Anfangsgrinde dr ariṭmeṭik tzum gbroich dr jugnd der jidišn naṭtziohn inzondrheiṭ ...

frfassṭ und heroisgegebn fon Feibš Segel Hurwitz

Sēfer ḥaqîrôt hal-lēv : bi-lešôn aškenaz ; hû ḥibbûr nā'ē mālē mûsār we-ḥōkemôt ...

ḥibbērô ... Šelōmō Zelman ... Ben-...Šimʿôn Weṣlr ... miq-q"q Firda

Sēfer Śimḥat han-nefeš : drinn werṭ gfundn gwiśi refues for dages un zorgn ; woś den laiṭn fil šedigṭ tz guf un nešome wen mn zi halṭ for borgn ...

[Elchanan Haendel Kirchhahn]

Ein wundrliche šine hisṭorie miṭ namin di @Zibn waizn mainśṭrs fun Rom : di noch ein mal fr lange tzaiṭ in Ṭaiṣ̌land iz gdrukṭ giwezn

[Jakob Maarssen]

Maftēaḥ lešôn haq-qôdeš : welchś biṭrachṭ hoṭ ... do miṭ zi zoln kenn di (tôrā nevî'îm û-ktûvîm) miṭ ali (šôrāšîm) ... fer ṭaiṭšn ...

... Jiśroel Ben-Avraham Avinu

Orden de leccion de Tora, Nebihim, y Quetubim : que por devocion deven [sic] leer todos los temientes del Señor en las noches de Sebuhoth y Hosaana Raba.

Mode of access: Internet.

Do ‘passive’ medical titanium surfaces deteriorate in service in the absence of wear?

Globally, more than 1000 tonnes of titanium (Ti) is implanted into patients in the form of biomedical devices on an annual basis. Ti is perceived to be ‘biocompatible’ owing to the presence of a robust passive oxide film (approx. 4 nm thick) at the metal surface. However, surface deterioration can lead to the release of Ti ions, and particles can arise as the result of wear and/or corrosion processes. This surface deterioration can result in peri-implant inflammation, leading to the premature loss of the implanted device or the requirement for surgical revision. Soft tissues surrounding commercially pure cranial anchorage devices (bone-anchored hearing aid) were investigated using synchrotron X-ray micro-fluorescence spectroscopy and X-ray absorption near edge structure. Here, we present the first experimental evidence that minimal load-bearing Ti implants, which are not subjected to macroscopic wear processes, can release Ti debris into the surrounding soft tissue. As such debris has been shown to be pro-inflammatory, we propose that such distributions of Ti are likely to effect to the service life of the device.

A smart micro-drill for cochleostomy formation:a comparison of cochlear disturbances with manual drilling and a human trial

Background: Cochleostomy formation is a key stage of the cochlear implantation procedure. Minimizing the trauma sustained by the cochlea during this step is thought to be a critical feature in hearing preservation cochlear implantation. The aim of this paper is firstly, to assess the cochlea disturbances during manual and robotic cochleostomy formation. Secondly, to determine whether the use of a smart micro-drill is feasible during human cochlear implantation. Materials and methods: The disturbances within the cochlea during cochleostomy formation were analysed in a porcine specimen by creating a third window cochleostomy, preserving the underlying endosteal membrane, on the anterior aspect of the basal turn of the cochlea. A laser vibrometer was aimed at this third window, to assess its movement while a traditional cochleostomy was performed. Six cochleostomies were performed in total, three manually and three with a smart micro-drill. The mean and peak membrane movement was calculated for both manual and smart micro-drill arms, to represent the disturbances sustained within cochlea during cochleostomy formation. The smart micro-drill was further used to perform live human robotic cochleostomies on three adult patients who met the National Institute of Health and Clinical Excellence criteria for undergoing cochlear implantation. Results: In the porcine trial, the smart micro-drill preserved the endosteal membrane in all three cases. The velocity of movement of the endosteal membrane during manual cochleostomy is approximately 20 times higher on average and 100 times greater in peak velocity, than for robotic cochleostomy. The robot was safely utilized in theatre in all three cases and successfully created a bony cochleostomy while preserving the underlying endosteal membrane. Conclusions: Our experiments have revealed that controlling the force of drilling during cochleostomy formation and opening the endosteal membrane with a pick will minimize the trauma sustained by the cochlea by a factor of 20. Additionally, the smart micro-drill can safely perform a bony cochleostomy in humans under operative conditions and preserve the integrity of the underlying endosteal membrane. © W. S. Maney & Son Ltd 2013.

A sensory-guided surgical micro-drill

This article describes a surgical robotic device that is able to discriminate tissue interfaces and other controlling parameters ahead of the drill tip. The advantage in such a surgery is that the tissues at the interfaces can be preserved. A smart tool detects ahead of the tool point and is able to control the interaction with respect to the flexing tissue, to avoid penetration or to control the extent of protrusion with respect to the position of the tissue. For surgical procedures, where precision is required, the tool offers significant benefit. To interpret the drilling conditions and the conditions leading up to breakthrough at a tissue interface, a sensing scheme is used that discriminates between the variety of conditions posed in the drilling environment. The result is a fully autonomous system, which is able to respond to the tissue type, behaviour, and deflection in real-time. The system is also robust in terms of disturbances encountered in the operating theatre. The device is pragmatic. It is intuitive to use, efficient to set up, and uses standard drill bits. The micro-drill, which has been used to prepare cochleostomies in the theatre, was used to remove the bone tissue leaving the endosteal membrane intact. This has enabled the preservation of sterility and the drilling debris to be removed prior to the insertion of the electrode. It is expected that this technique will promote the preservation of hearing and reduce the possibility of complications. The article describes the device (including simulated drill progress and hardware set-up) and the stages leading up to its use in the theatre. © 2010 Authors.

A smart surgical robotic for cochlear implantation

In this paper a surgical robotic device for cochlear implantation surgery is described that is able to discriminate tissue interfaces and other controlling parameters ahead of a drill tip. The advantage in surgery is that tissues at interfaces can be preserved. The smart tool is able to control interaction with respect to the flexing tissue to avoid penetration control the extent of protrusion with respect to the real-time position of the tissue. To interpret drilling conditions, and conditions leading up to breakthrough at a tissue interface, the sensing scheme used enables discrimination between the variety of conditions posed in the drilling environment. The result is a robust fully autonomous system able to respond to tissue type, behaviour and deflection in real-time. The paper describes the robotic tool that has been designed to be used in the surgical environment where it has been used in the operating room.

Mechatronic solutions for measuring disturbance levels within a cochlea

Hearing implants are an important devices for combating deafness over the next 15 years. In this paper, we focus on the means to determine the sensitivity of the hearing organ to disturbances produced by implants and other interventions, and those induced by implantation. The preservation of residual hearing is an important aspect to be considered, however, the sensitivity of this to the process of implantation, device location and power levels is not well understood. Within this paper, a new experimental set-up to contrast the merits of different implantation techniques, implant location and power transmission are discussed and the initial results regarding disturbance levels using different surgical techniques are described.