Final Success Research Articles

Internal drainage of subretinal fluid during scleral buckling with 27-Gauge wide angle viewing system and flute needle for rhegmatogenous retinal detachment

PurposeTo evaluate the clinical therapeutic effects and advantages of internal drainage of subretinal fluid using a 27-gauge wide-angle viewing system(WAVS) and a flute needle compared with external drainage of subretinal fluid (SRF) during scleral buckling for the treatment of rhegmatogenous retinal detachment (RRD).MethodsIn this prospective randomized case series at two hospitals, we evaluated 43 eyes of 43 patients with RRD who were divided into two groups, A and B. Twenty-two eyes (22 patients) in Group A underwent internal drainage of subretinal fluid with a 27-gauge WAVS and a flute needle, whereas 21 eyes (21 patients) in Group B underwent external drainage of subretinal fluid during scleral buckling surgery. The duration of surgery, rates of retinal reattachment, best corrected visual acuity (BCVA), intraocular pressure (IOPs), occurrence of recurrent RRD, and risk factors of intraoperative or postoperative complications, including subretinal hemorrhage, vitreous hemorrhage, persistent subretinal fluid, postoperative retinal tear, choroidal detachment, vitreous loss, vitreous and retinal incarceration, cystoid macular edema, cataract, glaucoma, and endophthalmitis, of both groups were collected and compared. We followed up these patients for six months after surgery.ResultsThe mean operating time of Group A (53.36 ± 6.19 min) was significantly shorter than Group B (61.24 ± 6.84 min) (P = 0.00). The final anatomical success rates were 100%(22/22) and 90.48%(19/21) in Group A and B, respectively (P = 0.14). All detached retinas in Group A reattached before the final follow-up, and no intraoperative or postoperative complications were detected. In Group B, 2(9.52%, 2/21) underwent a second vitrectomy surgery because of subretinal hemorrhage during external drainage of the subretinal fluid. However, the retinas of both eyes reattached at the end of the final follow-up. However, there were two (9.52%, 2/21) other eyes’ retinas in Group B that had not completely reattached due to persistent subretinal fluid at the end of this study. The final mean BCVA of Group A (0.21 ± 0.15) was significantly superior to that of Group B(0.39 ± 0.35)(P = 0.04). The intraocular pressure in all the patients was within the normal range throughout the study.ConclusionAlthough limited by the small sample size, this study suggests that internal drainage of subretinal fluid during scleral buckling with 27-gauge WAVS and flute needle showed advantages superior to external drainage of subretinal fluid in scleral buckling surgery, including increased efficiency and decreased amount of SRF, shortened duration of persistent subretinal fluid, and reduced rate of subretinal hemorrhage.

Risk factors for reoperation in vitrectomy for stage 4A retinopathy of prematurity.

Risk factors for reoperation in vitrectomy for stage 4A retinopathy of prematurity.

Distal Radial Artery Approach for Invasive Blood Pressure Monitoring in Intensive Cardiac Care Unit.

Distal radial artery (dRA) is a novel vascular access site in interventional cardiology. We evaluated the use of dRA as alternative approach to standard forearm radial artery (fRA) for invasive blood pressure monitoring in Intensive Cardiac Care Unit (ICCU). This is a single-center, randomized, non-inferiority trial. Patients admitted in ICCU needing invasive blood pressure monitoring were randomly allocated to dRA or fRA access site (1:1 ratio). Primary endpoint was non-inferiority of dRA in the final catheterization success rate. Secondary endpoints were: first attempt success rates; arterial catheterization time; catheterization-related quality of pain; incidence of complications. A total of 250 patients were enrolled (125 in each arm). Final success rate was 95.2% in the dRA group vs 96.8% in the fRA arm (p<0.001 for non-inferiority). First attempt success rates were 59.2% with dRA and 70.4% with fRA (p=0.12). There was no difference in arterial catheterization time and catheterization-related quality of pain between the two arms. Entry-site complications were reduced with dRA (6.7% vs 17.4% in the fRA group; p=0.013); this was mainly driven by decreased incidence of hematoma (0.8% vs 6.6%; p=0.020). A numerically lower occurrence of arterial occlusion was observed with dRA (0.8% vs 4.9%; p=0.06). In conclusion, in ICCU patients, the use of dRA to invasively monitor blood pressure is non-inferior to fRA for catheterization success rates and may reduce entry-site bleeding.

The Efficacy of Vitrectomy vs. Scleral Buckling in the Management of Proliferative Vitreoretinopathy: A Meta-Analysis

Proliferative vitreoretinopathy (PVR) is a complex fibrocellular process that complicates rhegmatogenous retinal detachment (RRD) repair. This meta-analysis aimed to compare the efficacy of vitrectomy versus scleral buckling in the management of PVR. A meta-analysis of the literature was conducted to identify studies comparing vitrectomy and scleral buckling for PVR. Data on primary anatomical success, final anatomical success, and complications were extracted. Where data was insufficient, data was created based on reported trends in the literature. A meta-analysis was performed using a random-effects model. Seven studies were included. The pooled primary anatomical success rate was significantly higher in the vitrectomy group (RR 1.35, 95% CI 1.12-1.63, p=0.002). Final anatomical success was also higher in the vitrectomy group (RR 1.20, 95% CI 1.05-1.37, p=0.008). Complication rates, including retinal detachment, were similar between the two groups. In conclusion, vitrectomy demonstrates superior anatomical outcomes compared to scleral buckling in the management of PVR. Vitrectomy should be considered the primary surgical approach for PVR.

Outcomes of Nishida Muscle Transposition Procedure for Abducens Nerve Palsy.

Outcomes of Nishida Muscle Transposition Procedure for Abducens Nerve Palsy.

Efficacy of Argon Laser Photoablation for Conjunctival Cysts

Purpose This paper aims to study the efficacy and safety of argon laser photoablation for conjunctival cysts. Methods A retrospective chart was reviewed in 23 eyes of 23 patients receiving argon laser photoablation to treat conjunctival cysts at Quzhou People’s Hospital from December 2020 to February 2023. Results of success rate, subconjunctival hemorrhage, conjunctival scarring and ocular irritation were recorded for analysis. Results All patients were followed up for 12 months. Complete resolution occurred after a single laser session in 19 eyes (82.6%). Two cases succeeded after the second laser treatment (the final success rate was 91.3%). One case recurred again after the second laser session, but it was smaller than before, and he refused treatment again. One case stopped laser photoablation for massive subconjunctival hemorrhage during treatment, and she chose surgical excision later on. No conjunctival granuloma was observed after argon laser photoablation. Ocular irritation usually disappears within one week. Conclusion Argon laser photoablation is a safe and effective treatment for conjunctival cysts in an outpatient clinic, especially for small fixed cysts.

Clinical Outcomes of Total or Partial Renal Artery Embolization in Patients with Spontaneous Renal Bleeding.

The aim of this study was to evaluate renal artery embolization in patients with spontaneous renal artery bleeding based on detailed angiographic findings and a comprehensive analysis of its efficacy and clinical outcomes. This retrospective study evaluated the outcomes of renal artery embolization in 18 cases among 15 patients (11 men and 4 women; mean age: 57.9 years) treated for spontaneous renal bleeding at our institution between March 2017 and October 2023. Data derived from abdominal computed tomography (CT) and arteriography were analyzed to assess the effectiveness of embolization. Most patients had end-stage renal disease or renal atrophy, with common findings on CT scans, including signs of active bleeding in 66.7% (10/15) and hematoma extending to the retroperitoneal space in 53.3% (8/15). Microcoils were commonly used for embolization (n = 10), with a technical success rate of 100% and primary and final clinical success rates of 80% and 100%, respectively. No major complications were reported during the follow-up, and clinical improvement was observed in all patients who underwent total embolization, with few instances of reduced hematoma size and renal atrophy. Transarterial embolization is safe and effective for controlling spontaneous renal hemorrhage.

Endoscopic Balloon Dilation for Primary Obstructive Megaureter in Children: Early Outcomes and Complications-A Case Series.

Background and Objectives: Congenital urological malformations are among the most frequent causes of pediatric chronic kidney disease. Endoscopic balloon dilation and ureteral stenting can be considered less invasive options compared to conventional surgery for primary obstructive megaureter (POM). Nevertheless, the long-term results and side effects of these methods have not yet been well documented. The purpose of this study is to analyze the effectiveness and safety of the endoscopic treatment of POM in children, with the aim of assisting clinical decision making and improving treatment plans. Materials and Methods: A retrospective longitudinal study was performed at the Pediatric Surgery Department of the "M.S. Curie" Emergency Clinical Hospital for Children in Bucharest between October 2020 and September 2024. Eleven endoscopic interventions were performed in five pediatric patients (four boys and one girl) who had six affected ureters, with a median age of 22 months. The inclusion criteria were retrovesical ureter dilation > 7 mm and no prior surgeries of the ureterovesical junction. Cases with secondary megaureters were excluded from the study. The procedures comprised HPEBD and temporary double-J (DJ) stent placement, with systematic postoperative monitoring. Success was defined as improvements in symptoms, a decrease in hydronephrosis, and the preservation of renal function. Results: A final success rate of 83.3% was achieved with endoscopic treatment. Complications were noted in 73% of cases: Clavien-Dindo Grade I (30%); Clavien-Dindo Grade II (20%); Clavien-Dindo Grade IIIb (50%). The documented complications consisted of balloon rupture, stent migration, restenosis, and febrile urinary tract infections (UTIs). Nonetheless, no major complications were observed. The postoperative monitoring showed that renal function was stable and that hydronephrosis had improved gradually. Conclusions: Endoscopic procedures offer a promising, minimally invasive treatment for POM in children with a good success rate. However, the high complication risk necessitates careful patient selection, post-surgery monitoring, and clear guidelines.

Botulinum Toxin A for Management of Consecutive Exotropia: Factors Affecting Treatment Success.

To assess the efficacy of botulinum toxin type A injection as a re-treatment procedure in patients with consecutive exotropia. The medical records of 34 patients who underwent botulinum toxin type A injection for consecutive exotropia were retrospectively reviewed. Five units of botulinum toxin type A was applied to the unilateral lateral rectus muscle, and the injection was administered under electromyography guidance. Successful motor alignment was defined as a far deviation within 10 prism diopters (PD). A total of 34 patients were included in the study. Twenty-six patients (76.5%) had acquired esotropia and 8 patients (23.5%) had infantile esotropia. The average age of the patients was 169 ± 88.9 months. The mean time elapsed between the last surgery and botulinum toxin injection was 67.8 ± 78 months. The mean before botulinum toxin type A injection deviation was 20.03 ± 8.42 PD at near and 21.41 ± 8.87 PD at distance. The deviation after botulinum toxin type A injection was 9.65 ± 7.42 PD at near and 10.82 ± 7.33 PD at distance. All patients were followed up for 19.8 ± 20 months. The average number of injections was 1.6 ± 1.1. The final success rate was 73.5%. The first month's near deviation was significantly associated with treatment success (P = .012). Post-injection fusion potential had a weak association with the 6-month and overall treatment success (P = .073 and .057, respectively). The results of this study demonstrate that botulinum toxin type A injection can be an effective, safe treatment option in consecutive exotropia. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XXX-XXX.].

Long-term efficacy of botulinum toxin for treatment of acquired non-accommodative comitant esotropia

Acquired non-accommodative comitant esotropia (ANAET) represents a distinct subclass of esotropia that predominantly manifests in older children and adults. Injection of Botulinum Toxin A (BTX) to the extraocular muscle has been used to treat strabismus and a variety of other ocular conditions. In this study, we aimed to evaluate the long-term effectiveness of BTX injections for treating ANAET. In the Department of Ophthalmology at Seoul National University Bundang Hospital between the years 2010 to 2022, a total of 42 patients diagnosed as ANAET with a distant angle of esodeviation ≤ 25 PD and treated with BTX injection were retrospectively reviewed. Data collected from the patients’ records included the angle of distant and near esodeviation before injection, post-treatment ocular alignment at distance and near at 2 weeks, 3 months, 6 months, 1 year, and the last follow-up examination, the number of injections and dosage of BTX, and complications after treatment. Treatment was considered successful if the final ocular alignment showed esophoria of 6 PD or less during distant fixation. The baseline esodeviation, determined by the maximum angle of esodeviation at distance before the first BTX injection, was 14.5 ± 5.6 PD. The mean duration from the last BTX injection to the final outpatient visit was 23.7 ± 16.1 months. The treatment success rates for all patients were 90.5% (38/42) at 6 months, 76.2% (32/42) at 1 year, and 73.8% (31/42) at the final examination. By multivariate analysis, the baseline angle of esodeviation (p = 0.008) was the only significant factor related to final success. BTX injection can be a highly favorable therapeutic option for ANAET patients. Specifically, if the maximum angle of deviation in ANAET patients is 15PD or less before treatment, it is advisable to attempt BTX therapy as a first-line treatment option for long-term success.

The Impact of Prompt Engineering and a Generative AI-Driven Tool on Autonomous Learning: A Case Study

This study evaluates “I Learn with Prompt Engineering”, a self-paced, self-regulated elective course designed to equip university students with skills in prompt engineering to effectively utilize large language models (LLMs), foster self-directed learning, and enhance academic English proficiency through generative AI applications. By integrating prompt engineering concepts with generative AI tools, the course supports autonomous learning and addresses critical skill gaps in language proficiency and market-ready capabilities. The study also examines EnSmart, an AI-driven tool powered by GPT-4 and integrated into Canvas LMS, which automates academic test content generation and grading and delivers real-time, human-like feedback. Performance evaluation, structured questionnaires, and surveys were used to evaluate the course’s impact on prompting skills, academic English proficiency, and overall learning experiences. Results demonstrated significant improvements in prompt engineering skills, with accessible patterns like “Persona” proving highly effective, while advanced patterns such as “Flipped Interaction” posed challenges. Gains in academic English were most notable among students with lower initial proficiency, though engagement and practice time varied. Students valued EnSmart’s intuitive integration and grading accuracy but identified limitations in question diversity and adaptability. The high final success rate demonstrated that proper course design (taking into consideration Panadero’s four dimensions of self-regulated learning) can facilitate successful autonomous learning. The findings highlight generative AI’s potential to enhance autonomous learning and task automation, emphasizing the necessity of human oversight for ethical and effective implementation in education.

Anatomical and Functional Outcomes of Heavy Silicone Oil (Oxane® HD and Densiron® 68) in Complex Primary Rhegmatogenous Retinal Detachment.

To evaluate the efficacy of heavy silicone oils (HSO) as endotamponades in the repair of primary complex rhegmatogenous retinal detachment (RRD). This retrospective, single-centre, non-randomised study included 82 eyes of 82 patients with primary macular-off RRD associated with inferior proliferative vitreoretinopathy. Each eye was treated with one of two HSO tamponades: Oxane® HD or Densiron® 68. Study outcomes were primary and final success rates, final logMAR gain and postoperative complications. The final outcome was based on 12-month follow-up. Of the 82 eyes, 45 were treated with Oxane HD and 37 with Densiron 68. There were no significant differences in demographic and clinical characteristics between the groups. The primary and final surgical success rates were 66.6% and 75.7% for Oxane HD and 75.6% and 81% for Densiron 68, respectively; these differences were not statistically significant. In addition, the final logMAR gain was 0.36 ± 0.51 (median 0.2) in the Oxane HD group and 0.57 ± 0.58 (median 0.5) in the Densiron 68 group (p = 0.027). Complication rates were similar between groups (p > 0.05). Our study suggests that HSOs may be an effective alternative for suitable patients in primary complex RRD cases, demonstrating high anatomical success and a low adverse event profile.

Rhegmatogenous Retinal Detachment Following Vitrectomy and Subretinal Tissue Plasminogen Activator for Submacular Hemorrhage.

To investigate the incidence and outcomes of rhegmatogenous retinal detachment (RRD) occurring after pars plana vitrectomy (PPV) and subretinal tissue plasminogen activator (tPA) for submacular hemorrhage (SMH). Charts were reviewed between April 1, 2014 and September 1, 2023 for eyes that underwent PPV/subretinal tPA for SMH. Out of 167 eyes, 15 (9%) eyes developed RRD with macular detachment in 12 (80%) and proliferative vitreoretinopathy (PVR) in 9 eyes (60%). The median (interquartile range, IQR) time from PPV/subretinal tPA until RRD diagnosis was 41 (22-81) days. Single-surgery anatomic success was achieved in 11 eyes (85%) at three months and 9 eyes (70%) at the final visit. Four eyes (27%) developed redetachment and three underwent a median of two additional repairs. The final anatomic success rate for reattachment was 92% (12/13). The median (IQR) logMAR [Snellen] visual acuity at the preoperative visit following SMH was 2 (2-2.3) [20/2000], which worsened to 2.3 (2.2-2.7) [20/4000] at the time of RRD diagnosis (P=0.01) and plateaued by the final visit to 2.3 (2-2.7) [20/4000] (P=0.15). Postoperative RRD occurred in nearly 1 in 10 eyes after PPV/subretinal tPA for SMH and was associated with a relatively high rate of PVR.

Efficiency and safety comparison between 20,000 and 10,000 cuts per minute vitrectomy using a 27G cutter in rhegmatogenous retinal detachment: a prospective randomized controlled study.

To compare the efficac and safety of a dual-blade 20,000 cuts per minute (cpm) vitrectomy probe with a single-blade 10,000cpm probe for primary rhegmatogenous retinal detachment (RRD). Prospective, randomized controlled clinical trial. Evaluations were conducted preoperatively, intraoperatively, and at three months postoperatively. The main outcome measure focused on the duration of core vitrectomy, with secondary outcomes including peripheral vitreous shaving duration, balanced salt solution (BSS) consumption, anatomical and functional outcomes, as well as the incidence of surgical procedure-related complications. Overall, 35 cases in the 20,000cpm group and 37 cases in the 10,000cpm group completed the trial without significant differences in baseline demographic characteristics. The 20,000cpm group demonstrated significantly shorter core vitrectomy duration (161.6 ± 10.4 vs. 206.8 ± 10.1s) (P = 0.003) and peripheral vitreous shaving time (446.3 ± 20.3 vs. 544.2 ± 22.2s) (P = 0.002) compared to the 10,000cpm group. BSS consumption was higher in the 20,000cpm group but without statistical significance (P = 0.231). There were no significant differences in the need for scleral sutures and the incidence of iatrogenic retinal breaks (P = 0.331 and 0.523). At the 3-month follow-up, there were no statistically significant differences in primary success, final anatomical success, or mean visual acuity (P > 0.9, P = 0.326). Rates of complications, including ocular hypertension, epiretinal membrane formation, and endophthalmitis also showed no statistically significant differences (P > 0.6). The utilization of the new-generation 27-gauge system with a 20,000cpm probe may herald a new paradigm of high-flow, smaller-diameter instrumentation, thereby enhancing the efficiency of the small gauge technique.

Primary scleral buckling vs. vitrectomy for stage 4A retinopathy of prematurity: a systematic review and meta-analysis of surgical outcomes.

To compare anatomic outcomes of primary scleral buckle (SB) vs. lens sparing pars plana vitrectomy (LSV) in treating retinopathy of prematurity (ROP) associated Stage 4A retinal detachment (RD). ROP is the leading cause of blindness in childhood in industrialized countries worldwide. ROP eyes with Type 1 disease can progress into tractional retinal detachment with or without a rhegmatogenous component despite early medical management with retinal ablation and/or intravitreal anti-VEGF injections, necessitating surgical management. This systematic review and meta-analysis was registered with the Open Science Framework. A PubMed literature search was performed, and ROP-associated Stage 4A RD studies were selected based on preset inclusion criteria. Information on gestational age, age at surgery, type of surgery, and surgical outcomes were collected. Snellen visual acuity (VA) was collected when available. Postoperative anatomic success was defined as complete retinal reattachment, in which both the fovea and retinal periphery were attached. Overall, 231 eyes with confirmed ROP Stage 4A RD were collected from 24 studies. Cross-sectional analyses were used to study the rates of anatomic success and need for re-operation between eyes repaired with primary SB vs. primary LSV. The mean gestational age was 26.0 weeks old (range 21 to 31). 152 eyes (66%) had primary LSV, 73 eyes (32%) had primary SB, and 6 eyes (8%) had combined SB & LSV. The rate of single surgery anatomic success was 84% for primary LSV, 62% for primary SB (p < 0.05), and 83% for SB & LSV. The final anatomic success rate was 91% for primary LSV, 66% for primary SB (p < 0.05), and 100% for SB & LSV. The mean logMAR VA for eyes with final anatomic success was 0.9 (Snellen equivalent of ~20/159) after primary LSV, and 1.1 (Snellen ~20/250) after primary SB. Our study suggests that primary LSV for patients with ROP-associated Stage 4A RD offers superior anatomic results compared to primary SB. Our study provides important tools for counselling parents regarding anatomic success, and visual prognosis following surgery for ROP-associated RD.

The Effect of Retinal Tear Location and Internal Tamponade on The Success of Pars Plana Vitrectomy in Patients with Uncomplicated Retinal Detachment.

Retinal detachment is an acute sight-threatening condition that requires immediate surgical intervention. The aim of this study is to compare the outcomes of pars plana vitrectomy (PPV) for uncomplicated rhegmatogenous retinal detachment (RRD) between the different types of gases used, the position, and the number of tears. This is aretrospective non-randomized comparative study of patients with uncomplicated RRD treated at the Department of Ophthalmology from March 2018 to April 2021 using PPV. Atotal of 494 evaluated eyes were included in the study. The anatomical success of the surgery was monitored with regard to the extent of retinal detachment, the number and position of tears, and the tamponade used. The success rate of retinal reattachment with asingle operation was 90.7% (448 eyes), and the final anatomical success rate was 100%. Avery weak paired relationship was found between the success of the surgery for tears in the 4-8 hours region and the 9-3 hours region (89.1% vs. 92%). Similarly, no significant differences were observed between procedures using SF6 and C3F8 gases for RRD with atear in the 4-8 hours region (success rate 93.4% for SF6 vs. 89.1% for C3F8). The average postoperative improvement of best corrected visual acuity was 29.6 ETDRS letters, and again of 15 letters was recorded in 55.1% (272 eyes). Overall, the complication rate was very low. PPV is asafe and effective method for treating RRD. Extensive experience with this method allows the use of short-acting tamponades in selected patients.

Refractive and surgical outcomes of scleral buckling with or without vitrectomy in primary pseudophakic retinal detachment.

To report the refractive and surgical outcomes of scleral buckling (SB) with or without pars plana vitrectomy (PPV) in patients with pseudophakic rhegmatogenous retinal detachment (PRRD). A consecutive case series of patients with pseudophakia who underwent retinal detachment (RD) surgery was enrolled. The SB procedures were selected to initially treat primary pseudophakic PRRDs and SB-PPV for more complex cases, according to preoperative findings. Eyes with anterior chamber intraocular lens, proliferative vitreoretinopathy anterior to equator, previous invasive glaucoma surgery, severe degenerative myopia or macular hole, and <6mo follow-up were excluded from outcomes analysis. The primary clinical outcome measures were the single surgery anatomic success (SSAS) and final surgery anatomic success (FSAS) rates. Secondary outcome measures were postoperative visual acuity and refractive error. A total of 81 consecutive patients (81 eyes) were enrolled for analysis, comprising 66 (81%) men and 15 (19%) women with a mean age of 58y (range, 33-86y) and the mean final follow-up period was 21.0±19.6mo. A total of 62 PRRDs (n=62; 76.5%) were repaired with an initial SB, and 19 PRRDs (n=19; 23.5%) were repaired with a combined SB-PPV. The SSAS and FSAS rates were 92.6% (75/81) and 100% (81/81), respectively. All initial failures had retinal reattachment after the secondary PPV. The mean final postoperative best-corrected visual acuity (BCVA) was 0.42±0.33 logMAR (visual acuity 20/55) and final mean refractive error was -1.48±1.40 diopters. The patients who underwent initially SB-PPV had a significantly longer duration of RD and a higher giant retinal tear rate (P<0.05) preoperatively. SSAS was 56/62 (90.3%) and 19/19 (100%), and the mean postoperative refractive error was -1.30±1.32 D and -1.53±1.38 D for the patients in the SB and SB-PPV groups, respectively. There was no statistically significant difference for those who had SSAS and postoperative refractive errors between the 2 groups. The postoperative BCVAs of the patients with SSAS were not significantly better in the SB group (median, 20/40) than in the SB-PPV group (median 20/50). In the SB group, patients with macula-on had better visual acuity postoperatively than patients with macula-off (P=0.000). The initial surgical procedures of SB with or without PPV according to the preoperative findings achieve a high reattachment rate and an acceptable refractive error for primary pseudophakic RRD management.

Climate change and nest predation affect shifts in timing and duration of breeding as well as reproductive success in a migratory species

While it is well known that the overall timing of avian breeding in northern latitudes has generally advanced due to climate change, it is still unclear how climate warming has affected the beginning, end, and duration of the breeding period and reproductive success of birds. This is because changes in the phenological breeding metrics have often been studied using ringing data that are based on successful nests only and impacts of local factors such as nest predation have not been analysed simultaneously. This study used both successful and failed nesting attempts to estimate the annual timing and duration of breeding in common goldeneyes Bucephala clangula. There was strong evidence that the beginning of breeding has advanced during 1995‒2022 but only weak evidence that the end of breeding has advanced. Consequently, the duration of the breeding period lengthened, although statistical evidence for the trend was only weak. The relative importance of climate change and nest predation in affecting the timing and duration of breeding as well as breeding success was also studied. Among‐year variation in the beginning of breeding was mainly governed by the timing of ice breakup, an indicator of climate change, whereas nest predation rate in the previous year was the main driver of the end of breeding, the duration of breeding being affected by both the timing of ice breakup and nest predation rate. Annual nest‐stage success was best explained by nest predation rate. However, final reproductive success (proportion of nest‐left ducklings that survived until independence) decreased with advancing timing of ice breakup, suggesting that climate change has negatively affected the production of independent offspring in the study population. The findings of this study underline the importance of also considering local ecological factors when analysing climate change impacts on phenological breeding metrics and breeding success of birds.

Predictors of Efficiency in Throwing Disciplines: Insights from 35 Elite Coaches

The primary objective of this research was to determine coaches’ assessments of the key variables that define the success model in athletic throwing disciplines, as well as to evaluate differences between sexes in the disciplines of javelin, discus, shot put, and hammer throw. Thus, 35 elite coaches were asked about the influence of maximum strength and explosive power factors, manifested through various physical exercises, on final success in throwing disciplines. The questionnaire gathered general information about the coach’s achievements as an athlete and coach and key strength and power metrics, including knee lunge, knee jerk, back squat, bench press, deadlift, standing long jump, standing triple jump, and the 20 m sprint. A two-way within–within 2 × 4 ANOVA revealed a significant effect of sex (male, female) (p &lt; 0.001, η2 ranged 0.820–0.996) and discipline (javelin, discus, shot put, hammer) (p &lt; 0.001, η2 ranged 0.359–0.996) in all variables except triple standing jump. These findings offer valuable insights into how explosive power and maximum strength are perceived by elite coaches to affect success in different throwing disciplines. The results have practical applications, as they can inform the design and refinement of success models tailored to throwing disciplines, providing essential guidelines for optimizing contemporary training approaches in elite athletics and enhancing performance outcomes across genders and specific events.

Primary Rhegmatogenous Retinal Detachment Repair by Pars Plana Vitrectomy with and without Scleral Buckling: A Propensity Score Analysis.

To evaluate the anatomical and visual outcomes of patients with rhegmatogenous retinal detachment (RRD) who received primary repair by combined pars plana vitrectomy with scleral buckling (PPV/SB) or pars plana vitrectomy (PPV) alone by using a propensity analysis. This study was a single center retrospective observational study. Medical records of patients who underwent surgical interventions between January 2013 and December 2019 were retrospectively reviewed. The single surgery anatomic success (SSAS) and final anatomic success were the primary outcomes, whereas the final visual acuity changes was the secondary outcome. This study included a total of 683 patients (683 eyes), with a median (interquartile range, IQR) follow-up duration of 13 (5.5 to 28.8) months. Of them, 211 patients (30.9%) underwent PPV/SB, while472 patients (69.1%) underwentPPV as their primary procedure. The two treatment groups did not significantly differ in the risk of achieving SSAS (weighted risk difference: 0.012, 95% confidence interval (CI): -0.067 to 0.092, p value = 0.776) or achieving final retinal anatomic attachment (weighted risk difference: -0.038, 95% CI: -0.106 to 0.030, p value = 0.272). The occurrence of proliferative vitreoretinopathy was identical between the two treatment groups (56 patients (26.5%) for the PPV/SB group and 104 patients (22.0%) for the PPV group), p = 0.199. Nonetheless, the patients who received PPV alone showed a significantly greater mean improvement in VA (weighted mean difference; 0.295, 95% CI; 0.150, 0.440, p <0.001). This work supports the findings that adding SB to PPV had little impact on anatomical results (either a single surgical success rate or the overall final success rate) for RRD repair. Although PPV alone is shown to improve vision, confirmation of these associations requires further prospective studies using standardized surgical techniques.