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OBJECTIVES To date, there are no standardized treatment algorithms or recommendations for patients with infective endocarditis (IE) and concomitant spondylodiscitis (SD). Therefore, our aim was to analyse whether the sequence of surgical treatment of IE and SD has an impact on postoperative outcome and to identify risk factors for survival and postoperative recurrence. METHODS Patients with IE underwent surgery in 4 German university hospitals between 1994 and 2022. Univariable and multivariable analyses were performed to identify possible predictors of 30-day/1-year mortality and recurrence of IE and/or SD. RESULTS From the total IE cohort (n  = 3991), 150 patients (4.4%) had concomitant SD. Primary surgery for IE was performed in 76.6%, and primary surgery for SD in 23.3%. The median age was 70.0 (64.0–75.6) years and patients were mostly male (79.5%). The most common pathogens detected were enterococci and Staphylococcus aureus followed by streptococci , and coagulase-negative Staphylococci. If SD was operated on first, 30-day mortality was significantly higher than if IE was operated on 1st (25.7% vs 11.4%; P  = 0.037) and we observed a tendency for a higher 1-year mortality. If IE was treated 1st, we observed a higher recurrence rate within 1 year (12.2% vs 0%; P  = 0.023). Multivariable analysis showed that primary surgery for SD was an independent predictor of 30-day mortality. CONCLUSIONS Primary surgical treatment for SD was an independent risk factor for 30-day mortality. When IE was treated surgically 1st, the recurrence rate of IE and/or SD was higher. [ABSTRACT FROM AUTHOR]

The tragic story of Flint has made it increasingly clear that the public needs to know how to evaluate sources of information. All of this is occurring in the age of "fake news," which heightens our awareness of the challenge of determining veracity. Furthermore, a flood of information can be found at our fingertips 24 hours a day. A quick Internet search can glean information that supports your viewpoint (whatever side you may be on) and crushes the opposition. We might begin to wonder if there is such a thing as "truth," and whether we can help students wade through the endless muck of false or misleading information to find it. This article explores how to teach source evaluation to upper elementary students with a focus on the right to clean water that is recognized in a United Nations resolution of 2010, and based on the 1948 Declaration of Human Rights.

This study examined how U.S. entry into World War I and related pedagogical reforms of the early twentieth century impacted elementary social education at a local level. Analysis of state curriculum guides, records from the collection of a rural school educator, report cards, and daily attendance registers for four counties indicated that elementary citizenship education emerged as a stand-alone subject area in Iowa's rural schools following World War I. While the "Civics of Iowa" was taught as part of the history curriculum prior to World War I, after the war civics became part of a larger framework for citizenship education. However, at a time of increasing nationalism, Iowa's rural schools taught citizenship in a way that privileged a local, relational approach centered on the home, school, and community. Findings from the study illustrate how rural schools kept pace with national trends in social education despite not yet embracing the integrated field of "social studies."

Curricular demands and best practices for middle school require interdisciplinary units. Arts integration can provide motivation and a new pathway to learning. This unit focused on inquiry into the natural history of artifacts and rocks recovered from the exposed subsoil of an area near Cedar Falls, Iowa that had been bulldozed as part of subdivision development. The described unit involved preservice teachers in exploration of all subject areas (language arts, mathematics, science, and social studies) with arts-integrated projects (agate watercolor painting, stone tool graphing, acrylic polymer clay agate keyring making, and stone tool drawings). The content area activities for social studies included identification and lifestyle interpretation of stone tools found intermixed with rocks and sand in the subsoil of the site. Science content activities included identification of rocks (igneous and metamorphic rocks; quartz nodules, geodes, and agates; and iron ore specimens) from the site along with interpretation of basalt cobbles that had been ground flat as glacially transported, and interpretation of maps and diagrams of glaciation, iron ore deposits, and agate deposits. Language arts activities involved word study through morpheme analysis of words such as "anthropology" and "artifact" along with matching a set of descriptive adjectives to objects related to agates. Mathematics content activities focused on graphing. Preservice teachers were highly engaged in the activities, remarking that they learned new content and pedagogy. Some expressed lack of confidence regarding artistic ability because of little experience and the desire to complete everything in the correct manner. At the end of the lessons, preservice teachers expressed that teaching the content through themes allowed for a great number of connections between subject areas, increased real-life connections, and deeper understandings of the topics.

Western science has grown increasingly reductionistic and, in parallel, the undergraduate life sciences curriculum has become disciplinarily fragmented. While reductionistic approaches have led to landmark discoveries, many of the most exciting scientific advances in the late 20th century have occurred at disciplinary interfaces; work at these interfaces is necessary to manage the world's looming problems, particularly those that are rooted in cellular-level processes but have ecosystem- and even global-scale ramifications (e.g., nonsustainable agriculture, emerging infectious diseases). Managing such problems requires comprehending whole scenarios and their emergent properties as sums of their multiple facets and complex interrelationships, which usually integrate several disciplines across multiple scales (e.g., time, organization, space). This essay discusses bringing interdisciplinarity into undergraduate cellular biology courses through the use of multiscalar topics. Discussing how cellular-level processes impact large-scale phenomena makes them relevant to everyday life and unites diverse disciplines (e.g., sociology, cell biology, physics) as facets of a single system or problem, emphasizing their connections to core concepts in biology. I provide specific examples of multiscalar topics and discuss preliminary evidence that using such topics may increase students' understanding of the cell's position within an ecosystem and how cellular biology interfaces with other disciplines.

Millions visited the World's Columbian Exhibition in Chicago between May and October, 1893. World's fairs and exhibitions had grown and developed grander purposes since the first one in London in 1851: "Beginning as large international industrial displays and showcases for the new inventions and discoveries of science and technology, they quickly became committed to the much more ambitious and comprehensive aim of revealing culture in all its dimensions" (Badger 1979). Chicago's Exhibition embraced the idea of revealing cultures, including several showcases deemed "less-civilized," as Native Americans, Egyptians, and Africans were shown in a theatrical exposition. The examples of Native "savagery" showed a way of life slowly disappearing. While these exhibits intended to show the "savagery" of the American Indians, a nearby exhibit revealed to crowds of Americans the possibility that American Indians could be "civilized." An exhibition of Native American children attempted to demonstrate what many believed at the time was the best way to Americanize the Indians: education. For two weeks in June 1893, students from St. Joseph's Indian Normal School demonstrated how Native American children were being pressured to abandon their cultures and adopt a new one. Both the children's and adults' exhibits showed the dominance of one race over another, but through vastly different methods. Displaying student performances, as well as examples of their work, revealed the development of St. Joseph's students' Americanization and assimilation. This article contextualizes St. Joseph's Indian Normal School in the larger religious debate within Indian education in the late-nineteenth century and focuses on how the school was unique in emulating government and Catholic schools in both policy and curriculum.

Background: Acute kidney injury (AKI) after cardiac surgery is a well-known risk factor for increased postoperative mortality and morbidity. The effect of postoperative developed AKI on postoperative outcomes in patients after Bentall procedure has been incompletely investigated. The present study was dedicated to assessing the impact of postoperative AKI on morbidity and 30-day mortality in this specific cohort. Methods: In a retrospective observational study, we investigated 249 patients undergoing Bentall procedure from January 2014 to March 2018 at the University Hospital of Cologne, Germany. After excluding patients with preoperative renal impairment, patients were divided into an AKI group (n = 88) and a non-AKI group (n = 97). Postoperative outcomes and 30-day mortality were analyzed using univariate regression analysis. AKI was defined by AKIN criteria. Results: Mortality during ICU and hospital stay, as well as 30-day mortality, was significantly higher in the AKI group (all p < 0.001). Patients with postoperative developed AKI revealed 9.3-fold higher odds for ICU mortality and 6.7-fold higher odds for 30-day mortality in comparison to non-AKI group (all p < 0.004) as well as 4.5-fold higher odds for stroke. Coronary artery bypass time, as well as cross-clamp time, were similarly distributed between groups, whereas incidences of postoperative bleeding, myocardial infarction, and need for rethoracotomy occurred significantly more often in patients with postoperatively developed AKI (all p < 0.04). Conclusion: Patients undergoing Bentall surgery who postoperatively developed AKI showed significantly higher morbidity and mortality. AKI points out to be an early predictor for poor outcomes. Thus, as a consequence, patients with postoperatively developed AKI should be highly monitored for immediate intervention. [ABSTRACT FROM AUTHOR]

Objective This study aimed to assess short-term outcomes of patients with failed aortic valve bioprosthesis undergoing valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) or redo surgical aortic valve replacement (rSAVR). Methods Between 2009 and 2019, 90 patients who underwent ViV-TAVR (n = 73) or rSAVR (n = 17) due to failed aortic valve bioprosthesis fulfilled the inclusion criteria. Groups were compared regarding clinical end points, including in-hospital all-cause mortality. Patients with endocarditis and in a need of combined cardiac surgery were excluded from the study. Results ViV-TAVR patients were older (78.0 ± 7.4 vs. 62.1 ± 16.2 years, p = 0.012) and showed a higher prevalence of baseline comorbidities such as atrial fibrillation, diabetes mellitus, hyperlipidemia, and arterial hypertension. In-hospital all-cause mortality was higher for rSAVR than in the ViV-TAVR group (17.6 vs. 0%, p < 0.001), whereas intensive care unit stay was more often complicated by blood transfusions for rSAVR patients without differences in cerebrovascular events. The paravalvular leak was detected in 52.1% ViV-TAVR patients compared with 0% among rSAVR patients (p < 0.001). Conclusion ViV-TAVR can be a safe and feasible alternative treatment option in patients with degenerated aortic valve bioprosthesis. The choice of treatment should include the patient's individual characteristics considering ViV-TAVR as a standard of care. [ABSTRACT FROM AUTHOR]