Mecánica ventricular izquierda en pacientes con infarto agudo del miocardio

RESUMEN Introducción El papel de las nuevas técnicas ecocardiográficas para el diagnóstico de infarto agudo del miocardio se encuentra en desarrollo y la realización de mecánica ventricular izquierda podría sugerir la presencia de enfermedad coronaria hemodinámicamente significativa. Objetivos Determinar si en pacientes con infarto agudo del miocardio la medición de strain longitudinal global y regional sirve para predecir la presencia de enfermedad coronaria significativa. Métodos Es un estudio de pruebas diagnósticas en el que se evaluaron las características operativas de la mecánica ventricular izquierda para la detección de enfermedad coronaria significativa comparado contra el cateterismo cardiaco, considerado el patrón de oro. Se analizaron 54 pacientes con infarto agudo del miocardio llevados a cateterismo cardiaco, a quienes se les realizó un ecocardiograma transtorácico con medición de strain longitudinal global y regional. Resultados De los 54 pacientes analizados, el 83% tenía enfermedad coronaria significativa. El hallazgo de un strain longitudinal global < -17.5 tuvo una sensibilidad del 85% y una especificidad del 78% para predecir la presencia de enfermedad coronaria; para la arteria descendente anterior un strain longitudinal regional < – 17.4 tuvo una sensibilidad de 82% y una especificidad de 44%, para la arteria circunfleja una sensibilidad del 87% y una especificidad del 37% y para la arteria coronaria derecha una sensibilidad de 73% y una especificidad de 32%. Conclusiones La realización de ecocardiografía con mecánica ventricular en pacientes con infarto agudo del miocardio es útil para predecir la presencia de enfermedad coronaria hemodinámicamente significativa.

Aplicació en línia d'un sistema variable de control multivariable en un Reactor ..

L’objecte del present treball és la realització d’una aplicació que permeti portar a terme el control estadístic multivariable en línia d’una planta SBR. Aquesta eina ha de permetre realitzar un anàlisi estadístic multivariable complet del lot en procés, de l’últim lot finalitzat i de la resta de lots processats a la planta. L’aplicació s’ha de realitzar en l’entorn LabVIEW. L’elecció d’aquest programa ve condicionada per l’actualització del mòdul de monitorització de la planta que s’està desenvolupant en aquest mateix entorn

Estudio de la aplicación de sistemas basados en el conocimiento a la operación de una planta de tratamiento de residuos sólidos urbanos por valorización energética

Una de las actuaciones posibles para la gestión de los residuos sólidos urbanos es la valorización energética, es decir la incineración con recuperación de energía. Sin embargo es muy importante controlar adecuadamente el proceso de incineración para evitar en lo posible la liberación de sustancias contaminantes a la atmósfera que puedan ocasionar problemas de contaminación industrial.Conseguir que tanto el proceso de incineración como el tratamiento de los gases se realice en condiciones óptimas presupone tener un buen conocimiento de las dependencias entre las variables de proceso. Se precisan métodos adecuados de medida de las variables más importantes y tratar los valores medidos con modelos adecuados para transformarlos en magnitudes de mando. Un modelo clásico para el control parece poco prometedor en este caso debido a la complejidad de los procesos, la falta de descripción cuantitativa y la necesidad de hacer los cálculos en tiempo real. Esto sólo se puede conseguir con la ayuda de las modernas técnicas de proceso de datos y métodos informáticos, tales como el empleo de técnicas de simulación, modelos matemáticos, sistemas basados en el conocimiento e interfases inteligentes. En [Ono, 1989] se describe un sistema de control basado en la lógica difusa aplicado al campo de la incineración de residuos urbanos. En el centro de investigación FZK de Karslruhe se están desarrollando aplicaciones que combinan la lógica difusa con las redes neuronales [Jaeschke, Keller, 1994] para el control de la planta piloto de incineración de residuos TAMARA. En esta tesis se plantea la aplicación de un método de adquisición de conocimiento para el control de sistemas complejos inspirado en el comportamiento humano. Cuando nos encontramos ante una situación desconocida al principio no sabemos como actuar, salvo por la extrapolación de experiencias anteriores que puedan ser útiles. Aplicando procedimientos de prueba y error, refuerzo de hipótesis, etc., vamos adquiriendo y refinando el conocimiento, y elaborando un modelo mental. Podemos diseñar un método análogo, que pueda ser implementado en un sistema informático, mediante el empleo de técnicas de Inteligencia Artificial.Así, en un proceso complejo muchas veces disponemos de un conjunto de datos del proceso que a priori no nos dan información suficientemente estructurada para que nos sea útil. Para la adquisición de conocimiento pasamos por una serie de etapas: - Hacemos una primera selección de cuales son las variables que nos interesa conocer. - Estado del sistema. En primer lugar podemos empezar por aplicar técnicas de clasificación (aprendizaje no supervisado) para agrupar los datos y obtener una representación del estado de la planta. Es posible establecer una clasificación, pero normalmente casi todos los datos están en una sola clase, que corresponde a la operación normal. Hecho esto y para refinar el conocimiento utilizamos métodos estadísticos clásicos para buscar correlaciones entre variables (análisis de componentes principales) y así poder simplificar y reducir la lista de variables. - Análisis de las señales. Para analizar y clasificar las señales (por ejemplo la temperatura del horno) es posible utilizar métodos capaces de describir mejor el comportamiento no lineal del sistema, como las redes neuronales. Otro paso más consiste en establecer relaciones causales entre las variables. Para ello nos sirven de ayuda los modelos analíticos - Como resultado final del proceso se pasa al diseño del sistema basado en el conocimiento. El objetivo principal es aplicar el método al caso concreto del control de una planta de tratamiento de residuos sólidos urbanos por valorización energética. En primer lugar, en el capítulo 2 Los residuos sólidos urbanos, se trata el problema global de la gestión de los residuos, dando una visión general de las diferentes alternativas existentes, y de la situación nacional e internacional en la actualidad. Se analiza con mayor detalle la problemática de la incineración de los residuos, poniendo especial interés en aquellas características de los residuos que tienen mayor importancia de cara al proceso de combustión.En el capítulo 3, Descripción del proceso, se hace una descripción general del proceso de incineración y de los distintos elementos de una planta incineradora: desde la recepción y almacenamiento de los residuos, pasando por los distintos tipos de hornos y las exigencias de los códigos de buena práctica de combustión, el sistema de aire de combustión y el sistema de humos. Se presentan también los distintos sistemas de depuración de los gases de combustión, y finalmente el sistema de evacuación de cenizas y escorias.El capítulo 4, La planta de tratamiento de residuos sólidos urbanos de Girona, describe los principales sistemas de la planta incineradora de Girona: la alimentación de residuos, el tipo de horno, el sistema de recuperación de energía, y el sistema de depuración de los gases de combustión Se describe también el sistema de control, la operación, los datos de funcionamiento de la planta, la instrumentación y las variables que son de interés para el control del proceso de combustión.En el capítulo 5, Técnicas utilizadas, se proporciona una visión global de los sistemas basados en el conocimiento y de los sistemas expertos. Se explican las diferentes técnicas utilizadas: redes neuronales, sistemas de clasificación, modelos cualitativos, y sistemas expertos, ilustradas con algunos ejemplos de aplicación.Con respecto a los sistemas basados en el conocimiento se analizan en primer lugar las condiciones para su aplicabilidad, y las formas de representación del conocimiento. A continuación se describen las distintas formas de razonamiento: redes neuronales, sistemas expertos y lógica difusa, y se realiza una comparación entre ellas. Se presenta una aplicación de las redes neuronales al análisis de series temporales de temperatura.Se trata también la problemática del análisis de los datos de operación mediante técnicas estadísticas y el empleo de técnicas de clasificación. Otro apartado está dedicado a los distintos tipos de modelos, incluyendo una discusión de los modelos cualitativos.Se describe el sistema de diseño asistido por ordenador para el diseño de sistemas de supervisión CASSD que se utiliza en esta tesis, y las herramientas de análisis para obtener información cualitativa del comportamiento del proceso: Abstractores y ALCMEN. Se incluye un ejemplo de aplicación de estas técnicas para hallar las relaciones entre la temperatura y las acciones del operador. Finalmente se analizan las principales características de los sistemas expertos en general, y del sistema experto CEES 2.0 que también forma parte del sistema CASSD que se ha utilizado.El capítulo 6, Resultados, muestra los resultados obtenidos mediante la aplicación de las diferentes técnicas, redes neuronales, clasificación, el desarrollo de la modelización del proceso de combustión, y la generación de reglas. Dentro del apartado de análisis de datos se emplea una red neuronal para la clasificación de una señal de temperatura. También se describe la utilización del método LINNEO+ para la clasificación de los estados de operación de la planta.En el apartado dedicado a la modelización se desarrolla un modelo de combustión que sirve de base para analizar el comportamiento del horno en régimen estacionario y dinámico. Se define un parámetro, la superficie de llama, relacionado con la extensión del fuego en la parrilla. Mediante un modelo linealizado se analiza la respuesta dinámica del proceso de incineración. Luego se pasa a la definición de relaciones cualitativas entre las variables que se utilizan en la elaboración de un modelo cualitativo. A continuación se desarrolla un nuevo modelo cualitativo, tomando como base el modelo dinámico analítico.Finalmente se aborda el desarrollo de la base de conocimiento del sistema experto, mediante la generación de reglas En el capítulo 7, Sistema de control de una planta incineradora, se analizan los objetivos de un sistema de control de una planta incineradora, su diseño e implementación. Se describen los objetivos básicos del sistema de control de la combustión, su configuración y la implementación en Matlab/Simulink utilizando las distintas herramientas que se han desarrollado en el capítulo anterior.Por último para mostrar como pueden aplicarse los distintos métodos desarrollados en esta tesis se construye un sistema experto para mantener constante la temperatura del horno actuando sobre la alimentación de residuos.Finalmente en el capítulo Conclusiones, se presentan las conclusiones y resultados de esta tesis.

Spatial covariation of Azotobacter abundance and soil properties: A case study using the wavelet transform

The soil microflora is very heterogeneous in its spatial distribution. The origins of this heterogeneity and its significance for soil function are not well understood. A problem for understanding spatial variation better is the assumption of statistical stationarity that is made in most of the statistical methods used to assess it. These assumptions are made explicit in geostatistical methods that have been increasingly used by soil biologists in recent years. Geostatistical methods are powerful, particularly for local prediction, but they require the assumption that the variability of a property of interest is spatially uniform, which is not always plausible given what is known about the complexity of the soil microflora and the soil environment. We have used the wavelet transform, a relatively new innovation in mathematical analysis, to investigate the spatial variation of abundance of Azotobacter in the soil of a typical agricultural landscape. The wavelet transform entails no assumptions of stationarity and is well suited to the analysis of variables that show intermittent or transient features at different spatial scales. In this study, we computed cross-variograms of Azotobacter abundance with the pH, water content and loss on ignition of the soil. These revealed scale-dependent covariation in all cases. The wavelet transform also showed that the correlation of Azotobacter abundance with all three soil properties depended on spatial scale, the correlation generally increased with spatial scale and was only significantly different from zero at some scales. However, the wavelet analysis also allowed us to show how the correlation changed across the landscape. For example, at one scale Azotobacter abundance was strongly correlated with pH in part of the transect, and not with soil water content, but this was reversed elsewhere on the transect. The results show how scale-dependent variation of potentially limiting environmental factors can induce a complex spatial pattern of abundance in a soil organism. The geostatistical methods that we used here make assumptions that are not consistent with the spatial changes in the covariation of these properties that our wavelet analysis has shown. This suggests that the wavelet transform is a powerful tool for future investigation of the spatial structure and function of soil biota. (c) 2006 Elsevier Ltd. All rights reserved.

Solar induced climate effects

Solar electromagnetic radiation powers Earth’s climate system and, consequently, it is often naively assumed that changes in this solar output must be responsible for changes in Earth’s climate. However, the Sun is close to a blackbody radiator and so emits according to its surface temperature and the huge thermal time constant of the outer part of the Sun limits the variability in surface temperature and hence output. As a result, on all timescales of interest, changes in total power output are limited to small changes in effective surface temperature (associated with magnetic fields) and potential, although as yet undetected, solar radius variations. Larger variations are seen in the UV part of the spectrum which is emitted from the lower solar atmosphere (the chromosphere) and which influences Earth’s stratosphere. There is interest in“top-down” mechanisms whereby solar UV irradiance modulates stratospheric temperatures and winds which, in turn, may influence the underlying troposphere where Earth’s climate and weather reside. This contrasts with “bottom-up” effects in which the small total solar irradiance (dominated by the visible and near-IR) variations cause surface temperature changes which drive atmospheric circulations. In addition to these electromagnetic outputs, the Sun modulates energetic particle fluxes incident on the Earth. Solar Energetic Particles (SEP) are emitted by solar flares and from the shock fronts ahead of supersonic (and super-Alfvenic) ejections of material from the solar atmosphere. These SEPs enhance the destruction of polar stratospheric ozone which could be an additional form of top-down climate forcing. Even more energetic are Galactic Cosmic Rays (GCRs). These particles are not generated by the Sun, rather they originate at the shock fronts emanating from violent galactic events such as supernovae explosions; however, the expansion of the solar magnetic field into interplanetary space means that the Sun modulates the number of GCRs reaching Earth. These play a key role in enabling Earth’s global electric (thunderstorm) circuit and it has been proposed that they also modulate the formation of clouds. Both electromagnetic and corpuscular solar effects are known to vary over the solar magnetic cycle which is typically between 10 and 14 yrs in length (with an average close to 11 yrs). The solar magnetic field polarity at any one phase of one of these activity cycles is opposite to that at the same phase of the next cycle and this influences some phenomena, for example GCRs, which therefore show a 22 yr (“Hale”) cycle on average. Other phenomena, such as irradiance modulation, do not depend on the polarity of the magnetic field and so show only the basic 11-yr activity cycle. However, any effects on climate are much more significant for solar drifts over centennial timescales. This chapter discusses and evaluates potential effects on Earth’s climate system of variations in these solar inputs. Because of the great variety of proposed mechanisms, the wide range of timescales studied (from days to millennia) and the many debates (often triggered by the application of inadequate statistical methods), the literature on this subject is vast, complex, divergent and rapidly changing: consequently the number of references cited in this review is very large (yet still only a small fraction of the total).

Revisiting youden’s index as a useful measure of the misclassification error in meta-analysis of diagnostic studies

The paper considers meta-analysis of diagnostic studies that use a continuous score for classification of study participants into healthy or diseased groups. Classification is often done on the basis of a threshold or cut-off value, which might vary between studies. Consequently, conventional meta-analysis methodology focusing solely on separate analysis of sensitivity and specificity might be confounded by a potentially unknown variation of the cut-off value. To cope with this phenomena it is suggested to use, instead, an overall estimate of the misclassification error previously suggested and used as Youden’s index and; furthermore, it is argued that this index is less prone to between-study variation of cut-off values. A simple Mantel–Haenszel estimator as a summary measure of the overall misclassification error is suggested, which adjusts for a potential study effect. The measure of the misclassification error based on Youden’s index is advantageous in that it easily allows an extension to a likelihood approach, which is then able to cope with unobserved heterogeneity via a nonparametric mixture model. All methods are illustrated at hand of an example on a diagnostic meta-analysis on duplex doppler ultrasound, with angiography as the standard for stroke prevention.

Food scares and trust: A European study

The complex interactions between the determinants of food purchase under risk are explored using the SPARTA model, based on the theory of planned behaviour, and estimated through a combination of multivariate statistical techniques. The application investigates chicken consumption choices in two scenarios: ( a) a 'standard' purchasing situation; and (b) following a hypothetical Salmonella scare. The data are from a nationally representative survey of 2,725 respondents from five European countries: France, Germany, Italy, the Netherlands and the United Kingdom. Results show that the effects and interactions of behavioural determinants vary significantly within Europe. Only in the case of a food scare do risk perceptions and trust come into play. The policy priority should be on building and maintaining trust in food and health authorities and research institutions, while food chain actors could mitigate the consequences of a food scare through public trust. No relationship is found between socio-demographic variables and consumer trust in food safety information.

Revisiting proportion estimators

Proportion estimators are quite frequently used in many application areas. The conventional proportion estimator (number of events divided by sample size) encounters a number of problems when the data are sparse as will be demonstrated in various settings. The problem of estimating its variance when sample sizes become small is rarely addressed in a satisfying framework. Specifically, we have in mind applications like the weighted risk difference in multicenter trials or stratifying risk ratio estimators (to adjust for potential confounders) in epidemiological studies. It is suggested to estimate p using the parametric family (see PDF for character) and p(1 - p) using (see PDF for character), where (see PDF for character). We investigate the estimation problem of choosing c 0 from various perspectives including minimizing the average mean squared error of (see PDF for character), average bias and average mean squared error of (see PDF for character). The optimal value of c for minimizing the average mean squared error of (see PDF for character) is found to be independent of n and equals c = 1. The optimal value of c for minimizing the average mean squared error of (see PDF for character) is found to be dependent of n with limiting value c = 0.833. This might justifiy to use a near-optimal value of c = 1 in practice which also turns out to be beneficial when constructing confidence intervals of the form (see PDF for character).

Mixture models for capture-recapture count data

The contribution investigates the problem of estimating the size of a population, also known as the missing cases problem. Suppose a registration system is targeting to identify all cases having a certain characteristic such as a specific disease (cancer, heart disease, ...), disease related condition (HIV, heroin use, ...) or a specific behavior (driving a car without license). Every case in such a registration system has a certain notification history in that it might have been identified several times (at least once) which can be understood as a particular capture-recapture situation. Typically, cases are left out which have never been listed at any occasion, and it is this frequency one wants to estimate. In this paper modelling is concentrating on the counting distribution, e.g. the distribution of the variable that counts how often a given case has been identified by the registration system. Besides very simple models like the binomial or Poisson distribution, finite (nonparametric) mixtures of these are considered providing rather flexible modelling tools. Estimation is done using maximum likelihood by means of the EM algorithm. A case study on heroin users in Bangkok in the year 2001 is completing the contribution.

Human language as a culturally transmitted replicator

Human languages form a distinct and largely independent class of cultural replicators with behaviour and fidelity that can rival that of genes. Parallels between biological and linguistic evolution mean that statistical methods inspired by phylogenetics and comparative biology are being increasingly applied to study language. Phylogenetic trees constructed from linguistic elements chart the history of human cultures, and comparative studies reveal surprising and general features of how languages evolve, including patterns in the rates of evolution of language elements and social factors that influence temporal trends of language evolution. For many comparative questions of anthropology and human behavioural ecology, historical processes estimated from linguistic phylogenies may be more relevant than those estimated from genes.

Revisiting Youden's index as a useful measure of the misclassification error in meta-analysis of diagnostic studies

The paper considers meta-analysis of diagnostic studies that use a continuous Score for classification of study participants into healthy, or diseased groups. Classification is often done on the basis of a threshold or cut-off value, which might vary between Studies. Consequently, conventional meta-analysis methodology focusing solely on separate analysis of sensitivity and specificity might he confounded by a potentially unknown variation of the cut-off Value. To cope with this phenomena it is suggested to use, instead an overall estimate of the misclassification error previously suggested and used as Youden's index and; furthermore, it is argued that this index is less prone to between-study variation of cut-off values. A simple Mantel-Haenszel estimator as a summary measure of the overall misclassification error is suggested, which adjusts for a potential study effect. The measure of the misclassification error based on Youden's index is advantageous in that it easily allows an extension to a likelihood approach, which is then able to cope with unobserved heterogeneity via a nonparametric mixture model. All methods are illustrated at hand of an example on a diagnostic meta-analysis on duplex doppler ultrasound, with angiography as the standard for stroke prevention.

An approximate Bayesian computation approach to overcome biases that arise when using amplified fragment length polymorphism markers to study population structure

There is great interest in using amplified fragment length polymorphism (AFLP) markers because they are inexpensive and easy to produce. It is, therefore, possible to generate a large number of markers that have a wide coverage of species genotnes. Several statistical methods have been proposed to study the genetic structure using AFLP's but they assume Hardy-Weinberg equilibrium and do not estimate the inbreeding coefficient, F-IS. A Bayesian method has been proposed by Holsinger and colleagues that relaxes these simplifying assumptions but we have identified two sources of bias that can influence estimates based on these markers: (i) the use of a uniform prior on ancestral allele frequencies and (ii) the ascertainment bias of AFLP markers. We present a new Bayesian method that avoids these biases by using an implementation based on the approximate Bayesian computation (ABC) algorithm. This new method estimates population-specific F-IS and F-ST values and offers users the possibility of taking into account the criteria for selecting the markers that are used in the analyses. The software is available at our web site (http://www-leca.uif-grenoble.fi-/logiciels.htm). Finally, we provide advice on how to avoid the effects of ascertainment bias.

Bayesian design and conduct of phase II single-arm clinical trials with binary outcomes: a tutorial

The aim of phase II single-arm clinical trials of a new drug is to determine whether it has sufficient promising activity to warrant its further development. For the last several years Bayesian statistical methods have been proposed and used. Bayesian approaches are ideal for earlier phase trials as they take into account information that accrues during a trial. Predictive probabilities are then updated and so become more accurate as the trial progresses. Suitable priors can act as pseudo samples, which make small sample clinical trials more informative. Thus patients have better chances to receive better treatments. The goal of this paper is to provide a tutorial for statisticians who use Bayesian methods for the first time or investigators who have some statistical background. In addition, real data from three clinical trials are presented as examples to illustrate how to conduct a Bayesian approach for phase II single-arm clinical trials with binary outcomes.

Multimodal semantic-associative collateral labelling and indexing of still images

A novel framework for multimodal semantic-associative collateral image labelling, aiming at associating image regions with textual keywords, is described. Both the primary image and collateral textual modalities are exploited in a cooperative and complementary fashion. The collateral content and context based knowledge is used to bias the mapping from the low-level region-based visual primitives to the high-level visual concepts defined in a visual vocabulary. We introduce the notion of collateral context, which is represented as a co-occurrence matrix, of the visual keywords, A collaborative mapping scheme is devised using statistical methods like Gaussian distribution or Euclidean distance together with collateral content and context-driven inference mechanism. Finally, we use Self Organising Maps to examine the classification and retrieval effectiveness of the proposed high-level image feature vector model which is constructed based on the image labelling results.