Rebecca Sieff Hospital (also Ziv Medical Center) (Hebrew: בית החולים רבקה זיו) is a general hospital in Safed, Israel that serves the residents of Safed, the Upper Galilee and the northern Golan Heights. Sieff Hospital has 310 beds and serves as a regional trauma center in the event of accidents, natural disasters, terror attacks and war. It is also serves as a teaching hospital associated with Bar-Ilan University’s school of medicine which is also located in Safed. The hospital also operates an urgent care center in Kiryat Shmona.Patients include Jews, Muslims, Christians and Druze.The maternity ward and pediatrics unit are the hospital's major departments. In 2007, there were 2,900 births (an average of 8 births a day) and 3,000 children were admitted to the pediatrics unit. The neonatal ICU and the Child Development Center offer health care for babies and children together with a team of medical clowns. The Accident and Emergency Department treated over 60,000 patients in 2007 and its Trauma Unit played an important role in the 2006 Lebanon War.During the 2006 Lebanon War, the hospital suffered a direct rocket hit, which caused damage to the infrastructure, as well as injuring five patients, 2 doctors and two other staff members.Since the outbreak of the Syrian Civil War in January 2014, the hospital has been treating Syrians injured in the fighting. An estimated 9 million dollars has been invested in treating Syrian refugees alone. The Israeli Defense Forces and the Israeli government cover two thirds of the cost, while a third is covered by the hospital itself.In 2014, Salman Zarka was appointed director-general of the hospital, replacing its long-time director Oscar Embon. Zarka, born in Peki'in in the Upper Galilee, is the first Druze to head an Israeli hospital.
Objective This study examines whether mode of birth is associated with postpartum psychological distress among women who experienced high-risk versus low-risk pregnancies. It adds an ethical perspective to the literature by considering how medicalization of birth may differentially affect women’s autonomy and well-being across pregnancy risk contexts. Method In a cohort of 138 women who gave birth at a northern Israeli hospital (January to September 2023), psychological outcomes were measured eight weeks postpartum using the DASS-21 and PTSD Checklist (PCL-5). Birth mode and pregnancy risk status were extracted from medical records. Pearson correlations were computed separately for high-risk (n = 20) and low-risk (n = 118) groups. Results Among women with high-risk pregnancies, more medicalized birth modes were significantly correlated with higher levels of stress (rp = 0.655), anxiety (rp = 0.863), depression (rp = 0.726), and PTSD symptoms (rp = 0.789). No significant associations were found in the low-risk group. Conclusions Birth mode plays a critical role in postpartum mental health for women with high-risk pregnancies. These findings underscore the ethical duty to prevent psychological harm and to respect women’s relational autonomy, making trauma-informed, autonomy-supportive care a moral imperative in medically complex births.
Background: Pathological tumor regression is a key prognostic marker in resectable gastric and gastroesophageal junction (GEJ) adenocarcinoma. Perioperative FLOT (fluorouracil, leucovorin, oxaliplatin, docetaxel) established the modern treatment backbone, and the recent MATTERHORN trial further intensified this paradigm with the addition of durvalumab. However, a substantial proportion of patients fail to achieve major pathological regression, and the prognostic magnitude of poor response in the FLOT era has not been systematically quantified. Methods: We performed a PRISMA 2020-compliant, PROSPERO registered (CRD420251150054) systematic review and meta-analysis. PubMed, Web of Science, Scopus, and Cochrane were searched through September 2025 for studies including patients with resectable gastric/GEJ adenocarcinoma treated with perioperative FLOT followed by curative surgery. Associations between poor pathological response and survival were quantified. Exploratory analyses evaluated completion of postoperative FLOT versus incomplete therapy. Random effects models were applied to pooled hazard ratios (HRs). Results: Twelve studies comprising 4201 resected patients were included in this systematic review; 1817 (43.2%) were classified as poor responders. Poor pathological response was strongly associated with inferior outcomes: pooled HR for overall survival (OS) was 2.73 (95% CI 2.18-3.43; I2=0.0%) and pooled HR for disease-free/recurrence-free survival (DFS/RFS) was 2.68 (95% CI 2.14-3.34; I2=51.2%). Effect direction was consistent across Becker, Mandard, and CAP grading systems. Exploratory analysis of three observational cohorts found an association between completion of postoperative FLOT and improved survival (HR 0.49, 95% CI 0.31-0.79); however, this comparison is inherently confounded by postoperative fitness and treatment selection and should not inform clinical decision-making. Conclusions: Poor pathological response after perioperative FLOT identifies a large, high risk subgroup with approximately threefold inferior survival despite R0 resection. These findings establish contemporary prognostic benchmarks and underscore the absence of prospective evidence guiding postoperative management in poor responders.
Background/Objectives: To examine longitudinal changes in total retinal nerve fiber layer thickness (RNFLT) as the primary outcome measure in newly diagnosed pediatric idiopathic intracranial hypertension (IIH) patients using Spectral-Domain Optical Coherence Tomography (SD-OCT) at one-year follow-up. Methods: This is a prospective observational cohort study with cross-sectional control-group comparison. We included children with clinically definite IIH (IIH group) and children without papilledema and a normal neurological exam as a control group. Optic nerve parameters, including the primary outcome measure RNFLT and secondary outcome measures such as total retinal thickness (TRT) and optic disk area (ODA), were evaluated using SD-OCT (3D OCT-2000, Topcon, Topcon Corporation, Tokyo, Japan). Evaluations took place at presentation and, for the IIH group, before lumbar puncture (LP), at 1-day post-LP and at 1-, 3-, 6-, and 12-month follow-ups. Results: A total of 44 children aged 7–17 years were recruited (IIH group: N = 19, control group: N = 25). The mean baseline RNFLT was 133.1 ± 18.5 µm and 113.1 ± 8.7 µm for the IIH and control groups (p < 0.001), respectively. The IIH group showed a significant decline in RNFLT at the third-month follow-up. Between 3-month to one-year follow-up, mean total RNFLT showed an insignificant decline of 6 µm and did not differ from the RNFLT of the control group; however, segmental analysis of RNFLT showed a significant decline in the thickness of the nasal segments. At the one-year follow-up, two children had significant thinning of RNFLT at the superior quadrant. Intracranial pressure measured in the IIH group was directly correlated with RNFLT at the superior segment. Conclusions: SD-OCT is a useful non-invasive adjunct tool for the diagnosis and follow-up of IIH in children from primary school age onward. RNFL thickening resolved in most children at 3 months from IIH diagnosis. The study is constrained by specific methodological limitations, including a small sample size and non-contemporaneous evaluation of the control group compared with the IIH group. The significance of the segmental RNFL changes observed after one year should be further investigated with regard to long-term development, if possible with a larger prospective study that also considers the ganglion cell layer to explore for permanent axonal damage to the optic nerve.
Purpose To examine the effect of ambient illumination on lens power during the development of low light myopia in chicken eyes. Methods Chickens were reared with unrestricted vision with fluorescent lights at three illuminance levels ( 10,000 , 500 and 50 lux , respectively). Chicks were examined for refractive error, keratometry and ultrasound biometry under general anesthesia at days 30 , 60 and 90 after hatching. Lens power was calculated with a customized, previously validated, version of Bennett’s equation. Means of the ocular parameters for several age and illuminance groups were studied with repeated-measures ANOVA. Results During this three-month growth period, the refractive error of the high-illuminance group remained hyperopic, while the medium-illuminance group reached emmetropia, and the low-illuminance group developed mild myopia. For the medium- and the high- illuminance groups, this process was accompanied by an increase in axial length ( AL ) growth while the refractive power of the eye was declining in corneal and lens power. The low-illuminance group showed atypical behavior in their lens power loss. In the first phase, between Days 30–60 , their lens had the highest decrease in power, while between Days 60–90 , the lens power remained relatively stable. The increased axial elongation rate, accompanied by stable lens power, was responsible for the development of myopia in chickens reared under 50 lux . Conclusions The development of myopia in chickens raised under low ambient illuminance over 90 days may be attributed to the stability of lens power during the third month of accelerated eye growth.
A deviated nasal septum (DNS) is a frequently observed anatomical abnormality that can lead to nasal airflow obstruction and reduced quality of life. Although septoplasty is widely regarded as the standard surgical approach for symptomatic cases, its effectiveness compared with conservative, nonsurgical treatments remains a subject of ongoing debate. Methods: We performed a systematic literature review up to 26 December 2025, using databases including PubMed, EMBASE, CENTRAL, and Web of Science. The review included only randomized controlled trials (RCTs) involving adult patients with DNS that compared septoplasty to non-surgical treatment strategies. Results: A total of three studies were included in the final analysis. Septoplasty significantly improved NOSE scores at 3 months (MD -12.58, 95% CI -19.10 to -6.06), 6 months (MD -28.73, 95% CI -33.44 to -24.03), and 12 months (MD -17.27, 95% CI -22.85 to -11.69) compared to non-surgical management. Similarly, SNOT-22 scores favored septoplasty at all time points, with the largest benefit observed at 6 months (MD -9.64, 95% CI -12.66 to -6.62). PNIF scores showed improvement in the septoplasty group at 6 months (MD 15.26, 95% CI 4.20 to 26.31), though significance varied over time. Conclusions: In adults with deviated nasal septum, the currently available randomized evidence suggests that septoplasty may provide greater improvement in symptoms and quality of life compared with non-surgical approaches. However, these findings should be interpreted cautiously due to the limited number of included studies and the low-to-moderate certainty of evidence.
