A kit and process of using for diagnosing multiple intelligences profile of an individual with verbal communication limitations from observational behavior. A trailing end is pressed in the predetermined reference direction by the first component. The prosthesis can also be without flange or have a tubular member with tapered center to peripheral part or from external part to intraluminal one, and it can be cut in the desired size and gauge. The exit orifice is adapted to receive the pressurized liquid from the chamber and pass the liquid out of the die housing. Various surgical implantation apparatus and methods for achieving proper device-to-anatomy juxtapositional relationships are employed in the implantation approach. Additionally, the rivet washer includes a membrane with at least one raised high pressure point skirt or rib and at least one recessed trough that provides a continuous seal over the outer surface of the washer body, the rivet body, and the mandrel head, and is sealably and continuously connected to the perimeter of the washer body and optionally a circumferential portion of the outer surface.