5 research outputs found
From WIS.2 to Smart Forest – a sustainable forest management decision support system
WIS.2 is a DSS for monitoring and implementing the goal-oriented and sustainable management of forest ecosystems, especially with regard to the integral management of significant spatial and temporal scales in forest ecosystems. WIS.2 considers multiple ecosystem goods and services in silvicultural management and the implementation of silvicultural interventions, which are in accordance with the Swiss silvicultural tradition. WIS.2 takes a top-down approach, starting with the entrepreneurial strategy, and ending at short and mid-term interventions at stand level. WIS.2 structures the overall decision process across multiple scales and provides decision support for each decision to be taken by organizing and connecting available data and models.
WIS.2 is based on MS Access and ArcGIS View and is composed of different applications, each handling a main aspect of the management of forest ecosystems. The tool is used at the level of higher education in forest management in Switzerland. WIS.2, initially developed during 2001-2005 within the framework of a PhD thesis at the ETH in Zurich (Rosset 2005a), has been successively improved through practical use in more than 10 case studies in five Swiss Cantons. The main challenge is now to advance from a prototype to an easily available consolidated IT product
Predictive models of syncope causes in an outpatient clinic
The investigation of unexplained syncope remains a challenging clinical problem. In the present study we sought to evaluate the diagnostic value of a standardized work-up focusing on non invasive tests in patients with unexplained syncope referred to a syncope clinic, and whether certain combinations of clinical parameters are characteristic of rhythmic and reflex causes of syncope. METHODS AND RESULTS: 317 consecutive patients underwent a standardized work-up including a 12-lead ECG, physical examination, detailed history with screening for syncope-related symptoms using a structured questionnaire followed by carotid sinus massage (CSM), and head-up tilt test. Invasive testings including an electrophysiological study and implantation of a loop recorder were only performed in those with structural heart disease or traumatic syncope. Our work-up identified an etiology in 81% of the patients. Importantly, three quarters of the causes were established non invasively combining head-up tilt test, CSM and hyperventilation testing. Invasive tests yielded an additional 7% of diagnoses. Logistic analysis identified age and number of significant prodromes as the only predictive factors of rhythmic syncope. The same two factors, in addition to the duration of the ECG P-wave, were also predictive of vasovagal and psychogenic syncope. These factors, optimally combined in predictive models, showed a high negative and a modest positive predictive value. CONCLUSION: A standardized work-up focusing on non invasive tests allows to establish more than three quarters of syncope causes. Predictive models based on simple clinical parameters may help to distinguish between rhythmic and other causes of syncop