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Abstract Background Toxoplasma gondii causes ocular toxoplasmosis (OT), involving inflammation, scarring, and retinal complications. The OT complications were retinal detachment (RD), and retinal breakage (RB). Surgical interventions like scleral buckling (SB) and vitrectomy are common. Limited understanding exists of the safety and efficacy of surgical management of RD/RB secondary to OT. Another complication is toxoplasmosis-related macular holes (tMH), with sparse evidence on surgical outcomes. This meta-analysis aims to clarify clinical characteristics, and surgical results, and enhance understanding of RD, RB, and MH secondary to OT. Methods PubMed, Cochrane, Embase and Web of Science database were queried for retrospective studies, case series and case reports that provided information on RD, RB and MH associated with OT and reported the outcomes of: (1) Retinal reattachment of RD/RB and tMH closure; (2) Best-corrected visual acuity (BCVA) improvement; and (3) Complications. Heterogeneity was examined with I2 statistics. A random-effects model was used for outcomes with high heterogeneity. Statistical analysis was performed using the software R (version 4.2.3, R Foundation for Statistical Computing, Vienna, Austria). Results Fourteen final studies, comprising a total of 96 patients were analyzed, 81 with RD or RB and 15 with tMH. Overall, surgical management was associated with several advantages: a high rate of retinal reattachment of RD/RB of 97% (95% Confidence Interval [CI] 92–100%; I2 = 0%), retinal reattachment of just RD of 96% (95% CI 89–100%; I2 = 30%) and tMH closure 97% (95% CI 87–100; I2 = 12%). There were significant differences in BCVA after surgeries in studies of RD/RB (MD 0.60; 95% CI 0.35–0.65; I2 = 20%) and MH (MD 0.67; 95% CI 0.50–0.84; I2 = 0%). The overall complication rate associated with surgical procedures in RD/RB secondary to OT was confirmed to be 25%. Conclusions The systematic review and meta-analysis showed that the treatment approaches currently in use are effective, with a remarkable rate of retinal reattachment of RD/RB, tMH closure, and substantial improvements in visual acuity. More randomized, long-term studies on disease and surgical factors can provide valuable insights into their impact on anatomical and visual outcomes.

Background The audit process may help improve performance indicators for colonoscopy quality but it is unclear whether this is sustained over several years.Methods 44138 procedures for 28 endoscopists from 2004 to 2019 were analysed for polyp detection rate and withdrawal time. From 2012, 14 endoscopists were analysed with additional data on polyp histology and number of polyps removed.Results Polyp detection increased from 40.7% in 2004 to 62.2% in 2019; removal of polyps>1 cm remained constant (11%). Adenoma detection rate was 25.8% in 2012 and 28.3% in 2019. Sessile serrated polyp (SSP) detection rate increased from 4.5% to 14.7%; most of the increase was in the first 2 years of the histology part of the audit. There was a significant correlation of adenoma detection rate with mean number of adenomas (r=0.72, p=0.004) and a significant correlation of SSP detection with mean number of SSPs (r=0.85, p=0.0001).Conclusion The audit process appears to encourage a higher rate of polyp detection. This was due to increased detection of smaller polyps and increased detection of SSPs.

Abstract Diabetic macular edema (DMO) is a leading cause of blindness in the working age population. Although anti-vascular endothelial growth factor (VEGF) therapy provided a major advance in treatment of DMO for many patients, there is a significant proportion of patients who maintain persistent DMO and have minimal response to anti-VEGF treatment. Iluvien (fluocinolone acetonide 0.19 mg [FAc]) is an important additional treatment option for DMO. In this review we describe the clinical context and the evidence for the use of the FAc implant in treating DMO, from pilot to randomized controlled studies, to later phase real world data. These studies indicate that the FAc implant is effective, well tolerated and a cost-effective option in the treatment of insufficiently responsive DMO.

Abstract Background To compare visual function and structural improvements in pseudophakic eyes with diabetic macular oedema (DMO) treated with the 0.19mg Fluocinolone Acetonide (FAc) intravitreal implant (IluvienTM) in a ‘real world’ setting. Methods A single centre retrospective evaluation of patients with DMO unresponsive to conventional treatment treated with the FAc implant according to UK guidelines. Primary efficacy endpoint was best corrected visual acuity (BCVA); secondary endpoints included optical coherence tomography evaluations of the macula (a) central retinal and (b) peak macular thickness collected at annual time points. Primary safety endpoint was new rise in IOP >27mmHg or glaucoma surgery. Patients with

As a prime driver, induction motor is the most electric energy consuming component in industry. The exposure of the motor to stator winding asymmetry, combined with broken rotor bar fault significantly increases the temperature and reduces the efficiency and life of the motor. Accurate and timely diagnosis of these faults will help to maintain motors operating under optimal status and avoid excessive energy consumption and severe damages to systems. This paper examines the performance of diagnosing the effect of asymmetry stator winding on broken rotor bar (BRB) faults under closed loop operation modes. It examines the effectiveness of conventional diagnostic features in both motor current and voltage signals using spectrum and modulation signal bispectrum analysis (MSBA). Evaluation results show that the combined faults cause an additional increase in the sideband amplitude and this increase in sideband can be observed in both the current and voltage signals under the sensorless control mode. MSB analysis has a good noise reduction capability and produces a more accurate and reliable diagnosis in that it gives a more correct indication of the fault severity and its location for all operating conditions.

The concurrent circumstances of an increasingly mobile workforce, disparities in access to healthcare, and the ability to deliver care through technology (e.g., telehealth) present the need and the opportunity to practice across state borders. Over the past four years, the Federation of State Boards of Physical Therapy (FSBPT) has explored professional licensure models that will allow cross border practice. This paper reviews FSBPT's exploratory process and describes some of the advantages of an interstate compact. It concludes that if agreement among state licensing boards can be achieved, a compact could serve as a viable means to increase patient access to quality physical therapy care.

In Western culture, feeding is viewed as symbolic of life, and nonfeeding at the end of life is often considered unacceptable. This sentiment is magnified for infants. Reframing nonfeeding into comprehensive care can be achieved by anticipatory guidance, which can make the experience of infant death meaningful for parents. Since 2004, the George Mark Children's House, an inpatient pediatric palliative care center, has offered this model of care and supported families with challenging clinical experiences. A case study is provided., (© 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.)

Purpose: This study assessed levels of stress and coping strategies in physician assistant (PA) students., Methods: The study used a descriptive, cross-sectional design. Data were collected through an electronic survey that was sent to all current student members of the Texas Academy of Physician Assistants (N = 560). The Perceived Stress Scale was used to measure level of stress, and the Brief COPE Inventory was used to measure coping strategies., Results: A total of 146 (26.3%) students participated in the study. Most respondents were female, young, single, and Caucasian/non-Hispanic. The mean stress score was 33.3, higher than that reported in the overall general US population. Areas of most concern included feeling nervous and stressed, feeling upset about unexpected happenings, and an inability to control life's irritations and manage personal problems. Self-distraction, venting, and self-blame were the most frequently used unhealthy coping strategies. Acceptance, active coping, and emotional support were the most frequently used positive coping strategies., Conclusion: The results of this study indicated that students in PA training experience higher levels of stress than the general population in the United States, making healthy coping strategies among PA students particularly important. The results of this study can inform future research, curriculum design, teaching methods, and educational intervention in PA training programs.