The Need for An Automated Acuity Tool for Children With Special Health Care Needs

Children with special health care needs (CSHCN) often require extended and continuous contact with health care professionals due to their chronic conditions. Additionally, some of these children have other non-health burdens, including multiple problems with access to care, that make it even more difficult to treat their medical illness. These extra obstacles illustrate that effective care for CSHCN requires proper care coordination among a network of doctors, nurses, and care coordinators. Unfortunately, care coordination has been inadequate due to large caseload assignments. An automated acuity tool that reassesses the child’s acuity (low, medium or high) regularly would help balance the caseloads and improve care coordination. Unique to this design, the tool would not only describe disease needs, but also account for modifiable psychosocial characteristics. It would first be deployed in South Florida where the population of CSHCN mainly consists of low-income, minority back- grounds with language barriers. The implementation of an acuity tool provides a thoughtful way to tackle the new challenges within the established structure of pediatric care

Engineered Biomaterials to Enhance Stem Cell-Based Cardiac Tissue Engineering and Therapy

Cardiovascular disease is a leading cause of death worldwide. Since adult cardiac cells are limited in their proliferation, cardiac tissue with dead or damaged cardiac cells downstream of the occluded vessel does not regenerate after myocardial infarction. The cardiac tissue is then replaced with nonfunctional fibrotic scar tissue rather than new cardiac cells, which leaves the heart weak. The limited proliferation ability of host cardiac cells has motivated investigators to research the potential cardiac regenerative ability of stem cells. Considerable progress has been made in this endeavor. However, the optimum type of stem cells along with the most suitable matrix-material and cellular microenvironmental cues are yet to be identified or agreed upon. This review presents an overview of various types of biofunctional materials and biomaterial matrices, which in combination with stem cells, have shown promises for cardiac tissue replacement and reinforcement. Engineered biomaterials also have applications in cardiac tissue engineering, in which tissue constructs are developed in vitro by combining stem cells and biomaterial scaffolds for drug screening or eventual implantation. This review highlights the benefits of using biomaterials in conjunction with stem cells to repair damaged myocardium and give a brief description of the properties of these biomaterials that make them such valuable tools to the field.Anwarul Hasan acknowledges the startup grant and the University Research Board (URB) grant from American University of Beirut, Lebanon, and the National Council for Scientific Research (CNRS) grant, Lebanon, as well as the Farouk Jabre interdisciplinary research award. Arghya Paul acknowledges the University of Kansas New Faculty General Research Fund for support and assistance with this work. The authors also acknowledge an investigator grant provided by the Institutional Development Award (IDeA) from the National Institute of General Medical Sciences (NIGMS) of the NIH Award Number P20GM103638-04 (to A.P.). R.W. acknowledges the financial support from NIGMS (NIH, T32-GM008359) Biotechnology Predoctoral Research Training Program

10 - Feasibility of allogeneic stem cells for heart regeneration

Stem cell therapy for heart disease is currently one of the most exciting ideas in regenerative medicine, and allogeneic mesenchymal stem cells (MSCs) are emerging as a lead candidate for cell-based therapeutics. These cells promote healing, have an excellent safety record in preclinical and clinical trials, and are readily available in large quantities. However, there is some controversy regarding their interaction with the host immune system. Allogeneic MSCs are currently in clinical trials as a cell therapy for heart disease, including one trial where the efficacy of allogeneic and autologous MSCs is directly compared. This chapter examines the current and future possibilities of using allogeneic MSCs for cardiac regeneration therapy