Age-specific differences in the association between prediabetes and cardiovascular diseases in China:A national cross-sectional study

BACKGROUND Cardiovascular disease(CVD)is a leading cause of morbidity and mortality worldwide,the global burden of which is rising.It is still unclear the extent to which prediabetes contributes to the risk of CVD in various age brackets among adults.To develop a focused screening plan and treatment for Chinese adults with prediabetes,it is crucial to identify variations in the connection between prediabetes and the risk of CVD based on age.AIM To examine the clinical features of prediabetes and identify risk factors for CVD in different age groups in China.METHODS The cross-sectional study involved a total of 46239 participants from June 2007 through May 2008.A thorough evaluation was conducted.Individuals with prediabetes were categorized into two groups based on age.Chinese atherosclerotic CVD risk prediction model was employed to evaluate the risk of developing CVD over 10 years.Random forest was established in both age groups.SHapley Additive exPlanation method prioritized the importance of features from the perspective of assessment contribution.RESULTS In total,6948 people were diagnosed with prediabetes in this study.In prediabetes,prevalences of CVD were 5(0.29%)in the younger group and 148(2.85%)in the older group.Overall,11.11%of the younger group and 29.59% of the older group were intermediate/high-risk of CVD for prediabetes without CVD based on the Prediction for ASCVD Risk in China equation in ten years.In the younger age group,the 10-year risk of CVD was found to be more closely linked to family history of CVD rather than lifestyle,whereas in the older age group,resident status was more closely linked.CONCLUSION The susceptibility to CVD is age-specific in newly diagnosed prediabetes.It is necessary to develop targeted approaches for the prevention and management of CVD in adults across various age brackets.

Non-linear relationship between age and subfoveal choroidal thickness in Chinese patients with proliferative diabetic retinopathy

BACKGROUND No study has investigated the change regularity between age and subfoveal choroidal thickness(SFCT)in proliferative diabetic retinopathy(PDR).AIM To investigate the relationship between the SFCT and age in Chinese patients with PDR.METHODS This was a cross-sectional retrospective study.The participants were hospitalized individuals with type 2 diabetes who underwent vitrectomy for PDR.Contralateral eyes that met the criteria were included in the study.All necessary laboratory tests were performed at the time of admission.Central macular thickness(CMT)and SFCT were two quantitative assessments made using enhanced depth imaging optical coherence tomography.CMT was measured automatically and SFCT was measured manually with digital calipers provided by the Heidelberg Eye Explorer software.RESULTS The final analysis included a total of 234 individuals with PDR.The average age was 55.60 years old±10.03 years old,and 57.69%of the population was male.Univariate analysis revealed a significant negative connection between age and SFCT in patients with PDR[β=-2.44,95%confidence interval(95%CI):-3.46 to-1.42;P<0.0001].In the fully adjusted model,the correlation between SFCT and age remained steady(β=-1.68,95%CI:-2.97 to-0.39;P=0.0117).Spline smoothing showed that the relationship between SFCT and age in patients with PDR was non-linear,with an inflection point at 54 years of age.CONCLUSION Our findings suggest that age is a key determinant of choroidal thickness.The non-linear link between SFCT and age in PDR patients should be taken into account.

Bowel preparation protocol for hospitalized patients ages 50 years or older:A randomized controlled trial

BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

Age Identity and Elderly Job Participation in China

In the context of rising life expectancy,there is a significant discrepancy between Chinese seniors’self-perceptions of the start of old age and the expectations of society around this age.The traditional paradigm,which forecasts individual economic behavior and formulates economic policies based on societal standards of age,is put to the test by this disparity.This study,which draws from the China Longitudinal Aging Society Survey(CLASS),examines the factors,processes,and improvement strategies that affect how older people choose to work.The following are our conclusions:(i)Chinese elderly believe their old age starts from 70 years on average;delaying perceived old age is a denial of aging and raises the likelihood of finding work.Elders who are youthful at heart have a 2.4%higher chance of remaining employed than elders who are old at heart.(ii)In contrast to old-at-heart elders,young-at-heart elders are more likely to maintain their middle-age lifestyles,continue working,become motivated to engage in social activities,and gain the confidence to face challenges and continue in their career.(iii)If the perceived old age is above 70 years,the milestone event of aging is retirement from work,and there are external pressures,particularly pressures from family intergenerational support,the perception of old age will have a more proactive impact on older workers.(iv)Despite rising pension benefits,older people’s decision to remain in the workforce is still heavily influenced by their perception of their age.However,this effect is notably gender-specific,as older women’s decision to remain in the workforce is not greatly influenced by their own perception of their age.

Can serum immunoglobulin G4 levels and age serve as reliable predictors of relapse in autoimmune pancreatitis?

We are writing in response to the paper published in the World Journal of Gastroenterology by Zhou et al.The authors identified higher serum immunoglobulin(Ig)G4 levels and age over 55 years as independent risk factors for disease relapse.Despite notable strengths,it is crucial to address potential biases.Firstly,the cohort study included 189 patients with autoimmune pancreatitis(AIP)type 1(with higher IgG4 seropositivity and higher relapse)and 24 with type 2(with lower IgG4 seropositivity and lower relapse).Consequently,most,if not all,AIP type 2 patients were assigned to the normal group,possibly inflating the association of higher serum IgG4 levels with relapse and potentially exaggerating the association of older age with relapse.Secondly,the authors did not provide sufficient details regarding AIP diagnosis,such as the ratio of definitive vs probable cases and the proportion of biopsies.In cases where histological evidence is unavailable or indeterminate,AIP type 2 may be misdiagnosed as definitive type 1,and type 1 may also be misdiagnosed as probable type 2,particularly in cases with normal or mildly elevated serum IgG4 levels.Lastly,in this retrospective study,approximately one-third of the consecutive patients initially collected were excluded for various reasons.Accordingly,the impact of nonrandom exclusion on relapse outcomes should be carefully considered.In conclusion,the paper by Zhou et al offers plausible,though not entirely compelling,evidence suggesting a predictive role of elevated serum IgG4 levels and advanced age in AIP relapse.The foundation for future investigations lies in ensuring a reliable diagnosis and accurate disease subtyping,heavily dependent on obtaining histological specimens.In this regard,endoscopic ultrasound-guided fine-needle biopsy emerges as a pivotal component of the diagnostic process,contributing to mitigating biases in future explorations of the disease.

The intrinsic developmental age signal defines an age-dependent climbing behavior in cucumber

The tendril is a climbing organ in cucurbits and functions in physical support and to avoid shading by neighboring vegetation.However,how cucurbits produce tendrils to obtain climbing ability is largely unknown.In this study,tendril phenotypes were investigated during different developmental stages.Our results revealed that tendril growth exhibited an age-dependent pattern in cucurbits.Tendril growth was inhibited,and the tendril was formed as a short tendril[nonfunctional tendril(nonF-tendril),approximately 0.1 cm]during the seedling stage.In contrast,enhanced cell proliferation and cell expansion led to rapid elongation of the tendril during the climbing stage,and the tendril formed as a functional tendril(F-tendril,approximately 30 cm)to obtain climbing ability.RT-qPCR detection showed that age-dependent tendril growth correlated negatively with the abundance of the conserved age regulator CsmiR156.Defoliation induced CsmiR156 to inhibit CsSPLs,and F-tendril formation and climbing ability were delayed in defoliated cucumbers,which confirmed the role of CsmiR156 in regulating tendril growth in vivo.Additionally,exogenous gibberellin(GA)treatment showed that GA positively regulated tendril growth,and RT-qPCR detection showed that the GA bio-synthetic genes and metabolic genes were affected by age pathway,suggesting that the age pathway depended on GA bio-synthetic and metabolic pathway to regulate cell expansion to determine tendril growth.In summary,our work reveals that change in tendril type is an important marker of phase transition in cucumber,and tendril growth is regulated by an intrinsic developmental age signal,ensuring that the cucumber obtains climbing ability at a suitable age.

Age of Loop Information with Flexible Transmission Enabled Communication and Control Co-Design in Industrial IoT

Precise and low-latency information transmission through communication systems is essential in the Industrial Internet of Things(IIoT).However,in an industrial system,there is always a coupling relationship between the control and communication components.To improve the system's overall performance,exploring the co-design of communication and control systems is crucial.In this work,we propose a new metric±Age of Loop Information with Flexible Transmission(AoLI-FT),which dynamically adjusts the maximum number of uplink(UL)and downlink(DL)transmission rounds,thus enhancing reliability while ensuring timeliness.Our goal is to explore the relationship between AoLI-FT,reliability,and control convergence rate,and to design optimal blocklengths for UL and DL that achieve the desired control convergence rate.To address this issue,we first derive a closed-form expression for the upper bound of AoLI-FT.Subsequently,we establish a relationship between communication reliability and control convergence rates using a Lyapunov-like function.Finally,we introduce an iterative alternating algorithm to determine the optimal communication and control parameters.The numerical results demonstrate the significant performance advantages of our proposed communication and control co-design strategy in terms of latency and control cost.

Afforestation with an age-sequence of Mongolian pine plantation promotes soil microbial residue accumulation in the Horqin Sandy Land, China

Land use change affects the balance of organic carbon(C)reserves and the global C cycle.Microbial residues are essential constituents of stable soil organic C(SOC).However,it remains unclear how microbial residue changes over time following afforestation.In this study,16-,23-,52-,and 62-year-old Mongolian pine stands and 16-year-old cropland were studied in the Horqin Sandy Land,China.We analyzed changes in SOC,amino sugar content,and microbial parameters to assess how microbial communities influence soil C transformation and preservation.The results showed that SOC storage increased with stand age in the early stage of afforestation but remained unchanged at about 1.27-1.29 kg/m2 after 52 a.Moreover,there were consistent increases in amino sugars and microbial residues with increasing stand age.As stand age increased from 16 to 62 a,soil pH decreased from 6.84 to 5.71,and the concentration of total amino sugars increased from 178.53 to 509.99 mg/kg.A significant negative correlation between soil pH and the concentration of specific and total amino sugars was observed,indicating that the effects of soil acidification promote amino sugar stabilization during afforestation.In contrast to the Mongolian pine plantation of the same age,the cropland accumulated more SOC and microbial residues because of fertilizer application.Across Mongolian pine plantation with different ages,there was no significant change in calculated contribution of bacterial or fungal residues to SOC,suggesting that fungi were consistently the dominant contributors to SOC with increasing time.Our results indicate that afforestation in the Horqin Sandy Land promotes efficient microbial growth and residue accumulation in SOC stocks and has a consistent positive impact on SOC persistence.

How forest age impacts on net primary productivity: Insights from future multi-scenarios

Forest net primary productivity(NPP)constitutes a key flux within the terrestrial ecosystem carbon cycle and serves as a significant indicator of the forests carbon sequestration capacity,which is closely related to forest age.Despite its significance,the impact of forest age on NPP is often ignored in future NPP projections.Here,we mapped forest age in Hunan Province at a 30-m resolution utilizing a combination of Landsat time series stack(LTSS),national forest inventory(NFI)data,and the relationships between height and age.Subsequently,NPP was derived from NFI data and the relationships between NPP and age was built for various forest types.Then forest NPP was predicted based on the NPP-age relationships under three future scenarios,assessing the impact of forest age on NPP.Our findings reveal substantial variations in forest NPP in Hunan Province under three future scenarios:under the age-only scenario,NPP peaks in 2041(133.56TgC·yr^(−1)),while NPP peaks three years later in 2044(141.14TgC·yr^(−1))under the natural development scenario.The maximum afforestation scenario exhibits the most rapid increase in NPP,with peaking in 2049(197.95TgC·yr^(−1)).However,with the aging of the forest,NPP is projected to then decrease by 7.54%,6.07%,and 7.47%in 2060,and 20.05%,19.74%,and 28.38%in 2100,respectively,compared to their peaks under the three scenarios.This indicates that forest NPP will continue to decline soon.Controlling the age structure of forests through selective logging,afforestation and reforestation,and encouraging natural regeneration after disturbance could mitigate this declining trend in forest NPP,but implications of these measures on the full forest carbon balance remain to be studied.Insights from the future multi-scenarios are expected to provide data to support sustainable forest management and national policy development,which will inform the achievement of carbon neutrality goals by 2060.

Age of Information for Short-Packet Covert Communication with Time Modulated Retrodirective Array

In this paper,the covert age of information(CAoI),which characterizes the timeliness and covertness performance of communication,is first investigated in the short-packet covert communication with time modulated retrodirective array(TMRDA).Specifically,the TMRDA is designed to maximize the antenna gain in the target direction while the side lobe is sufficiently suppressed.On this basis,the covertness constraint and CAoI are derived in closed form.To facilitate the covert transmission design,the transmit power and block-length are jointly optimized to minimize the CAoI,which demonstrates the trade-off between covertness and timelessness.Our results illustrate that there exists an optimal block-length that yields the minimum CAoI,and the presented optimization results can achieve enhanced performance compared with the fixed block-length case.Additionally,we observe that smaller beam pointing error at Bob leads to improvements in CAoI.

Characteristics of the HIV/AIDS Epidemic among People Aged≥50 Years in China during 2018–2021

Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.

Evaluation of Compatibilizers for Improving Compatibility between Waste Vegetable Oil and Aged Asphalt

Modifying agents 2,2-Bis(4-glycidyloxyphenyl)propane(2BPE)and dibutyl phthalate(DBP)were selected to enhance the compatibility.By using molecular simulation software(Materials Studio,MS),nine systems were constructed,including molecular models of aged asphalt and WVO monomers with 2BPE and/or DBP.The solubility parameters,Flory-Huggins parameters,and interaction energies of these systems were calculated to determine the impact of 2BPE and DBP on the compatibility of WVO and aged asphalt.Results showed that the addition of 2BPE and DBP reduced the difference in the solubility parameters between WVO and aged asphalt,thus improving the compatibility between WVO and aged asphalt.Additionally,using a combination of 2BPE and DBP in both aged asphalt and rejuvenator was found to be more effective than using either 2BPE or DBP alone.Finally,it was determined that evaluating the compatibility of WVO and aged asphalt using Van der Waals potential and non-bonding energy as evaluation indicators was more accurate than using electrostatic potential energy.

MSADCN:Multi-Scale Attentional Densely Connected Network for Automated Bone Age Assessment

Bone age assessment(BAA)helps doctors determine how a child’s bones grow and develop in clinical medicine.Traditional BAA methods rely on clinician expertise,leading to time-consuming predictions and inaccurate results.Most deep learning-based BAA methods feed the extracted critical points of images into the network by providing additional annotations.This operation is costly and subjective.To address these problems,we propose a multi-scale attentional densely connected network(MSADCN)in this paper.MSADCN constructs a multi-scale dense connectivity mechanism,which can avoid overfitting,obtain the local features effectively and prevent gradient vanishing even in limited training data.First,MSADCN designs multi-scale structures in the densely connected network to extract fine-grained features at different scales.Then,coordinate attention is embedded to focus on critical features and automatically locate the regions of interest(ROI)without additional annotation.In addition,to improve the model’s generalization,transfer learning is applied to train the proposed MSADCN on the public dataset IMDB-WIKI,and the obtained pre-trained weights are loaded onto the Radiological Society of North America(RSNA)dataset.Finally,label distribution learning(LDL)and expectation regression techniques are introduced into our model to exploit the correlation between hand bone images of different ages,which can obtain stable age estimates.Extensive experiments confirm that our model can converge more efficiently and obtain a mean absolute error(MAE)of 4.64 months,outperforming some state-of-the-art BAA methods.

Laboratory Evaluation of Performance Recovery of Aged SBS-modified Asphalt Using Regenerants with Different Base Oil Components

In this study,the regenerative effects of different regenerants on aged SBS-modified asphalt from different perspectives were investigated,including their conventional properties,viscoelastic behavior,creep-related properties,and micromorphology.Base oils composed of different proportions of aromatic and saturated hydrocarbons as well as the styrene-butadiene-styrene(SBS)restorer were used to prepare the regenerants.The results showed that the components of the base oil of the regenerant played a crucial role in determining the characteristics and performance of the recycled SBSmodified asphalt.Regenerants containing a high proportion of aromatics dissolved the hard segment in the SBS restorer,thereby delaying the effect of a reduction in the regenerants on the performance of the aged asphalts at a high temperature.Regenerants containing a high proportion of saturates dissolved the soft segment in the SBS restorer to enhance the lowtemperature performance of the recycled asphalts.In addition,the stress sensitivity of the recycled asphalts increased with the fraction of aromatics in the regenerant.As the aromatic content of the base oil components of the regenerants increased and their saturate content decreased,the state of dispersion of the SBS phase in the recycled SBS-modified asphalts improved.The optimal content of aromatics in the base oil of the regenerants should be set in the range of 33%to 47%to ensure the adequate performance of the recycled asphalts and a high efficiency of the SBS restorer.

Automatic Fetal Segmentation Designed on Computer-Aided Detection with Ultrasound Images

In the present research,we describe a computer-aided detection(CAD)method aimed at automatic fetal head circumference(HC)measurement in 2D ultrasonography pictures during all trimesters of pregnancy.The HC might be utilized toward determining gestational age and tracking fetal development.This automated approach is particularly valuable in low-resource settings where access to trained sonographers is limited.The CAD system is divided into two steps:to begin,Haar-like characteristics were extracted from ultrasound pictures in order to train a classifier using random forests to find the fetal skull.We identified the HC using dynamic programming,an elliptical fit,and a Hough transform.The computer-aided detection(CAD)program was well-trained on 999 pictures(HC18 challenge data source),and then verified on 335 photos from all trimesters in an independent test set.A skilled sonographer and an expert in medicine personally marked the test set.We used the crown-rump length(CRL)measurement to calculate the reference gestational age(GA).In the first,second,and third trimesters,the median difference between the standard GA and the GA calculated by the skilled sonographer stayed at 0.7±2.7,0.0±4.5,and 2.0±12.0 days,respectively.The regular duration variance between the baseline GA and the health investigator’s GA remained 1.5±3.0,1.9±5.0,and 4.0±14 a couple of days.The mean variance between the standard GA and the CAD system’s GA remained between 0.5 and 5.0,with an additional variation of 2.9 to 12.5 days.The outcomes reveal that the computer-aided detection(CAD)program outperforms an expert sonographer.When paired with the classifications reported in the literature,the provided system achieves results that are comparable or even better.We have assessed and scheduled this computerized approach for HC evaluation,which includes information from all trimesters of gestation.

An Overview on the Composition and Age of Upper Crust of Proto-Tethyan Lajishan Intra-oceanic Arc,NE Tibet Plateau

Identification and anatomy of oceanic arcs within ancient orogenic belt are significant for better understanding the tectonic framework and closure process of paleo-ocean basin.This article summarizes the geological,geochemical,and geochronological characteristics of upper crust of Proto-Tethyan Lajishan intra-oceanic arc and provides new data to constrain the subduction evolution of the South Qilian Ocean.The intra-oceanic arc volcanic rocks,including intermediate-mafic lava,breccia,tuff,and minor felsic rocks,are distributed along southern part of the Lajishan ophiolite belt.Geochemical and isotopic compositions indicate that the intermediate-mafic lava were originated from depleted mantle contaminated by sediment melts or hydrous fluids,whereas the felsic rocks were likely generated by partial melting of juvenile mafic crust in intra-oceanic arc setting.Zircons from felsic rocks yield consistent and concordant ages ranging from 506 to 523 Ma,suggesting these volcanic rocks represent the relicts of upper crust of the Cambrian intra-oceanic arc.Combined with the Cambrian forearc ophiolite and accretionary complex,we suggest that the Cambrian intra-oceanic arc in the Lajishan ophiolite belt is belonging to the intra-oceanic arc system which was generated by south-directed subduction in the South Qilian Ocean at a relatively short interval between approximately 530 and 480 Ma.

Survey on hospice care attitude of family members of advanced cancer patients at different ages

BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care.METHODS The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022.The participants were divided into youth(<40 years,n=65),middle-aged(40–60 years,n=59),and elderly(>60 years,n=51)groups.Researchers investigated and compared the degree of awareness regarding hospice care,attitudes,and whether the family members of patients would choose hospice care.RESULTS Among the family members of 175 patients,approximately 28%(49/175)were aware of hospice care.Awareness of hospice care,the proportion of hospice care acceptance and adaptation attitudes,and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups(P<0.05).No statistically significant difference was found in these three indicators between the middle-aged and elderly groups(P>0.05).Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment,whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns.CONCLUSION The family members of patients with advanced cancer had relatively low awareness of hospice care,while youth had a higher awareness of hospice care,acceptance,and adaptation attitudes,and were more willing to choose hospice care.

Association of age at diagnosis of diabetes with subsequent risk of age-related ocular diseases and vision acuity

BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively.In multivariable-adjusted analysis,individuals with T2D diagnosed<45 years of age[β95%CI:0.025(0.009,0.040)]had a larger increase in LogMAR.Theβ(95%CI)for LogMAR associated with T1D was 0.044(0.014,0.073).CONCLUSION The younger age at the diagnosis of diabetes is associated with a larger relative risk of incident ocular diseases and greater vision loss.

The Exploration of Teaching Historical Narratives Through Edith Wharton’s The Age of Innocence

Wharton’s novels serve as compelling cases for understanding the complexities of late 19th-century American society.The paper uses The Age of Innocence as an example to examine detailed depiction of the era’s social hierarchy,fashion,architecture,and the intricate social rituals that defined New York’s upper class.It explores the constraints and dilemmas women faced within a patriarchal society,highlighting Wharton’s personal experiences and her critical stance on the social norms of her time.The characters of Newland Archer,May Welland,and Ellen Olenska are analyzed to reveal the pressures of societal expectations and the struggles for individual desires within a rigid social structure.Additionally,the paper proposes various teaching methods,including contextual understanding,literary analysis with a historical focus,and historical research projects,to enhance students’comprehension of the cultural and historical context of the novel.These methods aim to immerse students in the narrative and promote their understanding of the Gilded Age’s social dynamics.

Age-specific heterogeneity of genetic susceptibility to cardiovascular disease might have opposite outcomes depending on the presence of prediabetes

Examining age-specific heterogeneity of susceptibility to cardiovascular disease is also essential in individuals without prediabetes to determine its relative size and direction compared to those with prediabetes.Of particular interest,age-specific heterogeneity in genetic susceptibility may exhibit opposite directions depending on the presence or absence of prediabetes.