Wednesday, July 4, 2018

How to fix a broken heart and Happy July 4th

We can consider ourselves "healed" when the chief motivating factor in our lives is the longing to love and to feel G-d's love.

Love Yehuda Lave

How can you mend a broken heart? Here are 4 ways

Zvi Herman    
Wednesday, 13 June 3:09 PM

by ISRAEL21c

Hearts can be broken in so many ways, and aren't easy to fix.

We're talking here not about emotional hearts but about physical hearts containing four chambers — left and right atriums on the top; left and right ventricles on the bottom – working together to circulate blood through our bodies.

Below we look at four Israeli startups with unique technologies for repairing or monitoring malfunctioning chambers on the left side of the heart.

First, a short anatomy lesson: The left atrium receives oxygenated blood returning from the lungs and pumps it into the left ventricle through the mitral valve. From there, the blood is ready to go on its bodily voyage.

Heart failure, affecting as many as 26 million adults worldwide, occurs gradually as the heart muscle weakens and struggles to do its job. The more common left-sided heart failure happens when the left ventricle doesn't pump efficiently. Blood backs up into the lungs, causing shortness of breath and fluid buildup.

With that background, we're ready to look at technologies focusing on left-sided heart failure.

Leviticus Cardio

Thousands of advanced heart-failure patients every year get an implanted mechanical pump called a left ventricular assist device (LVAD). The LVAD is connected to an external power pack by a wire ("driveline") to charge the batteries and must be worn 24/7.

Leviticus Cardio's wireless wearable charging system for implanted LVAD devices. Photo: courtesy

The driveline restricts mobility and is a source of infection and other potentially serious complications. Therefore, many patients who could benefit from LVAD therapy choose not to get implanted.

Leviticus Cardio has developed the only available wireless system for powering LVADs. The Coplanar Energy Transfer (CET) system makes it safer to receive an LVAD and allows patients to remove the external hardware for eight hours at a time.

In animal studies conducted at the Catholic University in Belgium, the CET system was shown to work efficiently for months, and it's now ready for human trials.

Leviticus Cardio was founded in 2008 in Petah Tikva. Major investors include The Trendlines Group, medical and agricultural companies, a consortium of cardiovascular physicians, private investors and the Israel Innovation Authority.


Another Trendlines Group portfolio company,  CorAlert is developing an accurate, low-cost, noninvasive detection and monitoring device measuring real-time left ventricular end-diastolic pressure (LVEDP), the standard way to detect and diagnose heart failure.

"LVEDP is always elevated in heart-failure patients and is elevated days or weeks before a severe condition appears, so it's very predictive for the prognosis of the disease," explains CorAlert CEO Amir Marmor, a software engineer who founded the company with his father, Dr. Alon Marmor, professor of cardiology at Bar-Ilan University and former director of cardiology at Ziv Medical Center in Safed (Tzfat).

Existing methods for measuring LVEDP are via a cardiac catheter or estimating pressure from Doppler echocardiography. Both have major drawbacks, and CorAlert aims to provide an alternative that cardiologists have been seeking for years, says Marmor.

CorAlert's system consists of two sensors: one placed on the chest and one on the arm inside a smart compression (blood pressure) cuff controlled by proprietary software that adjusts the pump to the patient's heart rate.

The sensors provide data on heartbeat and pressure from which LVEDP can be accurately estimated using a unique mathematical formula.

The beta model of the system is starting clinical trials at Ziv and at UC San Francisco Medical Center. "We will compare LVEDP measured by our device to invasively measured LVEDP and validate the accuracy of our  device," says Marmor.

Founded in 2012 in Ramat Hasharon, CorAlert is now raising $2 million.

Vectorious Medical Technologies

Moving up from the ventricle to the atrium, Tel Aviv-based  Vectorious Medical Technologies is developing V-LAP, the world's first miniature wireless microcomputer implant for left-atrial monitoring of heart failure.

The company recently raised $9.5 million, plus a $2 million Horizon 2020 grant from the EU Research and Innovation Program, as it increases staffing and prepares for clinical trials leading to EU regulatory approval.

V-LAP transmits daily pressure readings to the physician, who can easily spot any changes and adjust medication accordingly to prevent deterioration – something not currently possible in real time. The system will include an external home unit for the patient to self-monitor changes as well.

Founded in 2011 in the RadBioMed incubator, Vectorious has 15 employees in Tel Aviv and at the Cleveland Clinic, one of the company's investors.

"Chronic lack of supply to the heart is one of the most common causes of death in the Western world — 1.2 million people are hospitalized each year in the US from deterioration of the disease at a cost of $32 billion to the US health system," Vectorious CEO Oren Goldstein said.

"In addition, half of patients need to be re-hospitalized after six months because of defective diagnosis and treatment. Vectorious's product will prevent the disease from worsening, improve the quality of life of the patient and lengthen their lives."


Caesarea-based  V-Wave recently got a $70 million Series C investment that will help it move forward with clinical trials in North America, Europe and Israel of its V-Wave Interatrial Shunt System — a miniature, biocompatible interatrial implant to regulate left atrial pressure (LAP) in patients with chronic heart failure.

The shunt is intended to prevent episodes of elevated LAP and is thus expected to provide symptom relief, decrease hospitalization, increase exercise tolerance, improve quality of life and perhaps even extend survival.

Dr. William T. Abraham, chief of cardiovascular medicine at the Ohio State University Wexner Medical Center, explained that elevated LAP is the primary cause of breathing difficulty and hospitalization due to worsening heart failure.

"V-Wave's feasibility study results, presented in March 2018 as a late-breaking clinical trial at the American College of Cardiology, showed that shunting was safe and that morbidity and mortality were low compared to a matched population receiving optimal care. The upcoming pivotal trial in at least 400 randomized patients should provide sound assurance of the efficacy of this approach in patients that have a poor prognosis and few options," said Abraham. 


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The Torah, The Constitution, and the 4th of July


In his speech that became known as "The Spirit of Liberty," delivered in New York City's Central Library, in the midst of World War II, the preeminent judge and judicial philosopher, Learned Hand, asked, "What do we mean when we say that first of all we seek liberty? I often wonder whether we do not rest our hopes too much upon constitutions, upon laws and upon courts. These are false hopes; believe me these are false hopes. Liberty lies in the hearts of men and women; when it dies there, no constitution, no law, no court can even do much to help it." (As quoted in Time magazine, July 4, 2011)

There is a great deal of talk these days about the Constitution, about liberty and American values. In a cover story this week in Time, editor Richard Stengel asks if the Constitution still matters. Of course it does, but how we interpret it, how we try to understand what the framers meant, and how we apply it today is presenting us greater challenges than perhaps it did in the past. Stengel writes, "As a counterpoint to the rise of constitutional originalists (those who believe the document should be interpreted only as the drafters understood it), liberal scholars analyze the text just as closely to find the elasticity they believe the framers intended. Everywhere, there seems to be a debate about the scope and meaning and message of the Constitution. This is a healthy thing. Even the framers would agree on that." (ibid.) On this July 4th weekend, as we celebrate our country and all of the amazing contributions it has added to the world, including the ideals and values of the Declaration and the Constitution, I wanted to share some thoughts about how this struggle to understand the meaning of an original document, formulated in a different time, in a different era, by very different people, is a very Jewish idea, one that we in fact gave to the world thousands of years before 1776.

We don't have a constitution, but we do have a Torah. And, like the debate we are having today in regard to understanding what the framers meant when they crafted the Constitution, Jews have been arguing about the original intent of the Torah pretty much since...well, since the Torah itself! There are laws, statutes and directives in the Torah that have been subject to debate, discussion and overruling, starting with the daughters of Tzelofchad, which we will read about in a few weeks, who question the Torah's earlier ruling about inheritance only being for sons, and Moses inquires of God and the rule gets altered. There are verses in the Torah that were explained away by the rabbis of the Talmud as either not applying any longer, never applying or they get made so complex to enact that they eventually fall away. What the Jewish tradition has that almost no other religious tradition shares, and which a great deal of modern jurisprudence is based on, is the Talmud and all the subsequent later codes, all of which work to explain the meaning of the original document, the Torah, and what it's framer (or framers depending on your view) meant. The Torah condones the death penalty while the Talmud pretty much outlaws it. The Torah tells us to take our malcontent children to the gates of the city and if they can't be reformed by the elders, to stone them to death. The Talmud tells us that never happened and never should happen. Sorry!

And, in the reverse, the Torah is pretty clear about what keeping kosher should look like, and it is pretty simple, while the rabbis of the Talmud and later codes expanded the laws and made them quite complex. We have a long history of interpreting our Torah, redefining its meaning, and using very advanced and creative hermeneutical tools to either alter, or in some cases, downright change, what the original meaning seems to have been. We have the principle of PARDES, which is a rabbinic literary invention, whereby each word of the Torah has four levels of interpretation: the literal meaning, peshat, a more subtle or hinting reading, remez, a creative commentary, drash, and a totally hidden or mysterious meaning, sod. Through this technique, and many others, commentators, most famously Rashi, 11th century in France, have sometimes completely changed the text from what it literally says. Our tradition is incredibly fluid and flexible and always has been.

Today, both in American life and in our Jewish life, we are facing challenges from those that want to read both of our foundational texts, the Constitution and the Torah, in a literalist manner. I will leave the legal aspects of the Constitution and how to understand it to the lawyers and experts, but from what I have read and studied, the framers seemed to want a document that would grow and develop in meaning based on the growth and innovation of the new country they were founding. As Stengel writes in his Time article, "There have been few conflicts in American history greater than the internal debates the framers had about the Constitution. For better or for worse — and I would argue that it is for better — the Constitution allows and even encourages deep arguments about the most basic democratic issues." The Torah, I would argue, has a similar make-up, namely that we have been arguing about, discussing, and interpreting the meaning of the text for thousands of years. And, we know that the times were different for the framers of the Constitution as they were for the authors of the Torah. Cultures were different, practices were different, perhaps we might even say that morals were different.

The framers of the Constitution, while giving us freedom of religion and speech, also thought blacks were 3/5's of a human and slavery was okay. The Torah also thinks that slavery is okay, even as it seeks to give rights to slaves that never existed. And, in interpreting text for today, we are called upon to use our own minds, hearts and experiences to understand and apply meaning. Just as the Constitution didn't know from healthcare, military drones, the internet or globalized commerce, and so lawyers and judges must figure out how to legislate on these matters based on what they think the intent of the framers was, along with later precedent and case law, so too the Torah didn't know from many of the cultural and religious issues facing us today in modern American life: from end of life decisions that involve modern medicine to using technology to bring Shabbat services to homebound seniors. And, because it is so timely with New York's landmark marriage equality law passed just last week, I believe that the Torah verse from Leviticus that has been used for generations to deny gays and lesbians their equal rights in our tradition, must be finally read away with the same Talmudic logic and thinking that was used to read away killing our wayward children. We have changed, evolved, moved as a society and culture, even if some don't agree. Remember, plenty of people thought slavery was still okay, and the Civil War didn't finish the job when it comes to racial discrimination. As Judge Hand told us, we must sometimes trust our hearts and not our texts.

However, another timely issue that fascinates me, and directly relates to this discussion is that of circumcision. While this merits an entire sermon, I want to end with this thought: Why is it that this ritual, which appears in Genesis, is really, for the most part, one of the only so-called "primitive" rituals from the time of the Bible that we still follow and practice without any real challenge or dispute. Sure there are fringe groups of Jews that have always been against brit milah, but 99% of Jews, religious and secular, follow this ancient ritual without question. Sure, many moms have trepidation, but they still do it. We have never stopped doing it and today, in the face of ridiculous legal challenges, which have thankfully been abandoned in Santa Monica but continue in San Francisco, Jews of all stripes, along with Muslims and religious freedom advocates, are fighting for our right to continue this ancient practice, even as we don't do most of the ancient Biblical practices any longer. Why is that? Fascinating question.

And so, as we celebrate this 4th of July, let us be grateful that we live in one of the freest countries ever to exist, yet we are not perfect. The Constitution must never be allowed to become an idol, just as the Torah must never be allowed to become an idol. One midrash teaches that Moses shattered the first tablets as a reminder of that notion. We must always do battle between fear and liberty, between power and freedom. That is the great gift, and great challenge, of being human. Thomas Jefferson said it best, when he wrote, "All, too, will bear in mind this sacred principle, that though the will of the majority is in all cases to prevail, that will, to be rightful, must be reasonable; that the minority possess their equal rights, which equal laws must protect, and to violate which would be oppression." That is our great challenge, as Americans and as Jews. May we ponder deeply on this, our nation's birthday. Shabbat shalom and God bless America.

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Researchers believe they dug up 2,700-year-old seal of doomsday prophet Isaiah

The 2,700-year-old clay relic was found at the foot of the southern wall of Temple Mount.

February 22, 2018
Isaiah seal

The 2,700-year-old clay seal impression which potentially belonged to the biblical prophet Isaiah.. (photo credit: OURIA TADMOR/EILAT MAZAR)


The Ophel excavations, located at the foot of the southern wall of the Temple Mount, may have unearthed the seal impression of the prophet Isaiah, who advised King Hezekiah in the Kingdom of Judah during the eighth century BCE.

The discovery of the oval, 1 cm. bulla was made by Dr. Eilat Mazar of the Hebrew University of Jerusalem, who noted that because its upper end is missing and its lower left end is slightly damaged, a definitive determination cannot be made.

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In an article titled "Is this the Prophet Isaiah's Signature?" published in the most recent edition of The Biblical Archaeology Review, Mazar said the seal is divided into three registers.

"The surviving portion of the top register shows the lower part of a grazing doe – a motif of blessing and protection found in Judah, particularly in Jerusalem – present also on another bulla from the same area," she said.

"The middle register reads l'eyesha'yah[u] [belonging to Isaiah]; the damaged left end most likely included the [Hebrew] letter vav. The lower register reads ' n[ah]vy,' centered. The damaged left end of this register may have been left empty, as on the right – with no additional letters – but it also may have had an additional letter, such as an aleph, which would render the word... 'prophet' in Hebrew."

Mazar continued. "Whether or not the aleph was added at the end of the lower register is speculative, as meticulous examinations of that damaged part of the bulla could not identify any remnants of additional letters."

Alternately, Mazar conceded that it's possible the seal did not belong to the prophet Isaiah, but rather to one of King Hezekiah's officials named Isaiah, with the surname "N[ah]vy."

"Without an aleph at the end, the word 'n[ah]vy' is most likely just a personal name," she said.

However, noting the close relationship between Isaiah and Hezekiah, as described in the Bible, and the fact that the bulla was found next to one bearing the name of Hezekiah, Mazar said that it may indeed be authentic – despite the difficulties that have been presented by the bulla's damaged area.

"The discovery of the royal structures and finds from the time of King Hezekiah at the Ophel is a rare opportunity to reveal vividly this specific time in the history of Jerusalem," she said. "The finds lead us to an almost personal 'encounter' with some of the key players who took part in the life of the Ophel's Royal Quarter, including King Hezekiah and, perhaps, also the prophet Isaiah."




Did you know about this?

The National Veteran's Art Museum in Chicago has an unusual work of art which you may not have even known existed!

When visitors first enter the museum, they will hear a sound like wind chimes coming from above them and their attention will be drawn upward 24 feet to the ceiling of the two-story high atrium .

The dog tags of the more than 58,000 service men and women who died in the Vietnam War, were hung from the ceiling of the National Vietnam Veterans Art Museum in Chicago on Veterans Day, November 11, 2010. The 10-by-40-foot sculpture, entitled Above & Beyond, was designed by Ned Broderick and Richard Stein.

The thousands of metal dog tags are suspended 24 feet in the air, 1 inch apart, from fine lines that allow them to move and chime with shifting air currents. Museum employees using a kiosk and laser pointer help visitors locate the exact dog tag with the imprinted name of a lost friend or relative.

"If you can read this, thank a Teacher ...
If you are reading it in English, thank a VET."





Using Ramadan as Cover, 1,000 Waqf Workers 'Cleared' Soil Rich with Evidence of Jewish Temple

 2 Tammuz 5778 – June 15, 2018
Photo Credit: Public Committee for the Prevention of Destruction of Antiquities on the Temple Mount
A truck belonging to the Waqf dumped earth from an illegal dig on the Temple Mount, April, 2014.

The Jerusalem Islamic Waqf took advantage of the final days of the holy month of Ramadan, when Jews were barred from visiting the Temple Mount, to eliminate from the compound piles of earth that were rich with archaeological treasures dating back to the Temple period, Makor Rishon reported Friday. The piles of earth were created initially by illegal renovations the Waqf carried out in 1999.


The soil that was now eliminated was dug up by the Waqf as part of its project of erecting a new mosque in the Solomon's Stables area on the Temple Mount. At the time, 400 truckloads of ancient soil were unloaded in city dumps and in the Kidron Valley. Eventually, Israeli legal authorities became involved and banned the removal of the remaining piles of soil on the Temple Mount.

The Waqf was planning to get rid of those piles as well, but a court petition by the Public Committee for the Prevention of Destruction of Antiquities on the Temple Mount was accepted by the High Court of Justice, which in 2004 issued an injunction against the removal of the piles of soil.

But the Waqf never agreed with the court's decision, which stood in the way of its plan to pave over the eastern part of the compound, as they have done elsewhere on the Temple Mount. An Israeli archaeologist, Tzahi Devira, who runs the Sifting Project that has revealed tens of thousands of treasures in the dumped soil, has been keeping watch on the Waqf for close to two decades, to make sure they don't sin again.

So the Waqf did what so many faithful Muslim officials do when faced with a legal prohibition: they cheated, using the Israeli gesture of closing off the Temple Mount to Jews on the last week of Ramadan to complete their heinous crime against history and culture, and recruited more than 1,000 men to remove the piles of soil – this time making sure to get rid of the pesky evidence of there ever being a Jewish Temple there.

According to Makor Rishon, a group of Jews who stood near the Temple Mount gates one night this week noticed a truck entering the compound.

At this point, those tall piles of soil are gone from the Temple Mount, replaced by terraced stones. The crime paid. All evidence of a Jewish Temple have been permanently eliminated.

Israel Police offered a reassuring statement in response to the Makor Rishon inquiry – read slowly, let the implied message sink in: "The irregularity has been identified by Israel Police, and once the situation is restored to normal by the Waqf and under the supervision of professionals, additional measures will be weighed."

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