Auditory cortical responses in patients with cochlera implants

Currently, the most commonly used electrophysiological tests for cochlear implant evaluation are Averaged Electrical Voltages (AEV), Electrical Advisory Brainstem Responses (EABR) and Neural Response Telemetry (NRT). The present paper focuses on the study of acoustic auditory cortical responses, or slow vertex responses, which are not widely used due to the difficulty in recording, especially in young children. Aims of this study were validation of slow vertex responses and their possible applications in monitoring postimplant results, particularly restoration of hearing and auditory maturation. In practice, the use of tone-bursts, also through hearing aids or cochlear implants, as in slow vertex responses, allows many more frequencies to be investigated and louder intensities to be reached than with other tests based on a click as stimulus. Study design focused on latencies of N1 and P2 slow vertex response peaks in cochlear implants. The study population comprised 45 implant recipients (aged 2 to 70 years), divided into 5 different homogeneous groups according to chronological age, age at onset of deafness, and age at implantation. For each subject, slow vertex responses and free-field auditory responses (PTAS) were recorded for tone-bursts at 500 and 2000 Hz before cochlear implant surgery (using hearing aid amplification) and during scheduled sessions at 3rd and 12th month after implant activation. Results showed that N1 and P2 latencies decreased in all groups starting from 3rd through 12th month after activation. Subjects implanted before school age or at least before age 8 yrs showed the widest latency changes. All subjects showed a reduction in the gap between subjective thresholds (obtained with free field auditory responses) and objective thresholds (obtained with slow vertex responses), obtained in presurgery stage and after cochlear implant. In conclusion, a natural evolution of neurophysiological cortical activities of the auditory pathway, over time, was found especially in young children with prelingual deafness and implanted in preschool age. Cochlear implantation appears to provide hearing restoration, demonstrated by the sharp reduction of the gap between subjective free field auditory responses and slow vertex responses threshold obtained with hearing aids vs. cochlear implant

Research of Wheat Drying in a Microwave and Combined Filter-microwave Dryer

The aim of the conducted study is to determine kinetics of the complex effect of microwave energy supply and filter drying of the process of water release from the wheat layer. There is offered a combination of MW and filter drying. A special feature of this combination must be its more effectiveness and high speed of water elimination from surface layers of wet seeds and, as a result, the productivity increase of the drying way, decrease of specific energy consumption.There was determined the influence of the specific load of the material, radiator power on processes of microwave and filter-microwave drying of wheat seeds. There were compared microwave, filter-microwave and convective drying of seeds by parameters of specific energy consumption, drying speed.The specific energy consumption at microwave drying of seeds was 4 MJ/kg, at filter-microwave drying 3.8 MJ/kg that is lower than existent convective dryers. The speed of microwave drying changes from 0,5 to 3 %/min, filter-microwave – from 0.3 to 0.7 %/min. The speed is at the level of standard convective dryers.The conducted studies allow to recommend a new combined way of FMW drying of seeds with low energy consumption.Revealed features of heating and drying are possible to be used at developing industrial dryers.The base of experimental data is possible to be used for optimizing and determining effective conditions of MW and FMW drying

Development and characterization of positively selected brain-adapted SIV

HIV is found in the brains of most infected individuals but only 30% develop neurological disease. Both viral and host factors are thought to contribute to the motor and cognitive disorders resulting from HIV infection. Here, using the SIV/rhesus monkey system, we characterize the salient characteristics of the virus from the brain of animals with neuropathological disorders. Nine unique molecular clones of SIV were derived from virus released by microglia cultured from the brains of two macaques with SIV encephalitis. Sequence analysis revealed a remarkably high level of similarity between their env and nef genes as well as their 3' LTR. As this genotype was found in the brains of two separate animals, and it encoded a set of distinct amino acid changes from the infecting virus, it demonstrates the convergent evolution of the virus to a unique brain-adapted genotype. This genotype was distinct from other macrophage-tropic and neurovirulent strains of SIV. Functional characterization of virus derived from representative clones showed a robust in vitro infection of 174xCEM cells, primary macrophages and primary microglia. The infectious phenotype of this virus is distinct from that shown by other strains of SIV, potentially reflecting the method by which the virus successfully infiltrates and infects the CNS. Positive in vivo selection of a brain-adapted strain of SIV resulted in a near-homogeneous strain of virus with distinct properties that may give clues to the viral basis of neuroAIDS

Energetics of Eco-Industry of Food Concentrates Production

The determination of eco-industry in food production is formulated. The problems of processes of dehydration, heat balance and prospects of technologies directed energy action are considered. We offer the ways of solving an energy problems in product drying. The hypostases are formulated and the possibilities of laminar and turbulent diffusion to heat transfer mechanisms are analyzed. Increasing of drying speed with barodiffusional flows involvement is demonstrated. The extraction kinetic model is given in differential form. The prospects of usage directed action principles in target compounds extraction processes are analyzed. The analysis of drying technologies energy efficiency on base new similarity (similarity of energy action) is carried out. We demonstrated that impulse electromagnetic field can trigger in basically new effect, which one named mechanodiffusion

Systematic review of the literature on the clinical effectiveness of the cochlear implant procedure in paediatric patients

The aim of this systematic review of the literature was to summarize the results of scientific publications on the clinical effectiveness of the cochlear implant (CI) procedure in children. The members of the Working Group first examined existing national and international literature and the principal international guidelines on the procedure. They considered as universally-accepted the usefulness/effectiveness of unilateral cochlear implantation in severely-profoundly deaf children. Accordingly, they focused attention on systematic reviews addressing clinical effectiveness and cost/efficacy of the CI procedure, with particular regard to the most controversial issues for which international consensus is lacking. The following aspects were evaluated: post-CI outcomes linked to precocity of CI; bilateral (simultaneous/ sequential) CI vs. unilateral CI and vs. bimodal stimulation; benefits derived from CI in deaf children with associated disabilities. With regard to the outcomes after implantation linked to precocity of intervention, there are few studies comparing post-CI outcomes in children implanted within the first year of life with those of children implanted in the second year. The selected studies suggest that children implanted within the first year of life present hearing and communicative outcomes that are better than those of children implanted after 12 months of age. Concerning children implanted after the first year of life, all studies confirm an advantage with respect to implant precocity, and many document an advantage in children who received cochlear implants under 18 months of age compared to those implanted at a later stage. With regard to bilateral CI, the studies demonstrate that compared to unilateral CI, bilateral CI offers advantages in terms of hearing in noise, sound localization and during hearing in a silent environment. There is, however, a wide range of variability. The studies also document the advantages after sequential bilateral CI. In these cases, a short interval between interventions, precocity of the first CI and precocity of the second CI are considered positive prognostic factors. In deaf children with associated disabilities, the studies analyzed evidence that the CI procedure is also suitable for children with disabilities associated with deafness, and that even these children may benefit from the procedure, even if these may be slower and inferior to those in children with isolated deafness, especially in terms of high communicative and perceptive skills

MONTE CARLO CHARACTERIZATION OF PRESSURIZED WATER REACTOR SPENT FUEL ASSEMBLY FOR THE DEVELOPMENT OF A NEW INSTRUMENT FOR PIN DIVERSION DETECTION

A novel concept to detect pin-diversion from spent fuel assembly is proposed and described. The instrument will use multiple tiny neutron and gamma detectors in a form of cluster (detector cluster) and high precision driving system to collect radiation signatures inside pressurized water reactor (PWR) assembly. In order to validate our concept, a Monte Carlo study was done using a Monte Carlo code MCNP5. MONTEBURNS, a computational tool that links MCNP and ORIGEN, was used to produce accurate PWR spent fuel isotopic compositions. Monte Carlo simulations, using realistic fuel geometry and actual fuel material information, were performed to study radiation field inside a PWR spent fuel assembly. The preliminary Monte Carlo simulation study shows that indeed 2 dimensional neutron data, when obtained in the presence of missing pins, have data profiles distinctly different from the profiles obtained without missing pins

Development of a Safeguards Verification Method and Instrument to Detect Pin Diversion from Pressurized Water Reactor (PWR) Spent Fuel Assemblies

A technical safeguards challenge has remained for decades for the IAEA to identify possible diversion of nuclear fuel pins from Light Water Reactor (LWR) spent fuel assemblies. In fact, as modern nuclear power plants are pushed to higher power levels and longer fuel cycles, fuel failures (i.e., ''leakers'') as well as the corresponding fuel assembly repairs (i.e., ''reconstitutions'') are commonplace occurrences within the industry. Fuel vendors have performed hundreds of reconstitutions in the past two decades, thus, an evolved know-how and sophisticated tools exist to disassemble irradiated fuel assemblies and replace damaged pins with dummy stainless steel or other type rods. Various attempts have been made in the past two decades to develop a technology to identify a possible diversion of pin(s) and to determine whether some pins are missing or replaced with dummy or fresh fuel pins. However, to date, there are no safeguards instruments that can detect a possible pin diversion scenario to the requirements of the IAEA. The FORK detector system [1-2] can characterize spent fuel assemblies using operator declared data, but it is not sensitive enough to detect missing pins from spent fuel assemblies. Likewise, an emission computed tomography system [3] has been used to try to detect missing pins from a spent fuel assembly, which has shown some potential for identifying possible missing pins but this capability has not yet been fully demonstrated. The use of such a device in the future would not be envisaged, especially in an inexpensive, easy to handle setting for field applications. In this article, we describe a concept and ongoing research to help develop a new safeguards instrument for the detection of pin diversions in a PWR spent fuel assembly. The proposed instrument is based on one or more very thin radiation detectors that could be inserted within the guide tubes of a Pressurized Water Reactor (PWR) assembly. Ultimately, this work could lead to the development of a detector cluster and corresponding high-precision driving system to collect radiation signatures inside PWR spent fuel assemblies. The data obtained would provide the spatial distribution of the neutron and gamma flux fields within the spent fuel assembly, while the data analysis would be used to help identify missing or replaced pins. Monte Carlo simulations have been performed to help validate this concept using a realistic 17 x 17 PWR spent fuel assembly [4-5]. The initial results of this study show that neutron profile in the guide tubes, when obtained in the presence of missing pins, can be identifiably different from the profiles obtained without missing pins, Our latest simulations have focused upon a specific type of fission chamber that could be tested for this application

A registry for the collection of data in cochlear implant patients

The need to optimize the use of all the information that modern technological tools have made available to the physician ENT/audiologist has increasingly emerged within the Italian scientific community. Towards this purpose, it is necessary to create a registry of the patients using cochlear implants (CIs). This registry will include a homogeneous summary of the information deriving from multiple sources related to daily clinical practice, in order to assess auditory benefits, safety and reliability in patients with cochlear implants, and organization over the national territory. The primary objectives relative to the above-mentioned analysis are to assess the impact of the use of cochlear implants on patient health, to ensure traceability of the devices currently used, monitoring their safety and reliability over time, to guarantee access of the technique in clinical and organizational conditions that can allow the best possible benefits. The aspects concerning implementation of the registry were discussed extensively during the first meetings of the Working Group (WG). In particular, owing to the complexity and high costs related mainly to the development of the technological aspects and the need to involve technological partners external to the WG, and to respect current privacy laws, the WG members decided that the project should be limited to proposal of a paper registry to be implemented at a later stage, possibly within the framework of successive research projects. During meetings, the WG members discussed various aspects of implementation of the registry, and in particular the scientific features connected to objectives, inclusion criteria, and structure of the forms needed for data collection and organizational aspects. A registry is proposed herein

Analysis of the impact of professional involvement in evidence generation for the HTA Process, subproject “Cochlear Implants”: methodology, results and recommendations

The aim of Health Technology Assessment (HTA) is to provide decision-makers, distributors and recipients with information on the effectiveness, cost and impact of health technologies. The present study constitutes a subproject within the wider project “Analysis of the impact of professional involvement in evidence generation for the HTA process”, which is part of the strategic programme “Transfer of the results of the research in clinical practice and organisation of healthcare services”, coordinated by Laziosanità – Agency of Public Healthcare of the Lazio Region and AgeNaS (National Agency for Regional Healthcare Services). The objectives of the present subproject (cochlear implants) are as follows: a) to produce a report regarding the health impact of cochlear implants (CI) on their recipients, through a systematic review of literature and extensive selection of relative studies, combining the outcomes with metanalytical techniques. Output: report on the indications of usage in the groups of population for which benefits are controversial; b) to create a registry of patients using cochlear implants. The registry should contain a selection of anagraphic and clinical information relative to patient follow-up in order to assess factors associated with safety and impact on cochlear implant users. This source of information is essential for future observational studies. This was divided into 4 phases: 1st phase: definition of key participants in the assessment process; 2nd phase: definition of methods and timing of “Aims” (definition of the objective); 3rd phase: definition of the methods and times of the “assessment process”, 4th phase: production of the final report. From the analysis of systematic reviews and italian and international guidelines, the Working Group members approved recommendations on the following topics: results after CI in children in relation to age at implantation, bilateral CI in children, CI in deaf children with associated disabilities, CI in adults with advanced age, bilateral CI in adults and CI in adults with pre-lingual deafness. These recommendations have also been evaluated by the Consulting Committee members and approved with minimal suggestions

Accesso alla tecnologia. Access To Technologies (H.E.A.R.I.N.G. package of interventions, WHO 2021)

In Italia, lo Stato interviene con il Servizio Sanitario per l’assegnazione, agli aventi diritto, della tecnologia audiologica. La materia è regolata da una normativa specifica, spesso completata da provvedimenti regionali. Si ricorda che una normativa particolare è prevista per gli invalidi del lavoro ai quali, in caso di ipoacusia professionale, le prestazioni sono fornite dall’INAIL con procedure dedicate. Per i non aventi diritto la prescrizione medica è sempre necessaria, ma rispetto alle forniture pubbliche, non sono previste ulteriori valutazioni obbligatorie di controllo. Per le forniture pubbliche agli invalidi civili, i provvedimenti di interesse nazionale sono riportati nei Nomenclatori Tariffari del 1990 e del 1999 e nel provvedimento ad hoc sugli impianti cocleari del 2007. Oggi tutta la normativa ambulatoriale è stata sostituita dai LEA del 2017 (D.P.C.M 12 gennaio 2017) approvati, ma non ancora operativi, e che riuniscono tutti i principali argomenti in un unico documento eccetto le forniture chirurgiche. Distingueremo pertanto i LEA ambulatoriali, dai LEA chirurgici regolati da DRG. È importante sottolineare che l’atto legislativo dei LEA prevede il suo aggiornamento annuale da parte delle Societa Scientifiche, facoltà che, fino ad ora, non è mai stata esercitata