Development, Optimization and Clinical Evaluation Of Algorithms For Ultrasound Data Analysis Used In Selected Medical Applications.

The assessment of soft and hard tissues is critical when selecting appropriate protocols for restorative and regenerative therapy in the field of dental surgery. The chosen treatment methodology will have significant ramifications on healing time, success rate and overall long-time oral health. Currently used diagnostic methods are limited to visual and invasive assessments; they are often user-dependent, inaccurate and result in misinterpretation. As such, the clinical need has been identified for objective tissue characterization, and the proposed novel ultrasound-based approach was designed to address the identified need. The device prototype consists of a miniaturized probe with a specifically designed ultrasonic transducer, electronics responsible for signal generation and acquisition, as well as an optimized signal processing algorithm required for data analysis. An algorithm where signals are being processed and features extracted in real-time has been implemented and studied. An in-depth algorithm performance study has been presented on synthetic signals. Further, in-vitro laboratory experiments were performed using the developed device with the algorithm implemented in software on animal-based samples. Results validated the capabilities of the new system to reproduce gingival assessment rapidly and effectively. The developed device has met clinical usability requirements for effectiveness and performance

Contraception: past, present, and future

The most common method of birth control used since 3000 B.C., is the condom. It has been used continuously in the 21st century, but several other forms have been added. Due to reformers like Marie Stopes, Margret Sanger, Katharine McCormick and Gregory Pincus contraceptive usage has become popularized in today's society. New forms of contraceptive include, but are not limited to intrauterine devices (IUDs), shots, pill, patch, and vaginal rings. These devices have been developed as both hormonal and nonhormonal products. Hormonal birth control delivers hormones such as estrogen and progestin, which affect the joining of the sperm and egg. Products that are non-hormonal are a viable alternative for women who cannot tolerate hormonal regulation. Estrogen and progestin function as contraceptives by changing various areas in the vaginal tract by changes such as the thickening of cervical mucus, thinning the uterus lining, or increasing the vagina acidity. Researchers are also trying to develop other options such as a male contraceptive option to expand and reach a target population that is not currently reached. There are also government policies currently in Congress that address the issue of the uninsured; thereby reaching those who may need contraceptives the most. The Affordable Care Act also known as Obama care is trying to provide Medicaid to people who do not and would not ever be able to afford adequate health care, including contraceptives on their own. With the passing of the Affordable Care Act more women will be able to go to a medical provider to be informed and educated on the various contraceptive methods, enabling them to make an informed decision

The Development of a Porcine Model to Evaluate Wound Healing and Infection of Transcutaneous Osseointegrated Weight-Bearing Prostheses

Clinical studies have shown that up to 73.9% of the 1.04 million US lower limb amputees report skin problems such as sweating, irritation, and sores associated with their conventional prosthesis. An alternative option redirects ambulatory forces back to the skeleton using an implant that permanently protrudes through the skin (transcutaneous) to enable direct bone anchorage (osseointegration) of a prosthesis. Transcutaneous osseointegrated prostheses show a marked improvement in amputee acceptance over conventional prostheses. Advantages include limited tissue breakdown, a non-restricted range of motion, and enhanced functionality. However this prosthetic option has not been clinically implemented in the United States because of infection concerns and an incomplete understanding of transcutaneous wound healing. Being a potential state-of-the-art altering surgical option for trauma-induced amputees, transcutaneous osseointegration will require preliminary animal studies. To evaluate the efficacy of the transcutaneous osseointegrated option, a physiologically- similar, axially-loaded, weight bearing animal model was developed. Two pigs were fit with transcutaneous osseointegrated prostheses in a single-stage amputation and implantation surgical procedure. Clinical, microbiological, and histological data were examined to assess wound healing and infection at the skin-bone-implant interface. The animals achieved 70% and 67% pre-operative weight-bearing. Bacterial cultures indicated a likely deep tissue infection in one of the two animals. The transcutaneous wounds were in the proliferative phase of wound healing by the end of the 35 and 56 day studies. The epithelial skin layer was migrating towards the implant in one animal. Results obtained from the animal model will be used to implement future topographical and material changes at the transcutaneous site. The porcine model should become the standard for implementing and testing future iterations of weight-bearing transcutaneous osseointegrated prosthetic devices

UWOMJ Volume 63, Number 2, Spring 1994

Schulich School of Medicine & Dentistryhttps://ir.lib.uwo.ca/uwomj/1240/thumbnail.jp

Applications of aerospace technology in biology and medicine

Results of the medically related activities of the NASA Application Team Program at the Research Triangle Institute are reported. A survey of more than 300 major medical device manufacturers has been initiated for the purpose of determining their interest and opinions in regard to participating in the NASA Technology Utilization Program. Design and construction has been commissioned of a permanent exhibit of NASA Biomedical Application Team accomplishments for the aerospace building of the North Carolina Museum of Life and Science at Durham, North Carolina. The team has also initiated an expansion of its activities into the Northeastern United States

Beacon Light: Spring 1983

Discussion of cancer treatment with Dr. Bernard Rodgers. Pg. 2 The role of Physicist Rich Geise in patient treatment. Pg. 5 Explanation on how a CAT scanner works. Pg. 8 Profile on the TEFRA act. Pg, 12 Feature on Dr. Reg Watts. Pg. 1

His and Her Tort Reform: Gender Injustice in Disguise

This Article is an inquiry into the gendered nature of tort remedies. Modem tort law provides increased protection for injuries suffered by women. Drawing upon a national study of punitive damages in products liability and medical malpractice, Professors Koenig and Rustad argue that tort remedies are bifurcated into his and her tort worlds based upon gender roles. Nearly half of the punitive damages verdicts awarded to women stemmed from injuries caused by household consumer products and dangerously defective drugs or medical devices. In contrast, the punitive damages awarded to males arose from accidents involving industrial and farm machinery, asbestos, chemicals, containers, and vehicles. Two out of three plaintiffs receiving punitive damages awards in medical malpractice litigation are women. Women employ this remedy primarily to obtain redress for mismanaged child birth, cosmetic surgery, sexual abuse, and neglect in nursing homes—gender-based injuries. Women are also far more likely than men to be awarded noneconomic damages in medical products liability litigation. Consequently, proposed restrictions on non-economic damages and the Food and Drug Administration defense to punitive damages will have a disparate impact on women\u27s mass tort remedies. Similarly, limitations on medical malpractice remedies will disproportionately restrict pain and suffering awards as well as punitive damages to women. Without systematic analysis of the distinctive ways that tort law relates to gender, women\u27s voices will not be heard in the tort reform debate

Intracortical microstimulation of human somatosensory cortex as a source of cutaneous feedback

The field of brain computer interfaces (BCI) has been making rapid advances in decoding brain activity into control signals capable of operating neural prosthetic devices, such as dexterous robotic arms and computer cursors. Potential users of neural prostheses, including people with amputations or spinal cord injuries, retain intact brain function that can be decoded using BCIs. Recent work has demonstrated simultaneous control over up to 10 degrees-of-freedom, but the current paradigms lack a component crucial to normal motor control: somatosensory feedback. Currently, BCIs are controlled using visual feedback alone, which is important for many reaching movement and identifying target locations. However, as the actuators controlled by BCIs become more complex and include devices approximating the performance of human limbs, visual feedback becomes especially limiting, as it cannot convey information used during object manipulation, such as grip force. The objective of this work is to provide real-time, cutaneous, somatosensory feedback to users of dexterous prosthetic limbs under BCI control by applying intracortical microstimulation (ICMS) to primary somatosensory cortex (S1). Long-term microstimulation of the cortex with microelectrode arrays had never been attempted in a human prior to this work, and while this work is ultimately motivated by efforts to improve BCIs, this general approach also enables INTRACORTICAL MICROSTIMULATION OF HUMAN PRIMARY SOMATOSENSORY CORTEX AS A SOURCE OF CUTANEOUS FEEDBACK Sharlene Nicole Flesher, PhD University of Pittsburgh, 2017 v unprecedented access to the human cortex enabling investigations of more basic scientific issues surrounding cutaneous perception, its conscious components, and its role in motor planning and control. To this end, two microelectrode arrays were placed in human somatosensory cortex of a human participant. I first characterized qualities of sensations evoked via ICMS, such as percept location, modality, intensity and size, over a two-year study period. The sensations were found to be focal to a single digit, and increased in intensity linearly with pulse train amplitude, which suggests that ICMS will be a suitable means of relaying locations of object contact with single-digit precision, and a range of grasp forces can be relayed for each location. Additionally, I found these qualities to be stable over a two-year period, suggesting that delivering ICMS was not damaging the electrode-tissue interface. ICMS was then used as a real-time feedback source during BCI control of a robotic limb during tasks ranging from simple force-matching tasks to functional reach, grasp and carry tasks. Finally, we examined the relationship between pulse train parameters and conscious perception of sensations, an endeavor that until now could not have been undertaken. These results demonstrate that ICMS is a suitable means of relaying somatosensory feedback to BCI users. Adding somatosensory feedback to BCI users has the potential to improve embodiment and control of the devices, bringing this technology closer to restoring upper limb function

To Develop Techniques that will Enhance Dermal Cell and Tissue Attachment in Order to Create a Seal and Prevent Infection of Implant Biomaterials used for ITAP

Failure modalities of bone anchoring and skin penetrating devices, such as Intraosseous Transcutaneous Amputation Prosthesis (ITAP), stem from the lack of dermal cell and tissue attachment at the skin implant interface. As a result the implant shaft offers a direct route for harmful pathogens into the body. The aim of my thesis is to develop techniques that will enhance dermal cell and tissue attachment, in order to create a tight biological seal of implant biomaterials currently used for ITAP. I compared the effects of fibronectin against its cell binding region- a 3-amino- acid region know as Arginine-Glycine-Aspartic Acid (RGD)- on human dermal fibroblast (HDF) attachment to ITAP substrates. Silanization of RGD- polypeptides provided a durable biological functionalisation technique that significantly increased HDF attachment compared with controls. No significant difference was observed between fibronectin and RGD-polypeptide functionalised substrates in vitro. I then investigated the effects of porosity (as a function of pore and strut diameter) on soft fibrosis tissue in-growth and vascularisation. Electron Beam Manufacturing (EBM) provided an effective method of creating precise 3- dimensional porous structures. Porosity as a function of pore and strut diameter led to optimal soft fibrosis tissue in-growth with 700μm pore and 300μm strut diameters exhibiting significantly increased vascularisation over other implants groups after 4 weeks in vivo. The development of these functionalisation techniques, which utilised porous structures and silanization of RGD sequences, were combined and applied to the ITAP device. An EBM porous flange, of 700μm pore and 300μm strut diameters, were silanised with RGD-polypeptide and compared with the current clinical standard ITAP device. Implants were tested in a trans-tibial, transcutaneous ovine model for 5-months. Functionalisation techniques employed in this study did not eradicate the failure modalities of ITAP devices, however they did not detrimentally affect the formation of a stable transcutaneous interface compared with current clinical standards. Significant positive effects were observed, with the biological functionalisation, using silanised RGD-polypeptides, significantly increasing dermal tissue infiltration and porous structures, manufactured by EBM, significantly increasing vascularisation. Functionalisation with silanised RGD-polypeptides to porous structures may provide an opportunity to enhance the skin implant interface and tight biological seal for bone anchoring and skin penetrating devices, such as ITAP, clinically