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In this contribution we illustrate and discuss the decolonial approach adopted in a research project exploring the potential of including in education a language spoken by children and families from refugee backgrounds. The international project team from Palestine and the UK collaboratively designed a bespoke Levantine Arabic language course for beginners tailored to the needs identified by primary school staff, Arabic speaking pupils from refugee backgrounds, and their parents/carers. The course was offered to primary school staff in Scotland, enabling them to offer “linguistic hospitality” (Phipps, 2012) to Arabic speaking pupils and families. By delinking common assumptions and norms about language teaching/learning, the project strived to change the terms and the content of the conversation, unlocking possibilities for thinking and doing otherwise (Mignolo, 2007, 2018). In particular, the study questioned: who should be learning a language in an educational context; the teaching of the standard version of a language; expectations of expertise in educational settings; and the knowledge flow in international research with partners in Global South countries.

Objective: To describe trends in the use of non-invasive tests (NIST) and the interval between a positive NIST and diagnostic colonoscopy. Methods: Using a retrospective time-trend design, we examined medical records of patients within two large Indiana integrated healthcare systems who had a positive NIST between January 2019 and June 2021 and quantified the proportion of patients who had not completed colonoscopy within 60, 90, and 180 days to determine the interval between NIST result and diagnostic colonoscopy in days. Results: Of 1379 patients with positive NISTs, 930 (68 %) underwent diagnostic colonoscopy during the 30-month study timeframe. Median time to colonoscopy completion was significantly longer in 2020 compared to 2019 (50 vs. 37 days, p

Vitis vinifera L. ‘Gewürztraminer’ produces distinctive, aromatic wines that are strongly influenced by their terroir. This metabolomic study used a data-driven approach, including Principal Component Analysis (PCA) and Multifactorial Analysis (MFA), to correlate a quali-quantitative multivariate concept of terroir (including soil characteristics, and altitude) with sensory, phenolic, antioxidant, and volatile profiles of wines. The study analyzed wines from seven ‘Gewürztraminer’ vineyards, chosen to minimize the variability due to climate differences. Based on the soil data, the vineyards were clustered into two distinct groups: clay silicate (Group A) and dolomitic (Group B) soils. Group A exhibited lower levels of aromatic compounds such as linalool and higher levels of phenolic compounds such as gallocatechin than Group B. These findings indicate that even small changes in terroir within the same region can significantly impact the chemical, functional (antioxidant), and sensory properties of ‘Gewürztraminer’ wines, highlighting the importance of terroir in wine production. Statistical analyses confirmed the significance of these correlations (p

Viruses have brought humanity many challenges: respiratory infection, cancer, neurological impairment and immunosuppression to name a few. Virology research over the last 60+ years has responded to reduce this disease burden with vaccines and antivirals. Despite this long history, the COVID-19 pandemic has brought unprecedented attention to the field of virology. Some of this attention is focused on concern about the safe conduct of research with human pathogens. A small but vocal group of individuals has seized upon these concerns - conflating legitimate questions about safely conducting virus-related research with uncertainties over the origins of SARS-CoV-2. The result has fueled public confusion and, in many instances, ill-informed condemnation of virology. With this article, we seek to promote a return to rational discourse. We explain the use of gain-of-function approaches in science, discuss the possible origins of SARS-CoV-2 and outline current regulatory structures that provide oversight for virological research in the United States. By offering our expertise, we - a broad group of working virologists - seek to aid policy makers in navigating these controversial issues. Balanced, evidence-based discourse is essential to addressing public concern while maintaining and expanding much-needed research in virology.

Introdução O Ministério da Saúde, MS, vem adquirindo inovações promissoras e controvertidas e as testando mediante estudos controlados em polos de referência da Rede SUS. Apresenta-se o exemplo da aquisição de um robô cirúrgico visando avaliar segurança, efetividade e sua relação de custo-efetividade em um UNACON. Métodos Estudo controlado randomizado por blocos conforme os tipos de cirurgia de câncer contratualizados pelo MS nas especialidades de gastroenterologia, ginecologia, cirurgias de cabeça e pescoço, urologia e pneumologia. Casuística: portadores de neoplasias com indicação cirúrgica e elegíveis para as três técnicas cirúrgicas em estudo, i.e., cirurgia aberta, videolaparoscopia e videolaparoscopia robótica, informados e concordaram com o protocolo assinando o TCLE, foram randomizados. O protocolo delineado (NCT02292914/ ClinicalTrials.gov) foi executado segundo as Diretrizes Metodológicas/Avaliação Econômica do MS, com micro-custeio operacional. Os custos de treinamento, de aquisição de capital, de manutenção etc. e custos indiretos, foram excluídos. Instrumentos validados foram usados para comparar benefícios funcionais e qualidade de vida por 36 a 60 meses. Resultados Oito cirurgias de câncer foram avaliadas em 783 pacientes randomizados, (4 de gastroenterologia, 1 ginecologia, 1 de cabeça e pescoço, 1 urologia, e 1 pneumologia) nos 3 Grupos: Robô (n = 421), Videolaparoscopia (n = 173) e Convencional-Aberta (n = 189), Idade Média±DP de 62±9 anos e IMC 27,6±5,4 kg/m2, no ICESP/HCFMUSP entre 2014 e 2021, com impacto da pandemia COVID no seguimento. A distribuição absoluta dos custos dos controles (laparoscópicos, exceto prostatectomias vs. cirurgia aberta) e das diferenças médias incrementais pela robótica e desvios de dias de internação no período pós-operatório e de custos totais foi de Esofagectomias (R*n=21) -3,6 dias de internação e incremento de R$ 15.691,08± R$ 4.252,56 comparado aos 22/lap internados por 20,3±7,4 dias e custo de R$ 50.998,44± R$ 14.601,45; Gastrectomias (*n=20) -0,2 dias e incremento de R$ 14.644,03± R$ 1.758,44 vs. 24/ lap com 11,5±4,1 dias e custaram R$ 22.303,28± R$ 5.526,34; Reto (*n=24) -1,1 dias e mais R$ 7.642,08± R$ 1.959,34 vs. 24/lap com 10,0±2,5 e custo R$ 24.997,87± R$ 5.296,93; Pancreatectomias (*n=29) com 7,8±1,2 dias de internação e custaram R$ 23.901,79± R$ 3.785,65 sem controles; Histerectomias (R*n=43) com +0,1 dia adicionou R$ 9.141,37± R$ 744,27 vs. 42/lap com 3,3±1,3 dias e custo de R$ 22.025,58± R$ 10.054,45; Cabeça & Pescoço (*n=36) -2,5 e incrementou R$ 1.631,66± R$ 1.530,95 vs. 55/videolap com 7,3±5,4 dias e custo R$ 18.463,00± R$ 8.872,60; Prostatectomias (*n=169) -0,7 dias e mais R$ 9.660,99± R$ 3.305,69 que as 167/abertas com 3,7±0,9 dias e custo de R$ 8.989,73± R$ 1.909,38; e, Lobectomias pulmonares (R*n=43) -0,3 dia economizaram -R$ 420,60± R$ 2.602,66 vs. 40/lap que permaneceram 6,0±3,1 dias e custaram R$ 34.103,60± R$ 2.112,03, respectivamente. Não houve complicações maiores ou mortalidade relacionadas às cirurgias nos braços estudados. A qualidade de vida e escores funcionais tenderam a ser melhores até 12 meses e foram similares no seguimento extendido. Discussão e conclusões Embora com ganhos estruturais, trabalhistas, ensino e pesquisa, este estudo corroborou a controvérsia internacional sobre os modestos benefícios da robótica no local para os pacientes. Atualmente, o custo de materiais descartáveis e monopólio da empresa o tornam pouco sustentáveis no SUS.

Background: COVID-19 vaccines reduced mortality, hospitalizations and ICUs admissions. Conversely, the impact of vaccination on Long COVID-19 syndrome is still unclear. This study compared the prevalence of post-acute sequelae at short and long-term follow-up among hospitalized unvaccinated and vaccinated COVID-19 survivors through a multidisciplinary approach. Methods: After 2 months from discharge, unvaccinated and vaccinated COVID-19 survivors underwent a follow-up visit at a dedicated “post-COVID-19 Outpatient Clinic”. The follow-up visit included a cardiovascular evaluation, blood tests, chest computed tomography, 6-min walking test (6MWT), spirometry. A one-year telephone follow-up was performed to assess re-hospitalizations, death and long-lasting symptoms. An additional 1:1 case-control matching analysis adjusted for baseline characteristics was performed. Results: Between June 2020 and June 2022, a total of 458 unvaccinated and vaccinated patients (229 per group) underwent the follow-up visit. Vaccinated patients had lower rates of ICU admissions (1.7 % vs 9.6 %, p=

BackgroundCardiac neuroendocrine tumour metastases (CNTM) are rare, but advancements in molecular imaging including somatostatin receptor PET/CT (SSTR-PET/CT) could lead to a more frequent identification. The aim of this article is to perform a systematic review and meta-analysis on the detection of CNTM by SSTR-PET/CT.MethodsA comprehensive literature search of studies on CNTM detected by SSTR-PET/CT was carried out. Three different bibliographic databases were screened (Cochrane library, PubMed/MEDLINE, EMBASE) until 20 August 2024. Two review authors independently selected the eligible original articles and performed the quality assessment and the data extraction. Main findings of eligible studies were summarized and a proportion meta-analysis on the prevalence of patients with CNTM among those with neuroendocrine neoplasm (NEN) performing SSTR-PET/CT was carried out using a random-effects model.ResultsTen articles reporting data on 163 patients with CNTM were included in the systematic review. SSTR was able to detect CNTM earlier compared to other radiological imaging techniques. Most patients with CNTM had other metastatic sites and CNTM were often asymptomatic. The meta-analysis of seven articles demonstrated a pooled prevalence of 1.5% (95% confidence interval: 1.0–1.9%) of patients with CNTM (n = 119) among those performing SSTR-PET/CT for NEN (n = 9,300). Moderate statistical heterogeneity was found (I2 test: 62%).ConclusionEvidence-based data demonstrate that SSTR-PET/CT enables early and better detection of CNTM compared to other radiological imaging methods. CNTM are encountered with a pooled prevalence of 1.5% of NEN patients performing SSTR-PET/CT. Prospective and multicentric studies are warranted to better clarify the impact of CNTM detection by SSTR-PET/CT on overall survival and clinical decision-making in NEN patients.

Data supporting the clinical utility of multi-target stool DNA (mt-sDNA) at the guideline-recommended 3-year interval have not been reported.Between April 2015 and July 2016, candidates for colorectal cancer screening whose providers prescribed the mt-sDNA test were enrolled. Participants with a positive baseline test were recommended for colonoscopy and completed the study. Those with a negative baseline test were followed annually for 3 years. In year 3, the mt-sDNA test was repeated and colonoscopy was recommended independent of results. Data were analyzed using the Predictive Summary Index (PSI), a measure of the gain in certainty for dichotomous diagnostic tests (where a positive value indicates a net gain), and by comparing observed versus expected colorectal cancers and advanced precancerous lesions.Of 2,404 enrolled subjects, 2,044 (85%) had a valid baseline mt-sDNA result [284 (13.9%) positive and 1,760 (86.1%) negative]. Following participant attrition, the year 3 intention to screen cohort included 591 of 1,760 (33.6%) subjects with valid mt-sDNA and colonoscopy results, with no colorectal cancers and 63 advanced precancerous lesions [22 (34.9%) detected by mt-sDNA] and respective PSI values of 0% (P = 1) and 9.3% (P = 0.01). The observed 3-year colorectal cancer yield was lower than expected (one-sided P = 0.09), while that for advanced precancerous lesions was higher than expected (two-sided P = 0.009).Repeat mt-sDNA screening at a 3-year interval resulted in a statistically significant gain in detection of advanced precancerous lesions. Due to absence of year 3 colorectal cancers, the PSI estimate for colorectal cancer was underpowered and could not be reliably quantified. Larger studies are required to assess the colorectal cancer study findings.Prevention relevanceUnderstanding the 3-year yield of mt-sDNA for colorectal cancer and advanced precancerous polyps is required to ensure the clinical appropriateness of the 3-year interval and to optimize mt-sDNA's screening effectiveness.

Patients diagnosed with multiple endocrine neoplasia type-1 (MEN1) often initially present with primary hyperparathyroidism (pHPT), and typically undergo surgical intervention. While laboratory tests are fundamental for diagnosis, imaging is crucial for localizing pathological parathyroids to aid in precise surgical planning. In this pictorial review, we will begin by comprehensively examining key imaging techniques and their established protocols, evaluating their effectiveness in detecting abnormal parathyroid glands. This analysis will emphasize both the advantages and potential limitations within the clinical context of MEN1 patients. Additionally, we will explore integrated imaging approaches that combine multiple modalities to enhance localization accuracy and optimize surgical planning—an essential component of holistic management in MEN1 cases. Various imaging techniques are employed for presurgical localization, including ultrasound (US), multiphase parathyroid computed tomography (CT) scanning (4D CT), magnetic resonance imaging (MRI), and nuclear medicine techniques like single photon emission computed tomography/CT (SPECT/CT) and positron emission tomography/CT (PET/CT). US is non-invasive, readily available, and provides high spatial resolution. However, it is operator-dependent and may have limitations in certain cases, such as intrathyroidal locations, the presence of bulky goiters, thyroid nodules, and previous thyroidectomy. Four-dimensional CT offers dynamic imaging, aiding in the identification of enlarged parathyroid glands, particularly in cases of ectopic or supernumerary glands. Despite concerns about radiation exposure, efforts are underway to optimize protocols and reduce doses, including the use of dual-energy CT. MR imaging offers excellent soft tissue contrast without radiation exposure, potentially providing superior differentiation between parathyroid glands and the surrounding structures. Radionuclide imaging, especially PET/CT using radiopharmaceuticals like [18F]FCH, shows promising results in localizing parathyroid tumors, particularly in patients with MEN1. [18F]FCH PET/CT demonstrates high sensitivity and may provide additional information compared to other imaging modalities, especially in cases of recurrent HPT.

This article draws upon a research project on intercultural language education conducted online between 2014 and 2017 with people living in the Gaza Strip (Palestine). Because the Gaza Strip has been under blockade since 2007, people cannot travel in and out freely. This context thus prompts educators and scholars to reflect on intercultural competence from a context of protracted crisis and of forced immobility. This study considers pre-service and in-service English teachers' understandings of intercultural competence and how these educators encourage intercultural communicative competence (ICC) in their classrooms in the Gaza Strip, where neither teachers, nor students, may have travelled abroad or experienced a face-to-face intercultural encounter. Based on this analysis, this article argues that frameworks for intercultural education and ICC need to capture non-movement and the lack of face-to-face intercultural encounters as "agentic" in definitions of interculturality. In other words, ICC should be conceptualised in terms of the actual freedoms and opportunities that individuals have to develop and nurture it. In order to propose such a model, this article connects ICC with the capabilities approach (Nussbaum, 2011; Sen, 1999), the capability of mobility (de Haas, 2010), and with the capacity to aspire (Appadurai, 2004).

A 50-year-old patient with a history of limited cutaneous scleroderma began with polyarthralgia (left shoulder, elbows and hips) without stiffness or associated inflammatory syndrome. Treatment with oral anti-inflammatory drugs was started on suspicion of peripheral spondyloarthritis with partial response. This progressed with the appearance of stiffness and functional limitation of the hips as well as an increase in the inflammatory syndrome two weeks after onset. It was decided to perform an 18F-FDG-PET scan compatible with polymyalgia rheumatica. The patient was treated with oral corticosteroids with an excellent response after one week of treatment.

This study evaluated growth, yield and olive oil quality of mature pedestrian olive orchards. Trees of three Sicilian cultivars Calatina, Nocellara del Belice and Abunara were planted at four combinations of planting densities and training forms. Trees at 2 × 5 m were trained to central leader (CLx2), those at 3 × 5 m to free palmette (FPx3), those at 4 x 5 to globe vase (GVx4), and those at 5 x 5 to poly-conic vase (PVx5). ‘Calatina’ had the smallest trees in terms of trunk size in all growing systems, while canopy size of trees at higher densities was similar for all three cultivars. ‘Calatina’ was also the most growth efficient (m3 of canopy per cm2 of TCSA) and produced the least amount of pruning wood in the hedgerow systems (CLx2 and FPx3). Fruit yield per tree tended to be higher in more vigorous cultivars (Abunara and Nocellara) grown to 3D systems (GVx4 and PVx5), while ‘Calatina’ was the most yield efficient (kg of fruit per cm2 of TCSA) especially in the hedgerow growing systems. Fruit and oil yield per ha and average production value tended to be highest in CLx2 trees and lowest in GVx4 trees, with ‘Calatina’ showing the sharpest changes and ‘Nocellara’ the smallest changes among growing systems. According to the Jaen index, CLx2 tended to induce earlier fruit maturation, followed by PVx5, GVx4, and FPx3. The growing system did not affect oil fatty acid composition, while ‘Calatina’ had the highest amount of mono-unsaturated fatty acids and the lowest amount of saturated fatty acids. ‘Abunara’ oils exhibited the highest amount of total phenols in CLx2, while ‘Calatina’ and ‘Nocellara’ oils exhibited the highest amount in FPx3 and PVx5. Both, trans-2-hexenal (“cut grass” sensory note) and hexenyl acetate (“floral” sensory note) tended to be lowest in oils from trees grown at CLx2 and highest in those from trees grown at GVx4, showing a somewhat inverse relationship with fruit ripening degree. The outcome of the present study on mature pedestrian orchards shows that proper combinations of cultivars, planting densities, and training forms (canopy shape) may result in efficient intensive systems for growing olive in areas where super-high density systems cannot be profitable due to agronomic and environmental limitations (water shortage, steep sloping sites, small farm size, etc.). Pedestrian growing systems can also be used to exploit olive biodiversity by allowing the use of available local genotypes. For this reason, they may represent an effective and sustainable solution against unexpected climate changes and associated emerging diseases.

In this article we discuss the outcomes of a project which taught Arabic as a 'refugee language' to primary school staff so they could welcome Arabic speaking children and families. The project was grounded in a commitment to social justice and inclusive education practices, and in an understanding of integration as a two-way process. The evaluation shows that teaching Arabic to primary staff had a positive impact on Arabic speaking children and families, on staff's own practice, and on the wider school community. We list a set of recommendation to expand the languages spoken and taught in educational contexts.

This article discusses the language needs analysis which informed the development of a beginner Arabic language course for Scottish primary education staff who work with Arabic-speaking refugee children and families. Interviews and focus group were carried out with: Scottish educators; Arabic-speaking refugee children; and parents/carers. They highlighted the following language needs for the course: (a) language for hospitality; (b) language for wellbeing; and (c) language for school. In this article we highlight the language needs as identified by refugee pupils and their families and we start a discussion on the importance of teaching a refugee language within formal educational settings.

Background and Aims: The multitarget stool DNA (mt-sDNA) assay is a noninvasive average-risk colorectal cancer (CRC) screening test. A new biomarker panel was developed for a next-generation test to improve specificity while maintaining/increasing sensitivity. We aimed first to establish an algorithm and cutoff for the next-generation mt-sDNA test and then to validate it using archived samples from the pivotal DeeP-C study (NCT01397747) of the first-generation test. Methods: Algorithm development and cross-validation included 3011 samples from 2 specimen collection studies (NCT03821948 and NCT03789162). The algorithm and cutoff were locked before validation. Validation test set samples included 57 CRC, 583 advanced precancerous lesions (APLs), and 7022 samples negative for CRC or APLs from the DeeP-C study, which prospectively enrolled average-risk, asymptomatic adults aged 50–84 years before screening colonoscopy. Next-generation biomarkers included methylated DNA markers ceramide synthase 4 gene, leucine-rich repeat-containing protein 4 gene, serine/threonine-protein phosphatase 2A 56 kDa regulatory subunit gamma isoform gene, and zinc finger DHHC-type containing 1 gene (reference marker), and fecal hemoglobin. Primary validation end points were CRC sensitivity and specificity for the absence of advanced neoplasia. Secondary end points included APL sensitivity and specificity for non-neoplastic findings or negative colonoscopy. Results: Cross-validation and best-fit results from algorithm development closely matched, confirming algorithm reliability and reproducibility. For the test set, next-generation mt-sDNA test sensitivity was 93.0% (95% confidence interval [CI], 83.0%–98.1%) for CRC and 48.4% (95% CI, 44.2%–52.5%) for APLs. Specificity was 88.5% (95% CI, 87.7%–89.2%) for the absence of advanced neoplasia and 90.4% (95% CI, 89.5%–91.2%) for the combination of non-neoplastic findings or negative colonoscopy. Conclusion: Based on archived samples, the next-generation mt-sDNA test demonstrated promising CRC screening performance characteristics that will be further assessed in a prospective clinical validation study (BLUE-C; NCT04144738).

The serious widespread development of nematode resistance has motivated the use of combined anthelmintic formulations. However, the advantages/disadvantages of the combined use of anthelmintics require further scientific characterization. The goals of the current trial were a) to characterize the pharmacokinetics of closantel (CLO) and moxidectin (MXD) administered both subcutaneously (sc) and orally either separately or co-administered (CLO + MXD) to lambs; b) to compare the nematodicidal activity of both molecules given individually or co-administered to lambs infected with resistant nematodes. Seventy (70) Corriedale lambs naturally infected with multiple resistant gastrointestinal nematodes were involved in the pharmacokinetic and efficacy trials. The animals were allocated into six groups (n = 10) and treated with either CLO, MXD, or with the CLO + MXD combined formulation by both the oral and sc routes. Additionally, an untreated control group (n = 10) was included for the efficacy trial. The efficacy was estimated by the faecal egg count reduction test (FECRT). Higher systemic exposure of both CLO and MXD was observed after the sc compared to the oral administration in lambs. The combined administration of CLO + MXD did not markedly alter their disposition kinetics. At 13 days post-treatment, the administration of both molecules as a single active principle reached efficacy levels ranging between 80% (MXDoral), 84% (CLOoral), 85% (CLOsc), and 92% (MXDsc). The combined oral and sc treatments reached 99% efficacy. No adverse effects were observed after the combined treatment of CLO + MXD, and their co-administration did not show any adverse pharmacokinetic interaction. The combined effect of CLO + MXD successfully restored the maximum efficacy levels, which were not reached by the individual active ingredients.