Background Lynch syndrome is a rare familial cancer syndrome caused by pathogenic variants in the mismatch repair genes MLH1, MSH2, MSH6, or PMS2, that cause predisposition to various cancers, predominantly colorectal and endometrial cancer. Data are emerging that pathogenic variants in mismatch repair genes increase the risk of earlyonset aggressive prostate cancer. The IMPACT study is prospectively assessing prostate-specific antigen (PSA) screening in men with germline mismatch repair pathogenic variants. Here, we report the usefulness of PSA screening, prostate cancer incidence, and tumour characteristics after the first screening round in men with and without these germline pathogenic variants. MethodsThe IMPACT study is an international, prospective study. Men aged 40-69 years without a previous prostate cancer diagnosis and with a known germline pathogenic variant in the MLH1, MSH2, or MSH6 gene, and age-matched male controls who tested negative for a familial pathogenic variant in these genes were recruited from 34 genetic and urology clinics in eight countries, and underwent a baseline PSA screening. Men who had a PSA level higher than 3•0 ng/mL were offered a transrectal, ultrasound-guided, prostate biopsy and a histopathological analysis was done. All participants are undergoing a minimum of 5 years' annual screening. The primary endpoint was to determine the incidence, stage, and pathology of screening-detected prostate cancer in carriers of pathogenic variants compared with non-carrier controls. We used Fisher's exact test to compare the number of cases, cancer incidence, and positive predictive values of the PSA cutoff and biopsy between carriers and non-carriers and the differences between disease types (ie, cancer vs no cancer, clinically significant cancer vs no cancer). We assessed screening outcomes and tumour characteristics by pathogenic variant status. Here we present results from the first round of PSA screening in the IMPACT study. This study is registered with ClinicalTrials.gov, NCT00261456, and is now closed to accrual.

Immigrant integration in nation states increasingly focuses on the importance of learning the national state language. This is evidenced by increased emphasis on rigorous language testing and tighter citizenship regulations. This paper analyses immigrant integration in two sub-state contexts, Galicia and Wales, where presence of a national language as well as a local language reveal different linguistic complexities and realities which concern the new speaker. How do immigrants respond to bilingual host community settings? To what extent are new speakers able to claim ownership on more than one host community language? Are new immigrant speakers of Galician and Welsh considered 'legitimate' speakers of these languages? To answer these questions, this paper will compare and contrast results from two ethnographically-based research projects, showing that immigrants in both these contexts are challenging traditional concepts of new speakers of minority languages, opening up new ways of belonging but also revealing boundaries to their pathways of becoming legitimate new speakers.

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In Cabo Verde, Portuguese is the official language, while Kriolu is the first language of virtually all the population. The schooling context clearly reflects this diglossic situation: while the vast majority of children speak Kriolu at home, Portuguese continues to be the exclusive language of instruction. Thus, Portuguese in Cabo Verde represents a post-colonial language that has maintained its de jure status but has not entered de facto domains of use. The research described in this article is based on discourse analysis of legislative and policy documents and extended semi-structured interviews with politicians, educators and language activists. Our results in this former colonial context invite us to reconsider traditional understandings of pluricentricity, as they suggest that Cabo Verdean Portuguese is not (yet) associated with local identity and has not (yet) been accepted by its speakers as a legitimate, standardised variety.