1,610 research outputs found
Managing Cushing's disease: the state of the art.
Cushing's disease is a rare chronic disease caused by a pituitary adenoma, which leads to excess secretion of adrenocorticotropic hormone (ACTH). The over-production of ACTH leads to hyperstimulation of the adrenal glands and a chronic excess of cortisol, resulting in the signs and symptoms of a severe clinical state (Cushing's syndrome) that leads to significant morbidity, negative impacts on the patient's quality of life, and, if untreated, increased mortality. The management of patients with Cushing's disease is complicated by the heterogeneity of the condition, with signs and symptoms that overlap with those of other diseases, and high subclinical incidence rates. Controversies surrounding the tests used for screening and identifying patients with Cushing's disease add to the challenge of patient management. Surgical intervention to remove the adenoma is the first-line treatment for patients with Cushing's disease, but medical therapies are useful in patients who relapse or are unsuitable for surgery. The recent introduction of pasireotide, the first pituitary-directed medical therapy, expands the number of treatment options available for patients with Cushing's disease. This state-of-the-art review aims to provide an overview of the most recent scientific research and clinical information regarding Cushing's disease. Continuing research into improving the diagnosis and treatment of Cushing's disease will help to optimize patient management
Using phone features to improve dialogue state tracking generalisation to unseen states
The generalisation of dialogue state tracking
to unseen dialogue states can be very
challenging. In a slot-based dialogue system,
dialogue states lie in discrete space
where distances between states cannot be
computed. Therefore, the model parameters
to track states unseen in the training
data can only be estimated from more general
statistics, under the assumption that
every dialogue state will have the same underlying
state tracking behaviour. However,
this assumption is not valid. For example,
two values, whose associated concepts
have different ASR accuracy, may
have different state tracking performance.
Therefore, if the ASR performance of the
concepts related to each value can be estimated,
such estimates can be used as general
features. The features will help to relate
unseen dialogue states to states seen
in the training data with similar ASR performance.
Furthermore, if two phonetically
similar concepts have similar ASR
performance, the features extracted from
the phonetic structure of the concepts can
be used to improve generalisation. In
this paper, ASR and phonetic structurerelated
features are used to improve the
dialogue state tracking generalisation to
unseen states of an environmental control
system developed for dysarthric speakers
Recommended from our members
Towards end-to-end multi-domain dialogue modelling
This work was funded by a Google Faculty Re-
search Award (RG91111), an EPSRC studentship
(RG80792), an EPSRC grant (EP/M018946/1)
and by Toshiba Research Europe Ltd, Cam-
bridge Research Laboratory (RG85875
Statistical downscaling in Chile: selection of large-scale predictors and climate change projections
Variation of larval size and adult emergence period of Boyeria irene (Fonscolombe, 1838) (Odonata: Aeshnidae) in the Francia River of western Spain
Boyeria irene (Fonscolombe, 1838) is a large dragonfly common in rivers and streams in southern Europe, but it is little known about the biometrical variations of their populations. In this paper, we test whether the time of the emergence period of this species differs in the same river, whether the larval size varies during the emergence period, and whether the distinct size variations are associated with the different river sections. Results have revealed that 1) female exuviae are larger than those of males, 2) except for the paraproct length, the exuviae have similar size across the entire river length, 3) size of the exuviae is larger in the first period of
emergence than in the second one. A difference in emergence duration across the three river sections has been recorded.info:eu-repo/semantics/publishedVersio
Climate change scenarios in use: heat stress in Switzerland
Under hot conditions the human body is able to regulate its core temperature via sweat evaporation, but this ability is reduced when air humidity is high. These conditions of high temperature and high humidity invoke heat stress which is a major problem for humans, in particular for vulnerable groups of the population and people under physical stress (e.g. heavy duty work without appropriate cooling systems). It is generally expected that the frequency, duration and magnitude of such unfavorable conditions will increase with further climate warming. In this respect, climate services play a crucial role by putting together climatological information and adaptation solutions to reduce future heat stress. We here assess the recently developed CH2018 scenarios for Switzerland (https://www.climate-scenarios.ch) in terms of heat stress conditions including their future projections. For this purpose, we characterize future extreme heat conditions with the use of climate analogs. By doing so, we attempt to produce more accessible climate information which might foster the use and understanding of regional-scale climate scenarios.
Here heat stress is expressed through the Wet Bulb Temperature (TW), which is a relatively simple proxy for heat stress on the human body and which depends non-linearly on temperature and humidity. It is assessed in terms of single-day events and heat stress spells. Projections based on the CH2018 scenarios indicate increasing heat stress over Switzerland, which is accentuated towards the end of the century. High heat stress conditions might be about 3?5 times more frequent for an emission scenario without mitigation (RCP 8.5) than for the mitigation scenario (RCP 2.6) by the end of the 21st century. The projected increase of heat stress results in more and longer heat stress spells, thus highlighting the importance of timely and precise prevention strategies in the context of heat-health action plans. Spatial climate analogs based on heat stress spells in Switzerland greatly vary depending on the emission scenario and are found in Central Europe under a mitigation scenario and in southern Europe under unmitigated warming.Financial support for this work is provided by the HEAT-SHIELD Project (European Commission HORIZON 2020, research and innovation programme under the grant agreement 668786). A.C. acknowledges support from Project COMPOUND (TED2021-131334A-I00) funded by MCIN/AEI/10.13039/501100011033 and by the European Union NextGenerationEU/PRTR
Evaluation of bias correction methods for a multivariate drought index: case study of the Upper Jhelum Basin
Bias correction (BC) is often a necessity to improve the applicability of
global and regional climate model (GCM and RCM, respectively) outputs to
impact assessment studies, which usually depend on multiple potentially
dependent variables. To date, various BC methods have been developed which
adjust climate variables separately (univariate BC) or jointly (multivariate
BC) prior to their application in impact studies (i.e., the component-wise
approach). Another possible approach is to first calculate the multivariate
hazard index from the original, biased simulations and bias-correct the
impact model output or index itself using univariate methods (direct
approach). This has the advantage of circumventing the difficulties
associated with correcting the inter-variable dependence of climate
variables which is not considered by univariate BC methods.
Using a multivariate drought index (i.e., standardized precipitation
evapotranspiration index – SPEI) as an example, the present
study compares different state-of-the-art BC methods (univariate and
multivariate) and BC approaches (direct and component-wise) applied to
climate model simulations stemming from different experiments at different
spatial resolutions (namely Coordinated Regional Climate Downscaling Experiment (CORDEX), CORDEX Coordinated Output for Regional Evaluations (CORDEX-CORE), and 6th Coupled Intercomparison Project (CMIP6)). The BC methods
are calibrated and evaluated over the same historical period (1986–2005).
The proposed framework is demonstrated as a case study over a transboundary
watershed, i.e., the Upper Jhelum Basin (UJB) in the Western Himalayas.
Results show that (1) there is some added value of multivariate BC methods
over the univariate methods in adjusting the inter-variable relationship;
however, comparable performance is found for SPEI indices. (2) The best-performing BC methods exhibit a comparable performance under both approaches
with a slightly better performance for the direct approach. (3) The added
value of the high-resolution experiments (CORDEX-CORE) compared to their
coarser-resolution counterparts (CORDEX) is not apparent in this study.</p
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