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At the launch of How to be a Learning Developer in higher education (Syska and Buckley, 2024), a common thread emerged during contributor presentations: the need to develop a shared critical approach to position ourselves effectively within higher education. This approach would identify and implement strategies to resist the challenges of neoliberalism, working towards social justice for our students, using critical pedagogy. These themes are relatively common in the LD literature, and the ALDinHE value of ‘embracing […] critical pedagogy’ accompanies the manifesto statement that ‘neutrality is not an option’ (ALDinHE, 2023). These terms carry political connotations and implications for LD practice. Together, these factors suggest a move to develop a ‘signature’ critical LD pedagogy, underpinned by an explicitly ideological vision. Under these circumstances, we risk constructing ‘a bounded, enclosed media space that has the potential to both magnify the messages delivered within it and insulate them from rebuttal’ (Jamieson and Capella, 2008, p.76) — in short, an echo chamber. This raises some important questions: • Given the explicitly political nature of critical pedagogy, in recruitment of new LD colleagues, should we test for and limit entry to our critical pedagogy club to those with ‘acceptable’ political views? • Critical pedagogy is skeptical of dominant narratives. How will we prevent critical pedagogy from becoming the dominant narrative in our community? • What if we are wrong? Even if our diagnosis of the challenges we face is correct, how will we test our solutions in the absence of robust challenges from alternative perspectives?

I have often felt sceptical about the idea of academic literacies (AL), which presents a highly influential account of ‘how students learn to write at university’ (Lea and Street, 1998). AL theory has had a significant impact on the field, but some things about it bother me. Key ideas are frequently expressed in very abstract terms (it is hard to justify this comment in an academic context, but bear with me). Research has recognised difficulties in outlining AL’s core principles to students (Lea, 2016, p.91), and ‘the exact nature of the relationship between [its component] approaches’ (Hilsdon, Malone and Syska, 2019). It can be hard to convert the lofty AL aims of emancipation or transformation into practice. As theories go, it clearly thinks of itself as on ‘the right side of history’, and perhaps it is. However, having recently spent time wrangling with AL literature, I have developed more of a (grudging) respect for its insights and possible uses in practice. Drawing on theoretical writing and case studies of AL in use, this session aimed to identify the AL insights which are most relevant for the day-to-day practice of Learning Developers and present them in more concrete terms. In doing so, I hope to make this theory ‘meaningful, relevant and accessible to all’ (for Hockings’ definition of ‘inclusive’, see Hockings, 2010, p.1). After brief comments on its context and aims, I presented a short series of my ‘translations’ from AL into everyday English for use in everyday Learning Development practice.

Academic literacies (AL) research has made significant contributions to understandings of student writing and literacy across higher education and particularly learning development. However, researchers and practitioners both within and external to the AL movement have struggled to clarify the relationship between AL and pedagogy. English for Academic Purposes researchers have highlighted the lack of a workable AL pedagogy, whilst AL researchers maintain that the model represents a design space or heuristic for thinking about practice in context, rather than a source of pedagogic prescriptions. This theoretical discussion elaborates concerns with the structural coherence of the AL model, its broadly social constructivist underpinnings and evidence base, and the impact of its ideological orientation on the pedagogy we derive from it. Underpinning these critiques is a suspicion that the interpretation of social constructivist epistemology on which AL relies to pinpoint weaknesses in the models of literacy/writing which it subsumes cannot generate a practical pedagogy. We argue that these structural and ideological tensions in the AL model help to explain confusion over its interpretation and implementation. We speculate that this singular focus on social constructivist-derived theory, though well-intentioned, does more to reinforce a particular ideological commitment than to enhance student learning.

Inherited arrhythmia syndromes are rare genetic conditions that predispose seemingly healthy individuals to sudden cardiac arrest and death. The Hearts in Rhythm Organization is a multidisciplinary Canadian network of clinicians, researchers, patients, and families that aims to improve care for patients and families with inherited cardiac conditions, focused on those that confer predisposition to arrhythmia and sudden cardiac arrest and/or death. The field is rapidly evolving as research discoveries increase. A streamlined, practical guide for providers to diagnose and follow pediatric and adult patients with inherited cardiac conditions represents a useful tool to improve health system utilization, clinical management, and research related to these conditions. This review provides consensus care pathways for 7 conditions, including the 4 most common inherited cardiac conditions that confer predisposition to arrhythmia, with scenarios to guide investigation, diagnosis, risk stratification, and management. These conditions include Brugada syndrome, long QT syndrome, arrhythmogenic right ventricular cardiomyopathy and related arrhythmogenic cardiomyopathies, and catecholaminergic polymorphic ventricular tachycardia. In addition, an approach to investigating and managing sudden cardiac arrest, sudden unexpected death, and first-degree family members of affected individuals is provided. Referral to specialized cardiogenetic clinics should be considered in most cases. The intention of this review is to offer a framework for the process of care that is useful for both experts and nonexperts, and related allied disciplines such as hospital management, diagnostic services, coroners, and pathologists, in order to provide high-quality, multidisciplinary, standardized care. Résumé: Les syndromes d’arythmie héréditaires sont des troubles génétiques rares qui prédisposent des personnes en apparence en bonne santé à un arrêt cardiaque soudain et à la mort. L’organisation Hearts in Rhythm Organization est un réseau multidisciplinaire canadien qui regroupe des cliniciens, des chercheurs ainsi que des patients et leurs proches dans le but d’améliorer les soins prodigués aux patients atteints de maladies cardiaques héréditaires et à leur famille, en particulier dans le cas des maladies qui entraînent une prédisposition à l’arythmie et à un arrêt cardiaque soudain et/ou à la mort. Puisque ce champ de recherche évolue rapidement, la mise au point d’un guide pratique et simple à l’intention des professionnels de la santé pour le diagnostic et le suivi des patients enfants et adultes présentant une maladie cardiaque héréditaire serait donc un outil intéressant pour améliorer l’utilisation du système de santé et la prise en charge clinique de ces maladies tout en orientant la recherche à ce propos. La présente synthèse expose les trajectoires de soins faisant l’objet d’un consensus pour sept maladies, dont les quatre maladies cardiaques héréditaires les plus courantes qui prédisposent à l’arythmie. Elle présente aussi des scénarios pour orienter les examens, le diagnostic, la stratification du risque et la prise en charge des patients. Ces maladies sont le syndrome de Brugada, le syndrome du QT long, la cardiomyopathie arythmogénique du ventricule droit et les cardiomyopathies arythmogènes associées, et la tachycardie ventriculaire polymorphe catécholaminergique. En outre, une approche pour la prise en charge de l’arrêt cardiaque soudain, de mort subite inattendue et des membres de la famille immédiate de la personne touchée est proposée. L’orientation vers des cliniques spécialisées en cardiogénétique doit être envisagée dans la plupart des cas. L’objectif est d'établir un cadre de soins qui soit utile pour les experts et les non-experts ainsi que pour les professionnels des domaines connexes, par exemple le personnel de l’administration hospitalière et des services diagnostiques, les coroners et les pathologistes, en vue d’offrir des soins multidisciplinaires normalisés de grande qualité.

Critiques and polemics calling for ‘doing away with study skills’ as an ineffectual ‘Tinkerbell’ mirage that plays into neoliberal, deficit, anti-academic agendas have appeared both in academic scholarship and the higher education press (see, for example, Richards and Pilcher, 2021, 2023; Wingate, 2006). Often originating from outside the learning development community, misinformed and misdirected, these criticisms gain traction with senior leadership and academic colleagues, and cannot be ignored, avoided, or dismissed if we are to promote our ethos (and preserve our jobs). So nearly right in many ways, but for the wrong reasons, they come too close to the mark to shrug off. Yet there has been very little response—let alone rebuttal—from the learning development community, individually or collectively. Robust critique is fair and demands a reply: ‘rising above it’ is not a scholarly response. Any reluctance to engage in outward-facing debate is surely a problem given that there is so much at stake for students and for ourselves. Are we going to let them talk about us like this? Questions: • Are they right? • Can you prove it? • How will anyone know?

Threshold concepts (TCs) represent pivotal ‘eureka’ moments in learning, where a person makes a leap in understanding or ability ‘akin to a portal, opening up a new and previously inaccessible way of thinking about something’ (Meyer and Land, 2003, p. 1). Crossing these thresholds can be transformative, integrative, and irreversible, but also troublesome. Discussion of threshold concepts may provide a novel way of surfacing the core challenges of learning development work—whether in terms of helping students to progress or informing how we operate within the university context. Research in learning development has identified ‘generic’ threshold concepts that students might need to support their studies. However, it is also worth considering whether we as learning developers can collectively identify threshold concepts that increase our impact when working with students, academics, and other stakeholders. This session contextualised the idea by first looking at threshold concepts for student development. This activity aimed to enhance participants’ understanding of threshold concepts.

A recent blog post on the SEDA educational development forum led to a stimulating discussion about whether learning should be fun (Saunders, 2022). As learning developers, it makes sense to make learning activities enjoyable for students where we can. However, this lightning talk contended that some aspects of learning are unlikely to - and perhaps even cannot - be fun. Indeed, we may limit the inclusiveness of our approach if we fail to address this idea in our work. As such, it is important for learning developers to be clear with students that some aspects of their learning experience may involve struggle and discomfort. Whilst it is pleasant for us when students end interactions with learning developers feeling reassured and with a smile on their face, it may at times be more helpful to see them leave with a look of grim determination. For example, threshold concepts scholarship identifies dimensions of learning that may require transformation not only of one’s understanding but also elements of one’s identity. Wrangling with troublesome knowledge within often uncomfortable liminal states of ‘in-betweenness’ is therefore necessary for students to progress in their understanding or ability (Land et al., 2008). Drawing on recent educational and learning development discourse, in this talk White argued that recognising that learning cannot always be fun is important in creating an inclusive learning experience for students. Indeed, students can take comfort, confidence, and even a sense of belonging from understanding that their peers and lecturers struggle with some aspects of learning. At times, we may need to ‘suffer now’ to gain satisfaction and achievement in the longer term. We need to be up front about this in our interactions with students.

We have carried out a series of experiments to measure the Cl K-absorption edge for shock-compressed samples of chlorinated parylene. Colliding shocks allowed us to compress samples up to four times the initial density with temperatures up to 10 eV. Red shifts in the edge of about 10 eV have been measured. We have compared the measured shifts to analytical modelling using the Stewart–Pyatt model and adaptions of it, combined with estimates of density and temperature based on hydrodynamic modelling. Modelling of the edge position using density functional theory molecular dynamics (DFT-MD) was also used and it was found that good agreement was only achieved when the DFT simulations assumed conditions of lower temperature and slightly higher density than indicated by hydrodynamic simulations using a tabular equation of state.

Summary: Background: Catatonia is a psychomotor syndrome that has a wide range of aetiologies. Determining whether catatonia is due to a medical or psychiatric cause is important for directing treatment but is clinically challenging. We aimed to ascertain the performance of the electroencephalogram (EEG) in determining whether catatonia has a medical or psychiatric cause, conventionally defined. Methods: In this systematic review and meta-analysis of diagnostic test accuracy (PROSPERO CRD42021239027), Medline, EMBASE, PsycInfo, and AMED were searched from inception to May 11, 2022 for articles published in peer-reviewed journals that reported EEG findings in catatonia of a medical or psychiatric origin and were reported in English, French, or Italian. Eligible study types were clinical trials, cohort studies, case–control studies, cross-sectional studies, case series, and case reports. The reference standard was the final clinical diagnosis. Data extraction was conducted using individual patient-level data, where available, by two authors. We prespecified two types of studies to overcome the limitations anticipated in the data: larger studies (n ≥ 5), which were suitable for formal meta-analytic methods but generally lacked detailed information about participants, and smaller studies (n

Abstract Background Recently, the first randomized trials comparing minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) for non-malignant and malignant disease showed a 2-day reduction in time to functional recovery after MIDP. However, for pancreatic ductal adenocarcinoma (PDAC), concerns have been raised regarding the oncologic safety (i.e., radical resection, lymph node retrieval, and survival) of MIDP, as compared to ODP. Therefore, a randomized controlled trial comparing MIDP and ODP in PDAC regarding oncological safety is warranted. We hypothesize that the microscopically radical resection (R0) rate is non-inferior for MIDP, as compared to ODP. Methods/design DIPLOMA is an international randomized controlled, patient- and pathologist-blinded, non-inferiority trial performed in 38 pancreatic centers in Europe and the USA. A total of 258 patients with an indication for elective distal pancreatectomy with splenectomy because of proven or highly suspected PDAC of the pancreatic body or tail will be randomly allocated to MIDP (laparoscopic or robot-assisted) or ODP in a 1:1 ratio. The primary outcome is the microscopically radical resection margin (R0, distance tumor to pancreatic transection and posterior margin ≥ 1 mm), which is assessed using a standardized histopathology assessment protocol. The sample size is calculated with the following assumptions: 5% one-sided significance level (α), 80% power (1-β), expected R0 rate in the open group of 58%, expected R0 resection rate in the minimally invasive group of 67%, and a non-inferiority margin of 7%. Secondary outcomes include time to functional recovery, operative outcomes (e.g., blood loss, operative time, and conversion to open surgery), other histopathology findings (e.g., lymph node retrieval, perineural- and lymphovascular invasion), postoperative outcomes (e.g., clinically relevant complications, hospital stay, and administration of adjuvant treatment), time and site of disease recurrence, survival, quality of life, and costs. Follow-up will be performed at the outpatient clinic after 6, 12, 18, 24, and 36 months postoperatively. Discussion The DIPLOMA trial is designed to investigate the non-inferiority of MIDP versus ODP regarding the microscopically radical resection rate of PDAC in an international setting. Trial registration ISRCTN registry ISRCTN44897265 . Prospectively registered on 16 April 2018.

Background Northern England has been experiencing a persistent rise in the number of primary liver cancers, largely driven by an increasing incidence of hepatocellular carcinoma (HCC) secondary to alcohol-related liver disease and non-alcoholic fatty liver disease. Here we review the effect of the COVID-19 pandemic on primary liver cancer services and patients in our region.Objective To assess the impact of the COVID-19 pandemic on patients with newly diagnosed liver cancer in our region.Design We prospectively audited our service for the first year of the pandemic (March 2020–February 2021), comparing mode of presentation, disease stage, treatments and outcomes to a retrospective observational consecutive cohort immediately prepandemic (March 2019–February 2020).Results We observed a marked decrease in HCC referrals compared with previous years, falling from 190 confirmed new cases to 120 (37%). Symptomatic became the the most common mode of presentation, with fewer tumours detected by surveillance or incidentally (% surveillance/incidental/symptomatic; 34/42/24 prepandemic vs 27/33/40 in the pandemic, p=0.013). HCC tumour size was larger in the pandemic year (60±4.6 mm vs 48±2.6 mm, p=0.017), with a higher incidence of spontaneous tumour haemorrhage. The number of new cases of intrahepatic cholangiocarcinoma (ICC) fell only slightly, with symptomatic presentation typical. Patients received treatment appropriate for their cancer stage, with waiting times shorter for patients with HCC and unchanged for patients with ICC. Survival was associated with stage both before and during the pandemic. 9% acquired COVID-19 infection.Conclusion The pandemic-associated reduction in referred patients in our region was attributed to the disruption of routine healthcare. For those referred, treatments and survival were appropriate for their stage at presentation. Non-referred or missing patients are expected to present with more advanced disease, with poorer outcomes. While protective measures are necessary during the pandemic, we recommend routine healthcare services continue, with patients encouraged to engage.

Interactions between people and wildlife are often mediated by laws, policies, and other governance instruments with profound implications for species conservation. Despite its importance for conservation practice, governance of these human-wildlife relationships is an under-researched area. Our research aim was to understand the link between law/policy and human-wildlife conflict (HWC) and the implications for species conservation using a systematic quantitative review of the literature on the human dimensions of HWC. We identified 133 relevant HWC studies, conducted in 45 countries, involving 114 species. Over 80% of the articles mentioned law, mainly national-level legislation, with little reference to customary or tribal law. However, only 40%, stated whether the laws had influenced the HWC—most reported negative associations with HWC or a mix of positive and negative associations. The perceived ineffectiveness of law was primarily attributed to lack of implementation, support, and enforcement and perceived erroneous laws. The few positive associations included stakeholder involvement, management flexibility, and adequate compensation. Our findings reveal a knowledge deficit on the detailed effects of law on HWC and conservation conflicts in general. Overall, law as an institution seems to exacerbate or prolong most conflicts instead of providing a pathway to coexistence and enhancing species conservation.

OBJECTIVES:. The Seraph100 Microbind Affinity Blood Filter (Seraph 100) (ExThera Medical, Martinez, CA) is an extracorporeal therapy that can remove pathogens from blood, including severe acute respiratory syndrome coronavirus 2. The aim of this study was to evaluate safety and efficacy of Seraph 100 treatment for COVID-19. DESIGN:. Retrospective cohort study. SETTING:. Nine participating ICUs. PATIENTS:. COVID-19 patients treated with Seraph 100 (n = 53) and control patients matched by study site (n = 53). INTERVENTION:. Treatment with Seraph 100. MEASUREMENTS AND MAIN RESULTS:. At baseline, there were no differences between the groups in terms of sex, race/ethnicity, body mass index, and need for mechanical ventilation. However, patients in the Seraph 100 group were younger (median age, 54 yr; interquartile range [IQR], 41–65) compared with controls (median age, 64 yr; IQR, 56–69; p = 0.009). Charlson comorbidity index scores were lower in the Seraph 100 group (2; IQR, 0–3) compared with the control group (3; IQR, 2–4; p = 0.006). Acute Physiology and Chronic Health Evaluation II scores were also lower in Seraph 100 subjects (12; IQR, 9–17) compared with controls (16; IQR, 12–21; p = 0.011). The Seraph 100 group had higher vasopressor-free days with an incidence rate ratio of 1.30 on univariate analysis. This difference was not significant after adjustment. Seraph 100-treated subjects were less likely to die compared with controls (32.1% vs 64.2%; p = 0.001), a difference that remained significant after adjustment. However, no difference in mortality was observed in a post hoc analysis utilizing an external control group. In the full cohort of 86 treated patients, there were 177 total treatments, in which only three serious adverse events were recorded. CONCLUSIONS:. Although this study did not demonstrate consistently significant clinical benefit across all endpoints and comparisons, the findings suggest that broad spectrum, pathogen agnostic, blood purification can be safely deployed to meet new pathogen threats while awaiting targeted therapies and vaccines.

Background After sudden cardiac death in people aged

Sepsis is a debilitating condition associated with a high mortality rate that greatly strains hospital resources. Though advances have been made in improving sepsis diagnosis and treatment, our understanding of the disease is far from complete. Mathematical modeling of sepsis has the potential to explore underlying biological mechanisms and patient phenotypes that contribute to variability in septic patient outcomes. We developed a comprehensive, whole-body mathematical model of sepsis pathophysiology using the BioGears Engine, a robust open-source virtual human modeling project. We describe the development of a sepsis model and the physiologic response within the BioGears framework. We then define and simulate scenarios that compare sepsis treatment regimens. As such, we demonstrate the utility of this model as a tool to augment sepsis research and as a training platform to educate medical staff.

Abstract EFSA was asked to update the 2015 EFSA risk assessment on Xylella fastidiosa for the territory of the EU. In particular, EFSA was asked to focus on potential establishment, short‐ and long‐range spread, the length of the asymptomatic period, the impact of X. fastidiosa and an update on risk reduction options. EFSA was asked to take into account the different subspecies and Sequence Types of X. fastidiosa. This was attempted throughout the scientific opinion but several issues with data availability meant that this could only be partially achieved. Models for risk of establishment showed most of the EU territory may be potentially suitable for X. fastidiosa although southern EU is most at risk. Differences in estimated areas of potential establishment were evident among X. fastidiosa subspecies, particularly X. fastidiosa subsp. multiplex which demonstrated areas of potential establishment further north in the EU. The model of establishment could be used to develop targeted surveys by Member States. The asymptomatic period of X. fastidiosa varied significantly for different host and pathogen subspecies combinations, for example from a median of approximately 1 month in ornamental plants and up to 10 months in olive, for pauca. This variable and long asymptomatic period is a considerable limitation to successful detection and control, particularly where surveillance is based on visual inspection. Modelling suggested that local eradication (e.g. within orchards) is possible, providing sampling intensity is sufficient for early detection and effective control measures are implemented swiftly (e.g. within 30 days). Modelling of long‐range spread (e.g. regional scale) demonstrated the important role of long‐range dispersal and the need to better understand this. Reducing buffer zone width in both containment and eradication scenarios increased the area infected. Intensive surveillance for early detection, and consequent plant removal, of new outbreaks is crucial for both successful eradication and containment at the regional scale, in addition to effective vector control. The assessment of impacts indicated that almond and Citrus spp. were at lower impact on yield compared to olive. Although the lowest impact was estimated for grapevine, and the highest for olive, this was based on several assumptions including that the assessment considered only Philaenus spumarius as a vector. If other xylem‐feeding insects act as vectors the impact could be different. Since the Scientific Opinion published in 2015, there are still no risk reduction options that can remove the bacterium from the plant in open field conditions. Short‐ and long‐range spread modelling showed that an early detection and rapid application of phytosanitary measures, consisting among others of plant removal and vector control, are essential to prevent further spread of the pathogen to new areas. Further data collection will allow a reduction in uncertainty and facilitate more tailored and effective control given the intraspecific diversity of X. fastidiosa and wide host range.

Massive Open Online Courses (MOOCs) are frequently portrayed as “agents of change” in higher education (HE), impacting on institutional practices, processes and structures throughout HE. However, these courses do not “fit” neatly with the established aims and functions of universities, and accounts of technology-led change in universities predominate, simplistically emphasising technologically determinist narratives with incidental social effects. This study aims to explore the consequences of introducing these courses into HE in terms of the roles of educators, learning designers and the socio-technical construction of MOOCs. The research takes a socio-technical perspective, combining the established analytical strategy of Socio-Technical Interaction Networks (STIN) with the social theoretical ‘third space’ framework of HE activity. The paper reports on the first of three institutional cases studies, finding that learning designers occupy a hub-like position in the networks of actors involved in MOOC development within an emergent ‘third space’ between academic and managerial roles. The analysis also reveals how the massive and open elements of these courses elicit involvement of seemingly peripheral actors, who exert a strong influence on course production processes and content, with educators taking a less central role. This work adds a socio-technical element to understandings of third space activity in higher education, and can inform the planning and development of online education projects in accounting for changing roles in HE where massiveness and openness are combined in a course.

This article examines the regulation of companion animal welfare during disasters, with some context provided by two recent major disaster events in Australia. Important general lessons for improved disaster management were identified in subsequent inquiries. However, the interests of companion animals continue to be inadequately addressed. This is because key assumptions underpinning disaster planning for companion animals—the primacy of human interests over animal interests and that individuals will properly address companion animal needs during times of disaster—are open to question. In particular these assumptions fail to recognise the inherent value of companion animals, underestimate the strong bond shared by some owners and their animals and, at the same time, overestimate the capacity of some owners to adequately meet the needs of their animals.