BACKGROUND: In the United States in 2019, there was an outbreak of electronic cigarette, or vaping, product use-associated lung injury (EVALI). The manifestations of EVALI in adolescents are not well characterized. We describe the diagnosis, evaluation, and management of EVALI in adolescents hospitalized at a tertiary care, university-affiliated children's hospital. METHODS:A multidisciplinary committee developed an EVALI algorithm on the basis of guidelines from the Centers for Disease Control and Prevention. A retrospective chart review was conducted on patients diagnosed with EVALI. Descriptive analyses included sociodemographic characteristics, clinical presentation, laboratory and imaging results, pulmonary function testing, oxygen requirements, and clinic follow-up.RESULTS: Thirteen hospitalized adolescents were diagnosed with confirmed or probable EVALI. The majority were female (54%) with a mean age of 15.9 years. Sixty-nine percent of patients presented with respiratory symptoms, whereas gastrointestinal symptoms were prominent in 85% of patients. Vaping D-9-tetrahydrocannabinol was reported in 92% of patients, and vaping nicotine was reported in 62% of patients. All had bilateral ground-glass opacities on the chest computed tomography (CT) scan. Treatment with glucocorticoids led to clinical improvement in 11 of 12 patients. Treatment with glucocorticoids led to improvement in both forced expiratory volume in 1 second and forced vital capacity (P , .05). Four patients required home oxygen on the basis of 6-minute walk test results.CONCLUSIONS: Diagnosis of EVALI should be suspected on the basis of vaping history and clinical presentation. Glucocorticoid treatment led to an improvement in symptoms and lung function. The 6-minute walk test may help determine oxygen needs at discharge. WHAT'S KNOWN ON THIS SUBJECT:The prevalence of electronic cigarette use has more than doubled among eighth-to 12thgraders over the past 2 years. An outbreak of electronic cigarette, or vaping, product use-associated lung injury (EVALI) linked to vaping D-9-tetrahydrocannabinol occurred this fall, and adolescents were among those affected.WHAT THIS STUDY ADDS: Many teenagers affected by EVALI were female, were Hispanic, and had multiple psychosocial stressors. Lung function deficits due to EVALI appear reversible with steroids. Six-minute walk test results may help identify adolescents who would benefit from home oxygen.

Lactobacilli are low-virulence, commensal organisms of the gastrointestinal and genitourinary tracts and are commonly used as "probiotic supplements." Herein, we describe an episode of respiratory syncytial virus (RSV) bronchiolitis with bacterial superinfection secondary to administration of Lactobacillus rhamnosus in an 11-month-old female with trisomy 21. CASE REPORT

The study investigated constructivist practices through guided discovery approach and the effect on students’ cognitive achievement in Nigerian senior secondary school Physics. The study adopted pretest-posttest control group design. A criterion sampling technique was used to select six schools out of nine schools that met the criteria. A total of 278 students took part in the study; this was made up of 141 male students and 137 female students in their respective intact classes. Physic Achievement Test (PAT) with the internal consistency of 0.77 using Kuder Richardson formula 21 was the instrument used in collecting data. The data were analysed using Analysis of Covariance (ANCOVA) and t-test. The results showed that guided discovery approaches was the most effective in facilitating students’ achievement in physics after being taught using a pictorial organizer. This was followed by demonstration while expository was found to be the least effective. Also, there exists no significant difference in the achievement of male and female physics students taught with guided discovery, demonstration and expository teaching approaches and corresponding exposure to a pictorial organizer. It is recommended that physics teachers should endeavour to use constructivist practices through guided discovery approach in order to engage students in problem solving activities, independent learning, critical thinking and understanding, and creative learning, rather than in rote learning and memorization.

This study investigated -the first year University undergraduates' experiences in the use of open educational resources (OER) in online learning and their in-course achievement. The design selected for the study was survey and quasi-experimental. A total number of 106 University undergraduates participated in the study after a preliminary study was conducted to ascertain undergraduates' perception and acceptability of OER. A structured questionnaire on 4-point Likert scale and Achievement Test were used to collect data. The two instruments were validated and trial tested to established reliability using Cronbach's alpha. Data were analysed using simple percentage and t-test. The results clearly shown that understanding of online learners' skills, acceptability, perception, and competencies is necessary to provide intervention strategy and appropriate support service which could facilitate their understanding and learning of difficult concepts. It was also discovered that that students that have positive perception of OER performed very well in the achievement test administered.