Search

Abstract Background On October 7, 2023, Hamas carried out an unprecedented attack on the State of Israel and kidnapped 251 people into captivity to the Gaza Strip. Several months later, as part of a humanitarian exchange deal, 105 hostages were released in five phases and admitted to one of six hospitals throughout the country for treatment. Shamir Medical Center (SMC) was one of these facilities. This study aims to describe the structure, process and outcomes of establishing a comprehensive, multi-step, operational protocol for receiving hostages returning from captivity. Method The process of preparing SMC as a receiving center, the establishment of procedures for implementation of the medical protocol, and the assessment of multi-disciplinary team preparedness and implementation and outcomes in an institutional protocol are described. Results 24 returning hostages were received at SMC. Social workers, dietitians and translators were used by 100% of the majority group of returning hostages from the same country of origin and the sole individual from the other country of origin utilized a dietitian, social worker, ENT consultations, and a hearing test. Among the majority group, orthopedic and dermatological consultations were utilized by 17.4% and 13% received an ENT consultation. Of the administered imaging, 13% received a chest X-ray, 8.7% received a limb X-ray, 17.4% received a head CT scan, and 4.3% received an abdominal CT. In addition, 21.7% were provided antibiotic therapy. Protocol efficacy was measured by assessing time to various operational aspects of protocol implementation and medical procedures such as mean hours to room assignment, primary physician evaluation and social worker session. No correlation between age and operational variables was found. Conclusion This novel operational protocol was successfully implemented and may serve as a framework for managing similar unpredictable sensitive events in the case of future need.

Abstract Background Fibroblast differentiation to a myofibroblast phenotype is a feature of airway remodeling in asthma. Lung fibroblasts express the integrin receptor α4β7 and fibronectin induces myofibroblast differentiation via this receptor. Objectives To investigate the role of the β7 integrin receptor subunit and α4β7 integrin complex in airway remodeling and airway hyperresponsiveness (AHR) in a murine model of chronic allergen exposure. Methods C57BL/6 wild type (WT) and β7 integrin null mice (β7 -/-) were sensitized (days 1,10) and challenged with ovalbumin (OVA) three times a week for one or 4 weeks. Similar experiments were performed with WT mice in the presence or absence of α4β7 blocking antibodies. Bronchoalveolar (BAL) cell counts, AHR, histological evaluation, soluble collagen content, Transforming growth factor-β (TGFβ) and Interleukin-13 (IL13) were measured. Phenotype of fibroblasts cultured from WT and β7 -/- saline (SAL) and OVA treated mice was evaluated. Results Eosinophil numbers were similar in WT vs β7-/- mice. Prolonged OVA exposure in β7-/- mice was associated with reduced AHR, lung collagen content, peribronchial smooth muscle, lung tissue TGFβ and IL13 expression as compared to WT. Similar findings were observed in WT mice treated with α4β7 blocking antibodies. Fibroblast migration was enhanced in response to OVA in WT but not β7 -/- fibroblasts. α-SMA and fibronectin expression were reduced in β7-/- fibroblasts relative to WT. Conclusions The β7 integrin subunit and the α4β7 integrin complex modulate AHR and airway remodeling in a murine model of allergen exposure. This effect is, at least in part, explained by inhibition of fibroblast activation and is independent of eosinophilic inflammation.

Abstract Aims Left ventricular assist devices (LVADs) support the hearts of patients with advanced heart failure. Following LVAD implantation, patients face a complex regimen of self‐care behaviours including self‐care maintenance, self‐care monitoring and self‐care management. However, during the COVID‐19 pandemic, symptoms of anxiety and depression may have interfered with their self‐care. Currently, little is known on how specific self‐care behaviours of LVAD‐implanted patients changed during the COVID‐19 pandemic. We aim to describe the changes in self‐care behaviours among patients with an implanted LVAD in Israel during the COVID‐19 pandemic and explore the factors related to self‐care behaviour change. Methods A prospective observational cross‐sectional study design. A convenience sample of 27 Israeli LVAD‐implanted patients (mean age 62.4 ± 9, 86% male, 78.6% living with a partner) completed the LVAD Self‐Care Behaviour Scale (1 = never to 5 = always) and Hospital Anxiety and Depression Scale (0 = not at all to 3 = most of the time). Data were collected before and after the onset of the COVID‐19 pandemic in Israel. Statistical analyses included paired t‐tests, Pearson's correlations, and one‐way repeated measures ANOVAs. Results During the COVID‐19 pandemic, a significant decrease was found in patients' adherence to checking and recording their LVAD speed, flow, power and PI (Pulsatility Index) (P = 0.05), checking their INR (P = 0.01), and daily weighing (P

Summary: Most cell types in multicellular organisms can perform multiple functions. However, not all functions can be optimally performed simultaneously by the same cells. Functions incompatible at the level of individual cells can be performed at the cell population level, where cells divide labor and specialize in different functions. Division of labor can arise due to instruction by tissue environment or through self-organization. Here, we develop a computational framework to investigate the contribution of these mechanisms to division of labor within a cell-type population. By optimizing collective cellular task performance under trade-offs, we find that distinguishable expression patterns can emerge from cell-cell interactions versus instructive signals. We propose a method to construct ligand-receptor networks between specialist cells and use it to infer division-of-labor mechanisms from single-cell RNA sequencing (RNA-seq) and spatial transcriptomics data of stromal, epithelial, and immune cells. Our framework can be used to characterize the complexity of cell interactions within tissues.

IntroductionThe COVID-19 pandemic has placed additional burden on already strained healthcare systems worldwide, intensifying the responsibility and burden of healthcare workers. Although most hospital staff continued working during this stressful and challenging unprecedented pandemic, differences in the characteristics and attributes were noted between sectors and hospital departments. Israeli healthcare workers are trained and experienced in coping with national emergencies, but the pandemic has exposed variations in staff reactions. Understanding the intrinsic differences between sectors and departments is a key factor in staff and hospital preparedness for unexpected events, better resource utilization for timely interventions to mitigate risk and improve staff wellbeing.ObjectiveTo identify and compare the level of resilience, secondary traumatization and burnout among hospital workers, between different sectors and hospital departments, during the COVID-19 pandemic.MethodsCross-sectional research to assess the resiliency, secondary traumatization and burnout of healthcare workers at a large general public hospital in central Israel. The sample consisted of 655 participants across various hospital units exposed to COVID-19 patients.ResultsEmergency department physicians had higher rates of resilience and lower rates of burnout and secondary traumatization than staff in other hospital departments. In contrast, staff from internal medicine departments demonstrated the highest levels of burnout (4.29). Overall, physicians demonstrated higher levels of resilience (7.26) and lower levels of burnout compared to other workers.ConclusionIdentifying resilience characteristics across hospital staff, sectors and departments can guide hospital management in education, preparation and training of healthcare workers for future large-scale health emergencies such as pandemics, natural disasters, and war.

Anti-B-cell maturation antigen (BCMA) chimeric antigen receptor T-cell (CAR T) therapy shows remarkable efficacy in patients with relapsed and/or refractory (R/R) multiple myeloma (MM). HBI0101, a novel second generation optimized anti- BCMA CAR T-cell therapy, was developed in an academic setting. We conducted a phase I dose-escalation study of HBI0101 (cohort 1: 150x106 CAR T cells, n=6; cohort 2: 450x106 CAR T cells, n=7; cohort 3: 800x106 CAR T cells, n=7) in 20 heavily pre-treated R/R MM patients. Grade 1-2 cytokine release syndrome (CRS) was reported in 18 patients (90%). Neither grade 3-4 CRS nor neurotoxicity of any grade were observed. No dose-limiting toxicities were observed in any cohort. The overall response rate (ORR), (stringent) complete response (CR/sCR), and very good partial response rates were 75%, 50%, and 25%, respectively. Response rates were dose-dependent with 85% ORR, 71% CR, and 57% minimal residual disease negativity in the high-dose cohort 3. Across all cohorts, the median overall survival (OS) was 308 days (range 25-466+), with an estimated OS of 55% as of June 27th (data cut-off). The median progression-free survival was 160 days, with 6 subjects remaining progression free at the time of data cut-off. Our findings demonstrate the manageable safety profile and efficacy of HBI0101. These encouraging data support the decentralization of CAR T production in an academic setting, ensuring sufficient CAR T supply to satisfy the increasing local demand. Clinicaltrials.gov NCT04720313.

This study examines the extent of awareness among Iraqi English foreign language learners about the potential impact of reading literature on developing their creative writing abilities. Furthermore, this study investigates the relationship between those who partake in literature reading and their academic skills. It examines the participation of 120 Iraqi EFL learners currently enrolled in the faculties of Arts, Education, and Education in Qurna, affiliated with the University of Basrah. It employs a mixed methods approach, including a questionnaire and semi-structured interviews. The results demonstrate a significant correlation between reading literary texts and developing creative writing skills. Several literary elements enhance creative writing, including a comprehensive understanding of figures of speech, cultivating critical thinking skills, engaging in literature courses, practicing paraphrasing poetry, and exposure to various literary genres. The findings also demonstrate that EFL learners profoundly understand the impact of engaging with literary texts on their academic abilities.

This study retrospectively examines teaching practice within Israeli teacher education programs. A pilot study investigates the implementation of a novel teacher education program in Israeli academia, with a focus on the freedom it grants to institutions. This program emerged during the COVID-19 crisis when e-learning dominated. The study assesses 45 respondents' perceptions of teaching practice and the academia-school relationship through a combination of qualitative and quantitative methods. On the quantitative front, the study involved the examination of several questionnaires. These included a self-efficacy questionnaire, an attitude survey regarding teaching, an evaluation of professional identity, and an attitude questionnaire centered on practical experiences within schools. In the assessment of self-efficacy, we utilized a modified version of the General Self-Efficacy Scale (GSE). Additionally, the researchers crafted the other questionnaires. The study also encompassed an exploration of student satisfaction levels concerning collaboration during practical experiences, the acquisition of various skills during school-based practice, and the correlation between the teacher training program's different courses and practical work within school settings. The research covered the documentation and formative assessment of the design and alteration processes within teacher education based on the outlined changes. The study evaluated these processes through primary documents from the academic institution, which provided evidence of the change preparation. It also analyzes the goals, learning outcomes, and teaching methods for students specializing in education. The study highlights changes in teaching practice that foster connections between academia and the field, particularly in pedagogy. These changes focus on the intensified school-based experience, paired with e-teaching workshops. Findings reveal that in evaluating teaching practice competence, interpersonal skills and professional identity rank highly among skills gained during field experiences. The research also showcases the acquisition of essential teaching and class management skills. The study raises questions regarding the program's impact on institutions, particularly concerning its role in enhancing autonomy and relevance. The study evaluates the program's potential as a catalyst for effective teacher education and its ability to attract mission-driven, motivated individuals to the teaching profession.

Many studies have recently focused on the importance of the effective integration of Information and Communication Technology (ICT) tools in science education and the need for science teachers to receive adequate training and support to use them effectively. This paper aims to explore the Albanian science teachers' perceptions and use of ICTs in teaching processes. The study provides an interpretative analysis of the opinions of science teachers teaching in the middle and high schools of several Albanian regions expressed in an online survey. Overall, the results suggest that the use of ICT by science teachers in Albania is limited by a lack of proper infrastructure, limited access to technology, and training of teachers on integrating technology. However, there are indications that the adoption of ICT in science education may increase in the future, particularly after the boost from the COVID-19 pandemic emergency.

The study examines massive open online course (MOOC) students' engagement and learning challenges while comparing two groups: xMOOC, a structured course based on individual learning, and cMOOC, an interactive course based on collaborative learning. Applying a mixed-methods research design, data were collected via an online survey and semi-structured interviews. The findings indicated differences in students' "engagement profile" between the two groups. The xMOOC students asserted high means for cognitive and behavioral engagement, whereas the cMOOC students asserted high means for cognitive and social engagement. The main challenge for xMOOC students was the complexity of course content, while the cMOOC students were more concerned about technical problems. The results reinforce the need for teaching staff to adjust student support according to MOOC type.

Chimeric antigen receptor (CAR) T-cell based immunotherapy has become a promising treatment mainly for hematological malignancies. Following the major success of CD19-targeted CAR, new potential targets for other malignancies are required. As such, B-cell maturation antigen (BCMA) is an attractive tumor-associated antigen to be targeted in multiple myeloma (MM). Herein, we aimed at assessing the function and optimal configuration of different BCMA-specific CAR, based on the same targeting moiety but with a different hinge and co-stimulatory domain. We compared their function to that of a previously characterized BCMA-CAR used in clinical trials. All constructs were expressed at high levels by primary human T cells and could trigger cytokine production and cytotoxicity upon co-culture with multiple myeloma targets. Nonetheless, critical differences were observed in off-target activation, exhaustion, and activation marker expression and in vivo antitumoral activity mediated by these different constructs. Interestingly, we noted that CD8-based hinge, combined with a 4-1BB intracellular domain, proved superior compared to IgG4-connecting regions, and/or a CD28-signaling moiety respectively. Overall, this study emphasizes the influence of CAR primary structure on its function and led to the identification of a highly efficient BCMA-specific CAR, namely H8BB, which displayed superior anti-tumoral activity both in vitro and long-term in vivo efficacy.

Cosmopolitanism and nationalism are often presented in binary terms, as standing in opposition to each other, especially with regards to education. In this paper, we establish a framework for studying education policy today through the lens of a concept we have developed: 'cosmopolitan nationalism'. Many education systems around the world are grappling with and simultaneously integrating both cosmopolitan and nationalist elements in policy objectives, curricular content and pedagogic approaches. Through an in-depth analysis of three country examples -- China, the US and Israel -- we outline four different manifestations of education policy that can be explained by employing the analytical lens of cosmopolitan nationalism: (i) the increasing prominence and visibility of the International Baccalaureate within these three public education systems; (ii) reforms of specific curricula elements and pedagogies legitimised with reference to approaches assessed as globally leading through international assessments; (iii) efforts to promote national education systems as international beacons of best practice; (iv) creation of alternative education provisions that are promoted globally for very specific purposes and populations. We argue that, given our heterogeneous sample of case study countries, and careful analysis of these, a cosmopolitan nationalism lens offers important insights into education policy-making today which has the potential to be applied in other contexts.

This paper introduces a unified conceptual framework for understanding refugee identity construction within educational contexts, drawing on theories of social justice (Fraser, 2008), affective relations (Lynch, 2012), the resumption of ordinary life (Kohli, 2011) and ecological systems (Bronfenbrenner, 1977). Addressing a gap in the existing scholarship, the model emphasises the importance of affective relations in shaping refugee identities in education alongside other factors. The study examines the macro constructs of redistribution, recognition, representation and relational affect, highlighting their impact on refugee children's educational experiences. Further, it considers the micro constructs of safety, sense of belonging and success in integration and attainment in educational environments. The constructs are examined across various levels of Bronfenbrenner's ecological system, demonstrating the complexity of refugees' needs. This model aims to facilitate a holistic, justice-oriented approach to refugee education, which is crucial given the rise in global displacement. The study has significant implications for refugee education research and policymaking, potentially informing targeted interventions and programmes that foster academic success, overall well-being, and practice in refugee education.

Summary: Tissue repair is a protective response after injury, but repetitive or prolonged injury can lead to fibrosis, a pathological state of excessive scarring. To pinpoint the dynamic mechanisms underlying fibrosis, it is important to understand the principles of the cell circuits that carry out tissue repair. In this study, we establish a cell-circuit framework for the myofibroblast-macrophage circuit in wound healing, including the accumulation of scar-forming extracellular matrix. We find that fibrosis results from multistability between three outcomes, which we term “hot fibrosis” characterized by many macrophages, “cold fibrosis” lacking macrophages, and normal wound healing. This framework clarifies several unexplained phenomena including the paradoxical effect of macrophage depletion, the limited time-window in which removing inflammation leads to healing, and why scar maturation takes months. We define key parameters that control the transition from healing to fibrosis, which may serve as potential targets for therapeutic reduction of fibrosis. : In Silico Biology; Systems Biology; Tissue Engineering Subject Areas: In Silico Biology, Systems Biology, Tissue Engineering

Engineering education has slowly been making its way into schools with the aim of promoting engineering literacy, which is central to learning and working in a technology-oriented society. Educators and policy makers advocate the need for developing students' understanding of the nature of engineering (NOE); yet, there is an ongoing debate on the heuristics that should be applied. In this article, we review and discuss current studies on engineering education in schools and the integration of engineering into the science curriculum. We describe four aspects of engineering fields: Structures, Machines, Materials, and Data, each uniquely characterized by the technology used and the artefact produced. We discuss the application of the Family Resemblance Approach (FRA) to the characterization of NOE, focusing on the cognitive and epistemic domain. Accordingly, we describe NOE through four categories: Aims & Values, Engineering Practices, Methods & Methodological Rules, and Engineering Knowledge, which can guide teaching and learning about NOE. Building on the FRA, this paper provides a framework for a continuous discussion on NOE and the theoretical and practical relationships between science and engineering.

This study investigates how sensitizing graduate L2 students about source-text use might affect their citation practices. Two summary writing tasks involving two similar published articles, one irrelevant and one pertinent to source-text use, were assigned individually to 16 graduate English language teaching students from Iran. After completing the tasks, the students participated in retrospective interviews about their source-text use. Recursive thematic data analysis indicated that while they were inclined towards more direct source-text use in the first summary, they opted for more indirect and academic source-text use that involved their contribution and interpretation in the sensitizing task. The paper discusses the significance of sensitizing students to source-text use.