Glaucomatous visual field progression with frequency-doubling technology and standard automated perimetry in a longitudinal prospective study

PURPOSE. To compare frequency-doubling technology (FDT) perimetry with standard automated perimetry (SAP) for detecting glaucomatous visual field progression in a longitudinal prospective study.

METHODS. One eye of patients with open-angle glaucoma was tested every 6 months with both FDT and SAP. A minimum of 6 examinations with each perimetric technique was required for inclusion. Visual field progression was determined by two methods: glaucoma change probability (GCP) analysis and linear regression analysis (LRA). For GCP, several criteria for progression were used. The number of locations required to classify progression with FDT compared with SAP, respectively, was 1:2 (least conservative), 1:3, 2:3, 2:4, 2:6, 2:7, 3:6, 3:7, and 3:10 (most conservative). The number of consecutive examinations required to confirm progression was 2-of-3, 2-of-2, and 3-of-3. For LRA, the progression criterion was any significant decline in mean threshold sensitivity over time in each of the following three visual field subdivisions: (1) all test locations, (2) locations in the central 10° and the superior and inferior hemifields, and (3) locations in each quadrant. Using these criteria, the proportion of patients classified as showing progression with each perimetric technique was calculated and, in the case of progression with both, the differences in time to progression were determined.

RESULTS. Sixty-five patients were followed for a median of 3.5 years (median number of examinations, 9). For the least conservative GCP criterion, 32 (49%) patients were found to have progressing visual fields with FDT and 32 (49%) patients with SAP. Only 16 (25%) patients showed progression with both methods, and in most of those patients, FDT identified progression before SAP (median, 12 months earlier). The majority of GCP progression criteria (15/27), classified more patients as showing progression with FDT than with SAP. Contrary to this, more patients showed progression with SAP than FDT, when analysed with LRA; e.g., using quadrant LRA 20 (31%) patients showed progression with FDT, 23 (35%) with SAP, and only 10 (15%) with both.

CONCLUSIONS. FDT perimetry detected glaucomatous visual field progression. However, the proportion of patients who showed progression with both FDT and SAP was small, possibly indicating that the two techniques identify different subgroups of patients. Using GCP, more patients showed progression with FDT than with SAP, yet the opposite occurred using LRA. As there is no independent qualifier of progression, FDT and SAP progression rates vary depending on the method of analysis and the criterion used.

Risk of falls and motor vehicle collisions in glaucoma

PURPOSE. To investigate the risk of falls and motor vehicle collisions (MVCs) in patients with glaucoma.

METHODS. The sample comprised 48 patients with glaucoma (mean visual field mean deviation [MD] in the better eye = −3.9 dB; 5.1 dB SD) and 47 age-matched normal control subjects, who were recruited from a university-based hospital eye care clinic and are enrolled in an ongoing prospective study of risk factors for falls, risk factors for MVCs, and on-road driving performance in glaucoma. Main outcome measures at baseline were previous self-reported falls and MVCs, and police-reported MVCs. Demographic and medical data were obtained. In addition, functional independence in daily living, physical activity level and balance were assessed. Clinical vision measures included visual acuity, contrast sensitivity, standard automated perimetry, useful field of view (UFOV), and stereopsis. Analyses of falls and MVCs were adjusted to account for the possible confounding effects of demographic characteristics, medications, and visual field impairment. MVC analyses were also adjusted for kilometers driven per week.

RESULTS. There were no significant differences between patients with glaucoma and control subjects with respect to number of systemic medical conditions, body mass index, functional independence, and physical activity level (P > 0.10). At baseline, 40 (83%) patients with glaucoma and 44 (94%) control subjects were driving. Compared with control subjects, patients with glaucoma were over three times more likely to have fallen in the previous year (odds ratio [OR]adjusted = 3.71; 95% CI, 1.14–12.05), over six times more likely to have been involved in one or more MVCs in the previous 5 years (ORadjusted = 6.62; 95% CI, 1.40–31.23), and more likely to have been at fault (ORadjusted = 12.44; 95% CI, 1.08–143.99). The strongest risk factor for MVCs in patients with glaucoma was impaired UFOV selective attention (ORadjusted = 10.29; 95% CI, 1.10–96.62; for selective attention >350 ms compared with ≤350 ms).

CONCLUSIONS. There is an increased risk of falls and MVCs in patients with glaucoma.

Organizational factors in the diffusion of an industry standard: implementing an online documentation system for Australian exporters

At present, governments in many countries are actively engaged in the development of electronic trading and certification standards to enable the smooth operation of export markets. Standards and their usability underpin confidence in the operations of markets and their effective functioning. In institutional markets, an important role for government agencies lies in developing the initial specifications for standards for interoperable systems. Once these specifications are accepted, governments can then facilitate the eventual diffusion of a standard to the B2B marketplace. Acceptance of an industry standard can determine demand, which defines the viability of that market. In this paper, we describe an initiative by a government agency, the Australian Quarantine and Inspection Service (AQIS), in developing EXDOC, a standard for export documentation and the role that AQIS played in its implementation and diffusion. Our case study illustrates a successfully facilitated B2G implementation. It demonstrates how a standard can be supported and promulgated for the effective functioning of markets in the transition from manual to online export documentation. Once the overarching specifications for related industries have been established and diffused by government, opportunities arise for private sector markets to develop across these industries. Government agencies can promote the effective operation of standards for electronic markets. The EXDOC implementation and its iterations provide an exemplar of active engagement in the development of electronic trading and certification standards for an institutional market. Its successful diffusion provides a model of the implementation process for other export sectors and agencies.

Determination of sodium oxalate in Bayer liquor using flow-analysis incorporating an anion exchange column and tris(2,2`-bipyridyl)ruthenium(II) chemiluminescence detection

Semi-automated flow injection instrumentation, incorporating a small anion exchange column coupled with tris(2,2′-bipyridyl)ruthenium(II) (Ru(bipy)₃²⁺) chemiluminescence detection, was configured and utilised to develop rapid methodology for the determination of sodium oxalate in Bayer liquors. The elimination of both negative and positive interferences from aluminium(III) and, as yet, unknown concomitant organic species, respectively are discussed. The robustness of the methodology was considerably enhanced by using the temporally stable form of the chemiluminescence reagent, tris(2,2′-bipyridyl)ruthenium(III) perchlorate in dry acetonitrile. Real Bayer process samples were analysed and the results obtained compared well with those performed using standard methods within industrial laboratories.

Objective classification of fabric pilling based on the two-dimensional discrete wavelet transform

A number of methods for automated objective ratings of fabric pilling based on image analysis are described in the literature. The periodic structure of fabrics makes them suitable candidates for frequency domain analysis. We propose a new method of frequency domain analysis based on the two-dimensional discrete wavelet transform to objectively measure pilling intensity in sample images. We present a preliminary evaluation of the proposed method based on analysis of two series of standard pilling evaluation test images. The initial results suggest that the proposed method is feasible, and that the ability of the method to discriminate between levels of pilling intensity depends on the wavelet analysis scale being closely matched to the fabric interyarn pitch. We also present a heuristic method for optimal selection of an analysis wavelet and associated analysis scale.

The use of injury surveillance databases to identify emerging injury hazards

Among the many valuable uses of injury surveillance is the potential to alert health authorities and societies in general to emerging injury trends, facilitating earlier development of prevention measures. Other than road safety, to date, few attempts to forecast injury data have been made, although forecasts have been made of other public health issues. This may in part be due to the complex pattern of variance displayed by injury data. The profile of many injury types displays seasonality and diurnal variance, as well as stochastic variance. The authors undertook development of a simple model to forecast injury into the near term. In recognition of the large numbers of possible predictions, the variable nature of injury profiles and the diversity of dependent variables, it became apparent that manual forecasting was impractical. Therefore, it was decided to evaluate a commercially available forecasting software package for prediction accuracy against actual data for a set of predictions. Injury data for a 4-year period (1996 to 1999) were extracted from the Victorian Emergency Minimum Dataset and were used to develop forecasts for the year 2000, for which data was also held. The forecasts for 2000 were compared to the actual data for 2000 by independent t-tests, and the standard errors of the predictions were modelled by stepwise hierarchical multiple regression using the independent variables of the standard deviation, seasonality, mean monthly frequency and slope of the base data (R = 0.93, R² = 0.86, F_{(3, 27)} = 55.2, p < 0.0001). Significant contributions to the model included the SD (β = 1.60, p < 0.001), mean monthly frequency (β =  - 0.72, p < 0.002), and the seasonality of the data (β = 0.16, p < 0.02). It was concluded that injury data could be reliably forecast and that commercial software was adequate for the task. Variance in the data was found to be the most important determinant of prediction accuracy. Importantly, automated forecasting may provide a vehicle for identifying emerging trends.

Investigation into the temporal stability of aqueous standard solutions of psilocin and psilocybin using high performance liquid chromatography

This paper reports an investigation into the temporal stability of aqueous solutions of psilocin and psilocybin reference drug standards over a period of fourteen days. This study was performed using high performance liquid chromatography utilising a (955% vlv) methanol: 10 mM ammonium formate,
pH 3.5 mobile phase and absorption detection at 269 nm. It was found that the exclusion of light significantly prolonged the useful life of standards, with aqueous solutions of both psilocin and psilocybin being stable over a period of seven days.

Construction of aggregation operators for automated decision making via optimal interpolation and global optimization

This paper examines methods of point wise construction of aggregation operators via optimal interpolation. It is shown that several types of application-specific requirements lead to interpolatory type constraints on the aggregation function. These constraints are translated into global optimization problems, which are the focus of this paper. We present several methods of reduction of the number of variables, and formulate suitable numerical algorithms based on Lipschitz optimization.

The challenge for the dairy industry arising from the new health claims standard: an impetus for innovation

The publication of a Preliminary Final Assessment Report on 4 April 2007 heralded another step towards the introduction of a new Health Claims Standard to be inserted into the Australia New Zealand Food Standards Code. This Health Claims Standard, once approved by the Board of Food Standards Australia New Zealand and by the Australia New Zealand Food Regulation Ministerial Council, will permit the making of certain substantiated health claims. Prior to the introduction of the new Standard, health claims have not been permitted on food labels, with the exception of claims in relation to maternal folate consumption and its positive effect in reducing the risk of foetal neural tube defects. The new Health Claims Standard as outlined in the Preliminary Final Assessment Report is likely to have a significant impact on the dairy industry. This paper seeks to analyse that impact, including threats, opportunities and challenges that the Standard poses to the dairy industry and other food suppliers.

Determination of urea using high-performance liquid chromatography with fluorescence detection after automated derivatisation with Xanthydrol

A high-performance liquid chromatography (HPLC) method for the determination of urea that incorporates automated derivatisation with xanthydrol (9H-xanthen-9-ol) is described. Unlike the classic xanthydrol approach for the determination of urea, which involves the precipitation of dixanthylurea (N,N′-di-9H-xanthen-9-ylurea), the derivatisation procedure employed in this method produces N-9H-xanthen-9-ylurea, which remains in solution and can be quantified using fluorescence detection (λ_ex = 213 nm; λ_em = 308 nm) after chromatographic separation from interferences. The limit of detection for urea was 5 × 10⁻⁸ M (0.003 mg L⁻¹). This method was applied to the determination of urea in human and animal urine and in wine.

The diversity of emergency code telephone numbers in Australian hospitals: the feasibility of an Australian standard emergency code

This study explored the diversity of emergency code telephone numbers currently in use in Australian hospitals and examined the feasibility of a standard emergency code telephone number for all Australian hospitals, based on the United Kingdom experience. An email and telephone convenience survey of Australian hospitals from six states and two territories was conducted. Of the 108 hospitals surveyed, seven did not use a telephone number system and used a button/ pager system to call an emergency. Of the 101 hospitals surveyed that used a telephone number system, 40 different emergency telephone numbers were in place, and in nine hospitals the telephone number used for Code Blue (medical emergency) was different to the telephone number used for other emergency codes. With increasing mobility of staff across hospitals, uniformity of emergency code telephone numbers is required to reduce confusion, potential danger and improve staff response in emergency situations. A single Australian standard emergency telephone number for all Australian hospitals is advocated.