Ocular changes associated with accommodation in myopes and emmetropes

This thesis examines the short-term changes occurring in a number of the eye's structures during reading tasks, and explores how these changes differ between normal eyes, and those with short-sightedness (myopia). This research revealed changes in the shape and thickness of a number of the eye's structures during near work, and aspects of these changes showed differences associated with myopia. These findings have potentially important implications for our understanding of the role of near work in the development and progression of myopia.

7-point Subjective Global Assessment is more time sensitive than conventional Subjective Global Assessment in detecting nutrition changes

Background: It is important for nutrition intervention in malnourished patients to be guided by accurate evaluation and detection of small changes in the patient’s nutrition status over time. However, the current Subjective Global Assessment (SGA) is not able to detect changes in a short period of time. The aim of the study was to determine whether 7-point SGA is more time sensitive to nutrition changes than the conventional SGA. Methods: In this prospective study, 67 adult inpatients assessed as malnourished using both the 7-point SGA and conventional SGA were recruited. Each patient received nutrition intervention and was followed up post-discharge. Patients were reassessed using both tools at 1, 3 and 5 months from baseline assessment. Results: It took significantly shorter time to see a one-point change using 7-point SGA compared to conventional SGA (median: 1 month vs. 3 months, p = 0.002). The likelihood of at least a one-point change is 6.74 times greater in 7-point SGA compared to conventional SGA after controlling for age, gender and medical specialties (odds ratio = 6.74, 95% CI 2.88-15.80, p<0.001). Fifty-six percent of patients who had no change in SGA score had changes detected using 7-point SGA. The level of agreement was 100% (k = 1, p < 0.001) between 7-point SGA and 3-point SGA and 83% (k=0.726, p<0.001) between two blinded assessors for 7-point SGA. Conclusion: The 7-point SGA is more time sensitive in its response to nutrition changes than conventional SGA. It can be used to guide nutrition intervention for patients.

Driver’s behavioural changes with new Intelligent Transport System interventions at railway level crossings: A driving simulator study

Improving safety at railway level crossings is an important issue for the Australian transport system. Governments, the rail industry and road organisations have tried a variety of countermeasures for many years to improve railway level crossing safety. New types of Intelligent Transport System (ITS) interventions are now emerging due to the availability and the affordability of technology. These interventions target both actively and passively protected railway level crossings and attempt to address drivers’ errors at railway crossings, which are mainly a failure to detect the crossing or the train and misjudgement of the train approach speed and distance. This study aims to assess the effectiveness of three emerging ITS that the rail industry considers implementing in Australia: a visual in-vehicle ITS, an audio in-vehicle ITS, as well as an on-road flashing beacons intervention. The evaluation was conducted on an advanced driving simulator with 20 participants per trialled technology, each participant driving once without any technology and once with one of the ITS interventions. Every participant drove through a range of active and passive crossings with and without trains approaching. Their speed approach of the crossing, head movements and stopping compliance were measured. Results showed that driver behaviour was changed with the three ITS interventions at passive crossings, while limited effects were found at active crossings, even with reduced visibility. The on-road intervention trialled was unsuccessful in improving driver behaviour; the audio and visual ITS improved driver behaviour when a train was approaching. A trend toward worsening driver behaviour with the visual ITS was observed when no trains were approaching. This trend was not observed for the audio ITS intervention, which appears to be the ITS intervention with the highest potential for improving safety at passive crossings.

BIM and PLM: Comparing and learning from changes to professional practice across sectors

This paper explores the effects of PLM and BIM on professional practice. It draws on existing literature documenting the experiences of both communities of practice to explain shifts in professional boundaries. A review of case study based literature compares the nature of changes triggered by PLM and BIM relative to the new activities, roles/responsibilities and knowledge competencies, and supply chain relationships. The paper synthesises these changes and reflects PLM and BIM experiences against each other so as to contrast the continuing evolution of professional practice and lessons learned.

Changes in cervical spine bone mineral density in response to flight training

BACKGROUND High magnitude loads and unusual loading regimes are two important determinants for increasing bone mass. Past research demonstrated that positive Gz-induced loading, providing high loads in an unaccustomed manner, had an osteogenic effect on bone. Another determinant of bone mass is that the bone response to loading is site specific. This study sought to further investigate the site specific bone response to loading, examining the cervical spine response, the site suspected of experiencing the greatest loading, to high performance flight. METHODS Bone mineral density (BMD) and bone mineral content (BMC) was monitored in 9 RAAF trainee fighter pilots completing an 8-mo flight training course on a PC-9 and 10 age-height-weight-matched controls. RESULTS At completion of the course, the pilots had a significant increase in cervical spine BMD and total body BMC. No significant changes were found for the control group. CONCLUSIONS This study demonstrated that the physical environment associated with flight training may have contributed to a significant increase in cervical spine bone mass in the trainee PC-9 pilots. The increase in bone mass was possibly a response to the strain generated by the daily wearing of helmet and mask assembly under the influence of positive sustained accelerative forces.

Indian bank efficiency and productivity changes with undesirable outputs: A disaggregated approach

The objective of this study is to examine technical efficiency and productivity growth in the Indian banking sector over the period from 2004 to 2011. We apply an innovative methodological approach introduced by Chen et al. (2011) and Barros et al. (2012), who use a weighted Russell directional distance model to measure technical inefficiency. We further modify and extend that model to measure TFP change with NPLs. We find that the inefficiency levels are significantly different among the three ownership structure of banks in India. Foreign banks have strong market position in India and they pull the production frontier in a more efficient direction. SPBs and domestic private banks show considerably higher inefficiency. We conclude that the restructuring policy applied in the late 1990s and early 2000s by the Indian government has not had a long-lasting effect.

Changes in mood, depression and suicidal ideation after commencing pregabalin for neuropathic pain

Background Pregabalin is a treatment option for patients with persistent neuropathic pain. Its use has been associated with changes in mood and the development of depression and/or suicidal ideation. Objective Case presentations were reviewed of five patients reporting changes in mood, depression and suicidal ideation from the first 50 (approximately) patients commenced on pregabalin at the clinic. Discussion Although these patients had a history of depression, their mood had been stable before commencing pregabalin. Soon after commencement they reported changes in mood, and development of depression and/or suicidal ideation, which improved with dose reduction or cessation of pregabalin. Ultimately, all five patients ceased pregabalin treatment. Suicidal ideation is a recog-nised adverse effect of pregabalin. Patients should be warned of and monitored for deterioration in mood.

Seasonal variations of outdoor air pollution and factors driving them in the school environment in rural Bhutan

A quantitative understanding of outdoor air quality in school environments is crucial given that air pollution levels inside classrooms are significantly influenced by outdoor pollution sources. To date, only a handful of studies have been conducted on this important topic in developing countries. The aim of this study was to quantify pollutant levels in the outdoor environment of a school in Bhutan and assess the factors driving them. Measurements were conducted for 16 weeks, spanning the wet and dry seasons, in a rural school in Bhutan. PM10, PM2.5, particle number (PN) and CO were measured daily using real-time instruments, while weekly samples for volatile organic compounds (VOCs), carbonyls and NO2 were collected using a passive sampling method. Overall mean PM10 and PM2.5 concentrations (µg/m3) were 27 and 13 for the wet, and 36 and 29 for the dry season, respectively. Only wet season data were available for PN concentrations, with a mean of 2.56 × 103 particles/cm3. Mean CO concentrations were below the detection limit of the instrumentation for the entire measurement period. Only low levels of eight VOCs were detected in both the wet and dry seasons, which presented different seasonal patterns in terms of the concentration of different compounds. The notable carbonyls were formaldehyde and hexaldehyde, with mean concentrations (µg/m3) of 2.37 and 2.41 for the wet, and 6.22 and 0.34 for the dry season, respectively. Mean NO2 cocentration for the dry season was 1.7 µg/m3, while it was below the detection limit of the instrumentation for the wet season. The pollutant concentrations were associated with a number of factors, such as cleaning and combustion activities in and around the school. A comparison with other school studies showed comparable results with a few of the studies, but in general, we found lower pollutant concentrations in the present study.

In response: Changes in ultraviolet transmittance of hydrogel and silicone hydrogel contact lenses induced by wear

We thank Dr Shedden and Dr Pall for their insightful comments and the opportunity to clarify a number of points from our work.1 The “protection factor” (PF) expressed as the inverse of the transmittance of contact lens (CL) material (1/Tλ), where T is the percentage transmittance of ultraviolet radiation (UVR) in a given waveband (UVC, UVB or UVA) of the UV spectrum for contact lenses is the standard method for reporting PF values and as such there should not be any controversy. We have calculated the PF for each wavelength across the entire UV spectrum (UVC, UVB, UVA) as presented in figure 3 of our previous publication.1 In that article, we were simply stating the observation when transmission in the UVC spectra band is considered especially because appreciable amounts of potentially carcinogenic short UV wavelengths was shown to be present in sunlight in our region three decades ago2 and these short wavelength photons are reported to be more biologically damaging to ocular tissues.3 In addition, the depletion of the Ozone layer is still continuing. Nevertheless, we understand the concern of the authors that the results of the PF might be confusing to those who are not familiar with the science of UVR and as such we have made some revisions to the findings of the calculated PF...

Changes in disability, physical/mental health states and quality of life during an 8-Week multimodal physiotherapy programme in patients with chronic non-specific neck pain: A prospective cohort study

Aim The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP), integrating physical land-based therapeutic exercise (TE), adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP), on disability, general health/mental states and quality of life. Methods 175 CNSNP patients from a community-based centre were recruited to participate in this prospective study. Intervention: 60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel). Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session. Study outcomes: primary: disability (Neck Disability Index); secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively). Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables. Results Disability showed a significant improvement of 24.6% from a mean (SD) of 28.2 (13.08) at baseline to 16.88 (11.62) at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2) at baseline to 0.83 (0.2), for EuroQoL-5D, and from a mean of 40.6 (12.7) at baseline to 56.9 (9.5), for mental health state, at the end of the 8-week intervention. Conclusion After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical efficacy requires verification using a randomised controlled study design.

Monitoring changes of the tibialis anterior during dorsiflexion with electromyography, sonomyography, dynamometry and kinematic signals

Dorsiflexion (DF) of the foot plays an essential role in both controlling balance and human gait. Electromyography and Sonomyography can provide information on several aspects of muscle function. The aim was to describe a new method for real-time monitoring of muscular activity, as measured using EMG, muscular architecture, as measured using SMG, force, as measured using dynamometry, and kinematic parameters, as measured using IS during isometric and isotonic contractions of the foot DF. The present methodology may be clinically relevant because it involves a reproducible procedure which allows the function and structure of the foot DF to be monitored.

Changes in anatomical brain connectivity between ages 12 and 30: A HARDI study of 467 adolescents and adults

Graph theory can be applied to matrices that represent the brain's anatomical connections, to better understand global properties of anatomical networks, such as their clustering, efficiency and "small-world" topology. Network analysis is popular in adult studies of connectivity, but only one study - in just 30 subjects - has examined how network measures change as the brain develops over this period. Here we assessed the developmental trajectory of graph theory metrics of structural brain connectivity in a cross-sectional study of 467 subjects, aged 12 to 30. We computed network measures from 70×70 connectivity matrices of fiber density generated using whole-brain tractography in 4-Tesla 105-gradient high angular resolution diffusion images (HARDI). We assessed global efficiency and modularity, and both age and age 2 effects were identified. HARDI-based connectivity maps are sensitive to the remodeling and refinement of structural brain connections as the human brain develops.

Changes in white matter connectivity following therapy for anomia post stroke

Background. The majority of studies investigating the neural mechanisms underlying treatment-induced recovery in aphasia have focused on the cortical regions associated with language processing. However, the integrity of the white matter connecting these regions may also be crucial to understanding treatment mechanisms. Objective. This study investigated the integrity of the arcuate fasciculus (AF) and uncinate fasciculus (UF) before and after treatment for anomia in people with aphasia. Method. Eight people with aphasia received 12 treatment sessions to improve naming; alternating between phonologically-based and semantic-based tasks, with high angular resolution diffusion imaging conducted pre and post treatment. The mean generalized fractional anisotropy (GFA), a measure of fiber integrity, and number of fibers in the AF and UF were compared pre and post treatment, as well as with a group of 14 healthy older controls. Results. Pre treatment, participants with aphasia had significantly fewer fibers and lower mean GFA in the left AF compared with controls. Post treatment, mean GFA increased in the left AF to be statistically equivalent to controls. Additionally, mean GFA in the left AF pre and post treatment positively correlated with maintenance of the phonologically based treatment. No differences were found in the right AF, or the UF in either hemisphere, between participants with aphasia and controls, and no changes were observed in these tracts following treatment. Conclusions. Anomia treatments may improve the integrity of the white matter connecting cortical language regions. These preliminary results add to the understanding of the mechanisms underlying treatment outcomes in people with aphasia post stroke.

A new method of detecting changes in corneal health in response to toxic insults

The size and arrangement of stromal collagen fibrils (CFs) influence the optical properties of the cornea and hence its function. The spatial arrangement of the collagen is still questionable in relation to the diameter of collagen fibril. In the present study, we introduce a new parameter, edge-fibrillar distance (EFD) to measure how two collagen fibrils are spaced with respect to their closest edges and their spatial distribution through normalized standard deviation of EFD (NSDEFD) accessed through the application of two commercially available multipurpose solutions (MPS): ReNu and Hippia. The corneal buttons were soaked separately in ReNu and Hippia MPS for five hours, fixed overnight in 2.5% glutaraldehyde containing cuprolinic blue and processed for transmission electron microscopy. The electron micrographs were processed using ImageJ user-coded plugin. Statistical analysis was performed to compare the image processed equivalent diameter (ED), inter-fibrillar distance (IFD), and EFD of the CFs of treated versus normal corneas. The ReNu-soaked cornea resulted in partly degenerated epithelium with loose hemidesmosomes and Bowman’s collagen. In contrast, the epithelium of the cornea soaked in Hippia was degenerated or lost but showed closely packed Bowman’s collagen. Soaking the corneas in both MPS caused a statistically significant decrease in the anterior collagen fibril, ED and a significant change in IFD, and EFD than those of the untreated corneas (p < 0.05, for all comparisons). The introduction of EFD measurement in the study directly provided a sense of gap between periphery of the collagen bundles, their spatial distribution; and in combination with ED, they showed how the corneal collagen bundles are spaced in relation to their diameters. The spatial distribution parameter NSDEFD indicated that ReNu treated cornea fibrils were uniformly distributed spatially, followed by normal and Hippia. The EFD measurement with relatively lower standard deviation and NSDEFD, a characteristic of uniform CFs distribution, can be an additional parameter used in evaluating collagen organization and accessing the effects of various treatments on corneal health and transparency.