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  1. Article ; Online: Letter to the Editor.

    Hagay, Zion / Walfisch, Yossi / Borow, Malke

    The American journal of bioethics : AJOB

    2024  , Page(s) 1–2

    Language English
    Publishing date 2024-04-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2060433-6
    ISSN 1536-0075 ; 1526-5161
    ISSN (online) 1536-0075
    ISSN 1526-5161
    DOI 10.1080/15265161.2024.2340908
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The Physician on a Board of Directors: Bane or Benefit?

    Borow, Malke / Levi, Baruch / Avissar, Benny / Wapner, Leah

    Journal of healthcare leadership

    2022  Volume 14, Page(s) 17–23

    Abstract: With the accelerated development of innovative domains such as artificial intelligence, big data, and personalized healthcare, the continuing growth of health-tech and bio-tech industries is to be expected. Concurrently, the question of the extent and ... ...

    Abstract With the accelerated development of innovative domains such as artificial intelligence, big data, and personalized healthcare, the continuing growth of health-tech and bio-tech industries is to be expected. Concurrently, the question of the extent and nature of physicians' involvement in these rapidly evolving industries arises, especially in management and leadership capacities such as directors or chief executive officers of such companies. Against this backdrop, the Israeli Medical Association recently launched a first-of-its-kind course designed to train senior physicians as directors in health-tech companies by providing them with vast relevant financial, legislative, and professional proficiencies. Due to their medical knowledge and clinical experience, physicians bring a substantial added value to these industries. However, considering the inherent tensions and potential conflicts between adhering to the logic of a profit-making, competitive market on one hand and maintaining the doctor's oath on the other, it is inevitable that dilemmas and difficulties will emerge. Much has been written about the roles and responsibilities of boards of directors, but to date, little has focused on the unique position of physicians who serve in these roles. This article aims to examine the ways in which conflicts or dualities of interest manifest themselves for physicians who assume roles as directors and whether effective remedial strategies are available, based on the authors' own experience in the initiation of the IMA physician-directors course.
    Language English
    Publishing date 2022-02-22
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2587466-4
    ISSN 1179-3201 ; 1179-3201
    ISSN (online) 1179-3201
    ISSN 1179-3201
    DOI 10.2147/JHL.S344510
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Physician on a Board of Directors

    Borow M / Levi B / Avissar B / Wapner L

    Journal of Healthcare Leadership, Vol Volume 14, Pp 17-

    Bane or Benefit?

    2022  Volume 23

    Abstract: Malke Borow,1 Baruch Levi,1,2 Benny Avissar,1 Leah Wapner1 1Israeli Medical Association, Ramat Gan ...

    Abstract Malke Borow,1 Baruch Levi,1,2 Benny Avissar,1 Leah Wapner1 1Israeli Medical Association, Ramat Gan, Israel; 2Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, IsraelCorrespondence: Baruch Levi, Division of Law and Public Policy, Israeli Medical Association, 35 Jabotinsky St., Ramat Gan, Israel, Tel +972-54-6330935, Email baruch@ima.org.ilAbstract: With the accelerated development of innovative domains such as artificial intelligence, big data, and personalized healthcare, the continuing growth of health-tech and bio-tech industries is to be expected. Concurrently, the question of the extent and nature of physicians’ involvement in these rapidly evolving industries arises, especially in management and leadership capacities such as directors or chief executive officers of such companies. Against this backdrop, the Israeli Medical Association recently launched a first-of-its-kind course designed to train senior physicians as directors in health-tech companies by providing them with vast relevant financial, legislative, and professional proficiencies. Due to their medical knowledge and clinical experience, physicians bring a substantial added value to these industries. However, considering the inherent tensions and potential conflicts between adhering to the logic of a profit-making, competitive market on one hand and maintaining the doctor’s oath on the other, it is inevitable that dilemmas and difficulties will emerge. Much has been written about the roles and responsibilities of boards of directors, but to date, little has focused on the unique position of physicians who serve in these roles. This article aims to examine the ways in which conflicts or dualities of interest manifest themselves for physicians who assume roles as directors and whether effective remedial strategies are available, based on the authors’ own experience in the initiation of the IMA physician-directors course.Keywords: physicians, directors, health technology, biotechnology, leadership, ...
    Keywords physicians ; directors ; health technology ; biotechnology ; leadership ; management ; medical ethics ; Public aspects of medicine ; RA1-1270
    Subject code 941
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher Dove Medical Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article: [HOW MANY PHYSICIANS ARE ACTIVELY PRACTICING MEDICINE IN ISRAEL? ON THE DIFFERENCES BETWEEN VARIOUS METHODS OF MEASUREMENT].

    Levi, Baruch / Borow, Malke

    Harefuah

    2018  Volume 157, Issue 9, Page(s) 595–598

    Abstract: Introduction: In 2018, Israel replaced the workforce surveys of the Central Bureau of Statistics with administrative data files, as the source of its reports to the OECD on the number of physicians practicing medicine and their percentage of the ... ...

    Abstract Introduction: In 2018, Israel replaced the workforce surveys of the Central Bureau of Statistics with administrative data files, as the source of its reports to the OECD on the number of physicians practicing medicine and their percentage of the population. In the wake of the change, the scope of the medical workforce reported by Israel dropped by approximately 9%-15% in each one of the years from 2012-2015. Furthermore, while according to the previous measurement approach, Israeli figures were consistently equal to or higher than the yearly OECD averages, according to the new method these figures are lower than the averages of other OECD members. Essentially, according to the new data, the number of physicians practicing medicine in Israel straddles the minimum desirable amount recommended in the past by workforce planning committees in Israel. The new data are largely accordant with the feeling of distress and shortage in the medical workforce, which pervades the health system for many years, and simultaneously raise questions as to the reliability of official Israeli data as reported to the OECD - data upon which researchers, policy makers, the media and the public rely. Consequently, it is recommended to consistently improve the measurement and reporting to international organizations and to increase transparency regarding the measurement methods of various indicators in the health field.
    MeSH term(s) Humans ; Israel ; Physicians/supply & distribution ; Practice Patterns, Physicians'/statistics & numerical data
    Language Hebrew
    Publishing date 2018-05-10
    Publishing country Israel
    Document type Journal Article
    ZDB-ID 953872-0
    ISSN 0017-7768
    ISSN 0017-7768
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Prospective randomized controlled trial of the safety and feasibility of a novel mesenchymal precursor cell therapy in hypoplastic left heart syndrome.

    Wittenberg, Rachel E / Gauvreau, Kimberlee / Leighton, Jonah / Moleon-Shea, Melinda / Borow, Kenneth M / Marx, Gerald R / Emani, Sitaram M

    JTCVS open

    2023  Volume 16, Page(s) 656–672

    Abstract: Objective: To assess the safety and feasibility of low-dose, novel, allogenic mesenchymal precursor cell (MPC) therapy as an adjunct to left ventricular (LV) recruitment for patients with hypoplastic left heart syndrome (HLHS) and borderline left ... ...

    Abstract Objective: To assess the safety and feasibility of low-dose, novel, allogenic mesenchymal precursor cell (MPC) therapy as an adjunct to left ventricular (LV) recruitment for patients with hypoplastic left heart syndrome (HLHS) and borderline left ventricles. MPC injections into the hypoplastic left ventricle may stimulate neovascularization and beneficial LV remodeling and may improve the likelihood of achieving biventricular (BiV) or 1.5 ventricle (1.5V) circulation.
    Methods: Children <5 years with prior single ventricle palliation undergoing LV recruitment surgery at a single center were randomized to MPC injections into the LV endocardium/papillary muscles (MPCs) or standard-of-care (controls) and followed for 24 months. The primary endpoint was safety, including (serious) adverse events (S/AEs), and panel reactive antibodies (PRAs). Secondary endpoints included BiV/1.5V conversion and LV size and function.
    Results: Nineteen subjects were enrolled, including 9 MPC recipients and 10 controls. Fourteen patients (74%) had >1 AE, and 2 patients had SAEs, both deemed unrelated to the trial product. AE severity and frequency were similar in the 2 groups. Baseline PRA levels were high, with no difference between the groups at 12 months. The overall probability of BiV/1.5V conversion was 0.16 (95% confidence interval [CI], 0.05 to 0.41) at 12 months and 0.52 (95% CI, 0.31 to 0.77) at 24 months. For patients with imaging data at both time points, increases in LV volumes from baseline to 12 months were larger in the MPC group by 3-dimensional echocardiography and cardiac magnetic resonance imaging. For children who successfully underwent BiV conversion (n = 12), full BiV conversion was achieved at 24 months in 5 of 5 (100%) MPC-treated children compared with 4 of 7 (57%) controls.
    Conclusions: MPC injections were considered safe and feasible in HLHS patients. More than 50% of subjects underwent BiV/1.5V conversion within 2 years. Larger trials are needed to investigate the therapeutic potential of MPCs in this population.
    Language English
    Publishing date 2023-10-01
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-2736
    ISSN (online) 2666-2736
    DOI 10.1016/j.xjon.2023.09.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: [Plagiarism in medical journals--an editor's responsibility].

    Borow, M

    Harefuah

    2009  Volume 148, Issue 6, Page(s) 372

    MeSH term(s) Editorial Policies ; Humans ; Periodicals as Topic/standards ; Plagiarism ; Social Responsibility
    Language Hebrew
    Publishing date 2009-06
    Publishing country Israel
    Document type Editorial
    ZDB-ID 953872-0
    ISSN 0017-7768
    ISSN 0017-7768
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Home Hospitalization Worldwide and in Israel.

    Levi, Baruch / Borow, Malke / Wapner, Leah / Feldman, Zeev

    The Israel Medical Association journal : IMAJ

    2019  Volume 21, Issue 8, Page(s) 565–567

    Abstract: Background: Global trends, such as the population aging, the increase of chronic morbidity, soaring costs of healthcare services, and work overload in hospitals raise the need to find innovative solutions for providing quality medical services. One ... ...

    Abstract Background: Global trends, such as the population aging, the increase of chronic morbidity, soaring costs of healthcare services, and work overload in hospitals raise the need to find innovative solutions for providing quality medical services. One solution adopted by healthcare systems around the world is "home hospitalization," that is, providing an array of necessary health services in the patient's home, instead of in the hospital department. The aim of this focus article is to explore the spread of home hospitalization worldwide and examine the challenges and pathways for its adoption and implementation. Many countries, including the United States, Canada, the United Kingdom, and Australia, operate home-based hospitalization programs. In Israel, the service is in its infancy, but in view of the extreme workload and the high mortality rate from infections in acute care hospitals, home hospitalization has recently gained public interest and political support, which may encourage its further development.
    MeSH term(s) Australia ; Canada ; Home Care Services ; Hospitals ; Humans ; Internationality ; Israel ; United Kingdom ; United States
    Language English
    Publishing date 2019-07-26
    Publishing country Israel
    Document type Journal Article ; Review
    ZDB-ID 2008291-5
    ISSN 1565-1088 ; 0021-2180
    ISSN 1565-1088 ; 0021-2180
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Remestemcel-L Therapy for COVID-19-Associated Multisystem Inflammatory Syndrome in Children.

    Eckard, Allison Ross / Borow, Kenneth M / Mack, Elizabeth H / Burke, Elizabeth / Atz, Andrew M

    Pediatrics

    2021  Volume 147, Issue 5

    Abstract: Multisystem inflammatory syndrome in children (MIS-C) is a serious postinfectious immune dysregulation associated with coronavirus disease 2019 that may present with severe and life-threatening cardiovascular dysfunction, hemodynamic instability, shock, ... ...

    Abstract Multisystem inflammatory syndrome in children (MIS-C) is a serious postinfectious immune dysregulation associated with coronavirus disease 2019 that may present with severe and life-threatening cardiovascular dysfunction, hemodynamic instability, shock, and multisystem organ failure. Optimal treatment is unknown. Current standard of care consists of nonspecific anti-inflammatory and antithrombotic therapies. Interventions that target MIS-C's distinctive clinical features and immunophenotype are indicated. Remestemcel-L, an investigational mesenchymal stromal cell therapy, is a promising candidate for treatment of MIS-C because of its beneficial anti-inflammatory, immunomodulatory, endothelial function and vascular stabilizing effects, which align well with the pathophysiology of MIS-C. Here, we present the first two patients with life-threatening MIS-C ever treated with remestemcel-L under an expanded access program. Both were previously healthy children without any indication of previous coronavirus disease 2019 infection or exposure. They presented with severe clinical illness including myocardial dysfunction, hemodynamic instability, hypotension, acute kidney injury, and shock. At the time of hospital admission, both had negative polymerase chain reaction (PCR) test results and positive serology results for severe acute respiratory syndrome coronavirus 2. Both children received standard of care MIS-C treatment. Although the patients showed some clinical improvement, left ventricular ejection fraction remained reduced and inflammatory biomarkers remained significantly elevated. When treated with two intravenous doses of remestemcel-L separated by 48 hours, rapid normalization of left ventricular ejection fraction, notable reductions in biomarkers of systemic and cardiac inflammation, and improved clinical status occurred. Neither child experienced adverse effects associated with remestemcel-L administration. This treatment appears promising as a novel immunomodulatory cellular therapy for children with clinically significant cardiovascular manifestations of MIS-C.
    MeSH term(s) Anti-Inflammatory Agents/therapeutic use ; Antiviral Agents/therapeutic use ; Biological Products/therapeutic use ; Biomarkers/blood ; COVID-19/blood ; COVID-19/drug therapy ; COVID-19/physiopathology ; Child ; Child, Preschool ; Female ; Humans ; Male ; Mesenchymal Stem Cells ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/drug therapy ; Systemic Inflammatory Response Syndrome/physiopathology ; Treatment Outcome ; Ventricular Dysfunction, Left/physiopathology
    Chemical Substances Anti-Inflammatory Agents ; Antiviral Agents ; Biological Products ; Biomarkers ; remestemcel-l (H57D26Z9YK)
    Language English
    Publishing date 2021-02-12
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2020-046573
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: The Task Force for the Promotion of the Status of Women in Medicine in Israel.

    Borow, Malke / Levi, Baruch / Carmi, Rivka

    The Israel Medical Association journal : IMAJ

    2018  Volume 20, Issue 4, Page(s) 254–259

    Abstract: Background: In this article, we offer a brief summary of the report from the Task Force for the Promotion of the Status of Women in Medicine in Israel. The task force, formed by the Israel Medical Association in 2013, published a comprehensive report in ...

    Abstract Background: In this article, we offer a brief summary of the report from the Task Force for the Promotion of the Status of Women in Medicine in Israel. The task force, formed by the Israel Medical Association in 2013, published a comprehensive report in May 2015 dedicated to the promotion of equal opportunities for female doctors in the Israeli healthcare system and in the academic world. The aim of this paper is to present the work of the task force and to highlight its main principles and recommendations against the backdrop of the gender revolution in the Israeli healthcare system and worldwide.
    MeSH term(s) Delivery of Health Care/organization & administration ; Female ; Humans ; Israel ; Physicians, Women/organization & administration ; Physicians, Women/trends ; Women's Rights
    Language English
    Publishing date 2018-04-06
    Publishing country Israel
    Document type Journal Article ; Review
    ZDB-ID 2008291-5
    ISSN 1565-1088 ; 0021-2180
    ISSN 1565-1088 ; 0021-2180
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Phase 3 DREAM-HF Trial of Mesenchymal Precursor Cells in Chronic Heart Failure.

    Borow, Kenneth M / Yaroshinsky, Alex / Greenberg, Barry / Perin, Emerson C

    Circulation research

    2019  Volume 125, Issue 3, Page(s) 265–281

    Abstract: Advanced heart failure (HF) is a progressive disease characterized by recurrent hospitalizations and high risk of mortality. Indeed, outcomes in late stages of HF approximate those seen in patients with various aggressive malignancies. Clinical trials ... ...

    Abstract Advanced heart failure (HF) is a progressive disease characterized by recurrent hospitalizations and high risk of mortality. Indeed, outcomes in late stages of HF approximate those seen in patients with various aggressive malignancies. Clinical trials assessing beneficial outcomes of new treatments in patients with cancer have used innovative approaches to measure impact on total disease burden or surrogates to assess treatment efficacy. Although most cardiovascular outcomes trials continue to use time-to-first event analyses to assess the primary efficacy end point, such analyses do not adequately reflect the impact of new treatments on the totality of the chronic disease burden. Consequently, patient enrichment and other strategies for ongoing clinical trial design, as well as new statistical methodologies, are important considerations, particularly when studying a population with advanced chronic HF. The DREAM-HF trial (Double-Blind Randomized Assessment of Clinical Events With Allogeneic Mesenchymal Precursor Cells in Advanced Heart Failure) is an ongoing, randomized, sham-controlled phase 3 study of the efficacy and safety of mesenchymal precursor cells as immunotherapy in patients with advanced chronic HF with reduced ejection fraction. Mesenchymal precursor cells have a unique multimodal mechanism of action that is believed to result in polarization of proinflammatory type 1 macrophages in the heart to an anti-inflammatory type 2 macrophage state, inhibition of maladaptive adverse left ventricular remodeling, reversal of cardiac and peripheral endothelial dysfunction, and recovery of deranged vasculature. The objective of DREAM-HF is to confirm earlier phase 2 results and evaluate whether mesenchymal precursor cells will reduce the rate of nonfatal recurrent HF-related major adverse cardiac events while delaying or preventing progression of HF to terminal cardiac events. DREAM-HF is an example of an ongoing contemporary events-driven cardiovascular cell-based immunotherapy study that has utilized the concepts of baseline disease enrichment, prognostic enrichment, and predictive enrichment to improve its efficiency by using accumulating data from within as well as external to the trial. Adaptive enrichment designs and strategies are important components of a rational approach to achieve clinical research objectives in shorter clinical trial timelines and with increased cost-effectiveness without compromising ethical standards or the overall statistical integrity of the study. The DREAM-HF trial also presents an alternative approach to traditional composite time-to-first event primary efficacy end points. Statistical methodologies such as the joint frailty model provide opportunities to expand the scope of events-driven HF with reduced ejection fraction clinical trials to utilize time to recurrent nonfatal HF-related major adverse cardiac events as the primary efficacy end point without compromising the integrity of the statistical analyses for terminal cardiac events. In advanced chronic HF with reduced ejection fraction studies, the joint frailty model is utilized to reflect characteristics of the high-risk patient population with important unmet therapeutic needs. In some cases, use of the joint frailty model may substantially reduce sample size requirements. In addition, using an end point that is acceptable to the Food and Drug Administration and the European Medicines Agency, such as recurrent nonfatal HF-related major adverse cardiac events, enables generation of clinically relevant pharmacoeconomic data while providing comprehensive views of the patient's overall cardiovascular disease burden. The major goal of this review is to provide lessons learned from the ongoing DREAM-HF trial that relate to biologic plausibility and flexible clinical trial design and are potentially applicable to other development programs of innovative therapies for patients with advanced cardiovascular disease. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02032004.
    MeSH term(s) Cell Differentiation ; Clinical Trials, Phase III as Topic/methods ; Double-Blind Method ; Endothelium, Vascular/physiopathology ; Endpoint Determination ; Health Services Needs and Demand ; Heart Failure/economics ; Heart Failure/immunology ; Heart Failure/physiopathology ; Heart Failure/therapy ; Humans ; Immunotherapy/methods ; Inflammation ; Macrophages/classification ; Macrophages/immunology ; Mesenchymal Stem Cell Transplantation ; Multicenter Studies as Topic/methods ; Neovascularization, Pathologic/etiology ; Randomized Controlled Trials as Topic/methods ; Research Design ; Stroke Volume ; Treatment Outcome ; Ventricular Remodeling
    Language English
    Publishing date 2019-07-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80100-8
    ISSN 1524-4571 ; 0009-7330 ; 0931-6876
    ISSN (online) 1524-4571
    ISSN 0009-7330 ; 0931-6876
    DOI 10.1161/CIRCRESAHA.119.314951
    Database MEDical Literature Analysis and Retrieval System OnLINE

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