Introduction The use of telemedicine in oncology practice is rapidly expanding and is considered safe and cost effective. However, the implications of telemedicine on patient‐physician interaction, patient satisfaction, and absence of the personal touch have not been studied to date. Following the spread of COVID‐19, telemedicine services were rapidly incorporated at the Oncology Division of Tel Aviv Medical Center. We aimed to evaluate patients' perspectives and preferences regarding telemedicine and to assess whether this virtual communication platform affects the patient‐physician relationship. Methods Between March 2020 and May 2020, adult cancer patients who conducted at least one successful telemedicine meeting were interviewed by trained medical personnel. The interview was based on validated patient satisfaction questionnaires and focused on patient‐physician interaction in relation to the last in‐patient visit. Results Of 236 patients, 172 (74%) patients agreed to participate. The study population comprised mainly patients with gastrointestinal malignancies ( n = 79, 46%) with a median age of 63 years (range 21–88). The majority of patients were male ( n = 93, 54%). Eighty‐nine (51.7%) patients were receiving active oncologic treatment, and 58 (33.7%) were under routine surveillance following completion of active therapy. Almost all had a sense of secured privacy ( n = 171, 96%), the majority of patients affirmed that their concerns were met ( n = 166, 93%) and perceived that eye contact with the treating physician was perceived ( n = 156, 87%). Only a minority felt that the absence of physical clinic visits harmed their treatment ( n = 36, 20%). Most patients ( n = 146, 84.9%) wished to continue telemedicine services. A multivariate analysis revealed that higher satisfaction and visits for routine surveillance were both predictors of willingness to continue future telemedicine meetings over physical encounters (odds ratio [OR] = 2.41, p = .01; OR = 3.34, p = .03, respectively). Conclusion Telemedicine is perceived as safe and effective, and patients did not feel that it compromised medical care or the patient‐physician relationship. Integration of telemedicine is ideal for patients under surveillance after completion of active oncologic treatment. Physician communication skills workshops are warranted with implementing this platform. Implications for Practice During the COVID‐19 pandemic, telemedicine was rapidly implemented worldwide to facilitate continuity of quality care and treatment. Despite many potential setbacks, telemedicine has become a useful and safe tool for oncology practitioners to care for their pa...
In recent years, both homing endonucleases (HEases) and zinc-finger nucleases (ZFNs) have been engineered and selected for the targeting of desired human loci for gene therapy. However, enzyme engineering is lengthy and expensive and the off-target effect of the manufactured endonucleases is difficult to predict. Moreover, enzymes selected to cleave a human DNA locus may not cleave the homologous locus in the genome of animal models because of sequence divergence, thus hampering attempts to assess the in vivo efficacy and safety of any engineered enzyme prior to its application in human trials. Here, we show that naturally occurring HEases can be found, that cleave desirable human targets. Some of these enzymes are also shown to cleave the homologous sequence in the genome of animal models. In addition, the distribution of off-target effects may be more predictable for native HEases. Based on our experimental observations, we present the HomeBase algorithm, database and web server that allow a high-throughput computational search and assignment of HEases for the targeting of specific loci in the human and other genomes. We validate experimentally the predicted target specificity of candidate fungal, bacterial and archaeal HEases using cell free, yeast and archaeal assays.
We report two cases showing extreme response to vemurafenib, which could not be predicted prior to treatment commencement. Genetic testing demonstrated a resistant mechanism not previously reported in CRC or PTC patients, namely an acquired mutation of RAS. This is supported by an analysis of a large cohort of BRAF V600E-positive melanomas. Further studies are needed in order to identify predictive markers for response to vemurafenib and to explore novel strategies to overcome RAS-mediated resistance.
Oak-galling wasps (Hymenoptera: Cynipidae, Cynipini) have been studied in Israel only superficially so far, despite interest in the Israeli fauna given its location at the southern edge of distribution range of the wasps and their oak hosts. We provide the first comprehensive review of the Israeli fauna of oak cynipids based on an extensive survey of the five naturally occurring oak species in Israel. We report 53 cynipid species, 37 of which are reported from Israel for the first time, 10 are currently known only from this country, and 9 are undescribed. With 27 species, Andricus is by far the biggest genus in Israel, followed by Cerroneuroterus, Neuroterus Plagiotrochus, and Pseudoneuroterus with 4 species each. Andricus megalucidus is synonymized under A. cecconii and Cerroneuroterus cerrifloralis is synonymized under C. lanuginosus. The sexual generations of Andricus cecconii, A. coriariformis, A. coriarius, A. miriami, Cerroneuroterus lanuginosus and Pseudoneuroterus macropterus are reported here for the first time. We recorded 65 gall types, with bud galls being the most common and conspicuous, followed by leaf and catkin galls. We provide illustrated keys for all Israeli species based on their galls, as well as information on host associations, life history, phenology and distribution patterns where available. 21 cynipid species are associated with Quercus ithaburensis and 27 species are associated with Q. boissieri, whereas Q. libani, Q. calliprinos and Q. cerris host much fewer species. Most species are currently known from either their sexual or asexual generation while only 24% of them are known from both. Mount Hermon was found to be an important hotspot, hosting about half of the Israeli cynipid fauna, and species richness generally declines from the Golan Heights southwards to the Judean Mountains. Cynipid species that are associated with oaks of sections Cerris and Quercus in Europe are mostly associated with the same sections in Israel.
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