The Experiences of Students in the Modular and Online Learning: A Phenomenological Study

This study aimed to determine the specific experiences of university students in terms of cognitive, social, emotional, and adversity skills in an online or modular mode of learning. The study utilized a phenomenology research design, and a semi-structured interview was conducted. Participants in the study were composed of students enrolled in online and modular learning who were asked to share their experiences elaborately. The analysis revealed that despite the differences in the learning modalities, the students similarly experienced the same significant adjustments and academic challenges. These experiences include the lack or limited access to information, concerns about the accessibility of the learning opportunities, lack of economic resources, time management concerns, communication with professors and classmates, and self-motivation and coping mechanisms. As an intended outcome, a feasible distance learning blueprint composed of possible courses of action that can be taken to achieve a more effective and feasible distance learning setup is made

Changes in intracellular folate metabolism during high-dose methotrexate and Leucovorin rescue therapy in children with acute lymphoblastic leukemia

Background Methotrexate (MTX) is an important anti-folate agent in pediatric acute lymphoblastic leukemia (ALL) treatment. Folinic acid rescue therapy (Leucovorin) is administered after MTX to reduce toxicity. Previous studies hypothesized that Leucovorin could ‘rescue’ both normal healthy cells and leukemic blasts from cell death. We assessed whether Leucovorin is able to restore red blood cell folate levels after MTX. Methods We prospectively determined erythrocyte folate levels (5-methyltetrahydrofolate (THF) and non-methyl THF) and serum folate levels in 67 children with ALL before start (T0) and after stop (T1) of HD-MTX and Leucovorin courses. Results Erythrocyte folate levels increased between T0 and T1 (mean ± SD: 416.7 ± 145.5 nmol/L and 641.2 ± 196.3 nmol/L respectively, pT genotype. Conclusion Intracellular folate levels accumulate after HD-MTX and Leucovorin therapy in children with ALL, suggesting that Leucovorin restores the intracellular folate pool. Future studies are necessary to assess concomitant lower uptake of MTX

Associations of early changes in lung ultrasound aeration scores and mortality in invasively ventilated patients: a post hoc analysis

Background: Lung ultrasound (LUS) in an emerging technique used in the intensive care unit (ICU). The derivative LUS aeration score has been shown to have associations with mortality in invasively ventilated patients. This study assessed the predictive value of baseline and early changes in LUS aeration scores in critically ill invasively ventilated patients with and without ARDS (Acute Respiratory Distress Syndrome) on 30- and 90-day mortality. Methods: This is a post hoc analysis of a multicenter prospective observational cohort study, which included patients admitted to the ICU with an expected duration of ventilation for at least 24 h. We restricted participation to patients who underwent a 12-region LUS exam at baseline and had the primary endpoint (30-day mortality) available. Logistic regression was used to analyze the primary and secondary endpoints. The analysis was performed for the complete patient cohort and for predefined subgroups (ARDS and no ARDS). Results: A total of 442 patients were included, of whom 245 had a second LUS exam. The baseline LUS aeration score was not associated with mortality (1.02 (95% CI: 0.99 – 1.06), p = 0.143). This finding was not different in patients with and in patients without ARDS. Early deterioration of the LUS score was associated with mortality (2.09 (95% CI: 1.01 – 4.3), p = 0.046) in patients without ARDS, but not in patients with ARDS or in the complete patient cohort. Conclusion: In this cohort of critically ill invasively ventilated patients, the baseline LUS aeration score was not associated with 30- and 90-day mortality. An early change in the LUS aeration score was associated with mortality, but only in patients without ARDS. Trial registration: ClinicalTrials.gov, ID NCT04482621

Origin and mechanisms of high salinity in Hombolo Dam and groundwater in Dodoma municipality Tanzania, revealed

This research article published Springer Nature Switzerland AG.,2017The Hombolo dam (HD), in central Tanzania, is a shallow reservoir characterized by high salinity that limits its use for human activities. The origin of the salinity, mechanisms of reaching and concentrating in the dam remain unclear. These were assessed using hydrogeochemical facies, water type evolutions and mapping. The source of HD salinity was identified to be shallow groundwater (SG) and runoff from a seasonal floodplain with NaCl-rich lithological materails, along Little Kinyasungwe River that feeds the dam. The NaCl-rich lithological units, about 5–7 km upstream of the dam, were highly concentrated with NaCl to the extent that the local community was commercially separating table salt from them. The physicochemical parameters from these NaCl-rich lithological materials were well represented in HD and nearby groundwater sources, which suggests active water interactions. Water type evolution and surface hydrology assessments clearly showed that SG in the salty-floodplain was influenced by evaporation (ET) and was periodically carried to the HD. Clearly; HD water had high chemical similarity with the nearby SG. This agrees with previous studies that HD is partly fed by the local aquifer. However, this is the first attempt at mapping its physical origin. The origin of HD salinity was further supported by the spatial distribution of electrical conductivity (EC), where very high EC (up to 21,230 μScm−1) was recorded in SG within the NaCl-rich lithological unit while water sources far away from the NaCl-rich materials had much lower EC values. Thus, the study disagrees with previous conclusions that HD salinity was sorely due to high dam surface ET but is primarily due to geological reasons. Comparisons of HD with a nearby Matumbulu dam (MD), another earthen dam in climatologically similar settings, reveals that MD water was less saline/mineralised. This further shows that HD high salinity is most likely a geologic phenomenon, but local climatic factors, namely high ET, decreasing rainfall and warming trends are likely to have concentrated the salts further. Although HD is widely/ideally used for grape vine irrigation, it was clearly revealed that its prolonged usage would potentially affect the soil and grape productivity due to high salinity

Applications of Lagrangian Dispersion Modeling to the Analysis of Changes in the Specific Absorption of Elemental Carbon

We use a Lagrangian dispersion model driven by a mesoscale model with four-dimensional data assimilation to simulate the dispersion of elemental carbon (EC) over a region encompassing Mexico City and its surroundings, the study domain for the 2006 MAX-MEX experiment, which was a component of the MILAGRO campaign. The results are used to identify periods when biomass burning was likely to have had a significant impact on the concentrations of elemental carbon at two sites, T1 and T2, downwind of the city, and when emissions from the Mexico City Metropolitan Area (MCMA) were likely to have been more important. They are also used to estimate the median ages of EC affecting the specific absorption of light, aABS, at 870 nm as well as to identify periods when the urban plume from the MCMA was likely to have been advected over T1 and T2. Values of aABS at T1, the nearer of the two sites to Mexico City, were smaller at night and increased rapidly after mid-morning, peaking in the mid-afternoon. The behavior is attributed to the coating of aerosols with substances such as sulfate or organic carbon during daylight hours, but such coating appears to be limited or absent at night. Evidence for this is provided by scanning electron microscope images of aerosols collected at three sampling sites. During daylight hours the values of aABS did not increase with aerosol age for median ages in the range of 1-4 hours. There is some evidence for absorption increasing as aerosols were advected from T1 to T2 but the statistical significance of that result is not strong

t(2;11)(q33;q23) KMT2A/ABI2

Review on t(2;11)(q33;q23) with the gene fusion KMT2A/ABI

Clinical and Molecular Characteristics and Outcome of Cystic Partially Differentiated Nephroblastoma and Cystic Nephroma: A Narrative Review of the Literature

In children presenting with a predominantly cystic renal tumor, the most likely diagnoses include cystic partially differentiated nephroblastoma (CPDN) and cystic nephroma (CN). Both entities are rare and limited information on the clinical and molecular characteristics, treatment, and outcome is available since large cohort studies are lacking. We performed an extensive literature review, in which we identified 113 CPDN and 167 CN. The median age at presentation for CPDN and CN was 12 months (range: 3 weeks–4 years) and 16 months (prenatal diagnosis–16 years), respectively. No patients presented with metastatic disease. Bilateral disease occurred in both entities. Surgery was the main treatment for both. Two/113 CPDN patients and 26/167 CN patients had previous, concomitant, or subsequent other tumors. Unlike CPDN, CN was strongly associated with somatic (n = 27/29) and germline (n = 12/12) DICER1-mutations. Four CPDN patients and one CN patient relapsed. Death was reported in six/103 patients with CPDN and six/118 CN patients, none directly due to disease. In conclusion, children with CPDN and CN are young, do not present with metastases, and have an excellent outcome. Awareness of concomitant or subsequent tumors and genetic testing is important. International registration of cystic renal tumor cohorts is required to enable a better understanding of clinical and genetic characteristics

Fractures, Bone Mineral Density, and Final Height in Craniopharyngioma Patients with a Follow-up of 16 Years

CONTEXT: Pituitary hormonal deficiencies in patients with craniopharyngioma may impair their bone health. OBJECTIVE: To investigate bone health in patients with craniopharyngioma. DESIGN: Retrospective cross-sectional study. SETTING: Dutch and Swedish referral centers. PATIENTS: Patients with craniopharyngioma (n = 177) with available data on bone health after a median follow-up of 16 years (range, 1-62) were included (106 [60%] Dutch, 93 [53%] male, 84 [48%] childhood-onset disease). MAIN OUTCOME MEASURES: Fractures, dual X-ray absorptiometry-derived bone mineral density (BMD), and final height were evaluated. Low BMD was defined as T- or Z-score ≤-1 and very low BMD as ≤-2.5 or ≤-2.0, respectively. RESULTS: Fractures occurred in 31 patients (18%) and were more frequent in men than in women (26% vs. 8%, P = .002). Mean BMD was normal (Z-score total body 0.1 [range, -4.1 to 3.5]) but T- or Z-score ≤-1 occurred in 47 (50%) patients and T-score ≤-2.5 or Z-score ≤-2.0 in 22 (24%) patients. Men received less often treatment for low BMD than women (7% vs. 18%, P = .02). Female sex (OR 0.3, P = .004) and surgery (odds ratio [OR], 0.2; P = .01) were both independent protective factors for fractures, whereas antiepileptic medication was a risk factor (OR, 3.6; P = .03), whereas T-score ≤-2.5 or Z-score ≤-2.0 was not (OR, 2.1; P = .21). Mean final height was normal and did not differ between men and women, or adulthood and childhood-onset patients. CONCLUSIONS: Men with craniopharyngioma are at higher risk than women for fractures. In patients with craniopharyngioma, a very low BMD (T-score ≤-2.5 or Z-score ≤-2.0) seems not to be a good predictor for fracture risk