Visual functioning and health-related quality of life in diabetic patients about to undergo anti-vascular endothelial growth factor treatment for sight-threatening macular edema

Purpose To examine patient-reported outcome (PRO) in a selected group of Swedish patients about to receive anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME). Material and methods In this cross-sectional study, 59 patients with diabetes mellitus, who regularly visited the outpatient eye-clinics, were included. Sociodemographic and clinical data were collected and the patients completed PRO measures before starting anti-VEGF treatment. PRO measures assessed eye-specific outcomes (NEI-VFQ-25) and generic health-related quality of life (SF-36). Results The participants consisted of 30 men and 29 women (mean age, 68.5 years); 54 (92 %) patients had type 2 diabetes; Five (9%) patients had moderate or severe visual impairment; 28 (47 %) were classified as having mild visual impairment. Some of the patients reported overall problems in their daily lives, such as with social relationships, as well as problems with impaired sight as a result of reduced distance vision. Conclusions Further studies are needed to investigate PRO factors related to low perceived general health in this patient population. It is important to increase our understanding of such underlying mechanisms to promote improvements in the quality of patient care.

ANALYSIS & STUDY OF AI TECHNIQUES FORAUTOMATIC CONDITION MONITORING OFRAILWAY TRACK INFRASTRUCTURE : Artificial Intelligence Techniques

Since the last decade the problem of surface inspection has been receiving great attention from the scientific community, the quality control and the maintenance of products are key points in several industrial applications.The railway associations spent much money to check the railway infrastructure. The railway infrastructure is a particular field in which the periodical surface inspection can help the operator to prevent critical situations. The maintenance and monitoring of this infrastructure is an important aspect for railway association.That is why the surface inspection of railway also makes importance to the railroad authority to investigate track components, identify problems and finding out the way that how to solve these problems. In railway industry, usually the problems find in railway sleepers, overhead, fastener, rail head, switching and crossing and in ballast section as well. In this thesis work, I have reviewed some research papers based on AI techniques together with NDT techniques which are able to collect data from the test object without making any damage. The research works which I have reviewed and demonstrated that by adopting the AI based system, it is almost possible to solve all the problems and this system is very much reliable and efficient for diagnose problems of this transportation domain. I have reviewed solutions provided by different companies based on AI techniques, their products and reviewed some white papers provided by some of those companies. AI based techniques likemachine vision, stereo vision, laser based techniques and neural network are used in most cases to solve the problems which are performed by the railway engineers.The problems in railway handled by the AI based techniques performed by NDT approach which is a very broad, interdisciplinary field that plays a critical role in assuring that structural components and systems perform their function in a reliable and cost effective fashion. The NDT approach ensures the uniformity, quality and serviceability of materials without causing any damage of that materials is being tested. This testing methods use some way to test product like, Visual and Optical testing, Radiography, Magnetic particle testing, Ultrasonic testing, Penetrate testing, electro mechanic testing and acoustic emission testing etc. The inspection procedure has done periodically because of better maintenance. This inspection procedure done by the railway engineers manually with the aid of AI based techniques.The main idea of thesis work is to demonstrate how the problems can be reduced of thistransportation area based on the works done by different researchers and companies. And I have also provided some ideas and comments according to those works and trying to provide some proposal to use better inspection method where it is needed.The scope of this thesis work is automatic interpretation of data from NDT, with the goal of detecting flaws accurately and efficiently. AI techniques such as neural networks, machine vision, knowledge-based systems and fuzzy logic were applied to a wide spectrum of problems in this area. Another scope is to provide an insight into possible research methods concerning railway sleeper, fastener, ballast and overhead inspection by automatic interpretation of data.In this thesis work, I have discussed about problems which are arise in railway sleepers,fastener, and overhead and ballasted track. For this reason I have reviewed some research papers related with these areas and demonstrated how their systems works and the results of those systems. After all the demonstrations were taking place of the advantages of using AI techniques in contrast with those manual systems exist previously.This work aims to summarize the findings of a large number of research papers deploying artificial intelligence (AI) techniques for the automatic interpretation of data from nondestructive testing (NDT). Problems in rail transport domain are mainly discussed in this work. The overall work of this paper goes to the inspection of railway sleepers, fastener, ballast and overhead.

Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.