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Article ; Online: Nurturing next generation physicians: A new Israeli healthtech fellowship.

Rosen-Zvi, Michal / Frimer, Motti / Shoher, Aviv / Liel-Cohen, Noah / Sprecher, Eli / Reuveni, Miri Mizrahi / Shwarzman, Dan / Onn, Adva Tzuk / Voliovitch, Hedva

iScience

2023 Volume 26, Issue 9, Page(s) 107550

Abstract: The Israeli Society for HealthTech aims at advancing the integration of innovation and healthcare entrepreneurship into medical practice and across traditional health professions, to benefit patients and improve quality of care. In 2021, the Society ... ...

Abstract	The Israeli Society for HealthTech aims at advancing the integration of innovation and healthcare entrepreneurship into medical practice and across traditional health professions, to benefit patients and improve quality of care. In 2021, the Society launched the first fellowship for board certified physicians in HealthTech. This backstory discusses the motivation of launching the program and reviews the design of the fellowship, including curriculum, the expertise of the lecturers, and initial tangible results of the program.
Language	English
Publishing date	2023-08-24
Publishing country	United States
Document type	News
ISSN	2589-0042
ISSN (online)	2589-0042
DOI	10.1016/j.isci.2023.107550
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Article: [Portable ultrasound devices: a novel bedside approach for diagnosing cardiovascular disease].

Kobal, Sergio L / Horowitz, Itai / Liel-Cohen, Noah

Harefuah

2014 Volume 153, Issue 9, Page(s) 537–40, 557

Abstract: Bedside cardiovascular diagnosis by examination, palpation and auscultation is sub-optimal, even when performed by experts. While the diagnostic accuracy of imaging techniques is superior to physical examination, the feasibility of its integration into ... ...

Abstract	Bedside cardiovascular diagnosis by examination, palpation and auscultation is sub-optimal, even when performed by experts. While the diagnostic accuracy of imaging techniques is superior to physical examination, the feasibility of its integration into bedside examination has been precluded by the size and cost of imaging technology. Beyond these practical limitations, expertise in image acquisition and assessment is required. Nonetheless, these problems could be resolved by a low cost, easy to use, portable imaging device that could be used routinely at the bedside. Small, high-resolution cardiac ultrasound units have been developed. Published studies have demonstrated a remarkable increase in the accuracy of cardiovascular diagnosis by cardiologists and non-cardiologists when they added a brief cardiac ultrasound study to their conventional physical examination. This new diagnostic methodology is becoming common practice among cardiologists and non- cardiologists. As its use is becoming more popular, several factors must be resolved, such as: Which personnel may use it? Is the training necessary or compulsory? Which entities are responsible for training and continuous education? decisions regarding documentation, of findings and exams, and more. In this review, we will provide the latest literature updates and discuss whether there is enough evidence to justify the use of ultrasound mobile devices for a focused ultrasound examination to complement the traditional physical examination.
MeSH term(s)	Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/diagnostic imaging ; Echocardiography/instrumentation ; Equipment Design ; Humans ; Point-of-Care Systems
Language	Hebrew
Publishing date	2014-09
Publishing country	Israel
Document type	Journal Article ; Review
ZDB-ID	953872-0
ISSN	0017-7768
ISSN	0017-7768
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Article ; Online: Peer-teaching cardiac ultrasound among medical students: A real option.

Ben-Sasson, Alon / Lior, Yotam / Krispel, Jonathan / Rucham, Moshe / Liel-Cohen, Noah / Fuchs, Lior / Kobal, Sergio L

PloS one

2019 Volume 14, Issue 3, Page(s) e0212794

Abstract: Introduction: Teaching cardiac ultrasound (CU) image acquisition requires hands-on practice under qualified instructors supervision. We assessed the efficacy of teaching medical students by their previously trained classmates (teaching assistants [TAs]) ...

Abstract	Introduction: Teaching cardiac ultrasound (CU) image acquisition requires hands-on practice under qualified instructors supervision. We assessed the efficacy of teaching medical students by their previously trained classmates (teaching assistants [TAs]) compared to teaching by expert trainers (cardiologists or diagnostic medical sonographers. Methods: Sixty-six students received 8-hour CU training: 4-hour lectures on ultrasound anatomy and imaging techniques of 6 main CU views (parasternal long [PLAV] and short axis [PSAV]; apical 4-chamber [4ch], 2-chamber [2ch], and 3-chamber [3ch]; and sub costal [SC]) followed by 4 hours of hands-on exercise in groups of ≤5 students under direct supervision of a TA (group A: 44 students) or a qualified trainer (group B: 22 students). Students' proficiency was evaluated on a 6-minute test in which they were required to demonstrate 32 predetermined anatomic landmarks spread across the 6 views and ranked on a 0-100 scale according to a predetermined key. Results: The 6-minute test final grade displayed superiority of group A over group B (54±17 vs. 39±21, respectively [p = 0.001]). This trend was continuous across all 6 main views: PLAV (69±18 vs. 54±23, respectively), PSAV (65±33 vs. 41±32, respectively), 4ch (57±19 vs. 43±26, respectively), 2ch (37±29 vs. 33±27, respectively), 3ch (48±23 vs. 35±25, respectively), and SC (36±27 vs. 24±28, respectively). Conclusions: Teaching medical students CU imaging acquisition by qualified classmates is feasible. Moreover, students instructors were superior to senior instructors when comparing their students' capabilities in a practical test. Replacing experienced instructors with TAs could help medical schools teach ultrasound techniques with minimal dependence on highly qualified trainers.
MeSH term(s)	Adult ; Clinical Competence ; Curriculum ; Echocardiography ; Education, Medical, Undergraduate/methods ; Educational Measurement/statistics & numerical data ; Feasibility Studies ; Female ; Heart/diagnostic imaging ; Humans ; Male ; Peer Group ; Program Evaluation ; Prospective Studies ; Schools, Medical ; Students, Medical/statistics & numerical data ; Teaching
Language	English
Publishing date	2019-03-27
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0212794
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Article ; Online: Global longitudinal strain and long-term outcome in patients presenting to the emergency department with suspected acute coronary syndrome.

Fuks, Alexander / Liel-Cohen, Noah / Blondheim, David S / Shimoni, Sara / Jabaren, Mohamed / Leitman, Marina / Adawi, Salim / Jaffe, Ronen / Karkabi, Basheer / Asmer, Ihab / Ganaeem, Majdi / Kobal, Sergio L / Lavi, Idit / Saliba, Walid / Shiran, Avinoam

Echocardiography (Mount Kisco, N.Y.)

2021 Volume 38, Issue 8, Page(s) 1254–1262

Abstract: Aims: We have previously shown that 2-dimentional strain is not a useful tool for ruling out acute coronary syndrome (ACS) in the emergency department (ED). The aim of the present study was to determine whether in patients with suspected ACS, global ... ...

Abstract	Aims: We have previously shown that 2-dimentional strain is not a useful tool for ruling out acute coronary syndrome (ACS) in the emergency department (ED). The aim of the present study was to determine whether in patients with suspected ACS, global longitudinal strain (GLS), measured in the ED using 2-dimensional strain imaging, can predict long-term outcome. Methods: Long-term (median 7.7 years [IQR 6.7-8.2]) major adverse cardiac events (MACE; cardiac death, ACS, revascularization, hospitalization for heart failure, or atrial fibrillation) and all-cause mortality data were available in 525/605 patients (87%) enrolled in the Two-Dimensional Strain for Diagnosing Chest Pain in the Emergency Room (2DSPER) study. The study prospectively enrolled patients presenting to the ED with chest pain and suspected ACS but without a diagnostic ECG or elevated troponin. GLS was computed using echocardiograms performed within 24 hours of chest pain. MACE of patients with worse GLS (>median GLS) were compared to patients with better GLS (≤ median GLS). Results: Median GLS was -18.7%. MACE occurred in 47/261 (18%) of patients with worse GLS as compared with 45/264 (17%) with better GLS, adjusted HR 0.87 (95% CI 0.57-1.33, P = .57). There was no significant difference in all-cause mortality or individual endpoints between groups. GLS did not predict MACE even in patients with optimal 2-dimensional image quality (n = 164, adjusted HR=1.51, 95% CI 0.76-3.0). Conclusions: Global longitudinal strain did not predict long-term outcome in patients presenting to the ED with chest pain and suspected ACS, supporting our findings in the 2DSPER study.
MeSH term(s)	Acute Coronary Syndrome/diagnostic imaging ; Chest Pain/diagnostic imaging ; Echocardiography ; Emergency Service, Hospital ; Humans ; Predictive Value of Tests
Language	English
Publishing date	2021-06-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	843645-9
ISSN	1540-8175 ; 0742-2822
ISSN (online)	1540-8175
ISSN	0742-2822
DOI	10.1111/echo.15129
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Zs.A 2170: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: The feasibility and efficacy of implementing a focused cardiac ultrasound course into a medical school curriculum.

Kobal, Sergio L / Lior, Yotam / Ben-Sasson, Alon / Liel-Cohen, Noah / Galante, Ori / Fuchs, Lior

BMC medical education

2017 Volume 17, Issue 1, Page(s) 94

Abstract: Background: Teaching cardiac ultrasound to medical students in a brief course is a challenge. We aimed to evaluate the feasibility of teaching large groups of medical students the acquisition and interpretation of cardiac ultrasound images using a ... ...

Abstract	Background: Teaching cardiac ultrasound to medical students in a brief course is a challenge. We aimed to evaluate the feasibility of teaching large groups of medical students the acquisition and interpretation of cardiac ultrasound images using a pocket ultrasound device (PUD) in a short, specially designed course. Methods: Thirty-one medical students in their first clinical year participated in the study. All were novices in the use of cardiac ultrasound. The training consisted of 4 hours of frontal lectures and 4 hours of hands-on training. Students were encouraged to use PUD for individual practice. Finally, the students' proficiency in the acquisition of ultrasound images and their ability to recognize normal and pathological states were evaluated. Results: Sixteen of 27 (59%) students were able to demonstrate all main ultrasound views (parasternal, apical, and subcostal views) in a six-minute test. The most obtainable view was the parasternal long-axis view (89%) and the least obtainable was the subcostal view (58%). Ninety-seven percent of students correctly differentiated normal from severely reduced left ventricular function, 100% correctly differentiated a normal right ventricle from a severely hypokinetic one, 100% correctly differentiated a normal mitral valve from a rheumatic one, and 88% correctly differentiated a normal aortic valve from a calcified one, while 95% of them correctly identified the presence of pericardial effusion. Conclusions: Training of medical students in cardiac ultrasound during the first clinical year using a short, focused course is feasible and enables students with modest ability to acquire the main transthoracic ultrasound views and gain proficiency in the diagnosis of a limited number of cardiac pathologies.
Language	English
Publishing date	2017-05-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-017-0928-x
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Article ; Online: QT Prolongation as an Isolated Long-Term Cardiac Manifestation of Dichlorvos Organophosphate Poisoning in Rats.

Shiyovich, Arthur / Matot, Ran / Elyagon, Sigal / Liel-Cohen, Noah / Rosman, Yossi / Shrot, Shai / Kassirer, Michael / Katz, Amos / Etzion, Yoram

Cardiovascular toxicology

2017 Volume 18, Issue 1, Page(s) 24–32

Abstract: Organophosphates (OP) are used extensively as pesticides and as chemical weapons. Cardiotoxicity is a major concern in survivors of the acute poisoning. To characterize the delayed cardiac effects of OP, rats were poisoned by intraperitoneal ... ...

Abstract	Organophosphates (OP) are used extensively as pesticides and as chemical weapons. Cardiotoxicity is a major concern in survivors of the acute poisoning. To characterize the delayed cardiac effects of OP, rats were poisoned by intraperitoneal administration of dichlorvos. In group I, poisoning (0.25-, 0.75-, 1.4-LD
MeSH term(s)	Action Potentials/drug effects ; Animals ; Antidotes/pharmacology ; Atropine/pharmacology ; Cardiotoxicity ; Dichlorvos ; Disease Models, Animal ; Heart Conduction System/drug effects ; Heart Conduction System/physiopathology ; Heart Rate/drug effects ; Long QT Syndrome/chemically induced ; Long QT Syndrome/drug therapy ; Long QT Syndrome/physiopathology ; Male ; Obidoxime Chloride/pharmacology ; Organophosphate Poisoning/drug therapy ; Organophosphate Poisoning/etiology ; Organophosphate Poisoning/physiopathology ; Rats, Sprague-Dawley ; Time Factors
Chemical Substances	Antidotes ; Obidoxime Chloride (3HXR312Z9M) ; Atropine (7C0697DR9I) ; Dichlorvos (7U370BPS14)
Language	English
Publishing date	2017-06-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2036765-X
ISSN	1559-0259 ; 1530-7905
ISSN (online)	1559-0259
ISSN	1530-7905
DOI	10.1007/s12012-017-9409-z
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Article ; Online: Impact of Point-of-Care Ultrasound Examination on Triage of Patients With Suspected Cardiac Disease.

Kobal, Sergio L / Liel-Cohen, Noah / Shimony, Sarah / Neuman, Yoram / Konstantino, Yuval / Dray, Efrat Mazor / Horowitz, Itai / Siegel, Robert J

The American journal of cardiology

2016 Volume 118, Issue 10, Page(s) 1583–1587

Abstract: Complementing the physical examination with a point-of-care ultrasound study (POCUS) can improve patient triage. We aimed to study the impact of POCUS on the diagnosis and management of outpatients and hospitalized patients with suspected cardiac disease. ...

Abstract	Complementing the physical examination with a point-of-care ultrasound study (POCUS) can improve patient triage. We aimed to study the impact of POCUS on the diagnosis and management of outpatients and hospitalized patients with suspected cardiac disease. In this multicenter study, a pocket-sized device was used to perform POCUS when the diagnosis or patient management was unclear based on anamnesis, physical examination, and basic diagnostic testing. Eighteen physicians (cardiac fellows 49%, cardiologists 30%, and echocardiographers 21%) performed physical examinations extended by POCUS on 207 patients (inpatients 83% and outpatients 17%). POCUS findings resulted in a change in the primary diagnosis in 14% of patients. In patients whose diagnosis remained unchanged, POCUS results reinforced the initial diagnosis in 48% of the cases. In 39% of the patients, the diagnostic plan was altered, including referral (16%) or deferral (23%) to other diagnostic techniques. Alteration in medical treatment (drug discontinuation or initiation) occurred in 11% of the patients, and in 7% POCUS results influenced the decision whether to perform a therapeutic procedure. Hospitalization or discharge was determined after POCUS in 11% of the patients. In conclusion, during patient triage, extension of the physical examination by POCUS can cause physicians to alter their initial diagnosis, resulting in an immediate change of diagnostic and therapeutic procedures. Based on POCUS results, physicians altered the diagnostic plan either by avoiding or referring patients to other diagnostic procedures in almost half of the studied population.
MeSH term(s)	Female ; Heart Diseases/diagnosis ; Humans ; Inpatients ; Male ; Middle Aged ; Point-of-Care Systems ; Reproducibility of Results ; Triage/methods ; Ultrasonography/methods
Language	English
Publishing date	2016-11-15
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2016.08.028
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Article: Unanesthetized Rodents Demonstrate Insensitivity of QT Interval and Ventricular Refractory Period to Pacing Cycle Length.

Mulla, Wesam / Gillis, Roni / Murninkas, Michael / Klapper-Goldstein, Hadar / Gabay, Hovav / Mor, Michal / Elyagon, Sigal / Liel-Cohen, Noah / Bernus, Olivier / Etzion, Yoram

Frontiers in physiology

2018 Volume 9, Page(s) 897

Abstract: Aim: ...

Abstract	Aim:
Language	English
Publishing date	2018-07-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2018.00897
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Article ; Online: Effect of image quality on accuracy of two-dimensional strain echocardiography for diagnosing ischemic chest pain: a 2DSPER multicenter trial substudy.

Shiran, Avinoam / Blondheim, David S / Shimoni, Sara / Jabarren, Mohamed / Rosenmann, David / Sagie, Alex / Leibowitz, David / Leitman, Marina / Feinberg, Micha S / Beeri, Ronen / Adawi, Salim / Asmer, Ihab / Ganaeem, Majdi / Friedman, Zvi / Liel-Cohen, Noah

The international journal of cardiovascular imaging

2018 Volume 35, Issue 4, Page(s) 617–625

Abstract: Few data exist regarding the effect of image quality on measurements of two-dimensional longitudinal strain (2DLS). In the 2DLS for Diagnosing Chest Pain in the Emergency Room (2DSPER) multicenter study, 2DLS was not useful for ruling out acute coronary ... ...

Abstract	Few data exist regarding the effect of image quality on measurements of two-dimensional longitudinal strain (2DLS). In the 2DLS for Diagnosing Chest Pain in the Emergency Room (2DSPER) multicenter study, 2DLS was not useful for ruling out acute coronary syndromes (ACS) in the emergency department (ED). The aim of this substudy was to determine the effect of 2D image quality on the diagnostic accuracy of 2DLS for ACS. We reviewed apical views used for 2DLS analysis in all 605 patients included in the 2DSPER study. Studies with the best image quality (HighQ, n = 177), were compared to the lower quality group (LowQ, n = 428). Abnormal 2DLS was defined as PSS20% > - 17% (PSS20% being the peak left ventricular systolic strain value identifying the 20% worst strain values). Global longitudinal strain (GLS) and PSS20% were significantly worse in LowQ compared to HighQ patients. LowQ independently predicted abnormal 2DLS (OR 1.9, 95% CI 1.3-2.9, P = 0.003). The sensitivity of PSS20% > - 17% for ACS was 85% for LowQ vs. 73% for HighQ (P = 0.2), specificity 22% vs. 38% (P < 0.0001) and overall accuracy 29% vs. 44% (P = 0.0004). Despite better overall accuracy in the HighQ group there was no significant difference between the receiver operating characteristic curves of either GLS or PSS20% in the two groups and abnormal 2DLS did not predict ACS even in HighQ patients (OR 1.7, 95% CI 0.7-4.3, P = 0.3). LowQ echo is associated with worse 2DLS. Abnormal 2DLS was not clinically useful for excluding ACS in the ED even in patients with optimal 2D image quality.Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT01163019.
MeSH term(s)	Acute Coronary Syndrome/diagnostic imaging ; Acute Coronary Syndrome/physiopathology ; Aged ; Angina Pectoris/diagnostic imaging ; Angina Pectoris/physiopathology ; Biomechanical Phenomena ; Echocardiography/methods ; Emergency Service, Hospital ; Female ; Humans ; Israel ; Male ; Middle Aged ; Myocardial Contraction ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Ventricular Function, Left
Language	English
Publishing date	2018-11-14
Publishing country	United States
Document type	Clinical Trial ; Comparative Study ; Journal Article ; Multicenter Study
ZDB-ID	2055311-0
ISSN	1875-8312 ; 1573-0743 ; 1569-5794 ; 0167-9899
ISSN (online)	1875-8312 ; 1573-0743
ISSN	1569-5794 ; 0167-9899
DOI	10.1007/s10554-018-1495-x
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Zs.A 2104: Show issues

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Article ; Online: Speckle-tracking echocardiography elucidates the effect of pacing site on left ventricular synchronization in the normal and infarcted rat myocardium.

Mor, Michal / Mulla, Wesam / Elyagon, Sigal / Gabay, Hovav / Dror, Shani / Etzion, Yoram / Liel-Cohen, Noah

PloS one

2014 Volume 9, Issue 6, Page(s) e99191

Abstract: Background: Right ventricular (RV) pacing generates regional disparities in electrical activation and mechanical function (ventricular dyssynchrony). In contrast, left ventricular (LV) or biventricular (BIV) pacing can improve cardiac efficiency in the ... ...

Abstract	Background: Right ventricular (RV) pacing generates regional disparities in electrical activation and mechanical function (ventricular dyssynchrony). In contrast, left ventricular (LV) or biventricular (BIV) pacing can improve cardiac efficiency in the setting of ventricular dyssynchrony, constituting the rationale for cardiac resynchronization therapy (CRT). Animal models of ventricular dyssynchrony and CRT currently relay on large mammals which are expensive and not readily available to most researchers. We developed a methodology for double-site epicardial pacing in conscious rats. Here, following post-operative recovery, we compared the effects of various pacing modes on LV dyssynchrony in normal rats and in rats with ischemic cardiomyopathy. Methods: Two bipolar electrodes were implanted in rats as follows: Group A (n = 6) right atrial (RA) and RV sites; Group B (n = 7) RV and LV sites; Group C (n = 8) as in group B in combination with left coronary artery ligation. Electrodes were exteriorized through the back. Following post-operative recovery, two-dimensional transthoracic echocardiography was performed during pacing through the different electrodes. Segmental systolic circumferential strain (Ecc) was used to evaluate LV dyssynchrony. Results: In normal rats, RV pacing induced marked LV dyssynchrony compared to RA pacing or sinus rhythm, as measured by the standard deviation (SD) of segmental time to peak Ecc, SD of peak Ecc, and the average delay between opposing ventricular segments. LV pacing and, to a greater extend BIV pacing diminished the LV dyssynchrony compared to RV pacing. In rats with extensive MI, the effects of LV and BIV pacing were markedly attenuated, and the response of individual animals was variable. Conclusions: Rodent cardiac pacing mimics important features seen in humans. This model may be developed as a simple new tool to study the pathophysiology of ventricular dyssynchrony and CRT.
MeSH term(s)	Animals ; Cardiac Pacing, Artificial ; Coronary Sinus/diagnostic imaging ; Coronary Sinus/physiopathology ; Echocardiography ; Heart Atria/diagnostic imaging ; Heart Atria/physiopathology ; Heart Failure/diagnostic imaging ; Heart Failure/etiology ; Heart Failure/physiopathology ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Male ; Models, Cardiovascular ; Myocardial Infarction/complications ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/physiopathology ; Myocardial Ischemia/complications ; Myocardial Ischemia/diagnostic imaging ; Myocardial Ischemia/physiopathology ; Rats ; Rats, Sprague-Dawley ; Systole
Language	English
Publishing date	2014-06-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0099191
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