Non-alcoholic fatty liver disease (NAFLD) constitutes a major health problem worldwide and intimately links with obesity and diabetes. This study aimed to explore the therapeutic impact of early treatment with metformin (MTF) alone or in combination with Lactobacillus reuteri DSM 17938 (L. reuteri) + metronidazole (MTZ) in male Sprague Dawley rats with high-fat diet (HFD)-induced NAFLD. Hepatic steatosis was induced by feeding rats HFD for 6 weeks. MTF (150 mg/kg/day) or L. reuteri (2 × 109 colony forming unit/day) were given orally for 4 weeks; meanwhile, MTZ (15 mg/kg/day, p.o.) was administered for 1 week. selleck compound Administration of L. reuteri + MTZ in combination with MTF produced a superior effect concerning insulin resistance (IR), lipid profile, liver function, oxidative stress, inflammatory and autophagic markers than using each treatment alone. Besides, this combination resulted in disappearance of steatosis, inflammation and vacuolation within hepatic architecture. Moreover, it normalized short chain fatty acids (SCFAs) as well as Firmicutes and Bacteroidetes faecal contents. In conclusion, early treatment with L. reuteri + MTZ in combination with MTF could prevent NAFLD progression and liver injury through targeting gut dysbiosis, inflammation and autophagic pathways. Professionalism has been given different definitions over time. These are, commonly theoretical and difficult to operationalize. This study aimed to provide an operational definition of the concept of professionalism in occupational therapy. Based on a concept analysis design, a meta-narrative review was conducted to extract information from 30 occupational therapy manuscripts. Professionalism is a complex competence defined by the manifestation of distinct attitudes and behaviours that support excellence in the occupational therapy practice. In addition, professionalism is forged and evolves according to personal and environmental characteristics. The manifestation of professionalism can lead to positive consequences for occupational therapists, clients, and the discipline, notably contributing to a positive and strong professional identity. Moreover, professionalism is also subject to cultural influences, which leads to variations in its development, manifestations, and consequences. This study offers a contemporary operational definition of professionalism and levers to promote its development and maintenance.This study offers a contemporary operational definition of professionalism and levers to promote its development and maintenance. Velopharyngeal insufficiency (VPI) is a common speech disorder in patients with a history of cleft palate (CP) or 22q11.2 deletion syndrome. Pharyngeal flap (PF) and sphincter pharyngoplasty (SP) are 2 common surgeries to treat this disorder by decreasing unwanted nasal air emission and hypernasal resonance. Because Eustachian tube dysfunction (ETD) in patients with CP may be more frequent after surgery for VPI, we examined whether ETD was associated with either type of surgery. Retrospective cohort study. Children's hospital-based tertiary referral center. A total of 225 children with VPI who underwent primary PF (201) or SP (24) between 2006 and 2017. We examined differences in risk of ETD according to both surgical groups and proxies for postoperative nasal obstruction. These proxies included postoperative resonance measures and development of obstructive sleep apnea (OSA). Both surgical groups had similar preoperative measures, except the PF group had higher hypernasality by PSA. Postoperatively, the PF group demonstrated lower hypernasal resonance by nasometry and PSA. There were no differences between PF and SP groups with regard to ETD. Proxies for postoperative nasal obstruction also were not predictive of postoperative ETD. Degree of CP and younger age were found to be risk factors for ETD. There was no significant difference in the effects of PF and SP on ETD in this study. Neither lower hypernasality nor incidence of OSA had any impact on ETD. Degree of CP and younger age were the only significant risk factors for ETD that this study identified.There was no significant difference in the effects of PF and SP on ETD in this study. Neither lower hypernasality nor incidence of OSA had any impact on ETD. Degree of CP and younger age were the only significant risk factors for ETD that this study identified. Change agents' actions have been studied mainly from a theoretical perspective. This study aimed to empirically identify occupational therapists' actual change agent actions. As part of a research partnership with the Canadian Association of Occupational Therapists-Québec chapter, we conducted this cross-sectional pilot study using an online survey. The change agent practices of our 103 participants involve many types of actions but show underinvestment in mass communication. Mass communication actions are more frequent when participants have greater experience, additional academic degrees, and training in change agency. Also, occupational therapists with additional academic degrees and change agency training tend to use a wider variety of actions. Finally, our participants' actions principally target actors in the clinical context, rarely political actors. Our results suggest that occupational therapists can and will invest in the full range of change agent actions provided they can acquire the necessary knowledge and skills.Our results suggest that occupational therapists can and will invest in the full range of change agent actions provided they can acquire the necessary knowledge and skills.Stay at home orders-intended to reduce the spread of COVID-19 by limiting social contact-have forced people to remain in their homes. The additional stressors created by the need to stay home and socially isolate may act as triggers to intimate partner violence (IPV). In this article, we present data from a recent online cross-sectional survey with gay, bisexual and other men who have sex with men (GBMSM) in the United States to illustrate changes in IPV risks that have occurred during the U.S. COVID-19 epidemic. The Love and Sex in the Time of COVID-19 survey was conducted online from April to May 2020. GBMSM were recruited through paid banner advertisements featured on social networking platforms, recruiting a sample size of 696 GBMSM. Analysis considers changes in victimization and perpetration of IPV during the 3 months prior to the survey (March-May 2020) that represents the first 3 months of lockdown during the COVID-19 epidemic. During the period March-May 2020, 12.6% of participants reported experiencing any IPV with higher rates of emotional IPV (10.