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Body mass index (BMI) is an established risk factor for diabetes. However, the association between BMI and diabetic retinopathy (DR) has been inconclusive. We aimed to assess the association between BMI and DR in a large population-based sample of multi-ethnic Asian adults in Singapore. We examined 2,278 adults aged ≥40 years with diabetes who participated in three population-based studies conducted from 2004 to 2011: the Singapore Malay Eye Study, the Singapore Indian Eye Study, and the Singapore Chinese Eye Study. Retinal photographs taken from both eyes were graded for any and vision-threatening (VTDR) using the modified Airlie House Classification. BMI (kg/m(2)) was categorized into normal/underweight (<25), overweight (25-29.9), and obese (≥30). The prevalence rates of any and VTDR in the study population were 35.1 % and 9.1 %, respectively. The prevalence of any and VTDR decreased with increasing categories of BMI (P trend <0.001 and 0.005). In multivariable models adjusted for potential confounders, compared to those with normal weight, the odds ratio (95 % confidence interval) of any DR was 0.71 (0.57-0.88) for overweight and 0.70 (0.53-0.92) for obese. Corresponding estimates for VTDR were 0.84 (0.59-1.21) for overweight and 0.58 (0.35-0.94) for obese. The inverse association between BMI and any DR was consistently present when BMI was analyzed as a continuous variable and in analyses stratified by ethnicity and age. In a population-based sample of multi-ethnic Asian adults, BMI levels were inversely associated with any DR and VTDR.
Purpose To measure the COVID-19 pandemic impact on missed ophthalmology clinic visits and the influence of patient and eye disease characteristics on likelihood of missing clinic visits before and during the pandemic. Patients and Methods A retrospective observational study analyzing eye clinic patients at a large tertiary care academic institution. We identified patients scheduled for eye care during pre-COVID-19 (January 1–February 29, 2020) and early COVID-19 (March 16–May 31, 2020) time periods. Missed appointment frequency and characteristics were evaluated during each time period. Multivariable logistic regression models were developed to examine adjusted odds of having at least one missed appointment during a given time period. Covariates included age, sex, race/ethnicity, marital status, preferred language (non-English vs English), insurance, distance from clinic, and diagnosis. Results Overall, 82.0% (n = 11,998) of pre-COVID-19 patients completed all scheduled visits, compared to only 59.3% (n = 9020) during COVID-19. Missed visits increased dramatically in late March 2020, then improved week by week through the end of May 2020. General ophthalmology/cataract and strabismus clinics had the highest rates of missed clinic visits during the COVID-19 period; neuro-ophthalmology, retina, cornea, oculoplastics and glaucoma had the lowest. Females, Blacks, Hispanics, Asians, ages 50+, and married patients had higher adjusted odds of missing clinic visits, both pre-COVID-19 and during COVID-19. Asian, elderly, and cataract patients had the highest adjusted odds of missing clinic visits during COVID-19 and had significant increases in odds compared to pre-COVID-19. Non-married, diabetic macular edema, and wet age-related macular degeneration patients had the lowest adjusted odds of missed visits during COVID-19. Conclusion Missed clinic visits increased dramatically during the COVID-19 pandemic, particularly among elderly and nonwhite patients. These findings reflect differences in eye care delivery during the pandemic, and they indicate opportunities to target barriers to care, even during non-pandemic eras.
The present study examines the vortex street wake behavior of a flexible, helically wound, high aspect ratio marine cable in a linear shear flow. Particular attention is paid to the lock-on phenomena associated with uniform and sheared flow past the cable when it is forced to vibrate in the first mode, normal to the flow. An analysis is given of the effects on the vortex shedding and synchronization phenomena that are generated by placing distributions of spherical bluff body shapes along the span of the cable in uniform and sheared flow. The latter geometry is representative of a number of cable system deployments and has special consequencies for strumming in a shear flow. The effectiveness of these attached spheres as strumming-suppression devices is evaluated. Synchronized vibration and/or the presence of the bluff bodies significantly affected the spanwise character of the near wake cellular vortex shedding structure. The spanwise extent of the resonant, vortex-excited oscillations was significantly extended by the presence of the spheres along the cable span. This finding was particularly significant because it meant that the undesirable effects that accompanied synchronization would be extended over a longer portion of the cable span.
An alumni survey can be crafted which will evaluate even a small engineering program's success in imparting the abilities enumerated in the Engineering Criteria 2000 (EC 2000) guidelines. The core of the survey consists in its analysis of alumni ranking of both the importance of, and preparation in, the eleven key desired outcomes. Its originality lies in its establishing certain threshold percentages in the difference in perception of importance and preparation which indicate a level of under‐preparedness demanding immediate attention, so that the survey can function as an objective assessment tool. The responses of specific aggregates can also be analyzed in this manner, providing insight on the different perspectives of alumni by degree program, career path, and other demographic groupings.
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