Publications by authors named "Segal G"

Background: Home hospitalization is a care modality growing in popularity worldwide. Telemedicine-driven hospital-at-home (HAH) services could replace traditional hospital departments for selected patients. Chest x-rays typically serve as a key diagnostic tool in such cases.

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  • Israeli medical cadets undergo a crucial 12-month internship that significantly impacts their future, but many experience burnout and feelings of uncertainty.
  • A study in a tertiary hospital implemented personalized psychological and counseling services over 18 months, measuring cadets' satisfaction and socialization before and after the intervention.
  • Results indicated significant improvements in cadets' knowledge acquisition, departmental integration, motivation to recommend the program, and acceptance by staff nurses, suggesting that ongoing support may help reduce burnout.
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The Israeli health system is experiencing an ongoing manpower crisis that will deepen soon with the increase in the number of patients and the overcrowding in clinics and hospitals. The core of the crisis is the need to staff the hospitalization departments and clinics with quality manpower. Alongside the initial staffing, there is an obligation to ensure the survivability of the professional personnel in the system over the years, and this must be done while constantly preventing the process of professional burnout.

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Background: Emigration of healthcare professionals, particularly physicians, is an unresolved "pandemic", influenced by various factors. In high-income countries, the training phase (fellowship) abroad is critical for career development, yet it poses challenges for the retention of these professionals upon their completion of training. This study aimed to identify the determinants influencing Israeli physicians' decisions to return to their home country after completing fellowship training abroad.

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Background: Frailty constitutes a major factor that puts the elderly at risk of health and functional deterioration.

Objectives: To develop and validate an Electronic Frailty Index based on electronic data routinely collected in the HMO.

Study Design And Setting: A retrospective cohort of the HMO members.

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Sarcopenia is characterized by a loss of muscle mass and function and is often associated with frailty, a syndrome linked to physical disability and shortened survival in various patient populations, including cancer patients. Low serum alanine aminotransferase (ALT) values, serving as a biomarker for sarcopenia, were previously associated with frailty and shortened survival in several cancers. In the current study, we aimed to test the association between low ALT and shorter survival in renal cell carcinoma (RCC) patients and survivors.

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Hypothyroidism is very common worldwide. It is known to be associated with frailty which, in turn, is associated with increased morbidity and mortality in the elderly. Low ALT blood activity is an established marker for sarcopenia and frailty.

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Background: Prompt diagnosis of bacteremia in the emergency department (ED) is of utmost importance. Nevertheless, the average time to first clinical laboratory finding range from 1 to 3 days. Alongside a myriad of scoring systems for occult bacteremia prediction, efforts for applying artificial intelligence (AI) in this realm are still preliminary.

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Background: Recruitment to residency programs in hospitals located in other than major hubs ("remotely located") is a challenge in many countries. In 2011, the Israeli Ministry of Health launched a 10-year financial incentive to encourage physicians to enroll in residency programs in such hospitals. Nearly 1 billion New Israeli Shekels (260 million US$) were invested in that program which had only limited success.

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  • The bacterium Unlabelled grows within vacuoles of diverse host cells, utilizing the Icm/Dot type-IVb secretion system to deliver over 300 proteins, crucial for its survival and virulence.
  • A study identified LegA7, a protein linked to mitogen-activated protein kinase (MAPK) activation and growth inhibition in yeast, which relies on its cysteine protease domain and ankyrin repeats for function.
  • Mutations in LegA7 were found to disrupt its growth-inhibiting abilities, indicating that specific regions of the protein regulate its catalytic activity, providing insight into its role during infections in macrophages.
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  • Hospital-at-home (HAH) is emerging as a viable alternative to traditional hospital stays for acutely ill patients, allowing care in familiar environments.
  • A study comparing outcomes between HAH and in-hospital treatments showed that HAH patients experienced shorter hospital stays, with significantly lower 30-day mortality rates for both COVID-19 and non-COVID patients.
  • The results indicate that HAH could be a safe option, with no significant increase in readmission rates, suggesting it may effectively manage certain acute illnesses.
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  • Late identification of pulmonary embolism (PE), a serious condition affecting lung arteries, poses significant challenges in healthcare, prompting efforts to improve early diagnosis using existing medical record data.
  • The study developed machine learning models by analyzing data from over 55,000 patients, focusing on demographics and medical history to predict PE risk during hospital admission.
  • The models achieved an 80% accuracy in identifying high-risk patients, revealing specific subgroups with a notably higher prevalence of PE, which can help clinicians better target interventions and improve early detection.
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One in 7 US adults has knee osteoarthritis (OA) and almost two-thirds of them suffer from low back pain. OA is the third most rapidly rising condition associated with disability and leads to a significant burden on the healthcare system and society. This study looked at the healthcare resource utilization (HCRU) in patients with knee OA and low back pain before and after the utilization of a new, home-based, noninvasive, biomechanical intervention.

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Background: Medical trainees (medical students, residents, and fellows) are playing an active role in the development of new curricular initiatives; however, examinations of their advocacy efforts are rarely reported. The purpose of this study was to understand the experiences of trainees advocating for improved medical education on the care of people with intellectual and/or developmental disabilities.

Methods: In 2022-23, the authors conducted an explanatory, sequential, mixed methods study using a constructivist paradigm to analyze the experiences of trainee advocates.

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In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus.

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  • Researchers studied a protein called LegA7, which is found in bacteria and believed to affect host cell signaling and growth processes by interacting with the MAPK pathway.
  • Using a screening method, they identified that mutations in specific parts of LegA7 significantly reduce its ability to inhibit yeast growth, suggesting it plays a crucial role in regulating growth under high-stress conditions.
  • Their findings imply that LegA7 contains a protease domain and regions that help control its activity, indicating a complex mechanism by which this protein interacts with host cells.
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  • Sarcopenia, marked by loss of muscle mass and function, is linked to frailty and increased risks of falls, fractures, and physical disability, especially in cancer patients.
  • A study analyzed 3,075 bladder cancer patients and found that those with low alanine aminotransferase (ALT) levels, indicating sarcopenia, had significantly lower muscle mass and were older with poorer health metrics.
  • The results suggest that low ALT values are associated with a 22% increased mortality risk in bladder cancer patients, highlighting the importance of monitoring muscle health in cancer care.
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The intracellular pathogen Legionella pneumophila translocates more than 300 effector proteins into its host cells. The expression levels of the genes encoding these effectors are orchestrated by an intricate regulatory network. Here, we introduce LelA, the first L.

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Digital transformation in healthcare during the COVID-19 pandemic led to the development of new hybrid models integrating physical and virtual care. The ability to provide remote care by telemedicine technologies and the need to better manage and control hospitals' occupancy accelerated growth in hospital-at-home programs. The Sheba Medical Center restructured to create Sheba Beyond as the first virtual hospital in Israel.

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Background: The hospital-at-home (HAH) model is a viable alternative for conventional in-hospital stays worldwide. Serum electrolyte abnormalities are common in acute patients, especially in those with many comorbidities. Pathologic changes in cardiac electrophysiology pose a potential risk during HAH stays.

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Background: The task of writing multiple choice question examinations for medical students is complex, timely and requires significant efforts from clinical staff and faculty. Applying artificial intelligence algorithms in this field of medical education may be advisable.

Methods: During March to April 2023, we utilized GPT-4, an OpenAI application, to write a 210 multi choice questions-MCQs examination based on an existing exam template and thoroughly investigated the output by specialist physicians who were blinded to the source of the questions.

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Background: Technological advancement may bridge gaps between long-practiced medical competencies and modern technologies. Such a domain is the application of digital stethoscopes used for physical examination in telemedicine. This study aimed to validate the level of consensus among physicians regarding the interpretation of remote, digital auscultation of heart and lung sounds.

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Introduction: Epilepsy is a neurological disease characterized by sudden, unprovoked seizures. The unexpected nature of epileptic seizures is a major component of the disease burden. Predicting seizure onset and alarming patients may allow timely intervention, which would improve clinical outcomes and patient quality of life.

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Background: Hospital-at-Home (HAH) is a valid alternative for in-hospital stay for a wide variety of clinical indications. Occult myocardial injury, associated with acute illness, mainly occurs in patients with a background of non-obstructive coronary disease. The aim of this study was to describe the prevalence of this phenomenon in our HAH population.

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Background: Chronic lymphocytic leukemia (CLL) is one of the most common hematologic malignancies, especially among elderlies. Several prognostic scores are available that utilize the characteristics of patients' blood counts and cytogenetic anomalies-all are features of the disease rather than of the patient. Addressing the route of personalized rather than precise medicine, we refer to the assessment of patients' status of sarcopenia and frailty.

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