ObjectivesTo assess the prevalence of awareness and use of massive open online courses (MOOCs) among medical undergraduates in Egypt as a developing country, as well as identifying the limitations and satisfaction of using these courses.DesignA multicentre, cross-sectional study using a web-based, pilot-tested and self-administered questionnaire.SettingsTen out of 19 randomly selected medical schools in Egypt.Participants2700 undergraduate medical students were randomly selected, with an equal allocation of participants in each university and each study year.Primary and secondary outcome measuresPrimary outcome measures were the percentages of students who knew about MOOCs, students who enrolled and students who obtained a certificate. Secondary outcome measures included the limitations and satisfaction of using MOOCs through five-point Likert scale questions.ResultsOf 2527 eligible students, 2106 completed the questionnaire (response rate 83.3%). Of these students, 456 (21.7%) knew the term MOOCs or websites providing these courses. Out of the latter, 136 (29.8%) students had enrolled in at least one course, but only 25 (18.4%) had completed courses earning certificates. Clinical year students showed significantly higher rates of knowledge (p=0.009) and enrolment (p<0.001) than academic year students. The primary reasons for the failure of completion of courses included lack of time (105; 77.2%) and slow Internet speed (73; 53.7%). Regarding the 25 students who completed courses, 21 (84%) were satisfied with the overall experience. However, there was less satisfaction regarding student–instructor (8; 32%) and student–student (5; 20%) interactions.ConclusionsAbout one-fifth of Egyptian medical undergraduates have heard about MOOCs with only about 6.5% actively enrolled in courses. Students who actively participated showed a positive attitude towards the experience, but better time-management skills and faster Internet connection speeds are required. Further studies are needed to survey the enrolled students for a better understanding of their experience.
We found higher levels of serum glutamate in subjects with ASD and this might reflect altered glutamatergic neurotransmission which may aid early ASD detection. Further investigations are needed with a large number of participants to further clarify the possibility of using glutamate as a biomarker for ASD.
This triple anti-emetic regimen showed efficacy in controlling the multi-day cisplatin-induced nausea and vomiting. Further randomized controlled trials are needed to compare between 3-day and 7-day aprepitant for multi-day cisplatin regimens.
Background::
Androgen receptor (AR) upstreams complex signaling pathways that
regulate cell proliferation and contribute to breast tumorignensis. Several clinical trials were initiated
to investigate the clinical relevance of targeting AR especially in hormone-receptor-negative
breast cancer.
Methods::
The search was performed in PubMed and the meeting libraries of ASCO, ESMO,
SABCS, ImpakT congresses from January 2005 to July 2017. The following key words were
used: Breast cancer, Androgen receptor, androgen agonist/antagonist, Flutamide, Abiraterone, Bicalutamide,
Enzalutamide, Enobosarm, selective androgen receptor modulator.
Results::
Screening of title/abstracts yielded a total of 20 relevant results. Of those, twelve studies
were found eligible: eleven clinical trials along with one case report. Response rates ranged from
0 to 12% while clinical benefit rates reached up to 35% in 2 studies (with enzalutamide and enobosarm).
Progression-free survival ranged from 2.8 to 4.5 months. The most widely used cutoff
for AR expression was 10%. High expression of AR was associated with more clinical benefit.
Regarding safety, anti-androgens were generally well tolerated with hot flushes, elevated transaminases
and fatigue being the most commonly reported across all agents.
Conclusion::
Androgen receptor pathway targeting in advanced breast cancer remains a valid option
with reasonable clinical benefit in non-selected patients. Future studies are needed to define
an AR addicted cohort with better responses and outcome.
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