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Biomedical subjects

William Noble

Publications and source records attributed to William Noble.

6 recordsLinked to original sources

Safety and immunogenicity of a recombinant parvovirus B19 vaccine formulated with MF59C.1.

A recombinant human parvovirus B19 vaccine (MEDI-491; MedImmune) composed of the VP1 and VP2 capsid proteins and formulated with MF59C.1 adjuvant was evaluated in a randomized, double-blind, phase 1 trial. Parvovirus B19-seronegative adults (n=24) received either 2.5 or 25 microg MEDI-491 at 0, 1, and 6 months. MEDI-491 was safe and immunogenic. All volunteers developed neutralizing antibody titers that peaked after the third immunization and were sustained through study day 364.

Adjuvants, Immunologic↗

Patients utilizing a hearing aid and a cochlear implant: speech perception and localization.

OBJECTIVE: The purpose of this pilot study was to document speech perception and localization abilities in patients who use a cochlear implant in one ear and a hearing aid in the other ear. DESIGN: We surveyed a group of 111 cochlear implant patients and asked them whether they used a hearing aid on their unimplanted ear. The first three patients who were available were tested on word and sentence recognition and localization tasks. Speech stimuli were presented from the front in quiet and in noise. In the latter conditions, noise was either from the front, the right, or the left. Localization was tested with noise bursts presented at 45 degrees from the right or left. In addition we asked the patients about their abilities to integrate the information from both devices. RESULTS: Speech perception tests in quiet showed a binaural advantage for only one of the three patients for words and none for sentences. With speech and noise both in front of the patient, two patients performed better with both devices than with either device alone. With speech in front and noise on the hearing aid side, no binaural advantage was seen, but with noise on the cochlear implant side, one patient showed a binaural advantage. Localization ability improved with both devices for two patients. The third patient had above-chance localization ability with his implant alone. CONCLUSIONS: A cochlear implant in one ear and a hearing aid in the other ear can provide binaural advantages. The patient who did not show a clear binaural advantage had the poorest hearing aid alone performance. The absolute and relative levels of performance at each ear are likely to influence the potential for binaural integration.

Cochlear Implants↗

Extending the IOI to significant others and to non-hearing-aid-based interventions.

Two extensions of the International Outcome Inventory for Hearing Aids are described: the first is designed for the significant other (SO) (IOI-HA-SO), and the second for alternative interventions for hearing difficulties (IOI-AI). A feature of the IOI-HA-SO is that several items are modified to inquire about effects of the partner's hearing loss on the SO. The IOI-AI is designed to cover effects of use of listening aids other than personally worn hearing aids, use of hearing tactics, and aural surgery.

Communication↗

Hearing speech against spatially separate competing speech versus competing noise.

Listeners had the task of following a target speech signal heard against two competitors either located at the same spatial position as the target or displaced symmetrically to locations flanking it. When speech was the competitor, there was a significantly higher separation effect (maintained intelligibility with reduced target sound level), as compared with either steady-state or fluctuating noises. Increasing the extent of spatial separation slightly increased the effect, and a substantial contribution of interaural time differences was observed. When same- and opposite-sex voices were used, a hypothesis that the similarity between target and competing speech would explain the role for spatial separation was partly supported. High- and low-pass filtering showed that both parts of an acoustically similar competing signal contribute to the phenomenon. We conclude that, in parsing the auditory array, attention to spatial cues is heightened when the components of the array are confusable on other acoustic grounds.

Adult↗

U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

Attitude↗