Because nurse aides are one of the first-line care providers in hospitals, they should possess better knowledge, attitude, and behavioral intention toward COVID-19 during the pandemic. This study aimed to compare the improvements of COVID-19-related education on learning outcomes between multimedia-based and traditional face-to-face learning models for nurse aides. The parallel-group randomized controlled trial recruited 74 participants in both the experimental and control groups. Two 90 min interventions with the same contents, but in different ways, were delivered. A structured questionnaire was used to collect data of demographic information, knowledge, attitude, and behavioral intention toward COVID-19 before and after the interventions. Results from generalized estimation equations analysis indicated that the nurse aides in the multimedia-based learning group had greater improvement in the scores of knowledge (difference in change: 3.2, standard error: 0.97, p < 0.001), attitude (difference in change: 10.2, standard error: 2.97, p < 0.001), and behavioral intention (difference in change: 0.5, standard error: 0.04, p < 0.001) than those in the face-to-face learning group. During the outbreak of COVID-19, multimedia-based learning as an effective learning method could improve the learning outcomes related to COVID-19 and achieve learning goals without close contact.

Whether adjuvant chemotherapy should be different for patients with stage II and III gastric cancer is unknown. We retrospectively analyzed the effects of adjuvant chemotherapy on the outcomes of 140 and 256 patients with stage II and III gastric cancer, respectively, between January 2008 and December 2018. Chemotherapies were stratified as fluoropyrimidine plus platinum versus fluoropyrimidine alone, tegafur/gimeracil/octeracil (S-1)-containing versus non-S-1-containing regimens, and S-1 plus cisplatin versus S-1 alone. The median age of patients was 67.0 (range 24.6-98.8) years. With a median follow-up of 105 months, recurrence occurred in 32 (22.9%) and 130 (50.8%) patients with stage II and III disease, respectively. Adjuvant chemotherapy was administered as fluoropyrimidine monotherapy to 68 (48.6%) and 73 (28.5%) patients, fluoropyrimidine plus platinum to 9 (6.4%) and 104 (40.6%) patients, and none to 63 (45.0%) and 79 (30.9%) patients with stage II and III gastric cancer, respectively. Doublet chemotherapy was associated with longer disease-free survival (DFS) (26.5 vs. 15.2 months, P = 0.001) and overall survival (OS) (41.2 vs. 22.0 months, P < 0.001) than fluoropyrimidine monotherapy for stage IIIB-IIIC disease. Furthermore, S-1-containing regimens prolonged DFS (57.4 vs. 21.9 months, P = 0.044) and OS (81.4 vs. 28.6 months, P = 0.023) compared with non-S-1-containing chemotherapy in stage III disease. Although fluoropyrimidine monotherapy is feasible for stage II-IIIA disease, doublet chemotherapy is significantly associated with longer survival than monotherapy for stage IIIB-IIIC disease. S-1-containing regimens might lead to longer survival than non-S-1-containing chemotherapy in stage III gastric cancer.