Longitudinal Assessment of Neuropathy in Diabetes using novel ophthalmic MARKers (LANDMark): Baseline findings

Purpose:Over the past decade, corneal nerve morphology and corneal sensation threshold have been explored as potential surrogate markers for the evaluation of diabetic neuropathy. We present the baseline findings of a Longitudinal Assessment of Neuropathy in Diabetes using novel ophthalmic Markers (LANDMark). Methods:The LANDMark Study is a 5-year, two-site, natural history (observational) study of individuals with Type 1 diabetes stratified into those with (T1W) and without (T1WO) neuropathy according to the Toronto criteria, and control subjects. All study participants undergo detailed annual assessment of neuropathy including corneal nerve parameters measured using corneal confocal microscopy and corneal sensitivity measured using non-contact corneal esthesiometry. Results:396 eligible individuals (208 in Brisbane and 188 in Manchester) were assessed: 76 T1W, 166 T1WO and 154 controls. Corneal sensation threshold (mbars) was significantly higher in T1W (1.0 ± 1.1) than T1WO (0.7 ± 0.7) and controls (0.6 ± 0.4) (P=0.002); post-hoc analysis (PHA) revealed no difference between T1WO and controls (Tukey HSD, P=0.502). Corneal nerve fiber length (mm/mm2) (CNFL) was lower in T1W (13.8 ± 6.4) than T1WO (19.1 ± 5.8) and controls (23.2 ± 6.3) (P<0.001); PHA revealed CNFL to be lower in T1W than T1WO, and lower in both of these groups than controls (P<0.001). Corneal nerve branch density (branches/mm2) (CNBD) was significantly lower in T1W (40 ± 32) than T1WO (62 ± 37) and controls (83 ± 46) (P<0.001); PHA showed CNBD was lower in T1W than T1WO, and lower in both groups than controls (P<0.001). Alcohol and cigarette consumption did not differ between groups, although age, BMI, BP, waist circumference, HbA1c, albumin-creatinine ratio, and cholesterol were slightly greater in T1W than T1WO (p<0.05). Some site differences were observed. Conclusions:The LANDMark baseline findings confirm that corneal sensitivity and corneal nerve morphometry can detect differences in neuropathy status in individuals with Type 1 diabetes and healthy controls. Corneal nerve morphology is significantly abnormal even in diabetic patients ‘without neuropathy’ compared to control participants. Results of the longitudinal trial will assess the capability of these tests for monitoring change in these parameters over time as potential surrogate markers for neuropathy.

Non-invasive techniques for imaging in-vivo human corneal sub basal nerve mapping and migration rate in diabetic neuropathy

Purpose Corneal confocal microscopy (CCM) is a rapid non-invasive ophthalmic technique, which has been shown to diagnose and stratify the severity of diabetic neuropathy. Current morphometric techniques assess individual static images of the subbasal nerve plexus; this work explores the potential for non-invasive assessment of the wide-field morphology and dynamic changes of this plexus in vivo. Methods In this pilot study, laser scanning CCM was used to acquire maps (using a dynamic fixation target and semi-automated tiling software) of the central corneal sub-basal nerve plexus in 4 diabetic patients with and 6 without neuropathy and in 2 control subjects. Nerve migration was measured in an additional 7 diabetic patients with neuropathy, 4 without neuropathy and in 2 control subjects by repeating a modified version of the mapping procedure within 2-8 weeks, thus facilitating re-identification of distinctive nerve landmarks in the 2 montages. The rate of nerve movement was determined from these data and normalised to a weekly rate (µm/week), using customised software. Results Wide-field corneal nerve fibre length correlated significantly with the Neuropathy Disability Score (r = -0.58, p < 0.05), vibration perception (r = -0.66, p < 0.05) and peroneal conduction velocity (r = 0.67, p < 0.05). Central corneal nerve fibre length did not correlate with any of these measures of neuropathy (p > 0.05 for all). The rate of corneal nerve migration was 14.3 ± 1.1 µm/week in diabetic patients with neuropathy, 19.7 ± 13.3µm/week in diabetic patients without neuropathy, and 24.4 ± 9.8µm/week in control subjects; however, these differences were not significantly different (p = 0.543). Conclusions Our data demonstrate that it is possible to capture wide-field images of the corneal nerve plexus, and to quantify the rate of corneal nerve migration by repeating this procedure over a number of weeks. Further studies on larger sample sizes are required to determine the utility of this approach for the diagnosis and monitoring of diabetic neuropathy.

Eccentric hamstring strength and hamstring injury risk in Australian footballers

Purpose Is eccentric hamstring strength and between limb imbalance in eccentric strength, measured during the Nordic hamstring exercise, a risk factor for hamstring strain injury (HSI)? Methods Elite Australian footballers (n=210) from five different teams participated. Eccentric hamstring strength during the Nordic was taken at the commencement and conclusion of preseason training and in season. Injury history and demographic data were also collected. Reports on prospectively occurring HSIs were completed by team medical staff. Relative risk (RR) was determined for univariate data and logistic regression was employed for multivariate data. Results Twenty-eight HSIs were recorded. Eccentric hamstring strength below 256N at the start of preseason and 279N at the end of preseason increased risk of future HSI 2.7 (relative risk, 2.7; 95% confidence interval, 1.3 to 5.5; p = 0.006) and 4.3 fold (relative risk, 4.3; 95% confidence interval, 1.7 to 11.0; p = 0.002) respectively. Between limb imbalance in strength of greater than 10% did not increase the risk of future HSI. Univariate analysis did not reveal a significantly greater relative risk for future HSI in athletes who had sustained a lower limb injury of any kind within the last 12 months. Logistic regression revealed interactions between both athlete age and history of HSI with eccentric hamstring strength, whereby the likelihood of future HSI in older athletes or athletes with a history of HSI was reduced if an athlete had high levels of eccentric strength. Conclusion Low levels of eccentric hamstring strength increased the risk of future HSI. Interaction effects suggest that the additional risk of future HSI associated with advancing age or previous injury was mitigated by higher levels of eccentric hamstring strength.

Morphometric stability of the corneal subbasal nerve plexus in healthy individuals a 3-year longitudinal study using corneal confocal microscopy

Purpose We examined the age-dependent alterations and longitudinal course of subbasal nerve plexus (SNP) morphology in healthy individuals. Methods Laser-scanning corneal confocal microscopy, ocular screening, and health and metabolic assessment were performed on 64 healthy participants at baseline and at 12-month intervals for 3 years. At each annual visit, eight central corneal images of the SNP were selected and analyzed using a fully-automated analysis system to quantify corneal nerve fiber length (CNFL). Two linear mixed model approaches were fitted to examine the relationship between age and CNFL, and the longitudinal changes of CNFL over three years. Results At baseline, mean age was 51.9 ± 14.7 years. The cohort was sex balanced (χ2 = 0.56, P = 0.45). Age (t = 1.6, P = 0.12) and CNFL (t = -0.50, P = 0.62) did not differ between sexes. A total of 52 participants completed the 36-month visit and 49 participants completed all visits. Age had a significant effect on CNFL (F1,33 = 5.67, P = 0.02) with a linear decrease of 0.05 mm/mm2 in CNFL per one year increase in age. No significant change in CNFL was observed over the 36-month period (F1,55 = 0.69, P = 0.41). Conclusions The CNFL showed a stable course over a 36-month period in healthy individuals, although there was a slight linear reduction in CNFL with age. The findings of this study have implications for understanding the time-course of the effect of pathology and surgical or therapeutic interventions on the morphology of the SNP, and serves to confirm the suitability of CNFL as a screening/monitoring marker for peripheral neuropathies.

BIM-based lifecycle planning and specifications for sustainable cities of the future: A conceptual approach

Annually, several million tonnes of waste are produced from reworks, demolition, and use of substandard materials. Building Information Modelling (BIM), a digital representation of facilities and their constituent data, is a viable means of addressing some concerns about the impacts of these processes. BIM functionalities can be extended and combined with rich building information from specifications and product libraries, for efficient, streamlined design and construction. This paper conceptualises a framework for BIM-knowledge transfer from advanced economies for adaptation and use in urban development works in developing nations using the Sydney Down Under and Lagos Eko Atlantic projects as reference points. We present a scenario that highlights BIM-based lifecycle planning/specifications as agents of sustainable construction (in terms of cost and time) crucial to the quality of as-built data from early on in city development. We show how, through the use of BIM, city planners in developing nations can avoid high, retrospective (and sometimes wasteful) maintenance costs and leapfrog infrastructure management standards of advanced economies. Finally, this paper illustrates how BIM can address concerns about economic sustainability during city development in developing countries by enriching model objects with specification information sourced from a product library.

Experimental and numerical study of polymeric foam efficacy in portable water filled barriers

Portable, water filled road safety barriers are used to provide protection and reduce the potential hazard due to errant vehicles in areas where the road conditions change frequently (e.g. near road work sites). As part of an effort to reduce excessive working widths typical of these systems, a study was conducted to assess the effectiveness of introducing polymeric foam filled panels into the design. Surrogate impact tests of a design typical of such as barrier system were conducted utilising a pneumatically powered horizontal impact testing machine up to impact energies of 7.40 kJ. Results of these tests are utilised to examine the barrier behaviour, in addition to being used to validate a couple FE/SPH model of the barrier system. Once validated, the FE/SPH model it utilised as the basis for a parametric study into the efficacy and effects of the inclusion of polymeric foam filled panels on the performance of portable water filled road safety barriers. It was found that extruded polystyrene foam functioned well, with a greater thickness of the foam panel significantly reducing the impacting body velocity as the barrier began to translate.

Biceps femoris long-head architecture: A reliability and retrospective injury study

Purpose: To determine i) the reliability of two-dimensional ultrasonography for the assessment of biceps femoris long head (BFlh) architectural characteristics; ii) if limbs with a history of strain injury in the BFlh display different architecture and eccentric strength compared to uninjured limbs. Methods: This case-control study (control [n=20], injured group [n=16], males) assessed the BFlh architecture at rest and during graded isometric contractions using two-dimensional ultrasonography. The control group were assessed three times (>24hrs apart) to determine reliability. Previously injured individuals were evaluated once. Results The assessment of BFlh architecture was highly reliable (intraclass correlations >0.90). Fascicle length (p<0.001; d range: 0.67 to 1.34) and fascicle length relative to muscle thickness (p<0.001; d range: 0.58 to 0.85) of the previously injured BFlh were significantly less than the contralateral uninjured BFlh at all intensities. Pennation angle of the previously injured BFlh was significantly greater (p<0.001; d range: 0.62 to 0.88) than the contralateral uninjured BFlh at all intensities. Eccentric strength in the previously injured limb was significantly lower than the contralateral limb (-15.4%; -52.5N; 95% CI=-28.45 to -76.23; p<0.001, d=0.56). Conclusion These data indicate that two-dimensional ultrasonography is reliable for assessing BFlh architecture at rest and during graded isometric contractions. Fascicle length, fascicle length relative to muscle thickness and pennation angle are significantly different in previously injured BFlh compared to an uninjured contralateral BFlh. Eccentric strength of the previously injured limb is also significantly lower than the uninjured contralateral limb. These findings have implications for rehabilitation and injury prevention practices which should consider altered architectural characteristics.

The future Australian paramedic workforce : a snapshot of undergraduate paramedic students

Objective Describe the demographics of undergraduate paramedic students enrolled at a major Queensland University and explore the potential impact of demographic change in the paramedic workforce of the future. Method A retrospective, descriptive analysis of de-identified, routinely collected administrative data on students enrolled in the paramedic undergraduate degree program at Queensland University of Technology was undertaken for the period 2005-2013. Quantitative data were examined using the Statistical Package for Social Science version 21. Results A total of 914 students had commenced the paramedic degree since 2005, of whom slightly more than a third (33.4%; SD 9.5%) were enrolled in the double degree with nursing beginning from 2009. Half of the student cohort (52.1%;, SD 4.8%) were female, with the majority (82.9%;, SD 3.4) aged under 25 years old. Most (45.2%;, SD 13) of the student admissions were for graduate entry [i.e. prior tertiary education had been completed], while secondary education entry represented 35.9% (SD 14.9%). Conclusion By contrasting the results of our study to the most recent demographic data of the Australian paramedic workforce, a significant difference in the demographic characteristics of the current and future paramedic workforce is noted. Due to these differences, the need for increased flexibility in employment arrangements should be anticipated. This presentation will explore these characteristics and provide a complementary evidence base on which workforce planning within ambulance services can be conducted.

Fire performance and design of cold-formed steel wall systems

Traditionally, the fire resistance rating of Light gauge steel frame (LSF) wall systems is based on approximate prescriptive methods developed using limited fire tests. These fire tests are conducted using standard fire time-temperature curve given in ISO 834. However, in recent times fire has become a major disaster in buildings due to the increase in fire loads as a result of modern furniture and lightweight construction, which make use of thermoplastics materials, synthetic foams and fabrics. Therefore a detailed research study into the performance of load bearing LSF wall systems under both standard and realistic design fires on one side was undertaken to develop improved fire design rules. This study included both full scale fire tests and numerical studies of eight different LSF wall systems conducted for both the standard fire curve and the recently developed realistic design fire curves. The use of previous fire design rules developed for LSF walls subjected to non-uniform elevated temperature distributions based on AISI design manual and Eurocode 3 Parts 1.2 and 1.3 was investigated first. New simplified fire design rules based on AS/NZS 4600, North American Specification and Eurocode 3 Part 1.3 were then proposed with suitable allowances for the interaction effects of compression and bending actions. The importance of considering thermal bowing, magnified thermal bowing and neutral axis shift in the fire design was also investigated and their effects were included. A spread sheet based design tool was developed based on the new design rules to predict the failure load ratio versus time and temperature curves for varying LSF wall configurations. The accuracy of the proposed design rules was verified using the fire test and finite element analysis results for various wall configurations, steel grades, thicknesses and load ratios under both standard and realistic design fire conditions. A simplified method was also proposed to predict the fire resistance rating of LSF walls based on two sets of equations developed for the load ratio-hot flange temperature and the time-temperature relationships. This paper presents the details of this study on LSF wall systems under fire conditions and the results.

Wearable neuroimaging and emotion : investigating emotional responses to architectural environments with functional near-infrared spectroscopy (fNIRS)

Supported by contemporary theories of architectural aesthetics and neuro-aesthetics this paper presents a case for the use of portable fNIRS imaging in the assessment of emotional responses to spatial environments experienced by both blind and sighted. The aim of the paper is to outline the implications of fNIRS for spatial research and practice within the field of architecture, thereby suggesting a potential taxonomy of particular formations of space and affect. Empirical neurological study of affect and spatial experience from an architectural design perspective remains in many instances unchartered. Clinical research using the portable non-invasive neuro-imaging device, functional near infrared spectroscopy (fNIRS) is proving convincing in its ability to detect emotional responses to visual, spatio-auditory and task based stimuli, providing a firm basis to potentially track cortical activity in the appraisal of architectural environments. Additionally, recent neurological studies have sought to explore the manifold sensory abilities of the visually impaired to better understand spatial perception in general. Key studies reveal that early blind participants perform as well as sighted due to higher auditory and somato-sensory spatial acuity. For instance, face vision enables the visually impaired to detect environments through skin pressure, enabling at times an instantaneous impression of the layout of an unfamiliar environment. Studies also report pleasant and unpleasant emotional responses such as ‘weightedness’ or ‘claustrophobia’ within certain interior environments, revealing a deeper perceptual sensitivity then would be expected. We conclude with justification that comparative fNIRS studies between the sighted and blind concerning spatial experience have the potential to provide greater understanding of emotional responses to architectural environments.

The Ash Burner

Growing up with his father in a small coastal town, all Ted knows about his mother is that she died when he was a boy. His father has brought them halfway across the world to start anew, but her absence defines and haunts their lives. When Ted meets Anthony and Claire, an intense friendship begins, carrying them to Sydney and university. They introduce him to poetry and art, and he feels a sense of belonging at last. But as the trio’s friendship deepens over the years, Ted must learn to negotiate the boundaries of love, and come to terms with a legacy of secrets and silence. Written with extraordinary grace and sensitivity, The Ash Burner explores beauty and desire, grief and loss, and the search for one’s true self.

100 futures now : designing sustainable futures

This presentation tells the story of an initiative in middle schooling at Kelvin Grove State College that begins in the Art studios, but reaches out to other disciplines and approaches, and to community and industry partners. It is inspired by the potential of 'future thinking' to become a compelling focus in contemporary art and design. Ethically it espouses a simple premise": every student in our classrooms now has a stake in creating livable, democratic and creative futures. Every student has the potential to be an active force in making that future. "100 Futures Now" is a project that envisages creative and imaginative students working in collaboration with artists and designers to visualize amazing futures and communicate their vision through art and design. "100 Futures Now" is one in a series of innovative curriculum initiatives at Kelvin Grove State College designed to build sustainable practice in arts education with the support of partners in industry and universities and with resident artists and designers. The model blends elements of art and design methodology to focus on the critical and creative thinking skills prioritised in ACARA and 21st century curriculum. The organisers are developing a sustainable model for working with resident artists that goes beyond a single arts intervention or extension/enrichment experience. In this model artists and designers are collaborators in the design of learning experiences that support future programs. This model also looks to transfer the benefits of residencies to the wider school community (in this case to middle schooling curriculum) and to teachers in other curriculum areas, and not exclusively to the immediate target group. In "100 Futures Now", story-making is the engine that powers the creative process. For this reason the program uses a series of imaginative scenarios, including those of speculative fiction and science, as departure points for inquiry, and applies the methodologies of arts and design practice to explore and express student story telling and story making. The story-making responses of student teams will naturally be expressed multimodally through visual art, design artifacts, installation, performance and digital works. The project’s focus on narratives and its modes of communication (performance/installation) are inspired by the work of experimental contemporary design practices and the speculative scenarios of U.K. based designers Anthony Dunne and Fiona Raby. Thanks to the support of an Arts Queensland Artist-in -Residence grant in 2014, resident artists and designers who work with a diversity of ideas and approaches ranging over science, bio-ethics, biodiversity, behavior and ethics, ambient sound, urbanism, food, and wearable design, will work with middle school students as catalysts for deeper thinking and creative action. All these rich fields for future speculation will become triggers for team inquiry into the deeper connections between the past, the present, and future challenges such as climate, waste, energy, sustainability and resilience. These imagined futures will form the platform for a critical, sustainability/design futures approach that will involve questioning assumptions and empowering students as agents rather than consumers of change.

Detection of rain in acoustic recordings of the environment

Environmental monitoring has become increasingly important due to the significant impact of human activities and climate change on biodiversity. Environmental sound sources such as rain and insect vocalizations are a rich and underexploited source of information in environmental audio recordings. This paper is concerned with the classification of rain within acoustic sensor re-cordings. We present the novel application of a set of features for classifying environmental acoustics: acoustic entropy, the acoustic complexity index, spectral cover, and background noise. In order to improve the performance of the rain classification system we automatically classify segments of environmental recordings into the classes of heavy rain or non-rain. A decision tree classifier is experientially compared with other classifiers. The experimental results show that our system is effective in classifying segments of environmental audio recordings with an accuracy of 93% for the binary classification of heavy rain/non-rain.