Stepping accuracy and visuomotor control among older adults : effect of target contrast and refractive blur

Purpose: Older adults have increased visual impairment, including refractive blur from presbyopic multifocal spectacle corrections, and are less able to extract visual information from the environment to plan and execute appropriate stepping actions; these factors may collectively contribute to their higher risk of falls. The aim of this study was to examine the effect of refractive blur and target visibility on the stepping accuracy and visuomotor stepping strategies of older adults during a precision stepping task. Methods: Ten healthy, visually normal older adults (mean age 69.4 ± 5.2 years) walked up and down a 20 m indoor corridor stepping onto selected high and low-contrast targets while viewing under three visual conditions: best-corrected vision, +2.00 DS and +3.00 DS blur; the order of blur conditions was randomised between participants. Stepping accuracy and gaze behaviours were recorded using an eyetracker and a secondary hand-held camera. Results: Older adults made significantly more stepping errors with increasing levels of blur, particularly exhibiting under-stepping (stepping more posteriorly) onto the targets (p<0.05), while visuomotor stepping strategies did not significantly alter. Stepping errors were also significantly greater for the low compared to the high contrast targets and differences in visuomotor stepping strategies were found, including increased duration of gaze and increased interval between gaze onset and initiation of the leg swing when stepping onto the low contrast targets. Conclusions: These findings highlight that stepping accuracy is reduced for low visibility targets, and for high levels of refractive blur at levels typically present in multifocal spectacle corrections, despite significant changes in some of the visuomotor stepping strategies. These findings highlight the importance of maximising the contrast of objects in the environment, and may help explain why older adults wearing multifocal spectacle corrections exhibit an increased risk of falling.

Supine to standing Cobb angle change in idiopathic scoliosis : the effect of endplate pre-selection

Background Supine imaging modalities provide valuable 3D information on scoliotic anatomy, but the altered spine geometry between the supine and standing positions affects the Cobb angle measurement. Previous studies report a mean 7°-10° Cobb angle increase from supine to standing, but none have reported the effect of endplate pre-selection or whether other parameters affect this Cobb angle difference. Methods Cobb angles from existing coronal radiographs were compared to those on existing low-dose CT scans taken within three months of the reference radiograph for a group of females with adolescent idiopathic scoliosis. Reformatted coronal CT images were used to measure supine Cobb angles with and without endplate pre-selection (end-plates selected from the radiographs) by two observers on three separate occasions. Inter and intra-observer measurement variability were assessed. Multi-linear regression was used to investigate whether there was a relationship between supine to standing Cobb angle change and eight variables: patient age, mass, standing Cobb angle, Risser sign, ligament laxity, Lenke type, fulcrum flexibility and time delay between radiograph and CT scan. Results Fifty-two patients with right thoracic Lenke Type 1 curves and mean age 14.6 years (SD 1.8) were included. The mean Cobb angle on standing radiographs was 51.9° (SD 6.7). The mean Cobb angle on supine CT images without pre-selection of endplates was 41.1° (SD 6.4). The mean Cobb angle on supine CT images with endplate pre-selection was 40.5° (SD 6.6). Pre-selecting vertebral endplates increased the mean Cobb change by 0.6° (SD 2.3, range −9° to 6°). When free to do so, observers chose different levels for the end vertebrae in 39% of cases. Multi-linear regression revealed a statistically significant relationship between supine to standing Cobb change and fulcrum flexibility (p = 0.001), age (p = 0.027) and standing Cobb angle (p < 0.001). The 95% confidence intervals for intra-observer and inter-observer measurement variability were 3.1° and 3.6°, respectively. Conclusions Pre-selecting vertebral endplates causes minor changes to the mean supine to standing Cobb change. There is a statistically significant relationship between supine to standing Cobb change and fulcrum flexibility such that this difference can be considered a potential alternative measure of spinal flexibility.

The effect of endplate preselection when measuring supine versus standing cobb angle change in idiopathic scoliosis

The primary aim of this study was to determine whether endplate pre-selection makes a difference to the Cobb Angle change between supine and standing which is known to occur in idiopathic scoliosis. A secondary aim of this study was to identify which (if any) patient characteristics were correlated with supine versus standing Cobb change. The study found that pre-selecting vertebral endplates causes only has a minor effect on supine to standing Cobb change in scoliosis. There is a statistically significant relationship between supine to standing Cobb Angle change and fulcrum flexibility. Therefore, supine to standing Cobb Angle change can be considered as a measure of spinal flexibility when both standing and supine images are clinically available.

In vitro investigations on the effect of dermal fibroblasts on keratinocyte responses to ultraviolet B radiation

Exposure to ultraviolet radiation is closely linked to the development of skin cancers in humans. The ultraviolet B (UVB) radiation wavelength (280-320 nm), in particular, causes DNA damage in epidermal keratinocytes, which are linked to the generation of signature premalignant mutations. Interactions between dermal fibroblasts and keratinocytes play a role in epidermal repair and regeneration after UVB-induced damage. To investigate these processes, established two and three-dimensional culture models were utilized to study the impact of fibroblast-keratinocyte crosstalk during the acute UVB response. Using a coculture system it was observed that fibroblasts enhanced keratinocyte survival and the repair of cyclobutane pyrimidine dimers (CPDs) after UVB radiation exposure. These findings were also mirrored in irradiated human skin coculture models employed in this study. Fibroblast coculture was shown to play a role in the expression and activation of members of the apoptotic cascade, including caspase-3 and Bad. Interestingly, the expression and phosphorylation of p53, a key player in the regulation of keratinocyte cell fate postirradiation, was also shown to be influenced by fibroblast-produced factors. This study highlights the importance of synergistic interactions between fibroblasts and keratinocytes in maintaining a functional epidermis while promoting repair and regeneration following UVB radiation-induced damage.

The effect of previous hamstring strain injuries on the change in eccentric hamstring strength during preseason training in elite Australian footballers

Background Hamstring strain injuries (HSIs) are the most common injury type in Australian football and the rate of recurrence has been consistently high for a number of years. Long lasting neuromuscular inhibition has been noted in previously injured athletes but it is not known if this influences athletes adaptive response to training. Purpose To determine if elite Australian footballers with a prior unilateral HSI (previously injured group) display lesser improvements in eccentric hamstring strength during pre-season training compared to athletes without a history of HSI (control group). Study design Prospective cohort study. Methods Ninety-nine elite Australian footballers participated (17 with a history of unilateral HSI in the previous 12 month period). Eccentric hamstring strength was assessed at the start and end of pre-season training using an instrumented Nordic hamstring device. Change in eccentric strength across preseason was determine in absolute terms and normalised to start of preseason strength. Start of preseason strength was used as a covariate to control for differences in starting strength. Results The left and right limbs in the control group showed no difference in absolute or relative change (left limb absolute change, 60.7±72.9N; relative change, 1.28±0.34; right limb absolute change, 48.6±83.8N; relative change, 1.24±0.43) . Similarly, the injured and uninjured limbs from the previously injured group showed no difference for either absolute or relative measures of change (injured limb absolute change, 13.1±57.7N; relative change, 1.07±0.18; uninjured limb absolute change, 14.7±54.0N; relative change, 1.07±0.22N). The previously injured group displayed a significantly lesser increase in eccentric hamstring strength across the preseason (absolute change, 13.9±55.0; relative change, 1.07±0.20) compared to the control group (absolute change, 54.6±78.5; relative change, 1.26±0.39) for both absolute and relative measures (p < 0.001), even after controlling for differences in start of pre-season eccentric hamstring strength, which had a significant effect on strength improvement. Conclusion Elite Australian footballers with a unilateral HSI history displayed lesser improvements in eccentric hamstring strength across preseason training. The smaller improvements were not restricted to the previously injured limb as the contralateral limb also displayed similarly small improvements in eccentric strength. Whether this is the cause of or the result of injury remains to be seen, but it has the potential to contribute to the risk of hamstring strain re-injury.

Awards before and after the Nobel Prize : a Matthew effect and/or a ticket to one's own funeral?

The primary aim of this descriptive exploration of scientists’ life cycle award patterns is to evaluate whether awards breed further awards and identify researcher experiences after reception of the Nobel Prize. To achieve this goal, we collected data on the number of awards received each year for 50 years before and after Nobel Prize reception by all 1901–2000 Nobel laureates in physics, chemistry, and medicine or physiology. Our results indicate an increasing rate of awards before Nobel reception, reaching the summit precisely in the year of the Nobel Prize. After this pinnacle year, awards drop sharply. This result is confirmed by separate analyses of three different disciplines and by a random-effects negative binomial regression model. Such an effect, however, does not emerge for more recent Nobel laureates (1971–2000). In addition, Nobelists in medicine or physiology generate more awards shortly before and after prize reception, whereas laureates in chemistry attract more awards as time progresses.

The effect of knee flexion contracture following total knee arthroplasty on the energy cost of walking.

This study evaluated the energy cost of walking (Cw) with knee flexion contractures (FC) simulated with a knee brace, in total knee arthroplasty (TKA) recipients (n=16) and normal controls (n=15), and compared it to baseline (no brace). There was no significant difference in Cw between the groups at baseline but TKA recipients walked slower (P=0.048) and with greater knee flexion in this condition (P=0.003). Simulated FC significantly increased Cw in both groups (TKA P=0.020, control P=0.002) and this occurred when FC exceeded 20° in the TKA group and 15° in the controls. Reported perceived exertion was only significantly increased by FC in the control group (control P<0.001, TKA P=0.058). Simulated knee FCs less than 20° do not increase Cw or perceived exertion in TKA recipients.

The effect of work-integrated learning in highlighting the complexity of work : a pilot study of work self-efficacy

This pilot study aims to examine the effect of work-integrated learning (WIL) on work self-efficacy (WSE) for undergraduate students from the Queensland University of Technology. A WSE instrument was used to examine the seven subscales of WSE. These were; learning, problem solving, pressure, role expectations, team work, sensitivity and work politics. The results of this pilot study revealed that, overall the WSE scores were highest when the students’ did not participate in the WIL unit (comparison group) in comparison to the WIL group. The current paper suggests that WSE scores were changed as a result of WIL participation. These findings open a new path for future studies allowing them to explore the relationship between WIL and the specific subscales of WSE.

Effect of mobile phone use and aggression on speed selection by young drivers : a driving simulator study

Aggressive driving has been associated with engagement in other risky driving behaviours, such as speeding; while drivers using their mobile phones have an increased crash risk, despite the tendency to reduce their speed. Research has amassed separately for mobile phone use and aggressive driving among younger drivers, however little is known about the extent to which these behaviours may function independently and in combination to influence speed selection behaviour. The main aim of the current study was to investigate the effect of driver aggression (measured by the Driving Anger Expression Inventory) and mobile phone use on speed selection by young drivers. The CARRS-Q advanced driving simulator was used to test the speed selection of drivers aged 18 to 26 years (N = 32) in a suburban (60kph zone) driving context. A 2 (level of driving anger expression: low, high) X 3 (mobile phone use condition: baseline, hands-free, hand-held) mixed factorial ANOVA was conducted with speed selection as the dependent variable. Results revealed a significant main effect for mobile phone use condition such that speed selection was lowest for the hand-held condition and highest for the baseline condition. Speed selection, however, was not significantly different across the levels of driving anger expression; nor was there a significant interaction effect between the mobile phone use and driving anger expression. As young drivers are over-represented in road crash statistics, future research should further investigate the combined impact of driver aggression and mobile phone use on speed selection.

Effect of rod-cone interactions on mesopic visual performance mediated by chromatic and luminance pathways

We studied the effect of rod–cone interactions on mesopic visual reaction time (RT). Rod and cone photoreceptor excitations were independently controlled using a four-primary photostimulator. It was observed that (1) lateral rod–cone interactions increase the cone-mediated RTs; (2) the rod–cone interactions are strongest when rod sensitivity is maximal in a dark surround, but weaker with increased rod activity in a light surround; and (3) the presence of a dark surround nonselectively increased the mean and variability of chromatic (+L-M, S-cone) and luminance (L+M+S) RTs independent of the level of rod activity. The results demonstrate that lateral rod–cone interactions must be considered when deriving mesopic luminous efficiency using RT.

Effect of bifocal and prismatic bifocal spectacles on myopia progression in children

Importance Myopia is a significant public health problem, making it important to determine whether a bifocal spectacle treatment involving near prism slows myopia progression in children. Objective To determine whether bifocal and prismatic bifocal spectacles control myopia in children with high rates of myopia progression and to assess whether the treatment effect is dependent on the lag of accommodation and/or near phoria status. Design, Setting, and Participants This 3-year randomized clinical trial was conducted in a private practice. A total of 135 (73 female and 62 male) Chinese-Canadian children (aged 8-13 years; mean [SE] age, 10.29 [0.15] years; mean [SE] myopia, −3.08 [0.10] D) with myopia progression of at least 0.50 D in the preceding year were randomly assigned to 1 of 3 treatments. A total of 128 (94.8%) completed the trial. Interventions Single-vision lenses (control, n = 41), +1.50-D executive bifocals (n = 48), and +1.50-D executive bifocals with 3-Δ base-in prism in the near segment of each lens (n = 46). Main Outcomes and Measures Myopia progression (primary) measured using an automated refractor following cycloplegia and increase in axial length (secondary) measured using ultrasonography at intervals of 6 months for 36 months. Results Myopia progression over 3 years was an average (SE) of −2.06 (0.13) D for the single-vision lens group, −1.25 (0.10) D for the bifocal group, and −1.01 (0.13) D for the prismatic bifocal group. Axial length increased an average (SE) of 0.82 (0.05) mm, 0.57 (0.07) mm, and 0.54 (0.06) mm, respectively. The treatment effect of bifocals (0.81 D) and prismatic bifocals (1.05 D) was significant (P < .001). Both bifocal groups had less axial elongation (0.25 mm and 0.28 mm, respectively) than the single-vision lens group (P < .001). For children with high lags of accommodation (≥1.01 D), the treatment effect of both bifocals and prismatic bifocals was similar (1.1 D) (P < .001). For children with low lags (<1.01 D), the treatment effect of prismatic bifocals (0.99 D) was greater than of bifocals (0.50 D) (P = .03). The treatment effect of both bifocals and prismatic bifocals was independent of the near phoria status. Conclusions and Relevance Bifocal spectacles can slow myopia progression in children with an annual progression rate of at least 0.50 D after 3 years. These results suggest that prismatic bifocals are more effective for myopic children with low lags of accommodation.

The effect of the addition of hip strengthening exercises to a lumbopelvic exercise programme for the treatment of non-specific low back pain : a randomized controlled trial

Objectives To compare the efficacy of two exercise programs in reducing pain and disability for individuals with non-specific low back pain and to examine the underlying mechanical factors related to pain and disability for individuals with NSLBP. Design A single-blind, randomized controlled trial. Methods: Eighty participants were recruited from eleven community-based general medical practices and randomized into two groups completing either a lumbopelvic motor control or a combined lumbopelvic motor control and progressive hip strengthening exercise therapy program. All participants received an education session, 6 rehabilitation sessions including real time ultrasound training, and a home based exercise program manual and log book. The primary outcomes were pain (0-100mm visual analogue scale), and disability (Oswestry Disability Index V2). The secondary outcomes were hip strength (N/kg) and two-dimensional frontal plane biomechanics (°) measure during the static Trendelenburg test and while walking. All outcomes were measured at baseline and at 6-week follow up. Results There was no statistical difference in the change in pain (xˉ = -4.0mm, t= -1.07, p =0.29, 95%CI -11.5, 3.5) or disability (xˉ = -0.3%, t= -0.19, p =0.85, 95%CI -3.5, 2.8) between groups. Within group comparisons revealed clinically meaningful reductions in pain for both Group One (xˉ =-20.9mm, 95%CI -25.7, -16.1) and Group Two (xˉ =-24.9, 95%CI -30.8, -19.0). Conclusion Both exercise programs had similar efficacy in reducing pain. The addition of hip strengthening exercises to a motor control exercise program does not appear to result in improved clinical outcome for pain for individuals with non-specific low back pain.

Seeing pedestrians at night : effect of driver age and visual abilities

Purpose To quantify the effects of driver age on night-time pedestrian conspicuity, and to determine whether individual differences in visual performance can predict drivers' ability to recognise pedestrians at night. Methods Participants were 32 visually normal drivers (20 younger: M = 24.4 years ± 6.4 years; 12 older: M = 72.0 years ± 5.0 years). Visual performance was measured in a laboratory-based testing session including visual acuity, contrast sensitivity, motion sensitivity and the useful field of view. Night-time pedestrian recognition distances were recorded while participants drove an instrumented vehicle along a closed road course at night; to increase the workload of drivers, auditory and visual distracter tasks were presented for some of the laps. Pedestrians walked in place, sideways to the oncoming vehicles, and wore either a standard high visibility reflective vest or reflective tape positioned on the movable joints (biological motion). Results Driver age and pedestrian clothing significantly (p < 0.05) affected the distance at which the drivers first responded to the pedestrians. Older drivers recognised pedestrians at approximately half the distance of the younger drivers and pedestrians were recognised more often and at longer distances when they wore a biological motion reflective clothing configuration than when they wore a reflective vest. Motion sensitivity was an independent predictor of pedestrian recognition distance, even when controlling for driver age. Conclusions The night-time pedestrian recognition capacity of older drivers was significantly worse than that of younger drivers. The distance at which drivers first recognised pedestrians at night was best predicted by a test of motion sensitivity.

The effect of topical adrenergic and anticholinergic agents on the choroidal thickness of young healthy adults

The human choroid is capable of rapidly changing its thickness in response to a variety of stimuli. However little is known about the role of the autonomic nervous system in the regulation of the thickness of the choroid. Therefore, we investigated the effect of topical parasympatholytic and sympathomimetic agents upon the choroidal thickness and ocular biometrics of young healthy adult subjects. Fourteen subjects (mean age 27.9 ± 4 years) participated in this randomized, single-masked, placebo-controlled study. Each subject had measurements of choroidal thickness (ChT) and ocular biometrics of their right eye taken before, and then 30 and 60 min following the administration of topical pharmacological agents. Three different drugs: 2% homatropine hydrobromide, 2.5% phenylephrine hydrochloride and a placebo (0.3% hydroxypropyl methylcellulose) were tested in all subjects; each on different days (at the same time of the day) in randomized order. Participants were masked to the pharmacological agent being used at each testing session. The instillation of 2% homatropine resulted in a small but significant increase in subfoveal ChT at 30 and 60 min after drug instillation (mean change 7 ± 3 μm and 14 ± 2 μm respectively; both p < 0.0001). The parafoveal choroid also exhibited a similar magnitude, significant increase in thickness with time after 2% homatropine (p < 0.001), with a mean change of 7 ± 0.3 μm and 13 ± 1 μm (in the region located 0.5 mm from the fovea center), 6 ± 1 μm and 12.5 ± 1 μm (1 mm from the fovea center) and 6 ± 2 μm and 12 ± 2 μm (1.5 mm from the fovea center) after 30 and 60 min respectively. Axial length decreased significantly 60 min after homatropine (p < 0.01). There were also significant changes in lens thickness (LT) and anterior chamber depth (ACD) (p < 0.05) associated with homatropine instillation. No significant changes in choroidal thickness, or ocular biometrics were found after 2.5% phenylephrine or placebo at any examination points (p > 0.05). In human subjects, significant increases in subfoveal and parafoveal choroidal thickness occurred after administration of 2% homatropine and this implies an involvement of the parasympathetic system in the control of choroidal thickness in humans.