Medical Safety and Device Reliability of Active Transcutaneous Middle Ear and Bone Conducting Implants: A Long-Term Multi-Centre Observational Study

Active bone-conducting hearing devices (aBCHD; e.g., MEDEL Bonebridge® (BB)) and active middle ear implants (aMEI; e.g., MEDEL Vibrant Soundbridge® (VSB)) use radio frequency transmission to send information from an external microphone and sound processor to an internally implanted transducer. These devices potentially have an advantage over devices with percutaneous links because the skin is closed over the implantable components, which should reduce the risk of skin problems and infection. On the other hand, surgical procedures are more complex, with a greater risk of damage due to surgery. The objectives of this research were to quantify the reliability and long-term survival of MEDEL VSB and BB devices, determine the adverse and serious adverse device-related complications, and consider associated causes. A multi-center observational retrospective and prospective study was conducted at eleven auditory implant centers in the United Kingdom. Data was collected using a surgical questionnaire and audiological reports. Data were obtained from patient notes or from prospective cases that had a minimum follow-up of one year post-implant. Consecutive patient records were reviewed. Datasets from 109 BB and 163 VSB were reviewed. Of these, 205 were retrospective case note reviews, and 67 were prospective cases. The mean follow-up was 4 and 6 years, respectively, for BB and VSB. Kaplan–Meier Survival analyses indicated that the BB survival was 97% and 93.3% at 1 and 5 years, respectively, and the VSB was 92.1% and 87% at the same time points. This is a large cohort study for the field and has indicated that BB and VSB are safe interventions. Care should be taken to monitor magnet strength in the first few months. For the majority of device-related effects, there was no apparent association with etiology. However, an interesting pattern emerged for individuals who exhibited an inflammatory response, e.g., adhesions or device extrusion, and those with a history of chronic suppurative otitis media. This should be considered in future work and is not surprising given that many VSB recipients have a complicated hearing history, often associated with otitis media

Evaluating the effectiveness and reliability of the Vibrant Soundbridge and Bonebridge auditory implants in clinical practice: Study design and methods for a multi-centre longitudinal observational study.

BACKGROUND: The Vibrant Soundbridge middle ear implant and the Bonebridge bone conducting hearing device are hearing implants that use radio frequency transmission to send information from the sound processor to the internal transducer. This reduces the risk of skin problems and infection but requires a more involved surgical procedure than competitor skin penetrating devices. It is not known whether more complex surgery will lead to additional complications. There is little information available on the reliability of these systems and adverse medical or surgical events. The primary research question is to determine the reliability and complication rate for the Vibrant Soundbridge and Bonebridge. The secondary research question explores changes in quality of life following implantation of the devices. The tertiary research question looks at effectiveness via changes in auditory performance. METHOD: The study was designed based on a combination of a literature search, two clinician focus groups and expert review.A multi-centre longitudinal observational study was designed. There are three study groups, two will have been implanted prior to the start of the study and one group, the prospective group, will be implanted after initiation of the study. Outcomes are surgical questionnaires, measures of quality of life, user satisfaction and speech perception tests in quiet and in noise. CONCLUSION: This is the first multi-centre study to look at these interventions and includes follow up over time to understand effectiveness, reliability, quality of life and complications

Causal Economic Interactions between CO2 Emissions and Economic Growth

The environmental penalties of trade openness and foreign direct investment (FDI) got significant consideration in the current era. In this article, we aim to explore the impact of causal interactions of CO2 emission with FDI and trade openness on the economic growth of Pakistan's economy. The data are based on the period from 1972 to 2019. The Fully Modified OLS (FMOLS) cointegration procedure is used to gauge out the optimal long-run effects of these interactions on economic growth. The outcomes of cointegration regression show that the control variables; domestic investment, labor force and targeted variables CO2 emission, trade openness, FDI are having long-run significant relations with economic growth. The interaction terms, CO2 emission with trade openness and CO2 emission with FDI are showing positive relation to economic growth, but the interaction term of CO2 emission with FDI is not demonstrating a significant long-run relationship with economic growth. However, the second interaction term CO2 emission with trade openness is showing a significant positive relationship with economic growth. It indicates that a rise in foreign trade flourishes economic growth but at the cost of environmental damage

Large-scale remediation of oil-contaminated water using floating treatment wetlands

Oil-contaminated water: floating treatment wetlands Floating treatment wetlands, in combination with hydrocarbon-degrading bacteria, can effectively treat oil-contaminated water. Hydrocarbon-contaminated water pits are a result of oil and gas exploration. An international team from Pakistan, Denmark and the USA demonstrate an effective means for the large-area treatment of such pits at a site in Pakistan. They create a floating mat composed of four different plants and inoculate the mat with ten types of hydrocarbon-degrading bacteria. Within 18 months a number of key water quality parameters are improved by at least 80%, and the plants not only survived but grew. This study demonstrates that floating treatment wetlands can be effective for the long-term clean-up of oil-contaminated water

In Situ Fabrication of Foamed Titania Carbon Nitride Nanocomposite and Its Synergetic Visible-Light Photocatalytic Performance

Efficient visible-light-driven materials are key for environmental remediation. The foamed titania–carbon nitride nanocomposite (FTCN) was synthesized by in situ microemulsification followed by calcination using bulk g-C₃N₄ and TBOT. During calcination the bulk g-C₃N₄ transformed into ultrathin nanosheets. The nanocomposite is characterize by state of the art physicochemical techniques; the structure look like foam with mesoporous cavities. The carbon nitride nanosheets were uniformly distributed and mostly embedded inside the bulk of titania with close interfacial connection. The FTCN-3 nanocomposite has superior degradation performance for MB and RhB with rate constants of 0.096 and 0.061 (min^–1), respectively. This upmost photocatalytic activity could be ascribed to large <i>S</i>_BET (339 m² g^–1) and foamed structure. These are considered significant factors for efficient visible-light absorption and slow recombination of charges during photocatalysis. This is an inventive strategy to enhance the potential of TiO₂ in diverse fields