PURPOSE Luminal B-like breast cancer is sensitive to both chemotherapy and endocrine therapy. We aimed to assess the safety and efficacy of concomitant chemotherapy and endocrine therapy compared with chemotherapy alone in the preoperative setting in luminal B-like breast cancer. GSK461364 METHODS This two-arm randomized clinical trial enrolled patients with luminal B-like human epithelial growth factor 2-negative breast cancer, who were randomly assigned at a 11 ratio to receive preoperative chemotherapy alone or preoperative endocrine therapy concurrent with chemotherapy for 24 weeks before surgery. The primary endpoint was the pathological complete response (pCR) rate. The secondary endpoints included the clinical response rate, toxicity, and health-related quality of life (HRQOL). RESULTS Overall, 70 patients were randomly assigned to the chemotherapy and chemo-endocrine therapy groups. The pCR rates were 9.7% and 3.0% (P = 0.319), and the clinical complete response rates were 5.9% and 5.6% (P = 0.745) in the chemotherapy and chemo-endocrine therapy groups, respectively. There were no clear differences in treatment-related adverse events or HRQOL between the two groups. CONCLUSIONS In patients with luminal B-like breast cancer, the pCR, clinical response rate, toxicity, and HRQOL with the concomitant administration of endocrine therapy and chemotherapy were not superior to chemotherapy alone in the preoperative setting.BACKGROUND Elucidating behavioral protective factors for cognitive decline and dementia can have a far-reaching impact. AIMS To describe the association of present and past musical instrument playing with cognitive function in cognitively intact older adults. METHOD A post hoc observational analysis of the Zurich Disability Prevention Trial. Past and present musical instrument playing was correlated with Mini-Mental State Examination (MMSE) and EuroQol-Visual Analogue Scale (EQ-VAS) using linear regression at baseline and mixed-model linear regression over 1 year. RESULTS Two hundred community dwelling adults age 70 and older (mean age 77.7) were included. There were 48.5% (97/200) participants, who ever played a musical instrument; 35% (70/200) played in the past and 13.5% (27/200) played at present. At baseline, present players had a suggestively higher adjusted-MMSE than never players (28.9 vs. 28.5, p value 0.059). Over 12 months, compared to never players, ever players showed a significantly better improvement from baseline in adjusted-MMSE (0.29 vs. – 0.12, p value 0.007). The association remained significant even after restricting to participants without higher education (p value 0.03). Over time, no differences were observed for EQ-VAS (p value 0.45). However, past players had the largest decline in health-related quality of life at 12 months. DISCUSSION The support for a protective association in our observational study suggests the need for clinical trials to examine the effect of playing a musical instrument on cognitive function and decline. Both returning to play after an interruption and learning to play from the beginning should be examined. CONCLUSIONS Present and past musical instrument playing may assist in preserving cognitive function in community-dwelling older adults.BACKGROUND Patient education about osteoporosis is an important component of osteoporosis treatment. AIM To compare the effectiveness of osteoporosis education between video-based learning and traditional lecture-based learning. METHODS Participants who attended the Outpatient Department of Siriraj Hospital during June 2017 to November 2017 were recruited. Ten-question pre- and post-tests were used to evaluate participant osteoporosis knowledge. After finishing the pre-test, patients were randomized to receive osteoporosis education via either traditional lecture-based or video-based learning for 25 min. After the training, patient questions about the subject matter were answered, and then the post-test was administered. Change in score was compared between groups using non-inferiority test at a non-inferiority margin of - 1. RESULTS Of 413 participants, 207 and 206 people were allocated to the lecture-based group and the video-based group, respectively. There were no significant differences in baseline characteristics, change in score between pre-test and post-test, or change in score between pre-test and retention test between groups. Non-inferiority test revealed the change in score after video-based learning to be non-inferior to traditional lecture-based learning at a difference of > - 1, α = 0.05 (p  less then  0.001). DISCUSSION Video-based osteoporosis education can be used as part of a fracture liaison service to provide essential information about osteoporosis to both patients and caregivers. Video-based education is an efficient and effective tool that will reduce dependency on clinicians to provide lecture-based osteoporosis instruction. CONCLUSIONS Since video- and lecture-based education were found to be equally effective, a standard package for both education techniques should be developed and implemented for all patients.BACKGROUND SnapECG is a new handheld single-lead electrocardiograph (ECG) device used for arrhythmia screening, it is widely used in clinical practice but not in primary care. AIMS To evaluate the arrhythmia screening value of SnapECG among a community-based population. METHODS A cross-sectional community-based study of multistage stratified cluster sampling was conducted from March 1st to April 30th 2019. The sensitivities, specificities and the area under the receiver operating characteristic (AUCROC) curves of the SnapECG and reference 12-lead ECG on arrhythmia were calculated in three age-groups [50-64 years, 65-74 years, and over-75 years]. RESULTS A total of 2263 participants took part in the arrhythmia screening, these included 1479 aged 50-64 years, 602 aged 65-74 years and 182 aged over-75 years. The SnapECG categorized 1828 (80.8%) as sinus rhythm, 161 (7.1%) as premature atrial/ventricular contractions (PAVs/PCVs), 32 (1.4%) as possible atrial fibrillation (AF), 56 (2.5%) as supraventricular tachycardias or sinus bradycardia (SVT/SB) and 186 (8.