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As part of a large study aiming to understand how kindergarten children in Colombia used translanguaging during independent play, Paula (the teacher) along with Dr. Moses (lead researcher) co-designed a 6-week play-based intervention that included a variety of learning experiences such as partner reading, small-group reading, and supported play, among others. In this guide, we describe the step-by-step process followed to design the children's book the students used during instruction to learn the desired language, vocabulary, and interactions. Additionally, we provide suggestions on how to create a book that fits your teaching goals.

This article explores the findings from a formative study focused on language and literacy development in an international school's K5 classroom in South America. The teacher's pedagogical goal was to increase the amount of English used by students related to the social context of a restaurant. The intervention involved an integrated literacy and play-based unit to introduce, reinforce, and support vocabulary development and opportunities for independent play related to the content/vocabulary. The authors analyze video recordings of the students' independent play three times a week for 6 weeks using two different theoretical and methodological approaches. The authors collected quantitative data related to English usage and codeswitching analysis, and qualitative data of students' interactions, translanguaging, and identity work. The quantitative findings reveal a significant increase in English usage during independent play. The qualitative findings explore the ways in which young bilinguals draw on all their linguistic resources and use translanguaging practices to navigate play and negotiate identity. The constraints and affordances of each approach are discussed as the authors present new theoretical contributions by utilizing codeswitching and translanguaging approaches to explore the pedagogical intervention and student identity work. This study provides implications for literacy and play-based instruction for multilingual learners.

El concepto de eficacia colectiva vinculado a la investigación de delitos en barrios surgió en Estados Unidos en los años noventa y pronto fue reconocida como una teoría validada. Sin embargo, su aplicación en América Latina ha evidenciado inconsistencias. A partir de datos de Bogotá, Lima y Santiago, este artículo evalúa la estructura factorial del concepto y su aplicabilidad al estudio de delitos violentos en barrios latinoamericanos. Para ello se estimaron modelos factoriales, invarianza y comparación de medias. Los hallazgos revelan que la eficacia colectiva se compone de tres dimensiones (confianza, cohesión y control social informal), y para cada dimensión se observan medias diferenciadas según experiencia de victimización violenta y ciudad. Así, la composición multidimensional de la eficacia colectiva ofrece una perspectiva enriquecedora para profundizar en los desafíos de la prevención del delito en entornos criminológicos complejos del Sur global.

Introducción: la parasitosis zoonótica causada por Toxocara canis ha sido sugerida como posible agente etiológico del asma. Objetivo: evaluar la asociación entre la infección por Toxocara canis y el asma en niños del Hospital Nacional Cayetano Heredia (HNCH), Lima, Perú. Asimismo evaluar los factores asociados a la infección por T. canis en la población de estudio. Material y métodos: estudio caso-control, que incluyó a 75 niños asmáticos y 75 niños no asmáticos, de 2 a 13 años, atendidos en el HNCH en el año 2002. Se aplicó un cuestionario para evaluar los factores asociados a toxocariosis y a asma respectivamente. La seroprevalencia de T. canis fue determinada mediante la prueba ELISA IgG para T. canis. Resultados: la seroprevalencia de toxocariosis fue de 16%, no se encontró una asociación significativa entre la seropositividad para Toxocara canis y el asma. Sin embargo se observó una relación estadísticamente significativa entre una mayor frecuencia de crisis de sibilancia nocturna y una serología positiva para Toxocara canis. Los factores asociados a la toxocariosis fueron el contacto intenso con perros, particularmente con cachorros y una ausencia de grado de instrucción universitario de los padres. Los factores asociados al asma fueron: el poco contacto con perros y el grado de instrucción universitario de los padres. Conclusiones: no hubo asociación entre la presencia de serología positiva para T. canis y asma, pero sí con una mayor frecuencia de sibilancia nocturna. Son necesarios estudios posteriores que evalúen esta última observación.

**Background:** Crohn's disease is a chronic ailment affecting the gastrointestinal tract. Mucosal healing, a marker of reduced disease activity, is currently assessed in the colonic sections using ileocolonoscopy and magnetic resonance enteroscopy. Video capsule endoscopy (VCE) offers visualization of the entire GI mucosae. **Objective:** To validate a Crohn's disease model estimating the budget impact of VCE compared with the standard of care (SOC) in Italy. **Methods:** A patient-level, discrete-event simulation was developed to estimate the budget impact of VCE compared with SOC for Crohn's disease surveillance over 5 years in the Italian setting. Input data were sourced from a physician-initiated study from Sant'Orsola-Malpighi Hospital in Bologna, Italy, and the literature. The care pathway followed hospital clinical practice. Comparators were the current SOC (ileocolonoscopy, with or without magnetic resonance enteroscopy) and VCE. Sensitivity analysis was performed using 500-patient bootstraps. A comparative analysis regarding clinical outcomes (biologics use, surgical interventions, symptom remission) was performed to explore the validity of the model compared with real-world data. Cumulative event incidences were compared annually and semi-annually. Bayesian statistical analysis further validated the model. **Results:** Implementing VCE yielded an estimated €67 savings per patient per year, with savings in over 55% of patients, compared with SOC. While annual costs are higher up to the second year, VCE becomes cost saving from the third year onward. The real-world validation analysis proved a good agreement between the model and real-world patient records. The highest agreement was found for biologics, where Bayesian analysis estimated an 80.4% probability (95% CI: 72.2%-87.5%) that a decision maker would accept the result as an actual reflection of real-world data. Even where trend data diverged (eg, for surgery \[43.1% likelihood of acceptance, 95% CI: 33.7%-52.8%\]), the cumulative surgery count over 5 years was within the margin of error of the real-world data. **Conclusions:** Implementing VCE in the surveillance of patients with Crohn’s disease and small bowel involvement may be cost saving in Italy. The congruence between model predictions and real-world patient records supports using this discrete-event simulation to inform healthcare decisions.

Sargassum is a genus of brown algae that causes a major impact to marine ecosystems. Although accumulation of this invasive seaweed is considered an environmental problem, Sargassum can also be resource of valuable molecules such as alginates. Alginates are polysaccharides extracted from the cell walls of brown seaweeds with multiple applications in food, cosmetics, pharmaceuticals, and biotechnology. In this study, we explored four different extraction protocols to isolate alginates from Sargassum from the archipelago of Guadeloupe. H-NMR, FTIR, and SEM were carried out to characterize isolated samples and describe their chemical and morphological properties. Antioxidant capacity of the isolated alginates was tested in the sample. FRAP assay showed free radical scavenging activity, and cell viability assay showed that alginates keep protective capacity against oxidative stress in cell cultures. In sum, the isolation methods used in this study are effective extractive methods to obtain alginates from Sargassum, which highlight this seaweed as a potential source of bioactive compounds that may be exploited for industrial and biomedical purposes.

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Aim: Posterior cranial fossa (PCF) surgery is associated with complications, including cerebrospinal fluid (CSF) leakage. Dural sealants such as polyethylene glycol (PEG)-based hydrogels and fibrin glue can prevent CSF leaks, with evidence suggesting PEG hydrogels may outperform fibrin glue. However, the budget impact of using PEG hydrogels in PCF surgeries in Europe is unclear. Materials & methods: A decision tree was developed based on a previous US model, to assess the budget impact of switching from fibrin glue to PEG hydrogel in PCF surgery across five European countries. Input costs were derived from published sources for the financial year 2022/2023. Health outcomes, including CSF leaks, were considered. Results: The model predicted that using PEG hydrogel instead of fibrin glue in PCF surgery can lead to cost savings in five European countries. Cost savings per patient ranged from EUR 419 to EUR 1279, depending on the country. Sensitivity analysis showed that the incidence of CSF leaks and pseudomeningoceles had a substantial impact on the model’s results. Conclusion: PEG hydrogels may be a cost-effective alternative to fibrin glue in PCF surgery. The model predicted that cost savings would be mainly driven by a reduction in the incidence of postoperative CSF leaks, resulting in reduced reliance on lumbar drains, reparative surgery and shortened hospital stays.

# Background According to the European Centre for Disease Prevention and Control, surgical site infections (SSIs) constitute over 50% of all hospital-acquired infections. Reducing SSIs can enhance healthcare efficiency. # Objective This study explores the cost consequences of implementing an SSI prevention bundle (SPB) in total hip and knee arthroplasty (THKA). # Methods A health-economic model followed a cohort of THKA patients from admission to 90 days postdischarge. The perioperative process was modeled using a decision tree, and postoperative recovery and potential SSI evaluated using a Markov model. The model reflects the hospital payers’ perspective in Germany. The SPB includes antimicrobial incision drapes, patient warming, and negative pressure wound therapy in high-risk patients. SSI reduction associated with these interventions was sourced from published meta-analyses. An effectiveness factor of 70% was introduced to account for potential overlap of effectiveness when interventions are used in combination. Sensitivity analyses were performed to assess the robustness of model outcomes. # Results The cost with the SPB was €4274.32 per patient, €98.27, or 2.25%, lower than that of the standard of care (€4372.59). Sensitivity analyses confirmed these findings, indicating a median saving of 2.22% (95% credible interval: 1.00%-3.79%]). The SPB also reduced inpatient SSI incidence from 2.96% to 0.91%. The break-even point for the SPB was found when the standard of care had an SSI incidence of 0.938%. Major cost drivers were the cost of inpatient SSI care, general ward, and operating room, and the increased risk of an SSI associated with unintended, intraoperative hypothermia. Varying the effectiveness factor from 10% to 130% did not substantially impact model outcomes. # Conclusions Introducing the SPB is expected to reduce care costs if the inpatient SSI rate (superficial and deep combined) in THKA procedures exceeds 1%. Research into how bundles of measures perform together is required to further inform the results of this computational analysis.

Imagination is a fundamental human capacity, and to navigate our current global challenges, we need to define and encourage the practice of imagination, or what we term “applied imagination.” In this study, we convened a series of focus groups or “virtual salons” to address three guiding questions: (1) How might we define imagination? (2) How might we (or should we) measure imagination? And (3) How might we foster imagination? Our efforts to define applied imagination highlight the crucial role imagination plays in human survival and thriving, the role of social forces in fostering or discouraging imagination, the connection between imagination and faith, and the “dark side” or maladaptive aspects of imagination. The discussions on measuring imagination were quite divided, with some salon participants arguing for the potential of indirect modes for measuring imaginative capacity while others argued that measuring imagination was functionally impossible and morally suspect. Finally, our results around fostering imagination suggest the importance of using play and humor, separating imaginative activities from the everyday, and employing constraints to prompt imaginative responses. We end with a discussion of possible directions for future research and a call to create a transdisciplinary field of imagination studies.

BackgroundCurrently, the treatment of anemia in preterm infants is based on packed red blood cell (RBC) transfusions from adult donors. Oxygen (O2) is mainly transported to the tissues bound to hemoglobin (Hb). In extremely low gestational age neonates (ELGANs), fetal hemoglobin (HbF), which has a higher affinity for O2, represents up to 95% of circulating hemoglobin. During the first month of life, the majority of ELGANs will require an adult-donor RBC transfusion causing HbF levels to rapidly drop. HbA releases 50% more oxygen in peripheral tissues than HbF. Increased release of O2 in the retina is one of the main factors related to the development of retinopathy of prematurity (ROP). Collecting umbilical cord blood and using autologous umbilical cord whole blood (UCB) transfusions would contribute to maintaining physiological HbF concentrations in newborns and avoid oxygen-in-excess derived damage.MethodsThis is a randomized, double-blinded, multicenter clinical trial. ELGANs ≤28 weeks of gestational age will be randomized 1:1 to receive an autologous umbilical cord blood transfusion (intervention arm) or standard transfusion of packed RBC from an adult donor (control arm) to assess ROP development. Assuming a 50% reduction in ROP incidence, 134 patients (67 per group) will be recruited. When blood transfusion is indicated, the Blook Bank will supply UCB or RCB according to the patient's group. The primary endpoint is the incidence of any ROP. Secondary endpoints are assessessment of treatment safety, results of biomarkers related to ROP and its chronology, and urine oxidative stress markers. In addition, the cellular composition of umbilical cord blood and its relationship with prematurity-related pathologies will be analyzed. All patients will be followed-up to 24 months of corrected age to evaluate their neurodevelopment.DiscussionROP is a major cause of irreversible blindness in preterm newborns. Transfusions with adult donor blood can lead to complications, including ROP. UCB transfusions offer advantages by maintaining physiological HbF levels and potentially optimizing postnatal development. Moreover, autologous UCB transfusion could reduce risks associated with heterologous blood products, although volume collection remains challenging. UCB contains growth factors and progenitor cells that may impact ROP.

Osteosarcoma is a rare bone cancer in adolescents and young adults with a dismal prognosis because of metastatic disease and chemoresistance. Despite multiple clinical trials, no improvement in outcome has occurred in decades. There is an urgent need to better understand resistant and metastatic disease and to generate in vivo models from relapsed tumors. We developed eight new patient-derived xenograft (PDX) subcutaneous and orthotopic/paratibial models derived from patients with recurrent osteosarcoma and compared the genetic and transcriptomic landscapes of the disease progression at diagnosis and relapse with the matching PDX. Whole exome sequencing showed that driver and copy-number alterations are conserved from diagnosis to relapse, with the emergence of somatic alterations of genes mostly involved in DNA repair, cell cycle checkpoints, and chromosome organization. All PDX patients conserve most of the genetic alterations identified at relapse. At the transcriptomic level, tumor cells maintain their ossification, chondrocytic, and trans-differentiation programs during progression and implantation in PDX models, as identified at the radiological and histological levels. A more complex phenotype, like the interaction with immune cells and osteoclasts or cancer testis antigen expression, seemed conserved and was hardly identifiable by histology. Despite NSG mouse immunodeficiency, four of the PDX models partially reconstructed the vascular and immune-microenvironment observed in patients, among which the macrophagic TREM2/TYROBP axis expression, recently linked to immunosuppression. Our multimodal analysis of osteosarcoma progression and PDX models is a valuable resource to understand resistance and metastatic spread mechanisms, as well as for the exploration of novel therapeutic strategies for advanced osteosarcoma.

Objective: Evaluation of the influence of potential risk factors (RFs) on glycemic changes at 3 years postpartum. Methods: The glycemic status of 1400 women, in absence of a new pregnancy, was evaluated at 3 months (3 m) and 3 years (3 y) postpartum, after participation in the St. Carlos Gestational Study (2228 normoglycemic pregnant women followed from before gestational week 12 to delivery, from 2015–2017). Abnormal glucose regulation (AGR) was defined as fasting serum glucose ≥ 100 mg/dL and/or HbA1c ≥ 5.7% and/or 2 h 75 g OGTT glucose ≥ 140 mg/dL. In total, 12 modifiable and 3 unmodifiable RFs were analyzed. Results: 3 m postpartum, 110/1400 (7.9%) women had AGR; 3 y postpartum, 137 (9.8%) women exhibited AGR (110 with 3 m normal glucose tolerance [NGT]); 1263 (90.2%) had NGT (83 with 3 m AGR). More women with gestational diabetes mellitus (GDM) progressed to AGR at 3 y (OR: 1.60 [1.33–1.92]) than women without GDM. Yet, most women with 3 m and/or 3 y AGR had no GDM history. Having ≥2 unmodifiable RFs was associated with increased risk for progression to AGR (OR: 1.90 [1.28–2.83]) at 3 y postpartum. Having >5/12 modifiable RFs was associated with increased progression from NGT to AGR (OR: 1.40 [1.00–2.09]) and AGR persistence (OR: 2.57 [1.05–6.31]). Pregestational BMI ≥ 25 kg/m2 (OR: 0.59 [0.41–0.85]), postdelivery weight gain (OR: 0.53 [0.29–0.94]), and waist circumference > 89.5 cm (OR: 0.54 [0.36–0.79]) reduced the likelihood of NGT persisting at 3 y. Conclusions: 3-month and/or 3-year postpartum AGR can be detected if sought in women with no prior GDM. Modifiable and unmodifiable RF predictors of AGR at 3 y postpartum were identified. Universal screening for glycemic alterations should be considered in all women following delivery, regardless of prior GDM. These findings could be useful to design personalized strategies in women with risk factors for 3 y AGR.