Compliance with occlusion therapy for childhood amblyopia

Purpose. Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Methods. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). Results. One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P < 0.001) and with prolonged treatment duration (P < 0.001). Age, sex, amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. Conclusions. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664.

Enhancement of antimicrobial activities of whole and sub-fractionated white tea by addition of copper (II) sulphate and vitamin C against 'Staphylococcus aureus'; a mechanistic approach.

WT showed no efficacy in the combinations tested. WTF was enhanced with copper (II) sulphate and further with vitamin C. WT and WTF increased acidity of copper (II) sulphate possibly via the formation of chemical complexes. The difference in WT/WTF absorbance possibly represented substances less concentrated or absent in WTF. Investigations to establish which WTF component/s and in what proportions additives are most effective against target organisms are warranted

Can human amblyopia be treated in adulthood?

Amblyopia is a common visual disorder that results in a spatial acuity deficit in the affected eye. Orthodox treatment is to occlude the unaffected eye for lengthy periods, largely determined by the severity of the visual deficit at diagnosis. Although this treatment is not without its problems (poor compliance, potential to reduce binocular function, etc) it is effective in many children with moderate to severe amblyopia. Diagnosis and initiation of treatment early in life are thought to be critical to the success of this form of therapy. Occlusion is rarely undertaken in older children (more than 10 years old) as the visual benefits are considered to be marginal. Therefore, in subjects where occlusion is not effective or those missed by mass screening programs, there is no alternative therapy available later in life. More recently, burgeoning evidence has begun to reveal previously unrecognized levels of residual neural plasticity in the adult brain and scientists have developed new genetic, pharmacological, and behavioral interventions to activate these latent mechanisms in order to harness their potential for visual recovery. Prominent amongst these is the concept of perceptual learning—the fact that repeatedly practicing a challenging visual task leads to substantial and enduring improvements in visual performance over time. In the normal visual system the improvements are highly specific to the attributes of the trained stimulus. However, in the amblyopic visual system, learned improvements have been shown to generalize to novel tasks. In this paper we ask whether amblyopic deficits can be reduced in adulthood and explore the pattern of transfer of learned improvements. We also show that developing training protocols that target the deficit in stereo acuity allows the recovery of normal stereo function even in adulthood. This information will help guide further development of learning-based interventions in this clinical group

The effects of changes in salinity on osmoregulation and chloride cell morphology of juvenile Australian snapper, Pagrus auratus

The effect of rapid transfer of juvenile Australian snapper, Pagrus auratus from ambient seawater (30‰) to concentrated hyperosmotic (45‰) and diluted hyperosmotic (15‰) environments on serum osmolality, serum [Na+], [K+], [Cl−], blood haematocrit and branchial chloride cell morphology was assessed during 168 h after transfer. Serum osmolality, [Na+], [K+] and [Cl−] increased after 24 h in 45‰. In contrast, after 24 h in 15‰, [K+] did not change but serum osmolality, [Na+] and [Cl−] decreased. The serum chemistry changes were transient and had returned to near initial levels after 168 h in 45‰ and 15‰. Transfer from 30‰ to 45‰ and 15‰ did not affect blood haematocrit. Branchial chloride cells were identified in both filament and lamellar epithelia of snapper held in all salinity treatments by an immunocytochemical staining technique using an antiserum specific for Na+, K+–ATPase. In 45‰, the number of filament and lamellar chloride cells did not change, but filament chloride cells were more abundant than lamellar chloride cells. In contrast, filament chloride cells had increased in size after 72 h and by 168 h after transfer from 30‰ were 1.4-fold larger than the initial size. In 15‰, the number of filament chloride cells and the size of both filament and lamellar chloride cells had decreased after 72 h. Our results demonstrate that snapper can osmoregulate in a wide range of salinity and provide indirect evidence that both filament and lamellar chloride cells are responsible for excretion of excess salt from snapper in hyperosmotic environments. The ability for snapper to adapt rapidly and maintain homeostasis in a wide range of salinities supports the fact that snapper are a suitable species for land-based aquaculture in ponds, where rapid fluctuation in salinity can occur

Aquafin CRC Project 1B5: Feed Technology for Temperate f\Fish Species. Volume 2: Diet Development

World wide, consumption of edible seafood is increasing and by 2025, the world demand for edible seafood is predicted to reach about 140 million tonnes. Capture fisheries are predicted to meet no more than 42% of this demand, with the bulk being met through aquaculture. In fact, world wide aquaculture production has recently achieved parity with wild capture fisheries. The aquaculture of many species,\ud especially the high value carnivorous species most often cultured in the developed world has historically relied on the use of fish meal and fish oil to provide the protein and energy contained in commercial aqua-feeds. These ingredient resources are and will continue to be under considerable pressure and as such they are becoming increasingly expensive. Feed grade ingredients often used in\ud agri-feeds are also being directed into emerging industries such as the bio-fuel sector, further increasing competition and market volatility. Now, more than ever, aquaculture nutrition research is focusing on feed alternatives and ways to improve production efficiencies through a thorough\ud understanding of the nutritional requirements of species. These advances improve the profitability of farms, ensure that consumers have access to high quality, nutritious seafood and that the impacts on the environment are minimised.\ud \ud The research presented in this report has endeavoured to meet the aforementioned challenges as they pertain to the mulloway and yellowtail kingfish industries in NSW and other parts of Australia. In particular, this volume focuses on requirement studies that have increased our knowledge of the digestible protein and energy needs of mulloway and yellowtail kingfish. This volume also provides\ud valuable information on the digestibility of Australian feed ingredients by each species. Together, this work has resulted in the development of a bio-energetic model for both species which will be of great benefit to farmers and feed manufacturers, allowing construction of feeding tables, greater flexibility in feed formulation and the confidence to utilise alternatives to fishmeal in diets for either species. This report also presents separate studies investigating the utilisation of carbohydrates by mulloway and kingfish and the effects of increasing temperature on fish metabolism. In addition, we present two experiments that elucidate the effects of stocking density on the performance of mulloway during the important juvenile stages of growth

The effects of salinity and temperature on growth and survival of Australian snapper, Pagrus auratus larvae

The effects of salinity and temperature on performance were determined for Australian snapper, Pagrus auratus first-feeding to pre-metamorphosis larvae held in 100-l recirculation tanks. In the first experiment, performance was assessed after transfer from 35‰ at eight salinity treatments (5‰, 10‰, 15‰, 20‰, 25‰ 30‰, 35‰ and 45‰) in larvae from 3 to 21 days after hatching (dah). Survival of larvae was best within the range of 20–35‰. Final size of larvae was similar within the range of 10–35‰ (6.8 ± 0.1 to 7.1 ± 0.2 mm total length [TL]; 3.0 ± 0.3 to 3.3 ± 0.3 mg wet weight) but larvae were 15% shorter at 45‰. Final swimbladder inflation and feeding onset of larvae was not affected by salinity in the range of 10–45‰. The presence of calculi in the urinary bladder of larvae was correlated positively with increasing salinity but no relationship between urinary calculi and larval survival was observed. In a second experiment, performance was assessed after transfer from 21 °C at seven temperature treatments (15, 18, 21, 24, 27, 30 and 33 °C) in larvae from 3–21 dah. All larvae transferred from 21 °C to 30 °C and 33 °C died after 3 days and from 21 °C to 27 °C died after 9 days. Survival was not significantly different between 15 °C and 24 °C. Larval growth increased as temperature was increased; larvae at 24 °C (4.8 ± 0.2 mg wet weight) were 6-fold heavier than larvae at 15 °C. Swimbladder inflation of larvae grown at 18 °C, 21 °C and 24 °C was high (65.2 ± 18.0% to 86.7 ± 8.8%) and similar but inflation was lower in 15 °C and 27 °C. The incidence of urinary calculi occurred earlier and in a greater number of larvae when temperature was increased. Feeding onset was not affected by temperature. In a third experiment, performance was assessed at combinations of two salinities (20‰ and 35‰) and three temperatures (18 °C, 21 °C, and 24 °C) in larvae from 3 to 24 dah. Survival of snapper larvae was not significantly different between these treatments. Growth was not affected by salinity but larvae increased in size as temperature was increased and there was no interaction of salinity and temperature. The percentage of larvae that commenced feeding and inflated their swimbladders was similar in all treatments. Salinity and temperature influenced the incidence of urinary calculi and there was an interaction between the parameters. Based on our results in terms of larval performance (growth), development and survival, we conclude that the optimal conditions for larval rearing of snapper from first-feeding (3 dah) to pre-metamorphosis (24 dah) are combinations of salinity from 20‰ to 35‰ and a temperature of 24 °C

Refractive adaptation in amblyopia: quantification of effect and implications for practice

Aim: To describe the visual response to spectacle correction (“refractive adaptation”) for children with unilateral amblyopia as a function of age, type of amblyopia, and category of refractive error. Method: Measurement of corrected amblyopic and fellow eye logMAR visual acuity in newly diagnosed children. Measurements repeated at 6 weekly intervals for a total 18 weeks. Results: Data were collected from 65 children of mean (SD) age 5.1 (1.4) years with previously untreated amblyopia and significant refractive error. Amblyopia was associated with anisometropia in 18 (5.5 (1.4) years), strabismus in 16 (4.2 (0.98) years), and mixed in 31 (5.2 (1.5) years) of the study participants. Mean (SD) corrected visual acuity of amblyopic eyes improved significantly (p<0.001) from 0.67 (0.38) to 0.43 (0.37) logMAR: a mean improvement of 0.24 (0.18), range 0.0–0.6 log units. Change in logMAR visual acuity did not significantly differ as a function of amblyopia type (p = 0.29) (anisometropia 0.22 (0.13); mixed 0.18 (0.14); strabismic 0.30 (0.24)) or for age (p = 0.38) (“under 4 years” 0.23 (0.18); “4–6 years” 0.24 (0.20); “over 6 years” 0.16 (0.23)). Conclusion: Refractive adaptation is a distinct component of amblyopia treatment. To appropriately evaluate mainstream therapies such as occlusion and penalisation, the beneficial effects of refractive adaptation need to be fully differentiated. A consequence for clinical practice is that children may start occlusion with improved visual acuity, possibly enhancing compliance, and in some cases unnecessary patching will be avoided

Aerosol dispersal of the fish pathogen, Amyloodinium ocellatum

Amyloodinium ocellatum, a frequently encountered parasite in marine aquaculture, was investigated to determine if infective dinospore stages could be transported in aerosol droplets. We used an in vivo model incorporating static and dynamic airflow systems and found dinospores of A. ocellatum could travel in aerosol droplets (up to 440 turn in a static system and up to 3 m in a dynamic one). This is the first record of this transmission pathway for a marine protozoan parasite. It is possible that other marine protozoans can transfer via the aerobiological pathway. Management of A. ocellatum infections in aquaculture facilities could be affected, particularly where tanks and ponds are situated in close proximity. (c) 2006 Elsevier B.V. All rights reserved