in low- and middle-income countries (LMICs) with limited medical resources. PTC has now been taught for more than 25 years. Many studies have demonstrated that the 2-day PTC workshop is useful and informative to frontline health staff and has helped improve knowledge and confidence in trauma management; however, there is little evidence of the effect of the course on changes in clinical practice. The Kirkpatrick model (KM) and the knowledge, attitude, and practice (KAP) model are effective methods to evaluate this question., Objective: The aim of this study was to investigate how the 2-day PTC course impacts the satisfaction, knowledge, and skills of health care workers in 2 Vietnamese hospitals using a conceptual framework incorporating the KAP model and the 4-level KM as evaluation tools., Methods: The PTC course was delivered over 2 days in the emergency departments (EDs) of Thanh Hoa and Ninh Binh hospitals in February and March 2022, respectively. This study followed a prospective pre- and postintervention design. We used validated instruments to assess the participants' satisfaction, knowledge, and skills before, immediately after, and 6 months after course delivery. The Fisher exact test and the Wilcoxon matched-pairs signed rank test were used to compare the percentages and mean scores at the pretest, posttest, and 6-month postcourse follow-up time points among course participants., Results: A total of 80 health care staff members attended the 2-day PTC course and nearly 100% of the participants were satisfied with the course. At level 2 of the KM (knowledge), the scores on multiple-choice questions and the confidence matrix improved significantly from 60% to 77% and from 59% to 71%, respectively (P<.001), and these improvements were seen in both subgroups (nurses and doctors). The focus of level 3 was on practice, demonstrating a significant incremental change, with scenarios checklist points increasing from a mean of 5.9 (SD 1.9) to 9.0 (SD 0.9) and bedside clinical checklist points increasing from a mean of 5 (SD 1.5) to 8.3 (SD 0.8) (both P<.001). At the 6-month follow-up, the scores for multiple-choice questions, the confidence matrix, and scenarios checklist all remained unchanged, except for the multiple-choice question score in the nurse subgroup (P=.005)., Conclusions: The PTC course undertaken in 2 local hospitals in Vietnam was successful in demonstrating improvements at 3 levels of the KM for ED health care staff. The improvements in the confidence matrix and scenarios checklist were maintained for at least 6 months after the course. PTC courses should be effective in providing and sustaining improvement in knowledge and trauma care practice in other LMICs such as Vietnam., (© Ba Tuan Nguyen, Van Anh Nguyen, Christopher Leigh Blizzard, Andrew Palmer, Huu Tu Nguyen, Thang Cong Quyet, Viet Tran, Marcus Skinner, Haydn Perndt, Mark R Nelson. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

Abstract Background India has the world’s highest tuberculosis burden, and Mumbai is particularly affected by multidrug resistant tuberculosis (MDR-TB). WHO recommends short, intensive treatment (“Short Course”) for previously untreated pulmonary MDR-TB patients but does not require universal drug susceptibility testing (DST) before Short Course. DST would likely screen out many MDR-TB patients in places like Mumbai with significant drug resistance. Methods MDR-TB patients at a private clinic were recruited for a prospective observational cohort. Short Course eligibility was evaluated by clinical criteria and DST results. Eligibility by DST was classified as rifampin monoresistance (as tested by Xpert MTB/RIF), rifampin, fluoroquinolones, and 2nd-line injectable drugs resistance (as tested by line probe assays) and resistance to other drugs. Results Of 559 participants with MDR-TB, 33% met clinical eligibility for Short Course. DST for rifampin, fluoroquinolones, and 2nd-line injectable drugs excluded 74.7% of participants. Complete phenotypic DST excluded 96.6% of participants. Prior treatment with either 1st or 2nd-line drugs did not significantly affect eligibility. Conclusions In a global MDR-TB hotspot,

Background: 99DOTS (Directly Observed Treatment, Short course) is a low-cost, mobile phone-based technology that enables real-time remote monitoring of daily intake of treatment, first introduced by the Revised National Tuberculosis Programme under the national programme in 2015 in high-burden antiretroviral therapy (ART) centers. This project was launched for the first time in 2016 in Rajkot district, Gujarat, India, and hence this was an effort to evaluate 99DOTS. Objectives: The objective of this study was to evaluate treatment adherence rate and treatment outcome of 99DOTS-information communication technology (ICT)-based approach for tuberculosis (TB) management. Materials and Methods: Data from 99DOTS were obtained from February 2016 to September 2017 after obtaining approval from the Institutional Ethical Committee and permission from the head of the department of district TB center (DTC), Rajkot. Data were evaluated for sociodemographic pattern, adherence rate, and treatment outcome. Results: A total of total 347 registered patients, 197 (56.77%) patients diagnosed by private practitioners and 150 (43.22%) patients having HIV-TB from ART center were initiated TB treatment under 99DOTS project from nine different talukas of Rajkot district. Mean age of the registered TB patients was 36 ± 13.55 years with predominance of “new cases” (n = 275, 79.25%) and “male” gender (n = 257, 74.06%). The overall treatment adherence rate of 99DOTS was 96.03%, while adherence by “call” was 92.25% and adherence by “manual” was 32.12%. Cure rate was higher in patients with TB only (n = 113, 78.47%) as compared to patients with HIV-TB co-infection (n = 46, 67.64%). Defaulter rate (n = 19, 13.19%) was also higher in patients with TB only, while death rate (n = 14, 20.58%) was higher in patients of TB with HIV co-infection. Conclusion: 99DOTS is an effective approach for improving TB medication adherence, thereby increasing the compliance to TB treatment. It will be helpful for easy access of treatment to patients from remote areas, improve notification of patients from private practitioners, and enable differentiated care.

Purpose of Review: Neoadjuvant long-course chemoradiation (LCRT) and short-course radiotherapy (SCRT) are evidence-based treatment options for locally advanced rectal cancer. Both paradigms improve local control but have not shown to impact distant metastases or overall survival. Herein, we compare these two radiation approaches and review their role in the multidisciplinary management for locally advanced rectal cancer. Recent Findings: There are no significant differences in disease outcomes between LCRT and SCRT. Delaying surgery after either radiation regimens is safe and leads to tumor downstaging without compromising oncologic outcomes. Attempts to incorporate chemotherapy to intensify neoadjuvant radiation regimens are under active investigation. Summary: LCRT and SCRT are proven neoadjuvant regimens that improve local control. Supporters of LCRT emphasize the higher likelihood for tumor downstaging and sphincter preservation, while those favoring SCRT highlight lower acute toxicities, decreased costs, and patient convenience. Delaying surgery after either LCRT or SCRT is safe and provides pathologic downstaging. The optimal timing of surgery has yet to be determined. There is growing interest in total neoadjuvant therapy which incorporates chemotherapy with neoadjuvant radiation. [ABSTRACT FROM AUTHOR]

Context: Antimicrobial prophylaxis has been accepted as a universal protocol for reducing postoperative complications related to infections in surgical practice. Controversy still exists regarding the type of antibiotic and duration of administration for various surgical maneuvers. Aims: This study was conducted to compare the efficacy of short course of perioperative antibiotic prophylaxis against the long-term administration of antibiotics for the prevention of surgical site infections (SSIs). Settings and Design: This was a prospective, randomized, two arm, and open-label study. Subjects and Methods: All patients of either sex, who were admitted in orthopedic wards and planned for elective orthopedic surgical procedures, were included in the study. This was a prospective study, conducted from June 2011 to December 2012. Patients were randomly allocated into two groups. Group A (n = 153) was given 3 doses of 1 g intravenous (IV) ceftriaxone in combination with amikacin (15 mg/kg) perioperatively at an interval of 12 h and Group B (n = 142) was given the usual regimen (5 days of IV antibiotics [ceftriaxone 50 mg/kg twice daily in combination with amikacin 15 mg/kg 12 hourly], accompanied by oral cefuroxime, till elimination of stitches). Statistical Analysis Used: Chi-square test and Student's t-test were used for calculating the difference in rates of infection with 95% confidence intervals. Results: Out of the 295 patients, 13 patients suffered SSI. In Group “A,” superficial infection rate was 3.27% and deep infection rate was 1.31%, while in Group “B,” superficial infection rate was 1.41% and deep infection rate was 2.82%. The difference in infection rates between the two groups was statistically insignificant. Conclusions: There is no role of continuing prophylactic antibiotics beyond 24 h in elective orthopedic surgery to prevent SSI, rather it increases morbidity, mortality, cost for the patients, and antibiotic resistance. Short-course antimicrobial prophylaxis is equally good and as effective as the long-term dosage.

Paroxysmal hemicrania (PH) is a rare primary headache disorder, especially among children. We describe herein a case with the shortest course of pediatric PH among previously reported cases, and the first case report of Japanese pediatric PH. An 11‐year‐old boy was referred to our clinic by his primary care physician for a headache evaluation. He had been complaining of severe, sharp, pulsating headache for 5 days. Attacks were restricted to the left side with a duration ranging from 2 to 20 minutes, 20‐30 times a day. Attacks were associated with left autonomic symptoms (conjunctival injection, lacrimation, nasal congestion, eyelid edema, and ptosis). Two days after we prescribed indomethacin at 0.9 mg/kg/day, the patient was headache free. He stopped taking indomethacin 14 days after consultation because of drug eruptions. As of the time of writing, more than 1 year later, he has experienced no recurrence of headache. This case indicates the importance of improving awareness among general doctors regarding PH in children, and of conducting further investigations about low‐dose, short‐term indomethacin treatment. [ABSTRACT FROM AUTHOR]

In the neoadjuvant treatment of locally advanced rectal adenocarcinoma, long- and short-course radiotherapy are considered to be of equivalent efficacy based upon several randomized trials. The present study assessed the effect of radiotherapy dose on overall survival. Using the National Cancer Database (2006–2013) 458 individuals with clinical stage II/III rectal adenocarcinoma treated were identified, with either short- (25 Gy) or long- (45 or 50.4 Gy) course neoadjuvant radiotherapy followed by surgery, without neoadjuvant or adjuvant chemotherapy. Multivariate COX regression was employed to evaluate differences in overall survival according to radiotherapy regimen. An association with improved overall survival in individuals treated with long- compared with short-course radiotherapy was demonstrated (HR=0.50, 0.34–0.73). The 30- and 90-day post-surgery mortality rates were higher in the short-course group when compared with the long-course group (12.2 vs. 2.4%; and 18.5 vs. 5.4%, respectively). Following the exclusion of patients that succumbed within 90-days post-surgery, overall survival advantage in the long-course group compared with the short-course group was maintained [hazard ratio (HR)=0.62, 0.39–0.99], with a median overall survival of 25.3 months (IQR 16.9–41.6) for the short-course group compared with 43.5 months (IQR 25.6–67.9) for the long-course group. To the best of our knowledge, the present results suggest for the first time that long-course radiotherapy is associated with an improved overall survival compared with short-course radiotherapy in locally advanced rectal adenocarcinoma in the absence of chemotherapy usage. This possible advantage is clinically relevant mainly in patients who cannot tolerate systemic chemotherapy. [ABSTRACT FROM AUTHOR]

Background: 99DOTS (Directly Observed Treatment, Short course) is a low‑cost, mobile phone‑based technology that enables real‑time remote monitoring of daily intake of treatment, first introduced by the Revised National Tuberculosis Programme under the national programme in 2015 in high‑burden antiretroviral therapy (ART) centers. This project was launched for the first time in 2016 in Rajkot district, Gujarat, India, and hence this was an effort to evaluate 99DOTS. Objectives: The objective of this study was to evaluate treatment adherence rate and treatment outcome of 99DOTS‑information communication technology (ICT)‑based approach for tuberculosis (TB) management. Materials and Methods: Data from 99DOTS were obtained from February 2016 to September 2017 after obtaining approval from the Institutional Ethical Committee and permission from the head of the department of district TB center (DTC), Rajkot. Data were evaluated for sociodemographic pattern, adherence rate, and treatment outcome. Results: A total of total 347 registered patients, 197 (56.77%) patients diagnosed by private practitioners and 150 (43.22%) patients having HIV‑TB from ART center were initiated TB treatment under 99DOTS project from nine different talukas of Rajkot district. Mean age of the registered TB patients was 36 ± 13.55 years with predominance of “new cases” (n = 275, 79.25%) and “male” gender (n = 257, 74.06%). The overall treatment adherence rate of 99DOTS was 96.03%, while adherence by “call” was 92.25% and adherence by “manual” was 32.12%. Cure rate was higher in patients with TB only (n = 113, 78.47%) as compared to patients with HIV‑TB co‑infection (n = 46, 67.64%). Defaulter rate (n = 19, 13.19%) was also higher in patients with TB only, while death rate (n = 14, 20.58%) was higher in patients of TB with HIV co‑infection. Conclusion: 99DOTS is an effective approach for improving TB medication adherence, thereby increasing the compliance to TB treatment. It will be helpful for easy access of treatment to patients from remote areas, improve notification of patients from private practitioners, and enable differentiated care. [ABSTRACT FROM AUTHOR]

Objective/background: Despite several studies on health system delay (HSD) among tuberculosis (TB) patients in Nigeria, no study has compared HSD in private and public health facilities. This study assessed the determinants of HSD in public and private health facilities offering the directly observed treatment, short course (DOTS). Methods: A descriptive cross-sectional study was conducted. A total of 470 new smear-positive TB patients aged 14 years and older were consecutively recruited between October 1, 2012, and December 31, 2012, from 34 (23 public and 11 private) DOTS facilities that offered treatment and microscopy services. Mann–Whitney U test and logistic regression were used to assess the determinants of HSD. Results: The median HSD was longer at public DOTS facilities (14 days; interquartile range [IQR] 10–21 days) than private DOTS facilities (12.5 days; IQR 10.0–14.0 days, p = .002). Age and human immunodeficiency virus status were determinants of HSD at the public DOTS facilities, whereas sex and income were determinants of HSD at the private DOTS facilities. TB patients who first visited a nonhospital facility were over four times more likely (odds ratio 4.12; 95% confidence interval 2.25–7.54) to have prolonged HSD than those who first visited the government hospital when they first developed the symptoms of TB after controlling for other factors in the model. Conclusion: Determinants of HSD at the public and private DOTS facilities vary. Strategies to reduce HSD at both public and private DOTS facilities in Lagos State, Nigeria, are urgently needed.

Background: India has the world's highest tuberculosis burden, and Mumbai is particularly affected by multidrug resistant tuberculosis (MDR-TB). WHO recommends short, intensive treatment ("Short Course") for previously untreated pulmonary MDR-TB patients but does not require universal drug susceptibility testing (DST) before Short Course. DST would likely screen out many MDR-TB patients in places like Mumbai with significant drug resistance.Methods: MDR-TB patients at a private clinic were recruited for a prospective observational cohort. Short Course eligibility was evaluated by clinical criteria and DST results. Eligibility by DST was classified as rifampin monoresistance (as tested by Xpert MTB/RIF), rifampin, fluoroquinolones, and 2nd-line injectable drugs resistance (as tested by line probe assays) and resistance to other drugs.Results: Of 559 participants with MDR-TB, 33% met clinical eligibility for Short Course. DST for rifampin, fluoroquinolones, and 2nd-line injectable drugs excluded 74.7% of participants. Complete phenotypic DST excluded 96.6% of participants. Prior treatment with either 1st or 2nd-line drugs did not significantly affect eligibility.Conclusions: In a global MDR-TB hotspot, < 5% of participants with MDR-TB were appropriate for Short Course by clinical characteristics and DST results. Rapid molecular testing would not sufficiently identify drug resistance in this population. Eligibility rates were not significantly reduced by prior TB treatment. [ABSTRACT FROM AUTHOR]

Rectal cancer management can be defined as maximizing local tumor control and overall survival while preserving anal sphincter, bladder, and sexual functions or improving the quality of life with an overall reduction in morbidity. Appropriate preoperative or postoperative therapy is required to minimize the risks of both local and distant recurrence. Preoperative radiotherapy is the current standard for treating patients with high-risk rectal cancer owing to lower rates of local relapse and toxicity. Modern radiotherapy capabilities are well suited for any short- or long-course protocol with decreased toxicity in irradiated structures such as the small intestine, bladder, or femoral heads. As clinicians and researchers, we must aim to establish tailored treatments for these patients based on the most suitable evidence based ground in a multidisciplinary environment regarding the expectations of both our patients and team physicians. Herein, we present a review of ongoing clinical trials in order to shed light on the current debates of standard approaches for treating rectal cancer. [ABSTRACT FROM AUTHOR]