Publications by authors named "Michael Jaffe"

37 Publications

Hydrophobically Modified Isosorbide Dimethacrylates as a Bisphenol-A (BPA)-Free Dental Filling Material.

Materials (Basel) 2021 Apr 22;14(9). Epub 2021 Apr 22.

Interdisciplinary Program in Materials Science and Engineering, New Jersey Institute of Technology, Newark, NJ 07012, USA.

A series of bio-based hydrophobically modified isosorbide dimethacrylates, with , , and benzoate aromatic spacers (ISBGBMA), are synthesized, characterized, and evaluated as potential dental restorative resins. The new monomers, isosorbide 2,5-bis(4-glyceryloxybenzoate) dimethacrylate (ISB4GBMA), isosorbide 2,5-bis(3-glyceryloxybenzoate) dimethacrylate (ISB3GBMA), and isosorbide 2,5-bis(2-glyceryloxybenzoate) dimethacrylate (ISB2GBMA), are mixed with triethylene glycol dimethacrylate (TEGDMA) and photopolymerized. The resulting polymers are evaluated for the degree of monomeric conversion, polymerization shrinkage, water sorption, glass transition temperature, and flexural strength. Isosorbide glycerolate dimethacrylate (ISDGMA) is synthesized, and Bisphenol A glycerolate dimethacrylate (BisGMA) is prepared, and both are evaluated as a reference. Poly(ISBGBMA/TEGDMA) series shows lower water sorption (39-44 µg/mm) over Poly(ISDGMA/TEGDMA) (73 µg/mm) but higher than Poly(BisGMA/TEGDMA) (26 µg/mm). Flexural strength is higher for Poly(ISBGBMA/TEGDMA) series (37-45 MPa) over Poly(ISDGMA/TEGDMA) (10 MPa) and less than Poly(BisGMA/TEGDMA) (53 MPa) after immersion in phosphate-buffered saline (DPBS) for 24 h. Poly(ISB2GBMA/TEGDMA) has the highest glass transition temperature at 85 °C, and its monomeric mixture has the lowest viscosity at 0.62 Pa·s, among the (ISBGBMA/TEGDMA) polymers and monomer mixtures. Collectively, this data suggests that the ortho ISBGBMA monomer is a potential bio-based, BPA-free replacement for BisGMA, and could be the focus for future study.
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http://dx.doi.org/10.3390/ma14092139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122847PMC
April 2021

Editorial: Veterinary Sports Medicine and Physical Rehabilitation.

Front Vet Sci 2020 28;7:240. Epub 2020 Apr 28.

Kaneps Equine Sports Medicine and Surgery, Beverly, MA, United States.

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http://dx.doi.org/10.3389/fvets.2020.00240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212417PMC
April 2020

Applying Medical Device Informatics to Enable Safe and Secure Interoperable Systems: Medical Device Interface Data Sheets.

Anesth Analg 2020 09;131(3):969-976

MD PnP Program, Massachusetts General Hospital, Boston, Massachusetts.

This article describes the concept of Medical Device Interface Data Sheets (MDIDSs) to document and characterize medical device interface data requirements, the processes for creating MDIDSs, and its role in supporting patient safety and cybersecurity of current systems while enabling innovation in the area of next-generation medical Internet of Things (IoT) platforms for integrating sensors, actuators, and applications (apps).
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http://dx.doi.org/10.1213/ANE.0000000000004251DOI Listing
September 2020

Pathology in Practice.

J Am Vet Med Assoc 2018 Feb;252(3):297-299

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http://dx.doi.org/10.2460/javma.252.3.297DOI Listing
February 2018

Respiratory Gas Analysis-Technical Aspects.

Authors:
Michael B Jaffe

Anesth Analg 2018 03;126(3):839-845

From Cardiorespiratory Consulting, LLC, Cheshire, Connecticut.

A technology-focused review of respiratory gas analysis, with an emphasis on carbon dioxide analysis, is presented. The measurement technologies deployed commercially are highlighted, and the basic principles and technical concerns of infrared spectroscopy and mainstream versus sidestream gas sampling are discussed. The specifications of particular interest to the clinician, accuracy and response time, and the related standard, with typical values for a capnometer, are presented. Representative time and volumetric capnograms are shown with the clinically relevant parameters described. Aspects of the terminology in present-day use and the need for clarity in defining what is a breath and an end-tidal value are reviewed. The applications of capnography of particular interest to the anesthesiologist are noted, and key references are provided. Ongoing developments with respect to respiratory gas analysis, and those that will impact it, are noted.
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http://dx.doi.org/10.1213/ANE.0000000000002384DOI Listing
March 2018

Three-dimensional piezoelectric fibrous scaffolds selectively promote mesenchymal stem cell differentiation.

Biomaterials 2017 Dec 19;149:51-62. Epub 2017 Sep 19.

Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102-1982, USA. Electronic address:

The discovery of electric fields in biological tissues has led to efforts in developing technologies utilizing electrical stimulation for therapeutic applications. Native tissues, such as cartilage and bone, exhibit piezoelectric behavior, wherein electrical activity can be generated due to mechanical deformation. Yet, the use of piezoelectric materials have largely been unexplored as a potential strategy in tissue engineering, wherein a piezoelectric biomaterial acts as a scaffold to promote cell behavior and the formation of large tissues. Here we show, for the first time, that piezoelectric materials can be fabricated into flexible, three-dimensional fibrous scaffolds and can be used to stimulate human mesenchymal stem cell differentiation and corresponding extracellular matrix/tissue formation in physiological loading conditions. Piezoelectric scaffolds that exhibit low voltage output, or streaming potential, promoted chondrogenic differentiation and piezoelectric scaffolds with a high voltage output promoted osteogenic differentiation. Electromechanical stimulus promoted greater differentiation than mechanical loading alone. Results demonstrate the additive effect of electromechanical stimulus on stem cell differentiation, which is an important design consideration for tissue engineering scaffolds. Piezoelectric, smart materials are attractive as scaffolds for regenerative medicine strategies due to their inherent electrical properties without the need for external power sources for electrical stimulation.
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http://dx.doi.org/10.1016/j.biomaterials.2017.09.024DOI Listing
December 2017

Spatiotemporal modeling of laser tissue soldering using photothermal nanocomposites.

Lasers Surg Med 2018 02 9;50(2):143-152. Epub 2017 Oct 9.

Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana.

Objective: Laser tissue soldering using photothermal solders is a technology that facilitates rapid sealing using heat-induced changes in the tissue and the solder material. The solder material is made of gold nanorods embedded in a protein matrix patch that can be placed over the tissue rupture site and heated with a laser. Although laser tissue soldering is an attractive approach for surgical repair, potential photothermal damage can limit the success of this approach. Development of predictive mathematical models of photothermal effects including cell death, can lead to more efficient approaches in laser-based tissue repair.

Methods: We describe an experimental and modeling investigation into photothermal solder patches for sealing porcine and mouse cadaver intestine sections using near-infrared laser irradiation. Spatiotemporal changes in temperature were determined at the surface as well as various depths below the patch. A mathematical model, based on the finite element method, predicts the spatiotemporal temperature distribution in the patch and surrounding tissue, as well as concomitant cell death in the tissue is described.

Results: For both the porcine and mouse intestine systems, the model predicts temperatures that are quantitatively similar to the experimental measurements with the model predictions of temperature increase often being within a just a few degrees of experimental measurements.

Conclusion: This mathematical model can be employed to identify optimal conditions for minimizing healthy cell death while still achieving a strong seal of the ruptured tissue using laser soldering. Lasers Surg. Med. 50:143-152, 2018. © 2017 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/lsm.22746DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820132PMC
February 2018

The Importance of State and Context in Safe Interoperable Medical Systems.

IEEE J Transl Eng Health Med 2016 8;4:2800110. Epub 2016 Aug 8.

MDPnP Program Department of Anesthesia Massachusetts General Hospital Boston MA 02114 USA.

This paper describes why "device state" and "patient context" information are necessary components of device models for safe interoperability. This paper includes a discussion of the importance of describing the roles of devices with respect to interactions (including human user workflows involving devices, and device to device communication) within a system, particularly those intended for use at the point-of-care, and how this role information is communicated. In addition, it describes the importance of clinical scenarios in creating device models for interoperable devices.
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http://dx.doi.org/10.1109/JTEHM.2016.2596283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052027PMC
August 2016

The Need to Apply Medical Device Informatics in Developing Standards for Safe Interoperable Medical Systems.

Anesth Analg 2017 01;124(1):127-135

From the *Office of Science and Engineering Laboratories, FDA/CDRH, Silver Spring, Maryland; †MDPnP Program, Massachusetts General Hospital, Boston, Massachusetts; ‡ISO, Geneva, Switzerland, and AAMI, Arlington, Virginia; §Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts; and ‖Partners HealthCare System, Boston, Massachusetts.

Medical device and health information technology systems are increasingly interdependent with users demanding increased interoperability. Related safety standards must be developed taking into account these systems' perspective. In this article, we describe the current development of medical device standards and the need for these standards to address medical device informatics. Medical device information should be gathered from a broad range of clinical scenarios to lay the foundation for safe medical device interoperability. Five clinical examples show how medical device informatics principles, if applied in the development of medical device standards, could help facilitate the development of safe interoperable medical device systems. These examples illustrate the clinical implications of the failure to capture important signals and device attributes. We provide recommendations relating to the coordination between historically separate standards development groups, some of which focus on safety and effectiveness and others focus on health informatics. We identify the need for a shared understanding among stakeholders and describe organizational structures to promote cooperation such that device-to-device interactions and related safety information are considered during standards development.
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http://dx.doi.org/10.1213/ANE.0000000000001386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010005PMC
January 2017

Capturing Essential Information to Achieve Safe Interoperability.

Anesth Analg 2017 01;124(1):83-94

From the *Office of Science and Engineering Laboratories, Food and Drug Administration/Center for Devices and Radiological Health, Silver Spring, Maryland; †MD PnP Program, Massachusetts General Hospital, Boston, Massachusetts; ‡DocBox, Newton, Massachusetts; §Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts; and ‖Partners HealthCare System, Boston, Massachusetts.

In this article, we describe the role of "clinical scenario" information to assure the safety of interoperable systems, as well as the system's ability to deliver the requisite clinical functionality to improve clinical care. Described are methods and rationale for capturing the clinical needs, workflow, hazards, and device interactions in the clinical environment. Key user (clinician and clinical engineer) needs and system requirements can be derived from this information, therefore, improving the communication from clinicians to medical device and information technology system developers. This methodology is intended to assist the health care community, including researchers, standards developers, regulators, and manufacturers, by providing clinical definition to support requirements in the systems engineering process, particularly those focusing on development of Integrated Clinical Environments described in standard ASTM F2761. Our focus is on identifying and documenting relevant interactions and medical device capabilities within the system using a documentation tool called medical device interface data sheets and mitigating hazardous situations related to workflow, product usability, data integration, and the lack of effective medical device-health information technology system integration to achieve safe interoperability. Portions of the analysis of a clinical scenario for a "patient-controlled analgesia safety interlock" are provided to illustrate the method. Collecting better clinical adverse event information and proposed solutions can help identify opportunities to improve current device capabilities and interoperability and support a learning health system to improve health care delivery. Developing and analyzing clinical scenarios are the first steps in creating solutions to address vexing patient safety problems and enable clinical innovation. A Web-based research tool for implementing a means of acquiring and managing this information, the Clinical Scenario Repository™ (MD PnP Program), is described.
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http://dx.doi.org/10.1213/ANE.0000000000001351DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5161571PMC
January 2017

Sleep, Sleep Disorders, and Mild Traumatic Brain Injury. What We Know and What We Need to Know: Findings from a National Working Group.

Neurotherapeutics 2016 Apr;13(2):403-17

Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Disturbed sleep is one of the most common complaints following traumatic brain injury (TBI) and worsens morbidity and long-term sequelae. Further, sleep and TBI share neurophysiologic underpinnings with direct relevance to recovery from TBI. As such, disturbed sleep and clinical sleep disorders represent modifiable treatment targets to improve outcomes in TBI. This paper presents key findings from a national working group on sleep and TBI, with a specific focus on the testing and development of sleep-related therapeutic interventions for mild TBI (mTBI). First, mTBI and sleep physiology are briefly reviewed. Next, essential empirical and clinical questions and knowledge gaps are addressed. Finally, actionable recommendations are offered to guide active and efficient collaboration between academic, industry, and governmental stakeholders.
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http://dx.doi.org/10.1007/s13311-016-0429-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824019PMC
April 2016

Using the features of the time and volumetric capnogram for classification and prediction.

Authors:
Michael B Jaffe

J Clin Monit Comput 2017 Feb 18;31(1):19-41. Epub 2016 Jan 18.

Cardiorespiratory Consulting, LLC, 410 Mountain Road, Cheshire, CT, 06410, USA.

Quantitative features derived from the time-based and volumetric capnogram such as respiratory rate, end-tidal PCO, dead space, carbon dioxide production, and qualitative features such as the shape of capnogram are clinical metrics recognized as important for assessing respiratory function. Researchers are increasingly exploring these and other known physiologically relevant quantitative features, as well as new features derived from the time and volumetric capnogram or transformations of these waveforms, for: (a) real-time waveform classification/anomaly detection, (b) classification of a candidate capnogram into one of several disease classes, (c) estimation of the value of an inaccessible or invasively determined physiologic parameter, (d) prediction of the presence or absence of disease condition, (e) guiding the administration of therapy, and (f) prediction of the likely future morbidity or mortality of a patient with a presenting condition. The work to date with respect to these applications will be reviewed, the underlying algorithms and performance highlighted, and opportunities for the future noted.
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http://dx.doi.org/10.1007/s10877-016-9830-zDOI Listing
February 2017

POLYMER CHEMISTRY. Safer fuels by integrating polymer theory into design.

Science 2015 Oct;350(6256):32

Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA.

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http://dx.doi.org/10.1126/science.aac9827DOI Listing
October 2015

Gold Nanorod-Collagen Nanocomposites as Photothermal Nanosolders for Laser Welding of Ruptured Porcine Intestines.

ACS Biomater Sci Eng 2015 Sep 24;1(9):805-815. Epub 2015 Aug 24.

Chemical Engineering, Arizona State University, Tempe, Arizona 85287, United States.

Surgical site infection and postoperative leakage are complications that may develop following colorectal surgery and result in fatal consequences. Rapid, fluid-tight wound closure through laser tissue welding (LTW) can reduce postoperative leakage and thus decrease infection. Laser tissue welding involves generation of localized heat by exposing an exogenous chromophore to near-infrared (NIR) irradiation in order to seal wounds. In this study, we generated gold nanorod (GNR)-collagen nanocomposites (NCs) for laser-facilitated welding of ruptured intestinal tissue. The fluid content, stiffness, elasticity, and laser-induced temperature response of these nanocomposites were modulated to optimize laser-induced tissue fusion and minimize tissue damage. In addition, the effect of laser operating parameters including power density, femtosecond pulsed wave (PW) or continuous wave (CW) laser, and exposure duration were all studied. Laser power density and treatment duration significantly affected the temperatures reached during welding, as well as tissue weld strength and burst pressure. CW laser was found to induce significantly higher temperatures of the nanocomposites during treatment than PW laser, but the differences in weld strength and burst pressure for the two laser types were insignificant. This suggests that PW lasers can result in robust welds while minimizing potential thermal damage compared to CW lasers. The ultimate tensile strength of welded ruptured tissue was returned to as high as 68% of the native tissue strength through laser treatment, and laser treatment with these nanocomposites restored up to 64% of native tissue leak pressure and 42% of burst pressure. To the best of our knowledge, the laser power densities used (≤2.50 W/cm) are among the lowest reported for laser tissue welding, and the laser configuration and use require very little surgical skill. Our results indicate that GNR-collagen nanocomposites are promising photothermal biomaterials in laser tissue welding applications.
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http://dx.doi.org/10.1021/acsbiomaterials.5b00174DOI Listing
September 2015

Piezoelectric materials for tissue regeneration: A review.

Acta Biomater 2015 Sep 7;24:12-23. Epub 2015 Jul 7.

Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102-1982, USA. Electronic address:

Unlabelled: The discovery of piezoelectricity, endogenous electric fields and transmembrane potentials in biological tissues raised the question whether or not electric fields play an important role in cell function. It has kindled research and the development of technologies in emulating biological electricity for tissue regeneration. Promising effects of electrical stimulation on cell growth and differentiation and tissue growth has led to interest in using piezoelectric scaffolds for tissue repair. Piezoelectric materials can generate electrical activity when deformed. Hence, an external source to apply electrical stimulation or implantation of electrodes is not needed. Various piezoelectric materials have been employed for different tissue repair applications, particularly in bone repair, where charges induced by mechanical stress can enhance bone formation; and in neural tissue engineering, in which electric pulses can stimulate neurite directional outgrowth to fill gaps in nervous tissue injuries. In this review, a summary of piezoelectricity in different biological tissues, mechanisms through which electrical stimulation may affect cellular response, and recent advances in the fabrication and application of piezoelectric scaffolds will be discussed.

Statement Of Significance: The discovery of piezoelectricity, endogenous electric fields and transmembrane potentials in biological tissues has kindled research and the development of technologies using electrical stimulation for tissue regeneration. Piezoelectric materials generate electrical activity in response to deformations and allow for the delivery of an electrical stimulus without the need for an external power source. As a scaffold for tissue engineering, growing interest exists due to its potential of providing electrical stimulation to cells to promote tissue formation. In this review, we cover the discovery of piezoelectricity in biological tissues, its connection to streaming potentials, biological response to electrical stimulation and commonly used piezoelectric materials for tissue regeneration. This review summarizes their potential as a promising scaffold in the tissue engineering field.
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http://dx.doi.org/10.1016/j.actbio.2015.07.010DOI Listing
September 2015

Decreased surgical time with a vessel sealing device versus a surgical stapler in performance of canine splenectomy.

J Am Anim Hosp Assoc 2014 Jan-Feb;50(1):42-5. Epub 2013 Nov 11.

VCA Animal Referral and Emergency Center of Arizona, Mesa, AZ.

The purpose of this retrospective study of 72 dogs was to compare a vessel sealing device with a surgical stapling device for performance of splenectomy. The results of this study demonstrate a statistically significant shorter surgical time for splenectomy, without an adverse effect on outcomes, performed in dogs with the vessel sealing device (mean time, 58.4 min ± 3.3 min; median time, 60 min; range, 22-131 min) compared with a traditional stapling device (mean time, 66.9 min ± 2.4 min; median time, 66 min; range, 40-100 min). No other significant differences were found between the two groups of patients.
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http://dx.doi.org/10.5326/JAAHA-MS-5981DOI Listing
May 2015

Evaluation of two novel self-anchoring barbed sutures in a prophylactic laparoscopic gastropexy compared with intracorporeal tied knots.

Vet Surg 2013 Nov 23;42(8):932-42. Epub 2013 Sep 23.

VCA Advanced Veterinary Care Center, Fishers, IN.

Objective: To compare laparoscopic gastropexy using 2 self-anchoring barbed sutures to gastropexy using laparoscopically tied intracorporeal knots.

Study Design: Prospective, randomized controlled, clinical trial.

Animals: Dogs (n = 30) weighing >16 kg.

Methods: Dogs were randomly assigned to 1 of 3 laparoscopic gastropexy groups: group 1 (controls), intracorporeal 2-0 polydioxanone sutures (PDSII, Ethicon); group 2, barbed suture (0 Quill™ PDO; Angiotech); and group 3, barbed suture (2-0 V-Loc™ 180; Covidien). Gastropexy suturing time (GST) and total surgery time (TST) were recorded for each dog. Complications were recorded. Each dog was examined by ultrasound (1, 3, and 6 months postoperatively) to ensure persistence of the gastropexy. One dog each in group 2 and group 3 had 2nd look laparoscopy to evaluate the gastropexy.

Results: All gastropexies were intact at 6 months. Mean GST was significantly longer for group 1 (36 minutes; range, 25-46 minutes) than for groups 2 (20 minutes; range, 16-37 minutes) and 3 (19 minutes; range, 15-30 minutes; P < .05), which were not significantly different from each other. Likewise TSTs for groups 2 and 3 were significantly shorter than for group 1 (P < .05).

Conclusion: Barbed sutures (Quill™ and V-Loc™) allowed for effective intracorporeal laparoscopic suturing of an incisional gastropexy without tying intracorporeal knots.
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http://dx.doi.org/10.1111/j.1532-950X.2013.12043.xDOI Listing
November 2013

Structural changes in PVDF fibers due to electrospinning and its effect on biological function.

Biomed Mater 2013 Aug 17;8(4):045007. Epub 2013 Jun 17.

Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102-1982, USA.

Polyvinylidine fluoride (PVDF) is being investigated as a potential scaffold for bone tissue engineering because of its proven biocompatibility and piezoelectric property, wherein it can generate electrical activity when mechanically deformed. In this study, PVDF scaffolds were prepared by electrospinning using different voltages (12-30 kV), evaluated for the presence of the piezoelectric β-crystal phase and its effect on biological function. Electrospun PVDF was compared with unprocessed/raw PVDF, films and melt-spun fibers for the presence of the piezoelectric β-phase using differential scanning calorimetry, Fourier transform infrared spectroscopy and x-ray diffraction. The osteogenic differentiation of human mesenchymal stem cells (MSCs) was evaluated on scaffolds electrospun at 12 and 25 kV (PVDF-12 kV and PVDF-25 kV, respectively) and compared to tissue culture polystyrene (TCP). Electrospinning PVDF resulted in the formation of the piezoelectric β-phase with the highest β-phase fraction of 72% for electrospun PVDF at 25 kV. MSCs cultured on both the scaffolds were well attached as indicated by a spread morphology. Cells on PVDF-25 kV scaffolds had the greatest alkaline phosphatase activity and early mineralization by day 10 as compared to TCP and PVDF-12 kV. The results demonstrate the potential for the use of PVDF scaffolds for bone tissue engineering applications.
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http://dx.doi.org/10.1088/1748-6041/8/4/045007DOI Listing
August 2013

Global developmental delay and mental retardation--a pediatric perspective.

Dev Disabil Res Rev 2011 ;17(2):85-92

The Hannah Khoushy Child Development Center and The Bruce Rappaport Faculty of Medicine, The Technion, The Israeli Institute of Technology, Haifa, Israel.

Pediatricians play a leading role in the detection, diagnosis, and management of children with global developmental delay (GDD) and mental retardation (MR). Assessment, investigation, and consultation with the family are the prime responsibility of the developmental pediatrician, in collaboration with a multidisciplinary team. The model used by the developmental pediatrician depends on the community health framework. Significant progress has been recently achieved in identifying underlying etiologies, using a variety of laboratory tests including neuroimaging and genetic and metabolic investigations. Although being used to achieve an acceptable yield, this progress in diagnostic investigations should be associated with proper weighing of the value of each test to the diagnostic process. Optimal utilization of this rapidly expanding knowledge can only be accomplished in the setting of in-depth clinical evaluation, including a thoughtful assessment of the child and family needs. In this article, the literature on the process of clinical evaluation and laboratory work-up of the child with GDD/MR is reviewed, with an emphasis on a multidisciplinary team approach to the child and family needs. An integrated model used by the developmental pediatrician that relates to the process of evaluation and management as well as the consequences of the diagnosis on the child, his/her family, and the community is suggested.
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http://dx.doi.org/10.1002/ddrr.1103DOI Listing
March 2013

Continuous monitoring of respiratory flow and CO(2):challenges of on-airway measurements.

IEEE Eng Med Biol Mag 2010 Mar-Apr;29(2):44-52

Advanced Technology, Philips-Respironics, LLC, Wallingford, CT 06492, USA.

In this article, the challenges of simultaneous respiratory gas concentration and flow measurements in a breathing circuit are reviewed. The tradeoffs that were considered in the development of a clinically useful on-airway combination CO(2)/flow sensor are discussed as well as the applications enabled by this on-airway combination CO(2)/flow sensor.
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http://dx.doi.org/10.1109/MEMB.2009.935712DOI Listing
December 2010

A comparison of degradable synthetic polymer fibers for anterior cruciate ligament reconstruction.

J Biomed Mater Res A 2010 May;93(2):738-47

Orthopaedic Research Laboratory, UMDNJ-RWJMS, New Brunswick, New Jersey, USA.

We compared mechanical properties, degradation rates, and cellular compatibilities of two synthetic polymer fibers potentially useful as ACL reconstruction scaffolds: poly(desaminotyrosyl-tyrosine dodecyl dodecanedioate)(12,10), p(DTD DD) and poly(L-lactic acid), PLLA. The yield stress of ethylene oxide (ETO) sterilized wet fibers was 150 +/- 22 MPa and 87 +/- 12 MPa for p(DTD DD) and PLLA, respectively, with moduli of 1.7 +/- 0.1 MPa and 4.4 +/- 0.43 MPa. Strength and molecular weight retention were determined after incubation under physiological conditions at varying times. After 64 weeks strength decreased to 20 and 37% of the initial sterile fiber values and MW decreased to 41% and 36% of the initial values for p(DTD DD) and PLLA, respectively. ETO sterilization had no significant effect on mechanical properties. Differences in mechanical behavior may be due to the semicrystalline nature of PLLA and the small degree of crystallinity induced by mesogenic ordering in p(DTD DD) suggested by DSC analysis. Fibroblast growth was similar on 50-fiber scaffolds of both polymers through 16 days in vitro. These data suggest that p(DTD DD) fibers, with higher strength, lower stiffness, favorable degradation rate and cellular compatibility, may be a superior alternative to PLLA fibers for development of ACL reconstruction scaffolds.
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http://dx.doi.org/10.1002/jbm.a.32567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845725PMC
May 2010

Infrared measurement of carbon dioxide in the human breath: "breathe-through" devices from Tyndall to the present day.

Authors:
Michael B Jaffe

Anesth Analg 2008 Sep;107(3):890-904

Respironics-Novametrix, LLC., 5 Technology Drive, Wallingford, CT 06492, USA.

The ability to measure carbon dioxide (CO(2)) in the breath of a patient or capnometry, is one of the fundamental technological advances of modern medicine. I will chronicle the evolution and commercialization of mainstream capnometry based upon infrared measurement of CO(2) in the breath using information from the historical record and personal interviews with many of the developers.
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http://dx.doi.org/10.1213/ane.0b013e31817ee3b3DOI Listing
September 2008

Design of a filamentous polymeric scaffold for in vivo guided angiogenesis.

Tissue Eng 2006 Nov;12(11):3021-34

Skeletal Biotechnology Laboratory, Hebrew University-Hadassah Medical Center, Jerusalem, Israel.

Angiogenesis is mandatory for reperfusion of viable tissues, and lack of vascularization may cause ischemia. The increasing disparity between the demand and availability of adequate substitutes for small-diameter human blood vessels has prompted an intensive search for artificial materials or biological allograft tissues, both of which usually fail in the long term. The objective of this study was to pioneer a novel model for in vivo guided angiogenesis based on a specific design process of a filamentous polymeric scaffold with endothelial cells in a 3-dimensional culture system. To our knowledge, this is the first report of an in vivo guided angiogenesis approach based on a 2-step model, composed of endothelial cells and a filamentous polymeric scaffold framework. Endothelial cells that had been cultured on a specifically designed filamentous polymeric scaffold within a regulated dynamic tissue culture system were shown in vivo to induce guided angiogenesis. Cells seeded on a biodegradable polymeric scaffold were implanted into mice. On day 28 after implantation, analysis revealed a guided angiogenic process along the path of the implanted polymeric scaffold as well as initial evidence for early maturation of engineered vessels, allowing red blood cells to flow through the forming lumina of new vessels as the polymer degraded. The authors conclude that in vivo guided angiogenesis can be achieved by combining endothelial cells with biodegradable filamentous polymeric scaffolds and that this model can lay the cornerstone for vascular engineering and future development of clinically available protocols aimed to treat life-threatening cardiovascular conditions.
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http://dx.doi.org/10.1089/ten.2006.12.3021DOI Listing
November 2006

Idiopathic apparent life-threatening event in Northern Israel.

J Paediatr Child Health 2006 Jan-Feb;42(1-2):33-6

Department of Pediatrics, Bnai Zion Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Objective: To note whether the incidence of idiopathic apparent life-threatening event (IALTE) has decreased since 1993 in parallel to the decline in the incidence of sudden unexpected death in infancy (SUDI) 2. To compare their epidemiological profile to infants with acute unrelated illness.

Methods: The discharge diagnoses of each infant investigated for apparent life-threatening event or apnea in the five major hospitals in Northern Israel were reviewed over the period 1991-2000. Infants with identified aetiology or apnea only were excluded. Each infant was matched with two other infants admitted for an acute respiratory illness unrelated to apnea. IALTE rates were compared to the national rates of SUDI.

Results: Two hundred and forty-three infants were diagnosed with IALTE. No evidence for a decline in incidence was noted over the period of the study, while a consistent decline in the incidence of SUDI was observed. Only few differences in the epidemiological profile were noted between the study and the comparison group, that is, increased rate of prematurity and first-born infants.

Conclusions: (i) The two conditions probably do not share a common aetiology in the majority of cases; and (ii) the epidemiological profile of IALTE is predominantly similar to that of infants hospitalized for respiratory illness.
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http://dx.doi.org/10.1111/j.1440-1754.2006.00785.xDOI Listing
August 2006

Crohn's disease and recurrent appendicitis: a case report.

World J Gastroenterol 2005 Nov;11(43):6891-3

Department of Pediatrics, Bnai Zion Medical Center, 47 Golomb St. POB 4940, Haifa 31048, Israel.

The clinical diagnosis of classic Crohn's disease (CD) of the small bowel is based on a typical history, tender right lower quadrant fullness or mass, and characteristic radiographic findings of the terminal ileum. Appendicitis may as well present with chronic or recurrent symptoms and this presentation may be confused with CD. We herein describe the case of a young teenage girl with a presumptive diagnosis of CD, who was ultimately diagnosed as having chronic nongranulomatous appendicitis. The literature on the subject is reviewed.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725046PMC
http://dx.doi.org/10.3748/wjg.v11.i43.6891DOI Listing
November 2005

Neurological manifestations of an acute abdomen in children.

Pediatr Emerg Care 2005 Sep;21(9):594-7

Department of Pediatrics, Bnai Zion Medical Center, Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.

The acute abdomen in the pediatric age group is not infrequently fraught with diagnostic pitfalls. The younger the patient, the more problematic the presentation can be. Among the more unusual manifestations of an acute abdomen is an apparent encephalopathic picture. We present 2 cases which serve to illustrate the diagnostic difficulties encountered.
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http://dx.doi.org/10.1097/01.pec.0000177199.68408.3eDOI Listing
September 2005

The surgical manifestations of the intestinal tract in Kawasaki disease.

J Pediatr Surg 2005 Sep;40(9):e1-4

Department of Pediatrics, Faculty of Medicine, Bnai Zion Medical Center, Technion, Haifa, Israel.

Kawasaki disease (KD) is an inflammatory condition of unknown etiology. It involves mainly the skin, mucous membranes, lymph nodes, and myocardium. It may involve the gastrointestinal tract; however, it rarely presents as a surgical abdomen. We present a case of a young child with suspected small bowel obstruction who was subsequently diagnosed with KD. We review the surgical presentations of the intestinal tract in KD.
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http://dx.doi.org/10.1016/j.jpedsurg.2005.05.063DOI Listing
September 2005

Emotional and behavioral outcomes among adolescents with mild developmental deficits in early childhood.

J Adolesc Health 2005 Jan;36(1):70.e14-9

Division of Adolescent Medicine, Bnai Zion Medical Center, Haifa, Israel.

Purposes: To evaluate emotional and behavioral outcomes in adolescents who in early childhood were treated for mild developmental deficits; and to identify predictive factors in early childhood, for future emotional and social competence abnormalities.

Methods: The records of children referred to Hanna Khoushi Child Development Center in Haifa for mild developmental delay were reviewed. Parents and adolescents were requested to complete the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) 12 to 16 years after discharge from the Child Development Center. Analysis of the two questionnaires and identification of predictive variables in early childhood for emotional problems and social competence difficulties during adolescence were performed, using ANOVA Student's T-test, Chi-square, and multiple regression.

Results: The most frequent developmental diagnoses on admission to the Child Development Center were mild motor (27.3%) or language (23.2%) deficits. Of the treated children, 53.4% were discharged without any developmental deficit. All CBCL and YSR T-scores were within the nonpsychopathology range. No notable differences were found between the study scores and the scores regarding typical Israeli and American youths. Significant differences were, however, observed in self-perception of internalizing emotional problems between male and female adolescents: T-scores of 51.9 +/- 8.0 vs. 47.4 +/- 10.8, respectively (p < .05). Motor and language deficits were associated with lower general competence than general developmental delay and emotional developmental disturbances (T-scores: 47.9 vs. 49.1 and 50.9, p< .05). Admission to the Center after the age of 18 months was associated with higher T-scores for general as well as externalizing problems when compared with scores associated with admission before the age of 18 months (by 5.75 points for both parameters, p < .001).

Conclusion: The perception of parents and children with minor developmental deficits observed in early childhood regarding their emotional and social competence during adolescence is similar to typical youths.
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http://dx.doi.org/10.1016/j.jadohealth.2004.02.023DOI Listing
January 2005
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