Visual rehabilitation in low-moderate keratoconus : intracorneal ring segment implantation followed by same-day topography-guided photorefractive keratectomy and collagen cross linking

AIM: To present the results of same-day topography-guided photorefractive keratectomy (TG-PRK) and corneal collagen crosslinking (CXL) after previous intrastromal corneal ring segment (ISCR) implantation for keratoconus. METHODS: An experimental clinical study on twenty-one eyes of 19 patients aged, 27.1±6.6 years (range: 19 – 43 years), with low to moderate keratoconus who were selected to undergo customized TG-PRK immediately followed by same-day CXL, 9 months after ISCR implantation in a university ophthalmology clinic. Refraction, uncorrected (UDVA) and corrected distance visual acuities (CDVA), keratometry (K) values, central corneal thickness (CCT) and coma were assessed 3 months after TG/PRK and CXL. RESULTS: After TG-PRK/CXL: the mean UDVA (logMAR) improved significantly from 0.66±0.41 to 0.20±0.25 (P<0.05); K flat value decreased from: 48.44±3.66 D to 43.71±1.95 D; K steep value decreased from 45.61±2.40 D to 41.56±2.05D; K average also decreased from 42.42±2.07 D to 47.00±2.66 D (P<0.05 for all). The mean sphere and cylinder decreased significantly post-surgery from, -3.10±2.99 D to -0.11±0.93 D and from, -3.68±1.53 to -1.11±0.75D respectively, while the CDVA, CCT and coma showed no significant changes. Compared to post-ISCR, significant reductions (P ˂ 0.05 or all) in all K-values, sphere and cylinder were observed after TG-PRK/CXL. CONCLUSION: Same-day combined topography-guided PRK and corneal crosslinking following placement of ICRS is a safe and potentially effective option in treating low-moderate keratoconus. It significantly improved all visual acuity, reduced keratometry, sphere and astigmatism, but caused no change in central corneal thickness and coma.

One-year clinical outcomes of a two-step surgical management for keratoconus-topography-guided photorefractive keratectomy/cross-linking after intrastromal corneal ring implantation

PURPOSE - To present the results of same-day topography-guided photorefractive keratectomy (TG-PRK) and corneal collagen cross-linking (CXL) after intrastromal corneal ring (ISCR) implantation in patients with keratoconus. METHODS - Thirty-three patients (41 eyes) aged between 19 and 45 years were included in this prospective study. All patients underwent a femtosecond laser-enabled (Intralase FS; Abbott Medical Optics, Inc.) placement of intracorneal ring segments (Kerarings; Mediphacos, Brazil). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and keratometry readings remained stable for 6 months. Same-day PRK and CXL was subsequently performed in all patients. RESULTS - After 12 months of completion of the procedure, mean UDVA in log of minimal angle of resolution was significantly improved (0.74±0.54-0.10±0.16); CDVA did not improve significantly but 85% of eyes maintained or gained multiple lines of CDVA; mean refraction spherical equivalent improved (from -3.03±1.98 to -0.04±0.99 D), all keratometry readings were significantly reduced, from preoperative values, but coma did not vary significantly from preoperative values. Central corneal thickness and corneal thickness at the thinnest point were significantly (P<0.0001) reduced from 519.76±29.33 and 501.87±31.50 preoperatively to 464.71±36.79 and 436.55±47.42 postoperatively, respectively. Safety and efficacy indices were 0.97 and 0.88, respectively. From 6 months up until more than 1 year of follow-up, further significant improvement was observed only for UDVA (P<0.0001). CONCLUSIONS - Same-day combined TG-PRK and CXL after ISCR implantation is a safe and effective option for improving visual acuity and visual function, and it halts the progression of the keratoconus. The improvements recorded after 6 months of follow-up were maintained or improved upon 1 year after the procedure.

A pilot study investigating the efficacy of an imagery-based motivational intervention for smoking cessation

This pilot study evaluated the potential efficacy of an imagery-based intervention called Functional Imagery Training (FIT) as a therapeutic approach to smoking cessation. FIT showed promising results in reducing cigarette use, managing craving, and promoting abstinence among smokers when compared to a control condition, and may play a role in maintaining smokers' motivation to quit. This study was the first of its kind, and paves the way for future investigations into FIT as a smoking cessation intervention.

Photo-ionization and residual electron effects in guided streamers

Complementary experiments and numerical modeling reveal the important role of photo-ionization in the guided streamer propagation in helium-air gas mixtures. It is shown that the minimum electron concentration ∼108 cm−3 is required for the regular, repeated propagation of the plasma bullets, while the streamers propagate in the stochastic mode below this threshold. The stochastic-to-regular mode transition is related to the higher background electron density in front of the propagating streamers. These findings help improving control of guided streamer propagation in applications from health care to nanotechnology and improve understanding of generic pre-breakdown phenomena.

Topology-Guided Tessellation Of Quadratic Elements

Topology-based methods have been successfully used for the analysis and visualization of piecewise-linear functions defined on triangle meshes. This paper describes a mechanism for extending these methods to piecewise-quadratic functions defined on triangulations of surfaces. Each triangular patch is tessellated into monotone regions, so that existing algorithms for computing topological representations of piecewise-linear functions may be applied directly to the piecewise-quadratic function. In particular, the tessellation is used for computing the Reeb graph, a topological data structure that provides a succinct representation of level sets of the function.

CBCT-guided radiotherapy for locally advanced head and cancer: dosimetric impact of weight loss on VMAT and IMRT plans for selected organs at risk structures (OARs)

Purpose: It is common for head and neck patients to be affected by time trend errors as a result of weight loss during a course of radiation treatment. The objective of this planning study was to investigate the impact of weight loss on Volumetric Modulated Arc Therapy (VMAT) as well as Intensity modulated radiation therapy (IMRT) for locally advanced head and neck cancer using automatic co-registration of the CBCT. Methods and Materials: A retrospective analysis of previously treated IMRT plans for 10 patients with locally advanced head and neck cancer patients was done. A VMAT plan was also produced for all patients. We calculated the dose–volume histograms (DVH) indices for spinal cord planning at risk volumes (PRVs), the brainstem PRVs (SC+0.5cm and BS+0.5cm, respectively) as well as mean dose to the parotid glands. Results: The results show that the mean difference in dose to the SC+0.5cm was 1.03% and 1.27% for the IMRT and VMAT plans, respectively. As for dose to the BS+0.5, the percentage difference was 0.63% for the IMRT plans and 0.61% for the VMAT plans. The analysis of the parotid gland doses shows that the percentage change in mean dose to left parotid was -8.0% whereas that of the right parotid was -6.4% for the IMRT treatment plans. In the VMAT plans, the percentages change for the left and the right parotid glands were -6.6% and -6.7% respectively. Conclusions: This study shows a clinically significant impact of weight loss on DVH indices analysed in head and neck organs at risk. It highlights the importance of adaptive radiotherapy in head and neck patients if organ at risk sparing is to be maintained.

Fraunhoffer Diffraction Analysis of Satellite Cloud Imagery

The Fraunhoffer diffraction analysis of cloud-covered satellite imagery has shown that the diffraction pattern follows approximately cosine squared distribution. The overshooting tops of clouds and the shadows cast by them contribute much to the diffraction of light, particularly in the high-frequency range. Indeed, cloud-covered imagery can be distinguished from cloud-free imagery on the basis of rate of decay of the diffracted light power in the high-frequency band.

Detecting the attributes of a wheat crop using digital imagery acquired from a low-altitude platform

A low-altitude platform utilising a 1.8-m diameter tethered helium balloon was used to position a multispectral sensor, consisting of two digital cameras, above a fertiliser trial plot where wheat (Triticum spp.) was being grown. Located in Cecil Plains, Queensland, Australia, the plot was a long-term fertiliser trial being conducted by a fertiliser company to monitor the response of crops to various levels of nutrition. The different levels of nutrition were achieved by varying nitrogen application rates between 0 and 120 units of N at 40 unit increments. Each plot had received the same application rate for 10 years. Colour and near-infrared images were acquired that captured the whole 2 ha plot. These images were examined and relationships sought between the captured digital information and the crop parameters imaged at anthesis and the at-harvest quality and quantity parameters. The statistical analysis techniques used were correlation analysis, discriminant analysis and partial least squares regression. A high correlation was found between the image and yield (R2 = 0.91) and a moderate correlation between the image and grain protein content (R2 = 0.66). The utility of the system could be extended by choosing a more mobile platform. This would increase the potential for the system to be used to diagnose the causes of the variability and allow remediation, and/or to segregate the crop at harvest to meet certain quality parameters.

Estimating crop area using seasonal time series of enhanced vegetation index from MODIS satellite imagery

Cereal grain is one of the main export commodities of Australian agriculture. Over the past decade, crop yield forecasts for wheat and sorghum have shown appreciable utility for industry planning at shire, state, and national scales. There is now an increasing drive from industry for more accurate and cost-effective crop production forecasts. In order to generate production estimates, accurate crop area estimates are needed by the end of the cropping season. Multivariate methods for analysing remotely sensed Enhanced Vegetation Index (EVI) from 16-day Moderate Resolution Imaging Spectroradiometer (MODIS) satellite imagery within the cropping period (i.e. April-November) were investigated to estimate crop area for wheat, barley, chickpea, and total winter cropped area for a case study region in NE Australia. Each pixel classification method was trained on ground truth data collected from the study region. Three approaches to pixel classification were examined: (i) cluster analysis of trajectories of EVI values from consecutive multi-date imagery during the crop growth period; (ii) harmonic analysis of the time series (HANTS) of the EVI values; and (iii) principal component analysis (PCA) of the time series of EVI values. Images classified using these three approaches were compared with each other, and with a classification based on the single MODIS image taken at peak EVI. Imagery for the 2003 and 2004 seasons was used to assess the ability of the methods to determine wheat, barley, chickpea, and total cropped area estimates. The accuracy at pixel scale was determined by the percent correct classification metric by contrasting all pixel scale samples with independent pixel observations. At a shire level, aggregated total crop area estimates were compared with surveyed estimates. All multi-temporal methods showed significant overall capability to estimate total winter crop area. There was high accuracy at pixel scale (>98% correct classification) for identifying overall winter cropping. However, discrimination among crops was less accurate. Although the use of single-date EVI data produced high accuracy for estimates of wheat area at shire scale, the result contradicted the poor pixel-scale accuracy associated with this approach, due to fortuitous compensating errors. Further studies are needed to extrapolate the multi-temporal approaches to other geographical areas and to improve the lead time for deriving cropped-area estimates before harvest.

An imagery-based road map to tackle maladaptive motivation in clinical disorders

There is now a widespread recognition of the importance of mental imagery in a range of clinical disorders (1). This provides the potential for a transdiagnostic route to integrate some aspects of these disorders and their treatment within a common framework. This opinion piece argues that we need to understand why imagery is such a central and recurring feature, if we are to progress theories of the origin and maintenance of disorders. This will aid us in identifying therapeutic techniques that are not simply targeting imagery as a symptom, but as a manifestation of an underlying problem. As papers in this issue highlight, imagery is a central feature across many clinical disorders, but has been ascribed varying roles. For example, the involuntary occurrence of traumatic memories is a diagnostic criterion for PTSD (2), and it has been suggested that multisensory imagery of traumatic events normally serves a functional role in allowing the individual to reappraise the situation (3), but that this re-appraisal is disabled by extreme affective responses. In contrast to the disabling flashbacks associated with PTSD, depressed adults who experience suicidal ideation often report “flash forward” imagery related to suicidal acts (4), motivating them to self-harm. Socially anxious individuals who engage in visual imagery about giving a talk in public become more anxious and make more negative predictions about future performance than others who engage in more abstract, semantic processing of the past event (5). People with Obsessive Compulsive Disorder (OCD) frequently report imagery of past adverse events, and imagery seems to be associated with severity (6). The content of intrusive imagery has been related to psychotic symptoms (7), including visual images of the catastrophic fears associated with paranoia and persecution. Imagery has been argued (8) to play a role in the maintenance of psychosis through negative appraisals of imagined voices, misattribution of sensations to external sources, by the induction of negative mood states that trigger voices, and through maintenance of negative schemas. In addiction and substance dependence, Elaborated Intrusion (EI) Theory (9, 10) emphasizes the causal role that imagery plays in substance use, through its role in motivating an individual to pursue goals directed toward achieving the pleasurable outcomes associated with substance use...

High resolution satellite imagery and GPS collars can help assist in the assessment of patch selection by grazing cattle in semi-arid savannas.

The selection of different patch types for grazing by cattle in tropical savannas is well documented. Advances in high resolution satellite imagery and computing power now allow us to identify patch types over an entire paddock, combined with GPS collars as a non instrusive method of capturing positional data, an accurate and comprehensive picture of landscape use by cattle can be quantified.

Patch selection by cattle can be quantified using satellite imagery and GPS in extensive, semi-arid savannas.

Patch selection by grazing animals is difficult to quantify, particularly in large, extensive paddocks like those in northern Australia. However, advances in high resolution satellite imagery now allow identification of patch types over an entire paddock which combined with GPS collars to capture positional data, can give an accurate and comprehensive picture of landscape use by cattle.

Estimating winter crop area across seasons and regions using time-sequential MODIS imagery.

The wheat grain industry is Australia's second largest agricultural export commodity. There is an increasing demand for accurate, objective and near real-time crop production information by industry. The advent of the Moderate Resolution Imaging Spectroradiometer (MODIS) satellite platform has augmented the capability of satellite-based applications to capture reflectance over large areas at acceptable pixel scale, cost and accuracy. The use of multi-temporal MODIS-enhanced vegetation index (EVI) imagery to determine crop area was investigated in this article. Here the rigour of the harmonic analysis of time-series (HANTS) and early-season metric approaches was assessed when extrapolating over the entire Queensland (QLD) cropping region for the 2005 and 2006 seasons. Early-season crop area estimates, at least 4 months before harvest, produced high accuracy at pixel and regional scales with percent errors of -8.6% and -26% for the 2005 and 2006 seasons, respectively. In discriminating among crops at pixel and regional scale, the HANTS approach showed high accuracy. The errors for specific area estimates for wheat, barley and chickpea were 9.9%, -5.2% and 10.9% (for 2005) and -2.8%, -78% and 64% (for 2006), respectively. Area estimates of total winter crop, wheat, barley and chickpea resulted in coefficient of determination (R(2)) values of 0.92, 0.89, 0.82 and 0.52, when contrasted against the actual shire-scale data. A significantly high coefficient of determination (0.87) was achieved for total winter crop area estimates in August across all shires for the 2006 season. Furthermore, the HANTS approach showed high accuracy in discriminating cropping area from non-cropping area and highlighted the need for accurate and up-to-date land use maps. The extrapolability of these approaches to determine total and specific winter crop area estimates, well before flowering, showed good utility across larger areas and seasons. Hence, it is envisaged that this technology might be transferable to different regions across Australia.

Burnt area mapping in insular Southeast Asia using medium resolution satellite imagery

Burnt area mapping in humid tropical insular Southeast Asia using medium resolution (250-500m) satellite imagery is characterized by persisting cloud cover, wide range of land cover types, vast amount of wetland areas and highly varying fire regimes. The objective of this study was to deepen understanding of three major aspects affecting the implementation and limits of medium resolution burnt area mapping in insular Southeast Asia: 1) fire-induced spectral changes, 2) most suitable multitemporal compositing methods and 3) burn scars patterns and size distribution. The results revealed a high variation in fire-induced spectral changes depending on the pre-fire greenness of burnt area. It was concluded that this variation needs to be taken into account in change detection based burnt area mapping algorithms in order to maximize the potential of medium resolution satellite data. Minimum near infrared (MODIS band 2, 0.86μm) compositing method was found to be the most suitable for burnt area mapping purposes using Moderate Resolution Imaging Spectroradiometer (MODIS) data. In general, medium resolution burnt area mapping was found to be usable in the wetlands of insular Southeast Asia, whereas in other areas the usability was seriously jeopardized by the small size of burn scars. The suitability of medium resolution data for burnt area mapping in wetlands is important since recently Southeast Asian wetlands have become a major point of interest in many fields of science due to yearly occurring wild fires that not only degrade these unique ecosystems but also create regional haze problem and release globally significant amounts of carbon into the atmosphere due to burning peat. Finally, super-resolution MODIS images were tested but the test failed to improve the detection of small scars. Therefore, super-resolution technique was not considered to be applicable to regional level burnt area mapping in insular Southeast Asia.

Separating grazing and rainfall effects at regional scale using remote sensing imagery: A dynamic reference-cover method

Remote detection of management-related trend in the presence of inter-annual climatic variability in the rangelands is difficult. Minimally disturbed reference areas provide a useful guide, but suitable benchmarks are usually difficult to identify. We describe a method that uses a unique conceptual framework to identify reference areas from multitemporal sequences of ground cover derived from Landsat TM and ETM+ imagery. The method does not require ground-based reference sites nor GIS layers about management. We calculate a minimum ground cover image across all years to identify locations of most persistent ground cover in years of lowest rainfall. We then use a moving window approach to calculate the difference between the window's central pixel and its surrounding reference pixels. This difference estimates ground-cover change between successive below-average rainfall years, which provides a seasonally interpreted measure of management effects. We examine the approach's sensitivity to window size and to cover-index percentiles used to define persistence. The method successfully detected management-related change in ground cover in Queensland tropical savanna woodlands in two case studies: (1) a grazing trial where heavy stocking resulted in substantial decline in ground cover in small paddocks, and (2) commercial paddocks where wet-season spelling (destocking) resulted in increased ground cover. At a larger scale, there was broad agreement between our analysis of ground-cover change and ground-based land condition change for commercial beef properties with different a priori ratings of initial condition, but there was also some disagreement where changing condition reflected pasture composition rather than ground cover. We conclude that the method is suitably robust to analyse grazing effects on ground cover across the 1.3 x 10(6) km(2) of Queensland's rangelands. Crown Copyright (c) 2012 Published by Elsevier Inc. All rights reserved.