Herzog Hospital

In this doctoral pilot case study, I explored art therapy to reframe roles assigned to me as an adult with ADHD through a reflexive, single-case art-based research process. Using a seven-phase methodology integrating creative writing and visual art, I created three artworks revealing themes of energy, identity, multiplicity, transformation, and expression. As an art therapist with ADHD, I shifted roles (e.g., from “lazy” to “warrior”), enhancing agency and emotional regulation. A mentor triangulated findings to reduce bias. Despite limited generalizability, this replicable protocol underscores art therapy’s potential for neurodivergent clients, deepening self-understanding and suggesting broader applications for future neurodiversity case studies.

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by sustained airflow limitation that represents one of the main causes of disability in modern society. Depression affects approximately 40% of COPD patients. Both COPD and depression are associated with chronic systemic inflammation and their comorbidity represents a critical unmet treatment need. N-methyl-D-aspartate glutamatergic receptors (NMDAR) are well characterized in the central nervous system (CNS) and widely expressed in lung tissue and inflammation-related cells. Accumulating evidence indicates that pathologic NMDAR up-regulation, leading to pro-inflammatory pathways activation and tissue damage, may play a crucial role in chronic lung injury as well as in depression. D-cycloserine, a bacteriostatic antibiotic used since the 1950's in tuberculosis, acts at therapeutic dosages also as a NMDAR functional antagonist and has antidepressant and anti-inflammatory effects. We hypothesize that NMDAR down-regulation may represent a unified molecular target for the treatment of COPD - depression comorbidity and may simultaneously alleviate both respiratory and depression symptomatology. We postulate that D-cycloserine treatment may achieve these dual - hit objectives and envisage that our hypotheses may apply to additional inflammation disorders that are frequently accompanied by depression.

Abstract Purpose Mixed Vascular-Alzheimer's Dementia (MVAD) is coexistence of both Alzheimer's disease and cerebrovascular disease (CVD) in the same patient. Thus, the current investigation focused on retrospectively classifying and diagnosing older geriatric patients at risk for dementia with both vascular risk factors and neuro-atrophy factors in Alzheimer's disease (AD)versus patients with nonvascular-AD etiology. Methods The study evaluated demographic and clinical data collected from a cohort of 192 geriatric out-patients (age range = 60–97 years) admitted for one baseline and one follow-up clinical consultations within a period of three years. Mini Mental State Examination (MMSE) scores and cardiovascular risk factors were reevaluated and utilized in the assessment of basic cognitive functioning and clinical diagnosis of MVAD and AD dementia subgroups during follow-up visits. Results A relatively high prevalence of MVAD diagnosis was found across the entire sample (36%). MVAD diagnosis was significantly higher in men with 59% prevalence, while AD diagnosis without vascular etiology was significantly higher in women with 69% prevalence. MVAD diagnosis was more pronounced under the age of 85, while AD diagnosis without vascular history was significantly higher in ages 85 years or older. Importantly, non-palpations of peripheral pulse and atrial fibrillation-type arrhythmia were found to be significant early risk factors related to prospective MVAD diagnosis (p < .008, OR = 30, p < .009, OR = .005). Conclusion Early comprehensive clinical evaluation of specific vascular risk factors prior to dementia onset could putatively predict the onset of MVAD.

ABSTRACT Moral Injury (MI) and Posttraumatic Stress Disorder (PTSD) are potential outcomes following combat military service which exposes veterans to a range of potentially morally injurious events (PMIEs). Given the hypothesized social nature of MI symptoms, it was predicted that System Justification, the tendency to defend and justify systems, even when they may be disadvantageous, would be uniquely related to MI, compared to PTSD. A total of 146 male combat veterans filled in questionnaires relating to PMIEs (MIES), MI (EMIS-short), PTSD symptoms (PCL-5) and System Justification (GSJS). PMIEs (self, other and betrayal related) were all related to higher levels of MI. A parallel mediation model was conducted and demonstrated that PMIEs (self) were associated with higher levels of MI and PTSD symptoms and that MI symptoms mediated the relationship between PMIEs (self) and lower System Justification. There was no mediation effect of PTSD symptoms. This relationship was strongest when veterans did not perform reserve duty and thus were not affiliated with the military. The findings support the theory that MI symptomology, as opposed to PTSD symptomology, has a greater relationship with worldviews such as the relationship to societal systems and that this is greatest when transitioned to civilian life.

This study sought to investigate a positive dimension of coping with the COVID-19 pandemic, that of post-traumatic growth (PTG). This study investigated coping difficulties and PTG amongst parent and nonparent students in Israeli Universities. A total of 4022 parents (3648 Jews and 374 Palestinian-Arab Citizens [PACs]) and 14,651 nonparents (12,010 Jews and 2641 PACs) completed measures of coping, social support and PTG. Parents demonstrated significantly higher levels of coping and PTG. Amongst parents, fathers coped slightly better than mothers; however, while Jewish mothers demonstrated greater PTG than Jewish fathers, PAC fathers had significantly greater PTG than both PAC mothers and Jewish parents. These findings, while specific to COVID-19, indicate that PTG should be studied in greater depth in different ethnic and minority groups in order to develop enhanced understanding and facilitate promotion of post-traumatic growth, in addition to the prevention of COVID-19-related distress.

Venous thromboembolism (VTE) is a major cause of cardiovascular morbidity and mortality and has a known genetic contribution. We tested the performance of a genetic risk score for its ability to predict VTE in 3 cohorts of patients with cardiometabolic disease. We included patients from the FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Patients With Elevated Risk), PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin), and SAVOR-TIMI 53 (Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus) trials (history of a major atherosclerotic cardiovascular event, myocardial infarction, and diabetes, respectively) who consented for genetic testing and were not on baseline anticoagulation. We calculated a VTE genetic risk score based on 297 single nucleotide polymorphisms with established genome-wide significance. Patients were divided into tertiles of genetic risk. Cox proportional hazards models were used to calculate hazard ratios for VTE across genetic risk groups. The polygenic risk score was compared with available clinical risk factors (age, obesity, smoking, history of heart failure, and diabetes) and common monogenic mutations. A total of 29 663 patients were included in the analysis with a median follow-up of 2.4 years, of whom 174 had a VTE event. There was a significantly increased gradient of risk across VTE genetic risk tertiles (P-trend <0.0001). After adjustment for clinical risk factors, patients in the intermediate and high genetic risk groups had a 1.88-fold (95% CI, 1.23-2.89; P=0.004) and 2.70-fold (95% CI, 1.81-4.06; P<0.0001) higher risk of VTE compared with patients with low genetic risk. In a continuous model adjusted for clinical risk factors, each standard deviation increase in the genetic risk score was associated with a 47% (95% CI, 29-68) increased risk of VTE (P<0.0001). In a broad spectrum of patients with cardiometabolic disease, a polygenic risk score is a strong, independent predictor of VTE after accounting for available clinical risk factors, identifying 1/3 of patients who have a risk of VTE comparable to that seen with established monogenic thrombophilia.

Background: EEG-driven research is paramount in cognitive-neuropsychological studies, as it provides a non-invasive window to the underlying neural mechanisms of cognition and behavior. A myriad collection of software and hardware frameworks has been developed to alleviate some of the technical barriers involved in EEG-driven research. Methods: we propose an integrated development environment which encompasses the entire technical “data-collection pipeline” of cognitive-neuropsychological research, including experiment design, data acquisition, data exploration and analysis in a state-of-the-art user interface. Our framework is based on a unique integration between a python-based web framework, time-oriented databases and object-based data schemes. Results: we demonstrated our framework with the recording and analysis of an n-Back task completed by 15 elderly (ages 50 to 80) participants. This case study demonstrates the highly utilized nature of our integrated framework with a challenging target population. Furthermore, our results may provide new insights into the correlation between brain activity and working memory performance in elderly people, who are prone to experience accelerated decline in executive prefrontal cortex functioning. Conclusion: our framework extends the range of EEG-driven experimental methods for assessing cognition available for cognitive-neuroscientists, allowing them to concentrate on the creative part of their work instead of technical aspects.

Animal studies indicate a possible intrauterine immunological imprinting in pregnancies complicated by hypothyroidism. We aimed to evaluate whether exposure to maternal hypothyroidism during pregnancy increases the risk of long-term infectious morbidity of the offspring. A retrospective cohort study compared the long-term risk of hospitalization associated with infectious morbidity in children exposed and unexposed in utero to maternal hypothyroidism. Outcome measures included infectious diagnoses obtained during any hospitalization of the offspring (up to the age of 18 years). The study included 224,950 deliveries. Of them, 1.1% (n = 2,481) were diagnosed with maternal hypothyroidism. Children exposed to maternal hypothyroidism had a significantly higher rate of hospitalizations related to infectious morbidity (13.2 vs. 11.2% for control; odds ratio: 1.2; 95% confidence interval: 1.08-1.36; p = 0.002). Specifically, incidences of ear, nose, and throat; respiratory; and ophthalmic infections were significantly higher among the exposed group. The Kaplan-Meier curve indicated that children exposed to maternal hypothyroidism had higher cumulative rates of long-term infectious morbidity. In the Cox proportional hazards model, maternal hypothyroidism remained independently associated with an increased risk of infectious morbidity in the offspring while adjusting for confounders. Maternal hypothyroidism during pregnancy is associated with significant pediatric infectious morbidity of the offspring.