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Predicting cochlear implant performance: Moving beyond single biomarkers and leveraging artificial intelligence
Matthew Shew, Amit Walia, and Craig A. Buchman highlight that the significant variability in speech perception among cochlear implant users can be addressed by using a multi- faceted approach that incorporates emerging technologies like machine learning and artificial intelligence to improve outcome prediction models. Cochlear implants (CIs) represent one of the most successful neural prostheses, providing discrete frequency and intensity electrical stimulation to restore hearing, improve speech understanding, and enhance quality of life. Despite their transformative impact, a significant challenge remains: the substantial variability in speech perception outcomes among CI users. (1) While current methodologies excel at identifying individuals with severe hearing loss and, thus, strong CI candidates, they fall short in predicting the degree of benefit each recipient will gain from the device. This limitation hinders personalized care and underscores the need for more advanced predictive tools.

Background: Small cardiac tissue engineering constructs show promise for limiting post-infarct sequelae in animal models. This study sought to scale-up a 2-cm2 preclinical construct into a human-size advanced therapy medicinal product (ATMP; PeriCord), and to test it in a first-in-human implantation. Methods: The PeriCord is a clinical-size (12-16 cm2) decellularised pericardial matrix colonised with human viable Wharton's jelly-derived mesenchymal stromal cells (WJ-MSCs). WJ-MSCs expanded following good manufacturing practices (GMP) met safety and quality standards regarding the number of cumulative population doublings, genomic stability, and sterility. Human decellularised pericardial scaffolds were tested for DNA content, matrix stiffness, pore size, and absence of microbiological growth. Findings: PeriCord implantation was surgically performed on a large non-revascularisable scar in the inferior wall of a 63-year-old male patient. Coronary artery bypass grafting was concomitantly performed in the non-infarcted area. At implantation, the 16-cm2 pericardial scaffold contained 12.5E6 viable WJ-MSCs (85.4% cell viability; <0.51 endotoxin units (EU)/mL). Intraoperative PeriCord delivery was expeditious, and secured with surgical glue. The post-operative course showed non-adverse reaction to the PeriCord, without requiring host immunosuppression. The three-month clinical follow-up was uneventful, and three-month cardiac magnetic resonance imaging showed ~9% reduction in scar mass in the treated area. Interpretation: This preliminary report describes the development of a scalable clinical-size allogeneic Peri- Cord cardiac bioimplant, and its first-in-human implantation. Funding: La Marató de TV3 Foundation, Government of Catalonia, Catalan Society of Cardiology, "La Caixa" Banking Foundation, Spanish Ministry of Science, Innovation and Universities, Institute of Health Carlos III, and the European Regional Development Fund.

This essay ponders on the thorny issue of including artificial beings under the category of "citizen." The increasing humanization of the artificial being, it suggests, prevents us from seeing and treating the machine as a being. But if the humanoid robot performs all the functions of a human being, and acquires cultural traits such as emotional intelligence, rational thinking, or altruism, then on what grounds do we deny it the same status as a human person? Conversely, as more and more humans are cyborged, through transplants, implants, and prostheses, resulting in an erasure of their "core" humanity, then what is the difference between such a cyborged human with human rights and an artificial being?

La investigación explica la aplicación de la inteligencia artificial, la cual ayuda a mejorar las técnicas de aplicación de un implante dental. Se uso la investigación documental, recolectando datos mediante el método de registro descriptivo y se analizaron con una técnica de análisis de contenido. El análisis bibliométrico ayudó a realizar la búsqueda de información en tres bases de datos: Scopus, Pubmed y World of Science. El trabajo está integrado por investigaciones que analizaron los modelos de inteligencia artificial, que reconocen el tipo de implante a ser usado. Se concluyó, que se desarrollaron modelos de inteligencia artificial que mejoran la tensión de la conexión implante-hueso, además de optimizar la porosidad, la longitud y el diámetro de los implantes dentales.

Several obstacles must be overcome before preliminary cost-utility analyses (CUA) of prosthetic care innovations can be routinely performed. The basic framework of preliminary CUAs and hands-on recommendations suggested previously might contribute to wider adoption. However, a practical application for an emerging intervention is needed to showcase the capacity of this proposed preliminary CUA framework. This study presented the outcomes of preliminary CUA of the distal weight bearing Keep Walking Implant (KWI), an emerging prosthetic care innovation that may reduce socket fittings for individuals with transfemoral amputation. The preliminary CUAs compared the provision of prosthetic care without (usual intervention) and with the KWI (new intervention) using a 15-step iterative process focused on feasibility, constructs, analysis, and interpretations of outcomes from an Australia government prosthetic care perspective over a six-year time horizon. Baseline and incremental costs were extracted from schedules of allowable expenses. Baseline utilities were extracted from a study and converted into quality-adjusted life-year (QALY). Incremental utilities were calculated based on sensible gains of QALY from baselines. The provision of the prosthetic care with the KWI could generate an indicative incremental cost-utility ratio (ICUR) of -$36,890 per QALY, which was $76,890 per QALY below willingness-to-pay threshold, provided that the KWI reduces costs by $17,910 while increasing utility by 0.485 QALY compared to usual interventions. This preliminary CUA provided administrators of healthcare organizations in Australia and elsewhere with prerequisite evidence justifying further access to market and clinical introduction of the KWI. Altogether, this work suggests that the basic framework of the preliminary CUA of a prosthetic care innovation proposed previously is feasible and informative when a series of assumptions are carefully considered. This study further confirms that preliminary CUAs prosthetic care interventions might be a relevant alternative to full CUA for other medical treatments. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36366/28329 How To Cite: Guirao L, Samitier B, Frossard L. A preliminary cost-utility analysis of the prosthetic care innovations: case of the keep walking implant. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.11. https://doi.org/10.33137/cpoj.v4i2.36366 Corresponding Author: Laurent Frossard (PhD), Professor of BionicsYourResearchProject Pty Ltd, Brisbane, Australia.E-Mail: laurentfrossard@outlook.comORCID number: orcid:0000-0002-0248-9589

Abstract Several obstacles must be overcome before preliminary cost-utility analyses (CUA) of prosthetic care innovations can be routinely performed. The basic framework of preliminary CUAs and hands-on recommendations suggested previously might contribute to wider adoption. However, a practical application for an emerging intervention is needed to showcase the capacity of this proposed preliminary CUA framework. This study presented the outcomes of preliminary CUA of the distal weight bearing Keep Walking Implant (KWI), an emerging prosthetic care innovation that may reduce socket fittings for individuals with transfemoral amputation. The preliminary CUAs compared the provision of prosthetic care without (usual intervention) and with the KWI (new intervention) using a 15-step iterative process focused on feasibility, constructs, analysis, and interpretations of outcomes from an Australia government prosthetic care perspective over a six-year time horizon. Baseline and incremental costs were extracted from schedules of allowable expenses. Baseline utilities were extracted from a study and converted into quality-adjusted life-year (QALY). Incremental utilities were calculated based on sensible gains of QALY from baselines. The provision of the prosthetic care with the KWI could generate an indicative incremental cost-utility ratio (ICUR) of -$36,890 per QALY, which was $76,890 per QALY below willingness-to-pay threshold, provided that the KWI reduces costs by $17,910 while increasing utility by 0.485 QALY compared to usual interventions. This preliminary CUA provided administrators of healthcare organizations in Australia and elsewhere with prerequisite evidence justifying further access to market and clinical introduction of the KWI. Altogether, this work suggests that the basic framework of the preliminary CUA of a prosthetic care innovation proposed previously is feasible and informative when a series of assumptions are carefully considered. This study further confirms that preliminary CUAs prosthetic care ...

Front Cover -- Artificial Intelligence in Behavioral and Mental Health Care -- Copyright Page -- Contents -- List of Contributors -- About the Editor -- Preface -- 1 An Introduction to Artificial Intelligence in Behavioral and Mental Health Care -- Introduction and Overview -- Key Concepts and Technologies -- What Is AI? -- Machine Learning and Artificial Neural Networks -- Natural Language Processing -- Machine Perception and Sensing -- Affective Computing -- Virtual and Augmented Reality -- Cloud Computing and Wireless Technologies -- Robotics -- BCIs and Implants -- Supercomputing and Brain Simulation -- The Turing Test -- Technological Barriers -- Benefits of AI for Behavioral and Mental Health Care -- Intelligent Machines Are Better at Some Things -- Improved Self-Care and Access to Care -- Integration and Customization of Care -- Economic Benefits -- Additional Considerations -- Conclusion -- References -- Additional Resources -- 2 Expert Systems in Mental Health Care: AI Applications in Decision-Making and Consultation -- Introduction -- The History - Expert Systems and Clinical Artificial Intelligence in Health Care -- The Present - Dynamical Approaches to Clinical AI and Expert Systems -- Temporal Modeling Overview -- Real-World Clinical Applications - Predicting in a Dynamic World -- Multi-Agent Models for Personalized Medicine -- Technology-Enhanced Clinicians -- Summary of Dynamical Approaches for Clinical AI -- The Future -- Cognitive Computing in Health Care -- The Intersection Between Other Emerging Technologies and Clinical Artificial Intelligence -- Ethics and Challenges -- Conclusion -- References -- 3 Autonomous Virtual Human Agents for Healthcare Information Support and Clinical Interviewing -- Introduction -- The Rationale and Brief History of the Clinical Use of VHs -- Use Cases: SimCoach and SimSensei.

The work described in this thesis was part the European consortium DRIVE (Diabetes-reversing implants with enhanced viability and long-term efficacy), which was funded by European Union's Horizon 2020 research and innovation program. The aim of the DRIVE consortium was to develop a pancreatic islet transplantation device that functions as an "artificial pancreas" for treating diabetes type 1. One of the major hurdles towards clinical success of such a pancreatic islet transplantation device is the poor islet survival due to insufficient supply of nutrients and oxygen. To tackle this, microspheres that release vascular endothelial growth factor (VEGF) in an appropriate time frame for the induction of blood vessel formation (angiogenesis) are included in the devices that are developed for the DRIVE approach for encapsulation of pancreatic islets. As a result, the device will be vascularized, thereby supplying islets with oxygen and nutrients and removing waste products via the blood circulation. The work in this thesis focused on the development of sustained release formulations of VEGF and other proangiogenic growth factors via mild, protein-friendly encapsulation methods. In this context, endothelial cell based assays were applied for evaluating the bioactivity of released growth factors. Special emphasis was laid on obtaining a target release time frame of four weeks, which has been shown as ideal for stable blood vessel formation in rodent models.

Shipping list no.: 93-0529-P. ; Distributed to some depository libraries in microfiche. ; Includes bibliographical references (p. 61-64). ; Mode of access: Internet.

"Introduction: In the context of a relatively constant heart donation rate, the effort to satisfy the needs, has led to the development of mechanical devices that can replace the cardiac function. Estimating an annual potential of 100,000 artificial heart implants in the United States alone, there is an increased interest in these devices, which is why it is appropriate to explore the situations where its inactivation may be ethically appropriate. Method: We performed a systematic review, which includes all the studies regarding the dilemma of artificial hearts inactivation from the beginning until 2020, published in PubMed, Embase and Scopus. The searched keywords were "totally artificial heart and ethics"; the duplicate studies and those referring to other cardiac support devices were excluded. Results: Following the selection, 12 articles were included in the review. The conflict between the principle of discontinuity and the prohibition generated by the indispensability of the artificial heart was emphasized. The decision to inactivate the support dependent on the patient's declared level of happiness or clinical evolution over time was reviewed. The dilemma of self-inactivation of artificial cardiac support as suicide versus the acceptance of death caused by the underlying heart condition, as well as the impact of total removal of the native heart were included in the ethical analysis. Conclusions: Requests for withdrawal of TAH support are not uncommon among patients, their discontinuation being ethically acceptable when it does not serve the patient's interests, even though they may still be capable to prolong their life. "

Shipping list no.: 94-0291-P. ; Distributed to some depository libraries in microfiche. ; Includes bibliographical references (p. 152-153). ; Mode of access: Internet.

Bioengineered artificial skin substitutes (BASS) are the main treatment used in addition to autografts when skin injuries involve a large body surface area. Antiseptic/antibiotic treatment is necessary to prevent infections in the BASS implant area. This study aims to evaluate the effect of antiseptics and antibiotics on cell viability, structural integrity, and epidermal barrier function in BASS based on hyaluronic acid during a 28 day follow-up period. Keratinocytes (KTs) and dermal fibroblasts (DFs) were isolated from skin samples and used to establish BASS. The following antibiotic/antiseptic treatment was applied every 48 h: colistin (1%), chlorhexidine digluconate (1%), sodium chloride (0.02%), and polyhexanide (0.1%). Cell viability (LIVE/DEAD® assay), structural integrity (histological evaluation), and epidermal barrier function (trans-epidermal water loss, (TEWL), Tewameter®) were also evaluated. Cell viability percentage of BASS treated with chlorhexidine digluconate was significantly lower (p 0.001) than the other antiseptics at day 28. Compared to other treatments, chlorhexidine digluconate and polyhexanide significantly affected the epithelium. No significant differences were found regarding epidermal barrier. These results may be useful for treatment protocols after implantation of BASS in patients and evaluating them in clinical practice. BASS represent a suitable model to test in vitro the impact of different treatments of other skin wounds. ; Ministry of Science, Innovation and Universities of Spain ; University of Granada ; Instituto de Salud Carlos III PI13/02576 PI17/02083 ; European Regional Development Fund "A way to make Europe" ; Andalusian Regional Government SAS PI-0458-2016

Intro -- Preface -- Acknowledgments -- Contents -- About the Author -- A Brief Comment About Predictionsand Examples Used in the Book -- 1 The Technological Future -- Introduction -- Enhancing Humans -- Humans, Bionics, and Cyborgs -- Brain-Computer Interfaces -- Biological Enhancements -- New Opportunities in the 21st Century -- Cyborgs and Virtual Reality -- Cyborg Disputes -- Two Technologically Driven Revolutions -- Merging with Machines -- Questions for Our Cyborg Future -- The Reemergence of Luddites -- Enter the Horse -- Concluding Thoughts -- 2 The Coming Singularity -- Questions of Law and Policy -- Towards Machine Sentience -- Telepathy, Brain Nets, and Cyborgs -- Bodily Integrity -- The Singularity and Concerns for the Future -- Introducing Watson -- Who's Getting Smarter? -- Returning to Law and Regulations -- Summary -- 3 The Law of Artificially Intelligent Brains -- Placing an Exponent on Intelligence -- The Numbers Behind Brains -- Law and Brains -- More About Artificially Intelligent Brains -- Machine Learning and Brain Architectures -- Brain Architecture -- Hardware Protection for Artificially Intelligent Brains -- Our Competition Against Better Brains -- 4 Cognitive Liberty, Brain Implants, and Neuroprosthesis -- Introduction -- Medical Necessity and Beyond -- Third-Party Access to Our Minds -- Concerns and Roadblocks -- A Focus on Cognitive Liberty -- Reading the Brain, Lie Detection, and Cognitive Liberty -- Towards Telepathy -- Creating Artificial Memories -- Litigating Cognitive Liberty -- Implanting a Software Virus in the Mind -- Conclusion -- 5 Modifying, Enhancing, and Hacking the Body -- Introduction -- Hacking the Body -- The Risks of Body Hacking and Cyborg Technology -- Prosthesis, Implants and Law -- Body Hacking in the Digital Age -- Sensors and Implantable Devices -- Issues of Software -- Machines Hacking Machines.