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Objectives: To evaluate the major risk factors for adverse short and long term outcomes in patients with active native valve infective endocarditis needing cardiac surgery and to validate the EuroSCORE II in our cohort of patients. Methods: We retrospectively studied 149 patients who underwent native valve surgery for infective endocarditis in June 2000 - May 2011 at our referral centre. Ninety-six patients met the inclusion criteria for the study: 29 aortic valve replacements (AVR), 27 mitral valve replacements (MVR), 28 aortic/mitral (double) valve replacements (DVR) and 12 mitral valve repairs (MV Repair). Results: Mechanical valves were implanted in 68 patients (70.8%), bioprosthetic valves in 16 (16.7%) and mitral annuloplasty rings in 12 (12.5%). The Cox proportional hazard model showed that the most important risk factors for early 30-day mortality were: critical preoperative state, emergency surgery, EuroSCORE II >12%, low cardiac output state (LCOS), HIV positive status, preoperative embolic episodes, vegetation size >1cm and postoperative ventilation >24 hours. The EuroSCORE II underestimated early mortality for the entire cohort. The discriminatory ability was evaluated with the receiver operating characteristic (ROC) curve with an area under the curve of 0.796. The discriminatory ability in the subgroup analysis showed that the AUROC curve was poorer for MVR (0.696), 0.837 for DVR and better for AVR group (0.92). Conclusions: The EuroSCORE II underestimated mortality in the highest risk groups and overestimated mortality in the lowest risk groups. The discriminatory ability and model fit were evaluated to be good and a EuroSCORE II >12% predicted a signifi cantly higher early and medium term mortality.

Mycobacteriophages Deby, LaterM, LilPharaoh, Paola, SgtBeansprout, and Sulley were isolated from soil using Mycobacterium smegmatis mc2155. Genomic analysis indicated that they belong to subclusters K1 and K5. Their genomic architectures are typical of cluster K mycobacteriophages, with most variability occurring on the right end of the genome sequence.

One of the main reasons for acquiring a Bachelor's Degree is the perception of higher education as a means of improving graduates' financial status. In light of the increased accessibility of higher education, a growing number of students hope to use their studies as a financial springboard. In the current study we sought to examine this perception and to check whether and to what degree baccalaureate degrees indeed improve graduates' financial situation. In cooperation with Israel's Central Bureau of Statistics we gathered data on 6,091 graduates who completed their studies at the Ariel University Center during 2000-2008. Data analysis included exploring graduates' rate of employment and monthly salary from the day they began their academic studies until eight years later. We divided and distinguished between graduates by discipline and gender. The findings show that graduates earn almost three times the national average salary (and five times the median salary) and indicate employment rates of nearly 100%. Analysis of findings by discipline indicates that the most profitable fields are computer sciences and mathematics, engineering, and architecture. Salaries in the natural and social sciences and in the humanities are significantly lower both compared to the former fields and to the national average salary, at least for this eight year span. Analysis of the data by sex showed that the rate of employment among men is 12% higher than among women and that there is a disparity in employment within each discipline as well. Research conclusions show that academic degrees per se are not a guarantee of financial or occupational security. Employees with degrees in the social sciences and the humanities may find that their pay is no higher than those with no degree. One of the implications of this issue, already evident at this stage is that students are attempting to attain higher degrees in the hope of improving their financial status. The equation of a higher education with a higher income seems to involve other components as well, such as graduates' field of study, seniority on the job, and field of occupation.

Though technology has played an increasingly significant role in all types of classrooms, the actual use of technologies has not caught up with the increased availability of hardware and software. Building community in an assistive course, can make full use of advanced technologies and create a student-centred learning environment to meet each individual student's styles and needs.

Informed by the almost unimaginable unmet need for cardiac surgery in the developing regions of the world, leading surgeons, cardiologists, editors in chief of the major cardiothoracic journals as well as representatives of medical industry and government convened in December 2017 to address this unacceptable disparity in access to care. The ensuing "Cape Town Declaration" constituted a clarion call to cardiac surgical societies to jointly advocate the strengthening of sustainable, local cardiac surgical capacity in the developing world. The Cardiac Surgery Intersociety Alliance (CSIA) was thus created, comprising The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS), the European Association for Cardio-Thoracic Surgery (EACTS) and the World Heart Federation (WHF). The guiding principle was advocacy for sustainable cardiac surgical capacity in low-income countries. Summary: Informed by the almost unimaginable unmet need for cardiac surgery in the developing regions of the world, leading surgeons, cardiologists, editors in chief of the major cardiothoracic journals as well as representatives of medical industry and government convened in December 2017 to address this unacceptable disparity in access to care. The ensuing "Cape Town Declaration" constituted a clarion call to cardiac surgical societies to jointly advocate the strengthening of sustainable, local cardiac surgical capacity in the developing world. The Cardiac Surgery Intersociety Alliance (CSIA) was thus created, comprising The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS), the European Association for Cardio-Thoracic Surgery (EACTS) and the World Heart Federation (WHF). The guiding principle was advocacy for sustainable cardiac surgical capacity in low-income countries. As a first step, a global needs assessment confirmed rheumatic heart disease as the overwhelming pathology requiring cardiac surgery in these regions. Subsequently, CSIA published a request for proposals to support fledgling programmes that could demonstrate the backing by their governments and health care institution. Out of 11 applicants, and following an evaluation of the sites, including site visits to the 3 finalists, Mozambique and Rwanda were selected as the first Pilot Sites. Subsequently, a mentorship and training agreement was completed between Mozambique and the University of Cape Town, a middle-income country with a comparable burden of rheumatic heart disease. The agreement entails regular video calls between the heart teams, targeted training across all aspects of cardiac surgery, as well as on-site presence of mentoring teams for complex cases with the strict observance of 'assisting only'. In Rwanda, Team Heart, a US and Rwanda-based non-governmental organization (NGO) that has been performing cardiac surgery in Rwanda and helping to train the cardiac surgery workforce since 2008, has agreed to continue providing mentorship for the local team and to assist in the establishment of independent cardiac surgery with all that entails. This involves intermittent virtual conferences between Rwandan and US cardiologists for surgical case selection. Five years after CSIA was founded, it's 'Seal of Approval' for the sustainability of endorsed programmes in Mozambique and Rwanda has resulted in higher case numbers, a stronger government commitment, significant upgrades of infrastructure, the nurturing of generous consumable donations by industry and the commencement of negotiations with global donors for major grants. Extending the CSIA Seal to additional deserving programmes could further align the international cardiac surgical community with the principle of local cardiac surgery capacity-building in developing countries. [ABSTRACT FROM AUTHOR]

Teachers in academia are usually not required to have teacher training but must often be evaluated by their students who expect them to have much better teaching qualifications than their high school teachers. However, teachers in elementary and high schools are required to go through several years of teacher training, resulting in a teaching certificate, which is usually mandatory in the secondary school system. This anomaly causes great tension in colleges and universities and often results in pressure to "improve" teaching evaluation in regard to academic level. In many countries, a doctorate degree in any field automatically allows its holder to teach in academic institutions because the students are expected to learn on their own while the professor is the expert responsible for helping with complicated questions. These discrepancies often hamper the advances of higher education. This paper presents the situation of teaching in higher education in selected countries, while presenting various paradigms for improving the state of teaching in higher education. The aim is to study the methodologies used to assess the quality of teaching in higher education systems, in general, and in Israel, specifically.

This article deals with paradoxical relationships between Israeli universities and colleges and their effect on the system of higher education. The article analyzes the history of the higher-education discourse, ranging from patronizing and domineering relations to collaboration based on the recognition that Israel's entire system of higher education is headed in the same direction. Dialogue between the different types of academic schools in Israel is examined in light of the historical-organizational evolution of both universities and colleges. Paradoxical relationships are examined in light of the goals of the various schools, distinctive features of their student populations, their curricula, and their organizational structure. The article illuminates one of the most dynamic and paradoxical dialogues in Israel in the past decade and suggests a potential scenario encompassing the impact of this dialogue on Israel's entire system of higher education. The authors believe that the case of Israel can contribute to at least two important discussions in the field of international and comparative education: (1) the influence of local and global forces on education policy; and (2) policy implementation and the connection between policy and practice. Discussion of the case of Israel and the paradigmatic transformation of higher education may shed light on implications for the field of higher education worldwide.

South Africa recently experienced the third wave of the coronavirus disease 2019 (COVID-19) pandemic. Social media is flooded with polarised conversations, with opinions for and against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Many people are hesitant, and some are strongly opposed to vaccination. Vaccine hesitancy must be understood in historical, political and socio-cultural contexts. The aim of this study was to offer a valuesdriven approach to vaccine hesitancy conversations. It focusses on ethical dilemmas forthcoming from values violations, interrogating the personal and institutional scripts and rationalisations that prevent resolution, and offering ways of re-scripting these. Values-driven conversations provide safe spaces for vaccine-hesitant individuals to voice their reservations. The manner in which conversations are conducted is as important as the contents being discussed. Healthcare professionals are trusted by the public and should use ways of conversing that do not erode this trust. Creating respectful, compassionate platforms of engagement and incentivising vaccination are important measures for change in vaccine perspectives. [ABSTRACT FROM AUTHOR]

Rheumatic heart disease (RHD) affects more than 33,000,000 individuals, mostly from low- and middle-income countries. The Cape Town Declaration On Access to Cardiac Surgery in the Developing World was published in August 2018, signaling the commitment of the global cardiac surgery and cardiology communities to improving care for RHD patients. As the Cape Town Declaration formed the basis for which the Cardiac Surgery Intersociety Alliance (CSIA) was formed, the purpose of this article is to describe the history of the CSIA, its formation, ongoing activities, and future directions, including the announcement of selected pilot sites. The CSIA is an international alliance consisting of representatives from major cardiothoracic surgical societies and the World Heart Federation. Activities have included meetings at annual conferences, exhibit hall participation for advertisement and recruitment, and publication of selection criteria for cardiac surgery centers to apply for CSIA support. Criteria focused on local operating capacity, local championing, governmental and facility support, appropriate identification of a specific gap in care, and desire to engage in future research. Eleven applications were received for which three finalist sites were selected and site visits conducted. The two selected sites were Hospital Central Maputo (Mozambique) and King Faisal Hospital Kigali (Rwanda). Substantial progress has been made since the passing of the Cape Town Declaration and the formation of the CSIA, but ongoing efforts with collaboration of all committed parties—cardiac surgery, cardiology, industry, and government—will be necessary to improve access to life-saving cardiac surgery for RHD patients. [ABSTRACT FROM AUTHOR]