Showing papers by "La Trobe University published in 2011"

Differences Between Tight and Loose Cultures: A 33-Nation Study

Abstract: With data from 33 nations, we illustrate the differences between cultures that are tight (have many strong norms and a low tolerance of deviant behavior) versus loose (have weak social norms and a high tolerance of deviant behavior). Tightness-looseness is part of a complex, loosely integrated multilevel system that comprises distal ecological and historical threats (e.g., high population density, resource scarcity, a history of territorial conflict, and disease and environmental threats), broad versus narrow socialization in societal institutions (e.g., autocracy, media regulations), the strength of everyday recurring situations, and micro-level psychological affordances (e.g., prevention self-guides, high regulatory strength, need for structure). This research advances knowledge that can foster cross-cultural understanding in a world of increasing global interdependence and has implications for modeling cultural change.

Understanding the New Statistics: Effect Sizes, Confidence Intervals, and Meta-Analysis

Abstract: Preface. About this Book 1. Introduction to The New Statistics 2. From Null Hypothesis Significance Testing to Effect Sizes 3. Confidence Intervals 4. Confidence Intervals, Error Bars, and p Values 5. Replication 6. Two Simple Designs 7. Meta-Analysis 1: Introduction and Forest Plots 8. Meta-Analysis 2: Models 9. Meta-Analysis 3: Large-Scale Analyses 10. The Noncentral t Distribution 11. Cohen's d 12. Power 13. Precision for Planning 14. Correlations, Proportions, and Further Effect Size Measures 15. More Complex Designs and The New Statistics in Practice. Glossary. Appendixes A. Loading and Using ESCI. B. ESCI for the Normal and t Distributions, and Values of z and t. C. Guide to the ESCI Modules and Pages

Extreme learning machines: a survey

Abstract: Computational intelligence techniques have been used in wide applications. Out of numerous computational intelligence techniques, neural networks and support vector machines (SVMs) have been playing the dominant roles. However, it is known that both neural networks and SVMs face some challenging issues such as: (1) slow learning speed, (2) trivial human intervene, and/or (3) poor computational scalability. Extreme learning machine (ELM) as emergent technology which overcomes some challenges faced by other techniques has recently attracted the attention from more and more researchers. ELM works for generalized single-hidden layer feedforward networks (SLFNs). The essence of ELM is that the hidden layer of SLFNs need not be tuned. Compared with those traditional computational intelligence techniques, ELM provides better generalization performance at a much faster learning speed and with least human intervene. This paper gives a survey on ELM and its variants, especially on (1) batch learning mode of ELM, (2) fully complex ELM, (3) online sequential ELM, (4) incremental ELM, and (5) ensemble of ELM.

Impacts of the Cretaceous Terrestrial Revolution and KPg Extinction on Mammal Diversification

Abstract: Previous analyses of relations, divergence times, and diversification patterns among extant mammalian families have relied on supertree methods and local molecular clocks. We constructed a molecular supermatrix for mammalian families and analyzed these data with likelihood-based methods and relaxed molecular clocks. Phylogenetic analyses resulted in a robust phylogeny with better resolution than phylogenies from supertree methods. Relaxed clock analyses support the long-fuse model of diversification and highlight the importance of including multiple fossil calibrations that are spread across the tree. Molecular time trees and diversification analyses suggest important roles for the Cretaceous Terrestrial Revolution and Cretaceous-Paleogene (KPg) mass extinction in opening up ecospace that promoted interordinal and intraordinal diversification, respectively. By contrast, diversification analyses provide no support for the hypothesis concerning the delayed rise of present-day mammals during the Eocene Period.

Shrub expansion in tundra ecosystems: dynamics, impacts and research priorities

Abstract: Recent research using repeat photography, long-term ecological monitoring and dendrochronology has documented shrub expansion in arctic, high-latitude and alpine tundra

Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play

Abstract: Background An athlete9s intention to return to sport following anterior cruciate ligament (ACL) injury is a major indication for surgical intervention. Purpose The purpose of this review was to determine postoperative return-to-sport outcomes after ACL reconstruction surgery. Study design Meta-analysis and systematic review Methods Electronic databases including Medline, Embase, SPORTDiscus and CINAHL were searched from the earliest possible entry to April 2010. Studies were included that reported the number of patients returning to sports participation following ACL reconstruction surgery. The results were presented using the World Health Organization9s International Classification of Functioning, Disability and Health as a framework and combined using proportion meta-analyses. Results Forty-eight studies evaluating 5770 participants at a mean follow-up of 41.5 months were included for review. Overall, 82% of participants had returned to some kind of sports participation, 63% had returned to their preinjury level of participation, and 44% had returned to competitive sport at final follow-up. Approximately 90% of participants achieved normal or nearly normal knee function when assessed postoperatively using impairment-based outcomes such as laxity and strength, and 85% when using activity-based outcomes such as the International Knee Documentation Committee knee evaluation form. Fear of reinjury was the most common reason cited for a postoperative reduction in or cessation of sports participation. Conclusion The relatively low rate of return to competitive sport despite the high rates of successful outcome in terms of knee impairment-based function suggests that other factors such as psychological factors may be contributing to return-to-sport outcomes.

Genomic Analysis of the Necrotrophic Fungal Pathogens Sclerotinia sclerotiorum and Botrytis cinerea

Abstract: Sclerotinia sclerotiorum and Botrytis cinerea are closely related necrotrophic plant pathogenic fungi notable for their wide host ranges and environmental persistence. These attributes have made these species models for understanding the complexity of necrotrophic, broad host-range pathogenicity. Despite their similarities, the two species differ in mating behaviour and the ability to produce asexual spores. We have sequenced the genomes of one strain of S. sclerotiorum and two strains of B. cinerea. The comparative analysis of these genomes relative to one another and to other sequenced fungal genomes is provided here. Their 38-39 Mb genomes include 11,860-14,270 predicted genes, which share 83% amino acid identity on average between the two species. We have mapped the S. sclerotiorum assembly to 16 chromosomes and found large-scale co-linearity with the B. cinerea genomes. Seven percent of the S. sclerotiorum genome comprises transposable elements compared to ,1% of B. cinerea. The arsenal of genes associated with necrotrophic processes is similar between the species, including genes involved in plant cell wall degradation and oxalic acid production. Analysis of secondary metabolism gene clusters revealed an expansion in number and diversity of B. cinerea-specific secondary metabolites relative to S. sclerotiorum. The potential diversity in secondary metabolism might be involved in adaptation to specific ecological niches. Comparative genome analysis revealed the basis of differing sexual mating compatibility systems between S. sclerotiorum and B. cinerea. The organization of the mating-type loci differs, and their structures provide evidence for the evolution of heterothallism from homothallism. These data shed light on the evolutionary and mechanistic bases of the genetically complex traits of necrotrophic pathogenicity and sexual mating. This resource should facilitate the functional studies designed to better understand what makes these fungi such successful and persistent pathogens of agronomic crops.

Linear ubiquitination prevents inflammation and regulates immune signalling

Abstract: Members of the tumour necrosis factor (TNF) receptor superfamily have important functions in immunity and inflammation Recently linear ubiquitin chains assembled by a complex containing HOIL-1 and HOIP (also known as RBCK1 and RNF31, respectively) were implicated in TNF signalling, yet their relevance in vivo remained uncertain Here we identify SHARPIN as a third component of the linear ubiquitin chain assembly complex, recruited to the CD40 and TNF receptor signalling complexes together with its other constituents, HOIL-1 and HOIP Mass spectrometry of TNF signalling complexes revealed RIP1 (also known as RIPK1) and NEMO (also known as IKKγ or IKBKG) to be linearly ubiquitinated Mutation of the Sharpin gene (Sharpin(cpdm/cpdm)) causes chronic proliferative dermatitis (cpdm) characterized by inflammatory skin lesions and defective lymphoid organogenesis Gene induction by TNF, CD40 ligand and interleukin-1β was attenuated in cpdm-derived cells which were rendered sensitive to TNF-induced death Importantly, Tnf gene deficiency prevented skin lesions in cpdm mice We conclude that by enabling linear ubiquitination in the TNF receptor signalling complex, SHARPIN interferes with TNF-induced cell death and, thereby, prevents inflammation Our results provide evidence for the relevance of linear ubiquitination in vivo in preventing inflammation and regulating immune signalling

Drawing to Learn in Science.

Abstract: Should science learners be challenged to draw more? Certainly making visualizations is integral to scientific thinking. Scientists do not use words only but rely on diagrams, graphs, videos, photographs, and other images to make discoveries, explain findings, and excite public interest. From the notebooks of Faraday and Maxwell ( 1 ) to current professional practices of chemists ( 2 ), scientists imagine new relations, test ideas, and elaborate knowledge through visual representations ( 3 – 5 ).

Destination Competitiveness: An Analysis of Determinant Attributes

Abstract: The aim of this study was to develop an insight into the importance and impact of attributes which affect the competitiveness of tourism destinations. Using a general conceptual model of destination competitiveness, 36 competitiveness attributes were evaluated by “expert” judgment in the form of an online survey of destination managers and tourism researchers. These judgments were integrated and analyzed using the analytic hierarchy process (AHP). In addition to estimating the importance of the attributes of competitiveness, the results of the AHP were further analyzed to produce measures of attribute determinance. These measures were then tested statistically to identify which attributes were judged to exert the greatest determinant impact on destination competitiveness. Ten of the 36 attributes were found to have determinance measures statistically significantly greater than average.

MiD49 and MiD51, new components of the mitochondrial fission machinery

Abstract: Mitochondria form intricate networks through fission and fusion events. Here, we identify mitochondrial dynamics proteins of 49 and 51 kDa (MiD49 and MiD51, respectively) anchored in the mitochondrial outer membrane. MiD49/51 form foci and rings around mitochondria similar to the fission mediator dynamin-related protein 1 (Drp1). MiD49/51 directly recruit Drp1 to the mitochondrial surface, whereas their knockdown reduces Drp1 association, leading to unopposed fusion. Overexpression of MiD49/51 seems to sequester Drp1 from functioning at mitochondria and cause fused tubules to associate with actin. Thus, MiD49/51 are new mediators of mitochondrial division affecting Drp1 action at mitochondria.

Electrogenerated Chemiluminescence Detection in Paper-Based Microfluidic Sensors

Abstract: This paper describes the first approach at combining paper microfluidics with electrochemiluminescent (ECL) detection. Inkjet printing is used to produce paper microfluidic substrates which are combined with screen-printed electrodes (SPEs) to create simple, cheap, disposable sensors which can be read without a traditional photodetector. The sensing mechanism is based on the orange luminescence due to the ECL reaction of tris(2,2′-bipyridyl)ruthenium(II) (Ru(bpy)32+) with certain analytes. Using a conventional photodetector, 2-(dibutylamino)ethanol (DBAE) and nicotinamide adenine dinucleotide (NADH) could be detected to levels of 0.9 μM and 72 μM, respectively. Significantly, a mobile camera phone can also be used to detect the luminescence from the sensors. By analyzing the red pixel intensity in digital images of the ECL emission, a calibration curve was constructed demonstrating that DBAE could be detected to levels of 250 μM using the phone.

Return to the Preinjury Level of Competitive Sport After Anterior Cruciate Ligament Reconstruction Surgery Two-thirds of Patients Have Not Returned by 12 Months After Surgery

Abstract: Background: An athlete’s desire to return to sport after anterior cruciate ligament (ACL) injury is a major indication for ACL reconstruction surgery. Typical clearance to return is 6 to 12 months postoperatively.Purpose: To investigate the return-to-sport rate and participation level of a large cohort at 12 months after ACL reconstruction surgery.Study Design: Case series; Level of evidence, 4.Methods: Data were analyzed for 503 patients who participated in competitive-level Australian football, basketball, netball, or soccer after ACL reconstruction surgery using a quadruple-strand hamstring autograft. Inclusion criteria included participation in competitive sport before the ACL injury and clearance from the orthopaedic surgeon to return to sport postoperatively. Patients completed a self-report questionnaire regarding preoperative and postoperative sports participation and the Cincinnati Sports Activity Scale. The International Knee Documentation Committee (IKDC) knee evaluation form and hop tests were...

Productivity Is a Poor Predictor of Plant Species Richness

Abstract: For more than 30 years, the relationship between net primary productivity and species richness has generated intense debate in ecology about the processes regulating local diversity. The original view, which is still widely accepted, holds that the relationship is hump-shaped, with richness first rising and then declining with increasing productivity. Although recent meta-analyses questioned the generality of hump-shaped patterns, these syntheses have been criticized for failing to account for methodological differences among studies. We addressed such concerns by conducting standardized sampling in 48 herbaceous-dominated plant communities on five continents. We found no clear relationship between productivity and fine-scale (meters−2) richness within sites, within regions, or across the globe. Ecologists should focus on fresh, mechanistic approaches to understanding the multivariate links between productivity and richness.

What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review

Abstract: Pulmonary rehabilitation is an essential component of care for people with chronic obstructive pulmonary disease (COPD) and is supported by strong scientific evidence. Despite this, many people with COPD do not complete their program or choose not to attend at all. The aim of this study was to determine the factors associated with uptake and completion of pulmonary rehabilitation for people with COPD. Seven electronic databases were searched for qualitative or quantitative studies that documented factors associated with uptake and completion of pulmonary rehabilitation in people with COPD. Two reviewers independently extracted data, which was synthesized to provide overall themes. Travel and transport were consistently identified as barriers to both uptake and completion. A lack of perceived benefit of pulmonary rehabilitation also influenced both uptake and completion. The only demographic features that consistently predicted non-completion were being a current smoker (pooled odds ratio 0.17, 95% confidence interval 0.10 to 0.32) and depression. The limited data available regarding barriers to uptake indicated that disruption to usual routine, influence of the referring doctor and program timing were important. In conclusion poor access to transport and lack of perceived benefit affect uptake of pulmonary rehabilitation. Current smokers and patients who are depressed are at increased risk of non-completion. Enhancing attendance in pulmonary rehabilitation will require more attention to transportation, support for those at risk of non-completion and greater involvement of patients in informed decisions about their care.

Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects

Abstract: Background Neural tube defects arise during the development of the brain and spinal cord. Objectives The objective of this review was to assess the effects of increased consumption of folate or multivitamins on the prevalence of neural tube defects periconceptionally (that is before pregnancy and in the first two months of pregnancy). Search strategy We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: April 2001. Selection criteria Randomised and quasi-randomised trials comparing periconceptional supplementation by multivitamins with placebo, folate with placebo, or multivitamins with folate; different dosages of multivitamins or folate; prepregnancy dietary advice and counselling in primary care settings to increase the consumption of folate-rich foods, or folate-fortified foods, with standard care; increased intensity of information provision with standard public health dissemination. Data collection and analysis Two reviewers assessed trial quality and extracted data. Main results Four trials of supplementation involving 6425 women were included. The trials all addressed the question of supplementation and they were of variable quality. Periconceptional folate supplementation reduced the incidence of neural tube defects (relative risk 0.28, 95% confidence interval 0.13 to 0.58). Folate supplementation did not significantly increase miscarriage, ectopic pregnancy or stillbirth, although there was a possible increase in multiple gestation. Multivitamins alone were not associated with prevention of neural tube defects and did not produce additional preventive effects when given with folate. One dissemination trial, a community randomised trial, was identified involving six communities, matched in pairs, and where 1206 women of child-bearing age were interviewed following the dissemination intervention. This showed that the provision of printed material increased the awareness of the folate/neural tube defects association by 4%, (odds ratio 1.37, 95% confidence interval 1.33 to 1.42). Authors' conclusions Periconceptional folate supplementation has a strong protective effect against neural tube defects. Information about folate should be made more widely available throughout the health and education systems. Women whose fetuses or babies have neural tube defects should be advised of the risk of recurrence in a subsequent pregnancy and offered continuing folate supplementation. The benefits and risks of fortifying basic food stuffs, such as flour, with added folate remain unresolved.

Is Telomere Length a Biomarker of Aging? A Review

Abstract: Telomeres, the DNA-protein structures located at the ends of chromosomes, have been proposed to act as a biomarker of aging. In this review, the human evidence that telomere length is a biomarker of aging is evaluated. Although telomere length is implicated in cellular aging, the evidence suggesting telomere length is a biomarker of aging in humans is equivocal. More studies examining the relationships between telomere length and mortality and with measures that decline with "normal" aging in community samples are required. These studies would benefit from longitudinal measures of both telomere length and aging-related parameters.

Heatwave early warning systems and adaptation advice to reduce human health consequences of heatwaves.

Abstract: Introduction: With climate change, there has been an increase in the frequency, intensity and duration of heatwave events. In response to the devastating mortality and morbidity of recent heatwave events, many countries have introduced heatwave early warning systems (HEWS). HEWS are designed to reduce the avoidable human health consequences of heatwaves through timely notification of prevention measures to vulnerable populations. Objective: To identify the key characteristics of HEWS in European countries to help inform modification of current, and development of, new systems and plans. Methods: We searched the internet to identify HEWS policy or government documents for 33 European countries and requested information from relevant organizations. We translated the HEWS documents and extracted details on the trigger indicators, thresholds for action, notification strategies, message intermediaries, communication and dissemination strategies, prevention strategies recommended and specified target audiences. Findings and Conclusions: Twelve European countries have HEWS. Although there are many similarities among the HEWS, there also are differences in key characteristics that could inform improvements in heatwave early warning plans.

Subtypes of progressive aphasia: application of the International Consensus Criteria and validation using β-amyloid imaging.

Abstract: Primary progressive aphasia comprises a heterogeneous group of neurodegenerative conditions with diverse clinical profiles and underlying pathological substrates. A major development has been the publication of the recent International Consensus Criteria for the three major variants namely: semantic, non-fluent/agrammatic and logopenic. The logopenic variant is assumed to represent an atypical presentation of Alzheimer pathology although evidence for this is, at present, limited. The semantic and non-fluent/agrammatic variants are largely associated with frontotemporal lobar degeneration with TDP-43 and tau pathology, respectively. The applicability of the International Consensus Criteria to an unselected clinical sample is unknown and no agreed clinical evaluation scale on which to derive the diagnosis exists. We assessed 47 consecutive cases of primary progressive aphasic seen over a 3-year period in a specialist centre, using a newly developed progressive aphasia language scale. A subgroup of 30 cases underwent (11)C-labelled Pittsburgh Compound B positron emission tomography imaging, a putative biomarker of Alzheimer's disease that detects β-amyloid accumulation, and they were compared with an age-matched group (n = 10) with typical, predominately amnestic Alzheimer's disease. The application of an algorithm based on four key speech and language variables (motor speech disorders, agrammatism, single-word comprehension and sentence repetition) classified 45 of 47 (96%) of patients and showed high concordance with the gold standard expert clinical diagnosis based on the International Consensus Criteria. The level of neocortical β-amyloid burden varied considerably across aphasic variants. Of 13 logopenic patients, 12 (92%) had positive β-amyloid uptake. In contrast, one of nine (11%) semantic variant and two of eight (25%) non-fluent/agrammatic cases were positive. The distribution of β-amyloid across cortical regions of interest was identical in cases with the logopenic variant to that of patients with typical Alzheimer's disease although the total load was lower in the aphasic cases. Impairments of sentence repetition and sentence comprehension were positively correlated with neocortical burden of β-amyloid, whereas impaired single-word comprehension showed a negative correlation. The International Consensus Criteria can be applied to the majority of cases with primary progressive aphasic using a simple speech and language assessment scale based upon four key variables. β-amyloid imaging confirms the higher rate of Alzheimer pathology in the logopenic variant and, in turn, the low rates in the other two variants. The study offers insight into the biological basis of clinical manifestations of Alzheimer's disease, which appear topographically independent of β-amyloid load.

A Generalized Unsharp Masking Algorithm

Abstract: Enhancement of contrast and sharpness of an image is required in many applications. Unsharp masking is a classical tool for sharpness enhancement. We propose a generalized unsharp masking algorithm using the exploratory data model as a unified framework. The proposed algorithm is designed to address three issues: 1) simultaneously enhancing contrast and sharpness by means of individual treatment of the model component and the residual, 2) reducing the halo effect by means of an edge-preserving filter, and 3) solving the out-of-range problem by means of log-ratio and tangent operations. We also present a study of the properties of the log-ratio operations and reveal a new connection between the Bregman divergence and the generalized linear systems. This connection not only provides a novel insight into the geometrical property of such systems, but also opens a new pathway for system development. We present a new system called the tangent system which is based upon a specific Bregman divergence. Experimental results, which are comparable to recently published results, show that the proposed algorithm is able to significantly improve the contrast and sharpness of an image. In the proposed algorithm, the user can adjust the two parameters controlling the contrast and sharpness to produce the desired results. This makes the proposed algorithm practically useful.

Climate change and diseases of food crops

Abstract: Despite complex regional patterns of projected climate change, significant decreases in food crop yields have been predicted using the ‘worst case’ CO2 emission scenario (A1FI) of the Intergovernmental Panel on Climate Change. Overall, climate change is predicted to have a progressively negative effect on the yield of food crops, particularly in the absence of efforts to mitigate global CO2 emissions. As with all species, plant pathogens will have varying responses to climate change. Whilst the life cycle of some pathogens will be limited by increasing temperatures, e.g. Puccinia striiformis f.sp. tritici, other climatic factors such as increasing atmospheric CO2, may provide more favourable conditions for pathogens such as Fusarium pseudograminearum. Based on published literature and unpublished work in progress, we have reviewed the qualitative effects of climate change on pathogens that cause disease of four major food crops: wheat, rice, soybean and potato. The limited data show that the influence will be positive, negative or neutral, depending on the host–pathogen interaction. Quantitative analysis of climate change on pathogens of these crops is largely lacking, either from field or laboratory studies or from modelling-based assessments. Systematic quantitative analysis of these effects will be necessary in developing future disease management plans, such as plant breeding, altered planting schedules, chemical and biological control methods and increased monitoring for new disease threats.

Analysing the ‘Black Box’ of HRM: Uncovering HR Goals, Mediators, and Outcomes in a Standardized Service Environment

Abstract: This multi-level study analyses the ‘black box’ of HRM in an Australian cinema chain, a standardized service environment. Management's espoused goals for the casual workers who run the cinema service include attempts to build customer-oriented behaviour, both directly and via empowerment, and also efforts to ensure compliance with company policies and to enhance employee commitment. Our analysis of an employee survey and supervisory performance ratings shows that it is behavioural compliance that is positively associated with rated performance rather than customer-oriented behaviour. While customer service is an important value, it is willing engagement with a highly scripted, efficiency-oriented work process that makes it happen, not a more empowering form of work design. On the other hand, the management process also fosters a level of employee commitment, which has some value in a tight labour market. The study demonstrates the way in which actual models of HRM can contain a complex and ‘contradictory’ set of messages, consistent with critical accounts of the labour process and suggesting that notions of ‘internal fit’ need to recognize such tensions. It underlines the importance of identifying the multiple goals in management's espoused theories of HRM and then assessing their links via managerial behaviour and employee responses to performance outcomes.

The MYB80 Transcription Factor Is Required for Pollen Development and the Regulation of Tapetal Programmed Cell Death in Arabidopsis thaliana

Abstract: Arabidopsis thaliana MYB80 (formerly MYB103) is expressed in the tapetum and microspores between anther developmental stages 6 and 10. MYB80 encodes a MYB transcription factor that is essential for tapetal and pollen development. Using microarray analysis of anther mRNA, we identified 404 genes differentially expressed in the myb80 mutant. Employing the glucocorticoid receptor system, the expression of 79 genes was changed when MYB80 function was restored in the myb80 mutant following induction by dexamethasone. Thirty-two genes were analyzed using chromatin immunoprecipitation, and three were identified as direct targets of MYB80. The genes encode a glyoxal oxidase (GLOX1), a pectin methylesterase (VANGUARD1), and an A1 aspartic protease (UNDEAD). All three genes are expressed in the tapetum and microspores. Electrophoretic mobility shift assays confirmed that MYB80 binds to all three target promoters, with the preferential binding site containing the CCAACC motif. TUNEL assays showed that when UNDEAD expression was silenced using small interfering RNA, premature tapetal and pollen programmed cell death occurred, resembling the myb80 mutant phenotype. UNDEAD possesses a mitochondrial targeting signal and may hydrolyze an apoptosis-inducing protein(s) in mitochondria. The timing of tapetal programmed cell death is critical for pollen development, and the MYB80/UNDEAD system may regulate that timing.

Lateral wedge insoles for medial knee osteoarthritis: 12 month randomised controlled trial

Abstract: Objective To assess the effect of lateral wedge insoles compared with flat control insoles on improving symptoms and slowing structural disease progression in medial knee osteoarthritis. Design Randomised controlled trial. Setting Community in Melbourne, Australia. Participants 200 people aged 50 or more with clinical and radiographic diagnosis of mild to moderately severe medial knee osteoarthritis. Interventions Full length 5 degree lateral wedged insoles or flat control insoles worn inside the shoes daily for 12 months. Main outcome measures Primary symptomatic outcome was change in overall knee pain (past week) measured on an 11 point numerical rating scale. Primary structural outcome was change in volume of medial tibial cartilage from magnetic resonance imaging scans. Secondary clinical outcomes included changes in measures of pain, function, stiffness, and health related quality of life. Secondary structural outcomes included progression of medial cartilage defects and bone marrow lesions. Results Between group differences did not differ significantly for the primary outcomes of change in overall pain (−0.3 points, 95% confidence intervals −1.0 to 0.3) and change in medial tibial cartilage volume (−0.4 mm3, 95% confidence interval −15.4 to 14.6), and confidence intervals did not include minimal clinically important differences. None of the changes in secondary outcomes showed differences between groups. Conclusion Lateral wedge insoles worn for 12 months provided no symptomatic or structural benefits compared with flat control insoles. Trial registration Australian New Zealand Clinical Trials Registry ACTR12605000503628 and ClinicalTrials.gov NCT00415259.