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The lockdown that was imposed by governments as part of the attempt to contain the COVID-19 pandemic included extreme measures, such as home confinement and the shutting down of special education systems. Our aim was to learn about the core experiences of parents of children with autism during this significant life disturbance. Thirty-one parents of 25 children with autism participated in semi-structured telephone interviews which were transcribed verbatim and underwent a qualitative, immersion/crystallization analysis. The analysis was conducted in an iterative consensus-building process to identify parents' experiences, concerns, challenges, coping strategies, and perceived needs during the lockdown. The main themes that emerged related to the various parental concerns; the major difficulties encountered during this unique time, the functional, social, and behavioral implications the lockdown had on these children; and the manner in which the parents coped as an indication of their resourcefulness and outlook. Our findings broaden the insight into the underlying elements of the hardships and gains experienced by children with autism and their parents in times of significant life adversity. Programs in such times should be directed at supporting and guiding parents on how to better accommodate to the situation, thereby optimizing their coping strategies and resilience.

The main goal of this study was to determine whether, in schools that practice inclusion, there is a correlation between the attitudes of school principals and teachers in their schools, towards inclusion of student with special needs. For this purpose, 38 schools were sampled in each of which the school principal and five teachers who work with students from the school's inclusion program--were to respond to questionnaires about their attitudes towards inclusion. A total of 38 school principals and 195 teachers participated in this study. In addition, the principals were asked to describe their management styles concerning the inclusion of students with special needs. The teachers also completed questionnaires about the school climate. The main findings indicated that principals' positive attitudes towards inclusion were associated with teachers' positive attitudes. In addition, a correlation was found between styles of management that support inclusion (such as support for changes to adapt the school for inclusion) and teachers' perceptions of a positive school climate.

Encouraging and developing voice in the classroom is a key aim of dialogic pedagogy, but teachers' elicitation of student voices is not always experienced as empowering. This case study investigates a sixth grade literacy lesson discussion about responding to peer group social ostracism. The teacher pressed students to adopt and articulate a stance on this socially and morally charged issue, resulting in a series of student public confessions. Using linguistic ethnographic micro-analytic methods, we examine the realization of voice in these events. Though some confessions were student-initiated, their contents were firmly directed by the teacher and dominated by her voice. Students were compelled to take a stand, and to express improper thoughts or actions, in an appropriate voice, or be challenged and/or judged inadequate. This case study shows how attempts to empower voice can back-fire; we argue that dialogic pedagogy should include a right to remain silent.

Background: Research-practice partnerships (RPPs) are proliferating in education, generating increasing interest and posing many challenges. In this study, we shed light on the challenge of supporting practitioners' leadership and building capacity in an RPP. In the RPP literature, practitioner leadership is often highlighted as both a way to improve design development and enactment and as imperative for capacity building and sustainability. However, cultivating leadership also creates challenges which have not yet been adequately explored. Purpose: We explore these challenges and related dilemmas in a large-scale Israeli RPP designed to cultivate teacher leadership and build district capacity. We investigate how local actors asserted their leadership, the resources they drew upon, and the dilemmas this posed for us as researchers in an RPP. We critically reflect on how we addressed these dilemmas, and the consequences and implications of our courses of action. Setting: This study explores our partnership with two large Israeli districts, as part of a state-wide professional development reform supported by the Ministry of Education and a philanthropic foundation. The partnership aims to support teachers' collaborative, reflective inquiry on teaching and learning, in weekly in-school meetings facilitated by in-school leading teacher. The partnership began six years ago and currently includes 158 schools (458 leading teachers). Research Design: We use linguistic ethnographic methods to analyze leadership assertion in three focal cases, representing three different leadership roles, at different levels of the system: (1) a leading teacher demonstrating creative non-compliance in the team meetings she facilitated, (2) a coach exercising her voice and authority in her professional development workshops, (3) and a district manager independently shaping structures. Data Collection: Data were collected during the first three years of the RPP, including (participant) observations, audio-recordings, and field notes of in-school meetings, professional development workshops, interviews, and informal conversations. Findings and Conclusions: The analysis shows that leadership assertion played an important role in constructing actors' identities as competent leaders but posed dilemmas for us, such as how to acknowledge leaders' expertise while also maintaining program integrity. The case studies underscore the difficulties involved in managing a partnership in a large-scale educational intervention and the challenges to maintaining productive dialogue with different partners. The paper advances our understanding of the complexities involved in supporting leadership at different levels of the system, in day-to-day interaction, and at multiple micro and macro contexts in which it unfolds, in particular in a large-scale RPP.

Purpose: Heat intolerance (HI) is determined in the Israel Defense Force according to a heat tolerance test (HTT) before returning to duty after an exertional heat stroke (EHS) event. Recently, increased numbers of female combatants resulted in an increased number of EHS cases among women and a higher percentage of heat intolerance (HI) individuals. We aimed to evaluate the differences between tolerance to heat among women performing an HTT in relation to their menstrual cycle phase. Method: Thirty-three female participants were sorted into two groups: HI and heat tolerant (HT) according to two HTTs performed during both the luteal and follicular phases of the menstrual cycle or while consuming and during a break from consuming contraceptives. Results: HT women had an 18% higher maximal oxygen uptake (p < 0.005, 95% CI [2.6,9.8]) and 1.2% lower skin temperature in the HTT at the during and follicular phases (p < 0.01, 95% CI [0.12,0.77]) and 1.7% lower at the off and luteal phases (p < 0.001, 95% CI [0.34,0.92]). The mean sweat rate was 14% lower among the HI group only at the HTT at the during and follicular phases (p < 0.05, 95% CI (3,88)]). Conclusion: We found that HT can be predicted using aerobic capacity and core body temperature. Moreover, during the luteal phase, women presented altered thermoregulation that decreased the probability of being HT. This emphasizes the importance of considering the HT/HI criteria in the HTT for women, according to their aerobic ability and menstrual-cycle phase.

Multisystemic inflammatory syndrome in children (MIS-C) is a rare, severe, post-infectious hyperinflammatory condition that occurs after COVID-19 infection. In this study, we aimed to demonstrate the risk reduction of MIS-C and severe MIS-C after Pfizer–BioNTech BNT162b2 mRNA COVID-19 vaccination. This nationwide cohort study included 526,685 PCR-confirmed COVID-19 cases (age < 19 years), of whom 14,118 were fully vaccinated prior to COVID-19 infection. MIS-C cases were collected from all hospitals in Israel from April 2020 through November 2021. The MIS-C rates were calculated among two COVID-19 populations: positive PCR confirmed cases and estimated COVID-19 cases (PCR confirmed and presumed). Vaccination status was determined from Ministry of Health (MoH) records. The MIS-C risk difference (RD) and 95% confidence intervals (95%CI) between vaccinated and unvaccinated patients are presented. Overall, 233 MIS-C cases under the age of 19 years were diagnosed and hospitalized in Israel during the study period. Among the estimated COVID-19 cases, MIS-C RD realistically ranged between 2.1 [95%CI 0.7–3.4] and 1.0 [95%CI 0.4–1.7] per 10,000 COVID-19 cases. For severe MIS-C, RD realistically ranged between 1.6 [95%CI 1.3–1.9] and 0.8 [95%CI 0.7–1.0], per 10,000 COVID-19 cases. Sensitivity analysis was performed on a wide range of presumed COVID-19 rates, demonstrating significant RD for each of these rates. Conclusion: This research demonstrates that vaccinating children and adolescents against COVID-19 has reduced the risk of MIS-C during the study period. What is Known: • Most of the published literature regarding vaccine effectiveness is based on case-control studies, which are limited due to small sample sizes and the inability to fully estimate the risk of MIS-C among vaccinated and unvaccinated children and adolescents. • The known underestimation of COVID-19 diagnosis among children and adolescents is challenging, as they often have few to no symptoms. What is New: • Significant risk difference was found in favor of the vaccinated group, even after including extreme assumptions regarding the underdiagnosed COVID-19 rate. • During this nationwide study period, it was found that vaccinating children and adolescents reduced the risk of MIS-C and its complications. [ABSTRACT FROM AUTHOR]

Introduction: Emergency medicine (EM) was recognized as a specialty in Israel in 1999. Fifty-nine of the 234 (25%) attending physicians working in emergency departments (ED) nationwide in 2002 were boardcertified emergency physicians (EP). A 2012 study revealed that 123/270 (45%) of ED attendings were EPs, and that there were 71 EM residents. The EPs primarily worked midweek morning shifts, leaving the EDs mostly staffed by other specialties. Our objective in this study was to re-evaluate the EP workforce in Israeli EDs and their employment status and satisfaction 10 years after the last study, which was conducted in 2012. Methods: We performed a three-part, prospective cross-sectional study: 1) a survey, sent to all EDs in Israel, to assess the numbers, level of training, and specialties of physicians working in EDs; 2) an anonymous questionnaire, sent to EPs in Israel, to assess their demographics, training, employment, and work satisfaction; and 3) interviews of a convenience sample of EPs analyzed by a thematic approach. Results: There were 266 board-certified EPs, 141 (53%) of whom were employed in EDs full-time or part-time. Sixty-two non-EPs also worked in EDs. The EPs were present in the EDs primarily during weekday morning shifts. There were 273 EM residents nationwide. A total of 101 questionnaires were completed and revealed that EPs working part-time in the ED worked fewer hours, received higher salaries, and had more years of experience compared to EPs working full time or not working in the ED. Satisfaction correlated only with working part time. Meaningful work, diversity, and rewarding relationships with patients and colleagues were major positive reasons for working in the ED. Feeling undervalued, carrying a heavy caseload, and having complicated relationships with other hospital departments were reasons against working in the ED. Conclusion: Our study findings showed an increase in the number of trained and in-training EPs, and a decrease in the percentage of board-certified EPs who persevere in the EDs. Emergency medicine in Israel is at a crossroads: more physicians are choosing EM than a decade ago, but retention of boardcertified EPs is a major concern, as it is worldwide. We recommend taking measures to maintain trained and experienced EPs working in the ED by allowing part-time ED positions, introducing dedicated academic time, and diversifying EP roles, functioning, and work routine. [ABSTRACT FROM AUTHOR]

A learning experience may lead to changes in behavior during the experience, and also to memory expressed at a later time. Are signals causing changes in behavior during the learning experience related to the formation and expression of memory? We examined this question, using learning that food is inedible in "Aplysia." Treatment of an isolated buccal ganglia preparation with an NO donor elicited rejection-like motor programs. Rejection initiated by NO production is consistent with aspects of behavioral changes seen while animals learn, and with memory formation. Nonetheless, applying the NO donor during training had only minor effects on behavior during the training, and did not improve memory, indicating that the induction of rejection in the buccal ganglia is unlikely to be the means by which NO during training contributes to memory formation. Block of NO during memory retrieval prevented the expression of memory, as measured by a lack of savings in time to stop responding to food. Applying an NO donor to the cerebral ganglion while eliciting fictive feeding inhibited the expression of feeding activity, indicating that some NO effects on memory consolidation and on expression of memory may be via effects on the cerebral ganglion.

Teaching through controversial, politically charged issues is promoted in Anglo-American democracies as a key means for cultivating active citizenry and democratic values. However, the challenges of discussing controversial issues in the classroom may differ in younger, deeply divided democracies that lack common ground and institutional stability. In this study we ask, what approaches to the teaching of controversial issues do Israeli teachers adopt while enacting a curricular unit concerning Israel's founding fathers? The data were collected in an ethnographic study in two primary schools during the 2012-2013 school year. We use linguistic ethnographic methods to analyse the curricular materials and their enactment in four video-recorded lessons in three classrooms. We argue that while the curriculum addresses deeply controversial content, it is designed to inculcate a shared national ethos and therefore avoids controversy. In practice, teachers and students engaged with controversial issues, but in ways that defused their volatility. We highlight two heretofore undocumented approaches to controversial issues: (1) "sidestepping" controversy by stripping it of real world complexities, and (2) "scholasticizing" the discussion by focusing on literacy practices. Finally, we discuss the rationales for using these two approaches to defuse controversy in the classroom, and their limitations.

Background: This study explores vision care priorities and coping mechanisms for Israeli evacuees and following the October 7th, 2023, attack by Hamas, which displaced 150,000 individuals, with about 15,000 being evacuated to the Dead Sea area. Faced with minimal health care infrastructure in the Dead Sea area and often lacking personal belongings, including eyeglasses and ocular medicine, these evacuees confronted significant vision care challenges. This context sets the stage for investigating the emergency vision care needs and solutions for populations affected by conflict and displacement. Methods: In response to this crisis, a consortium led by Hadassah Academic College's Department of Optometry and the Dept. of Ophthalmology at Hadassah Medical Center established ophthalmic clinics in the Dead Sea region. These clinics offered comprehensive vision care services, including refractive and vision examinations, ophthalmological assessments, ocular imaging, and provision of free glasses. The setup included multiple stations for different vision tests, staffed by an interdisciplinary team of professionals. The study analyzes the effectiveness of these clinics, patient flow challenges, and the psychological impact of vision care in a crisis setting. Results: Approximately 800 evacuees received examinations, with around 700 pairs of glasses distributed. Notable cases included emergency referrals for serious conditions and instances where glasses served as psychological support. The operation highlighted the necessity of vision care during crises and its potential psychological and social implications. The clinics successfully provided immediate vision care, but challenges in patient flow and insufficient electronic medical record integration were noted. The experience underscores the importance of prepared eye care interventions in crises. Recommendations for health policy decision-makers include establishing a national emergency vision care network, developing standardized treatment protocols, training local health workers, and raising public awareness about eye health in emergencies. Conclusions: The consortium's effort in providing urgent vision care to evacuees from the Hamas attack on Israel demonstrates the critical role of rapid, organized eye care in crisis situations. Vision care, along with hearing and mobility, is often overlooked during evacuations but is vital for the well-being and survival of evacuees, especially under trying circumstances. This project serves as a model for future humanitarian interventions, emphasizing the importance of addressing overlooked healthcare issues once the immediate crisis has passed, and the need for strategic planning in health care policy for similar emergency scenarios. [ABSTRACT FROM AUTHOR]

The current study examined the role of interpersonal vulnerability, that is, self-perceived threats to one's interpersonal domain, in the mental health of bereaved parents. Israeli bereaved parents in older adulthood (N = 105, aged 48–88, M = 64.06, SD = 9.93) were pair-matched with equivalent 105 non-bereaved parents. Participants completed questionnaires assessing interpersonal vulnerability, satisfaction with life, and depressive symptoms. The results showed higher levels of interpersonal vulnerability among bereaved parents compared to their non-bereaved counterparts. Additionally, parental bereavement and interpersonal vulnerability were associated with worse mental health. Finally, interpersonal vulnerability mediated the association of parental bereavement with worse mental health. This study reveals interpersonal vulnerability as an important vulnerability factor among a significant minority in older adulthood. [ABSTRACT FROM AUTHOR]

COVID-19 has heralded a health and socioeconomic crisis that has made it difficult for nonprofit human service organizations (NPHSOs) to play their social roles and achieve their goals. This article examines how the merger of NPHSOs can serve as a strategy for coping with an organizational crisis caused by external extreme events such as the COVID-19 pandemic. The study focused on eight mergers of Israeli NPHSOs. Using in-depth interviews and a survey methodology of senior managers and board members who have participated in the merger process, we explore the motives, challenges, and key processes characterizing these mergers. The findings are organized around three stages in the merging process – the Three P's in human service mergers: Pre-merger, when the motives and barriers were examined; Process, where decision-making mechanisms, issues of belonging and identity, and coping with conflicts and trust-building were examined; and Post-merger, where attitudes toward the outcomes of the merger and its success in various organizational areas were assessed. The findings also point to a lack of proper preparation and orientation for the merger, ego struggles between managers and workers, and the need for socializing the employees to the merger. We conclude by discussing the importance of planning for and attending to the human capital in the merged NPHSOs, the need to build a shared sense of belonging, and the value of shaping a new and shared organizational culture. Implications to theory, practice, and policy are discussed. Executives of nonprofit human service organizations considering a merger in response to a crisis should prepare, orient, and socialize executives, board members, and employees before entering the merger process; part of this socialization should include emotional dimensions of trust building, respect, and empathy. Executives should establish mechanisms for shared decision-making and for coping with conflicts. Executives and board members should collaborate to plan the merger strategically (i.e. establish goals before initiating the merger) to make the process more efficient, effective, and adjusted to expected and unexpected events in the external environments. Umbrella organizations, infrastructure organizations, government agencies, and funders should develop knowledge and support systems to help organizations consider mergers. Funders should be engaged in due diligence to assess the organizations' financial and economic resilience before the merger. They should also consider the synergies of the merger and its added value to the beneficiaries before entering the process. [ABSTRACT FROM AUTHOR]

Shemitah , the Jewish sabbatical year, is increasingly being explored in ecological contexts. This research delves into the concept of stewardship examining the evolving discourse on Shemitah across different community sectors in the Israeli press during the last three sabbatical cycles (2007–2008, 2014–2015, and 2021–2022). Our analysis reveals stewardship worldviews that portray Jewish law as either the practical pathway to implement these worldviews or as an inspiration for contemporary socio-environmental initiatives. The secular-liberal sector emphasizes universal stewardship, aligning with Western environmental concepts, while the national-religious sector integrates both universal and particular stewardship, emphasizing the land's moral dimensions and connecting religious observance with environmental ethics. The ultra-Orthodox sector, though not explicitly expressing eco-theological views, focuses on soil regeneration. This empirical investigation serves as a significant case study and offers valuable guidance for addressing the challenge of instigating behavioral change in religious and traditional populations. [ABSTRACT FROM AUTHOR]

Immune-mediated or autoimmune encephalitis (AE) is a relatively new, rare and elusive form of encephalitis in children. We retrospectively collected seropositive children (0–18 years old) with well characterized antibodies through 3 reference laboratories in Israel. Clinical symptoms, MRI and EEG findings and treatment courses were described. A total of 16 patients were included in the study, with 10 females. Anti NMDA encephalitis was most common followed by anti HU and anti mGLuR1. Psychiatric symptoms, abnormal movements, seizures and behavioral changes were the most common presentation. Pathological MRI and EEG findings were described in 37% and 56% of children, respectively. Treatment with corticosteroids, Intravenous immunoglobulins (IVIG) was first line in most children. Following inadequate response children were treated with plasmapheresis and/or rituximab. Two patients relapsed following both first and second line protocols. In terms of long term prognosis, 9 children (56%) had one or more residual behavioral, psychiatric or neurologic findings. Three children required hospitalization for rehabilitation. AE remains a rare diagnosis with variable presenting symptoms, requiring a high index of suspicion. Consensus recommended treatment is generally effective in the pediatric population. Female gender was associated with a higher chance of severe disease. Larger cohorts would be needed to identify prognostic factors in the pediatric population. • In our national pediatric cohort of 16 children, anti NMDA encephalitis was most common followed by anti HU and anti mGLuR1. • Psychiatric symptoms, abnormal movements, seizures and behavioral changes were the most common presentation. • Nine children (56%) had one or more residual behavioral, psychiatric or neurologic findings. • Female gender was associated with a higher chance of severe disease. • AE remains a rare diagnosis with variable presenting symptoms, requiring a high index of suspicion. [ABSTRACT FROM AUTHOR]

Data regarding the contribution of COVID-19 vaccine rollouts to real-world uptake of influenza vaccination remains unclear. This cross-sectional survey-based study among Israel Defense Forces (IDF) soldiers aimed to assess the impact of the COVID-19 pandemic and specifically, previous COVID-19 vaccines uptake, on the intention to vaccinate for influenza during 2021–2022 season. Participants engaged in an online survey addressing vaccination history and current vaccine-related preferences. The survey was delivered prior to the initiation of the IDF's annual influenza immunization campaign. A multinomial logistic regression model was applied to analyze factors correlated with unwillingness to receive influenza vaccine. Overall, 825 invitations to participate in the survey were distributed and the overall response rate was 78.5%. Among the 648 participants who replied (61.6% males, median age of 20 years), 51.9% were willing to receive the upcoming influenza vaccine. Factors associated with vaccine reluctance included being female, not receiving the previous season's influenza vaccine, not having a previous diagnosis of COVID-19, and having decreased uptake of COVID-19 vaccines. Among participants not intending to receive an influenza vaccine, 50.3% stated that they are healthy and have no need for the vaccine and 36.2% stated they received too many vaccines over the previous year. The results of this study may suggest that influenza vaccination rates in the post-COVID-19 vaccine era may be reduced due to a perceived "vaccine saturation" phenomenon, owing to the density of COVID-19 vaccine administration. Future interventions such as campaigns related to maximizing influenza vaccination coverage should address repeated doses of COVID-19 vaccine administration. [ABSTRACT FROM AUTHOR]

Dialogic pedagogy is widely viewed as an excellent means of educating students for civic participation in deliberative democracy. While many intervention-based studies have researched dialogic teaching and learning, we know very little about the enactment of dialogic and related ideas "in the wild," in regular classrooms. This paper contributes to the naturalistic study of dialogic pedagogy through close examination of an episode of sustained student engagement with, and argumentation about, a controversial social issue in an Israeli primary school classroom. In particular, we focus on the emergence and interaction of voices, defined as (1) opportunity to speak, (2) expressing one's own ideas, (3) on one's own terms and (4) being heeded by others. While the norm in Israeli classrooms is exuberant, voiceless participation, in the rare classroom episode examined here, we find students--and their teacher--engaged in heated, multivocal deliberation. We follow the struggles of marginalized students to be heard and heeded, exploring the conditions which ultimately allow for the actualization of student voice, and the accompanying pedagogical challenges and dilemmas.

Summary: Background: Previous research on the association between body mass index (BMI) and visual impairment (VI) in youth has reported inconsistent findings. We aimed to investigate this association in a national cohort of Israeli adolescents. Methods: This retrospective, population‐based, cross‐sectional study included 1 697 060 adolescents (56.4% men; mean age 17 years) who underwent mandatory pre‐military service assessments from 1993 to 2017. BMI was classified based on the US age‐ and sex‐matched percentiles. Unilateral or bilateral VI was classified as best‐corrected visual acuity (BCVA) worse than 6/9 in either or both eyes, respectively. Sex‐stratified regression models adjusted for sociodemographic variables were used to analyse the BMI‐VI relationship. Results: Overall, 17 871 (1.05%) and 5148 (0.30%) adolescents had unilateral and bilateral VI, respectively. Compared with high‐normal BMI (50th to 85th percentile), adjusted odds ratios (ORs) for unilateral and bilateral VI gradually increased with higher BMI, reaching 1.33 (1.13–1.55) and 1.80 (1.37–2.35) in men with severe obesity, and 1.51 (1.24–1.84) and 1.52 (1.08–2.14) in women with severe obesity, respectively. Men with underweight also had increased ORs for unilateral and bilateral VI (1.23; 1.14–1.33 and 1.59; 1.37–1.84, respectively), a pattern not observed in women (0.96; 0.86–1.07 and 1.02; 0.83–1.25, respectively). Results were maintained when the outcome was restricted to mild VI, as well as in subgroups of adolescents with unimpaired health and those without moderate‐to‐severe myopia. Conclusions: Abnormal BMI, and particularly obesity, is associated with increased OR for VI in late adolescence. [ABSTRACT FROM AUTHOR]

This paper addresses the question "what is school?," and argues that the answer to this question has an essential political dimension. I focus on two very different attempts to characterize school--Ivan Illich's "Deschooling Society" and Jan Masschelein and Maarten Simons's "In Defence of the School"--and demonstrate that both texts miss the political potential which is inherent in school. The two texts are analyzed along two relational axes: relations between school and society, and relations between children and political subjects. Illich rejects children's de-politicization while accepting the assumption that school operates according to a similar logic as society in general. Masschelein and Simons, on the other hand, advocate a separation between school and society, but also accept the separation of children from politics. I aim to integrate Illich's analytical categories into Masschelein and Simons' discussion, in order to mark important directions for political struggles both over and within school.

Acute optic neuritis treatment lacks standardized protocols. The value of oral prednisone taper (OPT) following intravenous methylprednisolone (IVMP) on visual outcome parameters in optic neuritis (ON) has never been explored. In the present retrospective study, we investigated whether OPT after IVMP affects the structural and functional visual outcomes of inaugural clinically isolated syndrome (CIS)- or multiple sclerosis (MS)-ON. Adult patients with acute, inaugural, unilateral CIS- or MS-ON, treated with IVMP in Germany and Israel were stratified into patients treated with IVMP alone—versus IVMP and OPT. Inclusion criteria were age ≥18, CIS or MS diagnosis according to McDonald criteria 2017, available visual acuity (VA) at nadir before treatment initiation and at follow-up ≥5 months, as well as a spectral domain optic coherence tomography (OCT) data scan at follow-up. Exclusion criteria included recurrent ON, concomitant ophthalmological comorbidities, optical coherence tomography (OCT) of insufficient quality and ON-related escalation therapy after IVMP. The structural outcome was defined as the average retinal nerve fiber layer (RNFL) difference between the ON-affected and the unaffected eye, while the functional outcome was defined as the final high-contrast best-corrected VA (HC-BCVA) at follow-up compared to nadir. The comparative analysis was performed using linear regression analysis, adjusted for sex, age, and days-to-treatment. Fifty-one patients met the inclusion criteria (25% male). The mean age was 33.9 (±10.23) years. Twenty-six patients (51%) received OPT following IVMP. There was no difference in nadir HC-BCVA between the groups (0.39 No OPT; 0.49 With OPT, P = 0.36). Adjusted linear regression analysis did not indicate an influence of OPT on RNFL thickness or on HC-BCVA (beta coefficient for RNFL difference in percentages: 0.51, 95%-CI: [-4.58, 5.59], beta coefficient for logMAR: 0.11, 95%; CI [-0.12, 0.35] at follow-up. In conclusion, the addition of OPT to IVMP did not affect RNFL thickness or the final VA in a retrospective cohort of 51 patients with inaugural acute CIS- or MS-ON. The results of this exploratory study are currently being re-examined in a large-scale, demographically diverse, prospective study. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the experiences of post-sedation COVID-19 patients in rehabilitation. Eleven Israeli men and women were interviewed in semi-structured interviews. They were patients recovering in a neurological rehabilitation unit from severe COVID-19 post-mechanical ventilation and sedation. Five themes were generated through thematic analysis: "an unexpected turn of events," "filling the gaps," "emotional reactions," "ambiguity regarding medical condition," and "sense and meaning-making." Findings suggest a need for improved communication between patients and medical staff to enhance a sense of control and coherence. Psychological support should be considered to facilitate sense and meaning-making processes during hospitalization. [ABSTRACT FROM AUTHOR]

Onasemnogene abeparvovec-xioi (OA) has been available since 2019 as a gene replacement therapy for individuals with spinal muscular atrophy (SMA) under age two years. We aim to expand upon the sparse knowledge about its safety and clinical efficacy. The clinical outcome data of all the individuals with SMA who were treated with gene therapy in four tertiary hospitals in Israel were retrieved and analyzed. The study participants included 25 individuals who received the gene therapy between age 11 days and 23 months and whose median follow-up duration was 18.0 (interquartile range [IQR], 12.4 to 18.3) months. Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders scores increased by a median (IQR) of 13 (8 to 20) points at the last follow-up compared with baseline. None of the patients experienced regression in motor abilities after gene therapy, which was generally well tolerated. There was gradual improvement in motor function, especially among presymptomatic patients (P ≤ 0.001) whose disease duration was shorter (≤8 months) before receiving gene therapy (P ≤ 0.001) and who did not experience recurrent infections and illnesses in the months following treatment (P ≤ 0.001). OA was well tolerated and led to favorable functional motor outcomes at six to 24 months after treatment initiation. Better progress in motor function was observed in individuals who received OA earlier and who were presymptomatic, irrespective of the SMN2 copy number or type. Our results further strengthen the clinical efficacy of OA and reinforce the importance of early recognition of SMA via newborn screening programs. [ABSTRACT FROM AUTHOR]

This self-study explores the instruction of a novice teacher by an expert mentor teacher, while applying the strategy of asking questions instead of the more common pattern of giving advice and guidance in the form of telling. The study examines the educational potential embedded in the question-asking strategy as a key mentoring resource when used between an experienced teacher educator and a novice teacher for the professional development of both. The research data were collected by documenting their personal meetings and collecting the email printouts and notes written by the expert mentor in the novice teacher's journal. The findings from the self-study were analyzed and classified into four categories that explore the professional growth of the mentor and novice teacher. The process of a reflective dialog led to critical reflection and a change in the paradigm of the novice and expert teacher relationship. The non-judgmental questioning dialog between two learners strengthened the novice teachers' self-confidence and professional identity and led to a reframing of the expert teacher's mentoring style. (Contains 1 figure.)

Sixty-three visually impaired pupils from 40 different schools in Israel and their form teachers filled in questionnaires assessing quality of life. In addition, a total of 200 teachers were asked to fill in questionnaires on school climate and attitudes towards inclusion. Findings indicated that positive climate and positive attitudes correlated with high compatibility between pupils' and teachers' reports. Pupils attending schools characterized by a positive school environment (climate and attitudes) reported that they were not stigmatized by others. (Contains 3 tables and 1 figure.)

A scientific collaboration between the U.S. and Israel is underway to assess the suitability of a potential site for subsurface radioactive waste disposal in the Negev Desert, Israel. The Negev Desert has several favorable attributes for geologic disposal, including an arid climate, a deep vadose zone, interlayered low-permeability lithologies, and carbonate rocks with high uranium-sorption potential. These features may provide a robust natural barrier to radionuclide migration. Geologic and laboratory characterization data from the Negev Desert are incorporated into multiphase flow and transport models, solved using PFLOTRAN, to aid in site characterization and risk analysis that will support decision-making for waste disposal in an intermediate-depth borehole design. The lithology with the greatest uranium sorption potential at the site is phosphorite. We use modeling to evaluate the ability of this layer to impact uranium transport around a proposed disposal borehole. The current objective of the simulations is focused on characterizing hypothetical leakage from waste canisters and subsequent uranium migration under three infiltration scenarios. Here, we describe a hydrogeologic model based on data from a local exploratory borehole and present results for uranium flow and transport simulations under varying infiltration scenarios. We find that under the current climate conditions, it is likely that uranium will remain in the near-field of the borehole for thousands of years. However, under a hypothesized extreme climate scenario representing an increase in infiltration by a factor of 300x above present-day values, uranium may break through the phosphorite layer and exit the base of the model domain (~200 m above the water table) within 1000 years. Simulation results have direct implications for the planning of nuclear waste disposal in the Negev Desert, and specifically in intermediate-depth boreholes. [ABSTRACT FROM AUTHOR]

Research has demonstrated that Parkinson's disease can have adverse psychological effects on caregivers. Very few studies have focused on the experiences of spouses who are not primary caregivers or who do not identify as primary caregivers. The aim of this study was to explore the experiences of spouses who are not primary caregivers or do not identify as primary caregivers. Twelve Israeli women, spouses of men with Parkinson's disease, were interviewed using a semi-structured in-depth approach. Thematic analysis revealed five themes: before diagnosis, at diagnosis, after diagnosis, interpersonal ways of coping, and intrapersonal ways of coping. A dynamic of oscillation between confronting and avoiding losses was indicated. Non-death losses were mostly unacknowledged among spouses' social circles. Results were interpreted in the context of grieving processes after diagnosis. Findings suggest a need for psychological interventions aimed at creating safe spaces for spouses to engage in a grieving process after diagnosis. [ABSTRACT FROM AUTHOR]

Local communities have been identified as crucial actors in the diffusion of renewable energy, considered one of the most important eco-innovations of our time. Anecdotal evidence has indicated that local communities tend to play different roles in promoting eco-innovation, particularly renewable energy. However, what this heterogeneity looks like has not yet been quantitatively examined. Our study addresses this gap by systematically exploring the involvement of communities in the promotion of eco-innovation at the local level. We focus on their participation in renewable energy partnerships with the private sector in rural areas in Israel's southern periphery. Our study indicates that local communities play diverse roles in promoting renewable energy through varying involvement in finance, ownership, knowledge contribution, employment, energy consumption, and, most common according to our findings, the leasing of natural resources. The study further tracks the factors that shape this diverse involvement, including the community's land size, population size, socio-economic ranking, and experience. Finally, the study unpacks the levels of risks and gains that local communities face when promoting renewable energy through their partnerships with the private sector. By confronting theory with quantitative research, this study sheds light on the diverse roles local communities play in the diffusion of eco-innovation, a prerequisite for renewable energy. [ABSTRACT FROM AUTHOR]

Infectious diseases caused by marine bacterial pathogens inflict increasing economic losses to fisheries and aquaculture, while also posing a growing risk to public health and affected species conservation. In this study, four wild marine fish species were collected at five fishing sites in Israel, divided into two regions—north (Acre, Haifa, Shefayim) and center-south (Tel-Aviv and Ashdod), and screened for Photobacterium damselae. An initial screening was carried out using PCR analysis with specifically designed primers on DNA extracted from livers and kidneys. P. damselae-positive samples had their 16S rRNA amplicons sequenced. Later, an attempt to specify relevant sub-species was performed, using a three-layered gene screen: Car, ureC and toxR. Of 334 fish samples, 47 (14%) were found to be P. damselae-positive, of which 20 were identified as P. damselae subsp. piscicida (Phdp), two as P. damselae subsp. damselae (Phdd) and 25 could not be identified to subspecies. Our results strengthen the view that fish residing in a polluted environment are receptive of pathogenic microorganisms. To assess how the presence of pathogens may affect population management and conservation, this research should be followed by studies aimed at: (i) quantifying levels of pollutants that may affect pathogen emergence, and (ii) creating a standard pollution-level index as a basis for setting criteria, above which authorities should take measures of precaution. [ABSTRACT FROM AUTHOR]

• Planning discussions in a regulatory vacuum revolve around past experiences. • Negotiating memories in planning institutions impacts the diffusion of wind energy. • Institutional memories guide planning decisions when no adequate regulations exist. • Institutional memories shape the rules and regulations of emerging markets. • The use of machine learning methods reveals complex patterns in qualitative data. Memories of past experiences are at the heart of innovation processes, yet because they are difficult to operationalize, their role in the renewable energy transition remains elusive. Applying the concept of spillover to operationalize institutional memory, the current study addresses this problem for the first time. It examines how different actors in a planning institution in Israel reached decisions regarding 22 new wind projects by focusing on institutional memory as an explanatory variable. Our findings indicate that planning institutions relied on institutional memory to make decisions regarding contentious issues. Furthermore, they suggest that actors use institutional memories strategically to shape nascent rules and regulations in the regulatory vacuum of an emerging market. Employing machine learning methods to study the effect of institutional memory on the diffusion of wind energy opens up new research avenues in the dynamics of unfolding diffusion processes. [ABSTRACT FROM AUTHOR]

Initial deleterious effects of the COVID-19 pandemic on urologic oncology surgeries are well described, but the possible influence of vaccination efforts and those of pandemic conditions on surgical volumes is unclear. Our aim was to examine the association between changing vaccination status and COVID-19 burden throughout the pandemic and the volume of urologic oncology surgeries in Israel. This multi-center cross-sectional study included data collected from five tertiary centers between January 2019 and December 2021. All 7327 urologic oncology surgeries were included. Epidemiological data were obtained from the Israeli Ministry of Health database. A rising trend in total urologic oncology surgery volumes was observed with ensuing COVID-19 wave peaks over time ( X 2 = 13.184, df = 3, p = 0.004). Total monthly surgical volumes correlated with total monthly hospitalizations due to COVID-19 (R = −0.36, p = 0.015), as well as with the monthly average Oxford Stringency Index (R = −0.31, p = 0.035). The cumulative percent of vaccinations and of new COVID-19 cases per month did not correlate with total monthly urologic surgery volumes. Our study demonstrates the gradual acclimation of the Israeli healthcare system to the COVID-19 pandemic. However, hospitalizations due to COVID-19, as well as restriction stringency, correlate with lower volumes of urologic oncological surgeries, regardless of the population's vaccination status. [ABSTRACT FROM AUTHOR]

Gaps between physician and patient perceptions may lead to misunderstandings and mismanage of treatment. There are sparse data about the differences in opinions toward medical cannabis (MC) between patients and health professionals. The aim of this study was to examine the attitudes toward MC, its perceived efficacy, side effects and risk of dependency, among patients, nurses and physicians. A cross-sectional study of samples of 430 patients, 65 nurses and 65 physicians in two large medical centers in Israel. Questionnaires were administered on attitudes, perceived efficacy, side-effects and perceived risks of dependency. Compared with nurses and physicians, patients who were using MC had the most positive attitudes toward MC (p <.001). Younger age, high school education, being Jewish and ever using MC, were associated with more positive attitudes toward MC among patients (p <.001). Among nurses and physicians, having an oncology specialty predicted more positive attitudes toward MC. Physicians had a less positive attitude toward MC compared to nurses (p <.01). Our study provides evidence that physicians are less positive in their views toward MC compared to nurses and patients. More information and awareness to MC may reduce the gap in perceptions between physicians and patients. [ABSTRACT FROM AUTHOR]

One strategy for the containment of a pandemic is mass testing. Magen David Adom (MDA), the Israeli National Emergency Medical Services (EMS) Organization undertook this mission by operating a nationwide series of drive-through testing complexes. The objective of this study is to learn lessons from an analysis of these centers. Data from 198 stationary and mobile drive-through complexes from March 20, 2020, through October 17, 2020, were analyzed for temporal and geographic factors, and cost. Also, an operational improvement program was implemented and analyzed. A total of 931,074 patients were sampled in the MDA drive-through system: 46.9% in stationary complexes, and 53.1% in mobile complexes. The optimized cost per patient of home testing was estimated at 74.5 USD compared with 6.55 USD in the drive-through centers. An operational improvement program lowered the total sampling time from 128 s/patient to 98 s and decreased the total cost per patient from 6.55 USD to 6.27 USD. The EMS led drive-through complexes were cost-effective and efficient in performing large numbers of viral tests, especially when compared with home testing. Established concepts in clinical operations should be implemented to increase the number of persons that can be tested and decrease cost. [ABSTRACT FROM AUTHOR]

In this article, we examine the installation of surveillance cameras in the Bedouin town of Hura in the Negev desert in Israel, analysing the complex interactions between the state and the local inhabitants, for whom the cameras were an opportunity to exercise agency. Considering the long history of Jewish colonialism in the Negev, one could have assumed that the new surveillance technology was imposed on the Bedouins against their will. However, in‐depth interviews with Hura inhabitants demonstrated that the municipality and tribal authorities were active players in deciding on the installation and location of the surveillance cameras. In light of the conflictual relations of the Bedouin population to Israeli state authorities, we argue that while the cameras placed the Bedouins of Hura under a new layer of surveillance, their installation could also be understood as a reaction to the ongoing neglect of Bedouin lives and possessions by the state. [ABSTRACT FROM AUTHOR]

Floods rarely occur in hyper-arid deserts and little is known about the magnitude and frequency of sediment delivery from their basins, despite their importance to changes to the landscape, infrastructures and engineering activities. Sediment yield from the Nahal Nehushtan watershed (11.9 km2) located in the Timna Valley in southern Israel was determined by assessing stratigraphic sections in its 60-year reservoir deposits. Stratigraphic correlation between event couplets allowed for quantification of sediment yields representing 13 former flow and flood events. Based on the sediment volume in the reservoir, the 29.8 t km−2 year−1 average specific sediment yield is one of the lowest among other studied warm deserts. Among the event layers, the thickest layer, deposited by a flash flood caused by a single short rain event, contributed 31% of the total sediment yield. Based on event reservoir sedimentation from watersheds located in several hyper-arid areas in the Middle East and North America, we demonstrate that sediment yield increases with drainage area as expected and mean annual sediment yield increases in hyper-arid areas with flood frequency. Our quantitative results, together with previous studies of hyper-arid areas, provide complementary evidence of fluvial sediment transport—the main landscape designer in hyper-arid fluvial landscapes. [ABSTRACT FROM AUTHOR]

In this report, we describe a national-scale monitoring of the SARS-CoV-2 (SC-2) variant dynamics in Israel, using multiple-time sampling of 13 wastewater treatment plants. We used a combination of inclusive and selective quantitative PCR assays that specifically identify variants A19/A20 or B.1.1.7 and tested each sample for the presence and relative viral RNA load of each variant. We show that between December 2020 and March 2021, a complete shift in the SC-2 variant circulation was observed, where the B.1.1.7 replaced the A19 in all examined test points. We further show that the normalized viral load (NVL) values and the average new cases per week reached a peak in January 2021 and then decreased gradually in almost all test points, in parallel with the progression of the national vaccination campaign, during February–March 2021. This study demonstrates the importance of monitoring SC-2 variant by using a combination of inclusive and selective PCR tests on a national scale through wastewater sampling, which is far more amendable for high-throughput monitoring compared with sequencing. This approach may be useful for real-time dynamics surveillance of current and future variants, such as the Omicron (BA.1, BA.2) and other variants. [ABSTRACT FROM AUTHOR]

Enterovirus D68 (EVD68) was recently identified as an important cause of respiratory illness and acute flaccid myelitis (AFM), mostly in children. Here, we examined 472 pediatric patients diagnosed with severe respiratory illness and screened for EVD68 between April and October 2021. In parallel, samples collected from a wastewater treatment plant (WWTP) covering the residential area of the hospitalized patients were also tested for EVD68. Of the 472 clinical samples evaluated, 33 (7%) patients were positive for EVD68 RNA. All wastewater samples were positive for EVD68, with varying viral genome copy loads. Calculated EVD68 genome copies increased from the end of May until July 2021 and dramatically decreased at the beginning of August. A similar trend was observed in both clinical and wastewater samples during the period tested. Sequence analysis of EVD68-positive samples indicated that all samples originated from the same branch of subclade B3. This study is the first to use wastewater-based epidemiology (WBE) to monitor EVD68 dynamics by quantitative detection and shows a clear correlation with clinically diagnosed cases. These findings highlight the potential of WBE as an important tool for continuous surveillance of EVD68 and other enteroviruses. [ABSTRACT FROM AUTHOR]

Several countries have recently transitioned from the trivalent inactivated influenza vaccine (TIV) to the quadrivalent inactivated influenza vaccine (QIV) in order to outweigh influenza B vaccine-mismatch. However, few studies thus far evaluated its benefits versus the TIV in a systematic manner. Our objective was to compare the QIV VE with lineage-mismatched TIV VE. We estimated the 2015–2016, 2017–2018, 2019–2020 end-of season influenza B VE against laboratory-confirmed influenza-like illness (ILI) among community patients, using the test-negative design. VE was estimated for pre-determined age groups and for moving age intervals of 15 years. Since 2011–2012 season, alternate seasons in Israel were dominated by influenza B circulation. Compared with the lineage-mismatched TIV used during the 2015–2016 and 2017–2018 seasons, the 2019–2020 QIV showed the highest all-ages VE, with VE estimates of 56.9 (95% CI 30.1 to 73.4), 16.5 (95% CI –22.5 to 43.1) and −25.8 (95% CI −85.3 to 14.6) for the 2019–2020, 2017–2018 and 2015–2016 seasons, respectively. The 2019–2020 VE point estimated were the highest for the 0.5–4, 5–17 and 18–44 years age groups and for more 15-year age intervals as compared to the other seasons. Our results support the rapid transition from the TIV to the QIV. [ABSTRACT FROM AUTHOR]

Renewable energy transition is one of the keys to mitigating climate change. While attention has been given to various economic, institutional, technological, and sociocultural barriers to this transition, it is unclear how acute interstate conflict shadowed by geopolitical forces shapes the deployment of renewables. The literature is split between those who speculate that conflict conditions discourage renewable energy proliferation and their critics. This ambiguity is surprising, since renewable energy is often suggested as a panacea for many conflict and post-conflict areas with dysfunctional centralised electricity systems. A systematic assessment of these competing hypotheses is challenging because of the absence of reliable data in fragile states and areas. This study is the first to use remote sensing to examine the temporal and spatial diffusion of renewables in the Gaza Strip against the backdrop of conflict conditions with Israel. It finds that Gaza has become a renewable energy leader despite conflict conditions exacerbated by deep poverty. The balance between discouraging and encouraging factors rests on different variables: the impact of the conflict on the free movement of labour, goods, and fuel, the intensity of the conflict, the role of economies of scale, opportunity costs, and alternative energy production costs. [ABSTRACT FROM AUTHOR]

Urbanization is the land-use process that most significantly impacts flora and fauna. We conducted a multiple city comparison of two taxa to assess whether richness patterns are similar across cities and taxa. This study aimed to examine the effects socioecological factors, namely open area size, socioeconomic status and the built-up cover, on species richness and composition of plants and butterflies in five adjacent Mediterranean cities in Israel's coastal plain. Vegetation surveys were conducted in 170 open area sites in various urban settings. In 34 of them, the presence of butterfly species was also recorded. Mixed-effect generalized linear models were used to examine the site's characteristics effect on the species richness. The identity of each city was included as a random effect in the models. Results indicated that overall plant species richness increased with patch size, whereas butterfly richness was not associated with this factor. Plant and butterfly species richness in all categories decreased with the increase in building cover, except for endemic plant species. The results demonstrate the complex contribution of urban open area patches to the biodiversity of different taxa, being conditional on their size, surrounding built-up area and socioeconomic values. [ABSTRACT FROM AUTHOR]

Drought can cause tree mortality through hydraulic failure and carbon starvation. To prevent excess water loss, plants typically close their stomata before massive embolism formation occurs. However, unregulated water loss through leaf cuticles and bark continues after stomatal closure. Here, we studied the diurnal and seasonal dynamics of bark transpiration and how it is affected by tree water availability. We measured continuously for six months water loss and CO2 efflux from branch segments and needle-bearing shoots in Pinus halepensis growing in a control and an irrigation plot in a semi-arid forest in Israel. Our aim was to find out how much passive bark transpiration is affected by tree water status in comparison with shoot transpiration and bark CO2 emission that involve active plant processes, and what is the role of bark transpiration in total tree water use during dry summer conditions. Maximum daily water loss rate per bark area was 0.03–0.14 mmol m−2 s−1, which was typically ~76% of the shoot transpiration rate (on leaf area basis) but could even surpass the shoot transpiration rate during the highest evaporative demand in the control plot. Irrigation did not affect bark transpiration rate. Bark transpiration was estimated to account for 64–78% of total water loss in drought-stressed trees, but only for 6–11% of the irrigated trees, due to differences in stomatal control between the treatments. Water uptake through bark was observed during most nights, but it was not high enough to replenish the lost water during the day. Unlike bark transpiration, branch CO2 efflux decreased during drought due to decreased metabolic activity. Our results demonstrate that although bark transpiration represents a small fraction of the total water loss through transpiration from foliage in non-stressed trees, it may have a large impact during drought. [ABSTRACT FROM AUTHOR]

Background Amblyopia, when not diagnosed at appropriate age, leads to uncorrectable visual impairment with considerable social and financial implications. The aim of this study was to assess socio-demographic disparities in amblyopia prevalence among Israeli adolescents, in order to identify susceptible groups in the population. Methods A nationwide, population-based, cross-sectional study of Israeli adolescents examined between 1993 and 2017. All study participants underwent visual acuity examination with socio-demographic data and previous medical history documented. Associations were analyzed using univariable and multivariable logistic regression models. Results Among 1 334 650 Israeli-born candidates aged 17.15±0.26 years, amblyopia was diagnosed in 1.07%. The overall prevalence of amblyopia has declined from 1.59% in 1993 to 0.87% in 2017. Being in the lowest socioeconomic status and below average cognitive function scores increased the odds of amblyopia in both males [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.45–1.87; OR 1.27, 95% CI 1.19–1.35, respectively] and females (OR 1.61, 95% CI 1.30–1.98; OR 1.27, 95% CI 1.18–1.36, respectively). Among males, Orthodox and ultra-Orthodox educational systems were associated with increased odds of amblyopia (OR 1.16, 95% CI 1.09–1.25; OR 1.90, 95% CI 1.73–2.09). A significantly higher prevalence of amblyopia was recorded among 219 983 immigrants (1.51%, P <0.001). Conclusions Although the overall prevalence of amblyopia has decreased during the observed years, we found substantial evidence of socio-demographic disparities in amblyopia prevalence among adolescents, suggesting disparities in the prevention of the disease and its treatment. Demonstration of inequities at a national level could aid future guidance of health policy and augment current vision screening programs. [ABSTRACT FROM AUTHOR]

Taking a culturally sensitive approach, we set out to explore the social response to, and the cultural adoption of, charity sport events in Israel, where this phenomenon is relatively new and understudied. We show that charity sport events participation is accepted with mixed feelings: participants are motivated by their novice athletic aspirations and love for bike riding, and by their emotional connection to the cause, but at the same time are reluctant to fundraise and donate due to socio-cultural barriers. Using a qualitative, exploratory, single case study design, and relying on the literature of charity sports events, we show that in contrast to the extant distinction between philanthropic givers' motivations and non-givers' barriers, participants in charity sport events experience simultaneous motivations for and barriers to their own philanthropic giving. Although they strongly identify with their role as bike riders, and are motivated to take part in a challenging ride, they struggle with the roles of fundraiser and philanthropist that are inherent components of charity sports events. The combination of these experiences yields the experience of ambivalence towards philanthropic giving, which we accordingly term as ambivalent philanthropy. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is an obstacle to achieving high vaccination rates for COVID-19. Current knowledge on vaccine uptake is mostly based on hypothetical intention to vaccinate surveys. We compared intention to vaccinate and real-world vaccine uptake among 511 soldiers in a military unit during an unrestricted, on-site COVID-19 vaccine rollout. Soldiers were offered group lectures, on-site consultations and primary care office visits, discussing concerns on vaccination with a primary care physician. Overall, 359 (70.3%) soldiers participated in the group lectures, 33 (6.5%) in on-site consultations and 19 (3.7%) attended primary care visits. Overall, 459 (89.8%) of 511 soldiers vaccinated for COVID-19. Of the 90 soldiers initially refusing, 38 (42.2%) had agreed to receive a vaccine. On-site COVID-19 vaccine rollout joined with primary care communication interventions may maximize vaccine uptake within a young-adult community. Future studies should evaluate the effectiveness of these efforts across different populations in a controlled and comparative manner. [ABSTRACT FROM AUTHOR]

Background and purpose: Although the COVID‐19 vaccines are currently recommended for people with multiple sclerosis (MS), the fact that they were not specifically tested in people with MS raises uncertainty regarding their safety in this population. The purpose of this study was to report real‐life safety data of the BNT162b2 COVID‐19 vaccine in a cohort of MS patients. Methods: An anonymous survey was distributed to 425 MS patients. Participants were asked general demographic and disease‐related questions and specific questions regarding the safety profile of the COVID‐19 vaccine. Results: Of the 425 MS patients, 262 completed the questionnaire. The median (range) participant age was 42 (22–79) years, 199 participants were women (75.9%), and 66 participants (25.2%) had associated comorbidities. A total of 198 participants (75.6%) were treated with disease‐modifying therapies. In all, 239 participants (91.2% of the responders) had received the BNT162b2 COVID‐19 vaccine. Of these, 182 (76.1%) were aged <55 years, and 57 (23.9%) were aged >55 years. Adverse events were reported by 136 participants (56.9%; 52.5% of those aged <55 years and 40.3% of those aged >55 years; p = 0.1517) and 36 participants (15.1%) reported new or worsening neurological symptoms following the vaccination, the most frequent being sensory disturbances (21 participants, 58.3%). Most symptoms occurred within the first 24 h after vaccination and resolved within 3 days. A total of 28 participants (77.8%) did not require any medication to treat their symptoms. Conclusions: This survey indicates an overall favorable safety profile of the BNT162b2 vaccine in people with MS. These data should be confirmed in further prospective, large‐scale studies. This study indicates an overall favorable safety profile of the BNT162b2 COVID‐19 vaccine in people with MS. The spectrum of adverse events reported in our study is comparable to that reported in the general population. Adverse events among MS patients were more frequent in the young‐age group (< 55 years old) compared to individuals older than 55 years old. The overall rate of adverse events may be lower in MS patients treated with DMTs. The rate of new or worsening neurological symptoms is relatively low (15.1%), with most events being of mild severity, not requiring specific treatment, and resolving within a few days. [ABSTRACT FROM AUTHOR]

We study the effects of public pension systems on the retirement timing of older workers and, in turn, the health consequences of delaying retirement by those workers. Causal inference relies on a social security reform in Israel that shifted payments from husbands to their (nonworking) wives, thereby substantially reducing the implied tax on the husband's employment while keeping overall household wealth constant. Using administrative social security data, we estimate extensive-margin labor supply elasticities with respect to the average net-of-tax rate of about 0.43 for men over 65. Using the reform to instrument for employment, we find that working an additional full year at old age decreases longevity. This mortality effect occurs after age 75 and is driven by workers holding blue-collar jobs. Finally, we evaluate the effect of the reform on earnings. The results imply a small value for an additional year of life, suggesting that workers underestimate the health cost of employment at older ages. (JEL: J10, J26, J22, H31) [ABSTRACT FROM AUTHOR]

The Early Epipaleolithic (EEP) of the Southern Levant, roughly dated to 25-18 ka BP, is characterized by microlithic industries with highly variable synchronic and geographic techno-typological characteristics, the chronology of which remains poorly understood. Here, we present the results from excavations at Idan VII, a well-preserved site amongst a cluster of newly discovered EEP occurrences in the hyper-arid Arava Valley, Israel. The finds are embedded within the Late Pleistocene Lisan Formation lacustrine sediments, an extensively studied paleo-hydroclimatic archive in the Rift Valley. This unique situation enables contextualization of the archaeological finds within the detailed paleo-climatic chronology. The data presented include the stratigraphy (geomorphology and micro-geoarchaeology), relative (related to paleo-lake curve) and absolute (radiocarbon and U–Th) chronology, and archaeological (lithics, faunal and botanical) remains. The results demonstrate that the Idan EEP occurrences are situated within a localized relatively short-lived paleo-wetland area adjacent to Lake Lisan, during or immediately after the extremely cool and locally dry Heinrich Event 2 (H2), ca. 24 ka BP. The results are critically examined with respect to available radiocarbon dates from EEP archaeological sites in the Southern Levant. These, together with the geomorphological evidence, indicate that the Idan VII assemblage, while superficially resembling the so-called 'Late Kebaran' industry, actually significantly predates its most pertinent techno-typological analogs, highlighting the necessity of re-evaluating the "Kebaran complex". Rather, it is coeval with the local, but unrelated 'Masraqan' and 'Nebekian' industries at the very onset of the EEP, demonstrating the high degree of Last Glacial Maximum hunter-gatherer cultural diversity then present in the Levant. In contextualizing the results within the Northern Hemisphere chrono-climatic framework, we conclude that within the Southern Levant, the H2 provides a solid chrono-climatic anchor for the appearance of fully-fledged backed bladelets microlithic industries, which probably reflects a technological change in composite projectile hunting gear that occurred during the EEP. • Newly discovered complex of prehistoric occurrences in the Arava Valley, Israel. • The occurrences embedded within the Late Pleistocene Lisan Formation lacustrine sediments. • Integrating the archaeological finds into the Northern Hemisphere chrono-climatic framework. • Backed bladelets industries appeared in the Levant immediately after Heinrich event 2 ca. 24 ka BP. • Demonstrating the coexistence of several lithic industries in the Levant at ca. 24-23 ky BP. [ABSTRACT FROM AUTHOR]

Policy design studies have addressed the role of political and institutional limitations in formulating effective climate policies including renewable energy targets (RETs). However, it is still not entirely clear how and why these limitations result in policy designs that are incapable of staying on track to meet the overall goals of the Paris Agreement on climate change. In order to deepen our understanding, this study introduces a friction perspective—one of the core components of the punctuated equilibrium theory used in policy change literature—and adopts it to the policy design process of energy transitions. This study argues that in cases where governments struggle to design stringent RETs, the level of friction between the elastic sub-coalitions (comprising bureaucrats and politicians) can shed light on policy design choices. By using a causal mechanism approach, the study developed several friction mechanisms to test how friction has been built and often dissolved, resulting in inadequate policy outcomes. The design process for setting Israel's national RETs negotiated between 2015 and 2017 was used as a longitudinal case study to illustrate the role of friction and assess its impact. Unraveling how friction operates within policy design was found to be a good litmus test for the political feasibility of policy design choices. In other words, this study gives us a rudimentary blueprint of a "friction map" that, by tracing sequences of conflict and sequences of resolution, shows which particular design choices may generate more tension than others. [ABSTRACT FROM AUTHOR]

• Energy communities are not homogenous units. • Renewable energy projects trigger internal-community conflicts. • Community cohesion and fairness are the most influential variables on community acceptance. • Cultural attitudes (religion) mitigate some negative externalities. • Place attachment and monetary compensation have little influence on community acceptance. Public acceptance is critical to the successful implementation of renewable energy policy. Most of the literature on public acceptance within the community framework has focused on the tension between neighboring communities or the conflict between state planning processes and the needs of local communities. The community, in these cases, is often categorized as a unified and homogeneous unit of measurement. This emphasis on aggregate numbers at the regional and national levels rather than the community level conceals the inequalities that are likely to lurk beneath the surface and therefore hinder the renewable transformation. In an effort to understand the nuances of renewable energy conflict within a community and its effect on public acceptance, this article examines the acceptance of the establishment of renewable energy projects on a kibbutz and a moshav – two cooperative forms of rural settlement in Israel. Our findings suggest that policymakers interested in promoting renewable energy should also pay attention to inner community dynamics in order to foster bridge building initiatives and community cohesiveness. If the priority is to maintain the cohesion of an existing community, policymakers should first seek fairness and respect social acceptance. In both cases, religion was found to act as a strong pacifying factor shaping both community cohesion and community acceptance. In addition, it was found that a deep split within the community renders the introduction of monetary incentives inconsequential. [ABSTRACT FROM AUTHOR]

Complex microbial communities facilitate iron and methane transformations in anoxic methanic sediments of freshwater lakes, such as Lake Kinneret (the Sea of Galilee, Israel). The phylogenetic and functional diversity of these consortia are not fully understood, and it is not clear which lineages perform iron reduction and anaerobic oxidation of methane (AOM). Here, we investigated microbial communities from both natural Lake Kinneret iron-rich methanic sediments (>20 cm depth) and iron-amended slurry incubations from this zone using metagenomics, focusing on functions associated with iron reduction and methane cycling. Analyses of the phylogenetic and functional diversity indicate that consortia of archaea (mainly Bathyarchaeia, Methanomicrobia, Thermoplasmata, and Thermococci) and bacteria (mainly Chloroflexi (Chloroflexota), Nitrospirae (Nitrospirota), and Proteobacteria) perform key metabolic reactions such as amino acid uptake and dissimilation, organic matter fermentation, and methanogenesis. The Deltaproteobacteria, especially Desulfuromondales (Desulfuromonadota), have the potential to transfer electrons extracellularly either to iron mineral particles or to microbial syntrophs, including methanogens. This is likely via transmembrane cytochromes, outer-membrane hexaheme c-type cytochrome (OmcS) in particular, or pilin monomers (PilA), all of which were attributed to this lineage. Bona fide anaerobic oxidizers of methane (ANME) and denitrifying methanotrophs Methylomirabilia (NC10) may mediate AOM in these methanogenic sediments; however we also consider the role of methanogens in active AOM or back flux of methanogenesis. Putative aerobes, such as methane-oxidizing bacteria Methylomonas and their methylotrophic syntrophs Methylotenera , are found among the anaerobic lineages in Lake Kinneret iron-amended slurries and are also involved in the oxidation of methane or its intermediates, as suggested previously. We propose a reaction model for the metabolic interactions in these sediments, linking the potential players that interact via intricate metabolic tradeoffs and direct electron transfer between species. Our results highlight the metabolic complexity of microbial communities in an energy-limited environment, where aerobe and anaerobe communities may co-exist and facilitate AOM as one strategy for survival. [ABSTRACT FROM AUTHOR]

While present heat flow (HF) throughout Israel and the Dead Sea Transform (DST) area is considered low, a thermal anomaly exists near the Yarmuk valley at the southern tip of the Golan Heights. New temperature measurements in the southern Golan Heights show that the distribution of the thermal anomaly is significantly wider than previously thought. The new data conforms to either a local and shallow magmatic chamber, which is in thermal steady state with the surrounding rocks, or to a transient heat front associated with localized Pleistocene magmatic intrusions in the Yarmuk. An alternative mechanism suggests that the present HF intensity is higher than the HF value calculated based on the apparent borehole temperatures due to heat removal by deep aquifer flow. A paleothermal analysis was performed using high‐resolution organic matter maturation profiles on the Late Cretaceous source rocks, across the southern Golan basin. The maturation data show remarkably similar values throughout the basin, indicating that a single thermal event led to the source rock maturation. Constraints given by geological considerations have associated the paleothermal event with Pliocene volcanic eruptions, which has allowed the calculation of the basin paleo‐heat flows, and indicated on a basin wide heat source, such as a crustal heat source. The paleothermal event is sharply bounded by a DST branching fault. This observation is suggested to be related to either strike‐slip movement associated with the DST or to heat removal and modulation by a deep hydrological system. Key Points: New geothermal gradients are provided for the Golan Heights. The geothermal anomaly is significantly wider than previously reportedDuring the Pliocene, a regional thermal source led to maturation of Late Cretaceous source rocksThe thermal evolution, anomalies and sources are discussed and assessed for the period since the Pliocene to the present [ABSTRACT FROM AUTHOR]

aime Levy1,*1Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; 2Department of Internal Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel*These authors contributed equally to this workCorrespondence: Jaime LevyDepartment of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelEmail levjaime@gmail.com Objective: To present our hybrid telehealth medical retina clinic service with intravitreal injections (IVI) treatment as a safe alternative to in-person visits and examination during COVID-19 pandemic disease. Methods: Due to exposure to a COVID-19 positive retina fellow, our retina service, in quarantine, evaluated patients' medical files and retinal scans using a telemedicine approach. A different protocol for patients coming for IVI during the COVID-19 pandemic was established for IVI administration. Results: During the 14-day quarantine period (between March 18th and March 31st 2020), the hybrid telehealth medical retina clinic performed 523 IVI to 394 patients with a mean age ± SD 70.96 ± 14.4 years. IVI were administered for neovascular age-related macular degeneration in 50.5% of the cases (199 patients), diabetic macular edema in 21.3% (84 patients), retinal vein occlusion in 17.5% (69 patients), and 10.7% for other retinal pathologies (42 patients). No ocular or systemic complications were observed. Conclusion: During disasters and pandemics, IVI can be provided safely using a hybrid telehealth medical retina clinic approach but only in the appropriate patient and health care system. [ABSTRACT FROM AUTHOR]