In Vitro Inflammatory Cell-Induced Corrosion Using a Lymphocyte and Macrophage Coculture.

BACKGROUND: Cobalt-chromium-molybdenum (CoCrMo) and titanium alloys have been used for orthopaedic implants for decades. However, recent evidence has shown that inflammatory cell-induced corrosion (ICIC) can damage these metal alloys. This study aimed to investigate the mechanisms of ICIC by coculturing macrophages with lymphocytes. We hypothesized that macrophages would be able to alter the surface oxide layer of CoCrMo and titanium alloy (Ti6Al4V) disks, with greater oxide layer damage occurring in groups with a coculture compared to a macrophage monoculture and in groups with inflammatory activators compared to nonactivated groups. METHODS: Murine macrophages were cultured on American Society for Testing and Materials F1537 CoCrMo and F136 Ti6Al4V disks for 30 days and activated with interferon gamma and lipopolysaccharide. Interferon gamma and lipopolysaccharide were added to the culture medium to simulate local inflammation. Macrophages were either cultured alone or in a coculture with T helper lymphocytes. After the 30-day experiment, scanning electron microscopy was used to examine the disk surfaces, and oxide levels were found using energy dispersive x-ray spectroscopy. RESULTS: Pitting features consistent with previous reports of ICIC were found on disks cultured with cells. Both CoCrMo and Ti6Al4V disks had significantly lower oxide levels in all groups with cells compared to control groups with no cells (P < .01). Additionally, CoCrMo disks had significantly lower oxide levels when cultured with activated macrophages and lymphocytes compared to nonactivated macrophages alone (P < .001), activated macrophages alone (P < .01), and nonactivated macrophages and lymphocytes (P < .05). No differences in the oxide levels were found among the Ti6Al4V groups. CONCLUSIONS: This study demonstrates the ability of macrophages to alter the surface chemistry of commonly used orthopaedic alloys. We found that the addition of lymphocytes and a simulated local inflammatory response may contribute to the ICIC of CoCrMo implants.

Assistive technology evaluations: Remote-microphone technology for children with Autism Spectrum Disorder.

The goal of this study was to conduct assistive technology evaluations on 12 children diagnosed with Autism Spectrum Disorder (ASD) to evaluate the potential benefits of remote-microphone (RM) technology. A single group, within-subjects design was utilized to explore individual and group data from functional questionnaires and behavioral test measures administered, designed to assess school- and home-based listening abilities, once with and once without RM technology. Because some of the children were unable to complete the behavioral test measures, particular focus was given to the functional questionnaires completed by primary teachers, participants, and parents. Behavioral test measures with and without the RM technology included speech recognition in noise, auditory comprehension, and acceptable noise levels. The individual and group teacher (n=8-9), parent (n=8-9), and participant (n=9) questionnaire ratings revealed substantially less listening difficulty when RM technology was used compared to the no-device ratings. On the behavioral measures, individual data revealed varied findings, which will be discussed in detail in the results section. However, on average, the use of the RM technology resulted in improvements in speech recognition in noise (4.6dB improvement) in eight children, higher auditory working memory and comprehension scores (12-13 point improvement) in seven children, and acceptance of poorer signal-to-noise ratios (8.6dB improvement) in five children. The individual and group data from this study suggest that RM technology may improve auditory function in children with ASD in the classroom, at home, and in social situations. However, variability in the data and the inability of some children to complete the behavioral measures indicates that individualized assistive technology evaluations including functional questionnaires will be necessary to determine if the RM technology will be of benefit to a particular child who has ASD.

Fitting and verification of frequency modulation systems on children with normal hearing.

BACKGROUND: Several recent investigations support the use of frequency modulation (FM) systems in children with normal hearing and auditory processing or listening disorders such as those diagnosed with auditory processing disorders, autism spectrum disorders, attention-deficit hyperactivity disorder, Friedreich ataxia, and dyslexia. The American Academy of Audiology (AAA) published suggested procedures, but these guidelines do not cite research evidence to support the validity of the recommended procedures for fitting and verifying nonoccluding open-ear FM systems on children with normal hearing. Documenting the validity of these fitting procedures is critical to maximize the potential FM-system benefit in the above-mentioned populations of children with normal hearing and those with auditory-listening problems. PURPOSE: The primary goal of this investigation was to determine the validity of the AAA real-ear approach to fitting FM systems on children with normal hearing. The secondary goal of this study was to examine speech-recognition performance in noise and loudness ratings without and with FM systems in children with normal hearing sensitivity. RESEARCH DESIGN: A two-group, cross-sectional design was used in the present study. STUDY SAMPLE: Twenty-six typically functioning children, ages 5-12 yr, with normal hearing sensitivity participated in the study. INTERVENTION: Participants used a nonoccluding open-ear FM receiver during laboratory-based testing. DATA COLLECTION AND ANALYSIS: Participants completed three laboratory tests: (1) real-ear measures, (2) speech recognition performance in noise, and (3) loudness ratings. Four real-ear measures were conducted to (1) verify that measured output met prescribed-gain targets across the 1000-4000 Hz frequency range for speech stimuli, (2) confirm that the FM-receiver volume did not exceed predicted uncomfortable loudness levels, and (3 and 4) measure changes to the real-ear unaided response when placing the FM receiver in the child's ear. After completion of the fitting, speech recognition in noise at a -5 signal-to-noise ratio and loudness ratings at a +5 signal-to-noise ratio were measured in four conditions: (1) no FM system, (2) FM receiver on the right ear, (3) FM receiver on the left ear, and (4) bilateral FM system. RESULTS: The results of this study suggested that the slightly modified AAA real-ear measurement procedures resulted in a valid fitting of one FM system on children with normal hearing. On average, prescriptive targets were met for 1000, 2000, 3000, and 4000 Hz within 3 dB, and maximum output of the FM system never exceeded and was significantly lower than predicted uncomfortable loudness levels for the children. There was a minimal change in the real-ear unaided response when the open-ear FM receiver was placed into the ear. Use of the FM system on one or both ears resulted in significantly better speech recognition in noise relative to a no-FM condition, and the unilateral and bilateral FM receivers resulted in a comfortably loud signal when listening in background noise. CONCLUSIONS: Real-ear measures are critical for obtaining an appropriate fit of an FM system on children with normal hearing.