Background: To date, there is a lack of research that has focused on the needs of late cochlear implanted adults with prelingual deafness. The specific study aims were: (1) to explore the met and unmet long-term needs of late cochlear implanted adults with prelingual deafness from their own perspectives and those of the employees at SCIP; and 2) to identify a consensus of the most important met and unmet long-term needs of late cochlear implanted adults with prelingual deafness. Method: This study used a modified Delphi technique with two rounds. In the first round, nine adults who were considered experts on this topic participated in semi-structured in-depth interviews. The participants were five late cochlear implanted recipients with prelingual deafness who were involved in the Southern Cochlear Implant Programme in New Zealand, and four clinicians from the programme. The interview transcripts were analysed using qualitative content analysis. The results from the first round were used to inform the development of the survey for the second round. The second round of the study involved surveying the same participants who participated in the first round. These surveys were quantitatively analysed so as to discover which needs were considered important and met, and important and unmet for the cochlear implant recipients, from the perspectives of the two categories of participants. Results: The first round of the study revealed 42 met needs and 39 unmet needs that fell into 15 categories. Of these needs, 26 met needs and 18 unmet needs were identified as being important by a majority of the participants in the second round. Conclusion: The results from the study may impact potential CI recipients’ and their families’ expectations of what the device can provide, as well as the development of future services and governmental policies in the area.

published_or_final_version / abstract / toc / Surgery / Master / Master of Philosophy

Η αύξηση του προσδόκιμου διαβίωσης ενθαρρύνει την ευρύτερη χρήση τεχνητών εμφυτευμάτων για την αντικατάσταση ιστών και οργάνων ή την υποστήριξη των zωτικών λειτουργιών. Οι κυριότερες κατηγορίες υλικών που δύνανται να χρησιμοποιηθούν στα τεχνητά εμφυτεύματα είναι τα μέταλλα, τα κεραμικά, τα πολυμερή και τα σύνθετα υλικά και βρίσκουν εφαρμογή σε πολλούς τομείς της ιατρικής και της οδοντιατρικής. Στην παρούσα εργασία παρατίθενται οι κατηγορίες και οι ιδιότητες των υλικών, οι απαιτήσεις που πρέπει να πληρουν και οι εφαρμογές τους. Παρουσιάζονται, επίσης, μετρήσεις τραχύτητας επιφάνειας με τη μέθοδο afm σε κεφαλές από χάλυβα που μπορούν να χρησιμοποιηθούν στην ολική αρθροπλαστική ισχίου. / The use of medical implants in order to replace or maintain tissues and organs is now wider than ever before. The major categories of materials used in such applications in medicine and dentistry are metals, polymers, ceramics and composite materials. The aim of the present project is to present the properties, the requirements and the applications of biomaterials in medical implants. It is, also, measured with afm the roughness on surfaces of metallic heads suitable for hip joints replacement.

In the twenty-first century, new cutting-edge osseointegration technology is improving quality of life. Osseointegration is a new technique to suspend an implant prosthetic device for individuals with a limb-loss. The science of osseointegration is not clearly understood although there appears to be a special relationship between pure titanium that promotes activation of our bone building cells and bone remodeling. Direct bone-anchored osseointegration to integrate a foreign device into the body without the body rejecting the prosthesis is the new technology lacking knowledge and research clinical cases for human translation. The objective of the case study was to review the science of bone-anchored osseointegration as a limb-salvaging technique and potential translation to humans using a canine model in a well-defined control study. Aims were to enhance knowledge technology, improve mobility, decrease pain to improve quality of life and influence health care practices. By the year 2050, the projected number of American amputees is expected to reach 3.6 million. Many people depend on artificial limbs to perform their activities of daily living. Often these limbs start developing complications associated with stump-socket designs such as separation from the human tissue, poor fit with repeated fittings, recurrent skin infections, ulcers and pressure sores due to non-uniform pressure distribution over the socket contact area and pain which decreases their mobility. Since 2001, close to 28,500 American troops have been wounded in combat in Iraq and Afghanistan. Greater than 24,600 of them have survived their injury, the highest survival rate of any war in the history of the United States. Sadly, 700 of these services members have lost at least one limb from amputations. Lower limb amputations are still performed above the knee as not enough bone can be preserved below the knee for prosthesis. Osseointegration with limb-salvaging techniques could enhance mobility and quality of life for those individuals who sacrifice their limbs defending our freedoms.

Two trials were conducted to evaluate the effects of gender on optimal CP concentrations (TRIAL 1) and gender and anabolic implants on the somatotropic axis in feedlot cattle (TRIAL 2). More specifically, the objective of TRIAL 1 was to examine the effects of 3 dietary CP concentrations on performance, carcass characteristics, and serum urea nitrogen (SUN) in finishing steers and heifers and the objective of TRIAL 2 was to evaluate the effects of ovariectomy (OVX) and implantantation (200 mg of trenbolone acetate and 28 mg of estradiol benzoate; Synovex-Plus) on performance, serum urea nitrogen (SUN), serum IGF-1, and mRNA expression of hepatic IGF-1, GH receptor, and E receptor-α as well as pituitary GH, E receptor-α and GHRH receptor in feedlot heifers. TRIAL 1 results indicated that ADG was optimized when both steers and heifers were fed 12.5% CP and G:F was optimized for steers fed 12.5% CP but heifer G:F was optimal at 14.0% CP. Feeding diets containing 11.0% CP appears to cause a protein deficiency in both steers and heifers. TRIAL 2 data indicated that gender had no influence on performance or SUN in feedlot heifers. Serum IGF-1 is increased more in OVX heifers than intact heifers due to a greater response to implantation from the OVX heifers. However, the reason for the extra increase in serum IGF-1 is not clear, although trends in gene expression analysis suggest the possibility that the increased serum IGF-1 may be controlled outside of the somatotropic axis. Further research is warranted to examine the effects of OVX and anabolic implants on the somatotropic axis.

Im Rahmen der Untersuchungen wurden an 60 auf Implantatabutments zementierten Einzelzahnkronengerüsten aus Zirkoniumdioxid Abzugsversuche durchgeführt, um die zur Dezementierung der Kronengerüste nötigen Kräfte zu ermitteln. Als variable Parameter dienten hierbei drei unterschiedliche Abutmentgeometrien, sowie unterschiedliche Zementsysteme. Mittels des beschriebenen CAD/CAM- Verfahrens wurden die Kronengerüste aus Zirkoniumdioxid hergestellt. Die Zugversuche wurden mit der Universalprüfmaschine Zwick Z007 (Zwick, Ulm) durchgeführt und mittels „TestXpert“ (Software Zwick, Ulm) ausgewertet. Die nötige Kraft, welche zu einem vollständigen Abriss der Zirkoniumdioxidgerüste von dem Implantatabutment führt, wurde in Newton gemessen. In den Ergebnissen zeigt sich eine signifikante Wechselwirkung zwischen den beiden Faktoren Abutmentgeometrie und Zement (p<0.002). Während sich bei dem konfektionierten Abutment kaum ein Unterschied zwischen den Zementarten zeigt (p=0.2495, 95%KI [-26.93,7.45]), sind bei dem individuell niedrigen Abutment für den Zement Telio CS höhere Abzugskräfte nötig (p<0.0001, 95%KI [56.15, 98.01]). Dieser Effekt kehrt sich beim hohen Abutment um (p=0.0008, 95%KI [- 66.26,-20.62]). Es ist hier folglich kein einheitlicher Einfluss des Faktors Zement zu beobachten. Ein möglicher Einfluss auf die Retentionskraft, bzw. das Retentionsverhalten von zementierten Zirkoniumdioxid-Suprakonstruktionen auf Implantatabutments bedingt durch verschiedene Abutmentgeometrien wäre denkbar. Als Schlussfolgerung für die Praxis bestätigten sich die gezeigten Vorteile in der Anwendung von modernen semi-permanenten Kompositzementen für die Befestigung CAD/CAM gefertigter vollkeramischer Restaurationen auf Titanabutments, wobei die Indikation bei individuellen Abutmentgeometrien jeweils kritisch zu stellen ist.

Le diamant dopé bore (BDD) est un matériau extrêmement prometteur pour applications biomédicales par son unique combinaison de propriétés. Cette thèse a visé le développement de nouvelles structures de micro-électrodes en BDD et l'étude de leur intérêt et leurs performances pour des applications électroanalytiques et électrophysiologiques. En dépit de leurs propriétés électroanalytiques très supérieures à d'autres matériaux d'électrodes plus conventionnels, les électrodes BDD sont sujettes au "fouling", i.e. l'apparition d'un film à la surface du diamant qui réduit la réactivité électrochimique. Ceci est très compromettant dans des milieux complexes comme l'urine, les eaux stagnantes, des boissons, le plasma sanguin etc. Ici, un nouveau traitement d'activation a été développé pour nettoyer la surface des électrodes et recouvrir leur réactivité initiale, donc il permet leur usage pour de longues périodes d'enregistrement sans dégradation du signal. Ceci permet l'usage de ce type d'électrodes, pour des domaines d'applications, pour le suivi continu d'analytes, sans entretien spécifique, en solutions complexes. La grande originalité de ces techniques d'activation est qu'elle peut être menée directement dans l'analyte lui-même. En comparaison avec leurs équivalents en macro-électrodes, les microélectrodes permettent d'obtenir de plus grandes sensibilités, des courants résiduels moindre, des pertes ohmiques moindres, et donc des rapports signal à bruit meilleurs. Un procédé robuste et fiable a été optimisé pour la fabrication de réseaux de microélectrodes (MEA MicroElectrode Arrays) et d'ultra micro-électrodes, permettant par lithographie sur 4 pouces d'offrir une large flexibilité de fabrication. Par exemple, parmi d'autres prototypes, des microélectrodes BDD ont été utilisées pour applications de biocapteurs pour quantifier l'acide urique en temps quasi-réel. Bien que le diamant possède une très bonne biocompatibilité et des propriétés électrochimiques excellentes, la faible relative capacité de double couche limite leur application pour des applications électrophysiologiques. Des procédés de nanostructuration ont ainsi été mis au point pour accroitre les limites d'injection de charge. Parmi les approches, des procédés hybrides à base de polypyrrole se sont révélés prometteurs, de même que des procédés de gravure pour former de la "nano-herbe" diamant, très intéressantes pour la fabrication de MEAs en BDD. Ces matériaux à fort rapport d'aspect apparaissent comme d'excellents candidats pour applications d'interfaces neuronales et notamment pour la fabrication d'implants rétiniens.STAR

Everyday speech perception frequently occurs in degraded listening conditions, against a background of noise, interruptions and intermingling voices. Despite these challenges, speech perception is remarkably successful, due in part to perceptual learning. Previous research has demonstrated more rapid perceptual learning of acoustically-degraded speech when listeners are given the opportunity to map the linguistic content of utterances, presented in clear auditory form, onto the degraded auditory utterance. Here, I investigate whether learning is further enhanced by the provision of naturalistic facial gestural information, presented concurrently with either the clear auditory sentence (Experiment I), or with the degraded utterance (Experiment II). Recorded materials were noise-vocoded (4 frequency channels; 50- 8000 Hz). Noise-vocoding (NV) is a popular simulation of speech transduced through a cochlear implant, and 4-channel NV speech is difficult for naïve listeners to understand, but can be learned over several sentences of practice. In Experiment I, each trial began with an auditory-alone presentation of a degraded stimulus for report (D). In two conditions, this was followed by passive listening to either the clear spoken form and then the degraded form again (condition DCD), or the reverse (DDC); the former format of presentation (DCD) results in more efficient learning (Davis et al, 2005). Condition DCvD was similar to DCD, except that the clear spoken form was accompanied by facial gestural information (a talking face). The results indicate that presenting clear audiovisual feedback (DCvD) does not confer any advantage over clear auditory feedback (DCD). In Experiment II, two groups received a degraded sentence presentation with corresponding facial movements (Dv); the second group also received a second degraded (auditory-alone) presentation (DvD). Two control conditions and a baseline DCvD condition were also tested. Although they never received clear speech feedback, performance in the DvD group was significantly greater than in all others, indicating that perceptual learning mechanisms can capitalize on visual concomitants of speech. The DvD group outperformed the Dv group, suggesting that the second degraded presentation in the DvD condition further facilitates generalization of learning. These findings have important implications for improving comprehension of speech in an unfamiliar accent or following cochlear implantation. / Thesis (Master, Psychology) -- Queen's University, 2011-09-01 16:50:58.923

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