Changes In Accommodation Research Articles

Evolution of Late Oligocene - Early Miocene attached and isolated carbonate platforms in a volcanic ridge context (Maldives type), Yadana field, offshore Myanmar

This study investigates the stratigraphic evolution of the Late Oligocene - Early Miocene carbonate platforms of the Yadana area (offshore Myanmar). Well data, regional 2D and local 3D seismic surveys allow the identification of three shallow-water carbonate platforms (Yadana, 3DF and 3DE) showing various morphologic and stratigraphic patterns influenced by the presence of a paleohigh. The identification of seven seismic sequences in the Yadana area constrains the stratigraphic evolution in three stages: (1) development of aggrading attached and isolated platforms during the Chattian; (2) a period of platform emersion during the Oligocene - Miocene transition; (3) drowning of the smaller buildup (3DE) associated with km-scale backstepping on the large platforms (3DF and Yadana) during the Aquitanian. The Aquitanian marks the onset of renewed volcanic activity associated with the development of fringing carbonate reefs during the Burdigalian. The rapid (∼6 My) development of these wide (∼5–70 km) and thick (∼300–850 m) carbonate platforms has been mainly controlled by the subsidence. However, the results highlight a strong overprint of eustatic fluctuations on the rates of change in accommodation, and hence on the stratigraphic architecture of the carbonate platforms. Based on an alternative model for the Cenozoic geodynamic evolution of the Yadana area, our results suggest that the platforms developed on a volcanic ridge of hotspot origin located in the Indian Ocean and not on a volcanic arc. Subduction jump processes are interpreted to have played a key role in the demise of all platforms by drastically changing the paleoenvironmental conditions during the Early Miocene, and led to the present-day location of the Yadana Ridge in a back-arc setting. The carbonate platforms from the Yadana area are thus a representative example of the interplay between global mechanisms and local paleoenvironmental parameters on carbonate platform initiation, growth and demise.

Возрастные изменения рефракции и аккомодации у школьников младших классов

Возрастные изменения рефракции и аккомодации у школьников младших классов

Hair follicles' transit-amplifying cells govern concurrent dermal adipocyte production through Sonic Hedgehog.

Growth and regeneration of one tissue within an organ compels accommodative changes in the surrounding tissues. However, the molecular nature and operating logic governing these concurrent changes remain poorly defined. The dermal adipose layer expands concomitantly with hair follicle downgrowth, providing a paradigm for studying coordinated changes of surrounding lineages with a regenerating tissue. Here, we discover that hair follicle transit-amplifying cells (HF-TACs) play an essential role in orchestrating dermal adipogenesis through secreting Sonic Hedgehog (SHH). Depletion of Shh from HF-TACs abrogates both dermal adipogenesis and hair follicle growth. Using cell type-specific deletion of Smo, a gene required in SHH-receiving cells, we found that SHH does not act on hair follicles, adipocytes, endothelial cells, and hematopoietic cells for adipogenesis. Instead, SHH acts directly on adipocyte precursors, promoting their proliferation and their expression of a key adipogenic gene, peroxisome proliferator-activated receptor γ (Pparg), to induce dermal adipogenesis. Our study therefore uncovers a critical role for TACs in orchestrating the generation of both their own progeny and a neighboring lineage to achieve concomitant tissue production across lineages.

Accommodative changes after SMILE for moderate to high myopia correction.

BackgroundTo investigate accommodative response and accommodative lag changes after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction.MethodsA total of 32 eyes of 32 patients with no strabismus who underwent SMILE were enrolled in this prospective clinical study. The accommodative response was obtained viewing monocularly with spherical equivalent refractive error corrected, using an open-field autorefractor at different stimulus levels (2.00D, 2.50D, 3.00D, 4.00D and 5.00D) for the right eye before a standard SMILE surgery and at 1-month follow-up after surgery.ResultsThe mean age of the patients were 23.34 ± 2.90 years and the mean preoperative manifest refraction spherical equivalent was −5.74 ± 1.98 diopters. Significant differences were detected in both preoperative and postoperative accommodative responses to different stimulus levels (P < 0.001). Multiple linear regression model analysis revealed preoperative manifest refractive spherical equivalent (P = 0.006) and preoperative accommodative lag (P = 0.04) showed a significant impact on postoperative accommodative lag.ConclusionsThis is the first report of accommodative changes after SMILE. Our preliminary results showed that a decrease in postoperative accommodative lag that might be related to the relief of the visual discomfort symptom.

Pattern of Change in Accommodation and its Correlation with Mydriasis in Young Emmetropes After Instillation of Tropicamide Phenylephrine Eye Drops

Cycloplegics relax accommodation by blocking the action of ciliary muscles. The mydriasis obtained with these drugs is expected to be related to the degree of cycloplegia. This study evaluates the change in accommodation in young emmetropes and its correlation with mydriasis post instillation of tropicamide phenylephrine eye drops. A prospective descriptive study. Young adults of age group 18-22 years with uncorrected visual acuity of 6/6, near vision N6 and no asthenopic symptoms were included in the study. Age of the subject, NPA (near point of accommodation), NPC (near point of convergence), AA (accomodation amplitude), objective refraction with Autorefractometer, pupillary size and near vision (NV) were noted. The study group included 25 cases; mean age of 20.54 years (SD 1.046years). The amount of accommodation relaxed by drug ranged from 2.75D to 4.50 D. NPA, NPC, AA were inversely proportional to accommodation relaxed (p=0.00). The rate of change of pupillary dilatation and cycloplegia differed. The cycloplegic effect had a positive correlation with the increase in the visual angle; but was independent of the mydriatic effect.

Adaptation of horizontal eye alignment in the presence of prism in young children.

Young children experience decreased convergence and increased accommodation demands relative to adults, as a result of their small interpupillary distance and hyperopic refraction. Those with typical amounts of hyperopic refractive error must accommodate more than an emmetrope to achieve focused retinal images, which may also drive additional convergence through the neural coupling. Adults and older children have demonstrated vergence adaptation to a variety of visual stimuli. Can vergence adaptation help younger children achieve alignment in the presence of these potentially conflicting demands? Purkinje image eye tracking and eccentric photorefraction were used to record simultaneous vergence and accommodation responses in adults and young children (3–6 years). To assess vergence adaptation, heterophoria was monitored before, during, and after adaptation induced by both base-in and base-out prisms. Adaptation was observed in both adults and young children with no significant effect of age, F(1, 34) = 0.014, p = 0.907. Changes in accommodation between before, during, and after adaptation were less than 0.5 D in binocular viewing. Typically developing children appear capable of vergence adaptation, which might play an important role in the maintenance of eye alignment under their changing visual demands.

Accommodation succession (δ A /δ S ) sequence stratigraphy: observational method, utility and insights into sequence boundary formation

The future of sequence stratigraphy depends on stratigraphers making observations with a common method so that physical frameworks can be clearly separated from interpretations of driving mechanisms. Depositional sequence boundary selection is a well-known controversy that could be resolved with objective recognition criteria. Accommodation succession sequence stratigraphy refines traditional methods, using sedimentary facies, facies associations, vertical stacking, stratal geometries and stratal terminations as the objective record of competing rates of accommodation change and sediment fill through time. Observations are placed in context of lateral (transgression and regression) and vertical (aggradation and degradation) movement of shoreline through time, across multiple timescales in hierarchal stacks. The repeating motif consists of a subaerial unconformity and its correlative subaqueous surface overlain in coastal settings by a basinward shift in coastal onlap and strata with progradational to aggradation stacking, then retrogradation and aggradation–progradation–degradation stacking. These stacking patterns are bounded by key surfaces, recognized by stratal terminations and characteristic vertical successions of facies. This pattern is independent of time duration or position on a sea-level curve, but incorporates data resolution, regional extent and hierarchal stacking. Examples from multiple datasets show the utility and objectivity of the method and provide insights into sequence boundary formation.

Objective Measurement of Fusional Vergence Ranges and Heterophoria in Infants and Preschool Children

PurposeBinocular alignment typically includes motor fusion compensating for heterophoria. This study evaluated heterophoria and then accommodation and vergence responses during measurement of fusional ranges in infants and preschoolers.MethodsPurkinje image eye tracking and eccentric photorefraction (MCS PowerRefractor) were used to record the eye alignment and accommodation of uncorrected infants (n = 17; 3–5 months old), preschoolers (n = 19; 2.5–5 years), and naïve functionally emmetropic adults (n = 14; 20–32 years; spherical equivalent [SE], +1 to −1 diopters [D]). Heterophoria was derived from the difference between monocular and binocular alignments while participants viewed naturalistic images at 80 cm. The presence or absence of fusion was then assessed after base-in (BI) and base-out (BO) prisms (2–40 prism diopters [pd]) were introduced.ResultsMean (±SD) SE refractions were hyperopic in infants (+2.4 ± 1.2 D) and preschoolers (+1.1 ± 0.6 D). The average exophoria was similar (P = 0.11) across groups (Infants, −0.79 ± 2.5 pd; Preschool, −2.43 ± 2.0 pd; Adults, −1.0 ± 2.7 pd). Mean fusional vergence range also was similar (P = 0.1) for BI (Infants, 11.2 ± 2.5 pd; Preschool, 8.8 ± 2.8 pd; Adults, 11.8 ± 5.2 pd) and BO (Infants, 14 ± 6.6 pd; Preschool, 15.3 ± 8.3 pd; Adults, 20 ± 9.2 pd). Maximum change in accommodation to the highest fusible prism was positive (increased accommodation) for BO (Infants, 1.69 ± 1.4 D; Preschool, 1.35 ± 1.6 D; Adults, 1.22 ± 1.0 D) and negative for BI (Infants, −0.96 ± 1.0 D; Preschool, −0.78 ± 0.6 D; Adults, −0.62 ± 0.3 D), with a similar magnitude across groups (BO, P = 0.6; BI, P = 0.4).ConclusionsDespite typical uncorrected hyperopia, infants and preschoolers exhibited small exophorias at 80 cm, similar to adults. All participants demonstrated substantial fusional ranges, providing evidence that even 3- to 5-month-old infants can respond to a large range of image disparities.

Optometric Management of Sports-related Post-concussion Visual Symptoms in Teenagers with Vision Therapy: A Case Series

Background: Sports-related concussions are among the most common causes of mild traumatic brain injury (mTBI) in children and young adults. Post-concussion visual problems include: changes in refractive status, binocularity, accommodation, ocular motility, visual processing, and vestibular-visual interaction. Modifications to the traditional optometric exam, use of prisms, lenses, binasal occlusion, tints, filters, and a sequence of in-office vision therapy (VT) can successfully rehabilitate the visual symptoms and improve the quality of life (QoL) for this very unique patient population. Case Reports: 1) A 14 year old male presented with a history of a concussion from soccer. His symptoms included headaches, decreased concentration, difficulty copying form the board and difficulty transitioning from near to far activities. Clinical testing revealed an accommodative and oculomotor dysfunction (OMD). He was prescribed BU yoked prism glasses and vision therapy. 2) A 16 year old female presented with a history of two sports-related concussions from cheerleading. Her symptoms included headaches, blurry vision at near and difficulty keeping her place when reading. Clinical observation revealed OMD and accommodative insufficiency. She was prescribed reading glasses to relieve visual stress when reading while she completed vision therapy. 3) A 19 year old female presented with a history of multiple sports concussions while playing collegiate soccer, which resulted in headaches that became worse when reading, decreased reading stamina and difficulty keeping her place when reading. Clinical observation revealed accommodative insufficiency, binocular dysfunction and OMD. She was prescribed reading glasses and vision therapy. Conclusion: This case series outlines the exam procedures and therapy techniques used to manage three teenagers with postconcussive visual disorders. Symptoms such as blurred vision, headaches and difficulty reading can profoundly affect activities of daily living (ADLs). Optometric examinations and management through the use of prisms, tints, reading glasses, and in-office vision therapy can successfully resolve these visual complaints. Each patient described completed 10-12 sessions of in-office vision therapy [over a span of four to eight months], with home re-enforcement, and graduated with marked improvement of their visual signs and symptoms.

Impact of Price Hike on the Standard of Living of Middle Income People : A Study on Sylhet City, Bangladesh

The purpose of this research is to identify the impact of price hike on the living standard of middle income people. The researchers tried to identify the alternatives of middle class people in face of price hike or inflation. This descriptive analytical research is conducted by random probability sampling. The data were collected by a well designed questionnaire that was tested by experts in this field to ensure the validity of the research. The responses from 98 households are processed and analyzed by frequency distribution, cross tabulation and Chi-square tests. The impact of price hike (minor, medium and major) is tested in respect of compensate by more income, change in food habits, change in accommodation and education. The result showed that there is a small reaction in the minor inflation but in medium and major inflation most of the respondents seeks alternatives to face the crisis. A significant difference in the reaction is found in most of the cases with the levels of price hikes. But the middle income people have the tendency to maintain the status quo in their life style and standard of living. The management may generate new products or services for the middle class people by keeping the mindset of them in the time of price hike. The authority should consider compensating the middle class in various ways to restore their consumption level to continue the economic activities of a country.

Evaluation of the acute changes in objective accommodation, pupil size and ocular wavefront aberrations after cigarette smoking

Context: The acute effects of cigarette smoking on pupil size and ocular wavefront aberrations (OWA) have been previously documented. The accommodation status of the eye is well known to be related to ocular aberrations. No previous study has evaluated the impact of cigarette smoking on the accommodation status of the eye. This study presents intriguing findings regarding the changes in objective accommodation of the eye after cigarette smoking.Objective: To evaluate the acute changes in objective accommodation and OWA after cigarette smoking.Materials and methods: A total of 34 otherwise healthy cigarette smoker participants were included in this prospective study. All subjects smoked a single cigarette containing 1 mg nicotine. Measurements of pupil size, OWA and objective accommodation were done before and after smoking. A Wavefront Aberrometer device (Irx3, Imagine Eyes, Orsay, France) was used for the measurements.Results: The mean age of the participants was 36.6 ± 10.3 years (range 21–51 years). Pupil size did not significantly differ before (mean 5.72 ± 1.21 mm) and after smoking (mean 5.68 ± 1.14 mm) (p = 0.62). However, a significant decrease was observed in total spherical aberration (TSA) of the eye after smoking (p = 0.01). There was an increase in objective accommodation after smoking at each accommodative stimulus (range 0–5). This increment was significant at 2 D (p = 0.02) and 3 D (p = 0.03) of stimulus.Discussion and conclusions: The TSA of the eye significantly decreases after smoking. Cigarette smoking also causes a significant increase in objective accommodation at 2 D and 3 D of stimulus.

Aging Dogs Manifest Myopia as Measured by Autorefractor.

ObjectiveDogs, like humans, experience eye changes with aging: hardening and clouding of the lens and accumulated oxidative damage from UV sunlight. It has been debated whether such changes could be affecting the visual function of dogs. The objective of this study was to determine if autorefractometry could be used to measure visual function in dogs.Animals and MethodsNine Beagle dogs (ages 1 to 14 years) were examined by a veterinary ophthalmologist and their eyes determined to be free of cataracts. Spherical equivalent refractive error was measured by handheld autorefractor (Welch Allyn SureSight) under both indirect and direct lighting conditions with five measurements per condition, per eye. Measures were repeated on three different days for each dog within six weeks. Nonparametric statistics were used to detect differences among lighting conditions and test days, and between eyes. Spearmen correlation assessed the visual measurement outcomes’ association with age.ResultsThere was no difference for day-to-day or between-eye measurements. Significantly, the Beagles showed a myopic shift with aging (average spherical equivalent ranged from plano to -3.00 diopters), suggesting that dogs become more near-sighted as they age (r = -0.48 and -0.73 under direct and indirect lights; p<0.05 both). Younger dogs were able to make larger accommodation changes from indirect light to direct light conditions, indicating a more flexible lens (r = -0.50, p<0.05).ConclusionsAlthough designed for humans, the hand-held autorefractor technique is applicable to dogs and sensitive to light conditions. The age-associated myopic shift could be expected to compromise dogs’ visual functions.

Uniformity of accommodation across the visual field.

We asked the question: Does accommodation change the eye's focusing power equally over the central visual field in emmetropic and myopic adult eyes? To answer this question we modified our laboratory scanning wavefront aberrometer to rapidly measure ocular refractive state over the central 30° diameter of visual field as a function of foveal accommodative demand. On average, ocular refractive state changed uniformly over the central visual field as the eye accommodated up to 6 D. Visual field maps of accommodative error (relative to a spherical target surface of constant vergence) reveal subtle patterns of deviation on the order of ± 0.5 D that are unique to the individual and relatively invariant to changes in accommodative state. Population mean maps for accommodative error are remarkably uniform across the central visual field, indicating the retina of the hypothetical "average eye" is conjugate to a sphere of constant target vergence for all states of accommodation, even though individual eyes might deviate from the mean due to random variations. No systematic difference between emmetropic and myopic eyes was evident. Since accuracy of accommodation across the central visual field is similar to that measured in the fovea, loss of image quality due to accommodative errors, which potentially drives myopia and may affect many aspects of visual function, will be similar across the central retina.

Effects of orthokeratology lenses on the magnitude of accommodative lag and accommodativeconvergence/accommodation

To evaluate the change in accommodative lag and accommodation convergence/accommodation (AC/A) after patients with myopia wear orthokeratology lenses. A total of 48 myopic subjects (a test group), who wore orthokeratology lenses regularly, and 48 myopic subjects (a control group), who wore spectacles regularly, were enrolled for this study from January 2011 to January 2013 in Optometric Center, the Forth Hospital of Changsha. Accommodative lag was measured by fused cross cylinder method, where the patients should gaze at the front optotypes 40 cm away. Gradient of the AC/A ratio was measured by Von Grafe method to check closer distance heterophoria. Accommodative lag and AC/A ratio were analyzed by statistics. After 1-year follow-up, accommodative lag and AC/A rate in patients with low or moderate myopia in the test group was decreased in 1, 3, 6 months or 1 year compared with that in the control group (P<0.05). Compared with spectacles, orthokeratology lenses are able to decrease accommodative lag and high AC/A rate in patients with low or moderate myopia. The relationship between accommodation and convergence is improved by orthokeratology lenses. Orthokeratology is an effective way to control myopia.

Ramp sedimentation across a middle Albian, Arctic embayment: Influence of subsidence, eustasy and sediment supply on stratal architecture and facies distribution, Lower Cretaceous, Western Canada Foreland Basin

AbstractRegional mapping of Middle Albian, shallow‐marine clastic strata over ca 100 000 km2 of the Western Canada Foreland Basin was undertaken to investigate the relationship between large‐scale stratal architecture and lithology. Results suggest that, over ca 5 Myr, stratal geometry and facies were dynamically linked to tectonic activity in the adjacent Cordillera. Higher frequency modulation of accommodation is most reasonably ascribed to eustasy. The Harmon and Cadotte alloformations were deposited at the southern end of an embayment of the Arctic Ocean. The Harmon alloformation, forming the lower part of the succession, constitutes a wedge of marine mudstone that thickens westward over 400 km from &lt;5 m near the forebulge to &gt;150 m in the foredeep. Constituent allomembers are also wedge‐shaped but lack distinct clinothems, a rollover point or downlapping geometry. Ubiquitous wave ripples indicate that the sea floor lay above storm wave base. Deposition took place on an extremely low‐gradient ramp, where accommodation was limited by effective wave base. Lobate, river‐dominated deltas fringed the southern margin of the basin. The largest deltas are stacked in the same area, suggesting protracted stability of the feeder river. A buried palaeo‐valley on the underlying sub‐Cretaceous unconformity may have influenced compaction and controlled river location for ca 3 Myr. Adjacent to the western Cordillera, a predominantly mudstone succession is interbedded with abundant storm beds of very fine‐grained sandstone and siltstone that reflect supply from the adjacent orogen. Bioturbation indices in the Harmon alloformation range from zero to six which reflects the influence of stressors related to river‐mouth proximity. Harmon alloformation mudstone grades abruptly upward into marine sandstone and conglomerate of the overlying Cadotte alloformation. The Cadotte is composed of three allomembers ‘CA’ to ‘CC’, that represent the deposits of prograding strandplains 200 × 300 km in extent. Allomembers ‘CA’ and ‘CB’ are strongly sandstone‐dominated, whereas allomember ‘CC’ contains abundant conglomerate in the west. The dominantly aggradational wedge of Harmon alloformation mudstone records flexural subsidence driven by active thickening in the adjacent orogen: the high accommodation rate trapped coarser clastic detritus close to the basin margin. In contrast, the tabular, highly progradational sandstone and conglomerate bodies of the Cadotte alloformation record a low subsidence rate, implying tectonic quiescence in the adjacent orogen. Erosional unloading of the orogen through Cadotte time steepened rivers to the extent that they delivered gravel to the shore. These observations support an ‘anti‐tectonic’ model of gravel supply proposed previously for the United States portion of the Cretaceous foreland basin. Because Cadotte allomembers do not thicken appreciably into the foredeep, accommodation changes that controlled these transgressive–regressive successions were probably of eustatic origin.

The effect of viewing distance on responses to the pattern glare test

BackgroundWe investigated whether symptoms of pattern glare were affected by viewing distance, as distinct from spatial frequency, because of an association between symptoms and anomalies of accommodation and vergence.MethodsOne hundred young adults viewed gratings with spatial frequencies of 0.3, 2.3 and 9.4-cycles per degree (cpd) at four test distances (0.4, 0.8, 1.6 and 3.2 metres). Participants were asked to grade the presence of 15 symptoms of visual perceptual distortions and discomfort, on a scale from zero (no symptoms) to 10 (maximum perceptual and somatic symptoms).ResultsThe viewing distance did not affect the nature and strength of symptoms, when viewing gratings with similar spatial frequencies. The symptoms increased with spatial frequency (p < 0.008 for all comparisons).ConclusionsThe symptoms from the Pattern Glare Test do not appear to be modulated by the changes in accommodation and vergence associated with viewing distance, at least in an unselected sample of students. The highest spatial frequency of the current Pattern Glare Test was 9.4-cpd at 0.4 metre and this is insufficiently high to measure the reduction in symptoms at high spatial frequencies. If assessing relative aversion to gratings of different spatial frequencies, it may be useful to increase the testing distance to 0.6 metre so as to increase the spatial frequency of the third grating to 14.2-cpd.

Dynamics of cyclic carbonate deposition and biotic recovery on platforms during the Famennian of Late Devonian in Guangxi, South China: Constraints from high-resolution cycle and sequence stratigraphy

To better understand the dynamics of platform carbonate deposition, evolution and biotic recovery during the Famennian, high-resolution cycle and sequence stratigraphic analyses were carried out upon three platform sections (one in ramp, and two in rimmed platforms), along with a biostratigraphically well-constrained basinal section, in Guangxi, South China. Four main facies and fourteen lithofacies are identified in the three isolated platforms; these are vertically arranged into decimetre- to metre-scale, shallowing-upward peritidal and subtidal cycles (or parasequces), in which the peritidal cycles predominate over the lower-middle Famennian. Six third-order sequences (S1 to S6) are identified based on the cycle stacking patterns as illustrated by Fischer-plots and vertical facies changes; these sequences are temporally calibrated through correlation with basinal sequences constrained with conodont zonation, and match well the six main Famennian transgressive–regressive cycles (T1 to T6) in Euramerica and elsewhere, indicating a eustatic control. However, an opposite longer-term trend in accommodation change (S3 to S4) between platform interior and deeper open shelf-to-basin settings during the middle Famennian suggests a differential subsidence across the platform–basin section, likely driven by block tilting. Thus, both eustatic fluctuations and local tectonism had played an important role in platform development and evolution. After the Frasnian–Famennian biotic crisis, main marine benthos preferentially recovered in the normal marine niches on the nearshore open shelves, and radiated gradually into offshore restricted platforms. Brachiopods, notably rhychonellides, were the taxa recovering the earliest (S1) in the normal (or near normal) marine conditions, then echinoderms (S3), stromatoporoids (upper S3) and corals (S5) stepped in episodically. However, these benthos generally appeared later in the restricted platform interiors only as if the ecological conditions were improved well enough for their colonization. Therefore, the biotic recovery processes were diachronous: both taxonomically- and ecologically-specified.

Late Devonian Carbonate Margins and Foreslopes of the Lennard Shelf, Canning Basin, Western Australia, Part A: Development During Backstepping and the Aggradation-To-Progradation Transition

Abstract Carbonate reefal margin and foreslope settings are characteristically heterogeneous and difficult to predict due to a spectrum of sediment source factories, resedimentation processes, resultant deposit types, and controlling parameters. In particular, the effects of changes in long-term accommodation on the composition, architecture, and sediment distribution patterns of carbonate margin–foreslope–basin systems are poorly understood. Upper Devonian (Frasnian) outcrop exposures along the Lennard Shelf, northeast Canning Basin, Western Australia, were investigated to assess the development of reefal margin and foreslope settings during long-term 1) platform backstepping with aggradational pulses, and 2) across the transition from platform aggradation to progradation. Measured sections tied to interpreted photomosaics and detailed mapping using aerial photographs were collected from the South Lawford Range and Windjana Gorge areas. The exposures reveal distinctive differences in foreslope grain composition, deposit characteristics and proportions, margin morphology, and stratigraphic expression 1) during platform evolution between backstepping events, and 2) depending on position within the long-term accommodation setting. Between backstepping events, aggradational margins can be classified as “growth escarpments” with associated grain-dominated, onlapping foreslope deposits. Margins across the long-term transition from aggradation to progradation evolved from erosional escarpments with onlapping debris deposits to accretionary, interfingering configurations. Development of growth escarpments between backstepping events was a function of vertical reefal growth from sustained high accommodation conditions during the long-term transgressive systems tract, coupled with a Frasnian reefal assemblage that responded to light and tracked relative sea level. This net vertical reefal growth also resulted in relative margin stability and the deposition of grain-dominated foreslopes. Conversely, margins were highly unstable and underwent repeated failure across the long-term aggradation-to-progradation transition, reflecting a lack of underlying substrate to support basinward advance, and resulting in debris-dominated foreslopes. These observations provide relationships that predict margin and foreslope associations of facies-scale heterogeneity and seismic-scale geometry within a low-frequency sequence stratigraphic framework.

Botulinum toxin injections for treating neurogenic detrusor overactivity.

Neurogenic detrusor overactivity (NDO) is a disorder that can cause high intravesical pressure, decreased capacity, decreased bladder compliance, and upper urinary system damage. The current treatment options for NDO are established on the basis of agents that block parasympathetic innervation of the detrusor and inhibit involuntary bladder contractions. Several side effects, such as dryness of mouth, constipation, dyspepsia, changes in visual accommodation, somnolence, and being unable to obtain consistently favorable results, caused by anticholinergic agents, which are frequently used for this purpose, decrease the patient's compliance to treatment. Procedures such as neuromodulation, auto-augmentation, and enterocystoplasty are surgical options, and they could be used as the last alternative. Thus, botulinum toxin (BTX) injections to the detrusor have been commonly performed in recent years and lead to satisfactory results. The mechanism of action of BTX in NDO is based on the principal of smooth muscle relaxation in the bladder by the transient inhibition of neuromuscular nerve signals. The aim is to decrease acetylcholine secretion by blocking presynaptic vesicles in the neuromuscular junction. When studies were evaluated, it was observed that BTX injections to the detrusor muscle are a necessary and effective option in patients with incontinence caused by NDO. This treatment option could be indicated in situations where anticholinergic agents are not effective or could not be tolerated, and it could be a valuable alternative to major surgical treatments. In this review, we evaluated the effectiveness and reliability of BTX in patients with NDO.

A longitudinal study of accommodative changes in biometry during incipient presbyopia.

To profile accommodative biometric changes longitudinally and to determine the influence of age-related ocular structural changes on the accommodative response prior to the onset of presbyopia. Twenty participants (aged 34-41 years) were reviewed at six-monthly intervals over two and a half years. At each visit, ocular biometry was measured with the LenStar biometer (www.Haag-Streit.com) in response to 0.00, 3.00 and 4.50 D stimuli. Accommodative responses were measured by the WAM 5500 Auto Ref/Keratometer (www.grandseiko.com). During accommodation, anterior chamber depth reduced (F = 29, p < 0.001), whereas crystalline lens thickness (F = 39, p < 0.001) and axial length (F = 5.4, p = 0.009) increased. The accommodative response (F = 5.5, p = 0.001) and the change in anterior chamber depth (F = 3.1, p = 0.039), crystalline lens thickness (F = 3.0, p = 0.042) and axial length (F = 2.5, p = 0.038) in response to the 4.50 D accommodative target reduced after 2.5 years. However, the change in anterior chamber depth (F = 2.2, p = 0.097), crystalline lens thickness (F = 1.7, p = 0.18) and axial length (F = 1.0, p = 0.40) per dioptre of accommodation exerted remained invariant after 2.5 years. The increase in disaccommodated crystalline lens thickness with age was not significantly associated with the reduction in accommodative response (R = 0.32, p = 0.17). Despite significant age-related structural changes in disaccommodated biometry, the change in biometry per dioptre of accommodation exerted remained invariant with age. The present study supports the Helmholtz theory of accommodation and suggests an increase in lenticular stiffness is primarily responsible for the onset of presbyopia.