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Nodal Marginal Zone Lymphoma with Simultaneous Transformation at Diagnosis and Pleural Effusion as the Initial Presentation: A Case Report
No full textNodal Marginal Zone Lymphoma (NMZL) is a rare, indolent subtype of B-cell non-Hodgkin lymphoma. This case report presents a 67-year-old female diagnosed with NMZL, which had transformed into Diffuse Large B-cell Lymphoma (DLBCL) at the time of diagnosis. The patient’s initial presentation involved a dry cough and pleural effusion, a symptom rarely reported in NMZL cases. Diagnostic procedures, including cytology and immunohistochemistry, confirmed the presence of monoclonal B lymphocytes and identified markers consistent with NMZL transformation to DLBCL. The findings highlight the diagnostic challenges associated with NMZL due to the lack of specific immunohistochemical markers, emphasizing the need for histopathological analysis to distinguish NMZL from other lymphomas, such as follicular lymphoma. This case underscores the importance of early detection and differentiation in lymphomas presenting with pleural effusion, as transformation to aggressive forms like DLBCL significantly impacts the prognosis and treatment approaches. Despite the rarity of transformation at diagnosis, clinicians must consider it in NMZL cases with atypical presentations
Diagnostic Challenges in Lymphangioleiomyomatosis: From Ovarian Mass to Systemic Diagnosis
No full textBackground: Lymphangioleiomyomatosis (LAM) is a rare neoplastic disorder characterized by the proliferation of atypical smooth muscle-like or epithelioid cells within the lungs and axial lymphatic system. This pathological process leads to the formation of pulmonary cysts and impaired respiratory function. Although the disease primarily involves the lungs, extrapulmonary manifestations can occur in the abdominal cavity, lymphatic system, and retroperitoneum.Clinical case: A 48-year-old woman presented with abdominal numbness, leading to the discovery of a right ovarian mass. CT and MRI identified non-malignant solid mass in the ovary, as well as thin-walled cysts in the lungs, retroperitoneal pelvis, and upper abdomen, suggesting LAM. The patient was referred for pulmonology evaluation. Genetic testing and lung biopsy were inconclusive. One year later, during laparoscopic hysterectomy for early-stage uterine cancer, a biopsy of a left iliac lesion confirmed LAM. Postoperatively, the patient developed lymphocytic and chylous ascites, requiring further surgical intervention. However, the ascites recurred, and it was managed with diuretic therapy. Following the confirmed diagnosis, Sirolimus therapy was initiated. To date, the patient has not exhibited any significant respiratory symptoms, and follow-up lung imaging has shown no evidence of disease progression.Conclusions: Due to its rarity, diverse symptoms, and involvement of multiple organs, diagnosis of LAM is challenging. It requires careful clinical observation and a multidisciplinary approach. Early and accurate diagnosis, combined with timely therapeutic interventions, has the potential to significantly improve the patient outcomes in LAM
Bilateral Inguinal Hernia Repair: Laparoscopic Totally Extraperitoneal Versus Open Lichtenstein
No full textAim: To compare the outcome of laparoscopic totally extraperitoneal repair versus the open Lichtenstein technique in the treatment of primary bilateral inguinal hernias.Materials and methods: The study design was comprised of a matched and randomized research: a total of 93 patients were enrolled in the study and operated in clinic “Medikom” from 2015 to 2022. The patients were prospectively randomized and divided into two groups: Group 1 (n=45) underwent TEP repair, whereas Group 2 (n=48) received Lichtenstein repair.Result: No statistically significant differences were observed between the groups concerning the mean age, sex, body mass index, patient distribution by hernia type, European Hernia Society hernia type, and ASA score (p>0.05).The operating time in Group 1 was on 10.7% more than in Group 2 (p<0.05). At 6 hours post-surgery, the pain score in Group 2 was 1.19-fold significantly higher than in Group 1 (p<0.05). This significant difference persisted at 24 hours post-surgery, with Group 2 exhibiting a pain score 1.27 times greater than Group 1 (p<0.05). The time to resumption of normal activities was 1.5 times longer in Group 2 compared to Group 1, which is a difference that reached statistical significance (p<0.05). No statistically significant difference was observed regarding the incidence of early complications between the two groups (p>0.05 (χ2-test)). Following a 24-month follow-up period, a total of 42 (93.3%) patients from Group 1 and 45 (93.75%) patients from Group 2 were evaluated. Importantly, neither recurrence nor other complications were observed in either group.Conclusions: The findings of this trial indicate that laparoscopic total extraperitoneal (TEP) hernia repair offers substantial benefits for patients undergoing bilateral inguinal hernioplasty. The duration until resumption of normal activities was 1.5 times significantly longer for patients in the open hernia repair Group 2 compared to those in the laparoscopic hernia repair Group 1
Study on the Impact of Intercultural Education and the Technological Revolution on Sustainable Education
No full textThe quality education of young people in formal institutionalized frameworks is achieved only by connecting to the socio-cultural reality, while adapting to the transformations/changes caused by technological developments. Our study aims to investigate the perception of current and future teachers for primary and preschool education regarding the role and impact of the digital revolution on the achievement of quality educational actions and the influence of intercultural education in the economy of a sustainable education. The study was conducted on a sample of 354 students of the Faculty of Psychology and Educational Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania, majoring in Primary and Preschool Education Pedagogy. The investigation revealed the dependence relationship between the level of digital skills and their school/professional performance. At the same time, quality education is associated with intercultural education
Reasons of Social Exclusion of Elderly Persons
No full textThe article analyses social exclusion experienced by elderly persons living in one-person households in remote rural areas, its reasons and ways of reducing social exclusion. The qualitative research was conducted by employing the structured interview method, whereas the data collected in the study were processed by using deductive thematic analysis. The results of the study have revealed that the elderly encountered financial difficulties, health problems, lack of household utilities, poor infrastructure of their place of residence, challenges of modern technologies, inaccessibility of services and inequality of their provision, limited public transport, challenges in healthcare institutions, a lack of security, and a lack of information. Social exclusion is determined by low self-esteem, psychological experiences, loneliness, a lack of communication, emigration and the loss of loved ones, as well as absence of close neighbours. It is highly important for elderly persons to keep their homes and live in them as long as possible. In order to reduce social exclusion of the elderly, it is of importance to ensure that they can live in their own homes as long as possible, while being provided social services and help at home as needed. It is also relevant to improve the infrastructure of elderships: organisation and financing of transport, advocacy in contacting banks, healthcare facilities and other institutions, adaptation of the environment and residential premises for the elderly; also, it is essential to install security systems and ensure good condition of roads. To reduce social exclusion, it is fundamental to ensure that elderly people should have the opportunity to communicate, which can be achieved through development of volunteer activities and establishment of a mobile psychological service
Empowering STEAM Educators through AI: A Conceptual Framework for Adaptive, Inclusive Professional Development
No full textThe growing demand for interdisciplinary Science, Technology, Engineering, Arts, and Mathematics (STEAM) education has placed increasing pressure on secondary education teachers to develop integrative, technology-enhanced pedagogical competencies. However, conventional models of professional development (PD) often fall short in addressing the complex, practice-based learning needs required for effective STEAM instruction. This conceptual study explores the potential of Artificial Intelligence (AI) to transform teacher PD by synthesizing recent high-impact literature (2018–2025) across the fields of educational technology, learning sciences, and AI ethics. Four thematic strands are identified: personalization of learning, enhancement of Technological Pedagogical Content Knowledge (TPACK), support for collaboration and reflection, and challenges related to ethics, equity, and teacher readiness. In response, the paper proposes the Adaptive AI-STEAM PD Cycle (A²SPDC) – a six-phase framework that integrates AI-driven assessment, personalized pathways, practice environments, feedback, peer collaboration, and reflective analytics. The framework aims to promote context-sensitive, teacher-centered, and ethically responsible professional learning. While conceptual in nature, this work contributes a theoretically grounded model to guiding future empirical research and policy design, with the broader goal of supporting equitable, innovative, and socially responsive teacher development in STEAM education
Gyvenimo pasakojimas: latvių poetė Veronika Strėlertė
No full textThe article addresses the general concept of life writing, which refers to the creation of a text that focuses on the life and life experiences of a writer or another person. It centres on the poet Veronika Strēlerte’s self-reflection in her childhood recollections and on two people’s, who are close to her—her son Pāvils Johansons and the poet Margita Gūtmane, memories. The concepts of memory, experience, and identity offered by American scholars, Sidonie Smith and Julia Watson, proved instrumental in addressing life writing and its realisation through depictions and memories.
The article explores the motivations that prompted Strēlerte to revisit the images of her childhood memories, describes the relationship between the real and the fictional, and the narrative strategies (author’s and protagonist’s voices).
In discussing the two memoirs, the commonalities (belonging to the same generation) and differences (a sense of family, motherhood, and home) that define authors’ perspectives on the poet’s personality are examined. Johansons’ memoirs provide an insight into his family: his mother, a poet, and his father Andrejs Johansons, a cultural historian, religious studies scholar, essayist, and their relationship with him. They also vividly describe his parents’ inner circle, the Latvian intelligentsia in exile, and as such are important cultural and historical source. In her memoirs, Gūtmane portrays Strēlerte as a poet and as a “mere mortal,” thus creating a vibrant and versatile account of Strēlerte’s personality. She elaborates on the theme of exile, which was important for both Strēlerte and the memoirist, emphasising the inability of those who ended in exile to take root and find a home.
Strēlerte’s childhood memoirs significantly contribute to the autobiographical genre of Latvian literature. It can also be considered a part of Latvian children’s literature. The memoirs about her are not only artistically enjoyable but also a valuable material for the study of writer’s life and poetry.Straipsnyje, pasitelkus „gyvenimo pasakojimo“ (Life writing) konceptą, susitelkiama į latvių poetės Veronikos Strėlertės (Strēlerte) savirefleksiją vaizduojant vaikystės prisiminimus bei į dviejų jai artimų žmonių – sūnaus Povilo Johansono (Pāvils Johansons) bei poetės Margitos Gūtmanės – atsiminimus apie ją, motiną ir poetę. Gyvenimo pasakojimo ir jo realizavimo atsiminimuose tyrimui svarbus amerikiečių literatūros ir autobiografinius pasakojimus tiriančių mokslininkių Sidonie Smith ir Julia Watson siūlomas instrumentarijus – sąvokos atmintis, patirtis ir tapatybė, glaustai pristatomas straipsnyje. Tyrinėjama motyvacija, paskatinusi poetą Strėlertę atsidėti vaikystės prisiminimų užrašymui, gilinamasi į realybės ir fikcijos santykį juose, pasakojimo apibūdinimą (autorės ar protagonistės balsas), daroma išvada, jog poetė pavaizdavo savo brendimo istoriją.
Kalbant apie atsiminimų autorius nurodoma, kas jiems yra bendra (priklausymas tai pačiai kartai) ir skirtinga (šeimos, motinos, namų jausmas), kas lemia jų požiūrį į poetės asmenybę. Johansono prisiminimai leidžia pažvelgti į jo šeimos – poetės motinos, kultūros istoriko, religijų tyrėjo ir eseisto tėvo Andrejaus Johansono – požiūrių ypatumus ir santykius su sūnumi. Iškalbus artimiausių tėvų giminaičių rato, egzilyje atsidūrusios latvių inteligentijos aprašymas svarbus kaip kultūros istorijos medžiaga. Atsiminimų knygoje Gūtmanė pasakoja apie Strėlertę kaip apie „paprastą mirtingą žmogų“, sukurdama gyvą ir pilnakraujį Strėlertės asmenybės vaizdą, praplėsdama egzilio išgyvenimo temą, svarbią ir jai kaip atsiminimų autorei, ir Strėlertei, pabrėždama Strėlertės nesugebėjimą įsišaknyti ir atrasti namus.
Strėlertės vaikystės prisiminimai svarbiai papildo latvių autobiografinės literatūros žanrą, o atsiminimai apie ją ne tik meniškai įtaigūs, bet ir yra pravarti medžiaga poetės gyvenimo ir kūrybos tyrinėjimams
Regioninės atminties raiška Lietuvoje 1918–1940 metais: du Žemaitijos atvejai
No full textIn Lithuania in 1918–1940 it is possible to state the aspirations to strengthen the Samogitian region and the Samogitian identity. The strengthening of the Samogitian identity had to be accompanied by the creation of a Samogitia/Samogitian regional memory culture. The article seeks to answer the questions: whether there have been targeted efforts to form a regional Samogitia/Samogitian memory culture and what signs confirm these processes in the public space. In search of answers to these questions, two case studies were carried out, the objects of which were selected: the Samogitian museum “Alka” and the monument “Žemaitis” built in Raseiniai.Based on the case studies, it is stated that there were purposeful efforts to form a regional Samogitia/Samogitian memory culture. This was due to the perception of the representatives of the regional elite with a Samogitian identity that Samogitian identity is not possible without a culture of memory that confirms and supports it. It is recognized that the regional memory culture of Samogitia needs institutions representing it, for example, a museum, whose expositions will embody the narrative of Samogitian history and it will help to maintain and establish Samogitian identity. The process of formation of Samogitian memory culture is witnessed by the manifestations of this culture with the help of monuments in public space. This expression is confirmed by the monument “Žemaitis” built in Raseiniai. This monument, with the help of a depersonalized Samogitian peasant image, presented a historical narrative about how in the 19th century during the national revival, the awakened nation restored the state of Lithuania through armed struggles and the Samogitians were active participants in this historical process. At the same time, the monument told the history of Lithuania in recent times and the role of Samogitia/ Samogitians in this history. It can be as an example of how regional and national historical narratives intertwine and how a regional memory culture is formed under the influence of a national memory culture.Lietuvoje 1918–1940 metais galima konstatuoti siekius stiprinti Žemaitijos regiono ir žemaitišką tapatybę. Žemaitiškos tapatybės stiprėjimą turėjo lydėti ir Žemaitijos ir (ar) žemaičių regioninės atminties kultūros kūrimas. Šiame straipsnyje siekiama atsakyti į klausimus, ar buvo kryptingų pastangų formuojant regioninę Žemaitijos ir (ar) žemaičių atminties kultūrą ir kokie ženklai viešoje erdvėje patvirtina šiuos procesus. Ieškant atsakymų į šiuos klausimus atlikta dviejų atvejų studija, kurios tyrimo objektais buvo pasirinkti muziejus „Alka“ ir Raseiniuose pastatytas paminklas „Žemaitis“.Remiantis atliktomis atvejų studijomis teigiama, kad būta kryptingų pastangų formuoti regioninę Žemaitijos ir žemaičių atminties kultūrą. Tai lėmė žemaitišką tapatybę turinčio regioninio elito atstovų suvokimas, kad žemaitiška tapatybė negalima be ją patvirtinančios ir palaikančios atminties kultūros. Pripažinta, kad regioninei Žemaitijos atminties kultūrai reikia ją reprezentuojančių institucijų – tokių kaip, pavyzdžiui, muziejus, kurio ekspozicijos įkūnytų Žemaitijos istorijos naratyvą, o jis padėtų palaikyti ir įtvirtinti žemaitišką tapatybę. Žemaičių atminties kultūros formavimosi procesą liudija šios kultūros apraiškos viešoje erdvėje – paminklai. Tokią raišką patvirtina Raseiniuose pastatytas paminklas „Žemaitis“. Šis paminklas per nuasmenintą žemaičių valstiečio vaizdinį perteikė istorinį naratyvą apie tai, kaip XIX a. tautinio atgimimo metu atbudusi tauta ginkluotų kovų keliu atkūrė Lietuvos valstybę, o žemaičiai buvo aktyvūs šio istorinio proceso dalyviai. Paminklas vienu metu pasakojo ir naujausių laikų Lietuvos istoriją, ir Žemaitijos ir žemaičių vaidmenį šioje istorijoje. Jis gali būti pavyzdys, kaip susipina regioninis ir nacionalinis istoriniai naratyvai, kaip regioninė atminties kultūra formuojasi veikiama nacionalinės atminties kultūros
Laiškai tartum Dievo pyragai. Vyskupo Teofiliaus Matulionio epistolinio palikimo knyga
No full textTeofilius Matulionis. Laiškai, sudarytojas Vaidotas Žukas, Vilnius: Palaimintojo Teofiliaus Matulionio labdaros ir paramos fondas, 2023, 520 p., ISBN 978-609-08-0104-
Fizinio aktyvumo poveikis slaugytojų perdegimo sindromo prevencijai ir valdymui: literatūros apžvalga
No full textPsychological burnout is one of the most pressing problems facing modern healthcare professionals, especially nurses. Research reveals that more than a quarter of nurses in the European Union (EU) countries experience burnout. This creates the need to take active steps to address the issue. Physical activity (PA) is one of the potentially effective ways that can help reduce burnout symptoms and promote mental well-being. The aim of the study was to analyse the scientific literature examining the effects of physical activity on the prevention and management of the burnout syndrome in nurses. A review of scientific articles has been conducted using keywords and their combinations. Scientific articles were searched in international databases PubMed, Web of Science and in the specialised information search system Google Scholar. The PRISMA flow diagram was applied to the search results. The systematic review included 9 articles on the subject. Results: Nurses experienced high levels of burnout, and most of them were physically inactive. Nurses with low PA levels were more likely to experience fatigue and burnout. PA has a positive effect on nurses’ emotional balance, helping them cope with burnout symptoms. PA interventions help nurses manage burnout more effectively and act as a means of preventing burnout. Conclusions: The analysis reveals that PA has a positive effect on the management and prevention of burnout in nurses. It has been established that regular, recreational PA in nurses can suppress the expression of burnout, increase job satisfaction, and improve the physical and psychological health of nurses. In order to ensure regular PA in nurses, special programs and interventions are needed.Psichologinis perdegimas yra viena iš aktualiausių problemų, su kuria susiduria šiuolaikiniai sveikatos priežiūros specialistai, ypač slaugytojai. Moksliniai tyrimai atskleidžia, kad daugiau nei ketvirtadalis slaugytojų Europos sąjungos (ES) šalyse susiduria su perdegimo problema. Tai formuoja poreikį imtis aktyvių veiksmų ją spręsti. Fizinis aktyvumas (FA) yra vienas iš potencialiai veiksmingų būdų, galinčių padėti sumažinti perdegimo simptomus ir skatinti psichologinę gerovę. Darbo tikslas – išanalizuoti mokslinę literatūrą, kurioje nagrinėjamas fizinio aktyvumo poveikis slaugytojų perdegimo sindromo prevencijai ir valdymui. Atlikta mokslinių straipsnių apžvalga naudojant raktinius žodžius ir jų junginius. Mokslinių straipsnių ieškota tarptautinėse duomenų bazėse PubMed, Web of Science ir specializuotoje informacijos paieškos sistemoje Google Scholar. Paieškos rezultatams taikyta PRISMA Flow diagrama. Į sisteminę apžvalgą įtrinkti 9 straipsniai nagrinėjama tema.
Rezultatai: Slaugytojai, nuo 38 iki 65 proc., patyria aukštą perdegimo lygį, o dauguma jų buvo fiziškai neaktyvūs. Slaugytojai, kurių FA buvo žemas, dažniau susiduria su nuovargiu ir perdegimu. FA, teigiamai veikia slaugytojų emocinę pusiausvyrą, padėdamas jiems susidoroti su perdegimo simptomais. FA intervencijos padeda slaugytojams efektyviau valdyti perdegimą ir veikia kaip perdegimo prevencijos priemonė.
Išvados: FA turi teigiamą poveikį slaugytojų perdegimo valdymui ir jo prevencijai. Reguliarus, rekreacinio pobūdžio slaugytojų FA gali slopinti perdegimo raišką, didinti pasitenkinimą darbu ir pagerinti slaugytojų fizinę ir psichologinę sveikatą. Siekiant užtikrinti reguliarų slaugytojų FA reikalingos specialios programos ir intervencijos