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This review supports policy recommendations for the protective benefits of VMMC against STIs.
Evidence on the protective effect of VMMC against acquisition and transmission of common STIs is available for heterosexual men and women but more evidence is required for MSM. This review supports policy recommendations for the protective benefits of VMMC against STIs.Associations between substance use disorders (SUDs) and outbreaks of HIV and acute viral hepatitis have received considerable attention, but less research has focused on links between SUDs and sexually transmitted infections (STIs), apart from alcohol misuse. This narrative review describes the history of this public health crisis in the US and direct and indirect effects opioids and specific stimulants have on high risk sexual behaviors. We also review the epidemiology of STIs associated with opioids and stimulants in the U.S. and discuss opportunities for integrated interventions.
Clinical prediction rules (CPRs) can be used in STI testing environments to prioritize individuals at highest risk of infection and optimize resource allocation. We previously derived a CPR to predict asymptomatic chlamydia and/or gonorrhea (CT/NG) infection among women and heterosexual men at in-person STI clinics based on five predictors. Population differences between clinic-based and internet-based testers may limit the tool's application across settings. The primary objective of this study was to assess the validity, sensitivity, and overall performance of this CPR within an internet-based testing environment (GetCheckedOnline.com).

We analyzed GetCheckedOnline online risk assessment and laboratory data from 10/2015-06/2019. We compared the STI clinic population used for CPR derivation (data previously published) and the GetCheckedOnline validation population using chi-square tests. Calibration and discrimination were assessed using the Hosmer-Lemeshow (H-L) goodness-of-fit test and the Area Under thource allocation within publicly-funded health systems.Diarrhea is a major cause of infant mortality. Being a "nonsecretor" (having an inactive fucosyltransferase-2 gene) protects against diarrhea by inhibiting enteric infections. Breastfeeding also protects against diarrhea; however, the impact of maternal secretor status is unknown. In the ALSPAC cohort (N = 4971), we found that breastfeeding by nonsecretor mothers was especially protective against diarrhea, which could inform new prevention strategies.Coccidioidal meningitis remains difficult to treat. The newer triazole, isavuconazole, has demonstrated efficacy in invasive fungal disease with less side effects than other azoles. We describe a case of refractory pediatric coccidioidal meningitis with disease stabilization and improvement on isavuconazole after failing treatment with other antifungal agents.Rapid response is a common term in hospital settings, reflecting immediate clinical response to a critical challenge. ZDEVDFMK In preparation for the oncoming pandemic of novel coronavirus 2019, nurse leaders within a large health system in the Mountain West region implemented a rapid response to prepare nondirect care registered nurses for deployment to the bedside. This article highlights the prompt action, organization, and implementation of this process, as well as the lessons learned for future events.
To compare visual outcomes in patients without a history of macula edema following phacoemulsification using combination topical nonsteroidal anti-inflammatory drug (NSAID) plus prednisolone with prednisolone alone SETTING Kaiser Permanente Northern California, June 1, 2010, through May 31, 2015.

Retrospective cohort study.

Information was obtained from the electronic health record. The first measure of best-corrected visual acuity (BCVA) recorded during the period 3 weeks to 1 year after phacoemulsification was obtained. Confounding factors and clustering of eyes within patients were adjusted using linear mixed effects regression models for the continuous outcomes of BCVA improvement and general estimating equations for the dichotomous outcome of 20/20 or better versus 20/25 or worse.

The study included 62,700 health plan members of whom 42% (N=26,334) used topical prednisolone alone while 58% (N=36,366) used combination treatment. The average within-person change in BCVA from the preoperative measurement to the postoperative measurement was the same (-0.43 logMAR) for patients in the two groups. However, the group that received combination treatment was somewhat more likely to achieve BCVA of 20/20 or better (OR 1.24 with 95% CI 1.20-1.28).

In this large study of cataract surgery patients, a small statistically-significant association of combination treatment compared to prednisolone alone was observed.
In this large study of cataract surgery patients, a small statistically-significant association of combination treatment compared to prednisolone alone was observed.
To evaluate the refractive prediction error of intraocular lens calculation formulas in eyes that have undergone the Yamane technique for scleral fixation of intraocular lenses (IOL).

Alkek Eye Center, Cullen Eye Institute, Baylor College of Medicine, Houston, TX DESIGN Retrospective case series from electronic chart review.

Patients who had undergone scleral fixation of secondary IOLs were selected. The IOL refractive prediction errors (RPE) for 4 IOL prediction formulas - Barrett Universal II, Holladay 1, Hoffer-Q, and SRK/T - were obtained by subtracting the predicted spherical equivalent from post-operative spherical equivalent. The arithmetic mean RPE, mean absolute error (MAE), and percentages of eyes with prediction error of ≤0.5 D and ≤1.0 D were calculated and compared.

40 eyes of the 40 patients met inclusion criteria. All formulas produced hyperopic mean arithmetic RPE. MAE values were 0.73 D for Holladay 1, 0.76 D for Barrett, 0.80 D for SRK/T, and 0.86 D for Hoffer Q. The percentage of eyes with prediction error of ≤0.5 D and ≤1.0 D with these formulas were 45% (18 eyes) and 75% (30 eyes) for Holladay 1, 38.5% (15 eyes) and 77% (30 eyes) for Barrett, 32.5% (13 eyes) and 67.5% (27 eyes) for SRK/T, and 27.5% (11 eyes) and 62.5% (25 eyes) with Hoffer-Q. There were no significant differences in prediction errors between the 4 formulas.

Refractive outcomes of the Yamane technique are less predictable than standard cataract surgery. Arithmetic RPE is hyperopic to predicted for all formulas tested.
Refractive outcomes of the Yamane technique are less predictable than standard cataract surgery. Arithmetic RPE is hyperopic to predicted for all formulas tested.
To evaluate visual, refractive, aberrometric and patient-reported outcomes of wavefront-guided (WFG) myopic laser in situ keratomileusis (LASIK) using a high-resolution Hartmann-Shack aberrometer (iDesign Advanced WaveScan system, Johnson & Johnson Vision, Santa Ana, CA) with a new nomogram. The study was designed to determine if the new nomogram resolved the mild undercorrection that occurs with the manufacturer's default settings.

Three private LASIK practices.

Prospective, open label, non-comparative, multicenter study.

One hundred ninety eyes of 95 patients underwent bilateral WFG LASIK for the correction of myopia or myopic astigmatism. A new nomogram was used, which effectively adjusted the wavefront-measured refraction sphere up or down to equal the manifest refraction sphere. Patients were followed for six months.

Eighty-four patients completed final follow up. At 6 months, 96.4% (162/168) of eyes achieved monocular uncorrected distance visual acuity of 20/20 or better. No eye lost two ooved quality of life.
To evaluate the repeatability of aphakic intraoperative wavefront aberrometry and compare it to pre- and postoperative aberrometry.

Department of Ophthalmology, Hanusch Hospital, Vienna, Austria DESIGN Prospective case series METHODS Thirty eyes of 30 patients scheduled for cataract surgery were each measured three consecutive times via Shack-Hartmann wavefront sensing (SH-WFS) preoperatively, intraoperatively in aphakia, and 2-months postoperatively after IOL implantation by a single examiner. Intra-class correlation coefficients (ICC) of spherical equivalent (SE) values were evaluated for each time point. Intrasubject standard deviation (Sw) as repeatability (Sr) with corresponding repeatability limit (1.96 ?2 x Sw) were further assessed. Additionally, mean SE differences with corresponding limits of agreement (LoA) were calculated for comparison.

A high consistency of repeated measurements was found with ICCs above 0.9 for each of the three time-points. Intra-observer repeatability (Sr) and repeatability limit (r) of intraoperative aberrometry SE measurements were 0.34 and 0.95 D, respectively. The LoA for intraoperative aphakic SE across three consecutive measurements were -0.71 to +0.85 D. For comparison, Sr and r for phakic preoperative measurements in the cataractous state as well as postoperative measurements in the pseudophakic state were 0.33 and 0.93 D as well as 0.23 and 0.64 D, respectively. Similarly, the LoA for pre- and postoperative SE measurements were -0.66 to +0.60 D and -0.27 to +0.45 D, respectively.

Shack-Hartmann wavefront sensing test-retest reliability was high for all three time points, but the intraoperative setting resulted in a lower repeatability and broadened the agreement range.
Shack-Hartmann wavefront sensing test-retest reliability was high for all three time points, but the intraoperative setting resulted in a lower repeatability and broadened the agreement range.
To investigate the incidence and clinical features of red blood cell (RBC)-coated intraocular lens (IOL) in breakthrough vitreous hemorrhage (VH) with subretinal hemorrhage (SRH) secondary to neovascular age-related macular degeneration (nAMD).

Seoul National University Bundang Hospital, Seongnam, Korea.

Retrospective cohort analysis.

A total of 30 patients diagnosed as breakthrough VH with SRH in nAMD who underwent pars plana vitrectomy (PPV) were included in this study. Demographics and clinical characteristics of the subjects, visual acuities, and SRH sizes measured as optic disc diameters (DD) were analyzed. The correlation analysis between SRH size and absorption duration of RBC-coated IOL were performed.

RBC-coated IOLs were observed in 11 patients (37%). Appearance of RBC-coated IOLs was noted after postoperative 1 month, and mean duration of SRH absorption was 8.6±2.6 months. SRH sizes were significantly different between eyes with RBC-coated IOL and clear IOL (62.8±20.7 vs 27.4±14.2, P < 0.001). There was definite correlation between SRH size and absorption duration of RBC-coated IOL (correlation coefficient 0.899, P < 0.001, R2 = 0.831). There were no significant differences according to age, sex, laterality, underlying medical conditions, preoperative lens status, history of anti-VEGF treatment, and visual acuities. The degenerated RBC on the surface of IOL was confirmed by electron- and light-microscopy.

RBC-coated IOL could develop after vitrectomy surgery for breakthrough VH with massive SRH secondary to nAMD and it can be confused with IOL opacification. As it spontaneously disappears gradually, observation without IOL removal is warranted.
RBC-coated IOL could develop after vitrectomy surgery for breakthrough VH with massive SRH secondary to nAMD and it can be confused with IOL opacification. As it spontaneously disappears gradually, observation without IOL removal is warranted.
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