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therapy added to chemoradiotherapy must be discussed in multidisciplinary consultation meeting because it significantly improved recurrence-free survival and overall survival, as compared with chemoradiotherapy alone.

Volumetric modulated arctherapy technique with concurrent chemoradiotherapy is an effective treatment for nasopharyngeal carcinoma with excellent overall and locoregional control without severe toxicity. Distant metastasis is the major site of failure, so induction chemotherapy added to chemoradiotherapy must be discussed in multidisciplinary consultation meeting because it significantly improved recurrence-free survival and overall survival, as compared with chemoradiotherapy alone.Only 13.1% of US registered dietitian nutritionists and 27.8% of students enrolled in US dietetics education programs identify as racially/ethnically diverse individuals. National demographic trends show increasing percentages of racially/ethnically diverse individuals within the broader US and college student populations; however, these changes have not been mirrored within dietetics. Dietetics educators have an ethical and professional mandate to address diversity, equity, and inclusion within their programs. This paper reviews key terminology related to diversity, equity, and inclusion in the context of dietetics education, and describes a new framework to transform dietetics education based on the principles of cultural humility and culturally sustaining teaching. Strategies are presented to facilitate recruitment, admissions, retention, and mentorship for racially/ethnically diverse students and faculty, and to improve diversity, equity, and inclusion within curricula and classrooms. Lastly, this paper provides clear practice applications, including recommendations for program policy change and training/skill building activities for dietetics students, educators, and preceptors.Proline is a multifunctional amino acid that is accumulated in high concentrations in plants under various stress conditions. GSK-3 beta pathway Proline accumulation is intimately connected to many cellular processes, such as osmotic pressure, energy status, nutrient availability, changes in redox balance, and defenses against pathogens. Proline biosynthesis and catabolism is linked to photosynthesis and mitochondrial respiration, respectively. Proline can function as a signal, modulating gene expression and certain metabolic processes. We review important findings on proline metabolism and function of the last decade, giving a more informative picture about the function of this unusual amino acid in maintaining cellular homeostasis, modulating plant development, and promoting stress acclimation.Crimean-Congo hemorrhagic fever (CCHF) is a life-threatening tick-borne viral infection. The most important step in the treatment of CCHF is supportive therapy. Ribavirin is the recommended antiviral agent for infected patients. We present a case of a child who presented to our pediatric intensive care unit due to CCHF and was treated with plasmapheresis and ribavirin. A previously healthy seven-month-old male infant presented to the emergency room with a fever of 39.5 °C, nosebleed, cough, vomiting, and weakness. We decided to apply plasmapheresis treatment due to multiple organ failure associated with thrombocytopenia, acute liver failure, and a family history of death from the disease. Plasmapheresis was performed in three sessions. By the sixth day of his admission to the intensive care unit, the patient's clinical condition had improved and his laboratory values had returned to normal, so he was transferred to the infectious diseases service in stable condition.The COVID-19 pandemic resulted in multiple waves of infection worldwide. The large variations in case fatality rate among different geographical regions suggest that the human susceptibility against this virus varies substantially. Several studies from different parts of the world showed a significant association of ABO blood group and COVID-19 susceptibility. It was demonstrated that individuals with blood group O are at the lower risk of coronavirus infection. To establish the association of ABO blood group in SARS-CoV-2 susceptibility, we for the first time analysed SARS-CoV-2 neutralising antibodies among 509 individuals, collected from three major districts of Eastern Uttar Pradesh region of India. Interestingly, we found neutralising antibodies in a significantly higher percentage of people with blood group AB (0.36) followed by B (0.31), A (0.22) and lowest in people with blood group O (0.11). We further estimated that people with blood group AB are at comparatively higher risk of infection than other blood groups. Thus, among the asymptomatic SARS-CoV-2 recovered people blood group AB has highest, whilst individuals with blood group O has lowest risk of infection.

Drinking sugar-sweetened beverages is a risk factor for developing childhood obesity and nonalcoholic fatty liver disease (NAFLD). This study investigated the impact of an educational poster in pediatric offices on family's knowledge of sugar content in beverages and assessed awareness of NAFLD.

Preclinic visit surveys asked patients' caregivers about the sugar content in beverages and awareness of NAFLD. Postclinic visit surveys assessed improvement in knowledge of sugar content and willingness to change dietary habits.

Outpatient visits in a single center in Houston between September and November 2019.

One hundred and forty-nine caregivers were surveyed, and patients' median age was 5.5 years (range, 0-18 years) with 57% males.

Educational posters displayed the sugar content of common beverages in each clinic room.

Outcomes measured included pre-post clinic visit change and predictors of change in (1) knowledge of sugar content in beverages and (2) intent to change beverage consumption. Baseline awareness of NAFLD and associated predictors were also assessed.

Logistic regression identified factors associated with an intended change in beverage consumption, change in survey score, and NAFLD awareness.

Increased knowledge of sugar content with median scores of 25% preclinic to 50% postclinic (P < 0.001). Eighty-eight percent of caregivers were very/moderately likely to provide their children fewer sugar-sweetened beverages. Sixty percent of caregivers were aware of NAFLD, but only 32.8% were concerned.

Posters in clinics increased awareness of the sugar content in beverages, and most caregivers reported intent to decrease children's sugary beverage consumption.

Posters in clinics increased awareness of the sugar content in beverages, and most caregivers reported intent to decrease children's sugary beverage consumption.Built environment interventions have the potential to improve population health and reduce health inequities. The objective of this paper is to present the first wave of the INTErventions, Research, and Action in Cities Team (INTERACT) cohort studies in Victoria, Vancouver, Saskatoon, and Montreal, Canada. We examine how our cohorts compared to Canadian census data and present summary data for our outcomes of interest (physical activity, well-being, and social connectedness). We also compare location data and activity spaces from survey data, research-grade GPS and accelerometer devices, and a smartphone app, and compile measures of proximity to select built environment interventions.

Combined use of vancomycin (VCM) and piperacillin/tazobactam (PIPC/TAZ) has been reported to increase the incidence of acute kidney injury (AKI). However, the risk factors associated with AKI after VCM and PIPC/TAZ (VPT) administration have not yet been identified. Therefore, we retrospectively assessed patients treated with VPT to investigate the risk factors for AKI development.

The study involved patients who were treated with VPT from January 1, 2016 to March 31, 2020. The patients were divided into the AKI or non-AKI group. The clinical characteristics of patients and antimicrobial therapy were compared between the groups. Their association with AKI risk was evaluated using multivariate logistic regression analysis.

In total, 182 patients were included, with 118 in the non-AKI group and 64 in the AKI group. Therefore, the incidence of AKI was 35.2%. The initiation of VPT combination therapy on the same day and concomitant use of vasopressors were associated with an increased risk of AKI (odds ratio [OR] 2.55, 95% confidential interval [CI] 1.20-5.44 and OR 3.22, 95% CI 1.31-7.89, respectively).

Our findings suggest that the concomitant use of vasopressors and initiating VPT combination therapy on the same day are likely risk factors for AKI development.

Our findings suggest that the concomitant use of vasopressors and initiating VPT combination therapy on the same day are likely risk factors for AKI development.

Challenges exist with heterotaxy due to the complexity of heart disease, abnormal venous connections, and infection risks. This study aims to understand heart transplant outcomes for children with heterotaxy.

All children with congenital heart disease listed for transplant from 1993 to 2018 were included. Those with and without heterotaxy were compared. Waitlist outcomes and survival post-listing and transplant were analyzed. Post-transplant risk factors were identified using multiphase parametric hazard modeling.

There were 4814 children listed, of whom 196 (4%) had heterotaxy. Heterotaxy candidates were older (5.8 ± 5.7 vs 4.2 ± 5.5 years, p < 0.01), listed at a lower urgency status (29.8% vs 18.4%, p < 0.01), more commonly single ventricle physiology (71.3% vs 59.2%, p < 0.01), and less often supported by mechanical ventilation (22% vs 29.1%, p < 0.05) or extracorporeal membrane oxygenation (3.6% vs 7.5%, p < 0.05). There were no differences in waitlist outcomes of transplant, death, oreedom from both infection and severe rejection after transplant in heterotaxy highlights the challenges of balancing immune suppression.

The objective of this systematic review was to explore and report the evidence and gaps in the literature for randomized controlled trials (RCTs) studying the effects of motivational interviewing (MI)-based telehealth interventions on outcomes among persons with diabetes (PWD) or prediabetes.

Following a modified Cochrane approach, we searched Pubmed, CENTRAL, CINAHL, PsycINFO, and Clinicaltrials.gov. Included studies were RCTs published in English before March 25, 2021 evaluating MI-based telehealth on outcomes for adults with diabetes or prediabetes.

A total of 21 retained articles captured results for 6436 PWD. Among the most commonly investigated outcomes, 60% of articles documented A1C reductions (ranging from<1% to>3%), 56% documented systolic blood pressure reductions, 57% documented diabetes self-efficacy/empowerment improvements, and 40% documented physical activity improvements. Conversely, diastolic blood pressure, lipid panels, body mass index, depressive symptoms, and quality of life were frequently measured outcomes, where MI-based telehealth yielded minor effects (<30% of articles demonstrating improvements).

MI-based telehealth seems most effective for improving A1C, systolic blood pressure, diabetes self-efficacy, and physical activity behaviors. Variability in outcome assessment and intervention heterogeneity were key challenges impeding comparisons across retained articles.

MI-based telehealth interventions demonstrate promising results for improving outcomes in PWD.

MI-based telehealth interventions demonstrate promising results for improving outcomes in PWD.