Determinants and two-year change in anterior chamber angle width in a Chinese population

Objective: To study the population distribution and longitudinal changes in anterior chamber angle width and its determinants among Chinese adults. Design: Prospective cohort, population-based study. Participants: Persons aged 35 years or more residing in Guangzhou, China, who had not previously undergone incisional or laser eye surgery. Methods: In December 2008 and December 2010, all subjects underwent automated keratometry, and a random 50% sample had anterior segment optical coherence tomography with measurement of angle-opening distance at 500 μm (AOD500), angle recess area (ARA), iris thickness at 750 μm (IT750), iris curvature, pupil diameter, corneal thickness, anterior chamber width (ACW), lens vault (LV), and lens thickness (LT) and measurement of axial length (AL) and anterior chamber depth (ACD) by partial coherence laser interferometry. Main Outcome Measures: Baseline and 2-year change in AOD500 and ARA in the right eye. Results: A total of 745 subjects were present for full biometric testing in both 2008 and 2010 (mean age at baseline, 52.2 years; standard deviation [SD], 11.5 years; 53.7% were female). Test completion rates in 2010 varied from 77.3% (AOD500: 576/745) to 100% (AL). Mean AOD500 decreased from 0.25 mm (SD, 0.13 mm) in 2008 to 0.21 mm (SD, 13 mm) in 2010 (difference, -0.04; 95% confidence interval [CI], -0.05 to -0.03). The ARA decreased from 21.5±3.73 10^-2 mm² to 21.0±3.64 10 ^-2 mm² (difference, -0.46; 95% CI, -0.52 to -0.41). The decrease in both was most pronounced among younger subjects and those with baseline AOD500 in the widest quartile at baseline. The following baseline variables were significantly associated with a greater 2-year decrease in both AOD500 and ARA: deeper ACD, steeper iris curvature, smaller LV, greater ARA, and greater AOD500. By using simple regression models, we could explain 52% to 58% and 93% of variation in baseline AOD500 and ARA, respectively, but only 27% and 16% of variation in 2-year change in AOD500 and ARA, respectively. Conclusions: Younger persons and those with the least crowded anterior chambers at baseline have the largest 2-year decreases in AOD500 and ARA. The ability to predict change in angle width based on demographic and biometric factors is relatively poor, which may have implications for screening. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2012 American Academy of Ophthalmology.

Central corneal thickness and corneal hysteresis associated with glaucoma damage.

PURPOSE:

We sought to measure the impact of central corneal thickness (CCT), a possible risk factor for glaucoma damage, and corneal hysteresis, a proposed measure of corneal resistance to deformation, on various indicators of glaucoma damage.

DESIGN:

Observational study.

METHODS:

Adult patients of the Wilmer Glaucoma Service underwent measurement of hysteresis on the Reichert Ocular Response Analyzer and measurement of CCT by ultrasonic pachymetry. Two glaucoma specialists (H.A.Q., N.G.C.) reviewed the chart to determine highest known intraocular pressure (IOP), target IOP, diagnosis, years with glaucoma, cup-to-disk ratio (CDR), mean defect (MD), pattern standard deviation (PSD), glaucoma hemifield test (GHT), and presence or absence of visual field progression.

RESULTS:

Among 230 subjects, the mean age was 65 +/- 14 years, 127 (55%) were female, 161 (70%) were white, and 194 (85%) had a diagnosis of primary open-angle glaucoma (POAG) or suspected POAG. In multivariate generalized estimating equation models, lower corneal hysteresis value (P = .03), but not CCT, was associated with visual field progression. When axial length was included in the model, hysteresis was not a significant risk factor (P = .09). A thinner CCT (P = .02), but not hysteresis, was associated with a higher CDR at the most recent examination. Neither CCT nor hysteresis was associated with MD, PSD, or GHT "outside normal limits."

CONCLUSIONS:

Thinner CCT was associated with the state of glaucoma damage as indicated by CDR. Axial length and corneal hysteresis were associated with progressive field worsening.

Test-retest variability in structural and functional parameters of glaucoma damage in the glaucoma imaging longitudinal study.

PURPOSE:

To determine the test-retest variability in perimetric, optic disc, and macular thickness parameters in a cohort of treated patients with established glaucoma.

PATIENTS AND METHODS:

In this cohort study, the authors analyzed the imaging studies and visual field tests at the baseline and 6-month visits of 162 eyes of 162 participant in the Glaucoma Imaging Longitudinal Study (GILS). They assessed the difference, expressed as the standard error of measurement, of Humphrey field analyzer II (HFA) Swedish Interactive Threshold Algorithm fast, Heidelberg retinal tomograph (HRT) II, and retinal thickness analyzer (RTA) parameters between the two visits and assumed that this difference was due to measurement variability, not pathologic change. A statistically significant change was defined as twice the standard error of measurement.

RESULTS:

In this cohort of treated glaucoma patients, it was found that statistically significant changes were 3.2 dB for mean deviation (MD), 2.2 for pattern standard deviation (PSD), 0.12 for cup shape measure, 0.26 mm for rim area, and 32.8 microm and 31.8 microm for superior and inferior macular thickness, respectively. On the basis of these values, it was estimated that the number of potential progression events detectable in this cohort by the parameters of MD, PSD, cup shape measure, rim area, superior macular thickness, and inferior macular thickness was 7.5, 6.0, 2.3, 5.7, 3.1, and 3.4, respectively.

CONCLUSIONS:

The variability of the measurements of MD, PSD, and rim area, relative to the range of possible values, is less than the variability of cup shape measure or macular thickness measurements. Therefore, the former measurements may be more useful global measurements for assessing progressive glaucoma damage.

Measurement of intraocular pressure with pressure phosphene tonometry in children.

PURPOSE: To study the accuracy and acceptability of intraocular pressure (IOP) measurement by the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer in children. METHODS: Fifty children (5 to 14 years old) participated in this prospective comparative study. IOP was measured with the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer by three different examiners who were masked to the results. The children were also asked to grade the degree of discomfort from 0 to 5 (0 = no discomfort; 5 = most discomfort). RESULTS: The mean IOPs measured by the Goldmann tonometer, pressure phosphene tonometer, and non-contact tonometer were 15.9 mm Hg (standard deviation [SD]: = 5.5 mm Hg; range: 10 to 36 mm Hg), 16.0 mm Hg (SD: 2.9 mm Hg; range: 12 to 25 mm Hg), and 15.7 mm Hg (SD = 5.1 mm Hg; range: 8 to 32 mm Hg), respectively (P = .722). The mean difference between pressure phosphene tonometer and Goldmann tonometer readings was 2.9 mm Hg and that between non-contact tonometer and Goldmann tonometer readings was 2.1 mm Hg. The 95% confidence interval of the mean difference between pressure phosphene tonometer and Goldmann tonometer readings was -1.07 and 1.19, and that between non-contact tonometer and Goldmann tonometer readings was -1.07 and 0.53. The mean discomfort ratings for the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer were 0.6, 2.0, and 2.3, respectively (P < .001). CONCLUSION: Although the pressure phosphene tonometer was less accurate than the non-contact tonometer compared with Goldmann tonometer, it gave a reasonably close estimate and had a high specificity of raised IOP. In addition, measurement by the pressure phosphene tonometer is most acceptable to children. The pressure phosphene tonometer can be considered as an alternative method of IOP measurement in children.

Contribution of genetic and environmental effects on lens thickness: the Guangzhou Twin Eye study.

PURPOSE:

This study investigated the heritability of lens thickness (LT) and relative lens thickness (LT/axial length, rLT) measured by Lenstar among Chinese children and adolescents in the Guangzhou Twin Eye study.

METHODS:

Twins aged 8 to 22 years were enrolled from the Guangzhou Twin Registry. A series of LT and axial length (AL) measurements using the Lenstar were taken for each twin. Zygosity was confirmed by genotyping in all same-sex twin pairs. Heritability was assessed by structural variance component genetic modeling, after adjustment for age and sex with the Mx program.

RESULTS:

Seven hundred sixty-eight twin pairs (482 monozygotic [MZ] and 286 dizygotic [DZ] twins) were available for data analysis. The mean (standard deviation) LT and rLT were 3.45 (0.18) mm and 0.142 (0.01), respectively. The intraclass correlation coefficients (ICCs) for LT were 0.90 for the MZ and 0.39 for the DZ twins; and those for rLT were 0.90 for the MZ and 0.40 for the DZ twins, respectively. The best-fitting model yielded 89.5% (95% CI: 87.8%-91.0%) of additive genetic effects and 10.5% (95% CI: 9.0%-12.2%) of unique environmental effects for LT, and 89.3% (95% CI: 89.2%-89.3%) of additive genetic effects and 10.7% (95% CI: 10.7%-11.4%) of unique environmental effects for rLT.

CONCLUSIONS:

This study confirms that the LT in young healthy subjects may be mainly affected by additive genetic factors. High heritability remains even when the data are corrected for the influence of AL with the use of rLT.

Event-driven implicit authentication for mobile access control

In order to protect user privacy on mobile devices, an event-driven implicit authentication scheme is proposed in this paper. Several methods of utilizing the scheme for recognizing legitimate user behavior are investigated. The investigated methods compute an aggregate score and a threshold in real-time to determine the trust level of the current user using real data derived from user interaction with the device. The proposed scheme is designed to: operate completely in the background, require minimal training period, enable high user recognition rate for implicit authentication, and prompt detection of abnormal activity that can be used to trigger explicitly authenticated access control. In this paper, we investigate threshold computation through standard deviation and EWMA (exponentially weighted moving average) based algorithms. The result of extensive experiments on user data collected over a period of several weeks from an Android phone indicates that our proposed approach is feasible and effective for lightweight real-time implicit authentication on mobile smartphones.

Switched Diversity Techniques for Indoor Off-body Communications Channels: An Experimental Analysis and Modeling

This paper investigates the potential improvement in signal reliability for indoor off-body communications channels operating at 5.8 GHz using switched diversity techniques. In particular we investigate the performance of switch-and-stay combining (SSC), switch-and-examine combining (SEC) and switch-and-examine combining with post-examining selection (SECps) schemes which utilize multiple spatially separated antennas at the base station. During the measurements a test subject, wearing an antenna on his chest, performed a number of walking movements towards and then away from a uniform linear array. It was found that all of the considered diversity schemes provided a worthwhile signal improvement. However, the performance of the diversity systems varied according to the switching threshold that was adopted. To model the fading envelope observed at the output of each of the combiners, we have applied diversity specific equations developed under the assumption of Nakagami-$m$ fading. As a measure of the goodness-of-fit, the Kullback-Leibler divergence between the empirical and theoretical probability density functions (PDFs) was calculated and found to be close to 0. To assist with the interpretation of the goodness-of-fit achieved in this study, the standard deviation, $\sigma$, of a zero-mean, $\sigma^2$ variance Gaussian PDF used to approximate a zero-mean, unit variance Gaussian PDF is also presented. These were generally quite close to 1 indicating that the theoretical models provided an adequate fit to the measured data.

Wave Fields around Wave Energy Converter Arrays

Wave energy converters, by their nature, extract large amounts of energy
from incident waves. If the industry is to progress such that wave energy
becomes a significant provider of power in the future, large wave farms will
be required. Presently, consenting for these sites is a long and problematic
process, mainly due to a lack of knowledge of the potential environmental
impacts. Accurate numerical modelling of the effect of wave energy extraction
on the wave field and subsequent evaluation of changes to coastal
processes is therefore required. Modelling the wave field impact is also
necessary to allow optimum wave farm configurations to be determined.
This thesis addresses the need for more accurate representation of wave
energy converters in numerical models so that the effect on the wave field,
and subsequently the coastal processes, may be evaluated. Using a hybrid
of physical and numerical modelling (MIKE21 BW and SW models) the
effect of energy extraction and operation of a WEC array on the local wave
climate has been determined.
The main outcomes of the thesis are: an improved wave basin facility, in
terms of wave climate homogeneity, reducing the standard deviation of wave
amplitude by up to 50%; experimental measurement of the wave field around
WEC arrays, showing that radiated waves account for a significant proportion
of the wave disturbance; a new representation method of WECs for use
with standard numerical modelling tools, validated against experimental
results.
The methodology and procedures developed here allow subsequent evaluation
of changes to coastal processes and sediment transport due to WEC
arrays.

An optimized reverse-phase high performance liquid chromatographic method for evaluating percutaneous absorption of glucosamine hydrochloride

A relatively simple, selective, precise and accurate high performance liquid chromatography (HPLC) method based on a reaction of phenylisothiocyanate (PITC) with glucosamine (GL) in alkaline media was developed and validated to determine glucosamine hydrochloride permeating through human skin in vitro. It is usually problematic to develop an accurate assay for chemicals traversing skin because the excellent barrier properties of the tissue ensure that only low amounts of the material pass through the membrane and skin components may leach out of the tissue to interfere with the analysis. In addition, in the case of glucosamine hydrochloride, chemical instability adds further complexity to assay development. The assay, utilising the PITC-GL reaction was refined by optimizing the reaction temperature, reaction time and PITC concentration. The reaction produces a phenylthiocarbamyl-glucosamine (PTC-GL) adduct which was separated on a reverse-phase (RP) column packed with 5 microm ODS (C18) Hypersil particles using a diode array detector (DAD) at 245 nm. The mobile phase was methanol-water-glacial acetic acid (10:89.96:0.04 v/v/v, pH 3.5) delivered to the column at 1 ml min-1 and the column temperature was maintained at 30 degrees C. Galactosamine hydrochloride (Gal-HCl) was used as an internal standard. Using a saturated aqueous solution of glucosamine hydrochloride, in vitro permeation studies were performed at 32+/-1 degrees C over 48 h using human epidermal membranes prepared by a heat separation method and mounted in Franz-type diffusion cells with a diffusional area 2.15+/-0.1 cm2. The optimum derivatisation reaction conditions for reaction temperature, reaction time and PITC concentration were found to be 80 degrees C, 30 min and 1% v/v, respectively. PTC-Gal and GL adducts eluted at 8.9 and 9.7 min, respectively. The detector response was found to be linear in the concentration range 0-1000 microg ml-1. The assay was robust with intra- and inter-day precisions (described as a percentage of relative standard deviation, %R.S.D.) <12. Intra- and inter-day accuracy (as a percentage of the relative error, %RE) was <or=-5.60 and <or=-8.00, respectively. Using this assay, it was found that GL-HCl permeates through human skin with a flux 1.497+/-0.42 microg cm-2 h-1, a permeability coefficient of 5.66+/-1.6x10(-6) cm h-1 and with a lag time of 10.9+/-4.6 h.

Characterizing Human Cysticercosis In Portugal

Abstract text Introduction: Cysticercosis results from the ingestion Taenia solium eggs directly by faecal-oral route or contaminated food or water. While, still considered a leading cause of acquired epilepsy in developed countries, this zoonosis has been controlled or eradicated in industrialized countries due to significant improvements in sanitation, pig rearing and slaughterhouse control systems. Objectives: the health burden of human cysticercosis in Portugal. Material and Metodes: We developed a retrospective study on human neurocysticercosis (NCC) hospitalisations based on the national database resulting from National Health Service (NHS) hospital episodes except those of Madeira and Azores Islands. Results: Between 2006 and 2013 there were 357 hospitalized NCC cases in Portugal. Annual frequency of cases between 2006-2013 kept stable (mean 45). NCC was most frequent in those aged 25-34 years (59; 16,5%) and those >75 years (65; 18,2%). Overall, mean age was 47,3 years (median age 45, standard deviation 41,1, mode 28) and 176 cases were in males (49,3%); no significant differences were observed between age and gender (t-student, p>0,05). In Norte Region cases tended to be older than in Lisboa and Vale do Tejo Region. Conclusions: The Directorate-General of Health established the National Observatory of Cysticercosis and Teniiasis which will define criteria for NCC cases monitoring and surveillance (hospitalized and non-hospitalized cases).

In search of reliable centimeter-level indoor positioning: a smartphone-based approach

This thesis describes the design and implementation of a reliable centimeter-level indoor positioning system fully compatible with a conventional smartphone. The proposed system takes advantage of the smartphone audio I/O and processing capabilities to perform acoustic ranging in the audio band using non-invasive audio signals and it has been developed having in mind applications that require high accuracy, such as augmented reality, virtual reality, gaming and audio guides. The system works in a distributed operation mode, i.e. each smartphone is able to obtain its own position using only acoustic signals. To support the positioning system, a Wireless Sensor Network (WSN) of synchronized acoustic beacons is used. To keep the infrastructure in sync we have developed an Automatic Time Synchronization and Syntonization (ATSS) protocol with a standard deviation of the sync offset error below 1.25 μs. Using an improved Time Difference of Arrival (TDoA) estimation approach (which takes advantage of the beacon signals’ periodicity) and by performing Non-Line-of-Sight (NLoS) mitigation, we were able to obtain very stable and accurate position estimates with an absolute mean error of less than 10 cm in 95% of the cases and a mean standard deviation of 2.2 cm for a position refresh period of 350 ms.

The effect of carbohydrate mouth rinse on a 30-minute arm cranking performance

The aim of this study was to examine the effect of carbohydrate mouth rinse on 30-min arm cranking performance. Twelve healthy, active males (age 21.6, standard deviation (SD)=3.1 years; mass 76.2, SD=12.2 kg) volunteered in a single-blind, randomised crossover design. Firstly they completed an incremental exercise test to exhaustion (VO2max test) on an arm crank (50W for 2 min, increasing by 10W every min). During visit 2 and 3 they arm cranked for maximal distance over 30 min at a resistance equivalent to 50% of their peak power, mouth rinsing for 5 s with either 25 ml of a tasteless 6.4% maltodextrin solution (CHO) or 25 ml of water (placebo) every 6 min. A letter cancellation test was performed pre and post exercise to measure cognitive function. The result showed that cognitive function was not significantly different between trials (P=0.874). There was no significant difference in distance arm cranked between trials (P=0.164) even though 9 out of 12 participants had improved performance on the CHO trial. In conclusion, further research is needed to determine the ergogenic effect of CHO mouth rinsing on upper body exercise performance.

Validation of a method for the analysis of volatile organic compounds in water

Dissertação de mestrado, Qualidade em Análises, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

Comparison of Group-based Outpatient Physiotherapy With Usual Care After Total Knee Replacement: a Feasibility Study For a Randomized Controlled Trial

Objective: To evaluate the feasibility of conducting a randomized controlled trial comparing group-based outpatient physiotherapy with usual care in patients following total knee replacement. Design: A feasibility study for a randomized controlled trial. Setting: One secondary-care hospital orthopaedic centre, Bristol, UK. Participants: A total of 46 participants undergoing primary total knee replacement. Interventions: The intervention group were offered six group-based exercise sessions after surgery. The usual care group received standard postoperative care. Participants were not blinded to group allocation. Outcome measures: Feasibility was assessed by recruitment, reasons for non-participation, attendance, and completion rates of study questionnaires that included the Lower Extremity Functional Scale and Knee Injury and Osteoarthritis Outcome Score. Results: Recruitment rate was 37%. Five patients withdrew or were no longer eligible to participate. Intervention attendance was high (73%) and 84% of group participants reported they were ‘very satisfied’ with the exercises. Return of study questionnaires at six months was lower in the usual care (75%) than in the intervention group (100%). Mean (standard deviation) Lower Extremity Functional Scale scores at six months were 45.0 (20.8) in the usual care and 57.8 (15.2) in the intervention groups. Conclusion: Recruitment and retention of participants in this feasibility study was good. Group-based physiotherapy was acceptable to participants. Questionnaire return rates were lower in the usual care group, but might be enhanced by telephone follow-up. The Lower Extremity Functional Scale had high responsiveness and completion rates. Using this outcome measure, 256 participants would be required in a full-scale randomized controlled trial.

Ocorrência circadiária de crises em doentes com epilepsia

Tese de mestrado, Ciências do Sono, Faculdade de Medicina, Universidade de Lisboa, 2016