Behavioural correlates of ocular accomodation and the autonomic nervous system

The binding issue of th is thesis was the examination of workload, induced by relinotopic and spatiotopic stimuli, on both the ocu lomotor and cardiovascular systems together with investigating the covariation between the two systems - the 'eye-heart' link. Further, the influence of refractive error on ocular accommodation and cardiovascular function was assessed. A clinical evaluation was undertaken to assess the newly available open-view infrared Shin-Nippon NVision-K 5001 optometer, its benefit being the capability to measure through pupils = 2.3 mm. Measurements of refractive error taken with the NVision-K were found to be both accurate (Difference in Mean Spherical Equivalent: 0.14 ± 0.35 D; p = 0.67) and repeatable when compared to non-cycloplegic subjective refraction. Due to technical difficulties, however, the NVision-K could not be used for the purpose of the thesis, as such, measures of accommodation were taken using the continuously recording Shin-Nippon SRW-5000 openview infrared optometer, coupled with a piezo-electric finger pulse transducer to measure pulse. Heart rate variability (HRV) was spectrally analysed to determine the systemic sympathetic and parasympathetic components of the autonomic nervous system (ANS). A large sample (n = 60), cross-sectional study showed late-onset myopes (LOMs) display less accurate responses when compared to other refractive groups at high accommodative demand levels (3 .0 0 and 4.0D). Tonic accommodation (TA) was highest in the hypermetropes, fo llowed by emmetropes and early-onset myopes while the LOM subjects demonstrated statistically significant lower levels of TA. The root-meansquare (RMS) value of the accommodative response was shown to amplify with increased levels of accommodative demand. Changes in refractive error only became significant between groups at higher demand levels (3.0 D and 4.0 D) with the LOMs showing the largest magnification in oscilIations. Examination of the stimulus-response cross-over point with the unit ratio line and TA showed a correlation between the two (r = 0.45, p = 0.001), where TA is approximately twice the dioptric value of the stimulus-response cross-over point. Investigation of the relationship between ocular accommodation and systemic ANS function demonstrated covariation between the systems. Subjects with a faster heart rate (lower heart period) tended to have a higher TA value (r = -0.27, p < 0.05). Further, an increase in accommodative demand accompanies a faster heart rate. The influence of refractive error on the cardiovascular response to changes in accommodative demand, however, was equivocal. Examination of the microfluctuations ofacconunodation demonstrated a correlation between the temporal frequency location of the accommodative high Frequency component (HFC) and the arterial pulse frequency. The correlation was present at a range of accommodative demands from 0.0 D to 4.0 D and in all four refractive groups, suggesting that the HFC was augmented by physiological factors. Examination of the effect of visual cognition on ocular accommodation and the ANS confirmed that increasing levels of cognition affect the accommodative mechanism. The accommodative response shifted away from the subject at both near and far. This shift in accommodative response accompanied a decay in the systemic parasympathetic innervation to the heart. Differences between refractive groups also existed with LOMs showing less accurate responses compared to emmetropes. This disparity, however, appeared to be augmented by the systemic sympathetic nervous system. The investigations discussed explored Ihe role of oculomotor and cardiovascular fu nction in workload enviromnents, providing evidence for a behavioural link between the cardiovascular and oculomotor systems.

Autonomic dysfunction and systemic oxidative stress associated with glaucomatous optic neuropathy

There were four principal sections to the work: 1. Investigation of ocular and systemic vascular risk factors in POAG. The principal findings of this work were: a). Glaucoma patients exhibit an anticipatory reaction to the physical stress, similar to subjects at risk for cardiovascular diseases; a blunted BP response and a reduction in ONH blood flow in response to cold provocation was also recorded. b). Silent myocardial ischaemic episodes occurred during peaks in systemic BP and HR. c). Independent of a positive history for cardiovascular diseases, patients suffering from POAG demonstrate a blunt circadian rhythm of the ANS. 2. Assessment of the relationship between vascular and systemic vascular risk factors in GON. The principal findings of this work were: a). POAG patients demonstrate a high sympathetic tonus over a 24-h period. b). POAG patients with lower OBF demonstrate both 24-h systemic BP and HRV abnormalities. c). OBF alterations observed in some glaucoma patients could be either primary or secondary to systemic haemodynamic disturbances and not a consequence of ONH damage. 3. Assessment of the level of systemic anti-oxidant defence in POAG patients. The principal finding of this work was: Patients suffering from POAG demonstrated significantly lower GSH and t-GSH levels than normal controls. 4. Investigation of the effect of treatment with latanoprost 0.005% on visual function and OBF. The findings of this work were: a). Treatment with latanoprost 0.005% resulted in a significant decrease in IOP and increase in OPP. VF damage progression has also been stopped. b). Treatment with latanoprost 0.005% resulted in a significant increase in the OBF parameters measured at the ONH and peripapillary retina levels. Finally, the importance of a clear protocol for managing new POAG cases is highlighted and a clinical conduit is proposed.

Autonomic response in depersonalisation disorder

Background Emotional-processing inhibition has been suggested as a mechanism underlying some of the clinical features of depersonalization and/or derealization. In this study, we tested the prediction that autonomic response to emotional stimuli would be reduced in patients with depersonalization disorder. Methods The skin conductance responses of 15 patients with chronic depersonalization disorder according to DSM-IV, 15 controls, and 11 individuals with anxiety disorders according to DSM-IV, were recorded in response to nonspecific elicitors (an unexpected clap and taking a sigh) and in response to 15 randomized pictures with different emotional valences: 5 unpleasant, 5 pleasant, and 5 neutral. Results The skin conductance response to unpleasant pictures was significantly reduced in patients with depersonalization disorder (magnitude of 0.017 µsiemens in controls and 0.103 µsiemens in patients with anxiety disorders; P = .01). Also, the latency of response to these stimuli was significantly prolonged in the group with depersonalization disorder (3.01 seconds compared with 2.5 and 2.1 seconds in the control and anxiety groups, respectively; P = .02). In contrast, latency to nonspecific stimuli (clap and sigh) was significantly shorter in the depersonalization and anxiety groups (1.6 seconds) than in controls (2.3 seconds) (P = .03). Conclusions In depersonalization disorder, autonomic response to unpleasant stimuli is reduced. The fact that patients with depersonalization disorder respond earlier to a startling noise suggests that they are in a heightened state of alertness and that the reduced response to unpleasant stimuli is caused by a selective inhibitory mechanism on emotional processing.

Autonomic response in the perception of disgust and happiness in depersonalization disorder

Patients with depersonalization disorder have shown attenuated responses to emotional unpleasant stimuli, hence supporting the view that depersonalization is characterised by a selective inhibition on the processing of unpleasant emotions. It was the purpose of this study to establish if autonomic responses to facial emotional expressions also show the same blunting effect. The skin conductance responses (SCRs) of 16 patients with chronic DSM-IV depersonalization disorder, 15 normal controls and 15 clinical controls with DSM-IV anxiety disorders were recorded in response to facial expressions of happiness and disgust. Patients with anxiety disorders were found to have greater autonomic responses than patients with depersonalization, in spite of the fact that both groups had similarly high levels of subjective anxiety as measured by anxiety scales. SCR to happy faces did not vary across groups. The findings of this study provide further support to the idea that patients with depersonalization have a selective impairment in the processing of threatening or unpleasant emotional stimuli.

Glutamatergic input-output properties of thalamic astrocytes

Astrocytes in the somatosensory ventrobasal (VB) thalamus of rats respond to glutamatergic synaptic input with metabotropic glutamate receptor (mGluR) mediated intracellular calcium ([Ca²?](i)) elevations. Astrocytes in the VB thalamus also release the gliotransmitter (GT) glutamate in a Ca²?-dependent manner. The tripartite synapse hypothesis posits that astrocytic [Ca²?](i) elevations resulting from synaptic input releases gliotransmitters that then feedback to modify the synapse. Understanding the dynamics of this process and the conditions under which it occurs are therefore important steps in elucidating the potential roles and impact of GT release in particular brain activities. In this study, we investigated the relationship between VB thalamus afferent synaptic input and astrocytic glutamate release by recording N-methyl-D-aspartate (NMDA) receptor-mediated slow inward currents (SICs) elicited in neighboring neurons. We found that Lemniscal or cortical afferent stimulation, which can elicit astrocytic [Ca²?](i) elevations, do not typically result in the generation of SICs in thalamocortical (TC) neurons. Rather, we find that the spontaneous emergence of SICs is largely resistant to acute afferent input. The frequency of SICs, however, is correlated to long-lasting afferent activity. In contrast to short-term stimulus-evoked GT release effects reported in other brain areas, astrocytes in the VB thalamus do not express a straightforward input-output relationship for SIC generation but exhibit integrative characteristics.

Team effectiveness: a test of in-put process-output

This research addressed the question: "Which factors predict the effectiveness of healthcare teams?" It was addressed by assessing the psychometric properties of a new measure of team functioning with the use of data collected from 797 team members in 61 healthcare teams. This new measure is the Aston Team Performance Inventory (ATPI) developed by West, Markiewicz and Dawson (2005) and based on the IPO model. The ATPI was pilot tested in order to examine the reliability of this measure in the Jordanian cultural context. A sample of five teams comprising 3-6 members each was randomly selected from the Jordan Red Crescent health centers in Amman. Factors that predict team effectiveness were explored in a Jordanian sample (comprising 1622 members in 277 teams with 255 leaders from healthcare teams in hospitals in Amman) using self-report and Leader Ratings measures adapted from work by West, Borrill et al (2000) to determine team effectiveness and innovation from the leaders' point of view. The results demonstrate the validity and reliability of the measures for use in healthcare settings. Team effort and skills and leader managing had the strongest association with team processes in terms of team objectives, reflexivity, participation, task focus, creativity and innovation. Team inputs in terms of task design, team effort and skills, and organizational support were associated with team effectiveness and innovation whereas team resources were associated only with team innovation. Team objectives had the strongest mediated and direct association with team effectiveness whereas task focus had the strongest mediated and direct association with team innovation. Finally, among leadership variables, leader managing had the strongest association with team effectiveness and innovation. The theoretical and practical implications of this thesis are that: team effectiveness and innovation are influenced by multiple factors that must all be taken into account. The key factors managers need to ensure are in place for effective teams are team effort and skills, organizational support and team objectives. To conclude, the application of these findings to healthcare teams in Jordan will help improve their team effectiveness, and thus the healthcare services that they provide.

The efficiency and productivity of Malaysian banks:an output distance function approach

This study employs stochastic frontier analysis to analyze Malaysian commercial banks during 1996-2002, and particularly focuses on determining the impact of Islamic banking on performance. We derive both net and gross efficiency estimates, thereby demonstrating that differences in operating characteristics explain much of the difference in outputs between Malaysian banks. We also decompose productivity change into efficiency, technical, and scale change using a generalised Malmquist productivity index. On average, Malaysian banks experience mild decreasing return to scale and annual productivity change of 2.37 percent, with the latter driven primarily by technical change, which has declined over time. Our gross efficiency estimates suggest that Islamic banking is associated with higher input requirements. In addition, our productivity estimates indicate that the potential for full-fledged Islamic banks and conventional banks with Islamic banking operations to overcome the output disadvantages associated with Islamic banking are relatively limited. Merged banks are found to have higher input usage and lower productivity change, suggesting that bank mergers have not contributed positively to bank performance. Finally, our results suggest that while the East Asian financial crisis had an interim output-increasing effect in 1998, the crisis prompted a continuing negative impact on the output performance by increasing the volume of non-performing loans.

DesaLink:solar powered desalination of brackish groundwater giving high output and high recovery

Desalination of groundwater is essential in many arid areas that are far from both seawater and fresh water resources. The ideal groundwater desalination system should operate using a sustainable energy source and provide high water output per land area and cost. To avoid discharging voluminous brine, it should also provide high recovery. To achieve these aims, we have designed DesaLink, a novel approach to linking the solar Rankine cycle to reverse osmosis (RO). To achieve high recovery without the need for multiple RO stages, DesaLink adopts a batch mode of operation. It is suited to use with a variety of solar thermal collectors including linear Fresnel reflectors (LFR). For example, using a LFR occupying 1,000m of land and providing steam at 200°C and 15.5 bar, DesaLink is predicted to provide 350m of fresh water per day at a recovery ratio of 0.7, when fed with brackish groundwater containing 5,000ppm of sodium chloride. Here, we report preliminary experiments to assess the feasibility of the concept. We study the effects of longitudinal dispersion, concentration polarisation and describe a pilot experiment to demonstrate the batch process using a materials testing machine. In addition, we demonstrate a prototype of DesaLink running from compressed air to simulate steam.

Optimal input/output reduction in production processes

While conventional Data Envelopment Analysis (DEA) models set targets for each operational unit, this paper considers the problem of input/output reduction in a centralized decision making environment. The purpose of this paper is to develop an approach to input/output reduction problem that typically occurs in organizations with a centralized decision-making environment. This paper shows that DEA can make an important contribution to this problem and discusses how DEA-based model can be used to determine an optimal input/output reduction plan. An application in banking sector with limitation in IT investment shows the usefulness of the proposed method.

Input/output deterioration in production processes

In many real applications of Data Envelopment Analysis (DEA), the decision makers have to deteriorate some inputs and some outputs. This could be because of limitation of funds available. This paper proposes a new DEA-based approach to determine highest possible reduction in the concern input variables and lowest possible deterioration in the concern output variables without reducing the efficiency in any DMU. A numerical example is used to illustrate the problem. An application in banking sector with limitation of IT investment shows the usefulness of the proposed method. © 2010 Elsevier Ltd. All rights reserved.

A framework for assessing business-incubation input, process and output performance:proceedings of the RENT XXVII Conference, 20-22 November 2013, Vilnius, Lithuania

With business incubators deemed as a potent infrastructural element for entrepreneurship development, business incubation management practice and performance have received widespread attention. However, despite this surge of interest, scholars have questioned the extent to which business incubation delivers added value. Thus, there is a growing awareness among researchers, practitioners and policy makers of the need for more rigorous evaluation of the business incubation output performance. Aligned to this is an increasing demand for benchmarking business incubation input/process performance and highlighting best practice. This paper offers a business incubation assessment framework, which considers input/process and output performance domains with relevant indicators. This tool adds value on different levels. It has been developed in collaboration with practitioners and industry experts and therefore it would be relevant and useful to business incubation managers. Once a large enough database of completed questionnaires has been populated on an online platform managed by a coordinating mechanism, such as a business incubation membership association, business incubator managers can reflect on their practices by using this assessment framework to learn their relative position vis-à-vis their peers against each domain. This will enable them to align with best practice in this field. Beyond implications for business incubation management practice, this performance assessment framework would also be useful to researchers and policy makers concerned with business incubation management practice and impact. Future large-scale research could test for construct validity and reliability. Also, discriminant analysis could help link input and process indicators with output measures.

Tunable and multiple-wavelengths/temporal output from gain-switched diode laser and a four Bragg-grating fiber

The spectral narrowing and selective tuning of picosecond pulse outputs from gain-switched diode laser and a four Bragg-grating fiber, were investigated. The fiber used under investigation was designed to provide spectral narrowing and multiple wavelength/temporal output. The maximum transmission out of each of the four output fibers was ∼7.5 mW, for a current of 180 mA. The results show that an output of any combination of multiple wavelengths is only produced at modulation frequencies which satisfy resonant conditions for all cavity arms simultaneously.