Perspectives on Virtual Care for Childhood Cancer Survivors in Non-Metropolitan Areas during the COVID-19 Pandemic.

The COVID-19 pandemic paved the way for the widespread use of virtual care for childhood cancer survivors (CCSs). CCSs were virtual recipients of diverse care, including long-term follow-up (LTFU), primary care, mental health care, and several others. Virtual care comes with well-documented benefits and challenges. These are further magnified for CCSs living in rural or non-metropolitan areas. Here, we describe the virtual care of CCSs from two Upper Midwest cities with well-established childhood cancer survivor programs within large comprehensive cancer centers in the United States. CCSs from non-metropolitan areas, especially CCSs with two or more late effects, used virtual care more often during the COVID-19 pandemic compared to CCSs from metropolitan areas. A review of the related literature is also included and the identified challenges in providing virtual care, such as privacy concerns, technology-connectivity constraints, and medical license restrictions. Despite these limitations, the care of CCSs has evolved to leverage virtual care and its ability to increase access for patients and promote continuity of care for CCSs living in rural areas.

Impacts of changing atmospheric deposition chemistry on nitrogen and phosphorus loading to Ganga River (India).

Investigations on atmospheric deposition (AD) and water chemistry along a 35 km stretch of Ganga River indicated that although N:P stoichiometry of AD did not change, there were over 1.4-2.0 fold increase in AD-NO3⁻, AD-NH4⁺ and AD-PO4³â» overtime. Concentration of dissolved inorganic-N (DIN) in river showed significant positive correlations with AD-NO3⁻ and runoff DIN. Similarly, dissolved reactive-P (DRP) in river showed significant positive correlation with AD-PO4³â» and runoff DRP. The study shows that AD has become an important source of N and P input to Ganga River.