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These results are consistent with Sasongko et al. showing larger arteriolar branching angles in association with longer diabetes duration [ 23], but further suggest that this is primarily due to increased deflection of the smaller child vessel.
The main findings of our comparative study revealed a significant increase in all of the arteriolar and venular vascular segments width measurements with increased severity of DR. This was associated with a larger mean deflection angle of the smaller child vessel at bifurcations.
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The mean deflection angle of the child vessels may also be of some predictive value, although this is less clear.
This widening reflected specifically an associated steady increase in the branching angle of the smaller-child vessel segment (θ 2 ) with DR progression (p = 0.027).
Reduced arteriolar and venular smaller-child vessel width (d 2 ) at baseline significantly predicted future progression to PDR (OR = 0.73 (95% CI 0.58-0.92)).
Female sex was associated with decreased venular vascular width (p = <0.05) (apart from the diameter of the smaller-child vessel segment) as well as reduction in arteriolar and venular JER (p = <0.05).
The predictive study results have also shown that in adult diabetics with initially no clinically detectable retinopathy, alterations in RVG at baseline in the form of narrower arteriolar and venular small-child vessel segment diameter at a bifurcation and a reduced asymmetry and area ratio values may be correlated with future progression to PDR.
History of hypertension was associated with increased venular vascular width (p = <0.05) (excluding the small-child vessel segment), while history of high cholesterol was associated with increased both the arteriolar bifurcation angle (p = <0.05) and the smaller-child branching angle (θ 2 ) (p = <0.05).
In the comparative study, increased DR severity was associated with gradual vascular dilatation (p = 0.000), and widening of the bifurcating angle (p = 0.000) with increase in smaller-child-vessel branching angle (p = 0.027).
It's not clear whether the motive behind this effort to limit the earnings and autonomy of single women comes from The Handmaid's Tale, a novel by Margaret Atwood that envisions a future where women are stripped of their agency and reduced to child bearing vessels.
Niamh and Bronagh's brother Conor are the children; empty-vessel people who try to keep themselves topped up with alcohol or, as in this first episode, heroin.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com