A comprehensive model for measuring real-life cost-effectiveness in eyecare : automation in care and evaluation of system (aces-rwm (TM))

This paper describes a holistic, yet simple and comprehensible, ecosystem model to deal with multiple and complex challenges in eyecare. It aims at producing the best possible wellbeing and eyesight with the available resources. When targeting to improve the real-world cost-effectiveness, what gets done in everyday practice needs be measured routinely, efficiently and unselectively. Collection of all real-world data of all patients will enable evaluation and comparison of eyecare systems and departments between themselves nationally and internationally. The concept advocates a strategy to optimize real-life effectiveness, sustainability and outcomes of the service delivery in ophthalmology. The model consists of three components: (1) resource-governing principles (i.e., to deal with increasing demand and limited resources), (2) real-world monitoring (i.e., to collect structured real-world data utilizing automation and visualization of clinical parameters, health-related quality of life and costs), and (3) digital innovation strategy (i.e., to evaluate and benchmark real-world outcomes and cost-effectiveness). The core value and strength of the model lies in the consensus and collaboration of all Finnish university eye clinics to collect and evaluate the uniformly structured real-world outcomes data. In addition to ophthalmology, the approach is adaptable to any medical discipline to efficiently generate real-world insights and resilience in health systems.Peer reviewe

A comprehensive model for measuring real-life cost-effectiveness in eyecare: automation in care and evaluation of system (aces-rwm™)

This paper describes a holistic, yet simple and comprehensible, ecosystem model to deal with multiple and complex challenges in eyecare. It aims at producing the best possible wellbeing and eyesight with the available resources. When targeting to improve the real-world cost-effectiveness, what gets done in everyday practice needs be measured routinely, efficiently and unselectively. Collection of all real-world data of all patients will enable evaluation and comparison of eyecare systems and departments between themselves nationally and internationally. The concept advocates a strategy to optimize real-life effectiveness, sustainability and outcomes of the service delivery in ophthalmology. The model consists of three components: (1) resource-governing principles (i.e., to deal with increasing demand and limited resources), (2) real-world monitoring (i.e., to collect structured real-world data utilizing automation and visualization of clinical parameters, health-related quality of life and costs), and (3) digital innovation strategy (i.e., to evaluate and benchmark real-world outcomes and cost-effectiveness). The core value and strength of the model lies in the consensus and collaboration of all Finnish university eye clinics to collect and evaluate the uniformly structured real-world outcomes data. In addition to ophthalmology, the approach is adaptable to any medical discipline to efficiently generate real-world insights and resilience in health systems

Ultrathin Polyimide Membrane as Cell Carrier for Subretinal Transplantation of Human Embryonic Stem Cell Derived Retinal Pigment Epithelium

In this study, we investigated the suitability of ultrathin and porous polyimide (PI) membrane as a carrier for subretinal transplantation of human embryonic stem cell (hESC) -derived retinal pigment epithelial (RPE) cells in rabbits. The in vivo effects of hESC-RPE cells were analyzed by subretinal suspension injection into Royal College of Surgeons (RCS) rats. Rat eyes were analyzed with electroretinography (ERG) and histology. After analyzing the surface and permeability properties of PI, subretinal PI membrane transplantations with and without hESC-RPE were performed in rabbits. The rabbits were followed for three months and eyes analyzed with fundus photography, ERG, optical coherence tomography (OCT), and histology. Animals were immunosuppressed with cyclosporine the entire follow-up time. In dystrophic RCS rats, ERG and outer nuclear layer (ONL) thickness showed some rescue after hESC-RPE injection. Cells positive for human antigen were found in clusters under the retina 41 days post-injection but not anymore after 105 days. In rabbits, OCT showed good placement of the PI. However, there was loss of pigmentation on the hESC-RPE-PI over time. In the eyes with PI alone, no obvious signs of inflammation or retinal atrophy were observed. In the presence of hESC-RPE, mononuclear cell infiltration and retinal atrophy were observed around the membranes. The porous ultrathin PI membrane was well-tolerated in the subretinal space and is a promising scaffold for RPE transplantation. However, the rejection of the transplanted cells seems to be a major problem and the given immunosuppression was insufficient for reduction of xenograft induced inflammation.Public Library of Science open acces

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Ambiguous Memorial Landscapes in Post-socialist Cities: The Case of Tirana’s Pyramid

This article is a descriptive study that narrates the history of the so-called “Pyramid” since 1991 and explores why it was never either restored or demolished. The Pyramid is a memorial landscape in Tirana, constructed to commemorate former socialist leader Enver Hoxha. The Pyramid became a landmark building in Tirana and has been recurrently discussed. The Pyramid has survived all discussions, decisions, and plans, but is now in decay. Generating clear answers regarding the continued existence of the Pyramid proved to be arduous, as the Pyramid has been subject to overlapping discourses around architecture and urban design, politics, history, memory, and identity

Hitsausäänen ja sitä vaimentavien kuulonsuojaimien kuunneltava malli

Hitsaajan on tärkeää pystyä arvioimaan ja ohjaamaan työtään hitsauksesta syntyvän äänen avulla. Hitsausympäristö sisältää kuitenkin usein myös muita, häiritseviä sekä mahdollisesti kuuloa vaurioittavia ääniä, joilta pitää suojautua. Kuulonsuojaimien valinnassa voidaan käyttää apuna kehittämäämme kuunneltavaa mallia. Sen avulla voidaan tutkia melun vaikutuksia jo ennen kuulonsuojaimien valintaa ja käyttöä. Sillä voidaan myös kokeilla uudenlaisia kuulonsuojainmalleja, joita ei vielä todellisuudessa ole olemassa, sekä arvioida kuulonsuojauksen vaikutusta huonokuuloisilla henkilöillä. Malli koostuu sekä syntesoiduista että tallennetuista äänistä. Malli toimii tavallisessa kannettavassa tietokoneessa, ja lisäksi siitä on tehty kevyt verkkoversio, jota voi käyttää erilaisilla päätelaitteilla