Clinical characteristics and selection of treatment modality for patients with vitreomacular traction:real-world implementation of NICE guidance (TA297)

Aim: To investigate the qualitative aspects in patient selection and the quantitative impact of disease burden in real world treatment of vitreomacular traction (VMT) and implementation of the National Institute for Health and Care Excellence (NICE) guidance (TA297). Methods: A monocentric, retrospective review of consecutive patients undergoing optical coherence tomography (OCT) imaging over a 3 month period. Patients with VMT in at least one eye were identified for further data collection on laterality, visual acuity, symptoms, presence of epiretinal membrane, macular hole and treatment selection. Results: A total of 3472 patients underwent OCT imaging with a total of 6878 eyes scanned. Out of 87 patients, 74 patients had unilateral VMT (38 right, 36 left) and 13 patients had bilateral VMT. Eighteen patients with unilateral VMT satisfied NICE criteria of severe sight problems in the affected eye. Eight were managed for a coexisting pathology, one refused treatment, one patient did not attend, two closed spontaneously, and one received ocriplasmin prior to the study start date. Only two patients with unilateral VMT received ocriplasmin and three underwent vitrectomy. Those failing to meet NICE criteria for unilateral VMT were predominantly asymptomatic (n=49) or had coexisting ERM (n=5) or both (n=2). Conclusion: Ocriplasmin provides an alternative treatment for patients with symptomatic VMT. Our data shows that the majority of patients with VMT do not meet NICE TA297 primarily due to lack of symptoms. Those meeting NICE criteria, but not treated, tended to have coexisting macular pathology. Variation in patient selection due to subjective factors not outlined in NICE guidance suggests that real world outcomes of ocriplasmin therapy should be interpreted with caution.

The Weight of Language and Action: Epistemic Stance, Methodological Action,and Theoretical Perspective in Knowledge Organization

Knowledge organization (KO) research is a field of scholarship concerned with the design, study and critique of the processes of organizing and representing documents that societies see as worthy of preserving (Tennis, 2008). In this context we are concerned with the relationship between language and action.On the one hand, we are concerned with what language can and does do for our knowledge organization systems (KOS). For example, how do the words NEGRO or INDIAN work in historical and contemporary indexing languages? In relation to this, we are also concerned with how we know about knowledge organization (KO) and its languages. On the other hand, we are concerned with how to act given this knowledge. That is, how do we carry out research and how do we design, implement, and evaluate KO systems?It is important to consider these questions in the context of our work because we are delegated by society to disseminate cultural memory. We are endowed with a perspective, prepared by an education, and granted positions whereby society asks us to ensure that documentary material is accessible to future generations. There is a social value in our work, and as such there is a social imperative to our work. We must act with good conscience, and use language judiciously, for the memory of the world is a heavy burden.In this paper, I explore these two weights of language and action that bear down on KO researchers. I first summarize what extant literature says about the knowledge claims we make with regard to KO practices and systems. To make it clear what it is that I think we know, I create a schematic that will link claims (language) to actions in advising, implementing, or evaluating information practices and systems.I will then contrast this with what we do not know, that is, what the unanswered questions might be (Gnoli, 2008 ; Dahlberg, 2011), and I will discuss them in relation to the two weights in our field of KO.Further, I will try to provide a systematic overview of possible ways to address these open questions in KO research. I will draw on the concept of elenchus - the forms of epistemology, theory, and methodology in KO (Tennis, 2008), and framework analysis which are structures, work practice, and discourses of KO systems (Tennis, 2006). In so doing, I will argue for a Neopragmatic stance on the weight of language and action in KO (Rorty, 1982 ; 2000). I will close by addressing the lacuna left in Neopragmatic thought – the ethical imperative to use language and action in a particular good and moral way. That is, I will address the ethical imperative of KO given its weights, epistemologies, theories, and methods. To do this, I will review a sample of relevant work on deontology in both western and eastern philosophical schools (e.g., Harvey, 1995).The perspective I want to communicate in this section is that the good in carrying out KO research may begin with epistemic stances (cf., language), but ultimately stands on ethical actions. I will present an analysis describing the micro and the macro ethical concerns in relation to KO research and its advice on practice. I hope this demonstrates that the direction of epistemology, theory, and methodology in KO, while burdened with the dual weights of language and action, is clear when provided an ethical sounding board. We know how to proceed when we understand how our work can benefit the world.KO is an important, if not always understood, division of labor in a society that values its documentary heritage and memory institutions. Being able to do good requires us to understand how to balance the weights of language and action. We must understand where we stand and be able to chart a path forward, one that does not cause harm, but adds value to the world and those that want to access recorded knowledge.

Epistemic, Ontic, Axiologic, and Praxic Constructs in Knowledge Organization Research

The work of knowledge organization requires a particular set of tools. For instance we need standards of content description like Anglo-American Cataloging Rules Edition 2, Resource Description and Access (RDA), Cataloging Cultural Objects, and Describing Archives: A Content Standard. When we intellectualize the process of knowledge organization – that is when we do basic theoretical research in knowledge organization we need another set of tools. For this latter exercise we need constructs. Constructs are ideas with many conceptual elements, largely considered subjective. They allow us to be inventive as well as allow us to see a particular point of view in knowledge organization. For example, Patrick Wilson’s ideas of exploitative control and descriptive control, or S. R. Ranganathan’s fundamental categories are constructs. They allow us to identify functional requirements or operationalizations of functional requirements, or at least come close to them for our systems and schemes. They also allow us to carry out meaningful evaluation.What is even more interesting, from a research point of view, is that constructs once offered to the community can be contested and reinterpreted and this has an affect on how we view knowledge organization systems and processes. Fundamental categories are again a good example in that some members of the Classification Research Group (CRG) argued against Ranganathan’s point of view. The CRG posited more fundamental categories than Ranganathan’s five, Personality, Matter, Energy, Space, and Time (Ranganathan, 1967). The CRG needed significantly more fundamental categories for their work.1 And these are just two voices in this space we can also consider the fundamental categories of Johannes Kaiser (1911), Shera and Egan, Barbara Kyle (Vickery, 1960), and Eric de Grolier (1962). We can also reference contemporary work that continues comparison and analysis of fundamental categories (e.g., Dousa, 2011).In all these cases we are discussing a construct. The fundamental category is not discovered; it is constructed by a classificationist. This is done because it is useful in engaging in the act of classification. And while we are accustomed to using constructs or debating their merit in one knowledge organization activity or another, we have not analyzed their structure, nor have we created a typology. In an effort to probe the epistemological dimension of knowledge organization, we think it would be a fruitful exercise to do this. This is because we might benefit from clarity around not only our terminology, but the manner in which we talk about our terminology. We are all creative workers examining what is available to us, but doing so through particular lenses (constructs) identifying particular constructs. And by knowing these and being able to refer to these we would consider a core competency for knowledge organization researchers.

Effects of modality, urgency and situation on responses to multimodal warnings for drivers

Signifying road-related events with warnings can be highly beneficial, especially when imminent attention is needed. This thesis describes how modality, urgency and situation can influence driver responses to multimodal displays used as warnings. These displays utilise all combinations of audio, visual and tactile modalities, reflecting different urgency levels. In this way, a new rich set of cues is designed, conveying information multimodally, to enhance reactions during driving, which is a highly visual task. The importance of the signified events to driving is reflected in the warnings, and safety-critical or non-critical situations are communicated through the cues. Novel warning designs are considered, using both abstract displays, with no semantic association to the signified event, and language-based ones, using speech. These two cue designs are compared, to discover their strengths and weaknesses as car alerts. The situations in which the new cues are delivered are varied, by simulating both critical and non-critical events and both manual and autonomous car scenarios. A novel set of guidelines for using multimodal driver displays is finally provided, considering the modalities utilised, the urgency signified, and the situation simulated.

Physiological and symptomatic responses to cycling and walking in intermittent claudication

To shed light on the potential efficacy of cycling as a testing modality in the treatment of intermittent claudication (IC), this study compared physiological and symptomatic responses to graded walking and cycling tests in claudicants. Sixteen subjects with peripheral arterial disease (resting ankle: brachial index (ABI) < 0.9) and IC completed a maximal graded treadmill walking (T) and cycle (C) test after three familiarization tests on each mode. During each test, symptoms, oxygen uptake (VO2), minute ventilation (VE), respiratory exchange ratio (RER) and heart rate (HR) were measured, and for 10 min after each test the brachial and ankle systolic pressures were recorded. All but one subject experienced calf pain as the primary limiting symptom during T; whereas the symptoms were more varied during C and included thigh pain, calf pain and dyspnoea. Although maximal exercise time was significantly longer on C than T (690 +/- 67 vs. 495 +/- 57 s), peak VO2, peak VE and peak heart rate during C and T were not different; whereas peak RER was higher during C. These responses during C and T were also positively correlated (P < 0.05) with each other, with the exception of RER. The postexercise systolic pressures were also not different between C and T. However, the peak decline in ankle pressures from resting values after C and T were not correlated with each other. These data demonstrate that cycling and walking induce a similar level of metabolic and cardiovascular strain, but that the primary limiting symptoms and haemodynamic response in an individual's extremity, measured after exercise, can differ substantially between these two modes.

2D-3D Face Recognition Based on PCA and Feature Modelling

Hybrid face recognition, using image (2D) and structural (3D) information, has explored the fusion of Nearest Neighbour classifiers. This paper examines the effectiveness of feature modelling for each individual modality, 2D and 3D. Furthermore, it is demonstrated that the fusion of feature modelling techniques for the 2D and 3D modalities yields performance improvements over the individual classifiers. By fusing the feature modelling classifiers for each modality with equal weights the average Equal Error Rate improves from 12.60% for the 2D classifier and 12.10% for the 3D classifier to 7.38% for the Hybrid 2D+3D clasiffier.

Particle and gaseous emissions from commercial aircraft at each stage of the landing and takeoff cycle

A novel technique was used to measure emission factors for commonly used commercial aircraft including a range of Boeing and Airbus airframes under real world conditions. Engine exhaust emission factors for particles in terms of particle number and mass (PM2.5), along with those for CO2, and NOx were measured for over 280 individual aircraft during the various modes of landing/takeoff (LTO) cycle. Results from this study show that particle number, and NOx emission factors are dependant on aircraft engine thrust level. Minimum and maximum emissions factors for particle number, PM2.5, and NOx emissions were found to be in the range of 4.16×1015-5.42×1016 kg-1, 0.03-0.72 g.kg-1, and 3.25-37.94 g.kg-1 respectively for all measured airframes and LTO cycle modes. Number size distributions of emitted particles for the naturally diluted aircraft plumes in each mode of LTO cycle showed that particles were predominantly in the range of 4 to 100 nm in diameter in all cases. In general, size distributions exhibit similar modality during all phases of the LTO cycle. A very distinct nucleation mode was observed in all particle size distributions, except for taxiing and landing of A320 aircraft. Accumulation modes were also observed in all particle size distributions. Analysis of aircraft engine emissions during LTO cycle showed that aircraft thrust level is considerably higher during taxiing than idling suggesting that International Civil Aviation Organization (ICAO) standards need to be modified as the thrust levels for taxi and idle are considered to be the same (7% of total thrust) [1].

Size distribution and sites of origin of droplets expelled during expiratory activities

A new Expiratory Droplet Investigation System (EDIS) was used to conduct the most comprehensive program of study to date, of the dilution corrected droplet size distributions produced during different respiratory activities.----- Distinct physiological processes were responsible for specific size distribution modes. The majority of particles for all activities were produced in one or more modes, with diameters below 0.8 µm. That mode occurred during all respiratory activities, including normal breathing. A second mode at 1.8 µm was produced during all activities, but at lower concentrations.----- Speech produced particles in modes near 3.5 µm and 5 µm. The modes became most pronounced during continuous vocalization, suggesting that the aerosolization of secretions lubricating the vocal chords is a major source of droplets in terms of number.----- Non-eqilibrium droplet evaporation was not detectable for particles between 0.5 and 20 μm implying that evaporation to the equilibrium droplet size occurred within 0.8 s.

A visualisation framework for collaborative virtual environment usage information

Due to the popularity of modern Collaborative Virtual Environments, there has been a related increase in their size and complexity. Developers therefore need visualisations that expose usage patterns from logged data, to understand the structures and dynamics of these complex environments. This chapter presents a new framework for the process of visualising virtual environment usage data. Major components, such as an event model, designer task model and data acquisition infrastructure are described. Interface and implementation factors are also developed, along with example visualisation techniques that make use of the new task and event model. A case study is performed to illustrate a typical scenario for the framework, and its benefits to the environment development team.

Redundancy in interface design and its impact on intuitive use of a product in older users

Many older adults have difficulty using modern consumer products due to their complexity both in terms of functionality and interface design. It has been observed that older people also have more problems learning new systems. It was hypothesised that designing technological products that are more intuitive for older people to use can solve this problem. An intuitive interface allows a user’s to employ prior knowledge, thus minimizing the learning needed for effective interaction. This paper discusses an experiment investigating the effectiveness of redundancy in interface design. The primary objective of this experiment was to find out if using more than one modality for a product’s interface improves the speed and intuitiveness of interactions for older adults. Preliminary analysis showed strong correlation between technology familiarity and time on tasks, but redundancy in interface design improved speed and accuracy of use only for participants with moderate to high technology familiarity.

Improved detection and tracking of objects in surveillance video

Surveillance networks are typically monitored by a few people, viewing several monitors displaying the camera feeds. It is then very difficult for a human operator to effectively detect events as they happen. Recently, computer vision research has begun to address ways to automatically process some of this data, to assist human operators. Object tracking, event recognition, crowd analysis and human identification at a distance are being pursued as a means to aid human operators and improve the security of areas such as transport hubs. The task of object tracking is key to the effective use of more advanced technologies. To recognize an event people and objects must be tracked. Tracking also enhances the performance of tasks such as crowd analysis or human identification. Before an object can be tracked, it must be detected. Motion segmentation techniques, widely employed in tracking systems, produce a binary image in which objects can be located. However, these techniques are prone to errors caused by shadows and lighting changes. Detection routines often fail, either due to erroneous motion caused by noise and lighting effects, or due to the detection routines being unable to split occluded regions into their component objects. Particle filters can be used as a self contained tracking system, and make it unnecessary for the task of detection to be carried out separately except for an initial (often manual) detection to initialise the filter. Particle filters use one or more extracted features to evaluate the likelihood of an object existing at a given point each frame. Such systems however do not easily allow for multiple objects to be tracked robustly, and do not explicitly maintain the identity of tracked objects. This dissertation investigates improvements to the performance of object tracking algorithms through improved motion segmentation and the use of a particle filter. A novel hybrid motion segmentation / optical flow algorithm, capable of simultaneously extracting multiple layers of foreground and optical flow in surveillance video frames is proposed. The algorithm is shown to perform well in the presence of adverse lighting conditions, and the optical flow is capable of extracting a moving object. The proposed algorithm is integrated within a tracking system and evaluated using the ETISEO (Evaluation du Traitement et de lInterpretation de Sequences vidEO - Evaluation for video understanding) database, and significant improvement in detection and tracking performance is demonstrated when compared to a baseline system. A Scalable Condensation Filter (SCF), a particle filter designed to work within an existing tracking system, is also developed. The creation and deletion of modes and maintenance of identity is handled by the underlying tracking system; and the tracking system is able to benefit from the improved performance in uncertain conditions arising from occlusion and noise provided by a particle filter. The system is evaluated using the ETISEO database. The dissertation then investigates fusion schemes for multi-spectral tracking systems. Four fusion schemes for combining a thermal and visual colour modality are evaluated using the OTCBVS (Object Tracking and Classification in and Beyond the Visible Spectrum) database. It is shown that a middle fusion scheme yields the best results and demonstrates a significant improvement in performance when compared to a system using either mode individually. Findings from the thesis contribute to improve the performance of semi-automated video processing and therefore improve security in areas under surveillance.

Augmenting web service discovery by cognitive semantics and abduction

We argue that web service discovery technology should help the user navigate a complex problem space by providing suggestions for services which they may not be able to formulate themselves as (s)he lacks the epistemic resources to do so. Free text documents in service environments provide an untapped source of information for augmenting the epistemic state of the user and hence their ability to search effectively for services. A quantitative approach to semantic knowledge representation is adopted in the form of semantic space models computed from these free text documents. Knowledge of the user’s agenda is promoted by associational inferences computed from the semantic space. The inferences are suggestive and aim to promote human abductive reasoning to guide the user from fuzzy search goals into a better understanding of the problem space surrounding the given agenda. Experimental results are discussed based on a complex and realistic planning activity.

Resistance training for obese, type 2 diabetic adults: A review of the evidence

In both developed and developing countries, increased prevalence of obesity has been strongly associated with increased incidence of type 2 diabetes mellitus (T2DM) in the adult population. Previous research has emphasized the importance of physical activity in the prevention and management of obesity and T2DM, and generic exercise guidelines originally developed for the wider population have been adapted for these specific populations. However, the guidelines traditionally focus on aerobic training without due consideration to other exercise modalities. Recent reviews on resistance training in the T2DM population have not compared this modality with others including aerobic training, or considered the implications of resistance training for individuals suffering from both obesity and T2DM. In short, the optimal mix of exercise modalities in the prescription of exercise has not been identified for it benefits to the metabolic, body composition and muscular health markers common in obesity and T2DM. Similarly, the underlying physical, social and psychological barriers to adopting and maintaining exercise, with the potential to undermine the efficacy of exercise interventions, have not been addressed in earlier reviews. Because it is well established that aerobic exercise has profound effects on obesity and T2DM risk, the purpose of this review was to address the importance of resistance training to obese adults with T2DM.

Sustaining the sustainable? Developing a practice and problem-led new media praxis

In this chapter I introduce an ecological-philosophical approach to artmaking that has guided my work over the past 16 years. I call this ‘Ecosophical praxis’. To illustrate how this infuses and directs my research methodologies, I draw upon a case study called Knowmore (House of Commons), an emerging interactive installation due for first showings in late 2008. This allows me to tease out the complex interrelationships between research and practice within my work, and describe how they comment upon and model these eco-cultural theories. I conclude with my intentions and hopes for the continued emergence of a contemporary eco-political modality of new media praxis that self-reflexively questions how we might re-focus future practices upon ‘sustaining the sustainable’.