Abe Fortas: A Biography

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Auditory effects of autologous fat graft for TORP stabilization in the middle ear: a cadaveric study.

BACKGROUND: Total ossicular replacement prostheses (TORP) are often used to re-establish ossicular coupling of sound in an ear lacking a stapes supra-structure. The use of TORPs, however, is associated with a 2/3 five year failure rate due to their anatomic instability over time in the middle ear. The use of autologous fat to try and stabilize TORPs may improve long-term results with this challenging ossicular reconstruction technique. METHODS: A cadaveric temporal bone model was developed and laser Doppler vibrometry was used to measure and record round window membrane vibration in response to sound stimulation under the following conditions: normal middle ear, middle ear filled with fat, normal middle ear with TORP prosthesis, TORP prosthesis with fat around its distal end and TORP prosthesis with fat filling the middle ear. Fourteen temporal bones were used. RESULTS: There was a significant decrease in round window membrane velocity after filling the middle ear with fat in both the normal middle ear (- 8.6 dB; p  0.05). CONCLUSIONS: Autologous fat around the distal end of a TORP prosthesis may not be associated with any additional hearing loss, as demonstrated in this cadaveric model. The additional hearing loss potentially caused by using fat to completely surround the prosthesis and fill the middle ear is probably not clinically acceptable at this time, especially given the unknown way in which the fat will atrophy over time in this context

Identifying Mode Confusion in Recorded Aircraft Data

In recent decades, commercial aviation accidents have occurred due to human-machine interaction (HMI) problems known as “mode confusion.” This is caused, in some cases, by a lack of understanding of onboard systems by pilots. Large amounts of Flight Operational Quality Assurance (FOQA) data are available, analysis of which could assist in identification of safety risks in daily operations. Through analysis of pilot reactions and recorded aircraft data, methods to detect mode confusion are developed to improve aviation safety. This study was conducted by inducing mode confusion into a flight simulation scenario and analyzing aircraft data to detect emerging patterns. Three distinct Instrument Landing System approaches were flown by participants unaware of experiment details. Differences between these approaches force the pilot to capture the glideslope from above using automation. The results indicate that pilots reacted to the mode confusion by providing control input which opposed the goal of the automation. This reaction was a response to the divergence between pilot intent and automation intent. Further experimentation is needed to determine a general, universally accepted data marker for the occurrence of mode confusion. Ultimately, this outcome will assist the aviation community in addressing drawbacks of modern automation

Is There a Next For Reference Librarians?

In this opinion piece four reference librarians at a medium sized academic library in Louisiana, describe their experience with an unanticipated effect of educational technology (online computers) and their recommendations for taking advantage of this effect. This paper makes a case for teaching as the new occupation for reference librarians