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![]() Anti- VEGF injections alone can be considered for patients who are highly motivated and have no barriers to follow-up.PRP is usually preferred as treatment occurs in a single session (reduces risk of loss to follow-up).Both PRP and anti-VEGF therapy are equally effective.Proliferative retinopathy: PRP and/or anti-VEGF therapy.Severe NPDR: Treat as proliferative retinopathy with panretinal laser photocoagulation ( PRP) and/or anti-VEGF therapy.Mild NPDR to moderate NPDR: Observation only repeat dilated comprehensive eye examination every 6–12 months.For patients with significant vision impairment, consider:Įarly detection and treatment of diabetic retinopathy can prevent 90% of blindness.Arrange follow-up eye exams at regular intervals.Screen for additional microvascular complications of diabetes because of the high risk of co-occurrence.Continue aspirin if indicated for another condition.Initiate treatment for lipid disorders as indicated (see “ Guidelines for lipid-lowering therapy”).Treat hypertension if present (see “ Approach to management of hypertension”).Lifestyle recommendations for patients with diabetes mellitus.Antihyperglycemic treatment of diabetes.Refer all patients with diabetic retinopathy to an ophthalmologist.Noncenter-involving DME: ≥ 1 mm diameter retinal thickening that does not involve a central subfield.Center-involving DME: ≥ 1 mm diameter retinal thickening in a central subfield.If OCT has been performed, can be further categorized into:.Within 1 disc diameter of the center of the macula: any zone of retinal thickening ≥ 1 disc size in any area.Hard exudates (if associated with adjacent retinal thickening).Within 500 microns of the center of the macula.Or elsewhere in the eye, if accompanied by vitreous and/or preretinal hemorrhage.On the optic disc or within 1 disc diameter.In ≥ 1 retinal quadrant: moderate intraretinal microvascular abnormalities.In ≥ 2 retinal quadrants: signs of ischemia (e.g., venous beading).In all 4 retinal quadrants: capillary microaneurysms, dot intraretinal hemorrhages.Mild intraretinal microvascular abnormalities or signs of ischemia.Capillary microaneurysms (to a greater extent than in mild NPDR).Vitrectomy may be required for patients with complications, e.g., tractional retinal detachment, vitreous hemorrhage PRP, focal and/or grid laser, and anti-VEGF therapy may be considered depending on severity.PRP (usually first-line) and/or anti-VEGF therapy.Severe: Consider PRP or anti-VEGF therapy.Mild-to-moderate: observation only reassess every 6–12 months.Treatment of diabetes and underlying ASCVD risk factors.May result from vitreous hemorrhage, retinal detachment, or neovascular glaucoma.May occur in all stages of NPDR and PDR.Clinically significant retinal thickening and edema involving the macula, associated hard exudates.Fibrovascular proliferation → vitreous hemorrhage, traction retinal detachment.Neovascularization is the hallmark of PDR.Findings of nonproliferative retinopathy are usually present.Intraretinal microvascular abnormalities (IRMA).Retinal vessel microangiopathy → blood leaks → retinal hemorrhages → retinal infiltration with lipids and fluid → macular edemaĮxamination findings ( dilated comprehensive eye exam or retinal photography).Retinal vessel microangiopathy → chronic retinal hypoxia → abnormal proliferation of blood vessels → traction on retina → retinal detachment.Retinal vessel microangiopathy → blood leaks → retinal hemorrhages. 3/1/2024 0 Comments Paul gray"We have obviously seen, really since the start of the alt-right era. "This is something that's happened periodically over the last few years, because these are areas that are rife with conflict, making them hotbeds for this kind of activity," Hayden said. Hayden compared Gray's case to members of the Rise Above Movement, an MMA-obsessed white supremacist gang that sent members to the region to train with neo-Nazi paramilitary groups and compete in fighting tournaments. White nationalist groups have sent members to the region for training, and some even traveled there to hide out from legal charges (though there's no indication that applies to Gray). "It's a basic question of doing due diligence and background work to figure out what a person is doing there in the first place, because I just don't know many people that are out building gyms in Eastern Europe," noted Hayden. Where he got the money to open a gym is unknown. Collins, Colo., in 2018 and then to Ukraine sometime after that. (This reporter was there to deliver a talk on the history and tactics of modern antifascism.) Gray moved to Ft. Participants blocked the doors to prevent Patriot Front members from assaulting people inside. He also participated in Patriot Front's attempted disruption at the Houston Anarchist Bookfair, held at a community center in September 2017. Gray also teamed up for a time with Patriot Front, one of the most active white nationalist groups in the U.S., where he helped other veterans provide combat training. He worked as a security guard in the Austin area during this time. Gray defended the cafe on behalf of his sister, Rebecca, the owner of the business and a guest on. Also in June 2017, Gray and three other white supremacists assaulted activists outside the controversial (now defunct) east Austin Blue Cat Cafe, which was regularly targeted by anti-gentrification protests. Matt Schaefer, R-Tyler, who later told the Dallas Morning News that organizers lied to obtain his sponsorship, claiming they were a veterans' group. Along with Ken Reed, leader of the hate group White Lives Matter, Gray organized a June 17, 2017, rally at the Texas Capitol called "Tomorrow Belongs to Texas," attended by about two dozen white nationalists. In his most active years, he organized marches with white supremacist organizations such as the Nazi group Traditionalist Workers Party, which was active from 2013 to 2018, and Atomwaffen Division, a Texas-based terrorist neo-Nazi group linked to several murders. ![]() "They just hope that the audience doesn't ask any questions because then Fox will be forced to dig deeper into an uncomfortable story about our problems with radicalization here at home." Reports published by KETK, Tyler's Fox affiliate, did use Gray's full name and further identified him as an American citizen who's owned a gymnasium and reportedly "been an influence on the Ukrainian community."ĭuring the early years of the Trump presidency, especially 2017, Gray took part in street battles and helped organize racist events in Texas. "They elect not to report his full name and don't even stop to ask why he might already be in Ukraine," Hayden told the Chronicle. During a March 1 appearance in a segment titled "Former American paratrooper joins fight in Ukraine," Fox reporters praised Gray as a veteran volunteering to fight on behalf of Ukraine but neglected to mention his violent history.ĭespite Fox protecting Gray's identity by using only his first name, he was easily recognizable to extremism researchers like Michael Edison Hayden, senior investigative reporter and spokesperson for the Southern Poverty Law Center. Paul Gray, a white supremacist originally from Tyler and active in Austin during the Trump presidency, is being lauded by Fox News after volunteering to fight Russian invaders in Ukraine. ![]() Former paratrooper and white supremacist Paul Gray speaks on Fox News (Image via YouTube) 3/1/2024 0 Comments Izip bikes for saleEven my wife ultimately got on board and "authorized" the purchase of a (slightly) used Path+ for her and she loves it. I was able to turn my commute into a sweatless event (my main purchase priority), although I soon found myself using it for weekend rides and explorations. When I saw the Dash on their showroom floor I fell hard and purchased a few weeks later. I purchased my a Dash at a local shop where I'd purchased bikes, accessories and services over the years. So I wade in again in need of some real help, advice and guidance. Haven't posted here in a while, but when I was early on in my ebike investigation and ownership I spent a good deal of time pouring over these pages and left impressed by the community's knowledge and commitment. I am about 2500 miles deep into my 2014 Izip Dash. If a motor crapped out in less than a month, I'd like to know as much as possible about it so I can avoid it happening again. I live in Iowa, lots of salt/sand on roads from winter and few bike lanes. If it's not, izip should specify that the Dash is a pavement only bike. If my bike wasn't in the shop I'd snap a pic. And crevice was a bad choice of words, I meant that where the casing halves meet, there's a gap between them that allows dust to get in. I was wondering if the dirt inside the casing was normal, if it's okay for dust to get inside the motor casing or if it's a problem. As I addressed earlier, I wish I had purchased the 2017 model because the frame wraps around the motor. ![]() If you hit something, or if something kicks up and smacks the bottom of the motor at 28mph - there's going to be a chance something could crack. On some of the Easy Motion bikes I've ridden that have similar-sized (417Wh) batteries, they top out at around 25MPH, which helps to preserve the battery by limiting discharge current to ~15A/36V, whereas a lot of the IZIPs will draw to cruise at 30MPH, and their battery heats up and degrades quickly at that level of discharge current. If they had outfitted them with 13S4P batteries (adding an additional bank of 13 battery cells), not only would you get 33% greater range than with a 13S3P, your pack's cycle life would approximately double. Most IZIP S-pedelecs come with a 13S3P 48V battery that isn't up to the task of reliably cruising at 28MPH without degrading the battery quickly. The display indicates a range at full charge of 31 miles, but that's unrealistically optimistic. My 2015 IZIP E3 Dash has seen its range cut in half, from ~40 miles to ~20 miles, after ~3,000 miles. Hopefully I can get back on the road quick.īattery degradation is a problem that affects IZIP S-pedelecs far more than bikes from other brands. ![]() The rise on the top tube helps gives the bike amazing stability when making sharp turns, I can zip around really effectively zigging and zagging, I don't know if that's just a feeling I have or a design either way it's awesome. With the battery mount issue I think I'll need a whole replacement of motor (unless it's just a wiring issue) and a new battery and mount, and that's a tall order so fast after purchase but I don't want to pay $800 for a new battery down the line because this one has been rattling around the whole time. I'm bummed I can't ride my bike, I just got it this month, I'm nervous about the warranty - you never know how things are going to be covered. The 2017 Dash has its headlight mounted just underneath the display on the bars, so that isn't an issue. I tilted the display down once at night and the wires clipped the headlight while turning, bending the fender and separating the light wiring. I put my bike up to get a look at the bottom of the motor and there is a gap that was letting dirt and dust in and from what I can see the inside of the casing is just caked with dirt.Īnother thing to watch for is the wires that come off the handlebars and off the display. The 2017 model addresses the two biggest concerns/problems I've had - the semi-integrated battery holds it in place and doesn't allow rattle (which I worry has done unknown damage to my battery, as it has vibrated and rattled enough to dislodge pins in the battery mount) and the frame is built around the motor, protecting it from possible impacts and dirt/debris. To those thinking about one, had I known what I know now, I would have bought the 2017 model despite the price difference. I should point out that the Dash is a fantastic bike, an absolute blast to ride. ![]() ![]() I'm bringing it into my LBS tomorrow and hoping for the best on warranty coverage. If I'm not mistaken you hold the +/- buttons for 10 secs, correct? I've done that but it doesn't seem to do anything. I'm only seeing error code 1, I haven't gotten the diagnostics to work. |
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