Abstract Myopia, currently at epidemic levels in East Asia, is a leading cause of untreatable visual impairment. Genome-wide association studies (GWAS) in adults have identified 39 loci associated with refractive error and myopia. Here, the age-of-onset of association between genetic variants at these 39 loci and refractive error was investigated in 5200 children assessed longitudinally across ages 7–15 years, along with gene-environment interactions involving the major environmental risk-factors, nearwork and time outdoors. Specific variants could be categorized as showing evidence of: (a) early-onset effects remaining stable through childhood, (b) early-onset effects that progressed further with increasing age, or (c) onset later in childhood (N = 10, 5 and 11 variants, respectively). A genetic risk score (GRS) for all 39 variants explained 0.6% (P = 6.6E–08) and 2.3% (P = 6.9E–21) of the variance in refractive error at ages 7 and 15, respectively, supporting increased effects from these genetic variants at older ages. Replication in multi-ancestry samples (combined N = 5599) yielded evidence of childhood onset for 6 of 12 variants present in both Asians and Europeans. There was no indication that variant or GRS effects altered depending on time outdoors, however 5 variants showed nominal evidence of interactions with nearwork (top variant, rs7829127 in ZMAT4 ; P = 6.3E–04).
Abstract We assessed the validity and reliability of self-report of eye disease in participants with unilateral vision loss (presenting visual acuity worse than 6/12 in the worse eye and equal to or better than 6/12 in the better eye) or bilateral vision loss (presenting visual acuity worse than 6/12 in the better eye) in Australia’s National Eye Health Survey. In total, 1738 Indigenous Australians and 3098 non-Indigenous Australians were sampled from 30 sites. Participants underwent a questionnaire and self-reported their eye disease histories. A clinical examination identified whether participants had cataract, age-related macular degeneration, diabetic retinopathy and glaucoma. For those identified as having unilateral or bilateral vision loss (438 Indigenous Australians and 709 non-Indigenous Australians), self-reports were compared with examination results using validity and reliability measures. Reliability was poor for all four diseases (Kappa 0.06 to 0.37). Measures of validity of self-report were variable, with generally high specificities (93.7% to 99.2%) in all diseases except for cataract (63.9 to 73.1%) and low sensitivities for all diseases (7.6% in Indigenous Australians with diabetic retinopathy to 44.1% of non-Indigenous Australians with cataract). This study suggests that self-report is an unreliable population-based research tool for identifying eye disease in those with vision loss.
Abstract Background This study examined the risk of mortality in older adults with newly detected cognitive impairment or dementia. Methods Data from the Australian cohort of the ASPirin in Reducing Events in the Elderly (ASPREE) trial were examined. The ASPREE clinical trial compared daily low‐dose aspirin to a placebo and involved 16,703 individuals aged 70 years and over, who were without major cognitive impairment, physical disability, or cardiovascular disease at recruitment. During the trial, evidence of cognitive impairment, based on cognitive testing and medical record information, triggered dementia adjudication of participants using DSM‐IV criteria. Cox proportional hazard models were used to compare mortality rates across the dementia, trigger‐only, and no‐trigger groups. Results Over a median 4.7‐year follow‐up period, 806 participants triggered dementia adjudication, with 485 (60.2%) judged to have dementia. Following recruitment, mortality risks were 32.9, 33.6, and 10.8 events per 1000 person‐years in the dementia, trigger‐no‐dementia, and no‐trigger groups, respectively. In the fully adjusted model, mortality risks remained higher in the dementia and trigger‐no‐dementia groups, with hazard ratios of 1.7 (95% CI: 1.3–2.1) and 1.9 (95% CI: 1.5–2.6), respectively. There was no discernible difference between the dementia and trigger‐no‐dementia groups in mortality rates following recruitment, or following a dementia trigger. These two groups were more likely to die from sepsis, respiratory disease, and dementia, but less likely to die from cancer than the no‐trigger group, χ 2 = 161.5, p < 0.001. Conclusion ASPREE participants who triggered for a dementia evaluation experienced a substantially higher mortality rate than those who remained cognitively intact. The increase was indistinguishable among persons who met DSM‐IV criteria for dementia vs. those who triggered for a dementia evaluation but failed to meet DSM‐IV criteria. Future work should investigate whether earlier detection of cognitive decline can be used to identify and prevent early mortality.
This study determines the prevalence of unilateral vision impairment (VI) and unilateral blindness to assist in policy formulation for eye health care services.
Objective
To determine the prevalence and causes of unilateral VI and unilateral blindness in Australia.
Design, Setting, and Participants
This cross-sectional population-based survey was conducted from March 2015 to April 2016 at 30 randomly selected sites across all strata of geographic remoteness in Australia. A total of 1738 indigenous Australians 40 years or older and 3098 nonindigenous Australians 50 years or older were included.
Main Outcomes and Measures
The prevalence and causes of unilateral vision impairment and blindness, defined as presenting visual acuity worse than 6/12 and 6/60, respectively, in the worse eye, and 6/12 or better in the better eye.
Results
Of the 1738 indigenous Australians, mean (SD) age was 55.0 (10.0) years, and 1024 participants (58.9%) were female. Among the 3098 nonindigenous Australians, mean (SD) age was 66.6 (9.7) years, and 1661 participants (53.6%) were female. The weighted prevalence of unilateral VI in indigenous Australians was 12.5% (95% CI, 11.0%-14.2%) and the prevalence of unilateral blindness was 2.4% (95% CI, 1.7%-3.3%), respectively. In nonindigenous Australians, the prevalence of unilateral VI was 14.6% (95% CI, 13.1%-16.3%) and unilateral blindness was found in 1.4% (95% CI, 1.0%-1.8%). The age-adjusted and sex-adjusted prevalence of unilateral vision loss was higher in indigenous Australians than nonindigenous Australians (VI: 18.7% vs 14.5%;P = .02; blindness: 2.9% vs 1.3%;P = .02). Risk factors for unilateral vision loss included older age (odds ratio [OR], 1.60 for each decade of age for indigenous Australians; 95% CI, 1.39-1.86; OR, 1.65 per decade for nonindigenous Australians; 95% CI, 1.38-1.96), very remote residence (OR, 1.65; 95% CI, 1.01-2.74) and self-reported diabetes (OR, 1.52; 95% CI, 1.12-2.07) for indigenous Australians, and having not undergone an eye examination in the past 2 years for nonindigenous Australians (OR, 1.54; 95% CI, 1.04-2.27). Uncorrected refractive error and cataract were leading causes of unilateral VI in both populations (70%-75%). Corneal pathology (16.7%) and cataract (13.9%) were leading causes of unilateral blindness in indigenous Australians, while amblyopia (18.8%), trauma (16.7%), and age-related macular degeneration (10.4%) were major causes of unilateral blindness in nonindigenous Australians.
Conclusions and Relevance
Unilateral vision loss is prevalent in indigenous and nonindigenous Australians; however, most cases are avoidable. As those with unilateral vision loss caused by cataract and posterior segment diseases may be at great risk of progressing to bilateral blindness, national blindness prevention programs may benefit from prioritizing examination and treatment of those with unilateral vision loss.
富营养化是水生态系统主要的环境问题,自然条件下多种营养盐以组合形式进入水体,明确浮游植物群落对多种营养盐加富的响应对富营养化防治有重要意义。本研究以一座华南热带水库(大沙河水库)为例,分析了2021年枯水期(1—3月)和丰水期前期(4—6月)氮(N)、磷(P)、铁(Fe)和叶绿素a(Chl.a)浓度的变化趋势,并通过原位添加实验,解析浮游植物丰度和多样性对N、P、Fe加富的响应。结果表明:与1—3月相比,4—6月期间水体总磷浓度(TP)明显升高,总铁浓度(TFe)呈增加趋势但月度间波动较大,总氮浓度(TN)在4月最低,之后缓慢增加,期间Chl.a浓度从3月的5 μg/L快速增加到5月的29 μg/L。原位实验结果表明:浮游植物群落以蓝藻、绿藻和硅藻为主要组成,所有营养盐添加组浮游植物丰度均有增加,但只有NP同时添加时(NP和FeNP两组)生物量(以Chl.a表征)有显著升高;营养盐添加组细胞丰度的响应在门类和种类间差异明显,实验组组间群落结构和优势种类差异显著,所有处理组的群落多样性均明显高于对照组。N和P添加及其与Fe的联合添加(N、P、NP、FeN、FeP和FeNP)均导致蓝藻丰度升高,绿藻仅在NP添加组(FeNP组和NP组)显著升高且两组没有显著差异,硅藻仅在N和P单独添加组(N和P)显著升高。上述结果说明浮游植物生物量受N、P营养盐的共同影响而非单因子作用,N、P和Fe添加均影响群落结构和多样性,对水库富营养化的管理尤其是蓝藻水华防治应综合考虑3种营养盐的共同作用。;Eutrophication is one of the main threats to aquatic ecosystems, and various nutrients combined flow into water. It is important to understand the responses of phytoplankton communities to enrichment of multiple nutrients for eutrophication control. To elucidate the response of phytoplankton communities to three essential nutrients (N, P and Fe) in tropical reservoirs of southern China, we analyzed the variation of N, P, Fe and Chl.a in a typical reservoir (Dashahe Reservoir) from dry seasaon (from January to March) to wet season (from April to June) 2021. An in-situ experiment was conducted to clarify the responses of phytoplankton abundance and diversity to the N, P and Fe enrichment. Compared with the conditions from January to March, the total phosphorus concentration increased significantly from April to June, the total Fe concentration showed an increasing trend but fluctuated greatly among months, total nitrogen concentration reached the lowest value in April then increased slowly. Accompanied with the variation of nutrients, Chl.a concentration increased from 5 μg/L in March to 29 μg/L in May. The results of in-situ enrichment experiment showed that cyanobacteria, chlorophyta and diatom were the main compositions of phytoplankton. The increase in phytoplankton abundance was observed in all treatments, but only the combined addition of both N and P (NP and FeNP) caused significant increase of biomass (indicated by Chl.a concentration). The abundance responses to the same nutrient addition were different among phyla and species, and community structure and dominant species were significant differences among treatments. The community diversity of treatments pronounced higher than control. Cyanobacteria abundance increased in all of the treatments (N, P, NP, FeN, FeP and FeNP) except the treatment of single Fe addition, chlorophyta abundance significantly increased in NP and FeNP treatments while no significant difference was observed between these two treatments, and abundance of diatom significantly increased in single addition of N and P treatments. These results suggested that phytoplankton abundance was primarily limited by N and P. Therefore, the increase in abundance depends on the synergistic rather than the single effect of nutrients. The any addition of N, P and Fe can affect community structure and diversity. Our study implied that eutrophication management, especially controlling cyanobacteria blooms, should consider the synergistic effect of N, P and Fe.
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