Choroidal thickness in myopic and non-myopic children assessed with enhanced depth imaging optical coherence tomography

Purpose To examine choroidal thickness (ChT) and its topographical variation across the posterior pole in myopic and non-myopic children. Methods One hundred and four children aged 10-15 years of age (mean age 13.1 ± 1.4 years) had ChT measured using enhanced depth imaging optical coherence tomography (OCT). Forty one children were myopic (mean spherical equivalent -2.4 ± 1.5 D) and 63 non-myopic (mean +0.3 ± 0.3 D). Two series of 6 radial OCT line scans centred on the fovea were assessed for each child. Subfoveal ChT and ChT across a series of parafoveal zones over the central 6mm of the posterior pole were determined through manual image segmentation. Results Subfoveal ChT was significantly thinner in myopes (mean 303 ± 79 µm) compared to non-myopes (mean 359 ± 77 µm) (p<0.0001). Multiple regression analysis revealed both refractive error (r = 0.39, p<0.001) and age (r = 0.21, p = 0.02) were positively associated with subfoveal ChT. ChT also exhibited significant topographical variations, with the choroid being thicker in more central regions. The thinnest choroid was typically observed in nasal (mean 286 ± 77 µm) and inferior-nasal (306 ± 79 µm) locations, and the thickest in superior (346 ± 79 µm) and superior-temporal (341 ± 74 µm) locations. The difference in ChT between myopic and non-myopic children was significantly greater in central foveal regions compared to more peripheral regions (>3 mm diameter) (p<0.001). Conclusions Myopic children have significantly thinner choroids compared to non-myopic children of similar age, particularly in central foveal regions. The magnitude of difference in choroidal thickness associated with myopia appears greater than would be predicted by a simple passive choroidal thinning with axial elongation.

Exploring retinal markers of diabetic neuropathy

Purpose To investigate the application of retinal nerve fibre layer (RNFL) thickness as a marker for severity of diabetic peripheral neuropathy (DPN) in people with Type 2 diabetes. Methods This was a cross-sectional study whereby 61 participants (mean age 61 [41-75 years], mean duration of diabetes 14 [1-40 years], 70% male) with Type 2 diabetes and DPN underwent optical coherence tomography (OCT) scans. Global and 4 quadrant (TSNI) RNFL thicknesses were measured at 3.45mm around the optic nerve head of one eye. Neuropathy disability score (NDS) was used to assess the severity of DPN on a 0 to 10 scale. Participants were divided into three age-matched groups representing mild (NDS=3-5), moderate (NDS=6-8) and severe (NDS=9-10) neuropathy. Two regression models were fitted for statistical analysis: 1) NDS scores as co-variate for global and quadrant RNFL thicknesses, 2) NDS groups as a factor for global RNFL thickness only. Results Mean (SD) RNFL thickness (µm) was 103(9) for mild neuropathy (n=34), 101(10) for moderate neuropathy (n=16) and 95(13) in the group with severe neuropathy (n=11). Global RNFL thickness and NDS scores were statistically significantly related (b=-1.20, p=0.048). When neuropathy was assessed across groups, a trend of thinner mean RNFL thickness was observed with increasing severity of neuropathy; however, this result was not statistically significant (F=2.86, p=0.065). TSNI quadrant analysis showed that mean RNFL thickness reduction in the inferior quadrant was 2.55 µm per 1 unit increase in NDS score (p=0.005). However, the regression coefficients were not statistically significant for RNFL thickness in the superior (b=-1.0, p=0.271), temporal (b=-0.90, p=0.238) and nasal (b=-0.99, p=0.205) quadrants. Conclusions RNFL thickness was reduced with increasing severity of DPN and the effect was most evident in the inferior quadrant. Measuring RNFL thickness using OCT may prove to be a useful, non-invasive technique for identifying severity of DPN and may also provide additional insight into common mechanisms for peripheral neuropathy and RNFL damage.

Retinal nerve fibre layer thickness is associated with higher risk of foot ulceration in diabetic peripheral neuropathy

Purpose To evaluate the association between retinal nerve fibre layer (RNFL) thickness and diabetic peripheral neuropathy in people with type 2 diabetes, and specifically those at higher risk of foot ulceration. Methods RNFL thicknesses was measured globally and in four quadrants (temporal, superior, nasal and inferior) at 3.45 mm diameter around the optic nerve head using optical coherence tomography (OCT). Severity of neuropathy was assessed using the Neuropathy Disability Score (NDS). Eighty-two participants with type 2 diabetes were stratified according to NDS scores (0-10) as: none, mild, moderate, and severe neuropathy. A control group was additionally included (n=17). Individuals with NDS≥ 6 (moderate and severe neuropathy) have been shown to be at higher risk of foot ulceration. A linear regression model was used to determine the association between RNFL and severity of neuropathy. Age, disease duration and diabetic retinopathy levels were fitted in the models. Independent t-test was employed for comparison between controls and the group without neuropathy, as well as for comparison between groups with higher and lower risk of foot ulceration. Analysis of variance was used to compare across all NDS groups. Results RNFL thickness was significantly associated with NDS in the inferior quadrant (b= -1.46, p=0.03). RNFL thicknesses globally and in superior, temporal and nasal quadrants did not show significant associations with NDS (all p>0.51). These findings were independent of the effect of age, disease duration and retinopathy. RNFL was thinner for the group with NDS ≥ 6 in all quadrants but was significant only inferiorly (p<0.005). RNFL for control participants was not significantly different from the group with diabetes and no neuropathy (superior p=0.07, global and all other quadrants: p>0.23). Mean RNFL thickness was not significantly different between the four NDS groups globally and in all quadrants (p=0.08 for inferior, P>0.14 for all other comparisons). Conclusions Retinal nerve fibre layer thinning is associated with neuropathy in people with type 2 diabetes. This relationship is strongest in the inferior retina and in individuals at higher risk of foot ulceration.

A bricoleur (or two) in the consulting room

In popular contemporary use, the French term bricolage refers to the activities of the home handyman. It is sometimes used in a disparaging way to refer to work that is improvised, uninformed by expertise or specialist knowledge, and probably inferior in its results when compared with the work of a tradesman or professional. In 1962, anthropologist and philosopher Claude Lévi-Strauss argued that bricolage is a modality of human thought. Since then, the importance of bricolage as a mental activity has been identified in relation to art and architecture, as well as other fields of cultural activity. In this paper I consider bricolage as an activity of the ego and explore its role in the consulting room. I argue that by necessity the psychoanalytic work undertaken between patient and analyst relies on this modality of thought and, furthermore, that the use of bricolage is entirely compatible with evidence-based practice.

Resection-intersection bundle adjustment revisited

Bundle adjustment is one of the essential components of the computer vision toolbox. This paper revisits the resection-intersection approach, which has previously been shown to have inferior convergence properties. Modifications are proposed that greatly improve the performance of this method, resulting in a fast and accurate approach. Firstly, a linear triangulation step is added to the intersection stage, yielding higher accuracy and improved convergence rate. Secondly, the effect of parameter updates is tracked in order to reduce wasteful computation; only variables coupled to significantly changing variables are updated. This leads to significant improvements in computation time, at the cost of a small, controllable increase in error. Loop closures are handled effectively without the need for additional network modelling. The proposed approach is shown experimentally to yield comparable accuracy to a full sparse bundle adjustment (20% error increase) while computation time scales much better with the number of variables. Experiments on a progressive reconstruction system show the proposed method to be more efficient by a factor of 65 to 177, and 4.5 times more accurate (increasing over time) than a localised sparse bundle adjustment approach.

The younger audience : children and broadcasting in New Zealand

The role and influence of media in the The lives of children are ongoing sources of public, political and academic debates. These debates move back and forth along a care-control continuum (Cohen, 1997), and reflect a commitment both to educate children and to regulate their media experiences. Rapid advancements in computer technologies have vastly expanded the range of media experiences available to children. The development of Internet information and the rapid expansion of channels as a result of digital television have created increasingly accessible and diverse sources of media for children. These media are instantaneous and, in some circumstances, constantly available. As a result, a substantial body of international research has emerged that examines the influence of media consumption on children. How much time do children spend interacting with media? What sorts of media do they access? Are media harmful or beneficial to children? If so, in which contexts? Do media influence children’s personal development? And what role should governments, broadcasters and independent producers play in the regulation of the media? These questions remain central to contemporary debates about children and the media. This paper examines current patterns of television and radio consumption by New Zealand children in the context of household and peer environments. It explores parental attitudes towards and responsibilities for the protection of children in relation to broadcast media. The paper also aims to provide children with a voice by exploring their views about media content, and how they feel about the controls and regulations currently placed on their media consumption. Children do not constitute a unitary social category. They comprise a disparate group with diverse cultures and styles that must be examined from within. Rather than treating and studying children as inferior and underdeveloped beings, it is important to identify children as individual social actors (Smith, Taylor & Gollop, 2000). Children are often viewed as passive, invisible and irrational. However, a growing body of scholarship recognises that children are a heterogeneous group with valid and meaningful life experiences that must be accessed and analysed within specific cultural contexts (Burman, 1994; Atwool, 2000). In order to understand the media consumption habits of children and to explore issues of regulatory responsibility, it was essential to access children and their families. To this end, and within a New Zealand context, this paper enters relatively uncharted waters. To date, there are no other comprehensive New Zealand-based research projects that specifically identify the attitudes and behaviours of children in relation to broadcast media, and broadcasting standards.

Zymosan-induced inflammation stimulates neo-adipogenesis

Objective: To investigate the potential of inflammation to induce new adipose tissue formation in the in vivo environment. Methods and results: Using an established model of in vivo adipogenesis, a silicone chamber containing a Matrigel and fibroblast growth factor 2 (1 μg/ml) matrix was implanted into each groin of an adult male C57Bl6 mouse and vascularized with the inferior epigastric vessels. Sterile inflammation was induced in one of the two chambers by suspending Zymosan-A (ZA) (200-0.02 μg/ml) in the matrix at implantation. Adipose tissue formation was assessed at 6, 8, 12 and 24 weeks. ZA induced significant adipogenesis in an inverse dose-dependent manner (P<0.001). At 6 weeks adipose tissue formation was greatest with the lowest concentrations of ZA and least with the highest. Adipogenesis occurred both locally in the chamber containing ZA and in the ZA-free chamber in the contralateral groin of the same animal. ZA induced a systemic inflammatory response characterized by elevated serum tumour necrosis factor-α levels at early time points. Aminoguanidine (40 μg/ml) inhibited the adipogenic response to ZA-induced inflammation. Adipose tissue formed in response to ZA remained stable for 24 weeks, even when exposed to the normal tissue environment. Conclusions: These results demonstrate that inflammation can drive neo-adipogenesis in vivo. This suggests the existence of a positive feedback mechanism in obesity, whereby the state of chronic, low-grade inflammation, characteristic of the condition, may promote further adipogenesis. The mobilization and recruitment of a circulating population of adipose precursor cells is likely to be implicated in this mechanism.

Spontaneous large volume adipose tissue generation from a vascularized pedicled fat flap inside a chamber space

A novel method of spontaneous generation of new adipose tissue from an existing fat flap is described. A defined volume of fat flap based on the superficial inferior epigastric vascular pedicle in the rat was elevated and inset into a hollow plastic chamber implanted subcutaneously in the groin of the rat. The chamber walls were either perforated or solid and the chambers either contained poly(D,L-lactic-co-glycolic acid) (PLGA) sponge matrix or not. The contents were analyzed after being in situ for 6 weeks. The total volume of the flap tissue in all groups except the control groups, where the flap was not inserted into the chambers, increased significantly, especially in the perforated chambers (0.08 ± 0.007 mL baseline compared to 1.2 ± 0.08 mL in the intact ones). Volume analysis of individual component tissues within the flaps revealed that the adipocyte volume increased and was at a maximum in the chambers without PLGA, where it expanded from 0.04 ± 0.003 mL at insertion to 0.5 ± 0.08 mL (1250% increase) in the perforated chambers and to 0.16 ± 0.03 mL (400% increase) in the intact chambers. Addition of PLGA scaffolds resulted in less fat growth. Histomorphometric analysis rather than simple hypertrophy documented an increased number of adipocytes. The new tissue was highly vascularized and no fat necrosis or atypical changes were observed.

A disaggregate discrete choice model of transportation demand by elderly and disabled people in rural Virginia

This paper uses a correlated multinomial logit model and a Poisson regression model to measure the factors affecting demand for different types of transportation by elderly and disabled people in rural Virginia. The major results are: (a) A paratransit system providing door-to-door service is highly valued by transportation-handicapped people; (b) Taxis are probably a potential but inferior alternative even when subsidized; (c) Buses are a poor alternative, especially in rural areas where distances to bus stops may be long; (d) Making buses handicap-accessible would have a statistically significant but small effect on mode choice; (e) Demand is price inelastic; and (f) The total number of trips taken is insensitive to mode availability and characteristics. These results suggest that transportation-handicapped people take a limited number of trips. Those they do take are in some sense necessary (given the low elasticity with respect to mode price or availability). People will substitute away from relying upon others when appropriate transportation is available, at least to some degree. But such transportation needs to be flexible enough to meet the needs of the people involved.

No worries – we’ll take care of it!! An examination into managing equality and inclusivity in multicultural Australia

This paper explores the various paths to equality and inclusivity developed in the past 40 years within the Australian workplace with a view to critically examining their capability of addressing diversity and equality within the cultural needs of a unique society. A society which struggles to overcome the tyranny of distance and a colonial past as it takes its place in the world as a global 1st world economy country in what is often considered ‘the global north’ despite its geographical location. Findings indicate that despite various legislative and non-legislative approaches including anti-discrimination; affirmative action; equal opportunity; managing diversity and more recently gender equality, the individual members of the many diverse groups in the Australian workplace still experience inferior work conditions and work opportunities.

Exploring Retinal Markers of Diabetic Neuropathy

Purpose : To investigate the application of retinal nerve fibre layer (RNFL) thickness as a marker for severity of diabetic peripheral neuropathy (DPN) in people with Type 2 diabetes. Methods : This was a cross-sectional study whereby 61 participants (mean age 61 [41-75 years], mean duration of diabetes 14 [1-40 years], 70% male) with Type 2 diabetes and DPN underwent optical coherence tomography (OCT) scans. Global and 4 quadrant (TSNI) RNFL thicknesses were measured at 3.45mm around the optic nerve head of one eye. Neuropathy disability score (NDS) was used to assess the severity of DPN on a 0 to 10 scale. Participants were divided into three age-matched groups representing mild (NDS=3-5), moderate (NDS=6-8) and severe (NDS=9-10) neuropathy. Two regression models were fitted for statistical analysis: 1) NDS scores as co-variate for global and quadrant RNFL thicknesses, 2) NDS groups as a factor for global RNFL thickness only. Results : Mean (SD) RNFL thickness (µm) was 103(9) for mild neuropathy (n=34), 101(10) for moderate neuropathy (n=16) and 95(13) in the group with severe neuropathy (n=11). Global RNFL thickness and NDS scores were statistically significantly related (b=-1.20, p=0.048). When neuropathy was assessed across groups, a trend of thinner mean RNFL thickness was observed with increasing severity of neuropathy; however, this result was not statistically significant (F=2.86, p=0.065). TSNI quadrant analysis showed that mean RNFL thickness reduction in the inferior quadrant was 2.55 µm per 1 unit increase in NDS score (p=0.005). However, the regression coefficients were not statistically significant for RNFL thickness in the superior (b=-1.0, p=0.271), temporal (b=-0.90, p=0.238) and nasal (b=-0.99, p=0.205) quadrants. Conclusions : RNFL thickness was reduced with increasing severity of DPN and the effect was most evident in the inferior quadrant. Measuring RNFL thickness using OCT may prove to be a useful, non-invasive technique for identifying severity of DPN and may also provide additional insight into common mechanisms for peripheral neuropathy and RNFL damage.

Visions and values : the Children’s Book Council of Australia’s prizing of picture books in the twenty-first century

The Children’s Book Council of Australia (CBCA) administers the oldest national prize for children’s literature in Australia. Each year, the CBCA confers “Book of the Year” awards to literature for young people in five categories. In 2001, the establishment of an “Early Childhood” category opened up the venerable “Picture Book” category (first awarded in 1955) to books with an implied readership up to 18 years of age. As a result, this category has emerged in recent years as a highly visible space within which the CBCA can contest discourses of cultural marginalisation insofar as Australian (“colonial”) literature is constructed as inferior or adjunct to the major Anglophone literary traditions, and the consistent identification of children’s literature (and, indeed, of children) as lesser than its ‘adult’ counterparts. The CBCA is engaged in defining, evaluating, and legitimising a tradition of Australian children’s literature which is underpinned by a canonical impulse, and is a reflexive practice of self-definition, self-evaluation and self-legitimisation for the CBCA itself. While it is obviously problematic to identify award winners as a canon, it is equally obvious that literary prizing is a cultural practice derived from the logic of canonicity. In his discussion of the United States’s Newbery Medal, Kenneth Kidd notes that “Medal books are instant classics, the selection process an ostensible simulation of the test of time” (169) and that “the Medal is part of the canonical architecture of children's literature” (169). Thus, it is instructive to consider the visions and values of the national, of the social, and of the literary-aesthetic, in the picture books chosen by the Children’s Book Council of Australia (CBCA) as the “best” of the early twenty-first century. These books not only constitute a kind of canon for contemporary Australian children’s literature, but may well come to define what contemporary Australian children’s literature means in the wider literary field. The Book of the Year: Picture Book awards given by the CBCA since 2001 demonstrate that it is not only true of the Booker Prize that, “The choices of winning books reflect not only on the books themselves, then, but also back on the Prize, affecting its reputation and creating journalistic capital which is vital for the Prize to achieve its prominence and impact.” (81). Many of the twenty-first century CBCA award-winning picture books complicate traditional or comfortable understanding of Australianness, children’s literature, or “appropriate” modes of form and content, reminding us that “moments when texts resist or complicate recuperation into national discourses offer fruitful points for exploring the relationships between text and celebratory context” (Roberts 6). The CBCA has taken the opportunities offered by the liberation of the Picture Book category from an implied readership to challenge dominant constructions of children’s literature in Australia, and in so doing, are engaged in overt practices of canonicity with potentially long-lasting effects. Works Cited: Kidd, Kenneth. “Prizing Children’s Literature: The Case of Newbery Gold.” Children's Literature 35 (2007): 166-190. Roberts, Gillian. Prizing Literature: The Celebration and Circulation of National Culture. Toronto: U Toronto P, 2011. Squires, Claire. “Book Marketing and the Booker Prize.” Judging a Book by Its Cover: Fans, Publishers, Designers, and the Marketing of Fiction. Eds. Nicole Matthews and Nickianne Moody. Aldershot: Ashgate, 2007. 71-82.

Mismatch negativity in recent-onset and chronic schizophrenia : a current source density analysis

Mismatch negativity (MMN) is a component of the event-related potential elicited by deviant auditory stimuli. It is presumed to index pre-attentive monitoring of changes in the auditory environment. MMN amplitude is smaller in groups of individuals with schizophrenia compared to healthy controls. We compared duration-deviant MMN in 16 recent-onset and 19 chronic schizophrenia patients versus age- and sex-matched controls. Reduced frontal MMN was found in both patient groups, involved reduced hemispheric asymmetry, and was correlated with Global Assessment of Functioning (GAF) and negative symptom ratings. A cortically-constrained LORETA analysis, incorporating anatomical data from each individual's MRI, was performed to generate a current source density model of the MMN response over time. This model suggested MMN generation within a temporal, parietal and frontal network, which was right hemisphere dominant only in controls. An exploratory analysis revealed reduced CSD in patients in superior and middle temporal cortex, inferior and superior parietal cortex, precuneus, anterior cingulate, and superior and middle frontal cortex. A region of interest (ROI) analysis was performed. For the early phase of the MMN, patients had reduced bilateral temporal and parietal response and no lateralisation in frontal ROIs. For late MMN, patients had reduced bilateral parietal response and no lateralisation in temporal ROIs. In patients, correlations revealed a link between GAF and the MMN response in parietal cortex. In controls, the frontal response onset was 17 ms later than the temporal and parietal response. In patients, onset latency of the MMN response was delayed in secondary, but not primary, auditory cortex. However amplitude reductions were observed in both primary and secondary auditory cortex. These latency delays may indicate relatively intact information processing upstream of the primary auditory cortex, but impaired primary auditory cortex or cortico-cortical or thalamo-cortical communication with higher auditory cortices as a core deficit in schizophrenia.

Facial emotion modulates the neural mechanisms responsible for short interval time perception

Emotionally arousing events can distort our sense of time. We used mixed block/event-related fMRI design to establish the neural basis for this effect. Nineteen participants were asked to judge whether angry, happy and neutral facial expressions that varied in duration (from 400 to 1,600 ms) were closer in duration to either a short or long duration they learnt previously. Time was overestimated for both angry and happy expressions compared to neutral expressions. For faces presented for 700 ms, facial emotion modulated activity in regions of the timing network Wiener et al. (NeuroImage 49(2):1728–1740, 2010) namely the right supplementary motor area (SMA) and the junction of the right inferior frontal gyrus and anterior insula (IFG/AI). Reaction times were slowest when faces were displayed for 700 ms indicating increased decision making difficulty. Taken together with existing electrophysiological evidence Ng et al. (Neuroscience, doi: 10.3389/fnint.2011.00077, 2011), the effects are consistent with the idea that facial emotion moderates temporal decision making and that the right SMA and right IFG/AI are key neural structures responsible for this effect.

Brain networks subserving the evaluation of static and dynamic facial expressions

Because moving depictions of face emotion have greater ecological validity than their static counterparts, it has been suggested that still photographs may not engage ‘authentic’ mechanisms used to recognize facial expressions in everyday life. To date, however, no neuroimaging studies have adequately addressed the question of whether the processing of static and dynamic expressions rely upon different brain substrates. To address this, we performed an functional magnetic resonance imaging (fMRI) experiment wherein participants made emotional expression discrimination and Sex discrimination judgements to static and moving face images. Compared to Sex discrimination, Emotion discrimination was associated with widespread increased activation in regions of occipito-temporal, parietal and frontal cortex. These regions were activated both by moving and by static emotional stimuli, indicating a general role in the interpretation of emotion. However, portions of the inferior frontal gyri and supplementary/pre-supplementary motor area showed task by motion interaction. These regions were most active during emotion judgements to static faces. Our results demonstrate a common neural substrate for recognizing static and moving facial expressions, but suggest a role for the inferior frontal gyrus in supporting simulation processes that are invoked more strongly to disambiguate static emotional cues.