A state-wide school-work program for the mentally retarded.
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Attitude↗
Biomedical subjects
G M Clark
Publications and source records attributed to G M Clark.
Observations on the ability of Haemogamasus liponyssoides Ewing and Ornithonyssus bacoti (Hirst) (Acarina, Gamasina) to retain eastern equine encephalitis virus: preliminary report.
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Animals↗
Validity and power investigation of a test for serial correlation in univariate repeated measures analysis.
A common design in biostatistics and psychometrics is the repeated measures design. A popular example is a clinical trial with one grouping factor, e.g. treatment or drug, and one repeated measures factor, e.g. time or visit. For selected 'real world' parameter sets, we performed a validity and power study on a test for serial correlation in repeated measures analysis and also conducted a similar study of a test for sphericity. Simulation showed that the serial correlation test identified the serial correlation structure, whereas the sphericity test, for some parameter sets, failed to detect this non-spherical pattern as often as 85 per cent of the time.
Analysis of Variance↗
Renewal-process approximation of a stochastic threshold model for electrical neural stimulation.
In a recent set of modeling studies we have developed a stochastic threshold model of auditory nerve response to single biphasic electrical pulses (Bruce et al., 1999c) and moderate rate (less than 800 pulses per second) pulse trains (Bruce et al., 1999a). In this article we derive an analytical approximation for the single-pulse model, which is then extended to describe the pulse-train model in the case of evenly timed, uniform pulses. This renewal-process description provides an accurate and computationally efficient model of electrical stimulation of single auditory nerve fibers by a cochlear implant that may be extended to other forms of electrical neural stimulation.
Action Potentials↗
Cochlear implant place psychophysics 1. Pitch estimation with deeply inserted electrodes.
Numerical estimation of pitch was performed by 8 adult subjects implanted with cochlear prostheses manufactured by Cochlear Limited. The electrode arrays had been inserted into the scale tympani to between one and one and a half turns of the cochlea. Using bipolar stimulation, the pitch estimates for each subjects showed an overall reduction with insertion depth of the stimulated electrode. However, for several subjects, after decreasing regularly for the more basal electrodes, pitch estimates showed an abrupt decrease, followed in some cases by a region of low pitch. Two of the subjects, implanted with a modified electrode array, the '20 + 2' which allowed monopolar in addition to bipolar stimulation, exhibited an abrupt decrease in pitch estimate with bipolar but not with monopolar stimulation. In these two subjects, for stimulating electrodes inserted more deeply than about three quarters of a turn, bipolar stimuli produced lower pitch sensations, and presumably more apical neural excitation patterns, than monopolar stimuli.
Adolescent↗
Cochlear implant place psychophysics. 2. Comparison of forward masking and pitch estimation data.
Results for forward masking and numerical estimation of pitch were compared in a group of 6 adult subjects implanted with cochlear prostheses manufactured by Cochlear Limited. Data were collected for bipolar + 1 stimulation in all subjects, and for stimulation in one other mode, either common ground or monopolar, for all subjects but one. The pitch data show various irregularities and in each case can be seen to be broadly consistent with the corresponding forward masking data. It is shown that a 'centre of gravity' of the forward masking distribution varies with masker electrode in a manner that is qualitatively very similar to the variation of pitch estimate. It is suggested that, while pitch estimation results are consistent with those from forward masking, the latter contain more detailed information that may be useful in understanding intersubject variations in speech comprehension.
Adolescent↗
Observations of human fetal otoconial membranes.
Intact otoconial membranes from 31 human fetuses ranging in gestational age from 14 to 36 weeks were studied. At all stages of development specimens from different individuals showed marked variations in overall shape. During the course of the second and third trimesters, both saccular and utricular otoconial membranes were found to increase three to fourfold in surface area and more than twofold in weight. Near the end of gestation the fetal specimens were about equal in area and weight to otoconial membranes from children up to 13 years of age. However, the crystal layers of the fetal membranes has less prominently developed surface contours than usually observed in children and adults, indicating that maturational changes continue after the time of birth.
Acoustic Maculae↗
A multiple-channel cochlear implant: an evaluation using nonsense syllables.
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Cochlear Implants↗
Comparison of two cochlear implant speech-processing strategies.
Speech processors extracting either the fundamental frequency (F0) alone, or the fundamental frequency combined with second formant information (F0-F2), have been evaluated on a totally deaf patient using a multiple-channel cochlear implant. A closed set test using 16 spondees and a modified rhyme test showed that for electrical stimulation alone the F0-F2 speech processor was significantly better than the F0 processor. The open set tests using phonetically balanced words and Central Institute for the Deaf everyday sentences showed that for electrical stimulation alone and electrical stimulation combined with lipreading, the results with the F0-F2 speech processor were all significantly better than with the F0 processor. Information transmission for consonant speech features was also better when using the F0-F2 processor.
Cochlear Implants↗
Surgery for an improved multiple-channel cochlear implant.
An improved multiple-channel cochlear implant has been developed. The titanium container with enclosed electronics, the receiver coil, and the connector are embedded in medical-grade Silastic. The upper half of the implant has a diameter of 35 mm and a height of 4.5 mm, and the lower half a diameter of 23 mm and a height of 5 mm. The electrode array has also been designed to reduce the possibility of breakage due to repeated movements over many years. The surgery involves drilling a bed in the mastoid bone for the receiver-stimulator, and fixing the proximal electrode under the mastoid cortex. Gentle insertion of the electrode array through the round window and along the scala tympani is achieved with a specially designed microclaw .
Cochlear Implants↗
Banded intracochlear electrode array: evaluation of insertion trauma in human temporal bones.
A banded free-fit scala tympani array was inserted into the basal turn of nine human cochleas to evaluate the trauma produced by the procedure. These nine cochleas, together with five nonimplanted controls, were serially sectioned and examined microscopically for damage to the membranous labyrinth, in particular the spiral ligament, the basilar and Reissner's membranes, the stria vascularis, and the osseous spiral lamina. The severity and location of any trauma along the cochlear spiral were recorded. The results indicate that the insertion of the banded scala tympani array resulted in minimal mechanical damage, occurring primarily to a localized region of the spiral ligament. This would not result in significant neural degeneration, and therefore would not compromise the efficacy of the multichannel cochlear prosthesis.
Aged↗
Effect of experimentally induced otitis media on cochlear implants.
Cat cochleas implanted with scala tympani prostheses were investigated histologically after inoculating the bullae with a suspension of group A streptococci. The prosthesis was passed through the round window membrane in one ear. In the other the prosthesis bypassed the round window via an opening anteroinferior to the round window niche. Before death, horseradish peroxidase was administered as a tracer for possible pathways of infection. Results showed that group A streptococci were pathogenic to the cat and caused inflammation in the bulla. The unimplanted round window membrane and the seals around the electrode entry points prevented infection from entering the cochlea. The seals around electrodes inserted either through the round window membrane or an opening drilled anteroinferior to the niche were equally effective. The horseradish peroxidase tracer studies showed, however, that a gap existed between the electrode and membranous seal, and this could be a potentially vulnerable site under certain conditions. Drilling an anteroinferior opening into the cochlea resulted in bony sequestra entering the cochlea. This can be avoided by blue-lining the opening and removing bone with picks before making an opening through the endosteum.
Animals↗
Effect of low level X radiation on the antigenicity of Escherichia coli.
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Antigen-Antibody Reactions↗
A lysosomal pepstatin-insensitive proteinase as a novel biomarker for breast carcinoma.
Lysosomal proteinases play an important role in the turnover of intracellular proteins, and acidic proteinases such as cathepsin D are known to be increased in breast carcinoma. In the present study the activity of a newly discovered acidic lysosomal pepstatin-insensitive proteinase (CLN2p) was measured in breast tissues by the most sensitive and highly specific assay that we had developed for the diagnosis of late-infantile neuronal ceroid lipofuscinosis (LINCL) (2). Samples from eight normal subjects undergoing reductive mammoplasty and 200 patients with primary breast carcinoma were analyzed. The results suggest a two- to seventeen-fold higher CLN2p activity in tumors, which was significantly and positively correlated with already known breast cancer biomarkers such as levels of cathepsin D, estrogen receptor and progesterone receptor. These results suggest a diagnostic and prognostic potential for this novel acid proteinase in breast cancer.
Aminopeptidases↗
A multiple-channel cochlear implant and wearable speech-processor: an audiological evaluation.
Stand audiological tests were administered to a totally deaf multiple-channel cochlear implant patient with a wearable speech-processor in a monitored sound field under the following conditions: a wearable unit activated alone (WA), lipreading with the wearable unit off (LA), and wearable unit activated in combination with lipreading (WL). Thresholds obtained for narrow-band noise signals indicated that the wearable unit allowed the patient to detect a variety of sounds at different frequencies. The results obtained in closed-set word tests and open-set word and sentence tests showed significant improvements in word and sentence scores from LA to WL. In the open-set (C.I.D.) sentence test, the patient scored 22% for LA and 76% for WL. The WL score of 76% correlates with a satisfactory performance in understanding connected speech. The patient also scored 30% correct in a test involving the recognition of environmental sounds.
Cochlear Implants↗
A multiple-channel cochlear implant. An evaluation using an open-set word test.
Multiple-channel electrical stimulation of the hearing nerve in conjunction with speechreading has helped two post-lingually deaf patients with total hearing losses understand running speech in every day situations. This has been confirmed using open-set phonetically balanced word tests, where the patients achieved 60% and 40% scores with isolated-words, and 80% and 73% for phonemes-in-isolated words. The tests also showed that the cochlear implant improved word recognition by a factor of four in one patient and two in another, compared with speechreading alone. The speech processor used, extracted the voicing frequency and energy, and the frequency and energy of the dominant spectral peak in the mid-frequency range. The parameters for voicing determined the rate of stimulation for all electrodes, and the parameters for the dominant spectral peak in the mid-frequency range determined the site of electrode stimulation and current level.
Cochlear Implants↗
Amplitude and pulse rate difference limens for electrical stimulation of the cochlea following graded degeneration of the auditory nerve.
Experimentally deafened cats with differing populations of residual spiral ganglion cells were implanted with cochlear electrodes and were electrically stimulated. They were conditioned to respond to changes in electrical pulse rate and amplitude, and both electrical pulse rate and amplitude difference limens were determined. It was found that although there were some variations in difference limens between animals, these showed no correlation with residual cell populations over the range 8-44%.
Acoustic Stimulation↗
Perception of connected speech without lipreading, using a multi-channel hearing prosthesis.
Four of 13 totally deaf patients implanted with the Nucleus multi-channel hearing prosthesis at the University of Melbourne have demonstrated the ability to understand connected speech without lipreading or other visual cues. These patients were able to repeat verbatim unknown material read by a tester at rates of up to 35 words per minute. They were also able to understand an average of 78% of key words in everyday sentences in ideal acoustic conditions and 51% of equivalent material over the telephone. These results show that with a good proportion of postlingually deaf patients, the multi-channel hearing prosthesis can not only act as an aid to lipreading, but also restore effective speech understanding without lipreading.
Adult↗