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Collects eleven stories featuring the stars of Nickelodeon, including Sanjay and Craig, Pig, Boat, Banana, and Cricket, and Fee and Foo.

This study investigates the impact of the Flipped Classroom Model (FCM) on university students’ learning achievement, self-directed learning skills (SLS), and course interaction within the context of live online classes (LOC). Employing a 14-week quasi-experimental design, the research involved an experimental group (n = 34) exposed to the FCM and a control group (n = 25) taught through traditional methods. Pre-tests indicated that the groups were not statistically different at baseline. Post-intervention analyses revealed no statistically significant differences between the groups in terms of immediate learning achievement or course interaction. However, results from a delayed post-test indicated that students in the experimental group demonstrated significantly higher retention of learning content compared to their counterparts. No significant improvements were observed in self-directed learning skills, suggesting that the FCM, as implemented, may not effectively foster such competencies across all learners. Furthermore, the model did not significantly enhance student interaction in the online classroom environment. These findings suggest that while the FCM may support long-term retention, its overall impact on achievement, interaction, and the development of SLS in LOC settings is limited and may be moderated by students’ existing self-regulatory capacities.

Autoimmune myasthenia gravis (MG) is a neuromuscular junction disorder marked clinically by fatigable muscle weakness and serologically by the presence of autoantibodies against acetylcholine receptors (AChRs), muscle-specific kinase (MuSK), or lipoprotein-related protein 4 (LPR4). Over the past few decades, the mortality of patients with MG has seen a dramatic decline secondary to evolving interventions in critical care and medical management. In the past 2 to 3 years, there have been several changes in standard of care for the treatment of MG. These changes include confirmation of the benefit of thymectomy versus medical management alone in AChR patients and a new US Food and Drug Administration-approved medication for refractory MG. There are also several exciting new prospective drugs in the pipeline, which are in different stages of clinical trial testing.

Ciltacabtagene autoleucel (cilta-cel), a BCMA-directed CAR-T therapy, is approved for relapsed/refractory multiple myeloma (RRMM). Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are common, but reversible cerebral vasoconstriction syndrome (RCVS) is a previously unreported complication following cilta-cel. A 63-year-old female with RRMM (IgA lambda, t(14;16)), no vascular risk factors, received cilta-cel after two prior therapies, including autologous transplantation. On day +10 post-CAR-T infusion, she developed grade 1 CRS, managed with tocilizumab and vasopressors, including midodrine. On day +19, she presented with headache, leg weakness, and loss of fine motor skills. Neuroimaging showed multifocal cerebral stenosis and ischemic strokes, initially suggesting vasculitis. Subsequent imaging confirmed RCVS (RCVS2 score 9). Treatment with corticosteroids, anakinra, siltuximab, cyclophosphamide, verapamil, and nimodipine failed to halt neurological decline, resulting in right-sided hemiplegia and Gerstmann’s and Balint’s syndromes. By day +69, CT angiography showed resolved stenosis, but neurological deficits persisted. This case identifies RCVS as a novel, life-threatening complication following cilta-cel, possibly linked to CRS, tocilizumab, or midodrine. It underscores the need for broader differential diagnoses and tailored management for CAR-T neurotoxicities, warranting further research.

Omental infarcts are a rare cause of acute abdominal pain where the vascular supply to the omentum is disrupted by primary or secondary causes. Nurse practitioners should be aware of omental infarct symptoms, related diagnostic testing and how it can be managed. Acute abdominal pain has many differential diagnoses, and omental infarct is often not considered. This clinical case report will highlight the presentation, diagnosis, treatment, and outcome of a patient who developed an omental infarct.

Simulation-based learning (SBL) offers an extensive variety of chances to practice complex computer and networking skills in higher education and to implement diverse kinds of platforms to facilitate effective learning. Utilizing visualization and computer network simulation tools in teaching computer networking courses has been found to be useful for both teachers and learners. However, little effort has been made to assess the status of this research area and investigate the factors that influence students’ perceptions and intentions to use simulation-based learning. Therefore, this study performed a Systemic Literature Review (SLR) to analyze studies of simulation-based learning and utilized a factor derivation method to recognize and categorize the factors derived from students’ perceptions of simulation tools in education. Moreover, this study conducted bibliometric techniques to investigate SBL by analyzing scientific publications, the geographical distribution of articles, the co-occurrence of authors’ keywords, and the Cite score per year for each article. The study considered Scopus-indexed SBL articles published between 2012 and April 2023. VOSviewer software and PRISMA protocol were employed for bibliometric descriptive analysis and data analysis. The results obtained from the SLR indicate that Cisco Packet Tracer is the most commonly used tool in simulation-based learning for teaching computer networks. Furthermore, the results demonstrate that perceived ease of use, perceived usefulness, and behavioral intention, are among the most indicated factors from the review which influence students’ perception of simulation-based learning tools. The bibliometric analysis revealed that the USA is the leading country in SBL. Additionally, simulation-based learning was the most frequently used keyword in the abstract, keywords, and literature. This study provides the theoretical groundwork for forthcoming empirical studies and helps to understand the advantages of using simulation-based learning tools in teaching and learning.

This case study of colleges (n=13) in the South West of England explores the experiences and perceptions of senior leadership (n=8), heads of computing departments (n=10), and lecturers (n=14) in relation to the teaching of digital skills related courses at level 3. Existing literature reveals that there is a 'digital skills gap', with colleges identified as key in addressing this issue. However, they are suffering from a multitude of challenges and have historically been neglected politically and in research. Furthermore, the breadth of level 3 'digital skills' qualifications available only exacerbates the issue of identifying what is good practice in this complex and ever-changing environment. Through conducting semi-structured interviews, this thesis presents the voices from those on the 'front line' of digital skills delivery and provides key contributions to knowledge and implications for practice. First, this thesis addresses a key knowledge gap in how curriculum decisions are made, both regarding who makes this decision, and what curricula decisions are based upon. From these findings, a model of curriculum choice has been established which educational institutions can use to ensure curriculum decisions are made more systematically. Second, this thesis augments current literature which has typically focused on schools with regards to the challenges that influence the teaching of digital skills courses, but within a college setting. Thirdly, this thesis outlines what practices are being employed to overcome the challenges identified, which include the three main areas of working together, pedagogical approaches, and knowledge development, with the latter culminating in the creation of a continuing professional development framework. These findings should serve useful for practitioners in learning what practices are effective so they can adopt them into their own practice, while policy makers could utilise these findings to aid the formulation of future policy initiatives regarding the further education sector. Additionally, these findings are of particular significance to organisations involved in the advancement of college education or computing education such as the Association of Colleges, the National Centre for Computing Education, the Institute of Coding, and the British Computer Society.

Fatigue is one of the most disabling symptoms reported by people with multiple sclerosis. Although behavioural and pharmacological interventions might be partly beneficial, their combined effects have not been evaluated for multiple sclerosis fatigue, or examined with sufficient consideration of characteristics that might affect treatment response. In this comparative effectiveness research trial, we compared the effectiveness of cognitive behavioural therapy (CBT), modafinil, and their combination for treating multiple sclerosis fatigue. This randomised, analyst-blinded, parallel-arm, comparative effectiveness trial was done at two universities in the USA. Adults (aged ≥18 years) with multiple sclerosis and problematic fatigue (Fatigue Severity Scale [FSS] score ≥4) were randomly assigned (1:1:1), using a web-based treatment assignment system with minimisation, to receive CBT, modafinil, or both for 12 weeks. Statisticians were masked to group assignment, but participants, study neurologists, CBT interventionalists, and coordinators were not masked to treatment assignment. The primary outcome was the change in Modified Fatigue Impact Scale (MFIS) from baseline to 12 weeks, assessed using multiple linear regression, adjusted for age, sex, study site, anxiety, pain, baselines MFIS score, and physical activity. Analyses were done by intent to treat. The trial was registered with clinicaltrials.gov, NCT03621761, and is completed. Between Nov 15, 2018, and June 2, 2021, 336 participants were randomly assigned treatment (114 assigned to CBT, 114 assigned to modafinil, and 108 assigned to combination therapy). At 12 weeks, CBT (n=103), modafinil (n=107), and combination therapy (n=102) were associated with clinically meaningful within-group MFIS reductions of 15·20 (SD 11·90), 16·90 (15·90), and 17·30 (16·20) points, respectively. Change in MFIS scores from baseline to 12 weeks did not differ between groups: relative to combination therapy, the adjusted total mean difference in MFIS change score was 1·88 (95% CI –2·21 to 5·96) for CBT and 1·20 (–2·83 to 5·23) for modafinil. Most common adverse events for modafinil-containing treatment groups included insomnia (eight [7%] for modafinil and eight [7%] for combination therapy) and anxiety (three [3%] for modafinil and nine [8%] for combination therapy). Modafinil, CBT, and combination therapy were associated with similar reductions in the effects of multiple sclerosis fatigue at 12 weeks. Combination therapy was not associated with augmented improvement compared with the individual interventions. Further research is needed to determine whether effects of these interventions on multiple sclerosis-related fatigue is influenced by sleep hygiene and sleepiness. No serious adverse events related to the study drug were encountered. Patient-Centered Outcomes Research Institute and National Multiple Sclerosis Society.

At both the national and state level, school leadership turnover is at an alarmingly high rate. The role of a Catholic school principal as a spiritual, educational, and managerial leader has led to an ever-increasing workload that has been attributed to increased turnover. This qualitative study examined the factors contributing to principal retention in the Archdiocese of Los Angeles. Exploring the factors that contribute to long-term tenure in a principal position has the potential to influence the way the Archdiocese supports principals moving forward, thus contributing to greater sustainability for Catholic schools as a whole. Data was collected through in-depth interviews from 11 lay school leaders in low-income communities who have served at least 5 years in their position as elementary Catholic school principals. The findings articulate factors contributing to principal retention as well as recommendations for effective systems of support.

The title \"Exodus alludes to a restricted exclave encircled by a forbidding wall -- effect, a prison on the scale of a metropolis, and one in which people sought refuge voluntarily. Over the past forty years, similar walls have grown in the city of Belfast in an increasing effort to divide its Catholic and Protestant populations. Although the troubles have subsided, the walls continue to grow creating interface zones along their edges, where civic infrastructure becomes abandoned and left to ruin. Such zones become the stage for a new urban culture invigorated by invention and subversion, each with an objective of territorial gain through a type of architectural warfare that stakes its claim on the conterminous ruins along its edge. The result is manifested in adaptive architectural typologies that reinforce the edge condition of the wall through the re-appropriation of critical infrastructure, forced to confront its intersection with barrier lines.