Hierarchical modelling of timber reference properties using probabilistic methods: Maximum Likelihood Method, Bayesian Methods and Probability Networks

In recent decades, an increased interest has been evidenced in the research on multi-scale hierarchical modelling in the field of mechanics, and also in the field of wood products and timber engineering. One of the main motivations for hierar-chical modelling is to understand how properties, composition and structure at lower scale levels may influence and be used to predict the material properties on a macroscopic and structural engineering scale. This chapter presents the applicability of statistic and probabilistic methods, such as the Maximum Likelihood method and Bayesian methods, in the representation of timber’s mechanical properties and its inference accounting to prior information obtained in different importance scales. These methods allow to analyse distinct timber’s reference properties, such as density, bending stiffness and strength, and hierarchically consider information obtained through different non, semi or destructive tests. The basis and fundaments of the methods are described and also recommendations and limitations are discussed. The methods may be used in several contexts, however require an expert’s knowledge to assess the correct statistic fitting and define the correlation arrangement between properties.

Ambulatory blood pressure monitoring of patients with heart failure: a new prognosis marker

OBJECTIVE: To evaluate the relationship between 24-hour ambulatory arterial blood pressure monitoring and the prognosis of patients with advanced congestive heart failure. METHODS: We studied 38 patients with NYHA functional class IV congestive heart failure, and analyzed left ventricular ejection fraction, diastolic diameter, and ambulatory blood pressure monitoring data. RESULTS: Twelve deaths occurred. Left ventricular ejection fraction (35.2±7.3%) and diastolic diameter (72.2±7.8mm) were not correlated with the survival. The mean 24-hour (SBP24), waking (SBPw), and sleeping (SBPs) systolic pressures of the living patients were higher than those of the deceased patients and were significant for predicting survival. Patients with mean SBP24, SBPv, and SBPs > or = 105mmHg had longer survival (p=0.002, p=0.01 and p=0.0007, respectively). Patients with diastolic blood pressure sleep decrements (dip) and patients with mean blood pressure dip <=6mmHg had longer survival (p=0.04 and p=0.01, respectively). In the multivariate analysis, SBPs was the only variable with an odds ratio of 7.61 (CI: 1.56; 3704) (p=0.01). Patients with mean SBP<105mmHg were 7.6 times more likely to die than those with SBP > or = 105 mmHg CONCLUSION: Ambulatory blood pressure monitoring appears to be a useful method for evaluating patients with congestive heart failure.

Producción de información para las políticas públicas: observatorio de salud mental y derechos humanos en la provincia de córdoba. Documented information and indicators for the pubic policies in mental health: human rights obseratory in córdoba

El problema que enfrenta la institucionalidad estatal argentina es que existe un serio déficit de información no solamente en el momento de evaluar un resultado, sino ya al momento de diseñar la política. Las estadísticas oficiales de hechos vitales, salud y educación son difundidas en el mejor de los casos con un año de atraso. La información de indicadores de salud por su nivel de desagregación no permite conocer las realidades locales. Es posible constatar la falta de información sobre las medidas tomadas para asegurar el cumplimiento de las obligaciones del Estado en lo relativo a políticas y programas de salud mental. Del mismo modo que los organismos internacionales determinan los deficits de los sistemas de atención a la salud mental a través de las brechas de tratamiento y aun cuando no se dispone de estimaciones precisas se habla de brechas de información, que expresarían la distancia entre la información necesaria y la efectivamente disponible (OPS, 2009). Desde el mes de diciembre de 2007 se conforma la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos, con el objeto de instalar en agenda la necesidad de contar con una legislación que brinde el marco normativo para la transformación del sector. En los meses de octubre y noviembre de 2010 se aprobaron sendas leyes de salud mental en la Provincia de Córdoba y a nivel nacional. Ambas proponen la transformación progresiva en los sistemas de atención a los problemas de salud mental de la población. Desde la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos se afirma que la legislación es un marco necesario pero no suficiente, en tanto se constata que las princiales violaciones a los derechos humanos se producen en situaciones concretas. El presente proyecto nace de la necesidad de contar con un sistema de información que permita conocer la transformación de los servicios de salud mental en la provincia de Córdoba a partir de la sanción de la ley 9848 de Salud Mental en el mes de octubre de 2010. Una vez logrado este objetivo legislativo, se pretende monitorear la gestión con la formulación de los siguientes interrogantes: ¿a través de qué indicadores medir, evaluar y monitorear si la producción de los servicios de salud mental se lleva adelante desde la perspectiva del enfoque de derechos sancionada en el marco normativo vigente?; ¿cuáles son los indicadores que desde dicha perspectiva los organismos estatales de producción de servicios deben elaborar para el compromiso de acción y la rendición de cuentas frente a la ciudadanía? ¿cuáles son los indicadores que la ciudadanía debe reclamar a los fines de monitorear el cumplimiento de dichos compromisos? La puesta en marcha del Observatorio de Salud Mental y Derechos Humanos permitirá analizar las políticas y programas de salud mental desde la perspectiva de los derechos humanos y avanzar en el monitoreo de la producción de los servicios de salud mental. Objetivo General: analizar y hacer visible el cumplimiento de los objetivos sancionados en la ley 9848 de Salud Mental a través de la observación, el monitoreo y la incidencia en las políticas de salud mental de la provincia de Córdoba. Metodología: la construcción de indicadores de derechos humanos para la salud mental. El Observatorio de Salud Mental y Derechos Humanos pretende dar cuenta de las transformaciones que van a ocurrir a partir de la sanción de la ley 9848. Los resultados esperados están ligados a la producción y difusión de información sistematizada sobre las transformaciones en salud mental, a la vigilancia y el análisis del efecto/impacto de las políticas e incidir en las decisiones. El Observatorio pretende reconocer e integrar la información disponible y proponer indicadores que den cuenta de la situación inicial al momento de la implementación de los marcos normativos y permitir el monitoreo de las transformaciones emergentes. This project stems from the need for an information system designed to show the transformation of mental health services in the province of Cordoba after the enactment of the Mental Health Act 9848 in October 2010. Once achieved this legislative objective is to monitor the management with the formulation of the following questions: through which indicators to measure, evaluate and monitor whether the production of mental health services are carried forward from the perspective of rights-based approach enacted in two laws?, What are the indicators from that perspective the production agencies should develop services for the commitment to action and accountability to the public? What are the indicators that the public should demand that the purpose of monitoring compliance with these commitments? The launch of the Centre for Mental Health and Human Rights will review the policies and mental health programs from the perspective of human rights and progress in monitoring the production of mental health services. General Objective: to analyze and highlight the achievement of the objectives sanctioned by the Mental Health Act 9848 through the observation, monitoring and impact on mental health policy in the province of Cordoba. Methodology: building human rights indicators for mental health Mental Observatory Health and Human Rights aims to account for the changes that will occur after the enactment of Law 9848. The expected results are linked to production and dissemination of systematic information about changes in mental health, surveillance and analysis of the effect / impact and influence policy decisions. The Centre aims to recognize and integrate the available information and propose indicators that account for the initial situation at the time of implementation of regulatory frameworks and allow monitoring of change emerging.

Evaluation of fish pots as a feasible fishing method in Irish waters, with specific reference to the physiological effects of common and alternate pots on the lesser spotted dogfish (Scyliorhinus canicula).

Finfish pots have emerged as a “responsible” gear, when used in combination with conservational and technical measures to sustain fisheries. Previous trials in Irish waters have offered no published reported data and so three designs tested in the current study provide new information on this gear. The most successful traps in terms of fish catch were rigid steel framed rectangular pots used to target Conger eel. Although commercial yield was low (0.2 per trap haul), potential existed for a viable pot fishery. Deployment and storage of Norwegian floating pots was conducted with relative ease but performance in the water was poor resulting in loss of gear. Catch returns were notable even though effort was restricted as mega-faunal by-catch was a problem, which lead to ending this trial. From these initial trials it was evident that catch rates were low compared to established Norwegian fisheries (3.6 cod per pot), which resulted in the utilisation of pots, already established in the crustacean fishery, to find species readily accessible to pot capture. Although fished and designed differently, these gears provided an opportunity to establish the benefits of pot fishing to fish quality and to determine the effects on by-catch. The fishing effects of three catching methods (pots, angling and trawl) and the effects of air exposure on the physiological status of a common by-catch, the lesser spotted dogfish Scyliorhinus canícula (L.) were examined using a range of physiological biomarkers (plasma catecholamine, glucose, lactate, muscle pH and muscle lactate). Physiological responses of fish to an emersion stress regime resulted in a significant metabolic disturbance in groups, but may not have weakened the overall health of these fish, as signified in the revival of some metabolites. Plasma glucose and lactate concentrations did not however recovery to baseline levels indicating that to achieve an accurate profile, responses should be determined by a suite of biomarkers. Responses did not demonstrate that samples from the pots were significantly less stressed than for the other two methods; angling and trawling, which are in contrast to many other studies. Employment of finfish potting therefore in Irish waters needs further consideration before further promotion as a more responsible method to supplement or replace established techniques.

Cardiac Surgery Costs According to the Preoperative Risk in the Brazilian Public Health System

AbstractBackground:Heart surgery has developed with increasing patient complexity.Objective:To assess the use of resources and real costs stratified by risk factors of patients submitted to surgical cardiac procedures and to compare them with the values reimbursed by the Brazilian Unified Health System (SUS).Method:All cardiac surgery procedures performed between January and July 2013 in a tertiary referral center were analyzed. Demographic and clinical data allowed the calculation of the value reimbursed by the Brazilian SUS. Patients were stratified as low, intermediate and high-risk categories according to the EuroSCORE. Clinical outcomes, use of resources and costs (real costs versus SUS) were compared between established risk groups.Results:Postoperative mortality rates of low, intermediate and high-risk EuroSCORE risk strata showed a significant linear positive correlation (EuroSCORE: 3.8%, 10%, and 25%; p < 0.0001), as well as occurrence of any postoperative complication EuroSCORE: 13.7%, 20.7%, and 30.8%, respectively; p = 0.006). Accordingly, length-of-stay increased from 20.9 days to 24.8 and 29.2 days (p < 0.001). The real cost was parallel to increased resource use according to EuroSCORE risk strata (R$ 27.116,00 ± R$ 13.928,00 versus R$ 34.854,00 ± R$ 27.814,00 versus R$ 43.234,00 ± R$ 26.009,00, respectively; p < 0.001). SUS reimbursement also increased (R$ 14.306,00 ± R$ 4.571,00 versus R$ 16.217,00 ± R$ 7.298,00 versus R$ 19.548,00 ± R$935,00; p < 0.001). However, as the EuroSCORE increased, there was significant difference (p < 0.0001) between the real cost increasing slope and the SUS reimbursement elevation per EuroSCORE risk strata.Conclusion:Higher EuroSCORE was related to higher postoperative mortality, complications, length of stay, and costs. Although SUS reimbursement increased according to risk, it was not proportional to real costs.

Ambulatory Blood Pressure Monitoring: Five Decades of More Light and Less Shadows

Abstract Casual blood pressure measurements have been extensively questioned over the last five decades. A significant percentage of patients have different blood pressure readings when examined in the office or outside it. For this reason, a change in the paradigm of the best manner to assess blood pressure has been observed. The method that has been most widely used is the Ambulatory Blood Pressure Monitoring - ABPM. The method allows recording blood pressure measures in 24 hours and evaluating various parameters such as mean BP, pressure loads, areas under the curve, variations between daytime and nighttime, pulse pressure variability etc. Blood pressure measurements obtained by ABPM are better correlated, for example, with the risks of hypertension. The main indications for ABPM are: suspected white coat hypertension and masked hypertension, evaluation of the efficacy of the antihypertensive therapy in 24 hours, and evaluation of symptoms. There is increasing evidence that the use of ABPM has contributed to the assessment of blood pressure behaviors, establishment of diagnoses, prognosis and the efficacy of antihypertensive therapy. There is no doubt that the study of 24-hour blood pressure behavior and its variations by ABPM has brought more light and less darkness to the field, which justifies the title of this review.

Assessing the structural change of strategic mobility: determinants under hypercompetitive environments

The primary purpose of this exploratory empirical study is to examine the structural stability of a limited number of alternative explanatory factors of strategic change. On the basis of theoretical arguments and prior empirical evidence from two traditional perspectives, we propose an original empirical framework to analyse whether these potential explanatory factors have remained stable over time in a highly turbulent environment. This original question is explored in a particular setting: the population of Spanish private banks. The firms of this industry have experienced a high level of strategic mobility as a consequence of fundamental changes undergone in their environmental conditions over the last two decades (mainly changes related to the new banking and financial regulation process). Our results consistently support that the effect of most explanatory factors of strategic mobility considered did not remain stable over the whole period of analysis. From this point of view, the study sheds new light on major debates and dilemmas in the field of strategy regarding why firms change their competitive patterns over time and, hence, to what extent the "contextdependency" of alternative views of strategic change as their relative validation can vary over time for a given population. Methodologically, this research makes two major contributions to the study of potential determinants of strategic change. First, the definition and measurement of strategic change employing a new grouping method, the Model-based Cluster Method or MCLUST. Second, in order to asses the possible effect of determinants of strategic mobility we have controlled the non-observable heterogeneity using logistic regression models for panel data.

Hausman tests for inefficient estimators: application to demand for health care service (revised)

The Hausman (1978) test is based on the vector of differences of two estimators. It is usually assumed that one of the estimators is fully efficient, since this simplifies calculation of the test statistic. However, this assumption limits the applicability of the test, since widely used estimators such as the generalized method of moments (GMM) or quasi maximum likelihood (QML) are often not fully efficient. This paper shows that the test may easily be implemented, using well-known methods, when neither estimator is efficient. To illustrate, we present both simulation results as well as empirical results for utilization of health care services.

Terrestrial laser scanning for landslides deformation monitoring

Within last few years a new type of instruments called Terrestrial Laser Scanners (TLS) entered to the commercial market. These devices brought a possibility to obtain completely new type of spatial, three dimensional data describing the object of interest. TLS instruments are generating a type of data that needs a special treatment. Appearance of this technique made possible to monitor deformations of very large objects, like investigated here landslides, with new quality level. This change is visible especially with relation to the size and number of the details that can be observed with this new method. Taking into account this context presented here work is oriented on recognition and characterization of raw data received from the TLS instruments as well as processing phases, tools and techniques to do them. Main objective are definition and recognition of the problems related with usage of the TLS data, characterization of the quality single point generated by TLS, description and investigation of the TLS processing approach for landslides deformation measurements allowing to obtain 3D deformation characteristic and finally validation of the obtained results. The above objectives are based on the bibliography studies and research work followed by several experiments that will prove the conclusions.

Bioluminescent sensor proteins for point-of-care therapeutic drug monitoring.

For many drugs, finding the balance between efficacy and toxicity requires monitoring their concentrations in the patient's blood. Quantifying drug levels at the bedside or at home would have advantages in terms of therapeutic outcome and convenience, but current techniques require the setting of a diagnostic laboratory. We have developed semisynthetic bioluminescent sensors that permit precise measurements of drug concentrations in patient samples by spotting minimal volumes on paper and recording the signal using a simple point-and-shoot camera. Our sensors have a modular design consisting of a protein-based and a synthetic part and can be engineered to selectively recognize a wide range of drugs, including immunosuppressants, antiepileptics, anticancer agents and antiarrhythmics. This low-cost point-of-care method could make therapies safer, increase the convenience of doctors and patients and make therapeutic drug monitoring available in regions with poor infrastructure.

Structural analysis of Turtle mountain (Alberta) using digital elevation model: Toward a progressive failure

In 1903, the eastern slope of Turtle Mountain (Alberta) was affected by a 30 M m3-rockslide named Frank Slide that resulted in more than 70 casualties. Assuming that the main discontinuity sets, including bedding, control part of the slope morphology, the structural features of Turtle Mountain were investigated using a digital elevation model (DEM). Using new landscape analysis techniques, we have identified three main joint and fault sets. These results are in agreement with those sets identified through field observations. Landscape analysis techniques, using a DEM, confirm and refine the most recent geology model of the Frank Slide. The rockslide was initiated along bedding and a fault at the base of the slope and propagated up slope by a regressive process following a surface composed of pre-existing discontinuities. The DEM analysis also permits the identification of important geological structures along the 1903 slide scar. Based on the so called Sloping Local Base Level (SLBL) an estimation was made of the present unstable volumes in the main scar delimited by the cracks, and around the south area of the scar (South Peak). The SLBL is a method permitting a geometric interpretation of the failure surface based on a DEM. Finally we propose a failure mechanism permitting the progressive failure of the rock mass that considers gentle dipping wedges (30°). The prisms or wedges defined by two discontinuity sets permit the creation of a failure surface by progressive failure. Such structures are more commonly observed in recent rockslides. This method is efficient and is recommended as a preliminary analysis prior to field investigation.

Effort, reward and self-reported mental health: a simulation study on negative affectivity bias.

Background : In the present article, we propose an alternative method for dealing with negative affectivity (NA) biases in research, while investigating the association between a deleterious psychosocial environment at work and poor mental health. First, we investigated how strong NA must be to cause an observed correlation between the independent and dependent variables. Second, we subjectively assessed whether NA can have a large enough impact on a large enough number of subjects to invalidate the observed correlations between dependent and independent variables.Methods : We simulated 10,000 populations of 300 subjects each, using the marginal distribution of workers in an actual population that had answered the Siegrist's questionnaire on effort and reward imbalance (ERI) and the General Health Questionnaire (GHQ).Results : The results of the present study suggested that simulated NA has a minimal effect on the mean scores for effort and reward. However, the correlations between the effort and reward imbalance (ERI) ratio and the GHQ score might be important, even in simulated populations with a limited NA.Conclusions : When investigating the relationship between the ERI ratio and the GHQ score, we suggest the following rules for the interpretation of the results: correlations with an explained variance of 5% and below should be considered with caution; correlations with an explained variance between 5% and 10% may result from NA, although this effect does not seem likely; and correlations with an explained variance of 10% and above are not likely to be the result of NA biases. [Authors]

Le Q-sort, un outil pour la recherche en soins le cas des représentations chez les infirmiers en psychiatrie de l'âge avancé [Q-sort, a useful research method in care in cases of psychiatric nursing of the aged]

Q-sort is a research method which allows defining profiles of attitudes toward a set of statements, ordered in relation to each other. Pertaining to the Q Methodology, the qualitative analysis of the Q-sorts is based on quantitative techniques. This method is of particular interest for research in health professions, a field in which attitudes of patients and professionals are very important. The method is presented in this article, along with an example of application in nursing in old age psychiatry.

How reliable is the monitoring of permanent vegetation plots? A test with multiple observers

Questions: A multiple plot design was developed for permanent vegetation plots. How reliable are the different methods used in this design and which changes can we measure? Location: Alpine meadows (2430 m a.s.l.) in the Swiss Alps. Methods: Four inventories were obtained from 40 m(2) plots: four subplots (0.4 m(2)) with a list of species, two 10m transects with the point method (50 points on each), one subplot (4 m2) with a list of species and visual cover estimates as a percentage and the complete plot (40 m(2)) with a list of species and visual estimates in classes. This design was tested by five to seven experienced botanists in three plots. Results: Whatever the sampling size, only 45-63% of the species were seen by all the observers. However, the majority of the overlooked species had cover < 0.1%. Pairs of observers overlooked 10-20% less species than single observers. The point method was the best method for cover estimate, but it took much longer than visual cover estimates, and 100 points allowed for the monitoring of only a very limited number of species. The visual estimate as a percentage was more precise than classes. Working in pairs did not improve the estimates, but one botanist repeating the survey is more reliable than a succession of different observers. Conclusion: Lists of species are insufficient for monitoring. It is necessary to add cover estimates to allow for subsequent interpretations in spite of the overlooked species. The choice of the method depends on the available resources: the point method is time consuming but gives precise data for a limited number of species, while visual estimates are quick but allow for recording only large changes in cover. Constant pairs of observers improve the reliability of the records.

Measuring Avoidable Health Inequality with Realization of Conditional Potential Life Years (RCPLY)

In a series of papers (Tang, Chin and Rao, 2008; and Tang, Petrie and Rao 2006 & 2007), we have tried to improve on a mortality-based health status indicator, namely age-at-death (AAD), and its associated health inequality indicators that measure the distribution of AAD. The main contribution of these papers is to propose a frontier method to separate avoidable and unavoidable mortality risks. This has facilitated the development of a new indicator of health status, namely the Realization of Potential Life Years (RePLY). The RePLY measure is based on the concept of a “frontier country” that, by construction, has the lowest mortality risks for each age-sex group amongst all countries. The mortality rates of the frontier country are used as a proxy for the unavoidable mortality rates, and the residual between the observed mortality rates and the unavoidable mortality rates are considered as avoidable morality rates. In this approach, however, countries at different levels of development are benchmarked against the same frontier country without considering their heterogeneity. The main objective of the current paper is to control for national resources in estimating (conditional) unavoidable and avoidable mortality risks for individual countries. This allows us to construct a new indicator of health status – Realization of Conditional Potential Life Years (RCPLY). The paper presents empirical results from a dataset of life tables for 167 countries from the year 2000, compiled and updated by the World Health Organization. Measures of national average health status and health inequality based on RePLY and RCPLY are presented and compared.