Grading scales for contact lens complications

Purpose. To devise and validate artist-rendered grading scales for contact lens complications Methods. Each of eight tissue complications of contact lens wear (listed under 'Results') was painted by a skilled ophthalmic artist (Terry R. Tarrant) in five grades of severity: 0 (normal), 1 (trace), 2 (mild), 3 (moderate) and 4 (severe). A representative slit lamp photograph of a tissue response of each of the eight complications was shown to 404 contact lens practitioners who had never before used clinical grading scales. The practitioners were asked to grade each tissue response to the nearest 0.1 grade unit by interpolation. Results. The standard deviation (± s.d.) of the 404 responses for each tissue complication is tabulated below:_ing_ 0.5 Endothelial pplymegethisjij-4 0.7 Epithelial microcysts 0.5 Endothelial blebs_ 0.4 Stromal edema_onjunctiva! hyperemia 0.4 Stromal neovascularization 0.4 Papillary conjunctivitis 0.5 The frequency distributions and best-fit normal curves were also plotted. The precision of grading (s.d. x 2) ranged from 0.8 to 1.4, with a mean precision of 1.0. Conclusions. Grading scales afford contact lens practitioners with a method of quantifying the severity of adverse tissue responses to contact lens wear. It is noteworthy that the statistically verified precision of grading (1.0 scale unit) concurs precisely with the essential design feature of the grading scales that each grading step of 1.0 corresponds to clinically significant difference in severity. Thus, as a general rule, a difference or change in grade of > 1.0 can be taken to be both clinically and statistically significant when using these grading scales. Trained observers are likely to achieve even greater grading precision. Supported by Hydron Limited.

Collaborative academic/practitioner research in project management : examples and applications

Purpose – The purpose of this paper is to present a cost-benefit interpretation of academic-practitioner research by describing and analysing several recent relevant examples of academic-practitioner research with a focus on doctoral theses carried out at universities and business schools in clusters of research centred in North America, Australia and Europe. Design/methodology/approach – Using case study examples, a value proposition framework for undertaking collaborative research for higher degree level study is developed and presented. Findings – Value proposition benefits from this level of collaborative research can be summarised as enhancing competencies at the individual and organisational level as well as providing participating universities with high-quality candidates/students and opportunities for industry engagement. The project management (PM) professional bodies can also extend PM knowledge but they need to be prepared to provide active support. Practical implications – A model for better defining the value proposition of collaborative research from a range of stakeholder perspectives is offered that can be adapted for researchers and industry research sponsors. Originality/value – Few papers offer a value proposition framework for explaining collaborative research benefits. This paper addresses that need.

Ocular surface changes with short-term contact lens wear

Contact lenses are a common method for the correction of refractive errors of the eye. While there have been significant advancements in contact lens designs and materials over the past few decades, the lenses still represent a foreign object in the ocular environment and may lead to physiological as well as mechanical effects on the eye. When contact lenses are placed in the eye, the ocular anatomical structures behind and in front of the lenses are directly affected. This thesis presents a series of experiments that investigate the mechanical and physiological effects of the short-term use of contact lenses on anterior and posterior corneal topography, corneal thickness, the eyelids, tarsal conjunctiva and tear film surface quality. The experimental paradigm used in these studies was a repeated measures, cross-over study design where subjects wore various types of contact lenses on different days and the lenses were varied in one or more key parameters (e.g. material or design). Both, old and newer lens materials were investigated, soft and rigid lenses were used, high and low oxygen permeability materials were tested, toric and spherical lens designs were examined, high and low powers and small and large diameter lenses were used in the studies. To establish the natural variability in the ocular measurements used in the studies, each experiment also contained at least one “baseline” day where an identical measurement protocol was followed, with no contact lenses worn. In this way, changes associated with contact lens wear were considered in relation to those changes that occurred naturally during the 8 hour period of the experiment. In the first study, the regional distribution and magnitude of change in corneal thickness and topography was investigated in the anterior and posterior cornea after short-term use of soft contact lenses in 12 young adults using the Pentacam. Four different types of contact lenses (Silicone hydrogel/ Spherical/–3D, Silicone Hydrogel/Spherical/–7D, Silicone Hydrogel/Toric/–3D and HEMA/Toric/–3D) of different materials, designs and powers were worn for 8 hours each, on 4 different days. The natural diurnal changes in corneal thickness and curvature were measured on two separate days before any contact lens wear. Significant diurnal changes in corneal thickness and curvature within the duration of the study were observed and these were taken into consideration for calculating the contact lens induced corneal changes. Corneal thickness changed significantly with lens wear and the greatest corneal swelling was seen with the hydrogel (HEMA) toric lens with a noticeable regional swelling of the cornea beneath the stabilization zones, the thickest regions of the lenses. The anterior corneal surface generally showed a slight flattening with lens wear. All contact lenses resulted in central posterior corneal steepening, which correlated with the relative degree of corneal swelling. The corneal swelling induced by the silicone hydrogel contact lenses was typically less than the natural diurnal thinning of the cornea over this same period (i.e. net thinning). This highlights why it is important to consider the natural diurnal variations in corneal thickness observed from morning to afternoon to accurately interpret contact lens induced corneal swelling. In the second experiment, the relative influence of lenses of different rigidity (polymethyl methacrylate – PMMA, rigid gas permeable – RGP and silicone hydrogel – SiHy) and diameters (9.5, 10.5 and 14.0) on corneal thickness, topography, refractive power and wavefront error were investigated. Four different types of contact lenses (PMMA/9.5, RGP/9.5, RGP/10.5, SiHy/14.0), were worn by 14 young healthy adults for a period of 8 hours on 4 different days. There was a clear association between fluorescein fitting pattern characteristics (i.e. regions of minimum clearance in the fluorescein pattern) and the resulting corneal shape changes. PMMA lenses resulted in significant corneal swelling (more in the centre than periphery) along with anterior corneal steepening and posterior flattening. RGP lenses, on the other hand, caused less corneal swelling (more in the periphery than centre) along with opposite effects on corneal curvature, anterior corneal flattening and posterior steepening. RGP lenses also resulted in a clinically and statistically significant decrease in corneal refractive power (ranging from 0.99 to 0.01 D), large enough to affect vision and require adjustment in the lens power. Wavefront analysis also showed a significant increase in higher order aberrations after PMMA lens wear, which may partly explain previous reports of "spectacle blur" following PMMA lens wear. We further explored corneal curvature, thickness and refractive changes with back surface toric and spherical RGP lenses in a group of 6 subjects with toric corneas. The lenses were worn for 8 hours and measurements were taken before and after lens wear, as in previous experiments. Both lens types caused anterior corneal flattening and a decrease in corneal refractive power but the changes were greater with the spherical lens. The spherical lens also caused a significant decrease in WTR astigmatism (WRT astigmatism defined as major axis within 30 degrees of horizontal). Both the lenses caused slight posterior corneal steepening and corneal swelling, with a greater effect in the periphery compared to the central cornea. Eyelid position, lid-wiper and tarsal conjunctival staining were also measured in Experiment 2 after short-term use of the rigid and SiHy contact lenses. Digital photos of the external eyes were captured for lid position analysis. The lid-wiper region of the marginal conjunctiva was stained using fluorescein and lissamine green dyes and digital photos were graded by an independent masked observer. A grading scale was developed in order to describe the tarsal conjunctival staining. A significant decrease in the palpebral aperture height (blepharoptosis) was found after wearing of PMMA/9.5 and RGP/10.5 lenses. All three rigid contact lenses caused a significant increase in lid-wiper and tarsal staining after 8 hours of lens wear. There was also a significant diurnal increase in tarsal staining, even without contact lens wear. These findings highlight the need for better contact lens edge design to minimise the interactions between the lid and contact lens edge during blinking and more lubricious contact lens surfaces to reduce ocular surface micro-trauma due to friction and for. Tear film surface quality (TFSQ) was measured using a high-speed videokeratoscopy technique in Experiment 2. TFSQ was worse with all the lenses compared to baseline (PMMA/9.5, RGP/9.5, RGP/10.5, and SiHy/14) in the afternoon (after 8 hours) during normal and suppressed blinking conditions. The reduction in TFSQ was similar with all the contact lenses used, irrespective of their material and diameter. An unusual pattern of change in TFSQ in suppressed blinking conditions was also found. The TFSQ with contact lens was found to decrease until a certain time after which it improved to a value even better than the bare eye. This is likely to be due to the tear film drying completely over the surface of the contact lenses. The findings of this study also show that there is still a scope for improvement in contact lens materials in terms of better wettability and hydrophilicity in order to improve TFSQ and patient comfort. These experiments showed that a variety of changes can occur in the anterior eye as a result of the short-term use of a range of commonly used contact lens types. The greatest corneal changes occurred with lenses manufactured from older HEMA and PMMA lens materials, whereas modern SiHy and rigid gas permeable materials caused more subtle changes in corneal shape and thickness. All lenses caused signs of micro-trauma to the eyelid wiper and palpebral conjunctiva, although rigid lenses appeared to cause more significant changes. Tear film surface quality was also significantly reduced with all types of contact lenses. These short-term changes in the anterior eye are potential markers for further long term changes and the relative differences between lens types that we have identified provide an indication of areas of contact lens design and manufacture that warrant further development.

Controlled growth of carbon nanotubes for electronic and photovoltaic applications

Carbon nanotubes (CNTs), experimentally observed for the first time twenty years ago, have triggered an unprecedented research effort, on the account of their astonishing structural, mechanical and electronic properties. Unfortunately, the current inability in predicting the CNTs’ properties and the difficulty in controlling their position on a substrate are often limiting factors for the application of this material in actual devices. This research aims at the creation of specific methodologies for controlled synthesis of CNTs, leading to effectively employ them in various fields of electronics, e.g. photovoltaics. Focused Ion Beam (FIB) patterning of Si surfaces is here proposed as a means for ordering the assembly of vertical-aligned CNTs. With this technique, substrates with specific nano-structured morphologies have been prepared, enabling a high degree of control over CNTs’ position and size. On these nano-structured substrates, the growth of CNTs has been realized by chemical vapor deposition (CVD), i.e. thermal decomposition of hydrocarbon gases over a heated catalyst. The most common materials used as catalysts in CVD are transition metals like Fe and Ni; however, their presence in the CNT products often results in shortcomings for electronic applications, especially for those based on silicon, being the metallic impurities incompatible with very-large-scale integration (VLSI) technology. In the present work the role of Ge dots as an alternative catalysts for CNTs synthesis on Si substrates has been thoroughly assessed, finding a close connection between the catalytic activity of such material and the CVD conditions, which can affect both size and morphology of the dots. Successful CNT growths from Ge dots have been obtained by CVD at temperatures ranging from 750 to 1000°C, with mixtures of acetylene and hydrogen in an argon carrier gas. The morphology of the Si surface is observed to play a crucial role for the outcome of the CNT synthesis: natural (i.e. chemical etching) and artificial (i.e. FIB patterning, nanoindentation) means of altering this morphology in a controlled way have been then explored to optimize the CNTs yield. All the knowledge acquired in this study has been finally applied to synthesize CNTs on transparent conductive electrodes (indium-tin oxide, ITO, coated glasses), for the creation of a new class of anodes for organic photovoltaics. An accurate procedure has been established which guarantees a controlled inclusion of CNTs on ITO films, preserving their optical and electrical properties. By using this set of conditions, a CNTenhanced electrode has been built, contributing to improve the power conversion efficiency of polymeric solar cells.

Controlling Minimally-Actuated Vehicles for Applications in Ocean Observation

Establishing a persistent presence in the ocean with an AUV to observe temporal variability of large-scale ocean processes requires a unique sensor platform. In this paper, we propose a strategy that utilizes ocean model predictions to increase the autonomy and control of Lagrangian or profiling floats for precisely this purpose. An A* planner is applied to a local controllability map generated from predictions of ocean currents to compute a path between prescribed waypoints that has the highest likelihood of successful execution. The control to follow the planned path is computed by use of a model predictive controller. This controller is designed to select the best depth for the vehicle to exploit ambient currents to reach the goal waypoint. Mission constraints are employed to simulate a practical data collection mission. Results are presented in simulation for a mission off the coast of Los Angeles, CA USA, and show surprising results in the ability of a Lagrangian float to reach a desired location.

Toward non-invasive detection of concealed energetic materials in-field under ambient-light conditions

Spatially offset Raman spectroscopy (SORS) is demonstrated for the non-contact detection of energetic materials concealed within non-transparent, diffusely scattering containers. A modified design of an inverse SORS probe has been developed and tested. The SORS probe has been successfully used for the detection of various energetic substances inside different types of plastic containers. The tests have been successfully conducted under incandescent and fluorescent background lights as well as under daylight conditions, using a non-contact working distance of 6 cm. The interrogation times for the detection of the substances were less than 1 minute in each case, highlighting the suitability of the device for near real-time detection of concealed hazards in the field. The device has potential applications in forensic analysis and homeland security investigations.

Australian tax analysis - cases, commentary, commercial applications and questions [7th Ed.]

"Australian Tax Analysis, seventh edition, provides a comprehensive examination of taxation law with a practical commercial perspective. The seventh edition of this text features: two new chapters: "Offsets" and "Superannuation and Employer Responsibilities"; selected case extracts; Tax Commissioner Rulings; thought-provoking commentary; instruction on how to read the Acts; and engaging problem-based practice questions."--Publisher's website.

A novel CDVM based high-voltage converter using low power solid-state switches and a tuned resonant circuit designed for pulsed power applications

A novel concept of producing high dc voltage for pulsed-power applications is proposed in this paper. The topology consists of an LC resonant circuit supplied through a tuned alternating waveform that is produced by an inverter. The control scheme is based on the detection of variations in the resonant frequency and adjustment of the switching signal patterns for the inverter to produce a square waveform with exactly the same frequencies. Therefore the capacitor voltage oscillates divergently with an increasing amplitude. A simple one-stage capacitor-diode voltage multiplier (CDVM) connected to the resonant capacitor then rectifies the alternating voltage and gives a dc level equal to twice the input voltage amplitude. The produced high voltage appears then in the form of high-voltage pulses across the load. A basic model is simulated by Simulink platform of MATLAB and the results are included in the paper.

A new tip area function for instrumented nanoindentation at extremely small contact depths

The accuracy of measurement of mechanical properties of a material using instrumented nanoindentation at extremely small penetration depths heavily relies on the determination of the contact area of the indenter. Our experiments have demonstrated that the conventional area function could lead to a significant error when the contact depth was below 40. nm, due to the singularity in the first derivation of the function in this region and thus, the resultant unreasonable sharp peak on the function curve. In this paper, we proposed a new area function that was used to calculate the contact area for the indentations where the contact depths varied from 10 to 40. nm. The experimental results have shown that the new area function has produced better results than the conventional function. © 2011 Elsevier B.V.

A practical approach for identifying expected solution performance and robustness in operations research applications

A practical approach for identifying solution robustness is proposed for situations where parameters are uncertain. The approach is based upon the interpretation of a probability density function (pdf) and the definition of three parameters that describe how significant changes in the performance of a solution are deemed to be. The pdf is constructed by interpreting the results of simulations. A minimum number of simulations are achieved by updating the mean, variance, skewness and kurtosis of the sample using computationally efficient recursive equations. When these criterions have converged then no further simulations are needed. A case study involving several no-intermediate storage flow shop scheduling problems demonstrates the effectiveness of the approach.

Tear film surface quality with rigid and soft contact lenses

Objectives: To measure tear film surface quality (TFSQ) using dynamic high-speed videokeratoscopy during short-term (8 hours) use of rigid and soft contact lenses. Methods: A group of fourteen subjects wore 3 different types of contact lenses on 3 different non-consecutive days (order randomized) in one eye only. Subjects were screened to exclude those with dry eye. The lenses included a PMMA hard, an RGP (Boston XO) and a soft silicone hydrogel lens. Three 30 second long high speed videokeratoscopy recordings were taken with contact lenses in-situ, in the morning and again after 8 hours of contact lens wear, both in normal and suppressed blinking conditions. Recordings were also made on a baseline day with no contact lens wear. Results: The presence of a contact lens in the eye had a significant effect on the mean TFSQ in both natural and suppressed blinking conditions (p=0.001 and p=0.01 respectively, repeated measures ANOVA). TFSQ was worse with all the lenses compared to no lens in the eye (in the afternoon during both normal and suppressed blinking conditions (all p<0.05). In natural blinking conditions, the mean TFSQ for the PMMA and RGP lenses was significantly worse than the baseline day (no lens) for both morning and afternoon measures (p<0.05). Conclusions: This study shows that both rigid and soft contact lenses adversely affect the TFSQ in both natural and suppressed blinking conditions. No significant differences were found between the lens types and materials. Keywords: Tear film surface quality, rigid contact lens, soft contact lens, dynamic high-speed videokeratoscopy

High-voltage modular power supply using parallel and series configurations of flyback converter for pulsed power applications

To cover wide range of pulsed power applications, this paper proposes a modularity concept to improve the performance and flexibility of the pulsed power supply. The proposed scheme utilizes the advantage of parallel and series configurations of flyback modules in obtaining high-voltage levels with fast rise time (dv/dt). Prototypes were implemented using 600-V insulated-gate bipolar transistor (IGBT) switches to generate up to 4-kV output pulses with 1-kHz repetition rate for experimentation. To assess the proposed modular approach for higher number of the modules, prototypes were implemented using 1700-V IGBTs switches, based on ten-series modules, and tested up to 20 kV. Conducted experimental results verified the effectiveness of the proposed method

Clinical performance of a new silicone hydrogel contact lens over 6 months of extended wear

Purpose: Silicone hydrogel contact lenses (CLs) are becoming increasingly popular for daily wear (DW), extended wear (EW) and continuous wear (CW), due to their higher oxygen transmissibility compared to hydrogel CLs. The aim of this study was to investigate the clinical and subjective performance of asmofilcon A (Menicon Co., Ltd), a new surface treated silicone hydrogel CL, during 6-night EW over 6 months (M). Methods: A prospective, randomised, single-masked, monadic study was conducted. N=60 experienced DW soft CL wearers were randomly assigned to wear either asmofilcon A (test: Dk=129, water content (WC)=40%, Nanogloss surface treatment) or senofilcon A (control: Dk=103, WC=38%, PVP internal wetting agent, Vistakon, Johnson & Johnson Vision Care) CLs bilaterally for 6 M on an EW basis. A PHMB-preserved solution (Menicon Co., Ltd) was dispensed for CL care. Evaluations were conducted at CL delivery and after 1 week (W), 4 W, 3 M and 6 M of EW. At each visit, a range of objective and subjective clinical performance measures were assessed. Results: N=50 subjects (83%) successfully completed the study, with the majority of discontinuations due to loss to follow-up (n=3) or moving away/travel (n=5). N=2 subjects experienced adverse events; n=1 unilateral red eye with asmofilcon A and n=1 asymptomatic infiltrate with senofilcon A. There were no significant differences in high or low contrast distance visual acuity (HCDVA or LCDVA) between asmofilcon A and senofilcon A; however, LCDVA decreased significantly over time with both CL types (p<0.05). The two CL types did not vary significantly with respect to any of the objective and subjective measures assessed (p>0.05); CL fitting characteristics and CL surface measurements were very similar and mean bulbar and limbal redness measures were always less than grade 1.0. Superior palpebral conjunctival injection showed a statistically, but not clinically, significant increase over time with both CL types (p<0.05). Corneal staining did not vary significantly between asmofilcon A and senofilcon A (p>0.05), with low median gradings of less than 0.5 observed for all areas assessed. There were no solution-related staining reactions observed with either CL type. The asmofilcon A and senofilcon A CLs were both rated highly with respect to overall comfort, with medians of 14 or 15 hours of comfortable lens wearing time per day reported at each of the study visits (p>0.05). Conclusions: Over 6 months of EW, the asmofilcon A and senofilcon A CLs performed in a similar manner with respect to visual acuity, ocular health and CL performance measures. Some changes over time were observed with both CL types, including reduced LCDVA and increased superior palpebral injection, which warrant further investigation in longer-term EW studies. Asmofilcon A appeared to be equivalent in performance to senofilcon A.

District Court of Queensland Act 1968 s 68 : jurisdiction in pre-proceedings applications under Personal Injuries Proceedings Act 2002

In Woolworths Ltd v Graham [2007] QDC 301 Searles DCJ struck out a pre-proceedings application under the Personal Injuries Proceedings Act 2002 (Qld)on the basis that the material before the Court was not sufficient to attract the jurisdiction of the District Court.The decision serves more broadly as a reminder that the District Court is an inferior court of defined and limited jurisdiction and that any proceedings brought in it must be demonstrably within the jurisdiction conferred on that court by legislation.