While travelling the artist sets himself specific tasks, such as walking a straight line for a predetermined distance; never making permanent alterations to the landscape. (nationalgalleries.org)
Suffering a traumatic brain injury is a tragic and life - changing event that can cause permanent alterations in the victim's cognitive abilities, personality, and emotions. (mhsattorneys.com)
iii) Severe and permanent alteration of prior structure and function involving one or both legs as a result of which the insured person's score on the Spinal Cord Independence Measure, Version III, item 2, and applied over a distance of up to 10 meters on an even indoor surface is 0 to 5. (ottawa-attorneys.ca)