Current trends among pediatric ophthalmologists to decrease myopia progression—an international perspective

Purpose To explore what the current worldwide preferred practice patterns of pediatric ophthalmologists are to decrease myopia progression among their patients. Methods A questionnaire was sent to all members of supranational and national pediatric ophthalmology and strabismus societies. Results The questionnaire was fully completed by most respondents 90.10% (847 of 940 responses). Fifty-seven percent (457) routinely treat to decrease myopia progression. The most common parameter to initiate treatment was a myopic increase of 1 diopter/year or more (74.8%, 246). Seventy percent (345) prescribed eye drops. Atropine 0.01% was the most popular (63.4%, 277) followed by atropine 1% (10.9%, 48) and atropine 0.5% (8.9%, 39). Eighty-six percent (394) of the respondents advised to spend more time outdoors, to reduce the amount of time viewing screens (60.2%, 277), and cutback the use of smart phones (63.9%, 294). Conclusions Most pediatric ophthalmologists treat to decrease myopia. They employ a wide variety of means to decrease myopia progression. Atropine 0.01% is the most popular and safe modality used similarly to recent reports. However, there is no consensus when treatment should be initiated. Further prospective studies are needed to elucidate the best timing to start treatment and the applicability of recent studies in the Asian population to other ethnic groups. This will improve the ability to update pediatric ophthalmologist with evidenced-based treatment options to counter the myopia epidemic

Travelling waves in pipe flow

A family of three-dimensional travelling waves for flow through a pipe of circular cross section is identified. The travelling waves are dominated by pairs of downstream vortices and streaks. They originate in saddle-node bifurcations at Reynolds numbers as low as 1250. All states are immediately unstable. Their dynamical significance is that they provide a skeleton for the formation of a chaotic saddle that can explain the intermittent transition to turbulence and the sensitive dependence on initial conditions in this shear flow.Comment: 4 pages, 5 figure

Practice patterns to decrease myopia progression differ among paediatric ophthalmologists around the world

Introduction Myopia is a worldwide epidemic. Plethora of treatments are offered to decrease myopia progression. In this study, we compared between different geographical areas worldwide the practice patterns used by paediatric ophthalmologists to decrease the progression of myopia. Methods Global responses to a questionnaire were analysed (n=794) for demographic variations. Pharmacological, optical and behavioural categories were defined as effective or ineffective based on the current scientific peer reviewed literature. Results Treatment rates varied significantly between geographical regions (mean 57%, range 39%–89%, p<0.001). Nearly all participants who treat myopia used at least one form of effective treatment, regardless of location (98%, p=0.16). Among those prescribing pharmacological treatments, European physicians offered the lowest rate of effective treatment compared with other regions (85% vs mean 97%). Rates of effective optical treatment varied significantly between locations (p<0.001), from 16% (Central-South America) to 56% (Far East). Most treating respondents advocated behavioural modifications (92%), between 87% (North America) and 100% (Central Asia). Nearly all respondents used combinations of treatment modalities (95%)—mostly pharmacological, optical and behavioural combination. However, combination rates varied significantly between regions (p<0.001). Discussion The utility of treatment to decrease myopia progression differs significantly across the world both in type, combination and efficacy. Conclusion Paediatric ophthalmologists involvement and proficiency in myopia progression treatment varies around the world. This may entail promoting continuous medical education and other incentives to increase the number and proficiency of paediatric ophthalmologist to have a more effective impact to control the myopia epidemic in children

How does flow in a pipe become turbulent?

The transition to turbulence in pipe flow does not follow the scenario familiar from Rayleigh-Benard or Taylor-Couette flow since the laminar profile is stable against infinitesimal perturbations for all Reynolds numbers. Moreover, even when the flow speed is high enough and the perturbation sufficiently strong such that turbulent flow is established, it can return to the laminar state without any indication of the imminent decay. In this parameter range, the lifetimes of perturbations show a sensitive dependence on initial conditions and an exponential distribution. The turbulence seems to be supported by three-dimensional travelling waves which appear transiently in the flow field. The boundary between laminar and turbulent dynamics is formed by the stable manifold of an invariant chaotic state. We will also discuss the relation between observations in short, periodically continued domains, and the dynamics in fully extended puffs.Comment: for the proceedings of statphys 2

The rise of fully turbulent flow

Over a century of research into the origin of turbulence in wallbounded shear flows has resulted in a puzzling picture in which turbulence appears in a variety of different states competing with laminar background flow. At slightly higher speeds the situation changes distinctly and the entire flow is turbulent. Neither the origin of the different states encountered during transition, nor their front dynamics, let alone the transformation to full turbulence could be explained to date. Combining experiments, theory and computer simulations here we uncover the bifurcation scenario organising the route to fully turbulent pipe flow and explain the front dynamics of the different states encountered in the process. Key to resolving this problem is the interpretation of the flow as a bistable system with nonlinear propagation (advection) of turbulent fronts. These findings bridge the gap between our understanding of the onset of turbulence and fully turbulent flows.Comment: 31 pages, 9 figure

Evolution of turbulent spots in a parallel shear flow

The evolution of turbulent spots in a parallel shear flow is studied by means of full three-dimensional numerical simulations. The flow is bounded by free surfaces and driven by a volume force. Three regions in the spanwise spot cross-section can be identified: a turbulent interior, an interface layer with prominent streamwise streaks and vortices and a laminar exterior region with a large scale flow induced by the presence of the spot. The lift-up of streamwise streaks which is caused by non-normal amplification is clearly detected in the region adjacent to the spot interface. The spot can be characterized by an exponentially decaying front that moves with a speed different from that of the cross-stream outflow or the spanwise phase velocity of the streamwise roll pattern. Growth of the spots seems to be intimately connected to the large scale outside flow, for a turbulent ribbon extending across the box in downstream direction does not show the large scale flow and does not grow. Quantitatively, the large scale flow induces a linear instability in the neighborhood of the spot, but the associated front velocity is too small to explain the spot spreading.Comment: 10 pages, 10 Postscript figure

Effect of large-scale intermittency and mean shear on scaling-range exponents in a turbulent jet

The present study investigates the combined impact of the intermittency associated with the turbulent-nonturbulent interface and the mean shear rate in an axisymmetric jet on the structure of turbulence in the scaling range, where the spectrum exhibits a power-law behavior. Second-order structure functions, autocorrelations of the dissipation rate, and spectra of both the longitudinal velocity fluctuation and the passive temperature fluctuation are measured at a distance of 40 diameter downstream from the nozzle exit. All the scaling range exponents are influenced by the large-scale intermittency and the mean shear. The scalar fluctuation is much more sensitive to the variation in large-scale intermittency than the velocity fluctuation.J. Mi and R. A. Antoni