Impacts of climate change and environmental degradation on children in Malaysia.

The impacts of climate change and degradation are increasingly felt in Malaysia. While everyone is vulnerable to these impacts, the health and wellbeing of children are disproportionately affected. We carried out a study composed of two major components. The first component is an environmental epidemiology study comprised of three sub-studies: (i) a global climate model (GCM) simulating specific health-sector climate indices; (ii) a time-series study to estimate the risk of childhood respiratory disease attributable to ambient air pollution; and (iii) a case-crossover study to identify the association between haze and under-five mortality in Malaysia. The GCM found that Malaysia has been experiencing increasing rainfall intensity over the years, leading to increased incidences of other weather-related events. The time-series study revealed that air quality has worsened, while air pollution and haze have been linked to an increased risk of hospitalization for respiratory diseases among children. Although no clear association between haze and under-five mortality was found in the case-crossover study, the lag patterns suggested that health effects could be more acute if haze occurred over a longer duration and at a higher intensity. The second component consists of three community surveys on marginalized children conducted (i) among the island community of Pulau Gaya, Sabah; (ii) among the indigenous Temiar tribe in Pos Kuala Mu, Perak; and (iii) among an urban poor community (B40) in PPR Sg. Bonus, Kuala Lumpur. The community surveys are cross-sectional studies employing a socio-ecological approach using a standardized questionnaire. The community surveys revealed how children adapt to climate change and environmental degradation. An integrated model was established that consolidates our overall research processes and demonstrates the crucial interconnections between environmental challenges exacerbated by climate change. It is recommended that Malaysian schools adopt a climate-smart approach to education to instill awareness of the impending climate change and its cascading impact on children's health from early school age.

Localization of Neuronal Gain Control in the Pupillary Response.

Multifocal pupillographic objective perimetry (mfPOP) is being developed as an alternative to standard visual perimetry. In mfPOP, pupil responses to sparse multifocal luminance stimuli are extracted from the overall composite response. These individual test-region responses are subject to gain-control which is dependent on the temporal and spatial density of stimuli. This study aimed to localize this gain within the pupil pathway. Pupil constriction amplitudes of 8 subjects (41.5 ±12.7 y, 4 male) were measured using a series of 14 mfPOP stimulus variants. The temporal density of stimulus signal at the levels of retina, pretectal olivary nuclei (PON), and Edinger-Westphal nuclei (EWN) were controlled using a combination of manipulation of the mean interval between stimulus presentations (3 or 6 stimuli/s/hemiretina) and the restriction of stimuli to specific subsets of the 24 visual field test-regions per eye (left or right eye, left or right hemifield, or nasal or temporal hemifield). No significant difference was observed between mfPOP variants with differing signal density at the retina or PON but matched density at the other levels. In contrast, where signal density differed at the EWN but was the same at the retinal and PON levels e.g., between 3 stim/s homonymous hemifield and all test-region variants, significant reductions in constriction amplitudes were observed [t (30) = -2.07 to -2.50, all p < 0.05]. Similar, although more variable, relationships were seen using nasal, and temporal hemifield stimuli. Results suggest that the majority of gain-control in the subcortical pupillary pathway occurs at the level of the EWN.

Retinotopic effects of visual attention revealed by dichoptic multifocal pupillography.

Multifocal pupillographic objective perimetry (mfPOP) has recently been shown to be able to measure cortical function. Here we assessed 44 regions of the central 60 degrees of the visual fields of each eye concurrently in 7 minutes/test. We examined how foveally- and peripherally-directed attention changed response sensitivity and delay across the 44 visual field locations/eye. Four experiments were completed comparing white, yellow and blue stimulus arrays. Experiments 1 to 4 tested 16, 23, 9 and 6 subjects, 49/54 being unique. Experiment 1, Experiments 2 and 3, and Experiment 4 used three variants of the mfPOP method that provided increasingly improved signal quality. Experiments 1 to 3 examined centrally directed attention, and Experiment 4 compared effects of attention directed to different peripheral targets. Attention reduced the sensitivity of the peripheral locations in Experiment 1, but only for the white stimuli not yellow. Experiment 2 confirmed that result. Experiment 3 showed that blue stimuli behaved like white. Peripheral attention showed increased sensitivity around the attentional targets. The results are discussed in terms of the cortical inputs to the pupillary system. The results agree with those from multifocal and other fMRI and VEP studies. mfPOP may be a useful adjunct to those methods.

Effect of contrast, stimulus density, and viewing distance on multifocal steady-state visual evoked potentials (MSVs).

PURPOSE: We investigated the effects of image contrast, stimulus density, and viewing distance upon a multifocal steady-state visual evoked potential (MSV) method. METHODS: Fourteen adults with normal vision (mean age = 27.0 ± 6.6 years; 6 males) participated in the study. Each of the stimulus regions of the multifocal ensembles presented a contrast modulated grating, displaying spatial and temporal frequencies that evoke the spatial frequency doubling illusion. All subjects were tested at five contrasts: 0.06, 0.11, 0.22, 0.45, and 0.89; viewed at 16, 32, and 128 cm. A multivariate linear model estimated factors for each stimulus region, recording channel, number of stimuli (9 or 17 regions), and sex; and covariates for contrast, and octaves of viewing distance, and age. RESULTS: The responses per unit area for the 17-region display were significantly larger than for the 9-region display (P < 10⁻¹²). The contrast-response function could be described by a power law with exponent 0.068 (P < 0.008). The effect of viewing distance was small but significant: response amplitude dropped by -0.17 ± 0.03 dB per octave of viewing distance (P < 10⁻6), or 10% over 8 octaves. CONCLUSIONS: The response per unit area indicated that cortical folding diminishes responses to larger stimuli. Viewing distance did not greatly affect response amplitude. This suggested that we can use similar, but scaled, stimuli to study central and peripheral disease. The rapidly saturating contrast responses imply that there would be nothing lost from testing at contrasts as low as 20% given that higher, saturating contrasts might mask visual field defects.

Multifocal frequency-doubling pattern visual evoked responses to dichoptic stimulation.

OBJECTIVE: To examine the feasibility of a multifocal visual evoked potential (mfVEP) binocularly, using a variant of the multifocal frequency-doubling (FD) pattern-electroretinogram (MFP). METHODS: Stimuli were presented in both monocular and dichoptic conditions at eight visual field locations/eye. The incommensurate stimulus frequencies ranged from 15.45 to 21.51 Hz. Five stimulus conditions differing in spatial frequency and orientation were examined for three viewing conditions. The resulting 15 stimulus conditions were examined in 16 normal subjects who repeated all conditions twice. RESULTS: Several significant independent effects were identified. Response amplitudes were reduced for dichoptic viewing (by 0.85 times, p<4 x 10(-11)); offset by increases in responses for between eye differences of one octave of spatial frequency: lower (1.15 times, 0.1 cpd); higher (1.29 times, 0.4 cpd), both p<1.8 x 10(-7). Crossed orientations produced significant effects upon response phase (p=0.023) but not amplitude (p=0.062). CONCLUSIONS: The results indicated that dichoptic evoked potentials using multifocal frequency-doubling illusion stimuli are practical. The use of crossed orientation, or differing spatial frequencies, in the two eyes reduced binocular interactions. SIGNIFICANCE: The results indicate a method wherein several spatial or temporal and frequencies per visual field region can be tested in reasonable time using a multifocal VEP using spatial frequency-doubling stimuli.

Low-spatial-frequency channels and the spatial frequency-doubling illusion.

PURPOSE: This study examined the number and nature of spatiotemporal channels in the region where the frequency-doubling (FD) illusion would be expected to occur at eight locations spanning the central 30 degrees of the visual field. METHODS: The probability of seeing the FD illusion was examined in 17 subjects. Stimuli were presented at 5 octaves of low spatial frequencies, at each of seven flicker frequencies in the range 5.65 to 27.95 Hz. In a single trial, subjects matched the apparent spatial frequency of the flickering test pattern using a two-alternative, forced-choice method. Thirteen subjects were examined for stimuli presented at contrast 0.95. Three or four subjects were examined at each of the contrasts 0.2, 0.4, and 0.8. A factor analysis was conducted on the psychometric functions, quantifying the number and possible spatiotemporal tuning of neural channels present. RESULTS: At contrast 0.95, three factors were able to explain 79.3% of the total variance in the psychometric responses to the 35 test conditions. This simple form of three broad spatiotemporal channels was also found at the other contrasts and in different subjects. The factor scores showed differential distribution of the factors onto the eight different visual field locations. Thus the expression of the three channels differed somewhat across the visual field. CONCLUSIONS: The results support earlier reports, that there are several low-spatial-frequency channels below 1 cyc/deg in the periphery. The results may have implications for the FDT and matrix perimeters.