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Evaluating the particular Virtual Social Networks Usage amid Nursing Students: Any Cross-Sectional Detailed Study.
Lastly, we will review the potential toxicities of combined therapy and future directions of their role in the management of HNSCC.Current anatomic TNM stage classification fails to capture the immune heterogeneity of oral squamous cell carcinoma (OSCC). Increasing evidence indicates the strong association between epithelial-mesenchymal transition (EMT) and tumor immune response. Selleck Naphazoline In this study, we employed an EMT signature to classify OSCC patients into epithelial- (E-) and mesenchymal- (M-) phenotypes using TCGA and GSE41613 transcriptome data. The ESTIMATE and CIRBERSORT analyses implied that the EMT signature genes originated from the stroma of the bulk tissue. The M-subtype tumors were characterized as "immune-hot" with more immune cell infiltration than the E-subtype ones. The low infiltration of active immune cells, the high infiltration of inactive immune cells, and the high expressions of immune checkpoints demonstrated an immunosuppressive characteristic of the M-subtype tumors. Moreover, we developed and validated a novel prognostic classifier based on the EMT score, the expressions of seven immune checkpoints, and the TNM stages, which could improve the prediction efficiency of the current clinical parameter. Together, our findings provide a better understanding of the tumor immune heterogeneity and may aid guiding immunotherapy in OSCC.
Treatment of multiple brain metastases with single-isocenter volumetric modulated arc therapy causes unnecessary exposure to normal brain tissue. In this study, a longitudinal grouping method was developed to reduce such unnecessary exposure.

This method has two main aspects grouping brain lesions longitudinally according to their longitudinal projection positions in beam's eye view, and rotating the collimator to 90° to make the multiple leaf collimator leaves conform to the targets longitudinally group by group. For 11 patients with multiple (5-30) brain metastases, two single-isocenter volumetric modulated arc therapy plans were generated using a longitudinal grouping strategy (LGS) and the conventional strategy (CVS). The prescription dose was 52Gy for 13 fractions. Dose normalization to 100% of the prescription dose in 95% of the planning target volume was adopted. For plan quality comparison, Paddick conformity and the gradient index of the planning target volume, and the mean dose, the V
, V
, V
, and V
volumes of normal brain tissue were calculated.

There were no significant differences between the LGS and CVS plans in Paddick conformity (p= 0.374) and the gradient index (p= 0.182) of the combined planning target volumes or for V
(p= 0.266) and V
(p= 0.155) of the normal brain. However, the V
and V
of the normal brain which represented the low-dose region were significantly reduced in the LGS plans (p= 0.004 and p= 0.003, respectively). Consistently, the mean dose of the entire normal brain was 12.04 and 11.17 Gy in the CVS and LGS plans, respectively, a significant reduction in the LGS plans (p= 0.003).

The longitudinal grouping method can decrease unnecessary exposure and reduces the low-dose range in normal brain tissue.
The longitudinal grouping method can decrease unnecessary exposure and reduces the low-dose range in normal brain tissue.The coronavirus pandemic protracted disruption of in-person schooling, sports and other activities leading to obesity that could have long-lasting impact on children's health. As a result, education has changed dramatically, with the distinctive rise of E-learning. Children are snacking more, exercising less. Their increased screen time, sedentary life style and inadequate sleep anticipated weight gain during Lockdown that could lead to complications. To study the impact of the COVID-19 lockdown on increased weight gain in children. A cross-sectional study was conducted from March to May 2021 at tertiary care hospital, Thandalam among 2000 children between the age of 3-15 years on weight gain during COVID-19 Lockdown. A questionnaire requesting demographic and Anthropometric details was circulated. BMI percentiles were calculated, totalled and compared between pre-school closing and school closing period. Paired t-test was done. p value  less then  0.05 was considered statistically significant. Out of 2000 children, 308 were excluded. Male preponderance was noted. Age range was between 3 and 15 years with mean age being 8.5 years. Study revealed significant differences in variables such as body weight, body mass index before and after lockdown. Post-lockdown, the mean body mass index (BMI) increased among all participants from 17.32 to 17.80 kg/m2 (p  less then  0.001). Obesity definitely has a proportional impact on the children's Quality of Life (QOL). It is important to address childhood obesity, which if neglected may lead to long-term profound complications of higher eminence than the actual COVID-19 infection. The prevention and management of childhood obesity should be set as a priority at an individual, community and population level during this pandemic.The rapid emergence of COVID-19 has led to increase in the number of patients requiring prolonged ventilation and tracheostomy. Though global guidelines are evolving, there is a paucity of literature about optimal timing and outcome after tracheostomy in COVID-19 patients. We set out to assess the clinical characteristics and outcome of COVID-19 patients who underwent tracheostomy.This single-center, prospective observational cohort study analyzed all the consecutive tracheostomy performed on COVID-19 patients from April 1 2020 to January 31, 2021. The primary outcome measure was the 30-day mortality rate following tracheostomy and association with various prognostic risk factors. The secondary outcome measures included various tracheostomy-related events, perioperative complications, and decannulation rate.The study included 51 patients with a median age of 52 years and the majority were male (62.74%). 62.74% (32 of 51) tracheostomies were done early (within 10 days of intubation) and the mean duration from endotracheal intubation to tracheostomy was 10.27 days. The 30-day mortality rate was 66.66% (34 of 51) with no tracheostomy-related mortality and the mean duration between tracheostomy and death was 8.29 days. The presence of sepsis was associated with a higher rate of mortality (p = 0.002) while the timing of tracheostomy was not related to increased mortality (p = 0.365). The most common perioperative complication was tracheostoma bleeding (16.64%). At a median follow-up of 7.5 months, only four patients were decannulated.Though associated with a higher rate of 30-day mortality rate, tracheostomy among COVID-19 patients is a safe and an effective weaning tool.To evaluate the hearing status of COVID-19 patients and compare with control group. Prospective study carried out in 9 institutes. The pure tone audiogram and impedance audiometry of COVID-19 patients performed initially and at 3 months follow up. The control group consisted COVID-19 negative individuals with no history of ear related diseases. The average of air and bone conduction threshold (AC and BC) were compared between the COVID-19 patients and control group using independent t-test with a p value of less than 0.05 considered significant. Total of 331 patients, age 32 ± 4.3 years, 66.7% males and 33.3% females were included in the study. There were 80 individuals in the control group. Aural symptoms were, tinnitus in 1.8%, aural fullness in 1.4%, hearing loss in 3. 9%, and ear ache in 1.8% were present initially, resolved at 3 months follow up. The impedance audiometry demonstrated type B and type C curve in 5.1% and 1.15% ears, and out of these 64.7% and 40% improved at 3 months follow up respectively. No significant difference observed between the average AC and BC of the COVID-19 patients and control group. The COVID-19 infection may present with aural symptoms; however, it was concluded that there was no significant difference in the hearing status of the COVID-19 positive patients in comparison to the control group. The presence of some changes in the normal functioning of the eustachian tube and middle ear in the COVID-19 infection was also highlighted.There is no routinely determined treatment for olfactory dysfunction because of COVID-19. Saline irrigation and nasal corticosteroid treatments are safe and inexpensive methods, and have low side effects. In our study, we argue that saline nasal irrigation and topical corticosteroid treatment can be used in the treatment of patients with olfactory loss in all areas of rhinology. A total of 150 patients who admitted to our clinic with other symptoms or with only acute odor loss, diagnosed with COVID-19 with RT-PCR were divided into 3 equal groups.Fifty patients in Group 1 were not given any extra treatments. The other 50 patients in Group 2 were given saline irrigation for treatment; and the 50 people in Group 3 were given both saline irrigation and nasal steroid spray for treatment. The "Subjective Olfactory Capability (SOC)" was used for olfactory function evaluation of patients. Self-Rating Olfactory Score (SROS), and Olfactory Dysfunction Duration (ODD) were recorded on the 1st, 15th and 30th days. SROS of the group receiving Nasal Saline + Triamcinolone Acetonide treatment on the 30th day was significantly higher than in other groups ( p -1-3  = 0.018, p 2-3 = 0.033). Also, the ODD was significantly reduced in this group compared to other groups ( p -1-3 = 0.022, p 2-3 = 0.028,). link2 Topical triamcinolone treatment was found to be successful in the treatment of olfactory dysfunction due to COVID-19. Nasal steroids, which are both inexpensive and have low side effect profiles, can be used safely in the treatment of patients with olfactory losses.The coronavirus disease of 2019 is a global pandemic disease severely affecting the upper respiratory tract that can be fatal in some instances. The virus most commonly affects the respiratory system. However, in certain cases it affects the other systems, including cardiovascular, renal, gastrointestinal, neurological, and auditory. link3 Concerning the hearing and balance system, the microcirculation supply to the inner ear is hampered thus causing audiovestibular symptoms. Several case studies have reported sudden sensorineural hearing loss post-coronavirus disease and its detrimental impact on overall hearing. As both sudden sensorineural hearing loss and coronavirus disease deals with an emergency situation, there is a need to document case studies on how these individuals have been assessed and treated. The article has systematically reviewed these case reports involving a search strategy in databases like PubMed, PubMed Central, science direct, J-GATE, Google Scholar, and a manual Google Search.
Incivility in the workplace drowns the mental health of the nurses and hampers the daily routine. The majority of the nurses working at hospitals were experiencing incivility. It affects the physical and psychological health of the nurses. Experience of workplace incivility and its impact on stress and turnover among nurses was discussed in this study.

Cross-sectional survey approach was used to select 50 nurses by simple random sampling technique. Standard scales for incivility, stress, and pre-tested scale for the turnover intention was used to collect the data.

Nurses experience incivility in their workplace almost from all the sources. The majority (64%) of the staff nurses had a moderate level of stress and 30% had average intention to leave the present job. There was a positive relationship found between the experience of incivility and stress (
= 0.43,
< 0.002), stress, and turnover intention (
= 0.40,
< 0.004).

Experience of incivility provokes stress among the nurses, and this may influence turnover intention.
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