Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting

Aims To examine objective visual acuity measured with ETDRS, retinal thickness (OCT), patient reported outcome and describe levels of glycated hemoglobin and its association with the effects on visual acuity in patients treated with anti-VEGF for visual impairment due to diabetic macular edema (DME) during 12 months in a real world setting. Methods In this cross-sectional study, 58 patients (29 females and 29 males; mean age, 68 years) with type 1 and type 2 diabetes diagnosed with DME were included. Medical data and two questionnaires were collected; an eye-specific (NEI VFQ-25) and a generic health-related quality of life questionnaire (SF-36) were used. Results The total patient group had significantly improved visual acuity and reduced retinal thickness at 4 months and remains at 12 months follow up. Thirty patients had significantly improved visual acuity, and 27 patients had no improved visual acuity at 12 months. The patients with improved visual acuity had significantly improved scores for NEI VFQ-25 subscales including general health, general vision, near activities, distance activities, and composite score, but no significant changes in scores were found in the group without improvements in visual acuity. Conclusions Our study revealed that anti-VEGF treatment improved visual acuity and central retinal thickness as well as patient-reported outcome in real world 12 months after treatment start.

Solving the Vehicle Routing Problem with Genetic ALgorithm and Simulated Annealing

This Thesis Work will concentrate on a very interesting problem, the Vehicle Routing Problem (VRP). In this problem, customers or cities have to be visited and packages have to be transported to each of them, starting from a basis point on the map. The goal is to solve the transportation problem, to be able to deliver the packages-on time for the customers,-enough package for each Customer,-using the available resources- and – of course - to be so effective as it is possible.Although this problem seems to be very easy to solve with a small number of cities or customers, it is not. In this problem the algorithm have to face with several constraints, for example opening hours, package delivery times, truck capacities, etc. This makes this problem a so called Multi Constraint Optimization Problem (MCOP). What’s more, this problem is intractable with current amount of computational power which is available for most of us. As the number of customers grow, the calculations to be done grows exponential fast, because all constraints have to be solved for each customers and it should not be forgotten that the goal is to find a solution, what is best enough, before the time for the calculation is up. This problem is introduced in the first chapter: form its basics, the Traveling Salesman Problem, using some theoretical and mathematical background it is shown, why is it so hard to optimize this problem, and although it is so hard, and there is no best algorithm known for huge number of customers, why is it a worth to deal with it. Just think about a huge transportation company with ten thousands of trucks, millions of customers: how much money could be saved if we would know the optimal path for all our packages.Although there is no best algorithm is known for this kind of optimization problems, we are trying to give an acceptable solution for it in the second and third chapter, where two algorithms are described: the Genetic Algorithm and the Simulated Annealing. Both of them are based on obtaining the processes of nature and material science. These algorithms will hardly ever be able to find the best solution for the problem, but they are able to give a very good solution in special cases within acceptable calculation time.In these chapters (2nd and 3rd) the Genetic Algorithm and Simulated Annealing is described in details, from their basis in the “real world” through their terminology and finally the basic implementation of them. The work will put a stress on the limits of these algorithms, their advantages and disadvantages, and also the comparison of them to each other.Finally, after all of these theories are shown, a simulation will be executed on an artificial environment of the VRP, with both Simulated Annealing and Genetic Algorithm. They will both solve the same problem in the same environment and are going to be compared to each other. The environment and the implementation are also described here, so as the test results obtained.Finally the possible improvements of these algorithms are discussed, and the work will try to answer the “big” question, “Which algorithm is better?”, if this question even exists.

Abilities and Cultural Understanding through Literature in the EFL Classroom : - A Literature Review

The English language can be seen as a lingua franca of contemporary times. Its spread and use in the globalized world has affected most levels of society and it can be argued that, in current times, English is synonymous with communication. This need for communication has shaped the English as a Foreign Language (EFL) syllabus, which is evident in the Swedish national steering documents for the educational system. For the upper secondary school these documents show an emphasis on communication, on cultural understanding, and also on the use of literature within the EFL classroom. The need to possess communicative abilities and cultural understanding, in connection with the use of literature, has sparked an interest to investigate if and how literature itself can be used as a tool to develop and improve EFL students’ communicative skills and cultural understanding. This literature review thesis analyzes five international research articles from different geographical parts of the Globe. The findings are categorized, compared, synthesized, and finally discussed in order to answer the research questions asked, and also compared with the English subject syllabus for the Swedish upper secondary school. The findings indicate that the analyzed articles share a consensus, to a varied degree, regarding the positive aspects of literature use in the EFL setting. The arguments are that communicative skills and cultural understanding are intertwined - enabling each other to exist, develop, and improve. One cannot exist fully without the other, and literature is a good tool to use to develop and improve these abilities. Literature can help develop all skills needed to acquire and produce both written and spoken English, and it also enables cultural understanding and a broadening of the mind. Where the articles differ somewhat is in the ideas of why literature is a good tool, how to implement literature in the classrooms, and what some of the negative aspects might be. The thesis also brings the lack of Swedish studies within EFL to the readers’ attention, as well as the need to do more research focusing on the students’ perspectives towards literature use in the EFL setting.