Valve Endocarditis, to repair or not to repair, is that really the question?

The meta-analysis by He and collaborators [has the worth to cover, as much as possible, a gap of scientific evidence where conducting a randomized trial appears very complex for ethical and logistical reasons. The authors concluded that mitral valve repair (MVP) provide better pooled results, both early and late, with respect to mitral valve replacement (MVR). However, the superiority of MVP is driven by some single large cohort-studies where surgeons had wide experience in the field of MVP for IE. This finding is also confirmed by other studies. But if mitral repair produces such a better short- and long-term survival than replacement, why are there no clear indications from consensus and guidelines pushing surgeons toward the pursuit of a reconstructive procedure at almost any cost? We wonder but to repair or not to repair, is that really the question? The AATS consensus suggests to repair “whenever possible” but without providing more specific indications. If the two primary goals of surgery are total removal of infected tissues and reconstruction of cardiac morphology, including repair or replacement of the affected valve(s), probably MVP as to perform in case of less extensive tissue detriment by the infection. In more wide valve involvement, MVP may be the choice but only in very expert hands and in Centers with very large volume of valve repairing. This decision cannot therefore be the result of the choice of an individual but must derive from a careful multidisciplinary discussion to be held in an EndoTeam.

Reinventing Freire in the 21st century:

This year we remember three centennials that inspire many progressive educators around the world. First, 2021 marks the 100th anniversary of the creation of Summerhill, one of the first experiments (if not the first) on school democracy in the world. Second, this year we celebrate the 100th birthday of Edgar Morin, a French sociologist and philosopher who dedicated his life to the pursuit of social justice and made insightful contributions to the role of education to promote democracy, equality, social transformation, and sustainability (see, for instance, Morin 2002). Third, this year marks the 100th anniversary of the birth of Paulo Freire (1921-1997), one of the most influential educational thinkers of the second half of the 20th century. Given space constraints and the theme of this special issue of CICE, in this paper we will focus on the connections between some of Paulo Freire’s ideas (particularly those related to citizenship education and school democracy) and a process known as School Participatory Budgeting. “I don't want to be followed; I want to be reinvented”, Paulo Freire said on several occasions. It is in this spirit that we approach this paper. Inspired by Freire’s ideas, and especially by his practice as an educator in Brazil (both before his exile and after his return), in this paper we discuss the recent development and expansion of a process known as School Participatory Budgeting (School PB). This model emanates from Freire’s project of Escola Cidadã, which constitutes an interesting school- or district-wide experience from the global south that can be adapted to many contexts. Since its modest origins in Brazil, School PB has now been taken up in other cities and states across the US (e.g. Chicago, New York) and in many other countries across the globe, from Argentina and Mexico to Colombia, Spain, Russia, France, Italy, Zambia, South Korea, and Portugal. We argue that School PB aligns well with Freire’s ideas on dialogue, participation, collaboration, creativity, student agency, and change. In this paper we focus on the experience of School PB in Arizona, not only because it was in Arizona where the first School PB process in the U.S. was designed and implemented, but also because it has been a place for continuous experimentation and innovation.

University Teachers’ Digital Empowerment for Blended Teaching: An Online Training Design

Because of the impact of the pandemic in the different sectors of society, blended training solutions have acquired, in the field of education, an important relevance, speeding up a change that would normally require years to be developed.Teachers from all levels of education had to adapt and develop their practices using digital technologies without enough knowledge to do it properly. Considering this context, this paper will present the design of an online training that seeks to empower university teachers to take advantage of the potential of digital technologies to design and implement educational practices in blended settings while they acquire Digital Competences. This training will be applied with a challenge-based learning methodology and from a collaborative perspective. In addition, participants will develop the role of students and teachers at the same time in order to design blended educational practices that respond to the needs of their own students.The proposed training, that will be designed by teachers from the Open University of Catalonia with wide experience on training in Digital Competences and online teaching, will be implemented in 6 countries around Europe (Italy, Spain, Ireland, Greece, Cyprus and Finland), will be developed in the framework of the European project Empower Competences for Onlife Learning in HE (ECOLHE).

Sustainable pensions, democratic governance, and EU law

The quality of democracy in our economy depends on the governance of capital, but Europeans are still deprived of real voice over their retirement money: the single biggest source of capital in the 21st century. This paper outlines three major problems facing EU pensions: precarious retirement, escalating inequality, and mounting climate damage. These problems start with the places where we work, the institutions that control our retirement savings, and the votes on shares that come with them. The central argument is that pensions will only be sustainable once they are democratically, prudently, and loyally governed. First, member states have wide experience with co-determination in capital funds, which can inform the basis of minimum standards in EU law for ‘pension fund democracy’. Second, a growing number of investment rules draw upon Member States’ fiduciary duties and standards for prudence or care; but, these do not yet codify the requirement that beneficiaries’ environmental, social, and governance preferences are followed. Third, votes on shares - bought with pension fund assets - are still being cast by banks and asset managers who manage ‘other people’s money’. This is a serious problem because banks and asset managers have interests that systematically conflict with the ultimate investors: they vote in companies on other people’s money and, at the same time, sell financial products (e.g., pensions) to those companies. The problems are soluble with careful amendments to existing policy that ensure elected representatives of pension beneficiaries are the sole determinants of voting policies, with prudence and no conflicts of interest. A draft EU Directive, based upon emerging best practice, is proposed.

Vascular Resection for Intrahepatic Cholangiocarcinoma: Current Considerations

Intrahepatic cholangiocarcinoma (iCCA) accounts for approximately 10% of all primary liver cancers. Surgery is the only potentially curative treatment, even in cases of macrovascular invasion. Since resection offers the only curative chance, even extended liver resection combined with complex vascular or biliary reconstruction of the surrounding organs seems justified to achieve complete tumour removal. In selected cases, the major vascular resection is the only change to try getting the cure. The best results are achieved by the referral centre with a wide experience in complex liver surgery, such as ALPPS procedure, IVC resection, and ante-situ and ex-situ resections. However, despite aggressive surgery, tumour recurrence occurs frequently and long-term oncological results are very poor. This suggests that significant progress in prognosis cannot be expected by surgery alone. Instead, multimodal treatment including neoadjuvant chemotherapy, radiotherapy, and subsequent adjuvant treatment for iCCA seem to be necessary to improve results.

Sovereign wealth fund investments in private funds: selected tax planning considerations in the US, EU and UK

Purpose To discuss US, EU and UK tax-related issues that sovereign wealth funds should consider when investing in private funds. Design/methodology/approach Discusses various tax-related structuring, operational, risk-allocation, and economic matters that private funds, sovereign wealth funds and other non-US institutional investors should consider a series when evaluating potential private fund investments. Findings Despite the market disruption caused by the COVID-19 pandemic, sovereign wealth funds continued to make significant capital commitments to private funds in 2020 and, as the world emerges from the pandemic, are expected to make similar or greater commitments in 2021 and beyond. Originality/value Practical guidance from lawyers with wide experience in international tax planning and investment fund structuring.

New draft Federal law "Land Management" Is full of flaws

The article considers a new version of the draft Federal Law "Land Management" finalized after consideration with the Federal Service for State Registration, Cadastre and Cartography (Rosreestr) of the Department of Natural Resources, Land Relations and Agro-Industrial Complex of the Government of Russia and submitted on December 11, 2020 for approval in the Ministry of Agriculture of the Russian Federation. The article contains critical remarks and proposals, and also underlines the necessity to take wide experience of our country into account.

Hospital admissions of acute cerebrovascular diseases during and after the first wave of the COVID-19 pandemic: a state-wide experience from Austria

We investigated hospital admission rates for the entire spectrum of acute cerebrovascular diseases and of recanalization treatments for ischaemic stroke (IS) in the Austrian federal state of Styria during and also after the first coronavirus disease 2019 (COVID-19) wave. We retrospectively identified all patients with transient ischaemic attack (TIA), IS and non-traumatic intracranial haemorrhage (ICH; including intracerebral, subdural and subarachnoid bleeding types) admitted to one of the 11 public hospitals in Styria (covering > 95% of inhospital cerebrovascular events in this region). Information was extracted from the electronic medical documentation network connecting all public Styrian hospitals. We analysed two periods of interest: (1) three peak months of the first COVID-19 wave (March–May 2020), and (2) three recovery months thereafter (June–August 2020), compared to respective periods 4 years prior (2016–2019) using Poisson regression. In the three peak months of the first COVID-19 wave, there was an overall decline in hospital admissions for acute cerebrovascular diseases (RR = 0.83, 95% CI 0.78–0.89, p < 0.001), which was significant for TIA (RR = 0.61, 95% CI 0.52–0.72, p < 0.001) and ICH (0.78, 95% CI 0.67–0.91, p = 0.02), but not for IS (RR = 0.93, 95% CI 0.85–1, p = 0.08). Thrombolysis and thrombectomy numbers were not different compared to respective months 4 years prior. In the recovery period after the first COVID-19 wave, TIA (RR = 0.82, 95% CI 0.71–0.96, p = 0.011) and ICH (RR = 0.86, 95% CI 0.74–0.99, p = 0.045) hospitalizations remained lower, while the frequency of IS and recanalization treatments was unchanged. In this state-wide analysis covering all types of acute cerebrovascular diseases, hospital admissions for TIA and ICH were reduced during and also after the first wave of the COVID-19 pandemic, but hospitalizations and recanalization treatments for IS were not affected in these two periods.

Embedded Librarianship and Blended Learning

The library of the Rotterdam University of Applied Sciences has wide experience in providing different kinds of training in information literacy. For a long time the formats for these trainings were mostly standalone library instructions and online training. However, slowly over the last few years a shift towards workshops that are integrated into courses of various study programs has taken place. The reason for this transition is in line with the philosophy of embedded librarianship. Embedded information literacy training should be more successful than standalone instructions, but what other factors influence its success and how to increase its effectiveness even further? The library of the Rotterdam University has examined this question by not only embedding a complete information literacy course into the curriculum, but also by selecting blended learning as an innovative educational model for it.