Suitability of memory aids and strategies for people with posterior cortical atrophy: protocol for a scoping review.

BACKGROUND: Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterised by progressive visuospatial and visuoperceptual impairment. Recent research shows that memory impairment can also occur as an early symptom of the condition and that the impairment can be ameliorated by providing support in the memory recall phase, for example, by presenting a related cue. In Alzheimer's disease (AD), which is defined by an amnestic syndrome, memory aids and strategies have been used to help support everyday memory, which in turn can have a positive impact on patient and carer outcomes. Similar support for PCA could be achieved by using memory aids and strategies which help to encode and/or retrieve information, yet there are currently no guidelines for memory strategies that may be suitable in PCA. Due to the central visual disorder that defines PCA, careful consideration is needed when making recommendations. METHODS: A scoping review will be conducted of published studies that have assessed memory aids and strategies in people with AD and related dementias where memory is considered a core or supplementary feature, with the aim of distinguishing those that may be suitable or adaptable for PCA. The systematic search will include the electronic databases MEDLINE, PsycINFO and CINAHL, using search terms for dementia and memory aids and strategies identified in pilot searches. Findings will be mapped and described based on methods used, population, clinical data and memory aids and strategies identified. DISCUSSION: The scoping review will give an overview of the memory aids and strategies used in people with AD and related dementias and identify characteristics, modality and pragmatics to evaluate their suitability and adaptability for a PCA population. Tailored memory support strategies for people living with PCA could improve memory performance, with knock-on positive effects on patient and carer outcomes.

Immediate effects of Alpha/theta and Sensory-Motor Rhythm feedback on music performance.

This is one of a series of investigations comparing two EEG-neurofeedback protocols - Alpha/theta (A/T) and Sensory-Motor Rhythm (SMR) - for performance enhancement in the Arts, here with the focus on music. The original report (Egner and Gruzelier, 2003) established a beneficial outcome for elite conservatoire musicians following A/T training in two investigations. Subsequently this A/T advantage was replicated for both advanced instrumental and novice singing abilities, including improvisation, while SMR training benefited novice performance only (Gruzelier, Holmes et al., 2014). Here we report a replication of the latter study in university instrumentalists who as before were novice singers with one design change - post-training performances were conducted within the tenth final session instead of on a subsequent occasion. As before expert judges rated the domains of Creativity/Musicality, Communication/Presentation and Technique. The proximity to training of the music performances within the last session likely compromised gains from A/T learning, but perhaps reinforced the impact of SMR training efficacy. In support of validation there was evidence of strong within- and across-session A/T learning and positive linear trends for across-session SMR/theta and SMR/beta-2 ratio learning. In support of mediation learning correlated with music performance. The A/T outcome was markedly discrepant from previous studies and should dispel any impression that the hypnogogic state itself is transferred to the performance context. The effects of SMR ratio training are consistent with an impact on lower-order abilities required in novice performance such as sustained attention and memory, and benefiting all three domains of music assessment.

Replication of elite music performance enhancement following alpha/theta neurofeedback and application to novice performance and improvisation with SMR benefits.

Alpha/theta (A/T) and sensory-motor rhythm (SMR) neurofeedback were compared in university instrumentalists who were novice singers with regard to prepared and improvised instrumental and vocal performance in three music domains: creativity/musicality, technique and communication/presentation. Only A/T training enhanced advanced playing seen in all three domains by expert assessors and validated by correlations with learning indices, strongest with Creativity/Musicality as shown by Egner and Gruzelier (2003). Here A/T gains extended to novice performance - prepared vocal, improvised vocal and instrumental - and were recognised by a lay audience who judged the prepared folk songs. SMR learning correlated positively with Technical Competence and Communication in novice performance, in keeping with SMR neurofeedback's known impact on lower-order processes such as attention, working memory and psychomotor skills. The importance of validation through learning indices was emphasised in the interpretation of neurofeedback outcome.

Modification of the electro-optical properties of the B1 liquid-crystal phase using a rodlike liquid-crystal dopant.

It has recently been observed that on application of an alternating electric field, the B1 liquid-crystalline phase may be induced to form a switchable phase. This induced phase has been shown to have an almost thresholdless dielectric response. In this paper we examine this E-field-induced transition as a function of temperature both with and without a ferroelectric liquid-crystal dopant. Although the aim of this experiment was to enhance and stabilize the field-induced phase on addition of dopant, we find that the opposite is the case. The ferroelectric dopant actually increases the threshold E-fields required for transformation to the switching phase and at just 5 wt % dopant a smectic-A phase is formed. Addition of the dopant also acts against the low-field switching and significantly speeds relaxation back to the B1 phase on field removal. In addition we find that the field-induced phase experiences a slower crystallization. We use polarized optical microscopy, differential scanning calorimetry, and x-ray scattering experiments to characterize the physical properties of the mixtures.

[Corneal tattooing. A series of 14 case studies]. / De l'usage du tatouage cornéen. A propos de 14 cas.

AIMS: Evaluate the efficacy of a little-used surgical method: corneal tattooing, using a dermograph to hide unsightly corneal scars on nonfunctional eyes. PATIENTS AND METHODS: Retrospective study of 14 eyes of 13 patients treated by tattooing the corneal surface, by directly introducing the pigments into the corneal stroma using a dermograph. The effectiveness of tattooing was evaluated by pigmentation homogeneity and patient satisfaction. Tolerance was evaluated by the scarring at the 7th day and ocular inflammation. The average follow-up was 18 months. RESULTS: Fourteen eyes presented an unaesthetic, neovascularized major corneal edema (79% traumatism). In 12 eyes, the treatment was homogeneous with a very satisfactory aesthetic result for the patient. One eye presented minor complications of pigmentary migration. One eye presented a corneal perforation 40 days after the procedure on a very pathological cornea. CONCLUSION: Corneal tattooing using a dermograph is a little-used technique since changes in corneal transplantation indications but is also a simple and inexpensive alternative for corneal scar treatment on nonfunctional eyes.

Investigation into liquid crystalline smectic-C* subphase stability using chiral and achiral dopants.

In this paper we investigate the influence of chiral and achiral dopants on a chiral smectic liquid crystal material, which exhibits a rich phase sequence, including the antiferroelectric phase and the three-layer intermediate smectic (SmC*FI1) phase. Using polarized optical microscopy, differential scanning calorimetry, and x-ray diffraction we find that small amounts of achiral dopant have the ability to significantly broaden the SmC*FI1 phase, whereas an oppositely-handed dopant (otherwise identical to the host material) destabilizes the phase. This work clearly indicates that bulk chirality strongly influences SmC*FI1 phase formation and that steric effects also play an important role. Interestingly, addition of the shorter achiral molecule (8CB) was observed to increase the smectic layer spacing, most likely by suppressing interdigitation of alkyl chains between adjacent smectic layers. Control of the SmC*FI1 phase width using mixtures in this way is clearly important for effective phase characterization, and could potentially lead to commercially viable materials with a stable SmC*FI1 phase over a large temperature range.

Microchannel systems in titanium and silicon for structural and mechanical studies of aligned protein self-assemblies.

We report a technique for the alignment of self-assembled protein systems, such as F-actin bundles and microtubules, in a surface-modified titanium or silicon microfluidic device. Assembling filamentous protein systems in a confined geometry produces highly aligned samples for structural and mechanical studies. Biomolecular self-assembly can be investigated in a controlled fashion under different molecular concentration gradients and conditions along a channel length. We have shown that surface-modified devices produced via a high aspect ratio etch process in titanium and silicon can be used to confine and control such macromolecular assemblies and present examples of F-actin bundles and microtubules in this system.

Skin layer at the actin-gel surface: quenched protein membranes form flat, crumpled, and tubular morphologies.

We report the discovery of a hierarchically structured skin layer formed at the surface of an isotropic gel of filamentous actin bundles at high molar ratios of alpha-actinin, an actin cross-linker, to globular actin. Confocal microscopy has elucidated the full, micron scale 3D structure. The protein skin layer, composed of a directed network of bundles, exhibits flat, crumpled, tubelike and pleated multitubular morphologies, resulting from stresses due to the underlying gel. The skin layer, which readily detaches, constitutes a model anisotropic solid membrane with stress-induced, quenched disorder.

Structure of actin cross-linked with alpha-actinin: a network of bundles.

Three-dimensional laser scanning confocal microscopy has revealed that filamentous actin, when complexed with the cross-linking protein alpha-actinin, will spontaneously assemble on a micron scale into a structure comprised of a relatively rigid, frequently branching, 3D network of bundles with characteristic mesh size of the order of the persistence length of F-actin. In contrast, additional nanoscale ordering is observed, as synchrotron x-ray diffraction has revealed a disordered, distorted square lattice of actin fibers within the individual bundles.

Bony orbital anatomy of the koala (Phascolarctos cinereus).

This is the first documented study of the anatomical details of the normal koala orbit. Baseline data are established which are necessary for understanding and treating ocular disease in the koala (Phascolarctos cinereus). The bony anatomy of the orbit of the koala was examined and described from animals that presented dead or had been euthanized for humane reasons. Dissections of the orbital cavity were performed under magnification, and descriptions of the orbital bones were from macerated skulls that had been boiled and cleaned. In general, the orbital bones of the koala, and their respective foramina, are consistent with those of other carnivorous polyprotodont and herbivorous diprotodont marsupials.

Intraorbital anatomy of the koala (Phascolarctos cinereus).

This is the first documented study of the anatomical details of the contents of the normal koala orbit, excluding the bulbus oculi. Baseline data were established which are necessary for understanding and treating ocular disease in the koala (Phascolarctos cinereus). The anatomy of the orbital contents of the koala were examined and described from animals that presented dead or were euthanized for humane reasons. Dissections of the orbital cavity were performed under magnification. Polymethyl methacrylate (PMMA) casts of the nasolacrimal system and the vascular supply of the orbit were also made in order to study these systems. The superficial lymphatic drainage of the conjunctival tissues was studied by subcutaneous injection of Evan's Blue into the palpebral conjunctiva of a freshly deceased animal, and by Microfil casts of the efferent lymphatics. In general, the orbital contents of the koala are consistent with those of other carnivorous polyprotodont and herbivorous diprotodont marsupials.

Interlayer structures of the chiral smectic liquid crystal phases revealed by resonant X-ray scattering.

The structures of the liquid crystalline chiral subphases exhibited by several materials containing either a selenium or sulphur atom have been investigated using a resonant x-ray scattering technique. This technique provides a unique structural probe for the ferroelectric, ferrielectric, antiferroelectric, and SmC(*)(alpha) phases. An analysis of the scattering features allows the structural models of the different subphases to be distinguished, in addition to providing a measurement of the helical pitch. This paper reports resonant scattering features in the antiferroelectric hexatic phase, the three- and four-layer intermediate phases, the antiferroelectric and ferroelectric phases and the SmC(*)(alpha) phase. The helicoidal pitch has been measured from the scattering peaks in the four-layer intermediate phase as well as in the antiferroelectric and ferroelectric phases. In the SmC(*)(alpha) phase, an investigation into the helical structure has revealed a pitch ranging from 5 to 54 layers in different materials. Further, a strong resonant scattering signal has been observed in mixtures of a selenium containing material with as much as 90% nonresonant material.

Review of treatment of pterygium in Queensland: 10 years after a primary survey.

PURPOSE: To assess the practices in pterygium removal as a follow-up study to a similar project 10 years ago, in order to compare the current trends with those noted a decade ago. METHODS: A survey was sent to all practising ophthalmologists in Queensland (100). RESULTS: Eighty-seven of the 100 ophthalmologists undertook pterygium surgery with no change in indications for removal, grading or anaesthesia compared to 10 years ago. Nearly half of the ophthalmologists varied their surgical technique from eight commonly used methods according to the individual patient. More than half the respondents used a swinging conjunctival flap and 29% used simple excision leaving the area bare for primary pterygia, although nearly one-quarter of the ophthalmologists added adjunctive therapies such as beta irradiat on or mitomycin. For recurrent pterygia, one-third of ophthalmologists preferred adjunctve therapies, and 57% used an autoconjunctival transplant. CONCLUSION: There has been no consistent trend in surgical removal of pterygia with a significant number of primary pterygia still removed using bare scleral closure.

Corneal endothelial response to induced myopia in the chicken.

PURPOSE: To investigate the role of corneal endothelial surface enlargement in the chicken myopia model in inducing corneal endothelial changes. METHODS: Lid suture was performed on one eye of 1-day-old cockerels. Five chickens were killed at 1 week, and four chickens killed at each of 3 weeks, 6 weeks, and 10 weeks postnatal. The endothelial morphology was obtained by flat mounting the endothelial surface and the subsequent digitisation. Comparisons were undertaken between the control unsutured eye and the lid-sutured eye endothelium, and between the central endothelial areas compared to the peripheral endothelial areas in both the myopic and the normal corneas. Calculation of the contribution to the endothelial change by hypertrophy and mitosis were calculated using Bahn's formula. RESULTS: Total endothelial surface area increased significantly over time in the myopic model compared to control eyes but the mean cell area of endothelial cells remained the same for both the enlarged myopic endothelial surface area and in the normal controls. Sampling from the central and the peripheral corneal endothelial surface also disclosed no difference. The mean cell area did increase steadily with age but was the same for both normal and myopic corneas. CONCLUSIONS: It would appear that there are equal contributions from hypertrophy and mitosis in the myopic group and the normal corneal group with a slightly increasing trend towards mitotic activity in the myopic corneal endothelial layer.

The cytomorphology of ocular surface squamous neoplasia by using impression cytology.

BACKGROUND: The term ocular surface squamous neoplasia (OSSN) encompasses conjunctival and corneal intraepithelial neoplasia through to invasive squamous cell carcinoma of the ocular surface. The disease is related to prolonged exposure to solar ultraviolet light and has been proposed as an acquired immune deficiency syndrome-associated tumor. To the authors' knowledge, very few reports describing the cytology of these lesions have been published. METHODS: Impression cytology (IC) samples collected from the eyes of patients with a range of ocular surface diseases were available for study. From these, 267 sets of impressions had subsequent histopathology that had been collected within 6 months of the IC, and which indicated the presence of OSSN. The IC from these cases was used to describe the cytomorphology of intraepithelial and invasive OSSN. RESULTS: Within the intraepithelial group, keratinized dysplastic cells that often were accompanied by hyperkeratosis, syncytial-like groupings, and nonkeratinized dysplastic cells were described. Within the invasive group, cases with significant keratinization and an additional group of cases with little keratinization and sometimes also prominent macronucleoli were described. Keratinized cases were the most numerous in both the intraepithelial and invasive groups. A description also was given of a low number of cases with cytology and also subsequent histopathology indicating the presence of intraepithelial OSSN, in the absence of a clinically detectable lesion. CONCLUSIONS: This detailed description of the cytomorphology of a high number of cases of OSSN with confirmation by histopathology should assist others with little experience of the cytology of these lesions to examine them with increased confidence. Cancer (Cancer Cytopathol)

Use of topical cyclosporin for conjunctival manifestations of actinic prurigo.

PURPOSE: To report the successful treatment of conjunctival manifestations of actinic prurigo with topical cyclosporin. METHODS: A 12-year-old female with extensive limbal lesions and chronic conjunctivitis secondary to actinic prurigo was treated with topical cyclosporin, and a rapid clinical response was observed. RESULTS: The patient had the limbal lesions surgically excised. The lesions completely recurred over the first 2 postoperative months. Treatment with topical steroids and vitamin A ointment was unsuccessful. The patient was then treated with cyclosporine 2% drops and a dramatic improvement occurred. Over a 3-month period, the lesions completely resolved. CONCLUSION: Cyclosporine eyedrops may be an effective treatment for the conjunctival manifestations of actinic prurigo.

Ultraviolet light exposure as a risk factor for ocular melanoma in Queensland, Australia.

The state of Queensland, Australia, has one of the highest incidences of cutaneous melanoma in the world; this has been linked to the high sun exposure of the mainly Caucasian population. The role of sun exposure in the development of ocular melanoma (melanoma of the conjunctiva, iris, ciliary body or choroid) remains unclear. A case-control study involving 125 patients with ocular melanoma treated between 1972 and 1996, and 375 age- and sex-matched controls (three for each patient) was performed. A standardised telephone questionnaire examining ultraviolet exposure and other potential risk factors was administered. Cumulative lifetime ocular ultraviolet B (UV-B) exposure was assessed using the Melbourne Visual Impairment Project instrument. Risk factors identified include personal history of melanoma of the skin (odds ratio [OR] 2. 42, 95% confidence interval [CI] 0.88, 6.62) or other skin cancers (OR 1.52, CI 0.99, 2.35), and family history of ocu-lar melanoma (OR 6.89, CI 0.70, 67.38). Protective factors included olive or black skin (OR 0.72, CI 0.40, 1.31), brown iris colour (OR 0.89, CI 0.51, 1.54), high resistance to sunburn (OR 0.58, CI 0.26, 1.31), and wearing prescription glasses (OR 0.78, CI 0.48, 1.25). Sunglass wearing was not found to be protective. Cumulative lifetime ocular UV-B exposure was not found to be a risk factor for ocular melanoma. However, there were too few cases of conjunctival and iris melanoma for these to be analysed as separate sub-groups.

Knowledge of sunlight effects on the eyes and protective behaviors in adolescents.

The knowledge of the effects of sunlight on the eyes and protective behaviors were studied in an adolescent population. A group of 652 systematically sampled students aged between 13 and 17 years was surveyed with a standardized questionnaire in Brisbane, Australia in October-November, 1995. Survey data on the knowledge of sunlight effects on the eyes, ultraviolet light, eye and body protection as well as risk factors for ultraviolet (UV) exposure were relatively ranked and totalled to give overall scores. Of the 652 subjects, 330 (51%) were female. Most subjects (568 or 88%) were aged between 15 and 16 years. Overall, this group of subjects demonstrated a moderate level of knowledge with respect to UV, sunlight and the eyes. The knowledge of the effects of sunlight and body protection was higher than the knowledge of the effects of sunlight and eye protection. Almost three-quarters (462 or 71%) of the subjects owned a pair of sunglasses. The mean age at which subjects started to wear sunglasses was 10.4 years. However, most subjects (528 or 81%) only wore sunglasses occasionally or not at all. The reported frequency of wearing sunglasses was significantly related to personal, family and peer attitudes to such use, but not to media advertizing. Assessment of adolescent knowledge is important in the formulation of health promotion strategies designed to prevent excessive UV exposure at this young age.