Clinical judgment to estimate pretest probability in the diagnosis of Cushing's syndrome under a Bayesian perspective

OBJECTIVE: To estimate the pretest probability of Cushing's syndrome (CS) diagnosis by a Bayesian approach using intuitive clinical judgment. MATERIALS AND METHODS: Physicians were requested, in seven endocrinology meetings, to answer three questions: "Based on your personal expertise, after obtaining clinical history and physical examination, without using laboratorial tests, what is your probability of diagnosing Cushing's Syndrome?"; "For how long have you been practicing Endocrinology?"; and "Where do you work?". A Bayesian beta regression, using the WinBugs software was employed. RESULTS: We obtained 294 questionnaires. The mean pretest probability of CS diagnosis was 51.6% (95%CI: 48.7-54.3). The probability was directly related to experience in endocrinology, but not with the place of work. CONCLUSION: Pretest probability of CS diagnosis was estimated using a Bayesian methodology. Although pretest likelihood can be context-dependent, experience based on years of practice may help the practitioner to diagnosis CS. Arq Bras Endocrinol Metab. 2012;56(9):633-7

LOCKSS - USP: uma iniciativa de Preservação Digital

LOCKSS e preservação digital no BRASIL. Podemos definir Preservação Digital como o conjunto de atividades ou processos responsáveis por garantir o acesso contínuo a longo-prazo à informação científica, tecnológica e cultural existente em formatos digitais. O projeto LOCKSS (Lot Of Copies Keep Stuff Safe) é um software de código aberto desenvolvido pela Universidade de Stanford, com o intuito de preservar dados digitais. Possui uma abordagem peer-to-peer e garante a integridade e disponibilidade do dos acervos digitais preservados. No Brasil, a Rede Brasileira de Serviços de Preservação Digital, ou Rede Cariniana, é uma iniciativa do Instituto Brasileiro de Informação em Ciência e Tecnologia para a salvaguarda do patrimônio científico, tecnológico e cultural, de forma distribuída, por instituições de pesquisa em parceria com o IBICT. Sua implantação foi fundamentada na utilização do LOCKSS em uma infraestrutura descentralizada, utilizando recursos de computação distribuída .

Aerosols in Amazonia: Natural Biogenic Particles and Large Scale Biomass Burning Impacts.

The Large Scale Biosphere Atmosphere Experiment in Amazonia (LBA) is a long term (20 years) research effort aimed at the understanding of the functioning of the Amazonian ecosystem. In particular, the strong biosphere-atmosphere interaction is a key component looking at the exchange processes between vegetation and the atmosphere, focusing on aerosol particles. Two aerosol components are the most visible: The natural biogenic emissions of aerosols and VOCs, and the biomass burning emissions. A large effort was done to characterize natural biogenic aerosols that showed detailed organic characterization and optical properties. The biomass burning component in Amazonia is important in term of aerosol and trace gases emissions, with deforestation rates decreasing, from 27,000 Km2 in 2004 to about 5,000 Km2 in 2011. Biomass burning emissions in Amazonia increases concentrations of aerosol particles, CO, ozone and other species, and also change the surface radiation balance in a significant way. Long term monitoring of aerosols and trace gases were performed in two sites: a background site in Central Amazonia, 55 Km North of Manaus (called ZF2 ecological reservation) and a monitoring station in Porto Velho, Rondonia state, a site heavily impacted by biomass burning smoke. Several instruments were operated to measured aerosol size distribution, optical properties (absorption and scattering at several wavelengths), composition of organic (OC/EC) and inorganic components among other measurements. AERONET and MODIS measurements from 5 long term sites show a large year-to year variability due to climatic and socio-economic issues. Aerosol optical depths of more than 4 at 550nm was observed frequently over biomass burning areas. In the pristine Amazonian atmosphere, aerosol scattering coefficients ranged between 1 and 200 Mm-1 at 450 nm, while absorption ranged between 1 and 20 Mm-1 at 637 nm. A strong seasonal behavior was observed, with greater aerosol loadings during the dry season (Jul-Nov) as compared to the wet season (Dec-Jun). During the wet season in Manaus, aerosol scattering (450 nm) and absorption (637 nm) coefficients averaged, respectively, 14 and 0.9 Mm-1. Angstrom exponents for scattering were lower during the wet season (1.6) in comparison to the dry season (1.9), which is consistent with the shift from biomass burning aerosols, predominant in the fine mode, to biogenic aerosols, predominant in the coarse mode. Single scattering albedo, calculated at 637 nm, did not show a significant seasonal variation, averaging 0.86. In Porto Velho, even in the wet season it was possible to observe an impact from anthropogenic aerosol. Black Carbon was measured at a high 20 ug/m³ in the dry season, showing strong aerosol absorption. This work presents a general description of the aerosol optical properties in Amazonia, both during the Amazonian wet and dry seasons.

Comparing properties of natural biogenic with biomass burning particles in Amazonia.

The Large Scale Biosphere Atmosphere Experiment in Amazonia (LBA) is a long-term (20 years) research effort aimed at the understanding of the functioning of the Amazonian ecosystem. The strong biosphere-atmosphere interaction is a key component of the ecosystem functioning. Two aerosol components are the most visible: The natural biogenic emissions of particles and VOCs, and the biomass burning emissions. Two aerosol and trace gases monitoring stations were operated for 4 years in Manaus and Porto Velho, two very distinct sites, with different land use change. Manaus is a very clean and pristine site and Porto Velho is representative of heavy land use change in Amazonia. Aerosol composition, optical properties, size distribution, vertical profiling and optical depth were measured from 2008 to 2012. Aerosol radiative forcing was calculated over large areas. It was observed that the natural biogenic aerosol has significant absorption properties. Organic aerosol dominates the aerosol mass with 80 to 95%. Light scattering and light absorption shows an increase by factor of 10 from Manaus to Porto Velho. Very few new particle formation events were observed. Strong links between aerosols and VOC emissions were observed. Aerosol radiative forcing in Rondonia shows a high -15 watts/m² during the dry season of 2010, showing the large impacts of aerosol loading in the Amazonian ecosystem. The increase in diffuse radiation changes the forest carbon uptake by 20 to 35%, a large increase in this important ecosystem.