Addison's Disease Mimicking as Acute Pancreatitis: A Case Report.

Science.gov (United States)

Chaudhuri, Sayani; Rao, Karthik N; Patil, Navin; Ommurugan, Balaji; Varghese, George

2017-04-01

Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison's disease. Adrenal insufficiency (Addison's disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison's disease presenting as acute pain in abdomen mimicking clinical presentation of acute pancreatitis.

The role of patients' illness representations in coping and functioning with Addison's disease.

OpenAIRE

Heijmans, M.

1999-01-01

Objective: To examine the relationship between illness representations, coping behaviour and adaptive outcome in patients with Addison's disease (AD). Design: Cross-sectional. Following Leventhal's self-regulation model (Leventhal, Meyer & Nerenz, 1980), it was hypothesized that illness representations are directly associated with coping and, via coping, with adaptive outcome. Method: The illness representations held by 63 patients with a diagnosis of Addison's disease were explored using a q...

Diagnosis and management of Addison's disease: insights gained ...

African Journals Online (AJOL)

The prevalence of Addison's disease in South Africa is lower than in Western countries. This is concerning, since patients could be dying, undiagnosed. Enhanced awareness of this highly treatable condition is warranted. The epidemiology, aetiology, clinical presentation, screening and management of Addison's disease ...

Addison's disease secondary to connective tissue diseases: a report of six cases.

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Zhang, Zhuo-li; Wang, Yu; Zhou, Wei; Hao, Yan-jie

2009-04-01

Addison's disease is an autoimmune process. However, Addison's disease associated with connective tissue diseases (CTD) is only occasionally reported. Here, we report six cases of Addison's disease secondary to a variety of CTD, which include systemic lupus erythematosus, Takayasu arteritis, systemic sclerosis, ankylosing spondylitis (AS) and antiphospholipid antibody syndrome. The association of Addison's disease with Takayasu arteritis and AS is reported for the first time. We also found high prevalence of hypothyroidism as concomitant autoimmune disorder. Our case series highlight the autoimmune features of Addison's disease. Therefore, we suggest considering adrenal dysfunction in patients with CTD.

Prevalence of coeliac disease in Italian patients affected by Addison's disease.

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Biagi, Federico; Campanella, Jonia; Soriani, Alessandra; Vailati, Alberto; Corazza, Gino R

2006-03-01

It is well known that coeliac disease is associated with autoimmune endocrine diseases, such as autoimmune thyroid disease and insulin-dependent diabetes mellitus. Recently, coeliac disease has been shown in approximately 10% of patients with autoimmune Addison's disease. Addison's disease is the most common cause of primary adrenocortical insufficiency and it shares several clinical features with coeliac disease. Although hyperpigmentation and hypotension are the most specific signs, gastrointestinal symptoms are common and can be the first complaints of the patients. The aim of our study was to investigate the prevalence of coeliac disease in Italian patients with Addison's disease. Seventeen consecutive patients affected by Addison's disease (14 F, mean age 53.9 years, range 26-79 years) were enrolled in the study. Eleven of them were affected by Addison's disease associated with autoimmune thyroid disease and/or insulin-dependent diabetes mellitus; the other 6 patients were suffering from isolated Addison's disease. Diagnosis had been performed at the age of 40.5 years (range 23-55). Steroid treatment had already been started in 16 of the patients. Endomysial antibodies were tested in all of them and a duodenal biopsy was taken in those found to be positive for antiendomysial antibody (EMA). One out of 17 patients was found to be EMA positive. Duodenal biopsy confirmed the diagnosis of coeliac disease by showing subtotal villous atrophy. Although we studied only a small sample, our preliminary results confirmed that Addison's disease is associated with coeliac disease, being present in 5.9% of patients with Addison's disease. Since the symptoms can be similar and treatment of Addison's disease can mask coeliac disease, this association should always be actively investigated.

Treatment of Addison's disease during pregnancy.

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Oliveira, Diana; Lages, Adriana; Paiva, Sandra; Carrilho, Francisco

2018-01-01

Addison's disease, or primary adrenocortical insufficiency, is a long-term, potentially severe, rare endocrine disorder. In pregnancy, it is even rarer. We report the case of a 30-year-old pregnant patient with Addison's disease, referred to Obstetrics-Endocrinology specialty consult at 14 weeks gestation. She had been to the emergency department of her local hospital various times during the first trimester presenting with a clinical scenario suggestive of glucocorticoid under-replacement (nausea, persistent vomiting and hypotension), but this was interpreted as normal pregnancy symptoms. Hydrocortisone dose was adjusted, and the patient maintained regular follow-up. No complications were reported for the remainder of gestation and delivery. Pregnant patients with Addison's disease should be monitored during gestation and in the peripartum period by multidisciplinary teams. Adjustments in glucocorticoid and mineralocorticoid replacement therapy are often necessary, and monitoring should be based mainly on clinical findings, which becomes increasingly difficult during pregnancy. Patient education and specialized monitoring are key to avoiding complications from under- or over-replacement therapy in this period. An increase in glucocorticoid replacement dose is expected to be necessary during pregnancy in a woman with Addison's disease.Patient education regarding steroid cover and symptoms of acute adrenal crisis are fundamental.Monitoring in this period is challenging and remains mainly clinical.The increase in hydrocortisone dose often obviates the need to increase fludrocortisone dose.

Screening for X-linked adrenoleukodystrophy among adult men with Addison's disease.

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Horn, Morten A; Erichsen, Martina M; Wolff, Anette S B; Månsson, Jan-Eric; Husebye, Eystein S; Tallaksen, Chantal M E; Skjeldal, Ola H

2013-09-01

X-linked adrenoleukodystrophy is an important cause of Addison's disease in boys, but less is known about its contribution to Addison's disease in adult men. After surveying all known cases of X-linked adrenoleukodystrophy in Norway in a separate study, we aimed to look for any missed cases among the population of adult men with nonautoimmune Addison's disease. Among 153 adult men identified in a National Registry for Addison's Disease (75% of identified male cases of Addison's disease in Norway), those with negative indices for 21-hydroxylase autoantibodies were selected. Additionally, cases with low autoantibody indices (48-200) were selected. Sera from subjects included were analysed for levels of very long-chain fatty acids, which are diagnostic for X-linked adrenoleukodystrophy in men. Eighteen subjects had negative indices and 17 had low indices for 21-hydroxylase autoantibodies. None of those with low indices and only one of those with negative indices were found to have X-linked adrenoleukodystrophy; this subject had already been diagnosed because of the neurological symptoms. Cases of Addison's disease proved to be caused by X-linked adrenoleukodystrophy constitute 1·5% of all adult male cases in Norway; the proportion among nonautoimmune cases was 15%. We found X-linked adrenoleukodystrophy to be an uncommon cause of Addison's disease in adult men. However, this aetiological diagnosis has far-reaching consequences both for the patient and for his extended family. We therefore recommend that all adult men with nonautoimmune Addison's disease be analysed for levels of very long-chain fatty acids. © 2013 John Wiley & Sons Ltd.

Cure of Psoriasis and Arthritis when Addison's Disease Was Detected.

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Lind, Marcus

2010-06-01

INTRODUCTION: Corticoid therapy is well-known to improve the symptoms of psoriasis. Addison's disease is an autoimmune disease which leads to a loss of cortisol production in the adrenal glands. This case report describes a patient with wide-spread psoriasis for 34 years who was cured when Addison's disease was detected and substitution to reach normal biological cortisol levels was introduced. CASE REPORT: A 59-year-old man was diagnosed with Addison's disease. He had been tired for several years and had had difficulties in continuing his work. His brother had Addison's disease and recommended him to make a screen for the disease. Synacthen test diagnosed Addison's disease with a clear deficiency of cortisol production. After substitution with hydrocortisone the patient's constitution improved rapidly and he felt no longer tired during work. At the same time, all skin lesions of psoriasis disappeared as well as aches in several joints, both symptoms having been present for a couple of decades. Previously, salves of cortisol had been used to reduce the symptoms of psoriasis, but now, 1-2 years later, after the treatment of Addison's disease, no symptoms in the skin or joints have reoccurred. CONCLUSIONS: This report illustrates that Addison's disease, although a rare condition, should be kept in mind before treatment of psoriasis is started. Especially if other symptoms such as fatigue are present, a screening test of serum cortisol in the morning should be liberally made. The report also illustrates a need of examining corticoid levels in patients with psoriasis compared to the general population.

VT Lidar nDSM (1.6 meter) - 2012 - Addison County

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Vermont Center for Geographic Information — (Link to Metadata) This metadata applies to the following collection area(s): Addison County 2012 1.6m and related "normalized" Digital Surface Model (nDSM). Created...

A suspected case of Addison's disease in cattle.

Science.gov (United States)

Lambacher, Bianca; Wittek, Thomas

2015-09-01

A 4.75-year old Simmental cow was presented with symptoms of colic and ileus. The clinical signs and blood analysis resulted in the diagnosis of suspected primary hypoadrenocorticism (Addison's disease). Although Addison's disease has been frequently described in other domestic mammals, to our knowledge, this disease has not previously been reported in cattle.

The neuropsychiatric aspect of Addison's disease: a case report.

Science.gov (United States)

Abdel-Motleb, Mohamed

2012-10-01

Chronic adrenal insufficiency, known as Addison's disease, presents with a constellation of symptoms and signs. The neuropsychiatric aspect of this condition is not fully understood and not much has been documented about it in the English literature. This article presents a case of a 41-year old male patient who presented initially with depression after a recent life stressor. After his condition escalated and therapy continued to fail, the medical team revised its diagnosis to Addison's disease. Neuropsychiatric symptoms could be the first presentation of Addison's disease, and thus should be kept in mind whenever such a case presents to the physician.

Salivary cortisol day curves in assessing glucocorticoid replacement therapy in Addison's disease.

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Smans, Lisanne; Lentjes, Eef; Hermus, Ad; Zelissen, Pierre

2013-01-01

Patients with Addison's disease require lifelong treatment with glucocorticoids. At present, no glucocorticoid replacement therapy (GRT) can exactly mimic normal physiology. As a consequence, under- and especially overtreatment can occur. Suboptimal GRT may lead to various side effects. The aim of this study was to investigate the use of salivary cortisol day curves (SCDC) in the individual adjustment of GRT in order to approach normal cortisol levels as closely as possible, reduce over- and underreplacement and study the short-term effects on quality of life (QoL). Twenty patients with Addison's disease were included in this prospective study. A SCDC was obtained and compared to normal controls; general and disease specific QoL-questionnaires were completed. Based on SCDC assessment of over- and undertreatment (calculated as duration (h) × magnitude (nmol/L) at different time points, glucocorticoid dose and regime were adjusted. After 4 weeks SCDC and QoL assessment were repeated and the effect of adjusting GRT was analysed. At baseline, underreplacement was present in 3 and overreplacement in 18 patients; total calculated overreplacement was 32.8 h.nmol/L. Overreplacement decreased significantly to 13.3 h. nmol/L (p =0.005) after adjustment of GRT. Overreplacement was found particularly in the afternoon and evening. After reducing overreplacement in the evening, complaints about sleep disturbances significantly decreased. Individual adjustment of GRT based on SCDC to approach normal cortisol concentrations during the day can reduce overreplacement, especially in the evening. This can lead to a reduction of sleep disturbances and fatigue in patients with Addison's disease. A SCDC is a simple and patient-friendly tool for adjusting GRT and can be useful in the follow-up of patients with Addison's disease.

Jane Austen and Addison's disease: an unconvincing diagnosis.

Science.gov (United States)

White, K G

2009-12-01

Jane Austen's letters describe a two-year deterioration into bed-ridden exhaustion, with unusual colouring, bilious attacks and rheumatic pains. In 1964, Zachary Cope postulated tubercular Addison's to explain her symptoms and her relatively pain-free illness. Literary scholars later countered this posthumous diagnosis on grounds that are not well substantiated, while medical authors supported his conclusion. Important symptoms reported by contemporary Addison's patients-mental confusion, generalised pain and suffering, weight loss and anorexia-are absent from Jane Austen's letters. Thus, by listening to the patient's perspective, we can conclude it is unlikely that Addison's disease caused Jane Austen's demise. Disseminated bovine tuberculosis would offer a coherent explanation for her symptoms, so that Cope's original suggestion of infective tuberculosis as the cause of her illness may have been correct.

Autoimmune Addison's disease.

Science.gov (United States)

Napier, Catherine; Pearce, Simon H S

2012-12-01

Addison's disease is a rare autoimmune disorder. In the developed world, autoimmune adrenalitis is the commonest cause of primary adrenal insufficiency, where the majority of patients have circulating antibodies against the key steroidogenic enzyme 21-hydroxylase. A complex interplay of genetic, immunological and environmental factors culminates in symptomatic adrenocortical insufficiency, with symptoms typically developing over months to years. Biochemical evaluation and further targeted investigations must confirm primary adrenal failure and establish the underlying aetiology. The diagnosis of adrenocortical insufficiency will necessitate lifelong glucocorticoid and mineralocorticoid replacement therapy, aiming to emulate physiological patterns of hormone secretion to achieve well-being and good quality of life. Education of patients and healthcare professionals is essential to minimise the risk of a life-threatening adrenal crisis, which must be promptly recognised and aggressively managed when it does occur. This article provides an overview of our current understanding of the natural history and underlying genetic and immunological basis of this condition. Future research may reveal novel therapeutic strategies for patient management. Until then, optimisation of pharmacological intervention and continued emphasis on education and empowerment of patients should underpin the management of individuals with autoimmune Addison's disease. Copyright © 2012. Published by Elsevier Masson SAS.

Screening for Addison's disease in patients with type 1 diabetes mellitus and recurrent hypoglycaemia.

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Likhari, Taruna; Magzoub, Saeed; Griffiths, Melanie J; Buch, Harit N; Gama, R

2007-06-01

Addison's disease may present with recurrent hypoglycaemia in subjects with type 1 diabetes mellitus. There are no data, however, on the prevalence of Addison's disease presenting with recurrent hypoglycaemia in patients with diabetes mellitus. Three year retrospective study of diabetic patients with "unexplained" recurrent hypoglycaemia investigated with a short Synacthen test to exclude adrenocortical insufficiency. 95 patients with type 1 diabetes mellitus were studied. Addison's disease was identified as the cause of recurrent hypoglycaemia in one patient with type 1 diabetes mellitus. Addison's disease is a relatively rare but remedial cause of recurrent hypoglycaemia in patients with type 1 diabetes mellitus. A low threshold for investigating patients with type 1 diabetes mellitus and recurrent hypoglycaemia to detect Addison's disease is therefore suggested.

Delayed diagnosis of Addison's disease: an approach to management.

Science.gov (United States)

Mascarenhas, Janice V; Jude, Edward B

2014-07-18

Addison's disease accounts for the majority of cases of adrenal failure that are detected during hospital admissions. Unfortunately, prompt diagnosis of this condition is often delayed due to varied atypical manifestations and inadequate assessment at the time of presentation. We report a case of a 52-year-old woman who was detected to have hypotension during routine colonoscopy for evaluation of anaemia and progressive weight loss. During admission for evaluation of hypotension, she was also detected to have hyponatremia. Hyponatremia and hypotension failed to improve despite fluid resuscitation. Our endocrinological opinion was sought for and on further evaluation she was diagnosed with primary adrenal insufficiency. Glucocorticoid and mineralocorticoid replacement therapy were eventually instituted, which was followed by restoration of blood pressure and normalisation of serum sodium levels. 2014 BMJ Publishing Group Ltd.

Addison's disease and ACTH-producing pituitary microadenoma

Directory of Open Access Journals (Sweden)

S.S. Ortega

2015-10-01

Full Text Available A 28-year-old man diagnosed with primary adrenal insufficiency (Addison's disease in 2002. Following diagnosis, replacement therapy with hydrocortisone and fludrocortisone was indicated. Hydrocortisone replacement therapy was unsuccessful, and increased ACTH levels as high as 996 pg/dl were observed on outpatient follow-up. A pituitary MRI revealed a pituitary microadenoma. These findings raised three possibilities: (1 treatment is insufficient; (2 there is no relationship between Addison's disease and pituitary microadenoma; and (3 the microadenoma is similar to Nelson's syndrome. This latter is the most satisfactory explanation of this patient's clinical picture.

Screening for Addison's disease in patients with type 1 diabetes mellitus and recurrent hypoglycaemia

Science.gov (United States)

Likhari, Taruna; Magzoub, Saeed; Griffiths, Melanie J; Buch, Harit N

2007-01-01

Background Addison's disease may present with recurrent hypoglycaemia in subjects with type 1 diabetes mellitus. There are no data, however, on the prevalence of Addison's disease presenting with recurrent hypoglycaemia in patients with diabetes mellitus. Methods Three year retrospective study of diabetic patients with “unexplained” recurrent hypoglycaemia investigated with a short Synacthen test to exclude adrenocortical insufficiency. Results 95 patients with type 1 diabetes mellitus were studied. Addison's disease was identified as the cause of recurrent hypoglycaemia in one patient with type 1 diabetes mellitus. Conclusion Addison's disease is a relatively rare but remedial cause of recurrent hypoglycaemia in patients with type 1 diabetes mellitus. A low threshold for investigating patients with type 1 diabetes mellitus and recurrent hypoglycaemia to detect Addison's disease is therefore suggested. PMID:17551075

[Acute renal failure: a rare presentation of Addison's disease].

Science.gov (United States)

Salhi, Houda

2016-01-01

Addison's disease is a rare condition. Its onset of symptoms most often is nonspecific contributing to a diagnostic and therapeutic delay. Acute renal failure can be the first manifestation of this disease. We report the case of a patient with Addison's disease who was initially treated for acute renal failure due to multiple myeloma and whose diagnosis was adjusted thereafter. Patient's condition dramatically improved after treatment with intravenous rehydration; injectable hydrocortisone.

Residual adrenal function in autoimmune Addison's disease: improvement after tetracosactide (ACTH1-24) treatment.

Science.gov (United States)

Gan, Earn H; MacArthur, Katie; Mitchell, Anna L; Hughes, Beverly A; Perros, Petros; Ball, Stephen G; James, R Andrew; Quinton, Richard; Chen, Shu; Furmaniak, Jadwiga; Arlt, Wiebke; Pearce, Simon H S

2014-01-01

Despite lifelong steroid hormone replacement, there is excess morbidity and mortality associated with autoimmune Addison's disease. In health, adrenocortical cells undergo continuous self-renewal from a population of subcapsular progenitor cells, under the influence of ACTH, suggesting a therapeutic possibility. We aimed to determine whether tetracosactide (synthetic ACTH1-24) could revive adrenal steroidogenic function in autoimmune Addison's disease. Thirteen patients (aged 16-65 y) with established autoimmune Addison's disease for more than 1 year were recruited at the Newcastle University Clinical Research Facility. The intervention included a 20-week study of regular sc tetracosactide (ACTH1-24) therapy. Serum and urine corticosteroids were measured during medication withdrawal at baseline and every 5 weeks during the study. Serum cortisol levels remained less than 100 nmol/L in 11 of 13 participants throughout the study. However, two women achieved peak serum cortisol concentrations greater than 400 nmol/L after 10 and 29 weeks of tetracosactide therapy, respectively, allowing withdrawal of corticosteroid replacement. Concurrently, urine glucocorticoid and mineralocorticoid metabolite excretion increased from subnormal to above the median of healthy controls. One of these responders remains well with improving peak serum cortisol (672 nmol/L) 28 months after stopping all treatments. The other responder showed a gradual reduction in serum cortisol and aldosterone over time, and steroid therapy was recommenced after a 28-week period without glucocorticoid replacement. This is the first study to demonstrate that established autoimmune Addison's disease is amenable to a regenerative medicine therapy approach.

Erythema induratum of Bazin associated with Addison's disease: first description Eritema indurado de Bazin associado à doença de Addison: primeira descrição

Directory of Open Access Journals (Sweden)

Rodrigo Antonio Brandão Neto

2012-01-01

Full Text Available CONTEXT: Erythema induratum of Bazin (EIB is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive tuberculin test and positive BCG (bacillus Calmette-Guérin test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.CONTEXTO: O eritema indurado de Bazin (EIB é considerado uma reação tuberculoide e consiste de nódulos dolorosos recorrentes. O diagnóstico diferencial inclui doenças como vasculite nodular, perniose, poliarterite nodosa e eritema nodoso. RELATO DE CASO: Nós reportamos o caso de uma mulher com EIB que desenvolveu doença de Addison durante tratamento com drogas tuberculostáticas e com boa resposta com reposição de glicocorticoide. O diagnóstico foi realizado pela apresentação clínica, teste tuberculínico positivo e positividade para BCG (bacilo Calmette-Guérin no espécime histológico. A reposição de glicocorticoides e drogas tuberculostáticas levou ao desaparecimento dos sinais e sintomas. CONCLUSÕES: Este é o primeiro caso reportando a associação entre EIB e doença de Addison. Tuberculose é um importante agente etiológico da doença de Addison.

Extended exome sequencing identifies BACH2 as a novel major risk locus for Addison's disease.

Science.gov (United States)

Eriksson, D; Bianchi, M; Landegren, N; Nordin, J; Dalin, F; Mathioudaki, A; Eriksson, G N; Hultin-Rosenberg, L; Dahlqvist, J; Zetterqvist, H; Karlsson, Å; Hallgren, Å; Farias, F H G; Murén, E; Ahlgren, K M; Lobell, A; Andersson, G; Tandre, K; Dahlqvist, S R; Söderkvist, P; Rönnblom, L; Hulting, A-L; Wahlberg, J; Ekwall, O; Dahlqvist, P; Meadows, J R S; Bensing, S; Lindblad-Toh, K; Kämpe, O; Pielberg, G R

2016-12-01

Autoimmune disease is one of the leading causes of morbidity and mortality worldwide. In Addison's disease, the adrenal glands are targeted by destructive autoimmunity. Despite being the most common cause of primary adrenal failure, little is known about its aetiology. To understand the genetic background of Addison's disease, we utilized the extensively characterized patients of the Swedish Addison Registry. We developed an extended exome capture array comprising a selected set of 1853 genes and their potential regulatory elements, for the purpose of sequencing 479 patients with Addison's disease and 1394 controls. We identified BACH2 (rs62408233-A, OR = 2.01 (1.71-2.37), P = 1.66 × 10 -15 , MAF 0.46/0.29 in cases/controls) as a novel gene associated with Addison's disease development. We also confirmed the previously known associations with the HLA complex. Whilst BACH2 has been previously reported to associate with organ-specific autoimmune diseases co-inherited with Addison's disease, we have identified BACH2 as a major risk locus in Addison's disease, independent of concomitant autoimmune diseases. Our results may enable future research towards preventive disease treatment. © 2016 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

Episodic memory impairment in Addison's disease: results from a telephonic cognitive assessment.

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Henry, Michelle; Thomas, Kevin G F; Ross, Ian L

2014-06-01

Patients with Addison's disease frequently self-report memory and attention difficulties, even when on standard replacement therapy. However, few published studies examine, using objective measures and assessing across multiple domains, the cognitive functioning of Addison's disease patients relative to healthy controls. The primary aim of this study was to investigate whether the previously reported subjective cognitive deficits in Addison's disease are confirmed by objective measures. Conducting comprehensive neuropsychological assessments of patients with relatively rare clinical disorders, such as Addison's disease, is challenging because access to those patients is often limited, and because their medical condition might prevent extended testing sessions. Brief telephonic cognitive assessments are a useful tool in such circumstances. Hence, we administered the Brief Test of Adult Cognition by Telephone to 27 Addison's disease patients and 27 matched healthy controls. The instrument provides objective assessment of episodic memory, working memory, executive functioning, reasoning, and speed of processing. Statistical analyses confirmed that, as expected, patients performed significantly more poorly than controls on the episodic memory subtest. There were, however, no significant between-group differences on the attention, executive functioning, reasoning, and speed of processing subtests. Furthermore, patients with a longer duration of illness performed more poorly across all domains of cognition. We conclude that, for Addison's disease patients, previously reported subjective cognitive deficits are matched by objective impairment, but only in the domain of episodic memory. Future research might investigate (a) whether these memory deficits are material-specific (i.e., whether non-verbal memory is also affected), and (b) the neurobiological mechanisms underlying these deficits.

Development of a disease-specific quality of life questionnaire in Addison's disease.

Science.gov (United States)

Løvås, Kristian; Curran, Suzanne; Oksnes, Marianne; Husebye, Eystein S; Huppert, Felicia A; Chatterjee, V Krishna K

2010-02-01

Patients with Addison's disease reproducibly self-report impairment in specific dimensions of general well-being questionnaires, suggesting particular deficiencies in health-related quality-of-life (HRQoL). We sought to develop an Addison's disease-specific questionnaire (AddiQoL) that could better quantify altered well-being and treatment effects. Design, Setting, Patients, Intervention, and Outcomes: We reviewed the literature to identify HRQoL issues in Addison's disease and interviewed patients and their partners in-depth to explore various symptom domains. A list of items was generated, and nine expert clinicians and five expert patients assessed the list for impact and clarity. A preliminary questionnaire was presented to 100 Addison's outpatients; the number of items was reduced after analysis of the distribution of the responses. The final questionnaire responses were assessed by Cronbach's alpha and Rasch analysis. Published studies of HRQoL in Addison's disease indicated reduced vitality and general health perception and limitations in physical and emotional functioning. In-depth interviews of 14 patients and seven partners emphasized the impact of the disease on the emotional domain. Seventy HRQoL items were generated; after the expert consultation process and pretesting in 100 patients, the number of items was reduced to 36. Eighty-six patients completed the final questionnaire; the responses showed high internal consistency with Cronbach's alpha 0.95 and Person Separation Index 0.94 (Rasch analysis). We envisage AddiQoL having utility in trials of hormone replacement and management of patients with Addison's disease, analogous to similar questionnaires in GH deficiency (AGHDA) and acromegaly (AcroQoL).

Erythema induratum of Bazin associated with Addison's disease: first description

Directory of Open Access Journals (Sweden)

Rodrigo Antonio Brandão Neto

Full Text Available CONTEXT: Erythema induratum of Bazin (EIB is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive tuberculin test and positive BCG (bacillus Calmette-Guérin test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.

The role of patients' illness representations in coping and functioning with Addison's disease.

NARCIS (Netherlands)

Heijmans, M.

1999-01-01

Objective: To examine the relationship between illness representations, coping behaviour and adaptive outcome in patients with Addison's disease (AD). Design: Cross-sectional. Following Leventhal's self-regulation model (Leventhal, Meyer & Nerenz, 1980), it was hypothesized that illness

Addison's disease as a presentation of metastatic malignant melanoma.

Science.gov (United States)

Srinivasan, B; Patel, M; Ethunandan, M; Ilankovan, V

2016-01-01

Melanoma accounts for 5% of all skin cancers. The risk of metastasis is related to the thickness of the tumour, and can affect local, regional and distant sites. Adrenal metastasis from melanoma of the head and neck is uncommon and often asymptomatic. Addison's disease as a presentation of metastatic melanoma is extremely rare and we are unaware of previous reports in the world literature. We report a case of a patient with metastatic melanoma presenting with signs and symptoms of Addison's disease.

An unusual coexistence of Addison's disease and ...

African Journals Online (AJOL)

2013-07-17

Jul 17, 2013 ... Case Study: An unusual coexistence of Addison's disease and phaeochromocytoma. 164 ... strongly positive. ... Department of Endocrinology and Metabolism, Ondokuz Mayis University Medical School, Samsun, Turkey.

An Unusual Presentation of Addison's Disease-A Case Report.

Science.gov (United States)

Choudhary, Sandeep; Alam, Anwer; Dewan, Vivek; Yadav, Dinesh; Dubey, N K

2011-07-01

Addison's disease is most commonly due to autoimmune adrenalitis and tuberculosis and refers to primary hypoadrenalism caused by a total or near total destruction or dysfunction of both adrenal cortices. Usual manifestations involve chronic fatigue, muscle weakness, loss of appetite, nausea, vomiting, diarrhea, hypotension and hyperpigmentation of skin. We herein report a case of primary adrenal insufficiency presenting with fever and seizures in an 11-yr-old boy. His symptoms resolved after starting specific therapy. This kind of presentation of Addison's disease is rather unusual.

Addison's Disease Caused by Tuberculosis with Atypical Hyperpigmentation and Active Pulmonary Tuberculosis.

Science.gov (United States)

Namikawa, Hiroki; Takemoto, Yasuhiko; Kainuma, Shigeto; Umeda, Sakurako; Makuuchi, Ayako; Fukumoto, Kazuo; Kobayashi, Masanori; Kinuhata, Shigeki; Isaka, Yoshihiro; Toyoda, Hiromitsu; Kamata, Noriko; Tochino, Yoshihiro; Hiura, Yoshikazu; Morimura, Mina; Shuto, Taichi

2017-01-01

We herein report a case of Addison's disease caused by tuberculosis characterized by atypical hyperpigmentation, noted as exacerbation of the pigmentation of freckles and the occurrence of new freckles, that was diagnosed in the presence of active pulmonary tuberculosis. The clinical condition of the patient was markedly ameliorated by the administration of hydrocortisone and anti-tuberculosis agents. When exacerbation of the pigmentation of the freckles and/or the occurrence of new freckles are noted, Addison's disease should be considered as part of the differential diagnosis. In addition, the presence of active tuberculosis needs to be assumed whenever we treat patients with Addison's disease caused by tuberculosis, despite its rarity.

Recurrent hypoglycaemia in type-1 diabetes mellitus may unravel the association with Addison's disease: a case report.

Science.gov (United States)

Passanisi, Stefano; Timpanaro, Tiziana; Lo Presti, Donatella; Caruso-Nicoletti, Manuela

2014-09-12

Primary adrenocortical insufficiency or Addison's disease is caused by a progressive destruction of the adrenal cortex, resulting into a reduction of glucocorticoids, mineralocorticoids, and androgens. Autoimmune Addison's disease is the most common etiological form, accounting for about 80% of all cases. We describe the case of a 16-year-old Caucasian boy affected by type-1 diabetes mellitus and autoimmune thyroiditis, who experienced recurrent hypoglycaemia as presenting symptom of Addison's disease. Hypoglycaemia is not a common presenting feature of Addison's disease, both in patients with type-1 diabetes mellitus and in non-diabetic patients. However, hypoglycaemia may occur in association with primary and secondary glucocorticoid deficiency as a result of an enhanced insulin sensitivity. Hypoglycaemia is the most common acute complication of insulin therapy in patients with type-1 diabetes mellitus. Addison's disease has been described in approximately 0.5% of patients with type-1 diabetes mellitus, being more frequent in females and occurring in middle-aged patients. An association among type-1 diabetes mellitus, autoimmune thyroiditis, and Addison's disease is found in the "Schmidt's syndrome", a rare disorder that may occur in the paediatric age. Our case suggests that the presence of Addison's disease should be taken into consideration in patients with type-1 diabetes mellitus and frequent episodes of hypoglycaemia. We wish to highlight that there are no specific indications to screen for the association between Addison's disease and type-1 diabetes mellitus, although an early diagnosis of Addison's disease in diabetic patients would prevent the morbidity and potential mortality of this association.

Computerised tomography in tuberculous Addison's disease

International Nuclear Information System (INIS)

Perry, M.C.; Eason, R.J.; Croxson, M.S.

1983-01-01

The important contribution computerised tomography played in the diagnosis of tuberculous Addison's disease is described. While conventional radiographic methods of demonstrating this disease are often unhelpful, C.T. is an excellent technique for demonstrating the morphology of normal and abnormal adrenal glands

Misdiagnosis of Addison's disease in a patient with end-stage renal disease.

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Kocyigit, Ismail; Unal, Aydin; Tanriverdi, Fatih; Hayri Sipahioglu, Murat; Tokgoz, Bulent; Oymak, Oktay; Utas, Cengiz

2011-01-01

Addison's disease is a rare disorder in patients with end-stage renal disease (ESRD). In patients, the diagnosis of Addison's disease is difficult in clinical practice because most of the clinical findings of this disease are similar to those of the renal failure. We present a 51-year-old male patient, who underwent hemodialysis therapy for 8 years, diagnosed with Addison's disease after having myalgia, skin hyperpigmentation, weight loss, sweating, and nausea for the past few weeks. The physical examination was completely normal except for muscle weakness, hyperpigmentation on labial mucosa and skin in a patient. The laboratory tests revealed anemia and hypoglycemia. Serum cortisol, adrenocorticotropic hormone (ACTH) levels, and ACTH stimulation test results were consistent with Addison's disease. Adrenal computerized tomography revealed bilateral atrophic glands. Additionally, it was found that elevated serum thyroid stimulating hormone levels and antithyroid peroxidase antibody titer were positive. Our purpose is to emphasize that physicians should be alert to the potential for additional different conditions particularly in terms of adrenal failure in patients with ESRD.

Extended exome sequencing identifies BACH2 as a novel major risk locus for Addison's disease

OpenAIRE

Eriksson, D.; Bianchi, Matteo; Landegren, Nils; Nordin, Jessika; Dalin, Frida; Mathioudaki, Argyri; Eriksson, G. N.; Hultin-Rosenberg, Lina; Dahlqvist, Johanna; Zetterqvist, H.; Karlsson, Andreas; Hallgren, Anna; Farias, F. H. G.; Murén, Eva; Ahlgren, Kerstin M.

2016-01-01

BackgroundAutoimmune disease is one of the leading causes of morbidity and mortality worldwide. In Addisons disease, the adrenal glands are targeted by destructive autoimmunity. Despite being the most common cause of primary adrenal failure, little is known about its aetiology. MethodsTo understand the genetic background of Addisons disease, we utilized the extensively characterized patients of the Swedish Addison Registry. We developed an extended exome capture array comprising a selected se...

Computed tomographic follow-up in a case of Addison's disease

International Nuclear Information System (INIS)

Pozzi Mucelli, R.S.; Pozzi Mucelli, F.; Muner, G.

1985-01-01

Addison's disease of the adrenal glands presents with different pathological findings depending on the stage. In the acute phase the adrenal glands are bilaterally enlarged while in the chronic phase the glands are small and calcified. A case of Addison's disease with follow-up over a period of a year by CT is reported. CT showed the evolution of the adrenal glands from bilateral masses to small calcified glands. The differential diagnostic problems in the acute phase are also discussed. (orig.)

Addison's Disease and Dilated Cardiomyopathy: A Case Report and Review of the Literature.

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Mozolevska, Viktoriya; Schwartz, Anna; Cheung, David; Shaikh, Bilal; Bhagirath, Kapil M; Jassal, Davinder S

2016-01-01

Addison's disease is often accompanied by a number of cardiovascular manifestations. We report the case of a 30-year-old man who presented with a new onset dilated cardiomyopathy due to Addison's disease. The clinical presentation, treatment, and outcomes of this rare hormone mediated cardiac disorder are reviewed.

Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease.

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van der Valk, Eline S; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

2016-09-01

Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue. © 2016 John Wiley & Sons Ltd.

Apoptosis in subicular neurons: A comparison between suicide and Addison's disease

Science.gov (United States)

Printha, K.; Hulathduwa, S. R.; Samarasinghe, K.; Suh, Y. H.; De Silva, K. R. D.

2009-01-01

Background: Stress and depression shows possible links to neuronal death in hippocampus. Subiculum plays a prominent role in limbic stress integration and direct effect of corticosteroids on subicular neurons needs to be defined to assess its subsequent impact on hippocampal plasticity. Aim: This study was intended to assess apoptosis in subicular neurons of a young depressed suicide victim, where presumably stress induced excess of corticosteroids and a case of young Addison's disease with low level of corticosteroids. Materials and Method: Both bilateral adrenal glands (Addison's) and subiculum (both cases) were initially stained with hematoxylin and eosin; subicular neurons of both cases were examined for the degree of apoptosis using ‘ApopTag Kit’. Apoptotic cell counts were expressed as average number of labeled cells/mm2 and the results were analysed statistically using a non-parametric Mann–Whitney U test. Result: Apoptotic neurons were detected in the subicular region of both suicide and Addison victims, and it is statistically significant in both right and left between the cases (P Addison disease where the number of neuronal cell death between right and left was statistically insignificant (P > 0.05). Conclusion: The present study confirms the vulnerability of the subicular neurons to apoptosis, possibly due to corticosteroids in both ends of spectrum. PMID:20048453

[Addison's disease: forms of presentation in paediatrics].

Science.gov (United States)

Royo Gómez, M; Olmos Jiménez, M J; Rodríguez Arnao, M D; Roldán Martín, M B

2013-06-01

Addison's disease or primary adrenal insufficiency is a rare disease in children. The signs and symptoms at diagnosis are frequently non-specific and insidious. Since adrenal crisis represents an emergency, it is important to be aware and to have a high degree of suspicion of the disorder in order to achieve an early diagnosis and treatment. We present a retrospective study describing the epidemiological, clinical and etiological data at diagnosis of five patients with Addison's disease followed up in our hospital. Dehydration, hyponatremia and skin hyperpigmentation were the most prevalent signs and symptoms at onset of the disease. The patients had low serum cortisol levels and positive adrenal antibodies. One patient with negative antibodies presented with a polyglandular syndrome. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier España, S.L. All rights reserved.

Normal overall mortality rate in Addison's disease, but young patients are at risk of premature death.

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Erichsen, Martina M; Løvås, Kristian; Fougner, Kristian J; Svartberg, Johan; Hauge, Erik R; Bollerslev, Jens; Berg, Jens P; Mella, Bjarne; Husebye, Eystein S

2009-02-01

Primary adrenal insufficiency (Addison's disease) is a rare autoimmune disease. Until recently, life expectancy in Addison's disease patients was considered normal. To determine the mortality rate in Addison's disease patients. i) Patients registered with Addison's disease in Norway during 1943-2005 were identified through search in hospital diagnosis registries. Scrutiny of the medical records provided diagnostic accuracy and age at diagnosis. ii) The patients who had died were identified from the National Directory of Residents. iii) Background mortality data were obtained from Statistics Norway, and standard mortality rate (SMR) calculated. iv) Death diagnoses were obtained from the Norwegian Death Cause Registry. Totally 811 patients with Addison's disease were identified, of whom 147 were deceased. Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). Acute adrenal failure was a major cause of death; infection and sudden death were more common than in the general population. The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. Addison's disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison's disease.

Addison's disease presenting with muscle spasm.

Science.gov (United States)

Bhattacharjee, Rana; Sharma, A; Rays, A; Thakur, I; Sarkar, D; Mandal, B; Mookerjee, S K; Chatterjee, S K; Chowdhury, Pradip Roy

2013-09-01

Primary hypoadrenalism has various causes and protean manifestation. We report a young female patient who presented with severe muscle spasm as her primary complaint. On evaluation she was found to be a case of Addison's disease secondary to adrenal tuberculosis. Her muscle spasm disappeared rapidly with replacement dose of glucocorticoid.

Recovery of adrenal function in a patient with confirmed Addison's disease.

Science.gov (United States)

Baxter, M; Gorick, S; Swords, F M

2013-01-01

Addison's disease is a condition characterised by immune-mediated destruction of the adrenal glands leading to a requirement of lifelong replacement therapy with mineralocorticoid and glucocorticoid. We present a case of a 53-year-old man who presented at the age of 37 years with nausea, fatigue and dizziness. He was found to have postural hypotension and buccal pigmentation. His presenting cortisol level was 43 nmol/l with no response to Synacthen testing. He made an excellent response to conventional replacement therapy with hydrocortisone and fludrocortisone and then remained well for 16 years. On registering with a new endocrinologist, his hydrocortisone dose was revised downwards and pre- and post-dose serum cortisol levels were assessed. His pre-dose cortisol was surprisingly elevated, and so his dose was further reduced. Subsequent Synacthen testing was normal and has remained so for further 12 months. He is now asymptomatic without glucocorticoid therapy, although he continues on fludrocortisone 50 μg daily. His adrenal antibodies are positive, although his ACTH and renin levels remain elevated after treatment. Addison's disease is generally deemed to lead to irreversible cell-mediated immune destruction of the adrenal glands. For this reason, patients receive detailed counselling and education on the need for lifelong replacement therapy. To our knowledge, this is the third reported case of spontaneous recovery of the adrenal axis in Addison's disease. Recovery may therefore be more common than previously appreciated, which may have major implications for the treatment and monitoring of this condition, and for the education given to patients at diagnosis. Partial recovery from Addison's disease is possible although uncommon.Patients with long-term endocrine conditions on replacement therapy still benefit from regular clinical and biochemical assessment, to revisit optimal management.As further reports of adrenal axis recovery emerge, this may

Severe hyponatraemia with absence of hyperkalaemia in rapidly progressive Addison's disease.

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Thompson, Michael D; Kalmar, Eileen; Bowden, Sasigarn A

2015-05-28

We present a case of rapidly progressing Addison's disease in adrenal crisis with severe hyponatraemia and absence of hyperkalaemia in a 10-year-old girl. She presented with 2 weeks of vomiting, fatigue and weight loss. Her serum electrolytes obtained 1 week prior to presentation were normal, except for mild hyponatraemia at 131 mmol/L, which dropped to 112 mmol/L on admission. She had normal serum potassium, low-serum osmolality, with elevated urine sodium and osmolality, indistinguishable from syndrome of inappropriate antidiuretic hormone (SIADH). Subsequently, Addison's disease was diagnosed on the basis of gingival hyperpigmentation and undetectable cortisol on adrenocorticotropic hormone stimulation test. She rapidly responded to stress dose hydrocortisone, followed by hydrocortisone and fludrocortisone replacement therapy. The absence of hyperkalaemia in the presence of severe hyponatraemia cannot rule out Addison's disease in children. The mechanism of hypo-osmolar hyponatraemia in primary adrenal insufficiency and clinical clues to differentiate it from SIADH are discussed. 2015 BMJ Publishing Group Ltd.

Sarcoidosis Presenting Addison's Disease.

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Takahashi, Kentaro; Kagami, Shin-Ichiro; Kawashima, Hirotoshi; Kashiwakuma, Daisuke; Suzuki, Yoshio; Iwamoto, Itsuo

2016-01-01

We herein describe a second Japanese case of sarcoidosis presenting Addison's disease. A 52-year-old man was diagnosed with sarcoidosis based on clinical and laboratory findings, including bilateral hilar lymphadenopathy and elevated levels of serum angiotensin-converting enzyme and lysozyme, as well as the presence of noncaseating epithelioid granulomas. The patient also exhibited general fatigue, pigmentation, weight loss, hypotension and hyponatremia, suggestive of chronic adrenocortical insufficiency. An endocrine examination confirmed primary adrenocortical insufficiency. This case suggests the direct involvement of sarcoid granuloma in the adrenal glands.

Multifocal oral melanoacanthoma associated with Addison's disease and hyperthyroidism: a case report.

Science.gov (United States)

Dantas, Thinali Sousa; Nascimento, Isabelly Vidal do; Verde, Maria Elisa Quezado Lima; Alves, Ana Paula Negreiros Nunes; Sousa, Fabrício Bitu; Mota, Mário Rogério Lima

2017-01-01

Oral melanoacanthoma is a mucocutaneous, pigmented, rare, benign, and probably reactive lesion. This paper reports for the first time in the literature a case of multifocal oral melanoacanthoma in a patient diagnosed with Addison's disease and concomitant Graves' disease with hyperthyroidism. The patient presented with oral pigmented lesions, which were hypothesized to be mucosal pigmentation associated with Addison's disease. Due to their unusual clinical pattern, these oral lesions were biopsied and diagnosed as oral melanoacanthoma on histopathology and immunohistochemistry for HMB-45. At the moment of this report, the patient was being treated for her systemic conditions, but the lesions had not regressed. Reactive hyperpigmentation of the skin and mucous membranes may be found in Addison's disease and hyperthyroidism. This case reinforces the hypothesis of a reactive nature for oral melanoacanthoma and highlights the need for investigation of endocrine disorders in patients with multifocal oral melanoacanthoma.

Recovery of adrenal function in a patient with confirmed Addison's disease

Science.gov (United States)

Baxter, M; Gorick, S; Swords, F M

2013-01-01

Summary Addison's disease is a condition characterised by immune-mediated destruction of the adrenal glands leading to a requirement of lifelong replacement therapy with mineralocorticoid and glucocorticoid. We present a case of a 53-year-old man who presented at the age of 37 years with nausea, fatigue and dizziness. He was found to have postural hypotension and buccal pigmentation. His presenting cortisol level was 43 nmol/l with no response to Synacthen testing. He made an excellent response to conventional replacement therapy with hydrocortisone and fludrocortisone and then remained well for 16 years. On registering with a new endocrinologist, his hydrocortisone dose was revised downwards and pre- and post-dose serum cortisol levels were assessed. His pre-dose cortisol was surprisingly elevated, and so his dose was further reduced. Subsequent Synacthen testing was normal and has remained so for further 12 months. He is now asymptomatic without glucocorticoid therapy, although he continues on fludrocortisone 50 μg daily. His adrenal antibodies are positive, although his ACTH and renin levels remain elevated after treatment. Addison's disease is generally deemed to lead to irreversible cell-mediated immune destruction of the adrenal glands. For this reason, patients receive detailed counselling and education on the need for lifelong replacement therapy. To our knowledge, this is the third reported case of spontaneous recovery of the adrenal axis in Addison's disease. Recovery may therefore be more common than previously appreciated, which may have major implications for the treatment and monitoring of this condition, and for the education given to patients at diagnosis. Learning points Partial recovery from Addison's disease is possible although uncommon.Patients with long-term endocrine conditions on replacement therapy still benefit from regular clinical and biochemical assessment, to revisit optimal management.As further reports of adrenal axis recovery

What affects the quality of life in autoimmune Addison's disease?

Science.gov (United States)

Meyer, G; Hackemann, A; Penna-Martinez, M; Badenhoop, K

2013-02-01

Several studies have shown a reduced quality of life in patients with Addison's disease, but little is known about the potential influences. We determined the quality of life in 200 patients with Addison's disease using an Addison's disease-specific quality-of-life questionnaire. Data about first symptoms, time to diagnosis and current medication were collected by questionnaires. With increasing latency between first symptoms and diagnosis of adrenal insufficiency, the quality of life decreased in highly significant manner (pdisease (p=0.05), atrophic gastritis (p=0.01) and primary ovarian failure (p=0.01) were highly correlated with reduced scores. Quality of life was significantly lower in female patients and in those with manifestation at older ages. With more autoimmune comorbidities, the quality of life scores dropped. The most important factor, however, was latency between first symptoms and diagnosis that affected patients' quality of life even years after manifestation of the disease. These results confirm and extend previous observations and emphasize the importance of a timely diagnosis. Therefore, medical awareness for this rare but easily treatable disorder needs to be sharpened. © Georg Thieme Verlag KG Stuttgart · New York.

Coma hiponatrêmico como manifestação de doença de Addison Hyponatremic coma as a manifestation of Addison's disease

Directory of Open Access Journals (Sweden)

Paulo S.M. Esperon

2001-08-01

Full Text Available OBJETIVO: alertar sobre a importância de distúrbio hidroeletrolítico grave devido a doença crônica não previamente diagnosticada. MÉTODO: relato de um caso de coma hiponatrêmico devido a crise adrenal em criança portadora de doença de Addison não diagnosticada previamente, apesar de história clínica sugestiva desta doença há cerca de quatro anos. RESULTADO: Após atendimento inicial à emergência, com correção da hiponatremia grave com hipovolemia discreta, hipernatriúria e hiperpotassemia, o diagnóstico diferencial deste distúrbio hidroeletrolítico revelou tratar-se de uma crise adrenal secundária a uma insuficiência adrenal primária crônica. O tratamento com hidrocortisona oral possibilitou alta hospitalar com correção total dos distúrbios metabólicos. CONCLUSÃO: é importante manter um alto grau de suspeita de doença de Addison para evitar as graves conseqüências de seu diagnóstico tardio, como distúrbios hidroeletrolíticos graves, além de atraso de crescimento e desenvolvimento.OBJECTIVE: To show the importance of severe hydroelectrolytic disorder as a consequence of previously undiagnosed chronic disease. DESCRIPTION: Case report of hyponatremic coma caused by adrenal crisis in a child with previously undiagnosed Addison's disease despite suggestive clinical findings of this disease in the last four years. After correction of severe hyponatremia, mild hypovolemia, hypernatriuria and hyperkalemia, the differential diagnosis of this hydroelectrolytic disorder revealed an adrenal crisis resulting from a primary chronic adrenal insufficiency. Oral treatment with hydrocortisone was efficient in correcting the metabolic disorder and the patient was then discharged. COMMENTS: It is very important to highly suspect of Addison's disease in order to avoid the dangerous consequences of late diagnosis such as severe hydroelectrolytic disorders and retarded growth and development.

From Appearance of Adrenal Autoantibodies to Clinical Symptoms of Addison's Disease: Natural History.

Science.gov (United States)

Betterle, Corrado; Garelli, Silvia; Presotto, Fabio; Furmaniak, Jadwiga

2016-01-01

Recent progress in the immunopathology field has greatly improved our understanding of the natural history of autoimmune diseases, particularly of Addison's disease. Addison's disease is known to be a chronic illness characterized by adrenocortical gland insufficiency that develops following a long and mainly asymptomatic period, characterized by the presence of circulating autoantibodies directed to adrenal cortex antigens. In this chapter we describe the groups of subjects at risk of developing Addison's disease, together with the diagnostic tests considered the most appropriate for evaluating adrenal function: determination of basal plasma adrenocorticotropic hormone (ACTH) levels, plasma renin activity, plasma aldosterone and cortisol levels, and cortisol levels after intravenous stimulation with ACTH (ACTH test). The employment of specific clinical, immunological and functional criteria in the subjects with autoantibodies to the adrenal cortex allows identifying those at risk of developing overt disease. The independent risk factors for the progression to adrenal failure have also been identified and they contribute to different risks of developing clinical Addison's disease. Based on the risk level, the subjects should be monitored over time to observe early signs of adrenal dysfunction, and start substitutive treatment as soon as possible. For patients presenting with high risk, prevention strategies and trials might be available. © 2016 S. Karger AG, Basel.

Tuberculous Addison's disease: Morphological and quantitative evaluation with multidetector-row CT

International Nuclear Information System (INIS)

Ma Ensen; Yang Zhigang; Li Yuan; Guo Yingkun; Deng Yuping; Zhang Xiaochun

2007-01-01

Objective: To determine the characteristics of tuberculous Addison's disease on the axial and multiplanar reformatted (MPR) images of the multidetector-row computed tomography (MDCT). Materials and methods: The unenhanced and contrast-enhanced MDCT features in 19 patients with tuberculous Addison's disease were retrospectively assessed for the location, contour, size, calcification, attenuation, and enhancement patterns. The correlation between the duration of Addison's disease and the percentage of calcification presence was evaluated. Results: The adrenal glands were infected bilaterally in all of the 19 cases (100%, 38 glands). Enlargement of the glands appeared in 18 cases (94.7%, 36 glands) and the remaining one case (5.3%, two glands) showed atrophy bilaterally. Of the 36 enlarged adrenals, 13 (36.1%) had preserved contours, and the other 23 (63.9%) were mass-like. The size of the adrenals ranged from 0.6 to 4.8cm (mean 1.92+/-0.96cm). Calcification was revealed in 16 adrenals (16/38, 42.1%), increasing in incidence with disease progression. Fourteen of the 36 (38.9%) enlarged adrenals showed peripheral enhancement while the remaining 22 (61.1%) demonstrated heterogeneous enhancement. The ΔCT value, the attenuation measurement of mass-like lesions, was less in the central area (7+/-4HU) than that in the peripheral area (32+/-14HU) (P<0.01) between the unenhanced and contrast-enhanced scan. Conclusion: MDCT can reveal the characteristic morphology and CT attenuation in the tuberculous Addison's disease. Combined with its clinical presentations and biochemical findings, we can diagnose and stage adrenal tuberculosis with high specificity and accuracy on MDCT

Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

NARCIS (Netherlands)

van der Valk, Eline S.; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H.; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

BACKGROUND: Health related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to

Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

NARCIS (Netherlands)

Valk, E.S. Van der; Smans, L.C.C.J.; Hofstetter, H.; Stubbe, J.H.; Vries, M de; Backx, F.J.; Hermus, A.R.M.M.; Zelissen, P.M.J.

2016-01-01

BACKGROUND: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to

Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

NARCIS (Netherlands)

Valk, E.S. van der; Smans, L.C.C.J.; Hofstetter, H.; Stubbe, J.H.; Vries, M. de; Backx, F.J.G.; Hermus, A.R.M.M.; Zelissen, P.M.J.

2016-01-01

Background: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. Objective: The aim of this study was to

VT Lidar Slope (1.6 meter) - 2012 - Addison County

Data.gov (United States)

Vermont Center for Geographic Information — (Link to Metadata) This metadata applies to the following collection area(s): Addison County 2012 1.6m and related SLOPE datasets. Created using ArcGIS "SLOPE"...

VT Lidar Aspect (1.6 meter) - 2012 - Addison County

Data.gov (United States)

Vermont Center for Geographic Information — (Link to Metadata) This metadata applies to the following collection area(s): Addison County 2012 1.6m and related ASPECT datasets. This metadata complies with the...

Salivary cortisol day curves in Addison's disease in patients on hydrocortisone replacement.

Science.gov (United States)

Ross, I L; Levitt, N S; Van der Walt, J S; Schatz, D A; Johannsson, G; Haarburger, D H; Pillay, T S

2013-01-01

Using salivary cortisol (SC) measurements, cortisol exposure in Addison's disease patients on hydrocortisone replacement was determined and compared with healthy controls. Cortisol pharmacokinetics was assessed in 31 patients with Addison's disease on replacement hydrocortisone doses (median daily dose 20 mg; range 5-50 mg) and 30 healthy control subjects. Saliva samples (n=16) were collected between 08:00 and 00:00 h in 1 day, using a passive drool technique. Cortisol exposure was evaluated by noncompartmental approach. In the patients, cortisol exposure was significantly higher than in controls: median inter-quartile range (IQR) peak cortisol (C(max)) 174.5 (59.3-837.0) vs. 6.50 (4.7-19.3) nmol/l, p=0.0001; area under the curve (AUC) 390.1 (177.1-928.9) vs. 21.4 (14.6-28.4) minutes*nmol/l, p=0.0001, trough cortisol level (C(min)) 0.49 (0.49-0.96) vs. 0.49 (0.49-0.49) nmol/l, p=0.02, occurring at 480.0 (0.1-660.0) vs. 405.0 (180.0-570.0) min, p=0.56. First peak cortisol was 174.5 (53.0-754.7) vs. 6.27 (3.90-8.47) nmol/l, p=0.0001 and second peak cortisol 18.90 (5.22-76.9) vs. 3.12 (1.76-4.79) nmol/l, p=0.0001. The time to first peak cortisol differed between the 2 groups, 30 (30-75) vs. 0.1 (0.1-30) minutes; p=0.0001. At doses studied, hydrocortisone replacement therapy results in cortisol pharmacokinetics being markedly different from endogenous cortisol profiles in healthy control subjects. Addison's disease patients had significantly higher SC levels compared to healthy control subjects. © Georg Thieme Verlag KG Stuttgart · New York.

Addison's disease symptoms--a cross sectional study in urban South Africa.

Science.gov (United States)

Ross, Ian Louis; Levitt, Naomi S

2013-01-01

Addison's disease is a potentially life-threatening disorder, and prompt diagnosis, and introduction of steroid replacement has resulted in near normal life-expectancy. There are limited data describing the clinical presentation of Addison's disease in South Africa. It is hypothesised that patients may present in advanced state of ill-health, compared to Western countries. A national database of patients was compiled from primary care, referral centres and private practices. 148 patients were enrolled (97 white, 34 mixed ancestry, 5 Asian and 12 black). Demographic and clinical data were elicited using questionnaires. Biochemical data were obtained from folder reviews and laboratory archived results. The majority of the cohort was women (62%). The median and inter-quartile age range (IQR) of patients at enrolment was 46.0 (32.0-61.0) years, with a wide range from 2.8-88.0 years. The median and IQR age at initial diagnosis was 34.0 (20.0-45.0) years (range 0.02-77.0) years, indicating that at the time of enrolment, the patients, on average, were diagnosed with Addison's disease 12 years previously. Hyperpigmentation was observed in 76%, nausea and vomiting occurred in more than 40%, and weight loss was noted in 25%. Loss of consciousness as a presenting feature was recorded in 20%. with a 95% confidence interval [CI] of (14-28%) and shock occurred in 5% CI (1.5-8.5%). Case-finding was recorded at 3.1 per million. The usual constellation of hyperpigmentation, nausea, vomiting and weight loss suggests Addison's disease, but a significant proportion present with an advanced state of ill-health and Addisonian crises. A lower prevalence rate, compared to Western countries is suggested.

A case of Addison's disease accompanied with bilateral adrenal calcification on CT

International Nuclear Information System (INIS)

Lee, Li-Chik; Fujita, Naohisa; Ohba, Yachiyo

1985-01-01

A 62-year-old woman was admitted to our hospital with complaints of general malaise and hyperpigmentation. We diagnosed her case as primary adrenocortical insufficiency (Addison's disease) by endocrinological studies. CT demonstrated dense calcification in both adrenal beds without evidence of normal glandular remnants. Calcified adrenal is not specific to tuberculosis, but some points of CT findings are useful for pathogenetic approach. Recently, there have been several reports that ACTH producing pituitary tumors develop in patients treated with conventional corticosteroid replacement. Corticosteroid should be administered by monitoring of plasma cortisol and ACTH concentrations. (author)

Adrenal steroidogenesis after B lymphocyte depletion therapy in new-onset Addison's disease.

Science.gov (United States)

Pearce, Simon H S; Mitchell, Anna L; Bennett, Stuart; King, Phil; Chandran, Sukesh; Nag, Sath; Chen, Shu; Smith, Bernard Rees; Isaacs, John D; Vaidya, Bijay

2012-10-01

A diagnosis of Addison's disease means lifelong dependence on daily glucocorticoid and mineralocorticoid therapy and is associated with increased morbidity and mortality as well as a risk of unexpected adrenal crisis. The objective of the study was to determine whether immunomodulatory therapy at an early stage of autoimmune Addison's disease could lead to preservation or improvement in adrenal steroidogenesis. This was an open-label, pilot study of B lymphocyte depletion therapy in new-onset idiopathic primary adrenal failure. Doses of iv rituximab (1 g) were given on d 1 and 15, after pretreatment with 125 mg iv methylprednisolone. Six patients (aged 17-47 yr; four females) were treated within 4 wk of the first diagnosis of idiopathic primary adrenal failure. Dynamic testing of adrenal function was performed every 3 months for at least 12 months. Serum cortisol levels declined rapidly and were less than 100 nmol/liter (3.6 μg/dl) in all patients by 3 months after B lymphocyte depletion. Serum cortisol and aldosterone concentrations remained low in five of the six patients throughout the follow-up period. However, a single patient had sustained improvement in both serum cortisol [peak 434 nmol/liter (15.7 μg/dl)] and aldosterone [peak 434 pmol/liter (15.7 ng/dl)] secretion. This patient was able to discontinue steroid medications 15 months after therapy and remains well, with improving serum cortisol levels 27 months after therapy. New-onset autoimmune Addison's disease should be considered as a potentially reversible condition in some patients. Future studies of immunomodulation in autoimmune Addison's disease may be warranted.

Radioimmunoassay of gastrin level in duodenal ulcer, atrophic gostritis and Addison-Biermer's disease

International Nuclear Information System (INIS)

Hasik, J.; Kozal, H.; Kosowicz, J.; Hansz, J.

1975-01-01

Radioimmunoassay of gastrin level in the blood was performed in 20 controls, 12 patients with duodenal ulcer, 13 patients with atrophic gastritis and 14 patients with Addison-Biermer's disease. Gastrin level in the serum of the patients with duodenal ulcer did not differ significantly from that of controls. In atrophic gastritis and particularly in Addison-Biermer's disease gastrin level was found to be several times higher. This is probably a result of chronic gastrin secretion stimulation which is normally inhibited by gastric juice. (author)

Addison's disease symptoms--a cross sectional study in urban South Africa.

Directory of Open Access Journals (Sweden)

Ian Louis Ross

Full Text Available BACKGROUND: Addison's disease is a potentially life-threatening disorder, and prompt diagnosis, and introduction of steroid replacement has resulted in near normal life-expectancy. There are limited data describing the clinical presentation of Addison's disease in South Africa. It is hypothesised that patients may present in advanced state of ill-health, compared to Western countries. PATIENTS: A national database of patients was compiled from primary care, referral centres and private practices. 148 patients were enrolled (97 white, 34 mixed ancestry, 5 Asian and 12 black. METHODS: Demographic and clinical data were elicited using questionnaires. Biochemical data were obtained from folder reviews and laboratory archived results. RESULTS: The majority of the cohort was women (62%. The median and inter-quartile age range (IQR of patients at enrolment was 46.0 (32.0-61.0 years, with a wide range from 2.8-88.0 years. The median and IQR age at initial diagnosis was 34.0 (20.0-45.0 years (range 0.02-77.0 years, indicating that at the time of enrolment, the patients, on average, were diagnosed with Addison's disease 12 years previously. Hyperpigmentation was observed in 76%, nausea and vomiting occurred in more than 40%, and weight loss was noted in 25%. Loss of consciousness as a presenting feature was recorded in 20%. with a 95% confidence interval [CI] of (14-28% and shock occurred in 5% CI (1.5-8.5%. Case-finding was recorded at 3.1 per million. CONCLUSIONS: The usual constellation of hyperpigmentation, nausea, vomiting and weight loss suggests Addison's disease, but a significant proportion present with an advanced state of ill-health and Addisonian crises. A lower prevalence rate, compared to Western countries is suggested.

First presentation of Addison's disease as hyperkalaemia in acute kidney injury.

Science.gov (United States)

Maki, Sara; Kramarz, Caroline; Maria Heister, Paula; Pasha, Kamran

2016-05-11

Addison's disease is a rare endocrine disorder that frequently presents with non-specific symptoms, but may deteriorate rapidly into life-threatening Addisonian crisis if left untreated. Diagnosis can be difficult in patients without a suggestive medical history. We describe a case of a 37-year-old man who was admitted with acute kidney injury and hyperkalaemia, resistant to treatment with insulin/dextrose and calcium gluconate. On clinical examination, he was found to be hyperpigmented; a subsequent random serum cortisol of 49 nmol/L affirmed the preliminary diagnosis of Addison's disease. The patient's hyperkalaemia improved on treatment with hydrocortisone, and a follow-up morning adrenocorticotropic hormone of 1051 ng/L confirmed the diagnosis. 2016 BMJ Publishing Group Ltd.

JST Thesaurus Headwords and Synonyms: Addison-Biermer貧血 [MeCab user dictionary for science technology term[Archive

Lifescience Database Archive (English)

Full Text Available MeCab user dictionary for science technology term Addison-Biermer貧血 名詞 サ変接続 * * * * 悪性貧血... アクセイヒンケツ アクセイヒンケツ Thesaurus2015 200906044106165134 C LS51 UNKNOWN_2 Addison - Biermer 貧血

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison's disease with primary hypothyroidism.

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Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K; Vivekanandan, Muthupillai

2016-01-01

Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.

Male and female hypogonadism are highly prevalent in South Africans with Addison's disease.

Science.gov (United States)

Ross, I L; Levitt, N S; Blom, D J; Haarburger, D

2014-09-01

Hypogonadism may complicate Addison's disease (primary hypoadrenalism), but prevalence and metabolic sequelae of hypogonadism in Addison's disease are poorly described. We recruited patients from the South African Addison's disease national registry who received stable replacement doses of hydrocortisone and had no acute illness. Male biochemical testosterone deficiency was defined as an early morning basal testosterone10 or 12 IU/l). Testosterone deficiency did not correlate with age, disease duration or hydrocortisone dose. Untreated male hypogonadal subjects had a higher (mean ± standard deviation) BMI compared to eugonadal subjects 29.2 ± 4.9 kg/m(2) vs. 24.7 ± 3.4 kg/m(2) (p=0.01) and a higher median (interquartile range) high-sensitive-CRP 6.4 (2.5-14.0) mg/l vs. 1.45 (0.6-2.8) mg/l (p=0.002). There were no differences between the 2 groups in lipids, lipoproteins and fasting glucose. The median (interquartile range) DHEAS was lower in the hypogonadal 0.31 (0.27-0.37) μmol/l, compared with the eugonadal group 0.75 (0.50-1.51) μmol/l (p=0.005). POF was documented in 11% of female patients. Male testosterone deficiency was highly prevalent in this cohort and was primarily due to secondary hypogonadism. Only BMI and hs-CRP were increased in untreated male hypogonadal subjects. Male and female hypogonadism appears to be a common complication of Addison's disease and may contribute to its morbidity. © Georg Thieme Verlag KG Stuttgart · New York.

Primary Adrenal Insufficiency (Addison's Disease) Associated with Systemic Lupus Erythematosus: A Rare Occurrence.

Science.gov (United States)

Godswill, Okwuonu Chimezie; Odigie, Ojeh-Oziegbe

2014-10-01

Coexistence of Addison's disease and systemic lupus erythematosus (SLE) is a rare occurrence with only few reported cases in the literature. We describe a 29-year-old woman who presented to us with clinical features of acute Addisonian crisis and SLE. Laboratory investigations were confirmatory of Addison's disease in a background of SLE. The patient made remarkable improvement on administration of steroids as replacement therapy for adrenal insufficiency and treatment of SLE. Clinicians need to have a high-index of suspicion of this possible coexistence in order to avoid the associated deleterious hemodynamic and metabolic consequences.

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison's disease with primary hypothyroidism

Science.gov (United States)

Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K.; Vivekanandan, Muthupillai

2016-01-01

Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations. PMID:27042409

AIRE variations in Addison's disease and autoimmune polyendocrine syndromes (APS)

DEFF Research Database (Denmark)

Bøe Wolff, A S; Oftedal, B; Johansson, S

2008-01-01

Autoimmune Addison's disease (AAD) is often associated with other components in autoimmune polyendocrine syndromes (APS). Whereas APS I is caused by mutations in the AIRE gene, the susceptibility genes for AAD and APS II are unclear. In the present study, we investigated whether polymorphisms...

MANAGEMENT OF ENDOCRINE DISEASE: Regenerative therapies in autoimmune Addison's disease.

Science.gov (United States)

Gan, Earn H; Pearce, Simon H

2017-03-01

The treatment for autoimmune Addison's disease (AAD) has remained virtually unchanged in the last 60 years. Most patients have symptoms that are relatively well controlled with exogenous steroid replacement, but there may be persistent symptoms, recurrent adrenal crisis and poor quality of life, despite good compliance with optimal current treatments. Treatment with conventional exogenous steroid therapy is also associated with premature mortality, increased cardiovascular risk and complications related to excessive steroid replacement. Hence, novel therapeutic approaches have emerged in the last decade attempting to improve the long-term outcome and quality of life of patients with AAD. This review discusses the recent developments in treatment innovations for AAD, including the novel exogenous steroid formulations with the intention of mimicking the physiological biorhythm of cortisol secretion. Our group has also carried out a few studies attempting to restore endogenous glucocorticoid production via immunomodulatory and regenerative medicine approaches. The recent advances in the understanding of adrenocortical stem cell biology, and adrenal plasticity will also be discussed to help comprehend the science behind the therapeutic approaches adopted. © 2017 European Society of Endocrinology.

Management of hypertension and heart failure in patients with Addison's disease.

Science.gov (United States)

Inder, Warrick J; Meyer, Caroline; Hunt, Penny J

2015-06-01

Addison's disease may be complicated by hypertension and less commonly by heart failure. We review the pathophysiology of the renin-angiotensin-aldosterone axis in Addison's disease and how this is altered in the setting of hypertension and heart failure. An essential first step in management in both conditions is optimizing glucocorticoid replacement and considering dose reduction if excessive. Following this, if a patient with Addison's disease remains hypertensive, the fludrocortisone dose should be reviewed and reduced if there are clinical and/or biochemical signs of mineralocorticoid excess. In the absence of such signs, where the renin is towards the upper end of the normal range or elevated, an angiotensin II (AII) receptor antagonist or angiotensin converting enzyme (ACE) inhibitor is the treatment of choice, and the fludrocortisone dose should remain unchanged. Dihydropyridine calcium channel blockers are clinically useful as second line agents, but diuretics should be avoided. In the setting of heart failure, there is an increase in total body sodium and water; therefore, it is appropriate to reduce and rarely consider ceasing the fludrocortisone. Loop diuretics may be used, but not aldosterone antagonists such as spironolactone or eplerenone. Standard treatment with ACE inhibitors, or as an alternative, AII receptor antagonists, are appropriate. Measurements of renin are no longer helpful in heart failure to determine the volume status but plasma levels of brain natriuretic peptide (BNP/proBNP) may help guide therapy. © 2014 John Wiley & Sons Ltd.

Addison's Disease Revisited in Poland: Year 2008 versus Year 1990

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Kasperlik-Zaluska, Anna A.; Czarnocka, Barbara; Jeske, Wojciech; Papierska, Lucyna

2010-01-01

This study aimed at comparing two groups of patients with Addison's disease: A, including 180 patients described in 1991 and B, consisting of 138 patients registered since 1991. The incidence of coexisting autoimmune disorders was evaluated and etiological factors were analyzed. Immunological and imaging studies (computed tomography in group B) were performed. Adrenal autoantibodies were examined by an indirect immunofluorescence technique in group A, and by the assay measuring autoantibodies against steroid 21-hydroxylase in group B. Adrenal autoantibodies were revealed in 37% of patients examined by the immunofluorescence method and in 63% investigated by the modern technique. Tuberculosis was found in 52 patients in the group A and in two patients in the group B; metastatic infiltrations of the adrenals in CT were detected in 16 patients. Probable autoimmune Addison's disease was diagnosed in 125/180 patients (69%) in the group A and in 116/138 patients (84%) in the group B. PMID:21188237

Addison's Disease Revisited in Poland: Year 2008 versus Year 1990

Directory of Open Access Journals (Sweden)

Anna A. Kasperlik-Zaluska

2010-01-01

Full Text Available This study aimed at comparing two groups of patients with Addison's disease: A, including 180 patients described in 1991 and B, consisting of 138 patients registered since 1991. The incidence of coexisting autoimmune disorders was evaluated and etiological factors were analyzed. Immunological and imaging studies (computed tomography in group B were performed. Adrenal autoantibodies were examined by an indirect immunofluorescence technique in group A, and by the assay measuring autoantibodies against steroid 21-hydroxylase in group B. Adrenal autoantibodies were revealed in 37% of patients examined by the immunofluorescence method and in 63% investigated by the modern technique. Tuberculosis was found in 52 patients in the group A and in two patients in the group B; metastatic infiltrations of the adrenals in CT were detected in 16 patients. Probable autoimmune Addison's disease was diagnosed in 125/180 patients (69% in the group A and in 116/138 patients (84% in the group B.

Adrenal crisis in treated Addison's disease: a predictable but under-managed event.

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White, Katherine; Arlt, Wiebke

2010-01-01

Adrenal crisis is a life-threatening event that occurs regularly in Addison's patients receiving standard replacement therapy. Patient reports suggest that it is an underestimated and under-managed event. To assess the frequency of adrenal crisis in diagnosed patients and to understand the factors contributing to the risks of adrenal crisis. We conducted a postal survey of Addison's patients in four countries, UK (n=485), Canada (n=148), Australia (n=123) and New Zealand (n=85) in 2003, asking about patients' experiences of adrenal crisis and their demographic characteristics. In 2006, a shorter follow-up survey was conducted in the UK (n=261). The frequency and causes of adrenal crisis were compared across both surveys. Demographic data from the 2003 survey were analysed to establish the main variables associated with an elevated risk of crisis. Around 8% of diagnosed cases can be expected to need hospital treatment for adrenal crisis annually. Exposure to gastric infection is the single most important factor predicting the likelihood of adrenal crisis. Concomitant diabetes and/or asthma increase the frequency of adrenal crises reported by patients. The endocrinologist has a responsibility to ensure that Addison's patients have adequate access to life-saving emergency injection materials and repeated, practical training sessions in how to use them, while the general practitioner plays a vital role as in arranging prompt emergency admissions.

Hyperkalaemic periodic paralysis: a rare presentation of Addison's disease.

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Sowden, J. M.; Borsey, D. Q.

1989-01-01

A 44 year old man with longstanding diabetes mellitus gave a 6-month history of periodic attacks of flaccid quadriplegia. Following one of these episodes he was admitted for assessment. In view of persistent hyperkalaemia, hypoadrenalism was suspected and Addison's disease was confirmed biochemically. Adrenal replacement therapy restored the potassium levels to normal and resulted in no further attacks of paralysis. PMID:2594601

Partial recovery of adrenal function in a patient with autoimmune Addison's disease.

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Smans, L C C J; Zelissen, P M J

2008-07-01

To our knowledge, no case of remission in autoimmune Addison's disease has previously been reported. We describe a patient with primary adrenal insufficiency caused by autoimmune adrenalitis in whom partial remission was observed after 7 yr. A 39-yr-old male was referred because of extreme fatigue, weight loss, anorexia, nausea, and bouts of fever. During physical examination hyperpigmentation was seen. Laboratory tests showed a plasma cortisol of 0.02 micromol/l (08:30 h). Cortisol failed to increase during the ACTH stimulation test (0.02 to 0.03 micromol/l) and ACTH was markedly elevated (920 pmol/l). Adrenal auto-antibodies were weakly positive. A CT-scan showed no evidence of calcifications or other abnormalities of the adrenal glands. The diagnosis of autoimmune Addison's disease was made and replacement therapy with hydrocortisone and fludrocortisone was started. During the following years the dose of hydrocortisone was gradually decreased. Eventually, the patient decided to stop his medication completely. A repeated ACTH-stimulation test revealed a basal cortisol of 0.25 micromol/l and a peak cortisol of 0.30 micromol/l with a basal ACTH of 178 pmol/l. The patient did not have any complaints. Recovery of adrenal insufficiency, due to causes other than autoimmune adrenalitis, has been reported in the past. If our case of partial recovery of autoimmune adrenalitis is not unique this could have profound effects on treatment and follow-up of Addison's disease.

Vertebral fractures assessed with dual-energy X-ray absorptiometry in patients with Addison's disease on glucocorticoid and mineralocorticoid replacement therapy.

Science.gov (United States)

Camozzi, Valentina; Betterle, Corrado; Frigo, Anna Chiara; Zaccariotto, Veronica; Zaninotto, Martina; De Caneva, Erica; Lucato, Paola; Gomiero, Walter; Garelli, Silvia; Sabbadin, Chiara; Salvà, Monica; Costa, Miriam Dalla; Boscaro, Marco; Luisetto, Giovanni

2018-02-01

to assess bone damage and metabolic abnormalities in patients with Addison's disease given replacement doses of glucocorticoids and mineralocorticoids. A total of 87 patients and 81 age-matched and sex-matched healthy controls were studied. The following parameters were measured: urinary cortisol, serum calcium, phosphorus, creatinine, 24-h urinary calcium excretion, bone alkaline phosphatase, parathyroid hormone, serum CrossLaps, 25 hydroxyvitamin D, and 1,25 dihydroxyvitamin D. Clear vertebral images were obtained with dual-energy X-ray absorptiometry in 61 Addison's disease patients and 47 controls and assessed using Genant's classification. Nineteen Addison's disease patients (31.1%) had at least one morphometric vertebral fracture, as opposed to six controls (12.8%, odds ratio 3.09, 95% confidence interval 1.12-8.52). There were no significant differences in bone mineral density parameters at any site between patients and controls. In Addison's disease patients, there was a positive correlation between urinary cortisol and urinary calcium excretion. Patients with fractures had a longer history of disease than those without fractures. Patients taking fludrocortisone had a higher bone mineral density than untreated patients at all sites except the lumbar spine. Addison's disease patients have more fragile bones irrespective of any decrease in bone mineral density. Supra-physiological doses of glucocorticoids and longer-standing disease (with a consequently higher glucocorticoid intake) might be the main causes behind patients' increased bone fragility. Associated mineralocorticoid treatment seems to have a protective effect on bone mineral density.

Recurrent nocturnal hypoglycaemia as a cause of morning fatigue in treated Addison's disease--favourable response to dietary management: a case report.

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Petersen, Kristina S; Rushworth, R Louise; Clifton, Peter M; Torpy, David J

2015-10-24

Addison's disease, or primary adrenal insufficiency, is often associated with reduced well-being and fatigue despite use of currently recommended adrenal hormone replacement. Hypoglycaemia is a known manifestation of glucocorticoid deficiency, but is generally considered rare in adults and not relevant to troubling ongoing symptoms in patients with Addison's disease. A 43 year old woman with a three year history of Addison's disease complained of severe morning fatigue and headaches, despite standard glucocorticoid replacement therapy in the form of thrice daily hydrocortisone and mineralocorticoid replacement with fludrocortisone. Alternative glucocorticoid replacement regimens and the addition of dehydroepiandrosterone replacement therapy had no effect. Nocturnal hypoglycaemia was suspected and a 4-day continuous glucose monitor system (CGMS) revealed hypoglycaemia (interstitial glucose < 2.2 mmol/L) between 0200-0400 h on 3 of 4 days. The patient was counselled to take an evening snack designed to ensure slow absorption of ingested carbohydrates. Nocturnal hypoglycaemia was then absent on follow up CGMS assessment. The patient noted a marked symptomatic improvement in morning symptoms, but with persistent fatigue during the day. Currently, the best strategy for control of non-specific symptoms in treated Addison's disease is unknown, but it may be that investigation for hypoglycaemia and treatment, where necessary, could assist some sufferers to achieve improved wellbeing. A systematic study of this phenomenon in Addison's disease is required.

Addison's disease due to tuberculosis in a 13-year-old girl

International Nuclear Information System (INIS)

Jagannath, A.; Brill, P.W.; Winchester, P.

1986-01-01

A 13-year-old girl developed Addison's disease during antituberculous therapy for presumed tuberculous ventriculitis. CT of the abdomen showed diffusely enlarged hypodense adrenals and a hypodense lesion in the lower pole of the left kidney. Biopsy of the renal lesion revealed caseating and noncaseating granolomas. (orig.)

Addisons disease in an Indian female – A rarity | Brar | Sudanese ...

African Journals Online (AJOL)

caused by autoimmune destruction of adrenal gland cortex. Those with Addisons disease have a deficiency of cortisol and aldostreone. These deficiencies are accompanied by adrenal androgen depletion. A case report of 43 year old female is hereby reported. The patient presented with hyperpigmentation of nipples, ...

DOENÇA DE ADDISON: A DIFICULDADE DO DIAGNÓSTICO

Directory of Open Access Journals (Sweden)

Clara Preto

2016-07-01

Discussão: A doença de Addison é uma patologia rara em idade pediátrica e o seu diagnóstico requer um elevado grau de suspeição, dada a inespecificidade da sintomatologia inicial. Os autores pretendem alertar para a suspeição necessária perante uma clínica de hiponatrémia associada a sintomas constitucionais e gastrointestinais.

Salivary cortisol day curves in assessing glucocorticoid replacement therapy in Addison's disease

NARCIS (Netherlands)

Smans, L.; Lentjes, E.G.W.M.; Hermus, A.R.; Zelissen, P.M.J.

2013-01-01

OBJECTIVE: Patients with Addison's disease require lifelong treatment with glucocorticoids. At present, no glucocorticoid replacement therapy (GRT) can exactly mimic normal physiology. As a consequence, under- and especially overtreatment can occur. Suboptimal GRT may lead to various side effects.

Scott Foresman-Addison Wesley Elementary Mathematics. What Works Clearinghouse Intervention Report

Science.gov (United States)

What Works Clearinghouse, 2010

2010-01-01

"Scott Foresman-Addison Wesley Elementary Mathematics" is a core curriculum for students at all ability levels in prekindergarten through grade 6. The program supports students' understanding of key math concepts and skills and covers a range of mathematical content across grades. The What Works Clearinghouse (WWC) reviewed 12 studies on…

No Difference in Mood and Quality of Life in DHEA-S Deficient Adults with Addison's Disease vs. Type 2 Diabetes Patients with Normal DHEA-S Levels: Implications for Management of These Conditions.

Science.gov (United States)

Heald, Adrian H; Walther, Andreas; Davis, Julian R E; Moreno, Gabriela Y C; Kane, John; Livingston, Mark; Fowler, Helen L

2017-01-01

Patients with Addison's disease have relatively high rates of depression and anxiety symptoms compared with population-based reference samples. Addison's disease results in deficiency of dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S). There is considerable debate about the specific effects of DHEA deficiency on energy level and mood. We measured emotional well-being in 16 patients with Addison's disease and a group of 16 hospital attendees with type 2 diabetes. Participants completed the General Health Questionnaire-28 (GHQ-28), the Hospital Anxiety and Depression Scale (HADS), the World Health Organization's quality of life assessment (WHOQOL-BREF) and the Holmes-Rahe life event scale. DHEA-S was low in Addison's patients (Addison's men: 0.5 ± 0.1 μmol/l [normal range: 2.1-10.8] compared with diabetes men: 3.2 ± 1.2 μmol/l; Addison's women: 0.4 ± 0.01 μmol/l [normal range: 1.0-11.5] compared with diabetes women: 2.2 ± 0.71 μmol/l). Testosterone levels were similar in both groups studied. There were no differences in emotional well-being and quality of life (QOL) between patients with Addison's disease and Type 2 Diabetes Mellitus as measured by GHQ-28 (Addison's: 22.4 ± 2.6, Diabetes: 19.6 ± 2.7), HADS Depression (Addison's: 5.4 ± 0.9, Diabetes: 4.5 ± 1.4), HADS Anxiety and WHOQOL-BREF. There were no gender differences in affective symptomatology within the Addison's group. Life event scores were above average in both groups (Addison's: 195 ± 39.6, Diabetes: 131 ± 43.8), but not significant for difference between groups as was GHQ-28 total score. Both groups scored highly on the GHQ-28 and the life event scale, indicative of poorer health perceptions than the general population. This could be due to the chronicity of both disorders. We have not identified any specific effects of DHEA-S deficiency on mood or QOL.

Scott Foresman-Addison Wesley Elementary Mathematics. What Works Clearinghouse Intervention Report. Updated

Science.gov (United States)

What Works Clearinghouse, 2013

2013-01-01

"Scott Foresman-Addison Wesley Elementary Mathematics" is a core mathematics curriculum for students in prekindergarten through grade 6. The program aims to improve students' understanding of key math concepts through problem-solving instruction, hands-on activities, and math problems that involve reading and writing. The curriculum…

Addison's disease presenting with idiopathic intracranial hypertension in 24-year-old woman: a case report

Directory of Open Access Journals (Sweden)

Moore Peter

2010-02-01

Full Text Available Abstract Introduction Idiopathic intracranial hypertension can rarely be associated with an underlying endocrine disorder such as Cushing's syndrome, hyperthyroidism, or with administration of thyroxine or growth hormone. Though cases of idiopathic intracranial hypertension associated with Addison's disease in children have been reported, there is only one documented case report of this association in adults. We describe a case of an acute adrenal insufficiency precipitated by idiopathic intracranial hypertension in a Caucasian female. Case presentation A 24-year-old Caucasian woman was acutely unwell with a background of several months of generalised fatigue and intermittent headaches. She had unremarkable neurological and systemic examination with a normal computerised tomography and magnetic resonance imaging of the brain. Normal cerebrospinal fluid but increased opening pressure at lumbar puncture suggested intracranial hypertension. A flat short synacthen test and raised level of adrenocorticotrophic hormone were consistent with primary adrenal failure. Conclusion Addison's disease can remain unrecognised until precipitated by acute stress. This case suggests that idiopathic intracranial hypertension can rarely be associated with Addison's disease and present as an acute illness. Idiopathic intracranial hypertension is possibly related to an increase in the levels of arginine vasopressin peptide in serum and cerebrospinal fluid secondary to a glucocorticoid deficient state.

Prolonged Dyspnea after Interscalene Block: Attributed to Undiagnosed Addison's Disease and Myasthenia Gravis.

Science.gov (United States)

Skedros, John G; Kiser, Casey J; Mendenhall, Shaun D

2011-01-01

This report describes a patient who had a series of daily interscalene nerve blocks to treat pain following a shoulder manipulation for postsurgical stiffness. She experienced acute respiratory compromise that persisted for many weeks. All typical and unusual causes of these symptoms were ruled out. Her treating pulmonologist theorized that the ipsilateral carotid body had been injured. However, it was subsequently determined that the constellation of symptoms and their prolonged duration were best explained by a poor stress response from Addison's disease coupled with exacerbation of early onset myasthenia gravis. This patient's case is not a typical reaction to interscalene nerve blocks, and thus preoperative testing would not be recommended for myasthenia gravis or Addison's disease without underlying suspicion. We describe this report to inform physicians to consider a workup for these diagnoses if a typical workup rules out all usual causes of complications from an interscalene block.

Prolonged Dyspnea after Interscalene Block: Attributed to Undiagnosed Addison's Disease and Myasthenia Gravis

Directory of Open Access Journals (Sweden)

John G. Skedros

2011-01-01

Full Text Available This report describes a patient who had a series of daily interscalene nerve blocks to treat pain following a shoulder manipulation for postsurgical stiffness. She experienced acute respiratory compromise that persisted for many weeks. All typical and unusual causes of these symptoms were ruled out. Her treating pulmonologist theorized that the ipsilateral carotid body had been injured. However, it was subsequently determined that the constellation of symptoms and their prolonged duration were best explained by a poor stress response from Addison's disease coupled with exacerbation of early onset myasthenia gravis. This patient's case is not a typical reaction to interscalene nerve blocks, and thus preoperative testing would not be recommended for myasthenia gravis or Addison's disease without underlying suspicion. We describe this report to inform physicians to consider a workup for these diagnoses if a typical workup rules out all usual causes of complications from an interscalene block.

Addison hastalığı ve gebelik

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Bayrak, Z; Turan, V; Demirtaş, G; Erdoğan, M; Aşkar, N

2011-01-01

Primer adrenal yetmezlik nadir görülen bir endokrinolojik hastalıktır. Çoğu idiopatiktir. Tip 1 diabetes mellitus, hipertiroidizm, hipotiroidizm, pernisiyöz anemi gibi otoimmun hastalıklarla ilişkilidir. Yirmi sekiz yaşında 18 yıldır Addison hastalığı nedeni ile tedavi gören ve gebelik istemi olan olguyu gebeliğin ilk haftalarından doğuma ve puerperal döneme kadar takip ettik. Endokrinoloji kliniği ile birlikte takip ettiğimiz hastada kortikosteroid tedavisi ile antenatal ve postnatal dönemde...

Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's Disease).

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Meyer, Gesine; Hackemann, Annika; Reusch, Juergen; Badenhoop, Klaus

2012-05-01

Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days. In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.

Addison's Disease and Pituitary Enlargement.

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Winters, Stephen J; Vitaz, Todd; Nowacki, Michael R; Craddock, Durrett C; Silverman, Craig

2015-06-01

A 60-year-old man with Addison's disease, primary hypothyroidism and type 2 diabetes mellitus who was treated with stable doses of hydrocortisone and fludrocortisone developed increasing skin pigmentation and a bitemporal hemianopia. The plasma ACTH level was 14,464 pg/mL, and an invasive pituitary macroadenoma with suprasellar extension was found on magnetic resonance imaging leading to transnasal-transsphenoidal adenomectomy. The tumor demonstrated features of an eosinophilic adenoma and stained uniformly for ACTH. Residual tumor was treated with stereotactic radiotherapy. This case and the 13 cases published previously indicate that primary adrenal failure may predispose to corticotroph hyperplasia, and in some patients to the development of an invasive corticotroph adenoma. The ACTH level should be measured, and a pituitary magnetic resonance imaging is indicated when skin pigmentation increases in a patient with primary adrenal failure who is receiving customary treatment with glucocorticoids and mineralocorticoids.

Addison's disease due to bilateral post-traumatic adrenal haemorrhage: CT and MR findings

International Nuclear Information System (INIS)

Wilms, G.; Tits, J.; Vanstraelen, D.; Marchal, G.; Rigauts, H.; Baert, A.L.

1991-01-01

In a patient with Addison's disease, who gave a history of a severe car accident, CT showed bilateral enlargement of the adrenal glands. MRI, by demonstrating paramagnetic T1 shortening due to methaemoglobin and haemosiderin on T2-weighted images, confirmed the haemorrhagic nature of the lesions. (orig.)

Diagnosis and classification of Addison's disease (autoimmune adrenalitis).

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Brandão Neto, Rodrigo Antonio; de Carvalho, Jozélio Freire

2014-01-01

Autoimmune adrenalitis, or autoimmune Addison disease (AAD), is the most prevalent cause of primary adrenal insufficiency in the developed world. AAD is rare and can easily be misdiagnosed as other conditions. The diagnosis depends on demonstrating inappropriately low cortisol production and the presence of high titers of adrenal cortex autoantibodies (ACAs), along with excluding other causes of adrenal failure using other tests as necessary. The treatment corticosteroid replacement, and the prognosis following the treatment is the same as the normal population. Spontaneous recovery of adrenal function has been described but is rare. Copyright © 2014 Elsevier B.V. All rights reserved.

Addison disease in patients treated with glucocorticoid therapy.

LENUS (Irish Health Repository)

Cronin, C C

2012-02-03

Acute adrenal crisis in patients with unrecognized chronic adrenocortical failure is difficult to diagnose and potentially fatal. We describe 2 patients with acute adrenal crisis whose diagnoses were hindered because of concomitant glucocorticoid treatment. Acute adrenal insufficiency is primarily a state of mineralocorticoid deficiency. Prednisolone and prednisone, the most frequently prescribed anti-inflammatory corticosteroid agents, have minimal mineralocorticoid activity. Several conditions that may be treated with pharmacological glucocorticoids are associated with an increased risk of Addison disease. An acute adrenal crisis, against which concurrent glucocorticoid therapy does not confer adequate protection, may develop in such patients.

Immunoglobulins of patients with idiopathic Addison's disease block the in vitro action of adrenocorticotropin

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Wulffraat, N. M.; Drexhage, H. A.; Bottazzo, G. F.; Wiersinga, W. M.; Jeucken, P.; van der Gaag, R.

1989-01-01

The presence of serum immunoglobulins (Ig) blocking ACTH-induced adrenal DNA synthesis and/or cortisol production was studied in 25 patients with idiopathic Addison's disease. For this purpose guinea pig adrenal segments kept in organ culture were exposed to ACTH and graded concentrations of patient

High frequency of cytolytic 21-hydroxylase-specific CD8+ T cells in autoimmune Addison's disease patients.

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Dawoodji, Amina; Chen, Ji-Li; Shepherd, Dawn; Dalin, Frida; Tarlton, Andrea; Alimohammadi, Mohammad; Penna-Martinez, Marissa; Meyer, Gesine; Mitchell, Anna L; Gan, Earn H; Bratland, Eirik; Bensing, Sophie; Husebye, Eystein S; Pearce, Simon H; Badenhoop, Klaus; Kämpe, Olle; Cerundolo, Vincenzo

2014-09-01

The mechanisms behind destruction of the adrenal glands in autoimmune Addison's disease remain unclear. Autoantibodies against steroid 21-hydroxylase, an intracellular key enzyme of the adrenal cortex, are found in >90% of patients, but these autoantibodies are not thought to mediate the disease. In this article, we demonstrate highly frequent 21-hydroxylase-specific T cells detectable in 20 patients with Addison's disease. Using overlapping 18-aa peptides spanning the full length of 21-hydroxylase, we identified immunodominant CD8(+) and CD4(+) T cell responses in a large proportion of Addison's patients both ex vivo and after in vitro culture of PBLs ≤20 y after diagnosis. In a large proportion of patients, CD8(+) and CD4(+) 21-hydroxylase-specific T cells were very abundant and detectable in ex vivo assays. HLA class I tetramer-guided isolation of 21-hydroxylase-specific CD8(+) T cells showed their ability to lyse 21-hydroxylase-positive target cells, consistent with a potential mechanism for disease pathogenesis. These data indicate that strong CTL responses to 21-hydroxylase often occur in vivo, and that reactive CTLs have substantial proliferative and cytolytic potential. These results have implications for earlier diagnosis of adrenal failure and ultimately a potential target for therapeutic intervention and induction of immunity against adrenal cortex cancer. Copyright © 2014 by The American Association of Immunologists, Inc.

Vitamin D effects on monocytes' CCL-2, IL6 and CD14 transcription in Addison's disease and HLA susceptibility.

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Kraus, A U; Penna-Martinez, M; Meyer, G; Badenhoop, K

2018-03-01

Addison's disease is a rare autoimmune disorder leading to adrenal insufficiency and life-long glucocorticoid dependency. Vitamin D receptor (VDR) polymorphisms and vitamin D deficiency predispose to Addison's disease. Aim of the current study was, to investigate potential anti-inflammatory vitamin D effects on monocytes in Addison's disease, focusing on inflammatory CCL-2 and IL6, as well on monocyte CD14 markers. Addison's disease is genetically linked to distinct HLA susceptibility alleles. Therefore we analyzed, whether HLA genotypes differed for vitamin D effects on monocyte markers. CD14 + monocytes were isolated from Addison's disease patients (AD, n=13) and healthy controls (HC, n=15) and stimulated with 1,25-dihydroxyvitamin D 3 and IL1β as an inflammatory stimulant. Cells were processed for mRNA expression of CCL-2, IL6 and CD14 and DNA samples were genotyped for major histocompatibility class (MHC) class II-encoded HLA- DQA1-DQB1 haplotypes. We found a downregulation of CCL-2 after vitamin D treatment in IL1β-stimulated monocytes both from AD patients and HC (AD p<0.001; HC p<0.0001). CD14 expression however, was upregulated in both HC and AD patients after vitamin D treatment (p<0.001, respectively). HC showed higher CD14 transcription level than AD patients after vitamin D treatment (p=0.04). Compared to IL1β-induced inflammation, HC have increased CD14 levels after vitamin D treatment (p<0.001), whereas the IL1β-induced CD14 expression of AD patients' monocytes did not change after vitamin D treatment (p=0.8). AD patients carrying HLA high-risk haplotypes showed an increased CCL-2 expression after IL1β-induced inflammation compared to intermediate-risk HLA carriers (p=0.05). Also HC monocytes' CD14 transcription after IL1β and vitamin D co-stimulation differed according to HLA risk profile. We show that vitamin D can exert anti-inflammatory effects on AD patients' monocytes which may be modulated by HLA risk genotypes. Copyright © 2017 Elsevier

The acute effect of a mineralocorticoid receptor agonist on corticotrope secretion in Addison's disease.

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Berardelli, R; Karamouzis, I; D'Angelo, V; Fussotto, B; Minetto, M A; Ghigo, E; Giordano, R; Arvat, E

2016-05-01

Mineralocorticoid receptors (MR) in the hippocampus display an important role in the control of hypothalamic-pituitary-adrenal (HPA) axis, mediating the ''proactive'' feedback of glucocorticoids (GC). Fludrocortisone (FC), a potent MR agonist, has been shown to decrease HPA activity through a hippocampal mechanism. Since it has been demonstrated that FC shows a significant inhibition of the HPA axis response to hCRH stimulus in normal subjects, also at doses usually administered as replacement therapy in patients with Addison's disease, an FC effect at MRs in human pituitary or a GR-pituitary agonism stronger than believed until now has been postulated. Ten patients affected by autoimmune Addison's disease received: (1) placebo p.o. + placebo i.v., (2) hydrocortisone (H) 10 mg p.o. + placebo i.v., (3) FC 0.1 mg p.o. + placebo i.v., (4) FC 0.1 mg and H 10 mg p.o. + placebo i.v. to verify a possible GR FC-mediated effect that might display a repercussion on the GC-replacement therapy. H reduced ACTH (p < 0.01) and increased cortisol levels (p < 0.01) with respect to the placebo session, while FC did not affect either ACTH or cortisol levels compared to placebo, and higher ACTH and lower cortisol levels (p < 0.03 and p < 0.01) were observed compared with the H session; furthermore the co-administration of FC + H showed ACTH and cortisol profiles similar to that observed during H alone. Our study showed a lack of FC effect on corticotrope secretion in Addison's disease, thus making unlikely the hypothesis of its GR pituitary agonism and the risk of glucocorticoid excess in primary adrenal insufficiency.

Primary anti-phospholipid antibody syndrome causing recurrent venous thrombosis and thrombocytopenia in a patient with Addison's disease.

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Elebrashy, Ibrahim; Yousief, Elham; Saif, Aasem

2014-12-01

We report a case of Addison's disease presenting with recurrent deep venous thrombosis and thrombocytopenia and proved to have primary anti-phospholipid antibody syndrome. The case report highlights the shared autoimmune nature of both diseases.

Addison's Disease and Possible Cannabis Withdrawal Syndrome Presenting as an Eating Disorder in a Thirty-Year-Old Female.

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Lazare, Kimberly

2017-01-01

A 30-year-old female with a history of anxiety, cannabis use, and Avoidant/Restrictive Food Intake Disorder presented for residential treatment of a Cannabis Use Disorder. Upon arrival, she had not eaten for two days and was found to be hypotensive with electrolyte disturbances. She was admitted to a nearby hospital, where the Internist diagnosed her with Addison's disease. She was treated with corticosteroid therapy, with rapid normalization of her electrolytes, eating, and anxiety. This is the first published case of undiagnosed Addison's disease presenting as an eating disorder, with cannabis use likely contributing to symptoms. This case elucidates the importance of ruling out other biologic and psychologic causes of clinical presentations before an eating disorder diagnosis can be made.

Detection of adrenocortical autoantibodies in Addison's disease with a peroxidase-labelled protein A technique

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R.C. Silva

1998-09-01

Full Text Available Adrenocortical autoantibodies (ACA, present in 60-80% of patients with idiopathic Addison's disease, are conventionally detected by indirect immunofluorescence (IIF on frozen sections of adrenal glands. The large-scale use of IIF is limited in part by the need for a fluorescence microscope and the fact that histological sections cannot be stored for long periods of time. To circumvent these restrictions we developed a novel peroxidase-labelled protein A (PLPA technique for the detection of ACA in patients with Addison's disease and compared the results with those obtained with the classical IIF assay. We studied serum samples from 90 healthy control subjects and 22 patients with Addison's disease, who had been clinically classified into two groups: idiopathic (N = 13 and granulomatous (N = 9. ACA-PLPA were detected in 10/22 (45% patients: 9/13 (69% with the idiopathic form and 1/9 (11% with the granulomatous form, whereas ACA-IIF were detected in 11/22 patients (50%: 10/13 (77% with the idiopathic form and 1/9 (11% with the granulomatous form. Twelve of the 13 idiopathic addisonians (92% were positive for either ACA-PLPA or ACA-IIF, but only 7 were positive by both methods. In contrast, none of 90 healthy subjects was found to be positive for ACA. Thus, our study shows that the PLPA-based technique is useful, has technical advantages over the IIF method (by not requiring the use of a fluorescence microscope and by permitting section storage for long periods of time. However, since it is only 60% concordant with the ACA-IIF method, it should be considered complementary instead of an alternative method to IIF for the detection of ACA in human sera.

Addison's disease due to Histoplasma duboisii infection of the adrenal glands

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Mudawi, Hatim M.; Baraka, Omer Z.; El-Hassan, Ahmed M.; El-Amin, Elwaleed M.

2008-01-01

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the normal individual, both disseminated histoplasmosis and symptomatic adrenal histoplasmosis are rare. Herein, we describe the case of a 50-year-old gentleman residing in western Sudan who presented with 7-month history of generalized body weakness, easy fatigue and frequent attacks of vomiting and diarrhea. Physical examination and laboratory investigations confirmed the diagnosis of Addison's disease due to histoplasma capsulatum var duboisii infection of the adrenal glands. He was treated with intravenous hydrocortisone, followed by oral prednisolone and itraconazole. (author)

Autoimmune Addison's disease - An update on pathogenesis.

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Hellesen, Alexander; Bratland, Eirik; Husebye, Eystein S

2018-06-01

Autoimmunity against the adrenal cortex is the leading cause of Addison's disease in industrialized countries, with prevalence estimates ranging from 93-220 per million in Europe. The immune-mediated attack on adrenocortical cells cripples their ability to synthesize vital steroid hormones and necessitates life-long hormone replacement therapy. The autoimmune disease etiology is multifactorial involving variants in immune genes and environmental factors. Recently, we have come to appreciate that the adrenocortical cell itself is an active player in the autoimmune process. Here we summarize the complex interplay between the immune system and the adrenal cortex and highlight unanswered questions and gaps in our current understanding of the disease. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Value of the radioimmunological ACTH-determination in plasma for the diagnosis and therapy control of Addison's disease

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Wagner, H.; Degenhardt, G.; Wenning, N.

1974-01-01

The findings obtained before suggest that plasma ACTH determination is another valuable parameter supplementing the determination of plasma corticoids in the diagnosis of Addison's disease. In the assessment of the success of the treatment, plasma ACTH measurement is superior to the determination of plasma corticoids. (orig./AK) [de

BClI polymorphism of the glucocorticoid receptor gene is associated with increased obesity, impaired glucose metabolism and dyslipidaemia in patients with Addison's disease.

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Giordano, Roberta; Marzotti, Stefania; Berardelli, Rita; Karamouzis, Ioannis; Brozzetti, Annalisa; D'Angelo, Valentina; Mengozzi, Giulio; Mandrile, Giorgia; Giachino, Daniela; Migliaretti, Giuseppe; Bini, Vittorio; Falorni, Alberto; Ghigo, Ezio; Arvat, Emanuela

2012-12-01

Although glucocorticoids are essential for health, several studies have shown that glucocorticoids replacement in Addison's disease might be involved in anthropometric and metabolic impairment, with increased cardiovascular risk, namely if conventional doses are used. As the effects of glucocorticoids are mediated by the glucocorticoid receptor, encoded by NR3C1 gene, different polymorphisms in the NR3C1 gene have been linked to altered glucocorticoid sensitivity in general population as well as in patients with obesity or metabolic syndrome. We investigated the impact of glucocorticoid receptor gene polymorphisms, including the BclI, N363S and ER22/23EK variants, on anthropometric parameters (BMI and waist circumference), metabolic profile (HOMA, OGTT and serum lipids) and ACTH levels in 50 patients with Addison's disease (34 women and 16 men, age 20-82 year) under glucocorticoids replacement. Neither N363S nor ER22/23EK variants were significantly associated with anthropometric, metabolic or hormonal parameters, while patients carrying the homozygous BclI polymorphism GG (n = 4) showed higher (P Addison's disease and may contribute, along with other factors, to the increase in central adiposity, impaired glucose metabolism and dyslipidaemia. © 2012 Blackwell Publishing Ltd.

Metachronous adrenal metastasis from operated contralateral renal cell carcinoma with adrenalectomy and iatrogenic Addison's disease.

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Ozturk, Hakan; Karaaslan, Serap

2014-09-01

Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison's disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histo-pathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison's disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.

Addison's disease due to adrenal tuberculosis: Contrast-enhanced CT features and clinical duration correlation

International Nuclear Information System (INIS)

Guo Yingkun; Yang Zhigang; Li Yuan; Ma Ensen; Deng Yuping; Min Pengqiu; Yin Longlin; Hu Jian; Zhang Xiaochun; Chen Tianwu

2007-01-01

Purpose: To describe CT morphology of untreated adrenal tuberculosis during the different stages of the natural history of the disease and to evaluate the diagnostic implications of CT features. Materials and methods: We retrospectively evaluated CT features in 42 patients with documented adrenal tuberculosis for the location, size, morphology, and enhancement patterns shown on CT images. The clinical duration were correlated with the CT features. Results: Of the 42 patients with untreated adrenal tuberculosis, bilaterally enlarged adrenal glands were revealed in 38 cases (91%), unilaterally enlarged in 3 cases (7%), and normal size in 1 case (2%). Of the 41 cases (98%) with enlargement, mass-like enlargement was seen in 20 cases (49%) and enlargement with preserved contours in 21 cases (51%). Peripheral rim enhancement presented in 22 cases (52%) on contrast-enhanced CT. Non-enhanced CT scan revealed calcification in 21 cases (50%). As the duration of Addison's disease increased, the presence of calcification and contour preservation increased concomitantly (p < 0.001), whereas peripheral rim enhancement and mass-like enlargement decreased concomitantly on CT images (p < 0.001). Conclusion: CT may be helpful in diagnosing adrenal tuberculosis when clinically suspected, and CT features are correlated to the clinical duration of Addison's disease

Addison's disease with adrenal enlargement on sonography and computed toimography

International Nuclear Information System (INIS)

Renner, F.; Graninger, W.

1986-01-01

One of the major causes of chronic adrenal insufficiency (Addison's disease) is tuberculous adrenalopathy. Since sonography and computed tomography have become generally available in recent years and are of potential help in the diagnosis of this disease the merits of these methods are discussed in the light of 2 cases of adrenal tuberculosis, followed by a review of the literature. Adrenal calcification is the most significant, although not specific sign of adrenal insufficiency due to tuberculosis. Computed tomography has proven to be the method of choice in the non-invasive diagnosis of tuberculous adrenalopathy and in the monitoring of tuberculostatic treatment in this disease. Sonography is helpful as a preliminary investigation. (Author)

A rare case of Addison's disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency.

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Baleva, Marta P; Mihaylova, Snejina; Yankova, Petja; Atanasova, Iliana; Nikolova-Vlahova, Milena; Naumova, Elissaveta

2016-01-01

Selective IgA deficiency (IgAD) is the most prevalent type of primary immune deficiencies, but partial IgA deficiency is even more common. Addison's disease is a rare condition associated with primary adrenal insufficiency due to infection or autoimmune destruction of the adrenals. The association between IgA deficiency and Addison's disease is very rare. We observed a 22-year-old male patient with marked darkening of the skin, especially on the palms and areolae, jaundice on the skin and sclera, astheno-adynamia, hypotension (80/50 mm Hg), and pain in the right hypochondrium. The laboratory investigations revealed increased serum levels of total and indirect bilirubin, AST, ALT, GGT and LDH, negative HBsAg, anti-HBc IgM, anti-HCV and anti-HAV IgM, very low serum IgA levels (0.16 g/l) with normal IgG and IgM, negative ANA, ANCA, AMA, LKM-1, anti-GAD-60, anti-IA-2, anti-thyroglobulin antibodies, a mild increase in anti-TPO antibodies titer, a marked increase in IgG anti-tissue transglutaminase antibodies, with no typical changes in cellular immunity, negative T-SPOT-TB test, HLA - A*01; B*08; DRB1*03; DQB1*02, karyotype - 46, XY. We present a rare case of partial IgA deficiency with Addison's disease, hepatitis, thyroiditis and positive anti-tissue transglutaminase antibodies. IgAD and some autoimmune disorders share several predisposing HLA genes, thus explaining the increased prevalence of IgAD in certain patient groups.

A case of adrenoleukodystrophy presenting with manic symptoms in a patient on steroids for Addison's disease.

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Jyothi, K S; George, Cyriac; Shaji, K S

2016-01-01

Adrenoleukodystrophy (ALD) is an X-linked disorder with diverse clinical presentations. A 30-year-old male, previously diagnosed with Addison's disease, on steroid supplementation for 18 years, presented to us with manic symptoms for 4 years. He was found to have white matter hypodensities in computed tomography head and had white matter signal changes in magnetic resonance imaging, and therefore a diagnosis of ALD was made.

Adult cerebral adrenoleukodystrophy and Addison's disease in a female carrier.

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Chen, Xiaoyan; Chen, Zhiye; Huang, Dehui; Liu, Xiaofeng; Gui, Qiuping; Yu, Shengyuan

2014-07-10

We described a 38-year-old woman of rapidly progressive dementia with white matter encephalopathy and death. She had Addison's disease but the adrenal glands were hyperplastic. Brain magnetic resonance imaging revealed diffuse white matter lesion predominantly in the frontal lobe with band-like contrast enhancement. l-Methyl-11C-methionine positron emission tomography revealed accumulation of tracer in bilateral frontal lobes. Stereotactic biopsy demonstrated demyelination changes. A number of urinary organic acids were elevated. Adrenoleukodystrophy was diagnosed by elevated plasma very long chain fatty acid and ABCD1 gene mutation (C1544C/T). Adrenoleukodystrophy should be considered as a differential diagnosis in women with rapidly progressive white matter encephalopathy. Copyright © 2014 Elsevier B.V. All rights reserved.

Pulsatile luteinizing hormone secretion in patients with Addison's disease. Impact of glucocorticoid substitution

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Hangaard, J; Andersen, M; Grodum, E

1998-01-01

The physiological and pathophysiological role of cortisol in pulsatile LH release was investigated in 14 patients (5 men, 6 premenopausal women, and 3 postmenopausal women) with Addison's disease. The explicit effect of cortisol in relation to the effect of corticotropin-releasing factor (CRF......), ACTH, and opioids was ensured by hypo-, normo-, and hypercortisolism. Hypocortisolism was obtained by 24-h discontinuation of hydrocortisone (HC) followed by 23-h saline infusion. Eucortisolism was secured by infusion of HC (0.5 mg/kg) over 23 h. Stress-appropriate hypercortisolism was obtained...

Predicting the onset of Addison's disease: ACTH, renin, cortisol and 21-hydroxylase autoantibodies

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Baker, Peter R.; Nanduri, Priyaanka; Gottlieb, Peter A.; Yu, Liping; Klingensmith, Georgeanna J.; Eisenbarth, George S.; Barker, Jennifer M.

2016-01-01

Summary Context Autoantibodies to 21-hydroxylase (21OH-AA) precede onset of autoimmune Addison's disease (AD). Progression to AD can take months to years, and early detection of metabolic decompensation may prevent morbidity and mortality. Objective To define optimal methods of predicting progression to overt AD (defined by subnormal peak cortisol response to Cosyntropin) in 21OH-AA+ individuals. Design, Setting and Participants Individuals were screened for 21OH-AA at the Barbara Davis Center from 1993 to 2011. Subjects positive for 21OH-AA (n = 87) were tested, and the majority prospectively followed for the development of Addison's disease, including seven diagnosed with AD upon 21OH-AA discovery (discovered), seven who progressed to AD (progressors) and 73 nonprogressors. Main Outcome Measured Plasma renin activity (PRA), ACTH, baseline cortisol, peak cortisol and 21OH-AA were measured at various time points relative to diagnosis of AD or last AD-free follow-up. Results Compared with nonprogressors, in the time period 2 months–2 years prior to the onset of AD, progressors were significantly more likely to have elevated ACTH (11–22 pm, P < 1E-4), with no significant differences in mean PRA (P = 0·07) or baseline cortisol (P = 0·08), and significant but less distinct differences seen with 21OH-AA levels (P < 1E-4) and poststimulation cortisol levels (P = 6E-3). Conclusion Moderately elevated ACTH is a more useful early indicator of impending AD than 21OH-AA, PRA or peak cortisol, in the 2 months–2 years preceding the onset of AD. PMID:22066755

Addison's disease concomitant with corticotropin deficiency and pituitary CRH resistance - a case report.

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Lewandowski, Krzysztof C; Malicka, Katarzyna; Dąbrowska, Katarzyna; Lewiński, Andrzej

2017-01-01

A 36-year-old woman was found to have a low morning ACTH concentration despite a history of Addison's disease. Past medical history: At the age of 23 years the subject developed Graves's disease, which was treated with radioiodine. At about the same time, she claimed to have two episodes of pancreatitis treated with cholecystectomy. About seven months later she was euthyroid on L-thyroxine (TSH 1.51 mIU/mL) but was admitted with hypotension, hyponatraemia (sodium 109 mmol/L), and low morning cortisol (119 nmol/L). Further investigations confirmed primary adrenal failure with ACTH concentration of 779 pg/mL (ref. range 0-60) prior to the dose of hydrocortisone. About nine years later she complained about tiredness. Clinically she was normotensive and not pigmented. BMI 22.3 kg/m². Periods were regular. ACTH concentration was surprisingly low (ACTH 8.53 pg/mL, ref. range 0-46), despite very low cortisol (3.37 nmol/L). She was admitted for further assessment. Pituitary MRI scan was unremarkable. An insulin tolerance test was performed and showed a clear increase of ACTH (from 15.2 to 165 pg/mL). There was, however, hardly any increase of ACTH after CRH stimulation (from 6.05 pg/mL to 10.2 pg/mL), thus demonstrating central CRH resistance. In summary, this patient developed secondary adrenal failure in the setting of previous Addison's disease. Interestingly, hypoglycaemia (but not CRH) provided a stimulus for ACTH release, thus demonstrating CRH resistance. The case confirms that besides CRH, other factors are responsible for stimulation of the ACTH-cortisol axis during insulin tolerance test.

Two different cytochrome P450 enzymes are the adrenal antigens in autoimmune polyendocrine syndrome type I and Addison's disease.

OpenAIRE

Winqvist, O; Gustafsson, J; Rorsman, F; Karlsson, F A; Kämpe, O

1993-01-01

Autoimmune polyendocrine syndrome type I (APS I) and idiopathic Addison's disease are both disorders with adrenal insufficiency but with differences in genetic background, clinical presentation, and extent of extraadrenal manifestations. In this study the major adrenal autoantigen identified with sera from patients with APS I was characterized by analyses using indirect immunofluorescence, Western blots of adrenal subcellular fractions and of recombinant proteins, immunoprecipitations of [35S...

Addison's Disease in Evolution: An Illustrative Case and Literature Review.

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Hinz, Laura E; Kline, Gregory A; Dias, Valerian C

2014-09-01

To present a case of symptomatic autoimmune adrenal insufficiency with initially normal serum cortisol and to caution about limitations of the current diagnostic algorithm for adrenal insufficiency, which does not reflect the pathophysiology of early disease. We describe the clinical presentation and relevant investigations of a patient ultimately found to have Addison's disease, which is followed by a focused review of the literature. A 41-year-old Caucasian woman with autoimmune hypothyroidism, premature ovarian failure, and microscopic colitis presented with nausea, salt craving, increased skin pigmentation, and postural hypotension. Initial bloodwork revealed a normal morning cortisol of level of 19.2 μg/dL (normal, 7.2 to 25 μg/dL) but an adrenocorticotropic hormone (ACTH) level 10 times normal, at 513.6 pg/mL (normal, <52.5 pg/mL). Her potassium was normal, but her aldosterone level was 4.12 ng/dL (normal, 12.3 to 62.5 ng/dL) and her renin activity was increased (23.0 mg/dL/hour; normal, <6.0 mg/dL/hour). Six weeks after initial presentation, she was found to have anti-adrenal antibodies. It was not until 10 weeks after her initial symptomatic presentation that her morning cortisol level was found to be subnormal and a formal diagnosis of adrenal insufficiency was made. The present case and literature review reveal that common diagnostic approaches will miss patients with (possibly symptomatic) early adrenal insufficiency. We suggest that serum ACTH level testing or tests of mineralocorticoid function be included in the initial step of investigation for suspected primary adrenal insufficiency.

A Complex Interplay: Cognitive Behavioural Therapy for Severe Health Anxiety in Addison's Disease to Reduce Emergency Department Admissions.

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Daniels, Jo; Sheils, Elizabeth

2017-07-01

Addison's disease (AD) is a rare chronic illness caused by adrenocortical insufficiency. Due to the pivotal role of the regulating hormone cortisol in AD, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety in endocrinological disorders, however there is a paucity of research examining the complex interplay between AD and anxiety. This paper describes a single case study of a patient with severe health anxiety and co-morbid AD. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in AD can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions. A single case design was used, with pre- and post-measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain. Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment. This preliminary study provides a sound rationale for further research into AD complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of AD, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.

Altered DNA methylation profile in Norwegian patients with Autoimmune Addison's Disease.

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Bjanesoy, Trine E; Andreassen, Bettina Kulle; Bratland, Eirik; Reiner, Andrew; Islam, Shahinul; Husebye, Eystein S; Bakke, Marit

2014-06-01

Autoimmune Addison's Disease (AAD) is an endocrine and immunological disease of uncertain pathogenesis resulting from the immune system's destruction of the hormone producing cells of the adrenal cortex. The underlying molecular mechanisms are largely unknown, but it is commonly accepted that a combination of genetic susceptibility and environmental impact is critical. In the present study, we identified multiple hypomethylated gene promoter regions in patients with isolated AAD using DNA isolated from CD4+ T cells. The identified differentially methylated regions were distributed evenly across the 10.5-kb-promoter regions covered by the array, and a substantial number localized to promoters of genes involved in immune regulation and autoimmunity. This study reveals a hypomethylated status in CD4+ T cells from AAD patients and indicates differential methylation of promoters of key genes involved in immune responses. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

COEXISTENCE OF ADDISON'S DISEASE AND PERNICIOUS ANEMIA: IS THE NEW CLASSIFICATION OF AUTOIMMUNE POLYGLANDULAR SYNDROME APPROPRIATE?

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Vrkljan, Ana Marija; Pašalić, Ante; Strinović, Mateja; Perić, Božidar; Kruljac, Ivan; Miroševć, Gorana

2015-06-01

A case of autoimmune polyglandular syndrome (APS) is presented. A 45-year-old man was admitted due to fatigue, malaise and inappetence. He had a history of primary hypothyroidism and was on levothyroxine substitution therapy. One year before, he was diagnosed with normocytic anemia and vitamin B12 deficiency, which was treated with vitamin B12 substitution therapy. Physical examination revealed hypotension and marked hyperpigmentation. Laboratory testing showed hyponatremia, hyperkaliemia and severe normocytic anemia. Endocrinological evaluation disclosed low morning cortisol and increased adrenocorticotropic hormone levels. Hence, the diagnosis of Addison's disease was established. Additional laboratory workup showed positive parietal cell antibodies. However, his vitamin B12 levels were increased due to vitamin B12 supplementation therapy, which was initiated earlier. Gastroscopy and histopathology of gastric mucosa confirmed atrophic gastritis. Based on prior low serum vitamin B12 levels, positive parietal cell antibodies and atrophic gastritis, the patient was diagnosed with pernicious anemia. Hydrocortisone supplementation therapy was administered and titrated according to urinary-free cortisol levels. Electrolyte disbalance and red blood cell count were normalized. This case report demonstrates rather unique features of pernicious anemia in a patient with Addison's disease. It also highlights the link between type II and type III APS. Not only do they share the same etiological factors, but also overlap in pathophysiological and clinical characteristics. This case report favors older classification of APS, which consolidates all endocrine and other organ-specific autoimmune diseases into one category. This is important since it might help avoid pitfalls in the diagnosis and treatment of patients with APS.

Maternal and neonatal outcomes of pregnancies in women with Addison's disease: a population-based cohort study on 7.7 million births.

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Schneiderman, M; Czuzoj-Shulman, N; Spence, A R; Abenhaim, H A

2017-10-01

To assess if pregnancies among women with Addison's disease (AD) are at higher risk of adverse maternal and neonatal outcomes. Population-based retrospective cohort study. All births in the United States' Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 2003 to 2011. Baseline characteristics were compared between women with AD and those without, and prevalence over time was measured. Logistic regression was used to estimate the effect of AD on maternal and neonatal outcomes by calculating the crude and adjusted odds ratios (OR) and corresponding 95% confidence intervals (95% CI). We calculated a prevalence of AD in pregnancy of 5.5/100 000, increasing from 5.6 to 9.6/100 000 (P = 0.0001) over the 9-year study period. Compared with women without AD, women with AD were more likely to deliver preterm (OR 1.50, 95% CI 1.16-1.95), deliver by caesarean section (OR 1.32, 95% CI 1.08-1.61), have impaired wound healing (OR 4.28, 95% CI 2.55-7.18), develop infections (OR 2.44, 95% CI 1.66-3.58) and develop thromboembolism (OR 5.21, 95% CI 2.15-12.63), require transfusions (OR 6.69, 95% CI 4.69-9.54), and have prolonged postpartum hospital admissions (OR 5.71, 95% CI 4.37-7.47). Maternal mortality was significantly higher than in the comparison group (OR 22.30, 95% CI 6.82-72.96). Congenital anomalies (OR 3.62, 95% CI 2.05-6.39) and small-for-gestational age infants (OR 1.78, 95% CI 1.15-2.75) were more likely in these pregnancies. Addison's disease significantly increases the risk of severe adverse maternal and neonatal outcomes, so pregnant women with AD are best managed in tertiary-care centres. Pregnancies complicated by Addison's disease have an increased risk of adverse maternal and neonatal outcomes. © 2016 Royal College of Obstetricians and Gynaecologists.

Takotsubo-like syndrome triggered by fludrocortisone overdose for Addison's disease: a case report.

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Campean, Radu; Hasun, Matthias; Stöllberger, Claudia; Bucher, Johannes; Finsterer, Josef; Schnack, Christoph; Weidinger, Franz

2016-10-12

Reversible left ventricular dysfunction, also termed Takotsubo cardiomyopathy, is rarely reported in Addison's disease after initiation of hormone replacement therapy. The pathogenesis of this cardiomyopathy is unknown. A 41-year-old white woman with a history of autoimmune Hashimoto thyroiditis diagnosed 3 years earlier and acute adrenal insufficiency diagnosed 3 weeks earlier presented with new onset of heart failure New York Heart Association class IV, which had started shortly after initiation of hormone replacement therapy with hydrocortisone 20 mg/day and fludrocortisone 0.3 mg/day. Nine days before admission she had collapsed because of dizziness and had a cerebral concussion and open fracture of her nasal bone, however, no further investigations were carried out at that time. A physical examination revealed leg edema, tachycardia, tachypnea, bilateral basal crepitations, and blood pressure 110/70 mmHg. An electrocardiogram showed sinus tachycardia, low voltage, negative T-waves in V 5 and V 6 and a corrected QT interval of 590 ms. Echocardiography revealed a reduced left ventricular systolic function with an ejection fraction of 30 %, and septal, apical, and anterior wall akinesia. Cardiac magnetic resonance imaging showed relative enhancement of gadolinium, indicating hyperemia and capillary leakage, and no myocardial scars. Because of the improvement in her cardiac function, lack of cardiovascular risk factors, and lack of signs for ischemia on magnetic resonance imaging, no coronary angiography was carried out. The results of sellar and renal magnetic resonance imaging were normal. Her troponin T was slightly elevated. Bisoprolol and ramipril were started. Her fludrocortisone dose was reduced to 0.05 mg/day. Her electrocardiogram and systolic function, documented by echocardiography and magnetic resonance imaging, normalized within 6 months. Although we could not exclude coronary artery disease by coronary angiography, her clinical course and

Severe neuroinvasive West Nile virus infection in a child with undiagnosed Addison's disease

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Kevin Messacar

2014-01-01

Full Text Available This report describes a case of West Nile virus (WNV meningoencephalitis in a child who presented with fever, headache, seizures, and altered mental status, as well as hyponatremia and bronzing of the skin. Findings that led to the diagnosis of WNV included plasma-cell pleocytosis of the cerebrospinal fluid (CSF and linear chorioretinitis on ophthalmologic exam. The diagnosis was confirmed by a positive serum and CSF WNV IgM. The acute WNV infection triggered an adrenal crisis which uncovered a new diagnosis of underlying Addison's disease. This is the first case report of severe neuroinvasive WNV disease in a pediatric patient with primary adrenal insufficiency. Neuroinvasive WNV disease is uncommon in children, but may have a more severe presentation in those with certain underlying medical conditions.

Jane Austen's lifelong health problems and final illness: New evidence points to a fatal Hodgkin's disease and excludes the widely accepted Addison's.

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Upfal, A

2005-06-01

Jane Austen is typically described as having excellent health until the age of 40 and the onset of a mysterious and fatal illness, initially identified by Sir Zachary Cope in 1964 as Addison's disease. Her biographers, deceived both by Cassandra Austen's destruction of letters containing medical detail, and the cheerful high spirits of the existing letters, have seriously underestimated the extent to which illness affected Austen's life. A medical history reveals that she was particularly susceptible to infection, and suffered unusually severe infective illnesses, as well as a chronic conjunctivitis that impeded her ability to write. There is evidence that Austen was already suffering from an immune deficiency and fatal lymphoma in January 1813, when her second and most popular novel, Pride and Prejudice, was published. Four more novels would follow, written or revised in the shadow of her increasing illness and debility. Whilst it is impossible now to conclusively establish the cause of her death, the existing medical evidence tends to exclude Addison's disease, and suggests there is a high possibility that Jane Austen's fatal illness was Hodgkin's disease, a form of lymphoma.

Role of the X-linked gene GPR174 in autoimmune Addison's disease.

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Napier, C; Mitchell, A L; Gan, E; Wilson, I; Pearce, S H S

2015-01-01

Autoimmune endocrinopathies demonstrate a profound gender bias, but the reasons for this remain obscure. The 1000 genes on the X chromosome are likely to be implicated in this inherent susceptibility; various theories, including skewed X chromosome inactivation and fetal microchimerism, have been proposed. GPR174 is an Xq21 putative purinergic receptor that is widely expressed in lymphoid tissues. A single-nucleotide polymorphism, rs3827440, encoding Ser162Pro, has recently been associated with Graves' disease in Chinese and Polish populations, suggesting a role of this X chromosome gene in autoimmune disease. We investigated the role of rs3827440 in a UK cohort of patients with autoimmune Addison's disease (AAD). Samples from 286 AAD cases and 288 healthy controls were genotyped using TaqMan single-nucleotide polymorphism genotyping assays (C_25954273_10) on the Applied Biosystems 7900HT Fast real-time PCR system. Using a dominant (present/absent) model, the serine-encoding T allele of rs3827440 was present in 189 of 286 AAD patients (66%) compared with 132 of 288 unaffected controls (46%) [P = .010, odds ratio 1.80 (5%-95% confidence interval 1.22-2.67)]. An allele dosage model found a significant excess of the T allele in AAD patients compared with controls [P = .03, odds ratio 1.34 (5%-95% confidence interval 1.07-1.67)]. We have demonstrated a significant association of this X chromosome-encoded immunoreceptor with AAD for the first time. This X-linked gene could have a more generalized role in autoimmunity pathogenesis: G protein-coupled receptors are promising drugable targets, and further work to elucidate the functional role of GPR174 is now warranted.

Continuous subcutaneous hydrocortisone infusion therapy in Addison's disease: a randomized, placebo-controlled clinical trial.

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Gagliardi, Lucia; Nenke, Marni A; Thynne, Tilenka R J; von der Borch, Jenny; Rankin, Wayne A; Henley, David E; Sorbello, Jane; Inder, Warrick J; Torpy, David J

2014-11-01

Patients with Addison's disease (AD) report impaired subjective health status (SHS). Since cortisol exhibits a robust circadian cycle that entrains other biological clocks, impaired SHS may be due to the noncircadian cortisol profile achieved with conventional glucocorticoid replacement. Continuous subcutaneous hydrocortisone infusion (CSHI) reproduces a circadian cortisol profile, but its effects on SHS have not been objectively evaluated. The aim of this study was to determine the effect of CSHI on SHS in AD. This was a multicentre, double-blind, placebo-controlled trial of CSHI vs oral glucocorticoid therapy. Participants received in random order 4 weeks of: CSHI and oral placebo, and subcutaneous placebo and oral hydrocortisone, separated by a 2-week washout period. SHS was assessed using the Short-Form 36 (SF-36), General Health Questionnaire (GHQ-28), Fatigue Scale (FS), Gastrointestinal Symptom Rating Scale (GSRS); and Addison's Quality of Life Questionnaire (AddiQoL). Participants were asked their (blinded) treatment preference. Twenty-four hour urine free cortisol (UFC) and diurnal salivary cortisol collections compared cortisol exposure during each treatment. Ten participants completed the study. Baseline SHS scores (mean ± SE) were consistent with mild impairment: SF-36 physical component summary 48.4 (± 2.4), mental component summary 53.3 (± 3.0); GHQ-28 18.1 (± 3.3); GSRS 3.7 (± 1.6), and AddiQoL 94.7 (± 3.7). FS was similar to other AD cohorts 13.5 (± 1.0) (P = 0.82). UFC between treatments was not different (P = 0.87). The salivary cortisol at 0800 h was higher during CSHI (P = 0.03), but not at any other time points measured. There was no difference between the treatments in the SHS assessments. Five participants preferred CSHI, four oral hydrocortisone, and one was uncertain. Biochemical measurements indicate similar cortisol exposure during each treatment period, although a more circadian pattern was evident during CSHI. CSHI does not

Computed tomography morphology of the adrenal glands of patients with Addison's disease

International Nuclear Information System (INIS)

Ammini, A.C.; Gupta, R.; Mukopadhyay, C.; Shah, P.; Sandhu, M.S.; Vijayaraghavan, M.; Berry, M.

1996-01-01

To study the morphology of the adrenal glands of patients with Addison's disease an ultrasound and a computed tomographic scan of the adrenal glands were performed in 28 patients. Thirteen patients had bilateral, asymmetric adrenal enlargement. In six of these patients, areas of necrosis and calcification were also seen. Six patients had atrophic glands with calcification and nine patients had normal/atrophic glands without calcification. After instituting appropriate treatment, computed tomography (CT) was repeated between 6 months and 3 years later in 10 of the 13 patients with adrenal enlargement. A reduction in gland size was noted in all patients and one had functional recovery. It is concluded that the appearance of the adrenal glands on CT depends not only on the nature of the underlying disease but also on the duration of the illness and the type of treatment. The results highlighted the importance of studying adrenal morphology during the initial evaluation of patients with adrenal insufficiency. 11 refs., 4 tabs., 4 figs

Addison disease’s in puppy, congenital adrenal hyperplasia (adrenal 21 alpha hydroxilase deficiency) and Hypoparathyroidism in Dogs

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Castillo, Víctor; Ortemberg, L.

2009-01-01

La enfermedad de Addison (EA), la hiperplasia adrenal congénita (HAC) por déficit de 21 αhidroxilasa adrenal y el hipoparatiroidismo (HoPTH) son de diagnóstico poco frecuente, representando el 3% (EA) y 0,5% (tanto HAC como HoPTH) de las enfermedades endócrinas atendidas. Se describen 1 caso de EA congénito (collie de 6 meses de edad), 2 casos de HAC (una caniche toy y una labradora, ambas de 2 años) y 2 de HoPTH (cocker spaniel de 11 meses y una mestiza de 7 años). Por la signología clínica ...

Linkage Analysis in Autoimmune Addison's Disease: NFATC1 as a Potential Novel Susceptibility Locus.

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Anna L Mitchell

Full Text Available Autoimmune Addison's disease (AAD is a rare, highly heritable autoimmune endocrinopathy. It is possible that there may be some highly penetrant variants which confer disease susceptibility that have yet to be discovered.DNA samples from 23 multiplex AAD pedigrees from the UK and Norway (50 cases, 67 controls were genotyped on the Affymetrix SNP 6.0 array. Linkage analysis was performed using Merlin. EMMAX was used to carry out a genome-wide association analysis comparing the familial AAD cases to 2706 UK WTCCC controls. To explore some of the linkage findings further, a replication study was performed by genotyping 64 SNPs in two of the four linked regions (chromosomes 7 and 18, on the Sequenom iPlex platform in three European AAD case-control cohorts (1097 cases, 1117 controls. The data were analysed using a meta-analysis approach.In a parametric analysis, applying a rare dominant model, loci on chromosomes 7, 9 and 18 had LOD scores >2.8. In a non-parametric analysis, a locus corresponding to the HLA region on chromosome 6, known to be associated with AAD, had a LOD score >3.0. In the genome-wide association analysis, a SNP cluster on chromosome 2 and a pair of SNPs on chromosome 6 were associated with AAD (P <5x10-7. A meta-analysis of the replication study data demonstrated that three chromosome 18 SNPs were associated with AAD, including a non-synonymous variant in the NFATC1 gene.This linkage study has implicated a number of novel chromosomal regions in the pathogenesis of AAD in multiplex AAD families and adds further support to the role of HLA in AAD. The genome-wide association analysis has also identified a region of interest on chromosome 2. A replication study has demonstrated that the NFATC1 gene is worthy of future investigation, however each of the regions identified require further, systematic analysis.

Linkage Analysis in Autoimmune Addison's Disease: NFATC1 as a Potential Novel Susceptibility Locus.

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Mitchell, Anna L; Bøe Wolff, Anette; MacArthur, Katie; Weaver, Jolanta U; Vaidya, Bijay; Erichsen, Martina M; Darlay, Rebecca; Husebye, Eystein S; Cordell, Heather J; Pearce, Simon H S

2015-01-01

Autoimmune Addison's disease (AAD) is a rare, highly heritable autoimmune endocrinopathy. It is possible that there may be some highly penetrant variants which confer disease susceptibility that have yet to be discovered. DNA samples from 23 multiplex AAD pedigrees from the UK and Norway (50 cases, 67 controls) were genotyped on the Affymetrix SNP 6.0 array. Linkage analysis was performed using Merlin. EMMAX was used to carry out a genome-wide association analysis comparing the familial AAD cases to 2706 UK WTCCC controls. To explore some of the linkage findings further, a replication study was performed by genotyping 64 SNPs in two of the four linked regions (chromosomes 7 and 18), on the Sequenom iPlex platform in three European AAD case-control cohorts (1097 cases, 1117 controls). The data were analysed using a meta-analysis approach. In a parametric analysis, applying a rare dominant model, loci on chromosomes 7, 9 and 18 had LOD scores >2.8. In a non-parametric analysis, a locus corresponding to the HLA region on chromosome 6, known to be associated with AAD, had a LOD score >3.0. In the genome-wide association analysis, a SNP cluster on chromosome 2 and a pair of SNPs on chromosome 6 were associated with AAD (P <5x10-7). A meta-analysis of the replication study data demonstrated that three chromosome 18 SNPs were associated with AAD, including a non-synonymous variant in the NFATC1 gene. This linkage study has implicated a number of novel chromosomal regions in the pathogenesis of AAD in multiplex AAD families and adds further support to the role of HLA in AAD. The genome-wide association analysis has also identified a region of interest on chromosome 2. A replication study has demonstrated that the NFATC1 gene is worthy of future investigation, however each of the regions identified require further, systematic analysis.

MAVS is not a Likely Susceptibility Locus for Addison's Disease and Type 1 Diabetes.

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Zurawek, Magdalena; Fichna, Marta; Kazimierska, Marta; Fichna, Piotr; Dzikiewicz-Krawczyk, Agnieszka; Przybylski, Grzegorz; Ruchala, Marek; Nowak, Jerzy

2017-06-01

Mitochondrial antiviral signaling (MAVS) protein is an intracellular adaptor molecule, downstream of viral sensors, retinoid acid-inducible gene I (RIG-I)-like receptors (RLRs). Impaired antiviral cell signaling might contribute to autoimmunity. Studies have recently shown variations in genes encoding RLRs as risk factors for autoimmune diseases. We investigated whether MAVS coding polymorphisms are associated with Addison's disease (AD) and type 1 diabetes (T1D) in Polish population. We genotyped 140 AD, 532 T1D patients and 600 healthy controls for MAVS rs17857295, rs7262903, rs45437096 and rs7269320. Genotyping was performed by TaqMan assays. Distribution of the MAVS genotypes and alleles did not reveal significant differences between patients and controls (p > 0.05). This analysis did not indicate the association of the MAVS locus with susceptibility to AD and T1D.

Coexistence of Cushing syndrome from functional adrenal adenoma and Addison disease from immune-mediated adrenalitis.

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Colucci, Randall; Jimenez, Rafael E; Farrar, William; Malgor, Ramiro; Kohn, Leonard; Schwartz, Frank L

2012-06-01

A 56-year-old woman presented with an incidental adrenal adenoma and physical examination findings that included moderate obesity, a slight cervicothoracic fat pad ("buffalo hump"), increased supraclavicular fat pads, and white abdominal striae. Biochemical workup revealed elevated levels of 24-hour urinary free cortisol but normal serum morning cortisol and suppressed levels of corticotropin, suggestive of adrenal-dependent Cushing syndrome. The resected adrenal gland revealed macronodular cortical hyperplasia with a dominant nodule. Other findings included an absent cortisol response to corticotropin stimulation, presence of serum anti-21-hydroxylase antibodies, and mononuclear cell infiltration--consistent with adrenalitis. The findings represent, to the authors' knowledge, the first known case of a patient with coexistent functional cortisol-secreting macronodular adrenal tumor resulting in Cushing syndrome and immune-mediated adrenalitis resulting in Addison disease.

Unusual Onset of Celiac Disease and Addison's Disease in a 12-Year-Old Boy.

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Miconi, Francesco; Savarese, Emanuela; Miconi, Giovanni; Cabiati, Gabriele; Rapaccini, Valentina; Principi, Nicola; Esposito, Susanna

2017-07-29

Celiac disease (CD) is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison's disease (AD) and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD. A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced. This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD.

MicroRNA expressions in PMBCs, CD4+, and CD8+ T-cells from patients suffering from autoimmune Addison's disease.

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Bernecker, C; Halim, F; Haase, M; Willenberg, H S; Ehlers, M; Schott, M

2013-08-01

Autoimmune Addison's disease (AD) is a rare but potentially life threatening disease. The exact etiology of the immune response to the adrenal gland is still unknown. MicroRNAs (miRNAs) critically control gene-expression and play an important role in regulating the immune response. The aim of this study was to determine key immunoregulatory miRNAs influencing autoimmune adrenal insufficiency. For this purpose selected miRNAs were amplified by a semiquantitative SYBR Green PCR from blood mononuclear cells and after purification from CD4+ and CD 8+ cells of 6 patients with autoimmune adrenal insufficiency and 10 healthy controls. In CD4+ T-cells miRNA 181a*_1 (18.02 in AD vs. 11.99 in CG, p=0.0047) is significantly increased whereas miRNA 200a_1 (12.48 in AD vs. 19.40 in CG, p=0.0003) and miRNA 200a_2* (8.59 in AD vs. 17.94 in CG, p=0.0160) are significantly decreased. miRNA 200a_1 (12.37 in AD group vs. 18.12 in control group, p=0.001) and miRNA 200a_2* (10.72 in AD group vs. 17.84 in control group, p=0.022) are also significantly decreased in CD8+ T-cells. This study could show for the first time a significant change of three defined miRNAs in PBMCs, CD4+, and CD8+ T-cells of autoimmune AD patients in vivo. These data may help to better understand the cause of the autoimmune processes leading to autoimmune AD. They extend our very limited knowledge concerning miRNAs in autoimmune Addison's disease. © Georg Thieme Verlag KG Stuttgart · New York.

The Genetic-Algorithm-Based Normal Boundary Intersection (GANBI) Method; An Efficient Approach to Pareto Multiobjective Optimization for Engineering Design

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2006-05-15

of different evolutionary approaches to multiobjective optimal design are given by Van Veldhuizen ,7 Van Veldhuizen and Lamont,8 and Zitzler and Thiele...and Machine Learning, Addison-Wesley, Boston, 1989. 7. D. A. Van Veldhuizen , "Multiobjective Evolutionary Algorithms: Classifications, Analyses, and...New Innovations," Ph.D. Dissertation, Air Force Institute of Technology, 1999. 39 8. D. A. Van Veldhuizen and G. B. Lamont, "Multiobjective

CTLA-4 as a genetic determinant in autoimmune Addison's disease.

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Wolff, A S B; Mitchell, A L; Cordell, H J; Short, A; Skinningsrud, B; Ollier, W; Badenhoop, K; Meyer, G; Falorni, A; Kampe, O; Undlien, D; Pearce, S H S; Husebye, E S

2015-09-01

In common with several other autoimmune diseases, autoimmune Addison's disease (AAD) is thought to be caused by a combination of deleterious susceptibility polymorphisms in several genes, together with undefined environmental factors and stochastic events. To date, the strongest genomic association with AAD has been with alleles at the HLA locus, DR3-DQ2 and DR4. The contribution of other genetic variants has been inconsistent. We have studied the association of 16 single-nucleotide polymorphisms (SNPs) within the CD28-CTLA-4-ICOS genomic locus, in a cohort comprising 691 AAD patients of Norwegian and UK origin with matched controls. We have also performed a meta-analysis including 1002 patients from European countries. The G-allele of SNP rs231775 in CTLA-4 is associated with AAD in Norwegian patients (odds ratio (OR)=1.35 (confidence interval (CI) 1.10-1.66), P=0.004), but not in UK patients. The same allele is associated with AAD in the total European population (OR=1.37 (CI 1.13-1.66), P=0.002). A three-marker haplotype, comprising PROMOTER_1661, rs231726 and rs1896286 was found to be associated with AAD in the Norwegian cohort only (OR 2.43 (CI 1.68-3.51), P=0.00013). This study points to the CTLA-4 gene as a susceptibility locus for the development of AAD, and refines its mapping within the wider genomic locus.

Natural history of autoimmune primary ovarian insufficiency in patients with Addison's disease: from normal ovarian function to overt ovarian dysfunction.

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De Bellis, Annamaria; Bellastella, Giuseppe; Falorni, Alberto; Aitella, Ernesto; Barrasso, Mariluce; Maiorino, Maria Ida; Bizzarro, Elio; Bellastella, Antonio; Giugliano, Dario; Esposito, Katherine

2017-10-01

Women with autoimmune Addison's disease with normal ovulatory cycles but positive for steroid cell antibodies (StCA) have been considered at risk of premature ovarian insufficiency (POI). Thirty-three women younger than 40 years, with subclinical-clinical autoimmune Addison's disease but with normally ovulatory menses, were followed up for 10 years to evaluate the long-term time-related variations of StCA, ovarian function and follicular reserve. All patients and 27 control women were investigated at the start and every year for the presence and titre of StCA (by indirect immunofluorescence), serum concentrations of anti-Mullerian hormone (AMH) and ovarian function at four consecutive menses every year. At the start of the study StCA were present in 16 women (group 1), at low/middle titres (≤1:32) in seven of them (43.8%, group 1A), at high titres (>1:32) in the remaining nine patients (group 1B, 56.2%), while they were absent from 17 patients (group 2). During the follow-up period, all women in group 1A remained StCA-positive at low/middle titres with normal ovulatory menses and normal gonadotrophin and AMH levels, while all patients in group 1B showed a further increase of StCA titres (1:128-1:256) and progressed through three stages of ovarian function. None of the patients in group 2 and controls showed the appearance of StCA or ovarian dysfunction during the follow-up. The presence of StCA at high titres can be considered a good predictive marker of subsequent development of autoimmune POI. To single out the stages of autoimmune POI may allow a timely therapeutic choice in the subclinical and early clinical stages. © 2017 European Society of Endocrinology.

Salivary Cortisol and Cortisone do not Appear to be Useful Biomarkers for Monitoring Hydrocortisone Replacement in Addison's Disease.

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Ross, I L; Lacerda, M; Pillay, T S; Blom, D J; Johannsson, G; Dave, J A; Levitt, N S; Haarburger, D; van der Walt, J-S

2016-12-01

Salivary cortisol has been used to monitor hydrocortisone replacement in patients with Addison's disease (AD). Since salivary cortisol is metabolised to salivary cortisone, it may be an adjunctive analyte to assess adequacy of hydrocortisone replacement in patients with AD. We aimed to characterise the exposure of salivary cortisol and cortisone in patients and healthy controls. We measured salivary cortisol and cortisone by liquid chromatography-tandem mass spectrometry and constructed a day curve (08:00 until 24:00 h) with 16 time points in 25 AD patients taking their usual hydrocortisone dose and in 26 healthy controls. The median (interquartile range) area under the curve (AUC) for cortisol was not different for patients, compared with controls [55.63 (32.91-151.07) nmol*min*l -1 vs. 37.49 (27.41-52.00) nmol*min*l -1 ; p=0.098, respectively], whereas the peak cortisol C max was higher in patients [32.61 (5.75-146.19) nmol/l vs. 8.96 (6.96-12.23) nmol/l; p=0.013], compared with controls. The AUC for cortisone [23.65 (6.10-54.76) nmol*min*l -1 vs. 227.73 (200.10-280.52) nmol*min*l -1 ; p≤ 0.001, respectively], and peak cortisone C max was lower in patients than in controls [11.11 (2.91-35.85) nmol/l vs. 33.12 (25.97-39.95) nmol/l; p=0.002]. The AUC for salivary cortisol and salivary cortisone were not correlated with any measures of hydrocortisone dose. The time-course and AUC of salivary cortisol were similar between Addison's patients and healthy controls. Patients had substantially lower salivary cortisone AUC, compared to healthy controls. Salivary cortisol AUC and pharmacokinetics were not related to hydrocortisone dose and thus are not likely useful markers for the adequacy of hydrocortisone replacement. © Georg Thieme Verlag KG Stuttgart · New York.

Poor quality of life, depressed mood, and memory impairment may be mediated by sleep disruption in patients with Addison's disease.

Science.gov (United States)

Henry, Michelle; Wolf, Pedro S A; Ross, Ian L; Thomas, Kevin G F

2015-11-01

Standard replacement therapy for Addison's disease (AD) does not restore a normal circadian rhythm. In fact, hydrocortisone replacement in AD patients likely induces disrupted sleep. Given that healthy sleep plays an important role in improving quality of life, optimizing cognition, and ensuring affect regulation, the aim of this study was to investigate whether poor quality of life, mood alterations, and memory complaints reported by AD patients are associated with their disrupted sleep patterns. Sixty patients with AD and 60 matched healthy controls completed a battery of self-report questionnaires assessing perceived physical and mental health (Short-Form 36), mood (Beck Depression Inventory-II), sleep quality (Pittsburgh Sleep Quality Index), and cognition (Cognitive Failures Questionnaire). A latent variable model revealed that although AD had a significant direct effect on quality of life, the indirect effect of sleep was significantly greater. Furthermore, although AD had no direct effect on cognitive functioning, the indirect effect of sleep was significant. The overall model showed a good fit (comparative fit index = 0.91, root mean square of approximation = 0.09, and standardized root mean square residual = 0.05). Our findings suggest that disrupted sleep, and not the disease per se, may induce poor quality of life, memory impairment, and affect dysregulation in patients with AD. We think that improving sleep architecture may improve cognitive, affective, and physical functioning. Copyright © 2015 Elsevier Inc. All rights reserved.

Genome-wide copy number variation (CNV) in patients with autoimmune Addison's disease

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2011-01-01

Background Addison's disease (AD) is caused by an autoimmune destruction of the adrenal cortex. The pathogenesis is multi-factorial, involving genetic components and hitherto unknown environmental factors. The aim of the present study was to investigate if gene dosage in the form of copy number variation (CNV) could add to the repertoire of genetic susceptibility to autoimmune AD. Methods A genome-wide study using the Affymetrix GeneChip® Genome-Wide Human SNP Array 6.0 was conducted in 26 patients with AD. CNVs in selected genes were further investigated in a larger material of patients with autoimmune AD (n = 352) and healthy controls (n = 353) by duplex Taqman real-time polymerase chain reaction assays. Results We found that low copy number of UGT2B28 was significantly more frequent in AD patients compared to controls; conversely high copy number of ADAM3A was associated with AD. Conclusions We have identified two novel CNV associations to ADAM3A and UGT2B28 in AD. The mechanism by which this susceptibility is conferred is at present unclear, but may involve steroid inactivation (UGT2B28) and T cell maturation (ADAM3A). Characterization of these proteins may unravel novel information on the pathogenesis of autoimmunity. PMID:21851588

Genome-wide copy number variation (CNV in patients with autoimmune Addison's disease

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Brønstad Ingeborg

2011-08-01

Full Text Available Abstract Background Addison's disease (AD is caused by an autoimmune destruction of the adrenal cortex. The pathogenesis is multi-factorial, involving genetic components and hitherto unknown environmental factors. The aim of the present study was to investigate if gene dosage in the form of copy number variation (CNV could add to the repertoire of genetic susceptibility to autoimmune AD. Methods A genome-wide study using the Affymetrix GeneChip® Genome-Wide Human SNP Array 6.0 was conducted in 26 patients with AD. CNVs in selected genes were further investigated in a larger material of patients with autoimmune AD (n = 352 and healthy controls (n = 353 by duplex Taqman real-time polymerase chain reaction assays. Results We found that low copy number of UGT2B28 was significantly more frequent in AD patients compared to controls; conversely high copy number of ADAM3A was associated with AD. Conclusions We have identified two novel CNV associations to ADAM3A and UGT2B28 in AD. The mechanism by which this susceptibility is conferred is at present unclear, but may involve steroid inactivation (UGT2B28 and T cell maturation (ADAM3A. Characterization of these proteins may unravel novel information on the pathogenesis of autoimmunity.

MAGMA: A Liquid Software Approach to Fault Tolerance, Computer Network Security, and Survivable Networking

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2001-12-01

and Lieutenant Namik Kaplan , Turkish Navy. Maj Tiefert’s thesis, “Modeling Control Channel Dynamics of SAAM using NS Network Simulation”, helped lay...DEC99] Deconinck , Dr. ir. Geert, Fault Tolerant Systems, ESAT / Division ACCA , Katholieke Universiteit Leuven, October 1999. [FRE00] Freed...Systems”, Addison-Wesley, 1989. [KAP99] Kaplan , Namik, “Prototyping of an Active and Lightweight Router,” March 1999 [KAT99] Kati, Effraim

Total hip replacement infected with Mycobacterium tuberculosis complicated by Addison disease and psoas muscle abscess: a case report

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De Nardo Pasquale

2012-01-01

Full Text Available Abstract Introduction Prosthetic joint infection due to Mycobacterium tuberculosis is occasionally encountered in clinical practice. To the best of our knowledge, this is the first report of a prosthetic joint infection due to Mycobacterium tuberculosis complicated by psoas abscesses and secondary Addison disease. Case presentation A 67-year-old immunocompetent Caucasian woman underwent total left hip arthroplasty because of osteoarthritis. After 18 months, she underwent arthroplasty revision for a possible prosthetic infection. Periprosthetic tissue specimens for bacteria were negative, and empirical antibiotic therapy was unsuccessful. She was then admitted to our department because of complications arising 22 months after arthroplasty. A physical examination revealed a sinus tract overlying her left hip and skin and mucosal pigmentation. Her levels of C-reactive protein, basal cortisol, adrenocorticotropic hormone, and sodium were out of normal range. Results of the tuberculin skin test and QuantiFERON-TB Gold test were positive. Computed tomography revealed a periprosthetic abscess and the inclusion of the left psoas muscle. Results of microbiological tests were negative, but polymerase chain reaction of a specimen taken from the hip fistula was positive for Mycobacterium tuberculosis. Our patient's condition was diagnosed as prosthetic joint infection and muscle psoas abscess due to Mycobacterium tuberculosis and secondary Addison disease. She underwent standard treatment with rifampicin, ethambutol, isoniazid, and pyrazinamide associated with hydrocortisone and fludrocortisone. At 15 months from the beginning of therapy, she was in good clinical condition and free of symptoms. Conclusions Prosthetic joint infection with Mycobacterium tuberculosis is uncommon. A differential diagnosis of tuberculosis should be considered when dealing with prosthetic joint infection, especially when repeated smears and histology examination from infected

Mortality in patients with diabetes mellitus and Addison's disease: a nationwide, matched, observational cohort study.

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Chantzichristos, Dimitrios; Persson, Anders; Eliasson, Björn; Miftaraj, Mervete; Franzén, Stefan; Bergthorsdottir, Ragnhildur; Gudbjörnsdottir, Soffia; Svensson, Ann-Marie; Johannsson, Gudmundur

2017-01-01

Our hypothesis was that patients with diabetes mellitus obtain an additional risk of death if they develop Addison's disease (AD). Nationwide, matched, observational cohort study cross-referencing the Swedish National Diabetes Register with Inpatient, Cancer and Cause of Death Registers in patients with diabetes (type 1 and 2) and AD and matched controls with diabetes. Clinical characteristics at baseline, overall, and cause-specific mortality were assessed. The relative risk of death was assessed using a Cox proportional hazards regression model. Between January 1996 and December 2012, 226 patients with diabetes and AD were identified and matched with 1129 controls with diabetes. Median (interquartile range) follow-up was 5.9 (2.7-8.6) years. When patients with diabetes were diagnosed with AD, they had an increased frequency of diabetes complications, but both medical history of cancer and coronary heart disease did not differ compared with controls. Sixty-four of the 226 patients with diabetes and AD (28%) died, while 112 of the 1129 controls (10%) died. The estimated relative risk increase (hazard ratio) in overall mortality in the diabetes and AD group was 3.89 (95% confidence interval 2.84-5.32) compared with controls with diabetes. The most common cause of death was cardiovascular in both groups, but patients with diabetes and AD showed an increased death rate from diabetes complications, infectious diseases and unknown causes. Patients with the rare combination of diabetes and AD showed a markedly increased mortality and died more frequently from infections and unknown causes than patients with diabetes alone. Improved strategy for the management of this combination of metabolic disorders is needed. © 2017 European Society of Endocrinology.

Fisiopatología de la expresividad "psicosomática" del Morbus Basedow y del de Addison

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J. Gurría

1949-08-01

Full Text Available El título de este trabajo pretende, además de consignar su objetivo, señalar una insuficiencia: la de la patología psicosomática, impregnada, desde su origen, por conceptos psicoanalíticos que han dado lugar a explicaciones demasiado subjetivistas y alejadas de las ideas fisiopatológicas no superadas, al menos clínicamente, por la moderna versión norteamericana de las antiguas y equilibradas doctrinas socráticas de integración. Perseguimos en esta comunicación dos propósitos: contrastrar las concepciones psicosomáticas y fisiopatológicas del Basedow y de la insuficiencia suprarrenal, en el intento de poner de manifiesto la insuficiencia del criterio psicosomático; y, estudiar la fisiopatología de los principales síntomas del Basedow y del Addison que se expresan por la doble vertiente somatopsíquica. Estos síntomas serán, en el hipertiroidismo, la hiperemotividad y, singularmente, la prisa; y en la insuficiencia suprarrenal, la astenia.

Clues for early detection of autoimmune Addison's disease - myths and realities.

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Saevik, Å B; Åkerman, A-K; Grønning, K; Nermoen, I; Valland, S F; Finnes, T E; Isaksson, M; Dahlqvist, P; Bergthorsdottir, R; Ekwall, O; Skov, J; Nedrebø, B G; Hulting, A-L; Wahlberg, J; Svartberg, J; Höybye, C; Bleskestad, I H; Jørgensen, A P; Kämpe, O; Øksnes, M; Bensing, S; Husebye, E S

2018-02-01

Early detection of autoimmune Addison's disease (AAD) is important as delay in diagnosis may result in a life-threatening adrenal crisis and death. The classical clinical picture of untreated AAD is well-described, but methodical investigations are scarce. Perform a retrospective audit of patient records with the aim of identifying biochemical markers for early diagnosis of AAD. A multicentre retrospective study including 272 patients diagnosed with AAD at hospitals in Norway and Sweden during 1978-2016. Scrutiny of medical records provided patient data and laboratory values. Low sodium occurred in 207 of 247 (84%), but only one-third had elevated potassium. Other common nonendocrine tests were largely normal. TSH was elevated in 79 of 153 patients, and hypoglycaemia was found in 10%. Thirty-three per cent were diagnosed subsequent to adrenal crisis, in whom electrolyte disturbances were significantly more pronounced (P < 0.001). Serum cortisol was consistently decreased (median 62 nmol L -1 [1-668]) and significantly lower in individuals with adrenal crisis (38 nmol L -1 [2-442]) than in those without (81 nmol L -1 [1-668], P < 0.001). The most consistent biochemical finding of untreated AAD was low sodium independent of the degree of glucocorticoid deficiency. Half of the patients had elevated TSH levels. Only a minority presented with marked hyperkalaemia or other nonhormonal abnormalities. Thus, unexplained low sodium and/or elevated TSH should prompt consideration of an undiagnosed AAD, and on clinical suspicion bring about assay of cortisol and ACTH. Presence of 21-hydroxylase autoantibodies confirms autoimmune aetiology. Anticipating additional abnormalities in routine blood tests may delay diagnosis. © 2017 The Association for the Publication of the Journal of Internal Medicine.

Polymorphisms of the GR and HSD11B1 genes influence body mass index and weight gain during hormone replacement treatment in patients with Addison's disease.

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Molnár, Ágnes; Kövesdi, Annamária; Szücs, Nikolette; Tóth, Miklós; Igaz, Péter; Rácz, Károly; Patócs, Attila

2016-08-01

Glucocorticoid substitution is essential in patients with chronic primary adrenocortical insufficiency (Addison's disease) and both over-treatment and inadequate dosage have deleterious effects. Individual sensitivity to glucocorticoids is partly genetically determined. To test the hypothesis whether the well-characterized SNPs of the GR and HSD11B1 genes may modulate the individual sensitivity to exogenous glucocorticoids and may influence clinical and/or laboratory parameters and the glucocorticoid substitution dosage in patients with Addison's disease. 68 patients with primary adrenocortical insufficiency were involved. Clinical and laboratory data, as well as the dosage of the hormone replacement therapy were collected. Peripheral blood DNA was isolated, and the GR and HSD11B1 SNPs were examined using allele-specific PCR or Taqman assay on Real Time PCR. The allele frequency of the GR N363S polymorphism was higher in patients compared to the control group and the disease appeared significantly earlier in patients harbouring the GR A3669G compared to noncarriers. These patients had higher ACTH level measured at the time of diagnosis. Homozygous BclI carriers had higher body mass index (BMI) and lower total hydrocortisone equivalent supplementation dose needed than heterozygous or noncarriers. The BMI and weight gain during hormone replacement therapy were also higher in carriers of the HSD11B1 rs4844880 treated with glucocorticoids other than dexamethasone. The BclI polymorphism of the GR gene and the rs4844880 of the HSD11B1 gene may contribute to weight gain and may affect the individual need of glucocorticoid substitution dose in these patients. © 2016 John Wiley & Sons Ltd.

Autoimmunity predominates in a large South African cohort with Addison's disease of mainly European descent despite long-standing disease and is associated with HLA DQB*0201.

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Ross, Ian; Boulle, Andrew; Soule, Steven; Levitt, Naomi; Pirie, Fraser; Karlsson, Anders; Mienie, Japie; Yang, Ping; Wang, Hongjie; She, Jin-Xiong; Winter, William; Schatz, Desmond

2010-09-01

We sought to determine whether autoimmunity is the predominant cause of Addison's disease in South Africa and whether human leucocyte antigen (HLA) DQ association exists. We compiled a national registry of patients from primary care, referral centres and private practices. A total of 144 patients, 94 of European descent, 34 Mixed Ancestry, 5 Asian and 11 Black Africans (mean age 45.9 years, range 2.7-88 years; mean duration of disease 13.1 years, range 0-50 years) and controls were matched for gender and ethnicity. All potential causes were investigated. Fifty one per cent of cases (74 patients) were autoimmune in aetiology. Either 21-hydroxylase autoantibodies (72 patients, 50% of entire patient group) or adrenocortical autoantibodies (35 patients, 24%) were present, while 23% of patients had both. None of the Asian (n = 5) or Black (n = 11) patients had evidence of autoimmune disease. Overall 8% of patients had tuberculosis, 4% adrenoleucodystrophy, 1% adrenocorticotrophic hormone resistance syndrome and 6% X-linked adrenal hypoplasia. In those with autoimmune disease primary hypothyroidism (47%), premature ovarian failure (8%) and type 1 diabetes (7%) were the most prevalent accompanying autoimmune conditions. HLA DQB1*0201 alleles predominated in the autoimmune group (DQB1*0201: 65%vs 43% of controls P = 0.017) with the *0201/*0302 heterozygous genotype being the most prevalent (28%vs 8%P = 0.02). While autoimmunity accounts for at least half of patients with Addison's disease in South Africa and is associated with HLA DQB1*0201, none of the Black Africans or Asians in this cohort had adrenal autoantibodies. Moreover, 21-hydroxylase autoantibodies were detectable in a higher proportion than adrenocortical autoantibodies, especially in those patients with a long history after disease onset.

AIRE variations in Addison's disease and autoimmune polyendocrine syndromes (APS): partial gene deletions contribute to APS I.

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Bøe Wolff, A S; Oftedal, B; Johansson, S; Bruland, O; Løvås, K; Meager, A; Pedersen, C; Husebye, E S; Knappskog, P M

2008-03-01

Autoimmune Addison's disease (AAD) is often associated with other components in autoimmune polyendocrine syndromes (APS). Whereas APS I is caused by mutations in the AIRE gene, the susceptibility genes for AAD and APS II are unclear. In the present study, we investigated whether polymorphisms or copy number variations in the AIRE gene were associated with AAD and APS II. First, nine SNPs in the AIRE gene were analyzed in 311 patients with AAD and APS II and 521 healthy controls, identifying no associated risk. Second, in a subgroup of 25 of these patients, AIRE sequencing revealed three novel polymorphisms. Finally, the AIRE copy number was determined by duplex quantitative PCR in 14 patients with APS I, 161 patients with AAD and APS II and in 39 healthy subjects. In two Scandinavian APS I patients previously reported to be homozygous for common AIRE mutations, we identified large deletions of the AIRE gene covering at least exon 2 to exon 8. We conclude that polymorphisms in the AIRE gene are not associated with AAD and APS II. We further suggest that DNA analysis of the parents of patients found to be homozygous for mutations in AIRE, always should be performed.

A study of the epitopes on steroid 21-hydroxylase recognized by autoantibodies in patients with or without Addison's disease

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Volpato, M; Prentice, L; Chen, S; Betterle, C; Rees Smith, B; Furmaniak, J

1998-01-01

Steroid 21-hydroxylase (21-OH) autoantibodies are found in patients with autoimmune Addison's disease (AAD), either isolated or associated with autoimmune polyglandular syndrome (APS) type I and II and in adrenal-cortex autoantibody (ACA)-positive patients without AAD. In order to assess any differences in the 21-OH autoantibodies in these different patient groups, we have studied their reactivity with different epitopes on 21-OH using full length and modified 35S-labelled 21-OH proteins produced in an in vitro transcription/translation system. There were no major differences in the pattern of autoantibody reactivity with the different modified 21-OH proteins in patients with isolated AAD or with APS types I and II, and in 21-OH autoantibody-positive patients with clinical AAD, subclinical AAD and those maintaining a normal adrenal function. Our studies also indicate that the main epitopes for 21-OH autoantibodies in patients with different forms of autoimmune adrenal disease are located in the C-terminal end and in a central region of 21-OH. PMID:9486414

Adrenal insufficiency secondary to tuberculosis: the value of telemedicine in the remote diagnosis of Addison's disease in Ebeye, Republic of the Marshall Islands.

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Bush, Lisabeth A; Ruess, Lynne; Jack, Tom; Person, Donald A

2009-01-01

A young Marshallese woman presented with the insidious development of fever, cough, fatigue, profound weakness, massive weight loss, cachexia, alopecia, amenorrhea, and periumbilical hyperpigmentation. Limited laboratory studies revealed anemia, leukocytosis, and hyponatremia. Imaging studies, as well as digital photographs, transmitted over the Internet, using the secure Pacific Island Health Care Project (PIHCP), store-and-forward telemedicine system, suggested the diagnosis of disseminated tuberculosis, and antimycobacterial antibiotics were begun. Sputum cultures eventually grew Mycobacterium tuberculosis. Based on the constellation of clinical signs and symptoms, the transmitted images, and limited laboratory data, adrenal tuberculosis (Addison's disease) with adrenal insufficiency was diagnosed and corticosteroids were initiated. The patient responded dramatically This case underscores the utility of telemedicine in the diagnosis and treatment of patients with unusual conditions, rarely seen today in the United States, from remote sites in the Developing World.

Impaired quality and efficiency of sleep impairs cognitive functioning in Addison's disease.

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Henry, Michelle; Ross, Ian Louis; Wolf, Pedro Sofio Abril; Thomas, Kevin Garth Flusk

2017-04-01

Standard replacement therapy for Addison's disease (AD) does not restore a normal circadian rhythm. Periods of sub- and supra- physiological cortisol levels experienced by patients with AD likely induce disrupted sleep. Given that healthy sleep plays an important role in memory consolidation, the novelty of the current study was to characterise, using objective measures, the relationship between sleep and memory in patients with AD, and to examine the hypothesis that poor sleep is a biological mechanism underlying memory impairment in those patients. We used a within-subjects design. Ten patients with AD and 10 matched healthy controls completed standardised neuropsychological tests assessing declarative memory (Rey Auditory Verbal Learning Test) and procedural memory (Finger Tapping Task) before and after a period of actigraphy-measured sleep, and before and after a period of waking. Relative to healthy controls, patients with AD experienced disrupted sleep characterised by poorer sleep efficiency and more time spent awake. Patients also showed impaired verbal learning and memory relative to healthy controls (p=0.007). Furthermore, whereas healthy controls' declarative memory performance benefited from a period of sleep compared to waking (p=0.032), patients with AD derived no such benefit from sleep (p=0.448). Regarding the procedural memory task, analyses detected no significant between-group differences (all p's<0.065), and neither group showed significant sleep-enhanced performance. We demonstrated, using actigraphy and standardized measures of memory performance, an association between sleep disturbances and cognitive deficits in patients with AD. These results suggest that, in patients with AD, the source of memory deficits is, at least to some extent, disrupted sleep patterns that interfere with optimal consolidation of previously-learned declarative information. Hence, treating the sleep disturbances that are frequently experienced by patients with AD may

Impact of Month of Birth on the Risk of Development of Autoimmune Addison's Disease.

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Pazderska, Agnieszka; Fichna, Marta; Mitchell, Anna L; Napier, Catherine M; Gan, Earn; Ruchała, Marek; Santibanez-Koref, Mauro; Pearce, Simon H

2016-11-01

The pathogenesis of autoimmune Addison's disease (AAD) is thought to be due to interplay of genetic, immune, and environmental factors. A month-of-birth effect, with increased risk for those born in autumn/winter months, has been described in autoimmune conditions such as type 1 diabetes and autoimmune thyroid disease. Month-of-birth effect was investigated in 2 independent cohorts of AAD subjects. The monthly distribution of birth in AAD patients was compared with that of the general population using the cosinor test. A total of 415 AAD subjects from the United Kingdom cohort were compared with 8 180 180 United Kingdom births, and 231 AAD subjects from the Polish cohort were compared with 2 421 384 Polish births. Association between month of birth and the susceptibility to AAD. In the entire cohort of AAD subjects, month-of-birth distribution analysis showed significant periodicity with peak of births in December and trough in May (P = .028). Analysis of the odds ratio distribution based on month of birth in 2 cohorts of patients with AAD versus the general population revealed a December peak and May trough, and January peak and July trough, in the United Kingdom and Polish cohorts, respectively. For the first time, we demonstrate that month of birth exerts an effect on the risk of developing AAD, with excess risk in individuals born in winter months and a protective effect when born in the summer. Exposure to seasonal viral infections in the perinatal period, coupled with vitamin D deficiency, could lead to dysregulation of innate immunity affecting the risk of developing AAD.

The rs1990760 polymorphism within the IFIH1 locus is not associated with Graves' disease, Hashimoto's thyroiditis and Addison's disease

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Seidl Christian

2009-12-01

Full Text Available Abstract Background Three genes have been confirmed as major joint susceptibility genes for endocrine autoimmune disease:human leukocyte antigen class II, cytotoxic T-lymphocyte antigen 4 and protein tyrosine phosphatase non-receptor type 22. Recent studies showed that a genetic variation within the interferon induced helicase domain 1 (IFIH1 locus (rs1990760 polymorphism is an additional risk factor in type 1 diabetes and Graves' disease (GD. Methods The aim of the present study was to investigate the role of the rs1990760 polymorphism within the IFIH1 gene in German patients with GD (n = 258, Hashimoto's thyroiditis (HT, n = 106, Addison's disease (AD, n = 195 and healthy controls (HC, n = 227 as well as in 55 GD families (165 individuals, German and 100 HT families (300 individuals, Italian. Furthermore, the interaction between rs1990760 polymorphism with human leukocyte antigen (HLA risk haplotype DQ2(DQA*0501-DQB*0201, the risk haplotypes DQ2/DQ8 (DQA*0301-DQB*0302 and the status of thyroglobulin antibody (TgAb, thyroid peroxidase antibody (TPOAb and TSH receptor antibody (TRAb in patients and families were analysed. Results No significant differences were found between the allele and genotype frequencies for rs1990760 IFIH1 polymorphism in patients with GD, HT, AD and HC. Also no differences were observed when stratifying the IFIH1 rs1990760 polymorphism for gender, presence or absence of thyroid antibodies (GD:TRAb and HT:TPOAb/TgAb and HLA risk haplotypes (DQ2:for GD and HT, DQ2/DQ8:for AD. Furthermore the transmission analysis in GD and HT families revealed no differences in alleles transmission for rs1990760 IFIH1 from parents with or without HLA risk haplotype DQ2 to the affected offspring. In contrast, by dividing the HT parents according to the presence or absence of thyroid Ab titers, mothers and fathers both positive for TPOAb/TgAb overtransmitted the allele A of IFIH1 rs1990760 to their HT affected offspring (61.8% vs 38.2%;p = 0

Modeling Kanban Processes in Systems Engineering

Science.gov (United States)

2012-06-01

results in lower change traffic and defect incidence. • KSS: Incremental SE, with some design up-front and design continuing throughout development...Boston: Addison-Wesley. [11] Morgan, James M, and Jeffrey K Liker. (2006). The Toyota Product Development System: Integrating People, Process, and

Gonadal function in males with autoimmune Addison's disease and autoantibodies to steroidogenic enzymes.

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Dalla Costa, M; Bonanni, G; Masiero, S; Faggian, D; Chen, S; Furmaniak, J; Rees Smith, B; Perniola, R; Radetti, G; Garelli, S; Chiarelli, S; Albergoni, M P; Plebani, M; Betterle, C

2014-06-01

Steroidogenic enzyme autoantibodies (SEAbs) are frequently present and are markers of autoimmune premature ovarian failure (POF) in females with autoimmune Addison's disease (AAD). The prevalence and significance of SEAbs in males with AAD have not yet been defined. We studied the prevalence of SEAbs in a large cohort of males with AAD and assessed the relationship between SEAbs positivity and testicular function. A total of 154 males with AAD (mean age 34 years) were studied. SEAbs included autoantibodies to steroid-producing cells (StCA), detected by immunofluorescence, and steroid 17α-hydroxylase (17α-OHAbs) and side chain cleavage enzyme (SCCAbs) measured by immunoprecipitation assays. Gonadal function was evaluated by measuring follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHGB), anti-müllerian hormone (AMH) and inhibin-B (I-B). Twenty-six males, 10 SEAbs((+)) and 16 SEAbs((-)), were followed-up for a mean period of 7·6 years to assess the behaviour of SEAbs and testicular function. SEAbs were found in 24·7% of males with AAD, with the highest frequency in patients with autoimmune polyendocrine syndrome type 1 (APS-1). The levels of reproductive hormones in 30 SEAbs((+)) males were in the normal range according to age and were not significantly different compared to 55 SEAbs((-)) males (P > 0·05). During follow-up, both SEAbs((+)) and SEAbs((-)) patients maintained normal testicular function. SEAbs were found with high frequency in males with AAD; however, they were not associated with testicular failure. This study suggests that the diagnostic value of SEAbs in males with AAD differs compared to females, and this may be related to the immunoprivileged status of the testis. © 2014 British Society for Immunology.

Visceral Fat and Novel Biomarkers of Cardiovascular Disease in Patients With Addison's Disease: A Case-Control Study.

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Bergthorsdottir, Ragnhildur; Ragnarsson, Oskar; Skrtic, Stanko; Glad, Camilla A M; Nilsson, Staffan; Ross, Ian Louis; Leonsson-Zachrisson, Maria; Johannsson, Gudmundur

2017-11-01

Patients with Addison's disease (AD) have increased cardiovascular mortality. To study visceral fat and conventional and exploratory cardiovascular risk factors in patients with AD. A cross-sectional, single-center, case-control study. Patients (n = 76; n = 51 women) with AD and 76 healthy control subjects were matched for sex, age, body mass index (BMI), and smoking habits. The primary outcome variable was visceral abdominal adipose tissue (VAT) measured using computed tomography. Secondary outcome variables were prevalence of metabolic syndrome (MetS) and 92 biomarkers of cardiovascular disease. The mean ± standard deviation age of all subjects was 53 ± 14 years; mean BMI, 25 ± 4 kg/m2; and mean duration of AD, 17 ± 12 years. The median (range) daily hydrocortisone dose was 30 mg (10 to 50 mg). Median (interquartile range) 24-hour urinary free cortisol excretion was increased in patients vs controls [359 nmol (193 to 601 nmol) vs 175 nmol (140 to 244 nmol); P 1] and vasodilatory protective marker was decreased (FC, <1). Twenty-six patients (34%) vs 12 control subjects (16%) fulfilled the criteria for MetS (P = 0.01). Despite higher cortisol exposure, VAT was not increased in patients with AD. The prevalence of MetS was increased and several biomarkers of cardiovascular disease were adversely affected in patients with AD. Copyright © 2017 Endocrine Society

Analysis of cellular and humoral immune responses against cytomegalovirus in patients with autoimmune Addison's disease.

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Edvardsen, Kine; Hellesen, Alexander; Husebye, Eystein S; Bratland, Eirik

2016-03-09

Autoimmune Addison's disease (AAD) is caused by multiple genetic and environmental factors. Variants of genes encoding immunologically important proteins such as the HLA molecules are strongly associated with AAD, but any environmental risk factors have yet to be defined. We hypothesized that primary or reactivating infections with cytomegalovirus (CMV) could represent an environmental risk factor in AAD, and that CMV specific CD8(+) T cell responses may be dysregulated, possibly leading to a suboptimal control of CMV. In particular, the objective was to assess the HLA-B8 restricted CD8(+) T cell response to CMV since this HLA class I variant is a genetic risk factor for AAD. To examine the CD8(+) T cell response in detail, we analyzed the HLA-A2 and HLA-B8 restricted responses in AAD patients and healthy controls seropositive for CMV antibodies using HLA multimer technology, IFN-γ ELISpot and a CD107a based degranulation assay. No differences between patients and controls were found in functions or frequencies of CMV-specific T cells, regardless if the analyses were performed ex vivo or after in vitro stimulation and expansion. However, individual patients showed signs of reactivating CMV infection correlating with poor CD8(+) T cell responses to the virus, and a concomitant upregulation of interferon regulated genes in peripheral blood cells. Several recently diagnosed AAD patients also showed serological signs of ongoing primary CMV infection. CMV infection does not appear to be a major environmental risk factor in AAD, but may represent a precipitating factor in individual patients.

Insulin gene polymorphisms in type 1 diabetes, Addison's disease and the polyglandular autoimmune syndrome type II

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Hahner Stefanie

2008-07-01

Full Text Available Abstract Background Polymorphisms within the insulin gene can influence insulin expression in the pancreas and especially in the thymus, where self-antigens are processed, shaping the T cell repertoire into selftolerance, a process that protects from β-cell autoimmunity. Methods We investigated the role of the -2221Msp(C/T and -23HphI(A/T polymorphisms within the insulin gene in patients with a monoglandular autoimmune endocrine disease [patients with isolated type 1 diabetes (T1D, n = 317, Addison's disease (AD, n = 107 or Hashimoto's thyroiditis (HT, n = 61], those with a polyglandular autoimmune syndrome type II (combination of T1D and/or AD with HT or GD, n = 62 as well as in healthy controls (HC, n = 275. Results T1D patients carried significantly more often the homozygous genotype "CC" -2221Msp(C/T and "AA" -23HphI(A/T polymorphisms than the HC (78.5% vs. 66.2%, p = 0.0027 and 75.4% vs. 52.4%, p = 3.7 × 10-8, respectively. The distribution of insulin gene polymorphisms did not show significant differences between patients with AD, HT, or APS-II and HC. Conclusion We demonstrate that the allele "C" of the -2221Msp(C/T and "A" -23HphI(A/T insulin gene polymorphisms confer susceptibility to T1D but not to isolated AD, HT or as a part of the APS-II.

Global energy modeling - A biophysical approach

Energy Technology Data Exchange (ETDEWEB)

Dale, Michael

2010-09-15

This paper contrasts the standard economic approach to energy modelling with energy models using a biophysical approach. Neither of these approaches includes changing energy-returns-on-investment (EROI) due to declining resource quality or the capital intensive nature of renewable energy sources. Both of these factors will become increasingly important in the future. An extension to the biophysical approach is outlined which encompasses a dynamic EROI function that explicitly incorporates technological learning. The model is used to explore several scenarios of long-term future energy supply especially concerning the global transition to renewable energy sources in the quest for a sustainable energy system.

A rare case report of simultaneous presentation of myopathy, Addison's disease, primary hypoparathyroidism, and Fanconi syndrome in a child diagnosed with Kearns-Sayre syndrome.

Science.gov (United States)

Tzoufi, Meropi; Makis, Alexandros; Chaliasos, Nikolaos; Nakou, Iliada; Siomou, Ekaterini; Tsatsoulis, Agathoklis; Zikou, Anastasia; Argyropoulou, Maria; Bonnefont, Jean Paul; Siamopoulou, Antigone

2013-04-01

Kearns-Sayre syndrome (KSS) is a rare mitochondrial DNA deletion syndrome defined as the presence of ophthalmoplegia, pigmentary retinopathy, onset less than age 20 years, and one of the following: cardiac conduction defects, cerebellar syndrome, or cerebrospinal fluid protein above 100 mg/dl. KSS may affect many organ systems causing endocrinopathies, encephalomyopathy, sensorineural hearing loss, and renal tubulopathy. Clinical presentation at diagnosis is quite heterogeneous and, usually, few organs are affected with progression to generalized disease early in adulthood. We present the case of a boy with KSS presenting at the age of 5 years with myopathy, Addison's disease, primary hypoparathyroidism, and Fanconi syndrome. The proper replacement treatment along with the administration of mitochondrial metabolism-improving agents had a brief ameliorating effect, but gradual severe multisystemic deterioration was inevitable over the next 5 years. This report highlights the fact that in case of simultaneous presentation of polyendocrinopathies and renal disease early in childhood, KSS should be considered.

Comparisons of Multilevel Modeling and Structural Equation Modeling Approaches to Actor-Partner Interdependence Model.

Science.gov (United States)

Hong, Sehee; Kim, Soyoung

2018-01-01

There are basically two modeling approaches applicable to analyzing an actor-partner interdependence model: the multilevel modeling (hierarchical linear model) and the structural equation modeling. This article explains how to use these two models in analyzing an actor-partner interdependence model and how these two approaches work differently. As an empirical example, marital conflict data were used to analyze an actor-partner interdependence model. The multilevel modeling and the structural equation modeling produced virtually identical estimates for a basic model. However, the structural equation modeling approach allowed more realistic assumptions on measurement errors and factor loadings, rendering better model fit indices.

DHEA

Science.gov (United States)

... multiple sclerosis (MS), low levels of steroid hormones (Addison's disease), depression, schizophrenia, chronic fatigue syndrome (CFS), muscle damage ... Sjögren's syndrome that causes symptoms including dry mouth. Addison's disease. Research about the effects of DHEA on Addison's ...

Computational modeling of fully-ionized, magnetized plasmas using the fluid approximation

Science.gov (United States)

Schnack, Dalton

2005-10-01

Strongly magnetized plasmas are rich in spatial and temporal scales, making a computational approach useful for studying these systems. The most accurate model of a magnetized plasma is based on a kinetic equation that describes the evolution of the distribution function for each species in six-dimensional phase space. However, the high dimensionality renders this approach impractical for computations for long time scales in relevant geometry. Fluid models, derived by taking velocity moments of the kinetic equation [1] and truncating (closing) the hierarchy at some level, are an approximation to the kinetic model. The reduced dimensionality allows a wider range of spatial and/or temporal scales to be explored. Several approximations have been used [2-5]. Successful computational modeling requires understanding the ordering and closure approximations, the fundamental waves supported by the equations, and the numerical properties of the discretization scheme. We review and discuss several ordering schemes, their normal modes, and several algorithms that can be applied to obtain a numerical solution. The implementation of kinetic parallel closures is also discussed [6].[1] S. Chapman and T.G. Cowling, ``The Mathematical Theory of Non-Uniform Gases'', Cambridge University Press, Cambridge, UK (1939).[2] R.D. Hazeltine and J.D. Meiss, ``Plasma Confinement'', Addison-Wesley Publishing Company, Redwood City, CA (1992).[3] L.E. Sugiyama and W. Park, Physics of Plasmas 7, 4644 (2000).[4] J.J. Ramos, Physics of Plasmas, 10, 3601 (2003).[5] P.J. Catto and A.N. Simakov, Physics of Plasmas, 11, 90 (2004).[6] E.D. Held et al., Phys. Plasmas 11, 2419 (2004)

A Multi-Model Approach for System Diagnosis

DEFF Research Database (Denmark)

Niemann, Hans Henrik; Poulsen, Niels Kjølstad; Bækgaard, Mikkel Ask Buur

2007-01-01

A multi-model approach for system diagnosis is presented in this paper. The relation with fault diagnosis as well as performance validation is considered. The approach is based on testing a number of pre-described models and find which one is the best. It is based on an active approach......,i.e. an auxiliary input to the system is applied. The multi-model approach is applied on a wind turbine system....

The natural history of autoimmune Addison's disease with a non-classical presentation: a case report and review of literature.

Science.gov (United States)

Manso, Jacopo; Pezzani, Raffaele; Scarpa, Riccardo; Gallo, Nicoletta; Betterle, Corrado

2018-05-24

Autoimmune Addison's disease (AAD) is the most frequent cause of adrenocortical insufficiency. The natural history of AAD usually comprises five consecutive stages with the first stage characterized by the increase of plasma renin consistent with the impairment of pars glomerulosa, which is usually the first affected layer of the adrenal cortex. We describe a 19-year-old female with Hashimoto's thyroiditis (HT) who underwent an autoantibody screening due to having the personal and family history of other autoimmune diseases in the absence of relevant clinical manifestations. She was positive for adrenal cortex autoantibodies (ACA) and steroid 21-hydroxylase autoantibodies (21-OH Ab) at high titers. She had increased basal levels of ACTH with normal basal cortisol not responding to ACTH stimulation, reduced levels of dehydroepiandrosterone-sulfate but normal levels of orthostatic renin and aldosterone. This scenario was consistent with a subclinical AAD presenting with first impairments in pars fasciculata and reticularis and conserved pars glomerulosa function. Only subsequently, progressive deficiency in pars glomerulosa function has become evident. Review of the literature showed that there was only one case, reported to date, with a similar atypical natural history of AAD. The strategies for screening for ACA/21-OH Ab in patients with HT are discussed.

Longitudinal AddiQoL scores may identify higher risk for adrenal crises in Addison's disease.

Science.gov (United States)

Meyer, Gesine; Koch, Maike; Herrmann, Eva; Bojunga, Jörg; Badenhoop, Klaus

2018-05-01

Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. 110 patients with AD were asked to complete the disease specific-QoL questionnaire AddiQoL and a short questionnaire about adverse events once monthly over a period of ten months. AC was defined if at least two of the following symptoms were reported: (a) hypotension, (b) nausea or vomiting, (c) severe fatigue, (d) documented hyponatremia, hyperkalemia, or hypoglycemia, and subsequent parenteral glucocorticoid administration was carried out. Prevalence of AC was 10.9/100 patient years. AddiQoL scores in patients with AC showed a trend (p = 0,08) to a wider fluctuation over time. Subjective precrises not meeting the criteria for AC were reported by 31 patients who had significantly lower AddiQoL scores (p = 0,018). These are the first data showing the course of QoL during a period of ten months in patients with AD. Incidence of AC exceeds previous data. Our data show, that subjective precrises in AD associate with lower QoL. AC, as well as precrises affect intraindividual AddiQol-scores over time with a trend to a stronger fluctuation. Longitudinal AddiQol scores and self-reporting of precrises via patient diaries are additional clinical tools to identify higher risk for critical events.

Autoantibody response against NALP5/MATER in primary ovarian insufficiency and in autoimmune Addison's disease.

Science.gov (United States)

Brozzetti, Annalisa; Alimohammadi, Mohammad; Morelli, Silvia; Minarelli, Viviana; Hallgren, Åsa; Giordano, Roberta; De Bellis, Annamaria; Perniola, Roberto; Kämpe, Olle; Falorni, Alberto

2015-05-01

NACHT leucine-rich-repeat protein 5 (NALP5)/maternal antigen that embryo requires (MATER) is an autoantigen in hypoparathyroidism associated with autoimmune polyendocrine syndrome type 1 (APS1) but is also expressed in the ovary. Mater is an autoantigen in experimental autoimmune oophoritis. The objectives of the study were to determine the frequency of NALP5/MATER autoantibodies (NALP5/MATER-Ab) in women with premature ovarian insufficiency (POI) and in patients with autoimmune Addison's disease (AAD) and to evaluate whether inhibin chains are a target for autoantibodies in POI. Autoantibodies against NALP5/MATER and inhibin chains-α and -βA were determined by radiobinding assays in 172 patients with AAD without clinical signs of gonadal insufficiency, 41 women with both AAD and autoimmune POI [steroidogenic cell autoimmune POI (SCA-POI)], 119 women with idiopathic POI, 19 patients with APS1, and 211 healthy control subjects. NALP5/MATER-Ab were detected in 11 of 19 (58%) sera from APS1 patients, 12 of 172 (7%) AAD sera, 5 of 41 (12%) SCA-POI sera, 0 of 119 idiopathic POI sera and 1 of 211 healthy control sera (P < .001). None of 160 POI sera, including 41 sera from women with SCA-POI and 119 women with idiopathic POI, and none of 211 healthy control sera were positive for inhibin chain-α/βA autoantibodies. NALP5/MATER-Ab are associated with hypoparathyroidism in APS1 but are present also in patients with AAD and in women with SCA-POI without hypoparathyroidism. Inhibin chains do not appear to be likely candidate targets of autoantibodies in human POI.

SLS Navigation Model-Based Design Approach

Science.gov (United States)

Oliver, T. Emerson; Anzalone, Evan; Geohagan, Kevin; Bernard, Bill; Park, Thomas

2018-01-01

The SLS Program chose to implement a Model-based Design and Model-based Requirements approach for managing component design information and system requirements. This approach differs from previous large-scale design efforts at Marshall Space Flight Center where design documentation alone conveyed information required for vehicle design and analysis and where extensive requirements sets were used to scope and constrain the design. The SLS Navigation Team has been responsible for the Program-controlled Design Math Models (DMMs) which describe and represent the performance of the Inertial Navigation System (INS) and the Rate Gyro Assemblies (RGAs) used by Guidance, Navigation, and Controls (GN&C). The SLS Navigation Team is also responsible for the navigation algorithms. The navigation algorithms are delivered for implementation on the flight hardware as a DMM. For the SLS Block 1-B design, the additional GPS Receiver hardware is managed as a DMM at the vehicle design level. This paper provides a discussion of the processes and methods used to engineer, design, and coordinate engineering trades and performance assessments using SLS practices as applied to the GN&C system, with a particular focus on the Navigation components. These include composing system requirements, requirements verification, model development, model verification and validation, and modeling and analysis approaches. The Model-based Design and Requirements approach does not reduce the effort associated with the design process versus previous processes used at Marshall Space Flight Center. Instead, the approach takes advantage of overlap between the requirements development and management process, and the design and analysis process by efficiently combining the control (i.e. the requirement) and the design mechanisms. The design mechanism is the representation of the component behavior and performance in design and analysis tools. The focus in the early design process shifts from the development and

Evolutionary modeling-based approach for model errors correction

Directory of Open Access Journals (Sweden)

S. Q. Wan

2012-08-01

Full Text Available The inverse problem of using the information of historical data to estimate model errors is one of the science frontier research topics. In this study, we investigate such a problem using the classic Lorenz (1963 equation as a prediction model and the Lorenz equation with a periodic evolutionary function as an accurate representation of reality to generate "observational data."

On the basis of the intelligent features of evolutionary modeling (EM, including self-organization, self-adaptive and self-learning, the dynamic information contained in the historical data can be identified and extracted by computer automatically. Thereby, a new approach is proposed to estimate model errors based on EM in the present paper. Numerical tests demonstrate the ability of the new approach to correct model structural errors. In fact, it can actualize the combination of the statistics and dynamics to certain extent.

HEDR modeling approach

International Nuclear Information System (INIS)

Shipler, D.B.; Napier, B.A.

1992-07-01

This report details the conceptual approaches to be used in calculating radiation doses to individuals throughout the various periods of operations at the Hanford Site. The report considers the major environmental transport pathways--atmospheric, surface water, and ground water--and projects and appropriate modeling technique for each. The modeling sequence chosen for each pathway depends on the available data on doses, the degree of confidence justified by such existing data, and the level of sophistication deemed appropriate for the particular pathway and time period being considered

A Statistical Approach For Modeling Tropical Cyclones. Synthetic Hurricanes Generator Model

Energy Technology Data Exchange (ETDEWEB)

Pasqualini, Donatella [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-05-11

This manuscript brie y describes a statistical ap- proach to generate synthetic tropical cyclone tracks to be used in risk evaluations. The Synthetic Hur- ricane Generator (SynHurG) model allows model- ing hurricane risk in the United States supporting decision makers and implementations of adaptation strategies to extreme weather. In the literature there are mainly two approaches to model hurricane hazard for risk prediction: deterministic-statistical approaches, where the storm key physical parameters are calculated using physi- cal complex climate models and the tracks are usually determined statistically from historical data; and sta- tistical approaches, where both variables and tracks are estimated stochastically using historical records. SynHurG falls in the second category adopting a pure stochastic approach.

The effect of types I and III interferons on adrenocortical cells and its possible implications for autoimmune Addison's disease.

Science.gov (United States)

Hellesen, A; Edvardsen, K; Breivik, L; Husebye, E S; Bratland, E

2014-06-01

Autoimmune Addison's disease (AAD) is caused by selective destruction of the hormone-producing cells of the adrenal cortex. As yet, little is known about the potential role played by environmental factors in this process. Type I and/or type III interferons (IFNs) are signature responses to virus infections, and have also been implicated in the pathogenesis of autoimmune endocrine disorders such as type 1 diabetes and autoimmune thyroiditis. Transient development of AAD and exacerbation of established or subclinical disease, as well as the induction of autoantibodies associated with AAD, have been reported following therapeutic administration of type I IFNs. We therefore hypothesize that exposure to such IFNs could render the adrenal cortex susceptible to autoimmune attack in genetically predisposed individuals. In this study, we investigated possible immunopathological effects of type I and type III IFNs on adrenocortical cells in relation to AAD. Both types I and III IFNs exerted significant cytotoxicity on NCI-H295R adrenocortical carcinoma cells and potentiated IFN-γ- and polyinosine-polycytidylic acid [poly (I : C)]-induced chemokine secretion. Furthermore, we observed increased expression of human leucocyte antigen (HLA) class I molecules and up-regulation of 21-hydroxylase, the primary antigenic target in AAD. We propose that these combined effects could serve to initiate or aggravate an ongoing autoimmune response against the adrenal cortex in AAD. © 2014 British Society for Immunology.

Application of various FLD modelling approaches

Science.gov (United States)

Banabic, D.; Aretz, H.; Paraianu, L.; Jurco, P.

2005-07-01

This paper focuses on a comparison between different modelling approaches to predict the forming limit diagram (FLD) for sheet metal forming under a linear strain path using the recently introduced orthotropic yield criterion BBC2003 (Banabic D et al 2005 Int. J. Plasticity 21 493-512). The FLD models considered here are a finite element based approach, the well known Marciniak-Kuczynski model, the modified maximum force criterion according to Hora et al (1996 Proc. Numisheet'96 Conf. (Dearborn/Michigan) pp 252-6), Swift's diffuse (Swift H W 1952 J. Mech. Phys. Solids 1 1-18) and Hill's classical localized necking approach (Hill R 1952 J. Mech. Phys. Solids 1 19-30). The FLD of an AA5182-O aluminium sheet alloy has been determined experimentally in order to quantify the predictive capabilities of the models mentioned above.

A Unified Approach to Modeling and Programming

DEFF Research Database (Denmark)

Madsen, Ole Lehrmann; Møller-Pedersen, Birger

2010-01-01

of this paper is to go back to the future and get inspiration from SIMULA and propose a unied approach. In addition to reintroducing the contributions of SIMULA and the Scandinavian approach to object-oriented programming, we do this by discussing a number of issues in modeling and programming and argue3 why we......SIMULA was a language for modeling and programming and provided a unied approach to modeling and programming in contrast to methodologies based on structured analysis and design. The current development seems to be going in the direction of separation of modeling and programming. The goal...

Technical note: Comparison of methane ebullition modelling approaches used in terrestrial wetland models

Science.gov (United States)

Peltola, Olli; Raivonen, Maarit; Li, Xuefei; Vesala, Timo

2018-02-01

Emission via bubbling, i.e. ebullition, is one of the main methane (CH4) emission pathways from wetlands to the atmosphere. Direct measurement of gas bubble formation, growth and release in the peat-water matrix is challenging and in consequence these processes are relatively unknown and are coarsely represented in current wetland CH4 emission models. In this study we aimed to evaluate three ebullition modelling approaches and their effect on model performance. This was achieved by implementing the three approaches in one process-based CH4 emission model. All the approaches were based on some kind of threshold: either on CH4 pore water concentration (ECT), pressure (EPT) or free-phase gas volume (EBG) threshold. The model was run using 4 years of data from a boreal sedge fen and the results were compared with eddy covariance measurements of CH4 fluxes.Modelled annual CH4 emissions were largely unaffected by the different ebullition modelling approaches; however, temporal variability in CH4 emissions varied an order of magnitude between the approaches. Hence the ebullition modelling approach drives the temporal variability in modelled CH4 emissions and therefore significantly impacts, for instance, high-frequency (daily scale) model comparison and calibration against measurements. The modelling approach based on the most recent knowledge of the ebullition process (volume threshold, EBG) agreed the best with the measured fluxes (R2 = 0.63) and hence produced the most reasonable results, although there was a scale mismatch between the measurements (ecosystem scale with heterogeneous ebullition locations) and model results (single horizontally homogeneous peat column). The approach should be favoured over the two other more widely used ebullition modelling approaches and researchers are encouraged to implement it into their CH4 emission models.

System Behavior Models: A Survey of Approaches

Science.gov (United States)

2016-06-01

OF FIGURES Spiral Model .................................................................................................3 Figure 1. Approaches in... spiral model was chosen for researching and structuring this thesis, shown in Figure 1. This approach allowed multiple iterations of source material...applications and refining through iteration. 3 Spiral Model Figure 1. D. SCOPE The research is limited to a literature review, limited

Set-Theoretic Approach to Maturity Models

DEFF Research Database (Denmark)

Lasrado, Lester Allan

Despite being widely accepted and applied, maturity models in Information Systems (IS) have been criticized for the lack of theoretical grounding, methodological rigor, empirical validations, and ignorance of multiple and non-linear paths to maturity. This PhD thesis focuses on addressing...... these criticisms by incorporating recent developments in configuration theory, in particular application of set-theoretic approaches. The aim is to show the potential of employing a set-theoretic approach for maturity model research and empirically demonstrating equifinal paths to maturity. Specifically...... methodological guidelines consisting of detailed procedures to systematically apply set theoretic approaches for maturity model research and provides demonstrations of it application on three datasets. The thesis is a collection of six research papers that are written in a sequential manner. The first paper...

The role of functionally defective rare germline variants of sialic acid acetylesterase in autoimmune Addison's disease

Science.gov (United States)

Gan, Earn H; MacArthur, Katie; Mitchell, Anna L; Pearce, Simon H S

2012-01-01

Background Autoimmune Addison's disease (AAD) is a rare condition with a complex genetic basis. A panel of rare and functionally defective genetic variants in the sialic acid acetylesterase (SIAE) gene has recently been implicated in several common autoimmune conditions. We performed a case–control study to determine whether these rare variants are associated with a rarer condition, AAD. Method We analysed nine SIAE gene variants (W48X, M89V, C196F, C226G, R230W, T312M, Y349C, F404S and R479C) in a United Kingdom cohort of 378 AAD subjects and 387 healthy controls. All samples were genotyped using Sequenom iPlex chemistry to characterise primer extension products. Results A heterozygous rare allele at codon 312 (312*M) was found in one AAD patient (0.13%) but was not detected in the healthy controls. The commoner, functionally recessive variant at codon 89 (89*V) was found to be homozygous in two AAD patients but was only found in the heterozygous state in controls. Taking into account all nine alleles examined, 4/378 (1.06%) AAD patients and 1/387 (0.25%) healthy controls carried the defective SIAE alleles, with a calculated odds ratio of 4.13 (95% CI 0.44–97.45, two-tailed P value 0.212, NS). Conclusion We demonstrated the presence of 89*V homozygotes and the 312*M rare allele in the AAD cohort, but overall, our analysis does not support a role for rare variants in SIAE in the pathogenesis of AAD. However, the relatively small collection of AAD patients limits the power to exclude a small effect. PMID:23011869

Heritability of Addison's disease and prevalence of associated autoimmunity in a cohort of 112,100 Swedish twins.

Science.gov (United States)

Skov, Jakob; Höijer, Jonas; Magnusson, Patrik K E; Ludvigsson, Jonas F; Kämpe, Olle; Bensing, Sophie

2017-12-01

The pathophysiology behind autoimmune Addison's disease (AAD) is poorly understood, and the relative influence of genetic and environmental factors remains unclear. In this study, we examined the heritability of AAD and explored disease-associated autoimmune comorbidity among Swedish twins. A population-based longitudinal cohort of 112,100 Swedish twins was used to calculate the heritability of AAD, and to explore co-occurrence of 10 organ-specific autoimmune disorders in twin pairs with AAD. Diagnoses were collected 1964-2012 through linkage to the Swedish National Patient Register. The Swedish Prescribed Drug Register was used for additional diagnostic precision. When available, biobank serum samples were used to ascertain the AAD diagnosis through identification of 21-hydroxylase autoantibodies. We identified 29 twins with AAD. Five out of nine (5/9) monozygotic pairs and zero out of fifteen (0/15) dizygotic pairs were concordant for AAD. The probandwise concordance for monozygotic twins was 0.71 (95% CI 0.40-0.90) and the heritability 0.97 (95% CI 0.88-99). Autoimmune disease patterns of monozygotic twin pairs affected by AAD displayed a higher degree of similarity than those of dizygotic twins, with an incidence rate ratio of 15 (95% CI 1.8-116) on the number of shared autoimmune diagnoses within pairs. The heritability of AAD appears to be very high, emphasizing the need for further research on the genetic etiology of the disease. Monozygotic twin concordance for multiple autoimmune manifestations suggests strong genetic influence on disease specificity in organ-specific autoimmunity.

Challenges and opportunities for integrating lake ecosystem modelling approaches

Science.gov (United States)

Mooij, Wolf M.; Trolle, Dennis; Jeppesen, Erik; Arhonditsis, George; Belolipetsky, Pavel V.; Chitamwebwa, Deonatus B.R.; Degermendzhy, Andrey G.; DeAngelis, Donald L.; Domis, Lisette N. De Senerpont; Downing, Andrea S.; Elliott, J. Alex; Ruberto, Carlos Ruberto; Gaedke, Ursula; Genova, Svetlana N.; Gulati, Ramesh D.; Hakanson, Lars; Hamilton, David P.; Hipsey, Matthew R.; Hoen, Jochem 't; Hulsmann, Stephan; Los, F. Hans; Makler-Pick, Vardit; Petzoldt, Thomas; Prokopkin, Igor G.; Rinke, Karsten; Schep, Sebastiaan A.; Tominaga, Koji; Van Dam, Anne A.; Van Nes, Egbert H.; Wells, Scott A.; Janse, Jan H.

2010-01-01

A large number and wide variety of lake ecosystem models have been developed and published during the past four decades. We identify two challenges for making further progress in this field. One such challenge is to avoid developing more models largely following the concept of others ('reinventing the wheel'). The other challenge is to avoid focusing on only one type of model, while ignoring new and diverse approaches that have become available ('having tunnel vision'). In this paper, we aim at improving the awareness of existing models and knowledge of concurrent approaches in lake ecosystem modelling, without covering all possible model tools and avenues. First, we present a broad variety of modelling approaches. To illustrate these approaches, we give brief descriptions of rather arbitrarily selected sets of specific models. We deal with static models (steady state and regression models), complex dynamic models (CAEDYM, CE-QUAL-W2, Delft 3D-ECO, LakeMab, LakeWeb, MyLake, PCLake, PROTECH, SALMO), structurally dynamic models and minimal dynamic models. We also discuss a group of approaches that could all be classified as individual based: super-individual models (Piscator, Charisma), physiologically structured models, stage-structured models and trait-based models. We briefly mention genetic algorithms, neural networks, Kalman filters and fuzzy logic. Thereafter, we zoom in, as an in-depth example, on the multi-decadal development and application of the lake ecosystem model PCLake and related models (PCLake Metamodel, Lake Shira Model, IPH-TRIM3D-PCLake). In the discussion, we argue that while the historical development of each approach and model is understandable given its 'leading principle', there are many opportunities for combining approaches. We take the point of view that a single 'right' approach does not exist and should not be strived for. Instead, multiple modelling approaches, applied concurrently to a given problem, can help develop an integrative

Models of galaxies - The modal approach

International Nuclear Information System (INIS)

Lin, C.C.; Lowe, S.A.

1990-01-01

The general viability of the modal approach to the spiral structure in normal spirals and the barlike structure in certain barred spirals is discussed. The usefulness of the modal approach in the construction of models of such galaxies is examined, emphasizing the adoption of a model appropriate to observational data for both the spiral structure of a galaxy and its basic mass distribution. 44 refs

Original Research Original Research

African Journals Online (AJOL)

RAGHAVENDRA

Language and Art Studies, Institute of Language Studies and Journalism,. Wollega University, Post Box No: 395, Nekemte, Ethiopia ... tudies and Journalism,. Article Information. Article History: Received : 11-04-2015 ..... Teaching by principles: An interactive approach to language pedagogy. New York, NY: Addison.

Evaporator modeling - A hybrid approach

International Nuclear Information System (INIS)

Ding Xudong; Cai Wenjian; Jia Lei; Wen Changyun

2009-01-01

In this paper, a hybrid modeling approach is proposed to model two-phase flow evaporators. The main procedures for hybrid modeling includes: (1) Based on the energy and material balance, and thermodynamic principles to formulate the process fundamental governing equations; (2) Select input/output (I/O) variables responsible to the system performance which can be measured and controlled; (3) Represent those variables existing in the original equations but are not measurable as simple functions of selected I/Os or constants; (4) Obtaining a single equation which can correlate system inputs and outputs; and (5) Identify unknown parameters by linear or nonlinear least-squares methods. The method takes advantages of both physical and empirical modeling approaches and can accurately predict performance in wide operating range and in real-time, which can significantly reduce the computational burden and increase the prediction accuracy. The model is verified with the experimental data taken from a testing system. The testing results show that the proposed model can predict accurately the performance of the real-time operating evaporator with the maximum error of ±8%. The developed models will have wide applications in operational optimization, performance assessment, fault detection and diagnosis

Deep Appearance Models: A Deep Boltzmann Machine Approach for Face Modeling

OpenAIRE

Duong, Chi Nhan; Luu, Khoa; Quach, Kha Gia; Bui, Tien D.

2016-01-01

The "interpretation through synthesis" approach to analyze face images, particularly Active Appearance Models (AAMs) method, has become one of the most successful face modeling approaches over the last two decades. AAM models have ability to represent face images through synthesis using a controllable parameterized Principal Component Analysis (PCA) model. However, the accuracy and robustness of the synthesized faces of AAM are highly depended on the training sets and inherently on the genera...

A Bayesian approach to model uncertainty

International Nuclear Information System (INIS)

Buslik, A.

1994-01-01

A Bayesian approach to model uncertainty is taken. For the case of a finite number of alternative models, the model uncertainty is equivalent to parameter uncertainty. A derivation based on Savage's partition problem is given

Incidence, prevalence and seasonal onset variation of Addison's disease among persons with type 1 diabetes mellitus: nationwide, matched cohort studies.

Science.gov (United States)

Chantzichristos, Dimitrios; Persson, Anders; Eliasson, Björn; Miftaraj, Mervete; Franzén, Stefan; Svensson, Ann-Marie; Johannsson, Gudmundur

2018-01-01

We determined the incidence and prevalence of Addison's disease (AD) among persons with or without type 1 diabetes mellitus (T1DM) in nationwide, matched cohort studies. Persons with T1DM were identified from the Swedish National Diabetes Register and each was matched for age, sex, year and county to five controls randomly selected from the general population. Persons with AD were identified from the Swedish National Inpatient Register. Baseline demographics and seasonal onset variation of AD were presented by descriptive statistics. Prevalence and incidence were estimated by proportions and incidence rates, respectively. Times to AD were analyzed using the Cox proportional hazard model. Between 1998 and 2013, 66 persons with T1DM were diagnosed with AD at a mean age (s.d.) of 36.4 (13.0) years among 36 514 persons with T1DM, while 32 were diagnosed with AD at a mean age of 42.7 (15.2) years among 182 570 controls. The difference in mean age at diagnosis of AD between the groups was 6.3 years ( P value = 0.036). The incidence of AD for a person with or without T1DM was therefore 193 and 18 per million person-years, respectively. The adjusted relative risk increase of developing AD in T1DM was 10.8 (95% CI: 7.1-16.5). The highest incidence of AD was observed during February-March and September-October. The prevalence of AD in persons with or without T1DM in December 2012 was 3410 and 208 per million, respectively. The odds ratio for AD in persons with T1DM vs controls was 16.5 (95% CI: 11.1-24.5). The risk to develop AD among persons with T1DM is more than 10 times higher than in persons without T1DM. Persons with T1DM develop AD at a younger age. The incidence of AD may have a seasonal pattern. © 2018 European Society of Endocrinology.

Current approaches to gene regulatory network modelling

Directory of Open Access Journals (Sweden)

Brazma Alvis

2007-09-01

Full Text Available Abstract Many different approaches have been developed to model and simulate gene regulatory networks. We proposed the following categories for gene regulatory network models: network parts lists, network topology models, network control logic models, and dynamic models. Here we will describe some examples for each of these categories. We will study the topology of gene regulatory networks in yeast in more detail, comparing a direct network derived from transcription factor binding data and an indirect network derived from genome-wide expression data in mutants. Regarding the network dynamics we briefly describe discrete and continuous approaches to network modelling, then describe a hybrid model called Finite State Linear Model and demonstrate that some simple network dynamics can be simulated in this model.

Intelligent wireless forensic model (IWFM) for moving devices between wireless networks

CSIR Research Space (South Africa)

Ngobeni, SJ

2008-09-01

Full Text Available Donald, Forensic Analysis of the Contents of Nokia Mobile Phones, 2006, Pp 1-4. [3] W.G. Kruse and J.G. Heiser, Computer Forensics, Incident response essentials, Addison-Wesley, Boston, 2001. [4] M. Kohn, J.H.P. Eloff, M. Olivier, Framework for a Digital...

A hybrid agent-based approach for modeling microbiological systems.

Science.gov (United States)

Guo, Zaiyi; Sloot, Peter M A; Tay, Joc Cing

2008-11-21

Models for systems biology commonly adopt Differential Equations or Agent-Based modeling approaches for simulating the processes as a whole. Models based on differential equations presuppose phenomenological intracellular behavioral mechanisms, while models based on Multi-Agent approach often use directly translated, and quantitatively less precise if-then logical rule constructs. We propose an extendible systems model based on a hybrid agent-based approach where biological cells are modeled as individuals (agents) while molecules are represented by quantities. This hybridization in entity representation entails a combined modeling strategy with agent-based behavioral rules and differential equations, thereby balancing the requirements of extendible model granularity with computational tractability. We demonstrate the efficacy of this approach with models of chemotaxis involving an assay of 10(3) cells and 1.2x10(6) molecules. The model produces cell migration patterns that are comparable to laboratory observations.

Service creation: a model-based approach

NARCIS (Netherlands)

Quartel, Dick; van Sinderen, Marten J.; Ferreira Pires, Luis

1999-01-01

This paper presents a model-based approach to support service creation. In this approach, services are assumed to be created from (available) software components. The creation process may involve multiple design steps in which the requested service is repeatedly decomposed into more detailed

Risk prediction model: Statistical and artificial neural network approach

Science.gov (United States)

Paiman, Nuur Azreen; Hariri, Azian; Masood, Ibrahim

2017-04-01

Prediction models are increasingly gaining popularity and had been used in numerous areas of studies to complement and fulfilled clinical reasoning and decision making nowadays. The adoption of such models assist physician's decision making, individual's behavior, and consequently improve individual outcomes and the cost-effectiveness of care. The objective of this paper is to reviewed articles related to risk prediction model in order to understand the suitable approach, development and the validation process of risk prediction model. A qualitative review of the aims, methods and significant main outcomes of the nineteen published articles that developed risk prediction models from numerous fields were done. This paper also reviewed on how researchers develop and validate the risk prediction models based on statistical and artificial neural network approach. From the review done, some methodological recommendation in developing and validating the prediction model were highlighted. According to studies that had been done, artificial neural network approached in developing the prediction model were more accurate compared to statistical approach. However currently, only limited published literature discussed on which approach is more accurate for risk prediction model development.

Tradespace and Affordability - Phase 1

Science.gov (United States)

2013-07-09

will help make such decisions. A further approach growing in use is the workflow-oriented Kanban method of limiting work in progress and... Kanban , Blue Hole Press, 2010. 18. K.. Beck, Extreme Programming Explained, Addison Wesley, 1999. Contract Number: H98230-08-D-0171 TO 0031, RT

Sensitivity analysis approaches applied to systems biology models.

Science.gov (United States)

Zi, Z

2011-11-01

With the rising application of systems biology, sensitivity analysis methods have been widely applied to study the biological systems, including metabolic networks, signalling pathways and genetic circuits. Sensitivity analysis can provide valuable insights about how robust the biological responses are with respect to the changes of biological parameters and which model inputs are the key factors that affect the model outputs. In addition, sensitivity analysis is valuable for guiding experimental analysis, model reduction and parameter estimation. Local and global sensitivity analysis approaches are the two types of sensitivity analysis that are commonly applied in systems biology. Local sensitivity analysis is a classic method that studies the impact of small perturbations on the model outputs. On the other hand, global sensitivity analysis approaches have been applied to understand how the model outputs are affected by large variations of the model input parameters. In this review, the author introduces the basic concepts of sensitivity analysis approaches applied to systems biology models. Moreover, the author discusses the advantages and disadvantages of different sensitivity analysis methods, how to choose a proper sensitivity analysis approach, the available sensitivity analysis tools for systems biology models and the caveats in the interpretation of sensitivity analysis results.

On a model-based approach to radiation protection

International Nuclear Information System (INIS)

Waligorski, M.P.R.

2002-01-01

There is a preoccupation with linearity and absorbed dose as the basic quantifiers of radiation hazard. An alternative is the fluence approach, whereby radiation hazard may be evaluated, at least in principle, via an appropriate action cross section. In order to compare these approaches, it may be useful to discuss them as quantitative descriptors of survival and transformation-like endpoints in cell cultures in vitro - a system thought to be relevant to modelling radiation hazard. If absorbed dose is used to quantify these biological endpoints, then non-linear dose-effect relations have to be described, and, e.g. after doses of densely ionising radiation, dose-correction factors as high as 20 are required. In the fluence approach only exponential effect-fluence relationships can be readily described. Neither approach alone exhausts the scope of experimentally observed dependencies of effect on dose or fluence. Two-component models, incorporating a suitable mixture of the two approaches, are required. An example of such a model is the cellular track structure theory developed by Katz over thirty years ago. The practical consequences of modelling radiation hazard using this mixed two-component approach are discussed. (author)

Mathematical Modeling Approaches in Plant Metabolomics.

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Fürtauer, Lisa; Weiszmann, Jakob; Weckwerth, Wolfram; Nägele, Thomas

2018-01-01

The experimental analysis of a plant metabolome typically results in a comprehensive and multidimensional data set. To interpret metabolomics data in the context of biochemical regulation and environmental fluctuation, various approaches of mathematical modeling have been developed and have proven useful. In this chapter, a general introduction to mathematical modeling is presented and discussed in context of plant metabolism. A particular focus is laid on the suitability of mathematical approaches to functionally integrate plant metabolomics data in a metabolic network and combine it with other biochemical or physiological parameters.

Meta-analysis a structural equation modeling approach

CERN Document Server

Cheung, Mike W-L

2015-01-01

Presents a novel approach to conducting meta-analysis using structural equation modeling. Structural equation modeling (SEM) and meta-analysis are two powerful statistical methods in the educational, social, behavioral, and medical sciences. They are often treated as two unrelated topics in the literature. This book presents a unified framework on analyzing meta-analytic data within the SEM framework, and illustrates how to conduct meta-analysis using the metaSEM package in the R statistical environment. Meta-Analysis: A Structural Equation Modeling Approach begins by introducing the impo

24-hour urinary aldosterone excretion test

Science.gov (United States)

Aldosterone - urine; Addison disease - urine aldosterone; Cirrhosis - serum aldosterone ... Laxative abuse Lower than normal levels may indicate Addison disease , a disorder in which the adrenal glands do ...

Multisteroid LC–MS/MS assay for glucocorticoids and androgens and its application in Addison's disease

Science.gov (United States)

Methlie, Paal; Hustad, Steinar; Kellman, Ralf; Almås, Bjørg; Erichsen, Martina M; Husebye, Eystein S; Løvås, Kristian

2013-01-01

Objective Liquid chromatography–tandem mass spectrometry (LC–MS/MS) offers superior analytical specificity compared with immunoassays, but it is not available in many regions and hospitals due to expensive instrumentation and tedious sample preparation. Thus, we developed an automated, high-throughput LC–MS/MS assay for simultaneous quantification of ten endogenous and synthetic steroids targeting diseases of the hypothalamic–pituitary–adrenal axis and gonads. Methods Deuterated internal standards were added to 85 μl serum and processed by liquid–liquid extraction. Cortisol, cortisone, prednisolone, prednisone, 11-deoxycortisol, dexamethasone, testosterone, androstenedione and progesterone were resolved by ultra-high-pressure chromatography on a reversed-phase column in 6.1 min and detected by triple-quadrupole mass spectrometry. The method was used to assess steroid profiles in women with Addison's disease (AD, n=156) and blood donors (BDs, n=102). Results Precisions ranged from 4.5 to 10.1% relative standard deviations (RSD), accuracies from 95 to 108% and extraction recoveries from 60 to 84%. The method was practically free of matrix effects and robust to individual differences in serum composition. Most postmenopausal AD women had extremely low androstenedione concentrations, below 0.14 nmol/l, and median testosterone concentrations of 0.15 nmol/l (interquartile range 0.00–0.41), considerably lower than those of postmenopausal BDs (1.28 nmol/l (0.96–1.64) and 0.65 nmol/l (0.56–1.10) respectively). AD women in fertile years had androstenedione concentrations of 1.18 nmol/l (0.71–1.76) and testosterone concentrations of 0.44 nmol/l (0.22–0.63), approximately half of those found in BDs of corresponding age. Conclusion This LC–MS/MS assay provides highly sensitive and specific assessments of glucocorticoids and androgens with low sample volumes and is suitable for endocrine laboratories and research. Its utility has been

High-dose vitamin D in Addison's disease regulates T-cells and monocytes: A pilot trial.

Science.gov (United States)

Penna-Martinez, Marissa; Filmann, Natalie; Bogdanou, Dimitra; Shoghi, Firouzeh; Huenecke, Sabine; Schubert, Ralf; Herrmann, Eva; Koehl, Ulrike; Husebye, Eystein S; Badenhoop, Klaus

2018-05-01

On the basis of the immunomodulatory actions of vitamin D (VD), we investigated the effects of high-dose VD therapy over a 3 mo period on the immune response in patients with Addison's disease (AD). This randomized, controlled, crossover trial included 13 patients with AD who received either cholecalciferol (4000 IU/d) for 3 mo followed by 3 mo placebo oil or the sequential alternative placebo followed by verum. Glucocorticoid replacement doses remained stable. The primary outcome measures were changes in 25-hydroxyvitamin D3 (25(OH)D 3 ) levels and immune cells including T helper cells (Th; CD3 + CD4 + ), late-activated Th cells (CD3 + CD4 + HLA-DR + ), regulatory T cells (CD3 + CD4 + CD25 bright CD127 dim/neg ), cytotoxic T cells (Tc; CD3 + CD8 + ), late-activated Tc cells (CD3 + CD8 + HLA-DR + ), and monocytes. The explorative analysis included the correlation of changes with VD-related gene polymorphisms and 21-hydroxylase antibody titers. Ten of 13 patients (77%) were VD deficient. Median 25(OH)D 3 concentrations increased significantly to 41.5 ng/ml (median changes: 19.95 ng/ml; P = 0.0005) after 3 mo of cholecalciferol treatment. Within the T-cells, only the late-activated Th (median changes: 1.6%; P = 0.02) and late-activated Tc cells (median changes: 4.05%; P = 0.03) decreased, whereas monocytes (median changes: 1.05%; P = 0.008) increased after VD therapy. T-cell changes were associated with two polymorphisms (CYP27B1-rs108770012 and VDR-rs10735810), but no changes in the 21-hydroxylase antibody titers were observed. Three months of treatment with cholecalciferol achieved sufficient 25(OH)D 3 levels and can regulate late-activated T-cells and monocytes in patients with AD. Explorative analysis revealed potential genetic contributions. This pilot trial provides novel insights about immunomodulation in AD. Copyright © 2017 Elsevier Inc. All rights reserved.

Computational and Game-Theoretic Approaches for Modeling Bounded Rationality

NARCIS (Netherlands)

L. Waltman (Ludo)

2011-01-01

textabstractThis thesis studies various computational and game-theoretic approaches to economic modeling. Unlike traditional approaches to economic modeling, the approaches studied in this thesis do not rely on the assumption that economic agents behave in a fully rational way. Instead, economic

Modeling healthcare authorization and claim submissions using the openEHR dual-model approach

Science.gov (United States)

2011-01-01

Background The TISS standard is a set of mandatory forms and electronic messages for healthcare authorization and claim submissions among healthcare plans and providers in Brazil. It is not based on formal models as the new generation of health informatics standards suggests. The objective of this paper is to model the TISS in terms of the openEHR archetype-based approach and integrate it into a patient-centered EHR architecture. Methods Three approaches were adopted to model TISS. In the first approach, a set of archetypes was designed using ENTRY subclasses. In the second one, a set of archetypes was designed using exclusively ADMIN_ENTRY and CLUSTERs as their root classes. In the third approach, the openEHR ADMIN_ENTRY is extended with classes designed for authorization and claim submissions, and an ISM_TRANSITION attribute is added to the COMPOSITION class. Another set of archetypes was designed based on this model. For all three approaches, templates were designed to represent the TISS forms. Results The archetypes based on the openEHR RM (Reference Model) can represent all TISS data structures. The extended model adds subclasses and an attribute to the COMPOSITION class to represent information on authorization and claim submissions. The archetypes based on all three approaches have similar structures, although rooted in different classes. The extended openEHR RM model is more semantically aligned with the concepts involved in a claim submission, but may disrupt interoperability with other systems and the current tools must be adapted to deal with it. Conclusions Modeling the TISS standard by means of the openEHR approach makes it aligned with ISO recommendations and provides a solid foundation on which the TISS can evolve. Although there are few administrative archetypes available, the openEHR RM is expressive enough to represent the TISS standard. This paper focuses on the TISS but its results may be extended to other billing processes. A complete

A piecewise modeling approach for climate sensitivity studies: Tests with a shallow-water model

Science.gov (United States)

Shao, Aimei; Qiu, Chongjian; Niu, Guo-Yue

2015-10-01

In model-based climate sensitivity studies, model errors may grow during continuous long-term integrations in both the "reference" and "perturbed" states and hence the climate sensitivity (defined as the difference between the two states). To reduce the errors, we propose a piecewise modeling approach that splits the continuous long-term simulation into subintervals of sequential short-term simulations, and updates the modeled states through re-initialization at the end of each subinterval. In the re-initialization processes, this approach updates the reference state with analysis data and updates the perturbed states with the sum of analysis data and the difference between the perturbed and the reference states, thereby improving the credibility of the modeled climate sensitivity. We conducted a series of experiments with a shallow-water model to evaluate the advantages of the piecewise approach over the conventional continuous modeling approach. We then investigated the impacts of analysis data error and subinterval length used in the piecewise approach on the simulations of the reference and perturbed states as well as the resulting climate sensitivity. The experiments show that the piecewise approach reduces the errors produced by the conventional continuous modeling approach, more effectively when the analysis data error becomes smaller and the subinterval length is shorter. In addition, we employed a nudging assimilation technique to solve possible spin-up problems caused by re-initializations by using analysis data that contain inconsistent errors between mass and velocity. The nudging technique can effectively diminish the spin-up problem, resulting in a higher modeling skill.

A Discrete Monetary Economic Growth Model with the MIU Approach

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Wei-Bin Zhang

2008-01-01

Full Text Available This paper proposes an alternative approach to economic growth with money. The production side is the same as the Solow model, the Ramsey model, and the Tobin model. But we deal with behavior of consumers differently from the traditional approaches. The model is influenced by the money-in-the-utility (MIU approach in monetary economics. It provides a mechanism of endogenous saving which the Solow model lacks and avoids the assumption of adding up utility over a period of time upon which the Ramsey approach is based.

Nonperturbative approach to the attractive Hubbard model

International Nuclear Information System (INIS)

Allen, S.; Tremblay, A.-M. S.

2001-01-01

A nonperturbative approach to the single-band attractive Hubbard model is presented in the general context of functional-derivative approaches to many-body theories. As in previous work on the repulsive model, the first step is based on a local-field-type ansatz, on enforcement of the Pauli principle and a number of crucial sumrules. The Mermin-Wagner theorem in two dimensions is automatically satisfied. At this level, two-particle self-consistency has been achieved. In the second step of the approximation, an improved expression for the self-energy is obtained by using the results of the first step in an exact expression for the self-energy, where the high- and low-frequency behaviors appear separately. The result is a cooperon-like formula. The required vertex corrections are included in this self-energy expression, as required by the absence of a Migdal theorem for this problem. Other approaches to the attractive Hubbard model are critically compared. Physical consequences of the present approach and agreement with Monte Carlo simulations are demonstrated in the accompanying paper (following this one)

9β Polymorphism of the glucocorticoid receptor gene appears to have limited impact in patients with Addison's disease.

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Ian Louis Ross

Full Text Available BACKGROUND: Addison's disease (AD has been associated with an increased risk of cardiovascular disease. Glucocorticoid receptor polymorphisms that alter glucocorticoid sensitivity may influence metabolic and cardiovascular risk factors in patients with AD. The 9β polymorphism of the glucocorticoid receptor gene is associated with relative glucocorticoid resistance and has been reported to increase the risk of myocardial infarction in the elderly. We explored the impact of this polymorphism in patients with AD. MATERIALS AND METHODS: 147 patients with AD and 147 age, gender and ethnicity matched healthy controls were recruited. Blood was taken in a non-fasted state for plasma lipid determination, measurement of cardiovascular risk factors and DNA extraction. RESULTS: Genotype data for the 9β polymorphism was available for 139 patients and 146 controls. AD patients had a more atherogenic lipid profile characterized by an increase in the prevalence of small dense LDL (p = 0.003, increased triglycerides (p = 0.002, reduced HDLC (p<0.001 an elevated highly sensitive C-reactive protein (p = 0.01, compared with controls. The 9β polymorphism (at least one G allele was found in 28% of patients and controls respectively. After adjusting for age, gender, ethnicity, BMI and hydrocortisone dose per metre square of body surface area in patients, there were no significant metabolic associations with this polymorphism and hydrocortisone doses were not higher in patients with the polymorphism. CONCLUSIONS: This study did not identify any associations between the 9β polymorphism and cardiovascular risk factors or hydrocortisone dose and determination of this polymorphism is therefore unlikely to be of clinical benefit in the management of patients with AD.

Fractal approach to computer-analytical modelling of tree crown

International Nuclear Information System (INIS)

Berezovskaya, F.S.; Karev, G.P.; Kisliuk, O.F.; Khlebopros, R.G.; Tcelniker, Yu.L.

1993-09-01

In this paper we discuss three approaches to the modeling of a tree crown development. These approaches are experimental (i.e. regressive), theoretical (i.e. analytical) and simulation (i.e. computer) modeling. The common assumption of these is that a tree can be regarded as one of the fractal objects which is the collection of semi-similar objects and combines the properties of two- and three-dimensional bodies. We show that a fractal measure of crown can be used as the link between the mathematical models of crown growth and light propagation through canopy. The computer approach gives the possibility to visualize a crown development and to calibrate the model on experimental data. In the paper different stages of the above-mentioned approaches are described. The experimental data for spruce, the description of computer system for modeling and the variant of computer model are presented. (author). 9 refs, 4 figs

Model validation: a systemic and systematic approach

International Nuclear Information System (INIS)

Sheng, G.; Elzas, M.S.; Cronhjort, B.T.

1993-01-01

The term 'validation' is used ubiquitously in association with the modelling activities of numerous disciplines including social, political natural, physical sciences, and engineering. There is however, a wide range of definitions which give rise to very different interpretations of what activities the process involves. Analyses of results from the present large international effort in modelling radioactive waste disposal systems illustrate the urgent need to develop a common approach to model validation. Some possible explanations are offered to account for the present state of affairs. The methodology developed treats model validation and code verification in a systematic fashion. In fact, this approach may be regarded as a comprehensive framework to assess the adequacy of any simulation study. (author)

A moving approach for the Vector Hysteron Model

Energy Technology Data Exchange (ETDEWEB)

Cardelli, E. [Department of Engineering, University of Perugia, Via G. Duranti 93, 06125 Perugia (Italy); Faba, A., E-mail: antonio.faba@unipg.it [Department of Engineering, University of Perugia, Via G. Duranti 93, 06125 Perugia (Italy); Laudani, A. [Department of Engineering, Roma Tre University, Via V. Volterra 62, 00146 Rome (Italy); Quondam Antonio, S. [Department of Engineering, University of Perugia, Via G. Duranti 93, 06125 Perugia (Italy); Riganti Fulginei, F.; Salvini, A. [Department of Engineering, Roma Tre University, Via V. Volterra 62, 00146 Rome (Italy)

2016-04-01

A moving approach for the VHM (Vector Hysteron Model) is here described, to reconstruct both scalar and rotational magnetization of electrical steels with weak anisotropy, such as the non oriented grain Silicon steel. The hysterons distribution is postulated to be function of the magnetization state of the material, in order to overcome the practical limitation of the congruency property of the standard VHM approach. By using this formulation and a suitable accommodation procedure, the results obtained indicate that the model is accurate, in particular in reproducing the experimental behavior approaching to the saturation region, allowing a real improvement respect to the previous approach.

Personalization of models with many model parameters: an efficient sensitivity analysis approach.

Science.gov (United States)

Donders, W P; Huberts, W; van de Vosse, F N; Delhaas, T

2015-10-01

Uncertainty quantification and global sensitivity analysis are indispensable for patient-specific applications of models that enhance diagnosis or aid decision-making. Variance-based sensitivity analysis methods, which apportion each fraction of the output uncertainty (variance) to the effects of individual input parameters or their interactions, are considered the gold standard. The variance portions are called the Sobol sensitivity indices and can be estimated by a Monte Carlo (MC) approach (e.g., Saltelli's method [1]) or by employing a metamodel (e.g., the (generalized) polynomial chaos expansion (gPCE) [2, 3]). All these methods require a large number of model evaluations when estimating the Sobol sensitivity indices for models with many parameters [4]. To reduce the computational cost, we introduce a two-step approach. In the first step, a subset of important parameters is identified for each output of interest using the screening method of Morris [5]. In the second step, a quantitative variance-based sensitivity analysis is performed using gPCE. Efficient sampling strategies are introduced to minimize the number of model runs required to obtain the sensitivity indices for models considering multiple outputs. The approach is tested using a model that was developed for predicting post-operative flows after creation of a vascular access for renal failure patients. We compare the sensitivity indices obtained with the novel two-step approach with those obtained from a reference analysis that applies Saltelli's MC method. The two-step approach was found to yield accurate estimates of the sensitivity indices at two orders of magnitude lower computational cost. Copyright © 2015 John Wiley & Sons, Ltd.

Stochastic approaches to inflation model building

International Nuclear Information System (INIS)

Ramirez, Erandy; Liddle, Andrew R.

2005-01-01

While inflation gives an appealing explanation of observed cosmological data, there are a wide range of different inflation models, providing differing predictions for the initial perturbations. Typically models are motivated either by fundamental physics considerations or by simplicity. An alternative is to generate large numbers of models via a random generation process, such as the flow equations approach. The flow equations approach is known to predict a definite structure to the observational predictions. In this paper, we first demonstrate a more efficient implementation of the flow equations exploiting an analytic solution found by Liddle (2003). We then consider alternative stochastic methods of generating large numbers of inflation models, with the aim of testing whether the structures generated by the flow equations are robust. We find that while typically there remains some concentration of points in the observable plane under the different methods, there is significant variation in the predictions amongst the methods considered

Modeling healthcare authorization and claim submissions using the openEHR dual-model approach

Directory of Open Access Journals (Sweden)

Freire Sergio M

2011-10-01

Full Text Available Abstract Background The TISS standard is a set of mandatory forms and electronic messages for healthcare authorization and claim submissions among healthcare plans and providers in Brazil. It is not based on formal models as the new generation of health informatics standards suggests. The objective of this paper is to model the TISS in terms of the openEHR archetype-based approach and integrate it into a patient-centered EHR architecture. Methods Three approaches were adopted to model TISS. In the first approach, a set of archetypes was designed using ENTRY subclasses. In the second one, a set of archetypes was designed using exclusively ADMIN_ENTRY and CLUSTERs as their root classes. In the third approach, the openEHR ADMIN_ENTRY is extended with classes designed for authorization and claim submissions, and an ISM_TRANSITION attribute is added to the COMPOSITION class. Another set of archetypes was designed based on this model. For all three approaches, templates were designed to represent the TISS forms. Results The archetypes based on the openEHR RM (Reference Model can represent all TISS data structures. The extended model adds subclasses and an attribute to the COMPOSITION class to represent information on authorization and claim submissions. The archetypes based on all three approaches have similar structures, although rooted in different classes. The extended openEHR RM model is more semantically aligned with the concepts involved in a claim submission, but may disrupt interoperability with other systems and the current tools must be adapted to deal with it. Conclusions Modeling the TISS standard by means of the openEHR approach makes it aligned with ISO recommendations and provides a solid foundation on which the TISS can evolve. Although there are few administrative archetypes available, the openEHR RM is expressive enough to represent the TISS standard. This paper focuses on the TISS but its results may be extended to other billing

A Conceptual Modeling Approach for OLAP Personalization

Science.gov (United States)

Garrigós, Irene; Pardillo, Jesús; Mazón, Jose-Norberto; Trujillo, Juan

Data warehouses rely on multidimensional models in order to provide decision makers with appropriate structures to intuitively analyze data with OLAP technologies. However, data warehouses may be potentially large and multidimensional structures become increasingly complex to be understood at a glance. Even if a departmental data warehouse (also known as data mart) is used, these structures would be also too complex. As a consequence, acquiring the required information is more costly than expected and decision makers using OLAP tools may get frustrated. In this context, current approaches for data warehouse design are focused on deriving a unique OLAP schema for all analysts from their previously stated information requirements, which is not enough to lighten the complexity of the decision making process. To overcome this drawback, we argue for personalizing multidimensional models for OLAP technologies according to the continuously changing user characteristics, context, requirements and behaviour. In this paper, we present a novel approach to personalizing OLAP systems at the conceptual level based on the underlying multidimensional model of the data warehouse, a user model and a set of personalization rules. The great advantage of our approach is that a personalized OLAP schema is provided for each decision maker contributing to better satisfy their specific analysis needs. Finally, we show the applicability of our approach through a sample scenario based on our CASE tool for data warehouse development.

A BEHAVIORAL-APPROACH TO LINEAR EXACT MODELING

NARCIS (Netherlands)

ANTOULAS, AC; WILLEMS, JC

1993-01-01

The behavioral approach to system theory provides a parameter-free framework for the study of the general problem of linear exact modeling and recursive modeling. The main contribution of this paper is the solution of the (continuous-time) polynomial-exponential time series modeling problem. Both

METHODOLOGICAL APPROACHES FOR MODELING THE RURAL SETTLEMENT DEVELOPMENT

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Gorbenkova Elena Vladimirovna

2017-10-01

Full Text Available Subject: the paper describes the research results on validation of a rural settlement developmental model. The basic methods and approaches for solving the problem of assessment of the urban and rural settlement development efficiency are considered. Research objectives: determination of methodological approaches to modeling and creating a model for the development of rural settlements. Materials and methods: domestic and foreign experience in modeling the territorial development of urban and rural settlements and settlement structures was generalized. The motivation for using the Pentagon-model for solving similar problems was demonstrated. Based on a systematic analysis of existing development models of urban and rural settlements as well as the authors-developed method for assessing the level of agro-towns development, the systems/factors that are necessary for a rural settlement sustainable development are identified. Results: we created the rural development model which consists of five major systems that include critical factors essential for achieving a sustainable development of a settlement system: ecological system, economic system, administrative system, anthropogenic (physical system and social system (supra-structure. The methodological approaches for creating an evaluation model of rural settlements development were revealed; the basic motivating factors that provide interrelations of systems were determined; the critical factors for each subsystem were identified and substantiated. Such an approach was justified by the composition of tasks for territorial planning of the local and state administration levels. The feasibility of applying the basic Pentagon-model, which was successfully used for solving the analogous problems of sustainable development, was shown. Conclusions: the resulting model can be used for identifying and substantiating the critical factors for rural sustainable development and also become the basis of

A new approach for developing adjoint models

Science.gov (United States)

Farrell, P. E.; Funke, S. W.

2011-12-01

Many data assimilation algorithms rely on the availability of gradients of misfit functionals, which can be efficiently computed with adjoint models. However, the development of an adjoint model for a complex geophysical code is generally very difficult. Algorithmic differentiation (AD, also called automatic differentiation) offers one strategy for simplifying this task: it takes the abstraction that a model is a sequence of primitive instructions, each of which may be differentiated in turn. While extremely successful, this low-level abstraction runs into time-consuming difficulties when applied to the whole codebase of a model, such as differentiating through linear solves, model I/O, calls to external libraries, language features that are unsupported by the AD tool, and the use of multiple programming languages. While these difficulties can be overcome, it requires a large amount of technical expertise and an intimate familiarity with both the AD tool and the model. An alternative to applying the AD tool to the whole codebase is to assemble the discrete adjoint equations and use these to compute the necessary gradients. With this approach, the AD tool must be applied to the nonlinear assembly operators, which are typically small, self-contained units of the codebase. The disadvantage of this approach is that the assembly of the discrete adjoint equations is still very difficult to perform correctly, especially for complex multiphysics models that perform temporal integration; as it stands, this approach is as difficult and time-consuming as applying AD to the whole model. In this work, we have developed a library which greatly simplifies and automates the alternate approach of assembling the discrete adjoint equations. We propose a complementary, higher-level abstraction to that of AD: that a model is a sequence of linear solves. The developer annotates model source code with library calls that build a 'tape' of the operators involved and their dependencies, and

Towards a 3d Spatial Urban Energy Modelling Approach

Science.gov (United States)

Bahu, J.-M.; Koch, A.; Kremers, E.; Murshed, S. M.

2013-09-01

Today's needs to reduce the environmental impact of energy use impose dramatic changes for energy infrastructure and existing demand patterns (e.g. buildings) corresponding to their specific context. In addition, future energy systems are expected to integrate a considerable share of fluctuating power sources and equally a high share of distributed generation of electricity. Energy system models capable of describing such future systems and allowing the simulation of the impact of these developments thus require a spatial representation in order to reflect the local context and the boundary conditions. This paper describes two recent research approaches developed at EIFER in the fields of (a) geo-localised simulation of heat energy demand in cities based on 3D morphological data and (b) spatially explicit Agent-Based Models (ABM) for the simulation of smart grids. 3D city models were used to assess solar potential and heat energy demand of residential buildings which enable cities to target the building refurbishment potentials. Distributed energy systems require innovative modelling techniques where individual components are represented and can interact. With this approach, several smart grid demonstrators were simulated, where heterogeneous models are spatially represented. Coupling 3D geodata with energy system ABMs holds different advantages for both approaches. On one hand, energy system models can be enhanced with high resolution data from 3D city models and their semantic relations. Furthermore, they allow for spatial analysis and visualisation of the results, with emphasis on spatially and structurally correlations among the different layers (e.g. infrastructure, buildings, administrative zones) to provide an integrated approach. On the other hand, 3D models can benefit from more detailed system description of energy infrastructure, representing dynamic phenomena and high resolution models for energy use at component level. The proposed modelling strategies

Association of autoimmune Addison's disease with alleles of STAT4 and GATA3 in European cohorts.

Directory of Open Access Journals (Sweden)

Anna L Mitchell

Full Text Available Gene variants known to contribute to Autoimmune Addison's disease (AAD susceptibility include those at the MHC, MICA, CIITA, CTLA4, PTPN22, CYP27B1, NLRP-1 and CD274 loci. The majority of the genetic component to disease susceptibility has yet to be accounted for.To investigate the role of 19 candidate genes in AAD susceptibility in six European case-control cohorts.A sequential association study design was employed with genotyping using Sequenom iPlex technology. In phase one, 85 SNPs in 19 genes were genotyped in UK and Norwegian AAD cohorts (691 AAD, 715 controls. In phase two, 21 SNPs in 11 genes were genotyped in German, Swedish, Italian and Polish cohorts (1264 AAD, 1221 controls. In phase three, to explore association of GATA3 polymorphisms with AAD and to determine if this association extended to other autoimmune conditions, 15 SNPs in GATA3 were studied in UK and Norwegian AAD cohorts, 1195 type 1 diabetes patients from Norway, 650 rheumatoid arthritis patients from New Zealand and in 283 UK Graves' disease patients. Meta-analysis was used to compare genotype frequencies between the participating centres, allowing for heterogeneity.We report significant association with alleles of two STAT4 markers in AAD cohorts (rs4274624: P = 0.00016; rs10931481: P = 0.0007. In addition, nominal association of AAD with alleles at GATA3 was found in 3 patient cohorts and supported by meta-analysis. Association of AAD with CYP27B1 alleles was also confirmed, which replicates previous published data. Finally, nominal association was found at SNPs in both the NF-κB1 and IL23A genes in the UK and Italian cohorts respectively.Variants in the STAT4 gene, previously associated with other autoimmune conditions, confer susceptibility to AAD. Additionally, we report association of GATA3 variants with AAD: this adds to the recent report of association of GATA3 variants with rheumatoid arthritis.

A website evaluation model by integration of previous evaluation models using a quantitative approach

Directory of Open Access Journals (Sweden)

Ali Moeini

2015-01-01

Full Text Available Regarding the ecommerce growth, websites play an essential role in business success. Therefore, many authors have offered website evaluation models since 1995. Although, the multiplicity and diversity of evaluation models make it difficult to integrate them into a single comprehensive model. In this paper a quantitative method has been used to integrate previous models into a comprehensive model that is compatible with them. In this approach the researcher judgment has no role in integration of models and the new model takes its validity from 93 previous models and systematic quantitative approach.

A Bayesian approach for quantification of model uncertainty

International Nuclear Information System (INIS)

Park, Inseok; Amarchinta, Hemanth K.; Grandhi, Ramana V.

2010-01-01

In most engineering problems, more than one model can be created to represent an engineering system's behavior. Uncertainty is inevitably involved in selecting the best model from among the models that are possible. Uncertainty in model selection cannot be ignored, especially when the differences between the predictions of competing models are significant. In this research, a methodology is proposed to quantify model uncertainty using measured differences between experimental data and model outcomes under a Bayesian statistical framework. The adjustment factor approach is used to propagate model uncertainty into prediction of a system response. A nonlinear vibration system is used to demonstrate the processes for implementing the adjustment factor approach. Finally, the methodology is applied on the engineering benefits of a laser peening process, and a confidence band for residual stresses is established to indicate the reliability of model prediction.

Pernicious Anemia

Science.gov (United States)

... glands, such as Addison's disease, type 1 diabetes, Graves' disease, or vitiligo. Research suggests a link may exist ... disorders (such as Addison's disease, type 1 diabetes, Graves' disease, or vitiligo). Research suggests a link may exist ...

Acute adrenal crisis

Science.gov (United States)

... adrenal gland is damaged due to, for example, Addison disease or other adrenal gland disease, and surgery The ... Call your health care provider if you have Addison disease and are unable to take your glucocorticoid medicine ...

Cortisol - urine

Science.gov (United States)

... response Different diseases, such as Cushing syndrome and Addison disease , can lead to either too much or too ... disorders A lower than normal level may indicate: Addison disease in which the adrenal glands do not produce ...

Orthostatic Hypotension

Science.gov (United States)

... bed rest. The disorder may be associated with Addison's disease, diabetes, and certain neurological disorders including Multiple System ... bed rest. The disorder may be associated with Addison's disease, diabetes, and certain neurological disorders including Multiple System ...

What Are Some Types of Adrenal Gland Disorders?

Science.gov (United States)

... until the adrenal glands start functioning normally again. Addison's Disease This rare disorder develops when the adrenal glands ... not make enough cortisol. In most cases of Addison's disease, the body also doesn't make enough of ...

An algebraic approach to modeling in software engineering

International Nuclear Information System (INIS)

Loegel, C.J.; Ravishankar, C.V.

1993-09-01

Our work couples the formalism of universal algebras with the engineering techniques of mathematical modeling to develop a new approach to the software engineering process. Our purpose in using this combination is twofold. First, abstract data types and their specification using universal algebras can be considered a common point between the practical requirements of software engineering and the formal specification of software systems. Second, mathematical modeling principles provide us with a means for effectively analyzing real-world systems. We first use modeling techniques to analyze a system and then represent the analysis using universal algebras. The rest of the software engineering process exploits properties of universal algebras that preserve the structure of our original model. This paper describes our software engineering process and our experience using it on both research and commercial systems. We need a new approach because current software engineering practices often deliver software that is difficult to develop and maintain. Formal software engineering approaches use universal algebras to describe ''computer science'' objects like abstract data types, but in practice software errors are often caused because ''real-world'' objects are improperly modeled. There is a large semantic gap between the customer's objects and abstract data types. In contrast, mathematical modeling uses engineering techniques to construct valid models for real-world systems, but these models are often implemented in an ad hoc manner. A combination of the best features of both approaches would enable software engineering to formally specify and develop software systems that better model real systems. Software engineering, like mathematical modeling, should concern itself first and foremost with understanding a real system and its behavior under given circumstances, and then with expressing this knowledge in an executable form

CYP21A2 polymorphisms in patients with autoimmune Addison's disease, and linkage disequilibrium to HLA risk alleles.

Science.gov (United States)

Brønstad, Ingeborg; Skinningsrud, Beate; Bratland, Eirik; Løvås, Kristian; Undlien, Dag; Sverre Husebye, Eystein; Wolff, Anette Susanne Bøe

2014-12-01

Steroid 21-hydroxylase, encoded by CYP21A2, is the major autoantigen in autoimmune Addison's disease (AAD). CYP21A2 is located in the region of the HLA complex on chromosome 6p21.3, which harbours several risk alleles for AAD. The objective was to investigate whether CYP21A2 gene variants confer risk of AAD independently of other risk alleles in the HLA loci. DNA samples from 381 Norwegian patients with AAD and 340 healthy controls (HC) previously genotyped for the HLA-A, -B, -DRB1, and -DQB1 and MICA loci were used for genotyping of CYP21A2. Genotyping of CYP21A2 was carried out by direct sequencing. Linkage of CYP21A2 to the HLA loci was assessed using UNPHASED version 3.0.10 and PHASE version 2.1. Heterozygotes of the single-nucleotide polymorphisms (SNPs) rs397515394, rs6467, rs6474, rs76565726 and rs6473 were detected significantly more frequently in AAD patients compared with HC (P<0.005), but all SNPs were in a linkage disequilibrium (LD) with high-risk HLA-DRB1 haplotypes. rs6472C protected against AAD (odds ratio=0.15, 95% CI (0.08-0.30), P=3.8×10(-10)). This SNP was not in an LD with HLA loci (P=0.02), but did not increase protection when considering the effect of HLA-DRB1 alleles. Mutations causing congenital adrenal hyperplasia were found in heterozygosity in <1.5% of the cases in both groups. Genetic variants of CYP21A2 associated to AAD are in LD with the main AAD risk locus HLA-DRB1, and CYP21A2 does not constitute an independent susceptibility locus. © 2014 European Society of Endocrinology.

Impaired health-related quality of life in Addison's disease--impact of replacement therapy, comorbidities and socio-economic factors.

Science.gov (United States)

Kluger, Nicolas; Matikainen, Niina; Sintonen, Harri; Ranki, Annamari; Roine, Risto P; Schalin-Jäntti, Camilla

2014-10-01

Patients with Addison's disease (AD) on conventional replacement therapy have impaired health-related quality of life (HRQoL). It is possible that lower hydrocortisone (HC) doses recommended by current guidelines could restore HRQoL. We compared HRQoL in AD patients treated according to current HC recommendations to that of the age- and gender-standardized general population. We assessed HRQoL in a cross-sectional setting with the 15D instrument in a Finnish AD cohort (n = 107) and compared the results with those of a large sample of general population (n = 5671). We examined possible predictors of HRQoL in AD. Within the patient group, HRQoL was also assessed by SF-36. Mean HC dose was 22 mg/d, corresponding to 12 ± 4 mg/m2. HRQoL was impaired in AD compared with the general population (15D score; 0·853 vs 0·918, P < 0·001). Within single 15D dimensions, discomfort and symptoms, vitality and sexual activity were most affected. Stepwise regression analysis demonstrated that Patient's Association membership (P = 0·02), female gender (P < 0·01), presence of other autoimmune or inflammatory comorbidity (P < 0·02), lower education (P < 0·02) and longer disease duration (P < 0·05) independently predicted impaired HRQoL, whereas replacement regimens, autoimmune-related comorbidities, total number of comorbidities or level of healthcare follow-up did not. In AD, HRQoL was impaired also as assessed by SF-36. HRQoL is significantly impaired in AD compared with the general population despite use of recommended HC doses. Patient's Association membership was the most significant predictor of impaired HRQoL. This finding should be explored in more detail in the future. © 2014 John Wiley & Sons Ltd.

Atomistic approach for modeling metal-semiconductor interfaces

DEFF Research Database (Denmark)

Stradi, Daniele; Martinez, Umberto; Blom, Anders

2016-01-01

realistic metal-semiconductor interfaces and allows for a direct comparison between theory and experiments via the I–V curve. In particular, it will be demonstrated how doping — and bias — modifies the Schottky barrier, and how finite size models (the slab approach) are unable to describe these interfaces......We present a general framework for simulating interfaces using an atomistic approach based on density functional theory and non-equilibrium Green's functions. The method includes all the relevant ingredients, such as doping and an accurate value of the semiconductor band gap, required to model...

Multi-model approach to characterize human handwriting motion.

Science.gov (United States)

Chihi, I; Abdelkrim, A; Benrejeb, M

2016-02-01

This paper deals with characterization and modelling of human handwriting motion from two forearm muscle activity signals, called electromyography signals (EMG). In this work, an experimental approach was used to record the coordinates of a pen tip moving on the (x, y) plane and EMG signals during the handwriting act. The main purpose is to design a new mathematical model which characterizes this biological process. Based on a multi-model approach, this system was originally developed to generate letters and geometric forms written by different writers. A Recursive Least Squares algorithm is used to estimate the parameters of each sub-model of the multi-model basis. Simulations show good agreement between predicted results and the recorded data.

Peripheral Blood Cells from Patients with Autoimmune Addison's Disease Poorly Respond to Interferons In Vitro, Despite Elevated Serum Levels of Interferon-Inducible Chemokines

Science.gov (United States)

Bjånesøy, Trine; Hellesen, Alexander; Breivik, Lars; Bakke, Marit; Husebye, Eystein S.; Bratland, Eirik

2015-01-01

Autoimmune Addison's disease (AAD) is a disorder caused by an immunological attack on the adrenal cortex. The interferon (IFN)-inducible chemokine CXCL10 is elevated in serum of AAD patients, suggesting a peripheral IFN signature. However, CXCL10 can also be induced in adrenocortical cells stimulated with IFNs, cytokines, or microbial components. We therefore investigated whether peripheral blood mononuclear cells (PBMCs) from AAD patients display an enhanced propensity to produce CXCL10 and the related chemokine CXCL9, after stimulation with type I or II IFNs or the IFN inducer poly (I:C). Although serum levels of CXCL10 and CXCL9 were significantly elevated in patients compared with controls, IFN stimulated patient PBMC produced significantly less CXCL10/CXCL9 than control PBMC. Low CXCL10 production was not significantly associated with medication, disease duration, or comorbidities, but the low production of poly (I:C)-induced CXCL10 among patients was associated with an AAD risk allele in the phosphatase nonreceptor type 22 (PTPN22) gene. PBMC levels of total STAT1 and -2, and IFN-induced phosphorylated STAT1 and -2, were not significantly different between patients and controls. We conclude that PBMC from patients with AAD are deficient in their response to IFNs, and that the adrenal cortex itself may be responsible for the increased serum levels of CXCL10. PMID:25978633

Peripheral Blood Cells from Patients with Autoimmune Addison's Disease Poorly Respond to Interferons In Vitro, Despite Elevated Serum Levels of Interferon-Inducible Chemokines.

Science.gov (United States)

Edvardsen, Kine; Bjånesøy, Trine; Hellesen, Alexander; Breivik, Lars; Bakke, Marit; Husebye, Eystein S; Bratland, Eirik

2015-10-01

Autoimmune Addison's disease (AAD) is a disorder caused by an immunological attack on the adrenal cortex. The interferon (IFN)-inducible chemokine CXCL10 is elevated in serum of AAD patients, suggesting a peripheral IFN signature. However, CXCL10 can also be induced in adrenocortical cells stimulated with IFNs, cytokines, or microbial components. We therefore investigated whether peripheral blood mononuclear cells (PBMCs) from AAD patients display an enhanced propensity to produce CXCL10 and the related chemokine CXCL9, after stimulation with type I or II IFNs or the IFN inducer poly (I:C). Although serum levels of CXCL10 and CXCL9 were significantly elevated in patients compared with controls, IFN stimulated patient PBMC produced significantly less CXCL10/CXCL9 than control PBMC. Low CXCL10 production was not significantly associated with medication, disease duration, or comorbidities, but the low production of poly (I:C)-induced CXCL10 among patients was associated with an AAD risk allele in the phosphatase nonreceptor type 22 (PTPN22) gene. PBMC levels of total STAT1 and -2, and IFN-induced phosphorylated STAT1 and -2, were not significantly different between patients and controls. We conclude that PBMC from patients with AAD are deficient in their response to IFNs, and that the adrenal cortex itself may be responsible for the increased serum levels of CXCL10.

Nonlinear Modeling of the PEMFC Based On NNARX Approach

OpenAIRE

Shan-Jen Cheng; Te-Jen Chang; Kuang-Hsiung Tan; Shou-Ling Kuo

2015-01-01

Polymer Electrolyte Membrane Fuel Cell (PEMFC) is such a time-vary nonlinear dynamic system. The traditional linear modeling approach is hard to estimate structure correctly of PEMFC system. From this reason, this paper presents a nonlinear modeling of the PEMFC using Neural Network Auto-regressive model with eXogenous inputs (NNARX) approach. The multilayer perception (MLP) network is applied to evaluate the structure of the NNARX model of PEMFC. The validity and accurac...

Sodium Blood Test: MedlinePlus Lab Test Information

Science.gov (United States)

... levels, it may indicate: Diarrhea Vomiting Kidney disease Addison disease , a condition in which your body's adrenal glands ... Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2017. Addison Disease [cited 2017 Apr 2]; [about 2 screens]. Available ...

Understanding Gulf War Illness: An Integrative Modeling Approach

Science.gov (United States)

2017-10-01

using a novel mathematical model. The computational biology approach will enable the consortium to quickly identify targets of dysfunction and find... computer / mathematical paradigms for evaluation of treatment strategies 12-30 50% Develop pilot clinical trials on basis of animal studies 24-36 60...the goal of testing chemical treatments. The immune and autonomic biomarkers will be tested using a computational modeling approach allowing for a

Heat transfer modeling an inductive approach

CERN Document Server

Sidebotham, George

2015-01-01

This innovative text emphasizes a "less-is-more" approach to modeling complicated systems such as heat transfer by treating them first as "1-node lumped models" that yield simple closed-form solutions. The author develops numerical techniques for students to obtain more detail, but also trains them to use the techniques only when simpler approaches fail. Covering all essential methods offered in traditional texts, but with a different order, Professor Sidebotham stresses inductive thinking and problem solving as well as a constructive understanding of modern, computer-based practice. Readers learn to develop their own code in the context of the material, rather than just how to use packaged software, offering a deeper, intrinsic grasp behind models of heat transfer. Developed from over twenty-five years of lecture notes to teach students of mechanical and chemical engineering at The Cooper Union for the Advancement of Science and Art, the book is ideal for students and practitioners across engineering discipl...

Polynomial Chaos Expansion Approach to Interest Rate Models

Directory of Open Access Journals (Sweden)

Luca Di Persio

2015-01-01

Full Text Available The Polynomial Chaos Expansion (PCE technique allows us to recover a finite second-order random variable exploiting suitable linear combinations of orthogonal polynomials which are functions of a given stochastic quantity ξ, hence acting as a kind of random basis. The PCE methodology has been developed as a mathematically rigorous Uncertainty Quantification (UQ method which aims at providing reliable numerical estimates for some uncertain physical quantities defining the dynamic of certain engineering models and their related simulations. In the present paper, we use the PCE approach in order to analyze some equity and interest rate models. In particular, we take into consideration those models which are based on, for example, the Geometric Brownian Motion, the Vasicek model, and the CIR model. We present theoretical as well as related concrete numerical approximation results considering, without loss of generality, the one-dimensional case. We also provide both an efficiency study and an accuracy study of our approach by comparing its outputs with the ones obtained adopting the Monte Carlo approach, both in its standard and its enhanced version.

ACTH (cosyntropin) stimulation test

Science.gov (United States)

... occurs when there is not enough cortisol) Addison disease (adrenal glands do not produce enough cortisol) Hypopituitarism (pituitary gland ... A.M. Editorial team. Addison Disease Read more Adrenal Gland Disorders Read more Pituitary Disorders Read more A.D. ...

A model-driven approach to information security compliance

Science.gov (United States)

Correia, Anacleto; Gonçalves, António; Teodoro, M. Filomena

2017-06-01

The availability, integrity and confidentiality of information are fundamental to the long-term survival of any organization. Information security is a complex issue that must be holistically approached, combining assets that support corporate systems, in an extended network of business partners, vendors, customers and other stakeholders. This paper addresses the conception and implementation of information security systems, conform the ISO/IEC 27000 set of standards, using the model-driven approach. The process begins with the conception of a domain level model (computation independent model) based on information security vocabulary present in the ISO/IEC 27001 standard. Based on this model, after embedding in the model mandatory rules for attaining ISO/IEC 27001 conformance, a platform independent model is derived. Finally, a platform specific model serves the base for testing the compliance of information security systems with the ISO/IEC 27000 set of standards.

Eutrophication Modeling Using Variable Chlorophyll Approach

International Nuclear Information System (INIS)

Abdolabadi, H.; Sarang, A.; Ardestani, M.; Mahjoobi, E.

2016-01-01

In this study, eutrophication was investigated in Lake Ontario to identify the interactions among effective drivers. The complexity of such phenomenon was modeled using a system dynamics approach based on a consideration of constant and variable stoichiometric ratios. The system dynamics approach is a powerful tool for developing object-oriented models to simulate complex phenomena that involve feedback effects. Utilizing stoichiometric ratios is a method for converting the concentrations of state variables. During the physical segmentation of the model, Lake Ontario was divided into two layers, i.e., the epilimnion and hypolimnion, and differential equations were developed for each layer. The model structure included 16 state variables related to phytoplankton, herbivorous zooplankton, carnivorous zooplankton, ammonium, nitrate, dissolved phosphorus, and particulate and dissolved carbon in the epilimnion and hypolimnion during a time horizon of one year. The results of several tests to verify the model, close to 1 Nash-Sutcliff coefficient (0.98), the data correlation coefficient (0.98), and lower standard errors (0.96), have indicated well-suited model’s efficiency. The results revealed that there were significant differences in the concentrations of the state variables in constant and variable stoichiometry simulations. Consequently, the consideration of variable stoichiometric ratios in algae and nutrient concentration simulations may be applied in future modeling studies to enhance the accuracy of the results and reduce the likelihood of inefficient control policies.

Advanced language modeling approaches, case study: Expert search

NARCIS (Netherlands)

Hiemstra, Djoerd

2008-01-01

This tutorial gives a clear and detailed overview of advanced language modeling approaches and tools, including the use of document priors, translation models, relevance models, parsimonious models and expectation maximization training. Expert search will be used as a case study to explain the

Lightweight approach to model traceability in a CASE tool

Science.gov (United States)

Vileiniskis, Tomas; Skersys, Tomas; Pavalkis, Saulius; Butleris, Rimantas; Butkiene, Rita

2017-07-01

A term "model-driven" is not at all a new buzzword within the ranks of system development community. Nevertheless, the ever increasing complexity of model-driven approaches keeps fueling all kinds of discussions around this paradigm and pushes researchers forward to research and develop new and more effective ways to system development. With the increasing complexity, model traceability, and model management as a whole, becomes indispensable activities of model-driven system development process. The main goal of this paper is to present a conceptual design and implementation of a practical lightweight approach to model traceability in a CASE tool.

Smeared crack modelling approach for corrosion-induced concrete damage

DEFF Research Database (Denmark)

Thybo, Anna Emilie Anusha; Michel, Alexander; Stang, Henrik

2017-01-01

In this paper a smeared crack modelling approach is used to simulate corrosion-induced damage in reinforced concrete. The presented modelling approach utilizes a thermal analogy to mimic the expansive nature of solid corrosion products, while taking into account the penetration of corrosion...... products into the surrounding concrete, non-uniform precipitation of corrosion products, and creep. To demonstrate the applicability of the presented modelling approach, numerical predictions in terms of corrosion-induced deformations as well as formation and propagation of micro- and macrocracks were......-induced damage phenomena in reinforced concrete. Moreover, good agreements were also found between experimental and numerical data for corrosion-induced deformations along the circumference of the reinforcement....

An Alternative Approach to the Extended Drude Model

Science.gov (United States)

Gantzler, N. J.; Dordevic, S. V.

2018-05-01

The original Drude model, proposed over a hundred years ago, is still used today for the analysis of optical properties of solids. Within this model, both the plasma frequency and quasiparticle scattering rate are constant, which makes the model rather inflexible. In order to circumvent this problem, the so-called extended Drude model was proposed, which allowed for the frequency dependence of both the quasiparticle scattering rate and the effective mass. In this work we will explore an alternative approach to the extended Drude model. Here, one also assumes that the quasiparticle scattering rate is frequency dependent; however, instead of the effective mass, the plasma frequency becomes frequency-dependent. This alternative model is applied to the high Tc superconductor Bi2Sr2CaCu2O8+δ (Bi2212) with Tc = 92 K, and the results are compared and contrasted with the ones obtained from the conventional extended Drude model. The results point to several advantages of this alternative approach to the extended Drude model.

An object-oriented approach to energy-economic modeling

Energy Technology Data Exchange (ETDEWEB)

Wise, M.A.; Fox, J.A.; Sands, R.D.

1993-12-01

In this paper, the authors discuss the experiences in creating an object-oriented economic model of the U.S. energy and agriculture markets. After a discussion of some central concepts, they provide an overview of the model, focusing on the methodology of designing an object-oriented class hierarchy specification based on standard microeconomic production functions. The evolution of the model from the class definition stage to programming it in C++, a standard object-oriented programming language, will be detailed. The authors then discuss the main differences between writing the object-oriented program versus a procedure-oriented program of the same model. Finally, they conclude with a discussion of the advantages and limitations of the object-oriented approach based on the experience in building energy-economic models with procedure-oriented approaches and languages.

Improvement of anthropometric and metabolic parameters, and quality of life following treatment with dual-release hydrocortisone in patients with Addison's disease.

Science.gov (United States)

Giordano, Roberta; Guaraldi, Federica; Marinazzo, Elisa; Fumarola, Federica; Rampino, Alessia; Berardelli, Rita; Karamouzis, Ioannis; Lucchiari, Manuela; Manetta, Tilde; Mengozzi, Giulio; Arvat, Emanuela; Ghigo, Ezio

2016-02-01

In patients with Addison's disease (AD), a dual-release preparation of hydrocortisone (Plenadren, PLEN) has been demonstrated to maintain cortisol levels in a more physiological range than conventional glucocorticoid therapy, and to exert positive effects. This study aimed to assess variations of anthropometric, metabolic, and hormonal parameters in patients with AD after switching from conventional hydrocortisone (HC) treatment to PLEN. In nineteen AD patients (15 F and 4 M, age 27-65 years) treated with HC 20 mg/day thrice daily, body weight, BMI, waist circumference, fasting glucose, HbA1c, serum lipids, plasma renin activity, electrolytes, and blood pressure were evaluated at baseline, and 1, 3, 6, and 12 months after switching from HC to PLEN. At baseline, and after 1 and 12 months of PLEN, blood ACTH and cortisol (at 0800 h at fasting, and 30, 60, 90, 120, and 240 min after drug ingestion), and health-related quality of life (HRQoL), using 30-AddiQoL questionnaire, were evaluated. During PLEN, waist and serum lipid progressively decreased. After 12 months of PLEN, a significant difference was observed in waist circumference (P = 0.007), HbA1c (P = 0.002), total and LDL-cholesterol levels (P < 0.05). ACTH levels at 240 min and the area under the curve (AUC) were lower (P < 0.05) during PLEN than HC, while cortisol peaks and AUC were similar. 30-AddiQoL total score also improved (P = 0.04) during PLEN. In AD patients, PLEN reduces central adiposity, and improves glucose and metabolism parameters and HRQoL.

Multiscale approach to equilibrating model polymer melts

DEFF Research Database (Denmark)

Svaneborg, Carsten; Ali Karimi-Varzaneh, Hossein; Hojdis, Nils

2016-01-01

We present an effective and simple multiscale method for equilibrating Kremer Grest model polymer melts of varying stiffness. In our approach, we progressively equilibrate the melt structure above the tube scale, inside the tube and finally at the monomeric scale. We make use of models designed...

A Variant in the BACH2 Gene Is Associated With Susceptibility to Autoimmune Addison's Disease in Humans.

Science.gov (United States)

Pazderska, Agnieszka; Oftedal, Bergithe E; Napier, Catherine M; Ainsworth, Holly F; Husebye, Eystein S; Cordell, Heather J; Pearce, Simon H S; Mitchell, Anna L

2016-11-01

Autoimmune Addison's disease (AAD) is a rare but highly heritable condition. The BACH2 protein plays a crucial role in T lymphocyte maturation, and allelic variation in its gene has been associated with a number of autoimmune conditions. We aimed to determine whether alleles of the rs3757247 single nucleotide polymorphism (SNP) in the BACH2 gene are associated with AAD. This case-control association study was performed in two phases using Taqman chemistry. In the first phase, the rs3757247 SNP was genotyped in 358 UK AAD subjects and 166 local control subjects. Genotype data were also available from 5154 healthy UK controls from the Wellcome Trust (WTCCC2) for comparison. In the second phase, the SNP was genotyped in a validation cohort comprising 317 Norwegian AAD subjects and 365 controls. The frequency of the minor T allele was significantly higher in subjects with AAD from the United Kingdom compared to both the local and WTCCC2 control cohorts (58% vs 45 and 48%, respectively) (local controls, P = 1.1 × 10 -4 ; odds ratio [OR], 1.68; 95% confidence interval [CI], 1.29-2.18; WTCCC2 controls, P = 1.4 × 10 -6 ; OR, 1.44; 95% CI, 1.23-1.69). This finding was replicated in the Norwegian validation cohort (P = .0015; OR, 1.41; 95% CI, 1.14-1.75). Subgroup analysis showed that this association is present in subjects with both isolated AAD (OR, 1.53; 95% CI, 1.22-1.92) and autoimmune polyglandular syndrome type 2 (OR, 1.37; 95% CI, 1.12-1.69) in the UK cohort, and with autoimmune polyglandular syndrome type 2 in the Norwegian cohort (OR, 1.58; 95% CI, 1.22-2.06). We have demonstrated, for the first time, that allelic variability at the BACH2 locus is associated with susceptibility to AAD. Given its association with multiple autoimmune conditions, BACH2 can be considered a "universal" autoimmune susceptibility locus.

A novel approach to modeling and diagnosing the cardiovascular system

Energy Technology Data Exchange (ETDEWEB)

Keller, P.E.; Kangas, L.J.; Hashem, S.; Kouzes, R.T. [Pacific Northwest Lab., Richland, WA (United States); Allen, P.A. [Life Link, Richland, WA (United States)

1995-07-01

A novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.

Development of a Conservative Model Validation Approach for Reliable Analysis

Science.gov (United States)

2015-01-01

CIE 2015 August 2-5, 2015, Boston, Massachusetts, USA [DRAFT] DETC2015-46982 DEVELOPMENT OF A CONSERVATIVE MODEL VALIDATION APPROACH FOR RELIABLE...obtain a conservative simulation model for reliable design even with limited experimental data. Very little research has taken into account the...3, the proposed conservative model validation is briefly compared to the conventional model validation approach. Section 4 describes how to account

Autoantibodies against Cytochrome P450 Side-Chain Cleavage Enzyme in Dogs (Canis lupus familiaris) Affected with Hypoadrenocorticism (Addison's Disease).

Science.gov (United States)

Boag, Alisdair M; Christie, Michael R; McLaughlin, Kerry A; Syme, Harriet M; Graham, Peter; Catchpole, Brian

2015-01-01

Canine hypoadrenocorticism likely arises from immune-mediated destruction of adrenocortical tissue, leading to glucocorticoid and mineralocorticoid deficiency. In humans with autoimmune Addison's disease (AAD) or autoimmune polyendocrine syndrome (APS), circulating autoantibodies have been demonstrated against enzymes associated with adrenal steroid synthesis. The current study investigates autoantibodies against steroid synthesis enzymes in dogs with spontaneous hypoadrenocorticism. Coding regions of canine CYP21A2 (21-hydroxylase; 21-OH), CYP17A1 (17-hydroxylase; 17-OH), CYP11A1 (P450 side-chain cleavage enzyme; P450scc) and HSD3B2 (3β hydroxysteroid dehydrogenase; 3βHSD) were amplified, cloned and expressed as 35S-methionine radiolabelled recombinant protein. In a pilot study, serum samples from 20 dogs with hypoadrenocorticism and four unaffected control dogs were screened by radio-immunoprecipitation assay. There was no evidence of reactivity against 21-OH, 17-OH or 3βHSD, but five dogs with hypoadrenocorticism showed immunoreactivity to P450scc compared with controls. Serum samples were subsequently obtained from 213 dogs diagnosed with hypoadrenocorticism and 110 dogs from a hospital control population. Thirty control dogs were randomly selected to establish a threshold for antibody positivity (mean + 3 × standard deviation). Dogs with hypoadrenocorticism were more likely to be P450scc autoantibody positive than hospital controls (24% vs. 1.2%, respectively; p = 0.0016). Sex was significantly associated with the presence of P450scc autoantibodies in the case population, with 30% of females testing positive compared with 17% of males (p = 0.037). Significant associations with breed (p = 0.015) and DLA-type (DQA1*006:01 allele; p = 0.017) were also found. This cross-sectional study indicates that P450scc autoantibodies are present in a proportion of dogs affected with hypoadrenocorticism.

Autoantibodies against Cytochrome P450 Side-Chain Cleavage Enzyme in Dogs (Canis lupus familiaris Affected with Hypoadrenocorticism (Addison's Disease.

Directory of Open Access Journals (Sweden)

Alisdair M Boag

Full Text Available Canine hypoadrenocorticism likely arises from immune-mediated destruction of adrenocortical tissue, leading to glucocorticoid and mineralocorticoid deficiency. In humans with autoimmune Addison's disease (AAD or autoimmune polyendocrine syndrome (APS, circulating autoantibodies have been demonstrated against enzymes associated with adrenal steroid synthesis. The current study investigates autoantibodies against steroid synthesis enzymes in dogs with spontaneous hypoadrenocorticism. Coding regions of canine CYP21A2 (21-hydroxylase; 21-OH, CYP17A1 (17-hydroxylase; 17-OH, CYP11A1 (P450 side-chain cleavage enzyme; P450scc and HSD3B2 (3β hydroxysteroid dehydrogenase; 3βHSD were amplified, cloned and expressed as 35S-methionine radiolabelled recombinant protein. In a pilot study, serum samples from 20 dogs with hypoadrenocorticism and four unaffected control dogs were screened by radio-immunoprecipitation assay. There was no evidence of reactivity against 21-OH, 17-OH or 3βHSD, but five dogs with hypoadrenocorticism showed immunoreactivity to P450scc compared with controls. Serum samples were subsequently obtained from 213 dogs diagnosed with hypoadrenocorticism and 110 dogs from a hospital control population. Thirty control dogs were randomly selected to establish a threshold for antibody positivity (mean + 3 × standard deviation. Dogs with hypoadrenocorticism were more likely to be P450scc autoantibody positive than hospital controls (24% vs. 1.2%, respectively; p = 0.0016. Sex was significantly associated with the presence of P450scc autoantibodies in the case population, with 30% of females testing positive compared with 17% of males (p = 0.037. Significant associations with breed (p = 0.015 and DLA-type (DQA1*006:01 allele; p = 0.017 were also found. This cross-sectional study indicates that P450scc autoantibodies are present in a proportion of dogs affected with hypoadrenocorticism.

Sexual dysfunctions in men affected by autoimmune Addison's disease before and after short-term gluco- and mineralocorticoid replacement therapy.

Science.gov (United States)

Granata, Antonio; Tirabassi, Giacomo; Pugni, Valeria; Arnaldi, Giorgio; Boscaro, Marco; Carani, Cesare; Balercia, Giancarlo

2013-08-01

There is evidence suggesting that autoimmune Addison's disease (AD) could be associated with sexual dysfunctions probably caused by gluco- and mineralocorticoid deficiency; however, no study has yet treated this subject in males. To evaluate male sexuality and psychological correlates in autoimmune AD before and after gluco- and mineralocorticoid replacement therapy. Twelve subjects with a first diagnosis of autoimmune AD were studied before (baseline) and 2 months after (recovery phase) initiating hormone replacement therapy. Erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), overall satisfaction (OS), depression, and anxiety were studied using a number of questionnaires (International Index of Erectile Function, Beck Depression Inventory, and Spielberger State-Trait Anxiety Inventory); clinical, biochemical, and hormone data were included in the analysis. At baseline, low values were found for EF, OF, SD, IS, and OS and high values for depression and anxiety; all of these parameters improved significantly in the recovery phase compared with baseline. EF variation between the two phases correlated significantly and positively with the variation of serum cortisol, urinary free cortisol, systolic blood pressure, and diastolic blood pressure and inversely with that of upright plasma renin activity. Multiple linear regression analysis using EF variation as dependent variable confirmed the relationship of the latter with variation of serum cortisol, urinary free cortisol, and upright plasma renin activity but not with variation of systolic and diastolic blood pressure. Our study showed that onset of autoimmune AD in males is associated with a number of sexual dysfunctions, all reversible after initiating replacement hormone therapy; cortisol and aldosterone deficiency seems to play an important role in the genesis of erectile dysfunction although the mechanism of their activity is not clear. © 2012 International Society

A dual model approach to ground water recovery trench design

International Nuclear Information System (INIS)

Clodfelter, C.L.; Crouch, M.S.

1992-01-01

The design of trenches for contaminated ground water recovery must consider several variables. This paper presents a dual-model approach for effectively recovering contaminated ground water migrating toward a trench by advection. The approach involves an analytical model to determine the vertical influence of the trench and a numerical flow model to determine the capture zone within the trench and the surrounding aquifer. The analytical model is utilized by varying trench dimensions and head values to design a trench which meets the remediation criteria. The numerical flow model is utilized to select the type of backfill and location of sumps within the trench. The dual-model approach can be used to design a recovery trench which effectively captures advective migration of contaminants in the vertical and horizontal planes

A robust quantitative near infrared modeling approach for blend monitoring.

Science.gov (United States)

Mohan, Shikhar; Momose, Wataru; Katz, Jeffrey M; Hossain, Md Nayeem; Velez, Natasha; Drennen, James K; Anderson, Carl A

2018-01-30

This study demonstrates a material sparing Near-Infrared modeling approach for powder blend monitoring. In this new approach, gram scale powder mixtures are subjected to compression loads to simulate the effect of scale using an Instron universal testing system. Models prepared by the new method development approach (small-scale method) and by a traditional method development (blender-scale method) were compared by simultaneously monitoring a 1kg batch size blend run. Both models demonstrated similar model performance. The small-scale method strategy significantly reduces the total resources expended to develop Near-Infrared calibration models for on-line blend monitoring. Further, this development approach does not require the actual equipment (i.e., blender) to which the method will be applied, only a similar optical interface. Thus, a robust on-line blend monitoring method can be fully developed before any large-scale blending experiment is viable, allowing the blend method to be used during scale-up and blend development trials. Copyright © 2017. Published by Elsevier B.V.

An ontology-based approach for modelling architectural styles

OpenAIRE

Pahl, Claus; Giesecke, Simon; Hasselbring, Wilhelm

2007-01-01

peer-reviewed The conceptual modelling of software architectures is of central importance for the quality of a software system. A rich modelling language is required to integrate the different aspects of architecture modelling, such as architectural styles, structural and behavioural modelling, into a coherent framework.We propose an ontological approach for architectural style modelling based on description logic as an abstract, meta-level modelling instrument. Architect...

An Approach to Enforcing Clark-Wilson Model in Role-based Access Control Model

Institute of Scientific and Technical Information of China (English)

LIANGBin; SHIWenchang; SUNYufang; SUNBo

2004-01-01

Using one security model to enforce another is a prospective solution to multi-policy support. In this paper, an approach to the enforcing Clark-Wilson data integrity model in the Role-based access control (RBAC) model is proposed. An enforcement construction with great feasibility is presented. In this construction, a direct way to enforce the Clark-Wilson model is provided, the corresponding relations among users, transformation procedures, and constrained data items are strengthened; the concepts of task and subtask are introduced to enhance the support to least-privilege. The proposed approach widens the applicability of RBAC. The theoretical foundation for adopting Clark-Wilson model in a RBAC system with small cost is offered to meet the requirements of multi-policy support and policy flexibility.

Web-based modelling of energy, water and matter fluxes to support decision making in mesoscale catchments??the integrative perspective of GLOWA-Danube

Science.gov (United States)

Ludwig, R.; Mauser, W.; Niemeyer, S.; Colgan, A.; Stolz, R.; Escher-Vetter, H.; Kuhn, M.; Reichstein, M.; Tenhunen, J.; Kraus, A.; Ludwig, M.; Barth, M.; Hennicker, R.

scale and connect to their environment through fluxes. The presented paper excerpts the hydrological view point of GLOWA-Danube, its approach of model coupling and network-based communication, and object-oriented techniques to simulate physical processes and interactions at the land surface. The mechanisms and technologies applied to communicate data and model parameters across the typical discipline borders are demonstrated from the perspective of the Landsurface object. It comprises the capabilities of interdependent expert models for energy exchange at various surface types, snowmelt, soil water movement, runoff formation and plant growth in a distributed Java-based modelling environment using the remote method invocation [Pitt et al., Java.rmi: The Remote Method Invocation Guide, Addison Wesley Professional, Reading, 2001, p. 320]. The presented text summarizes the GLOWA-Danube concept and shows the state of an implemented DANUBIA prototype after completion of the first project-year (2001).

The Generalised Ecosystem Modelling Approach in Radiological Assessment

Energy Technology Data Exchange (ETDEWEB)

Klos, Richard

2008-03-15

An independent modelling capability is required by SSI in order to evaluate dose assessments carried out in Sweden by, amongst others, SKB. The main focus is the evaluation of the long-term radiological safety of radioactive waste repositories for both spent fuel and low-level radioactive waste. To meet the requirement for an independent modelling tool for use in biosphere dose assessments, SSI through its modelling team CLIMB commissioned the development of a new model in 2004, a project to produce an integrated model of radionuclides in the landscape. The generalised ecosystem modelling approach (GEMA) is the result. GEMA is a modular system of compartments representing the surface environment. It can be configured, through water and solid material fluxes, to represent local details in the range of ecosystem types found in the past, present and future Swedish landscapes. The approach is generic but fine tuning can be carried out using local details of the surface drainage system. The modular nature of the modelling approach means that GEMA modules can be linked to represent large scale surface drainage features over an extended domain in the landscape. System change can also be managed in GEMA, allowing a flexible and comprehensive model of the evolving landscape to be constructed. Environmental concentrations of radionuclides can be calculated and the GEMA dose pathway model provides a means of evaluating the radiological impact of radionuclide release to the surface environment. This document sets out the philosophy and details of GEMA and illustrates the functioning of the model with a range of examples featuring the recent CLIMB review of SKB's SR-Can assessment

The Generalised Ecosystem Modelling Approach in Radiological Assessment

International Nuclear Information System (INIS)

Klos, Richard

2008-03-01

An independent modelling capability is required by SSI in order to evaluate dose assessments carried out in Sweden by, amongst others, SKB. The main focus is the evaluation of the long-term radiological safety of radioactive waste repositories for both spent fuel and low-level radioactive waste. To meet the requirement for an independent modelling tool for use in biosphere dose assessments, SSI through its modelling team CLIMB commissioned the development of a new model in 2004, a project to produce an integrated model of radionuclides in the landscape. The generalised ecosystem modelling approach (GEMA) is the result. GEMA is a modular system of compartments representing the surface environment. It can be configured, through water and solid material fluxes, to represent local details in the range of ecosystem types found in the past, present and future Swedish landscapes. The approach is generic but fine tuning can be carried out using local details of the surface drainage system. The modular nature of the modelling approach means that GEMA modules can be linked to represent large scale surface drainage features over an extended domain in the landscape. System change can also be managed in GEMA, allowing a flexible and comprehensive model of the evolving landscape to be constructed. Environmental concentrations of radionuclides can be calculated and the GEMA dose pathway model provides a means of evaluating the radiological impact of radionuclide release to the surface environment. This document sets out the philosophy and details of GEMA and illustrates the functioning of the model with a range of examples featuring the recent CLIMB review of SKB's SR-Can assessment

Popularity Modeling for Mobile Apps: A Sequential Approach.

Science.gov (United States)

Zhu, Hengshu; Liu, Chuanren; Ge, Yong; Xiong, Hui; Chen, Enhong

2015-07-01

The popularity information in App stores, such as chart rankings, user ratings, and user reviews, provides an unprecedented opportunity to understand user experiences with mobile Apps, learn the process of adoption of mobile Apps, and thus enables better mobile App services. While the importance of popularity information is well recognized in the literature, the use of the popularity information for mobile App services is still fragmented and under-explored. To this end, in this paper, we propose a sequential approach based on hidden Markov model (HMM) for modeling the popularity information of mobile Apps toward mobile App services. Specifically, we first propose a popularity based HMM (PHMM) to model the sequences of the heterogeneous popularity observations of mobile Apps. Then, we introduce a bipartite based method to precluster the popularity observations. This can help to learn the parameters and initial values of the PHMM efficiently. Furthermore, we demonstrate that the PHMM is a general model and can be applicable for various mobile App services, such as trend based App recommendation, rating and review spam detection, and ranking fraud detection. Finally, we validate our approach on two real-world data sets collected from the Apple Appstore. Experimental results clearly validate both the effectiveness and efficiency of the proposed popularity modeling approach.

Modeling gene expression measurement error: a quasi-likelihood approach

Directory of Open Access Journals (Sweden)

Strimmer Korbinian

2003-03-01

Full Text Available Abstract Background Using suitable error models for gene expression measurements is essential in the statistical analysis of microarray data. However, the true probabilistic model underlying gene expression intensity readings is generally not known. Instead, in currently used approaches some simple parametric model is assumed (usually a transformed normal distribution or the empirical distribution is estimated. However, both these strategies may not be optimal for gene expression data, as the non-parametric approach ignores known structural information whereas the fully parametric models run the risk of misspecification. A further related problem is the choice of a suitable scale for the model (e.g. observed vs. log-scale. Results Here a simple semi-parametric model for gene expression measurement error is presented. In this approach inference is based an approximate likelihood function (the extended quasi-likelihood. Only partial knowledge about the unknown true distribution is required to construct this function. In case of gene expression this information is available in the form of the postulated (e.g. quadratic variance structure of the data. As the quasi-likelihood behaves (almost like a proper likelihood, it allows for the estimation of calibration and variance parameters, and it is also straightforward to obtain corresponding approximate confidence intervals. Unlike most other frameworks, it also allows analysis on any preferred scale, i.e. both on the original linear scale as well as on a transformed scale. It can also be employed in regression approaches to model systematic (e.g. array or dye effects. Conclusions The quasi-likelihood framework provides a simple and versatile approach to analyze gene expression data that does not make any strong distributional assumptions about the underlying error model. For several simulated as well as real data sets it provides a better fit to the data than competing models. In an example it also

A modular approach to numerical human body modeling

NARCIS (Netherlands)

Forbes, P.A.; Griotto, G.; Rooij, L. van

2007-01-01

The choice of a human body model for a simulated automotive impact scenario must take into account both accurate model response and computational efficiency as key factors. This study presents a "modular numerical human body modeling" approach which allows the creation of a customized human body

A systemic approach to modelling of radiobiological effects

International Nuclear Information System (INIS)

Obaturov, G.M.

1988-01-01

Basic principles of the systemic approach to modelling of the radiobiological effects at different levels of cell organization have been formulated. The methodology is proposed for theoretical modelling of the effects at these levels

Dynamics and control of quadcopter using linear model predictive control approach

Science.gov (United States)

Islam, M.; Okasha, M.; Idres, M. M.

2017-12-01

This paper investigates the dynamics and control of a quadcopter using the Model Predictive Control (MPC) approach. The dynamic model is of high fidelity and nonlinear, with six degrees of freedom that include disturbances and model uncertainties. The control approach is developed based on MPC to track different reference trajectories ranging from simple ones such as circular to complex helical trajectories. In this control technique, a linearized model is derived and the receding horizon method is applied to generate the optimal control sequence. Although MPC is computer expensive, it is highly effective to deal with the different types of nonlinearities and constraints such as actuators’ saturation and model uncertainties. The MPC parameters (control and prediction horizons) are selected by trial-and-error approach. Several simulation scenarios are performed to examine and evaluate the performance of the proposed control approach using MATLAB and Simulink environment. Simulation results show that this control approach is highly effective to track a given reference trajectory.

Model-centric approaches for the development of health information systems.

Science.gov (United States)

Tuomainen, Mika; Mykkänen, Juha; Luostarinen, Heli; Pöyhölä, Assi; Paakkanen, Esa

2007-01-01

Modeling is used increasingly in healthcare to increase shared knowledge, to improve the processes, and to document the requirements of the solutions related to health information systems (HIS). There are numerous modeling approaches which aim to support these aims, but a careful assessment of their strengths, weaknesses and deficiencies is needed. In this paper, we compare three model-centric approaches in the context of HIS development: the Model-Driven Architecture, Business Process Modeling with BPMN and BPEL and the HL7 Development Framework. The comparison reveals that all these approaches are viable candidates for the development of HIS. However, they have distinct strengths and abstraction levels, they require local and project-specific adaptation and offer varying levels of automation. In addition, illustration of the solutions to the end users must be improved.

Risk Modelling for Passages in Approach Channel

Directory of Open Access Journals (Sweden)

Leszek Smolarek

2013-01-01

Full Text Available Methods of multivariate statistics, stochastic processes, and simulation methods are used to identify and assess the risk measures. This paper presents the use of generalized linear models and Markov models to study risks to ships along the approach channel. These models combined with simulation testing are used to determine the time required for continuous monitoring of endangered objects or period at which the level of risk should be verified.

An approach to model validation and model-based prediction -- polyurethane foam case study.

Energy Technology Data Exchange (ETDEWEB)

Dowding, Kevin J.; Rutherford, Brian Milne

2003-07-01

Enhanced software methodology and improved computing hardware have advanced the state of simulation technology to a point where large physics-based codes can be a major contributor in many systems analyses. This shift toward the use of computational methods has brought with it new research challenges in a number of areas including characterization of uncertainty, model validation, and the analysis of computer output. It is these challenges that have motivated the work described in this report. Approaches to and methods for model validation and (model-based) prediction have been developed recently in the engineering, mathematics and statistical literatures. In this report we have provided a fairly detailed account of one approach to model validation and prediction applied to an analysis investigating thermal decomposition of polyurethane foam. A model simulates the evolution of the foam in a high temperature environment as it transforms from a solid to a gas phase. The available modeling and experimental results serve as data for a case study focusing our model validation and prediction developmental efforts on this specific thermal application. We discuss several elements of the ''philosophy'' behind the validation and prediction approach: (1) We view the validation process as an activity applying to the use of a specific computational model for a specific application. We do acknowledge, however, that an important part of the overall development of a computational simulation initiative is the feedback provided to model developers and analysts associated with the application. (2) We utilize information obtained for the calibration of model parameters to estimate the parameters and quantify uncertainty in the estimates. We rely, however, on validation data (or data from similar analyses) to measure the variability that contributes to the uncertainty in predictions for specific systems or units (unit-to-unit variability). (3) We perform statistical

Feedback structure based entropy approach for multiple-model estimation

Institute of Scientific and Technical Information of China (English)

Shen-tu Han; Xue Anke; Guo Yunfei

2013-01-01

The variable-structure multiple-model (VSMM) approach, one of the multiple-model (MM) methods, is a popular and effective approach in handling problems with mode uncertainties. The model sequence set adaptation (MSA) is the key to design a better VSMM. However, MSA methods in the literature have big room to improve both theoretically and practically. To this end, we propose a feedback structure based entropy approach that could find the model sequence sets with the smallest size under certain conditions. The filtered data are fed back in real time and can be used by the minimum entropy (ME) based VSMM algorithms, i.e., MEVSMM. Firstly, the full Markov chains are used to achieve optimal solutions. Secondly, the myopic method together with particle filter (PF) and the challenge match algorithm are also used to achieve sub-optimal solutions, a trade-off between practicability and optimality. The numerical results show that the proposed algorithm provides not only refined model sets but also a good robustness margin and very high accuracy.

Banking Crisis Early Warning Model based on a Bayesian Model Averaging Approach

Directory of Open Access Journals (Sweden)

Taha Zaghdoudi

2016-08-01

Full Text Available The succession of banking crises in which most have resulted in huge economic and financial losses, prompted several authors to study their determinants. These authors constructed early warning models to prevent their occurring. It is in this same vein as our study takes its inspiration. In particular, we have developed a warning model of banking crises based on a Bayesian approach. The results of this approach have allowed us to identify the involvement of the decline in bank profitability, deterioration of the competitiveness of the traditional intermediation, banking concentration and higher real interest rates in triggering bank crisis.

Hypercompetitive Environments: An Agent-based model approach

Science.gov (United States)

Dias, Manuel; Araújo, Tanya

Information technology (IT) environments are characterized by complex changes and rapid evolution. Globalization and the spread of technological innovation have increased the need for new strategic information resources, both from individual firms and management environments. Improvements in multidisciplinary methods and, particularly, the availability of powerful computational tools, are giving researchers an increasing opportunity to investigate management environments in their true complex nature. The adoption of a complex systems approach allows for modeling business strategies from a bottom-up perspective — understood as resulting from repeated and local interaction of economic agents — without disregarding the consequences of the business strategies themselves to individual behavior of enterprises, emergence of interaction patterns between firms and management environments. Agent-based models are at the leading approach of this attempt.

A Review of Accident Modelling Approaches for Complex Critical Sociotechnical Systems

National Research Council Canada - National Science Library

Qureshi, Zahid H

2008-01-01

.... This report provides a review of key traditional accident modelling approaches and their limitations, and describes new system-theoretic approaches to the modelling and analysis of accidents in safety-critical systems...

Parameter identification and global sensitivity analysis of Xin'anjiang model using meta-modeling approach

Directory of Open Access Journals (Sweden)

Xiao-meng Song

2013-01-01

Full Text Available Parameter identification, model calibration, and uncertainty quantification are important steps in the model-building process, and are necessary for obtaining credible results and valuable information. Sensitivity analysis of hydrological model is a key step in model uncertainty quantification, which can identify the dominant parameters, reduce the model calibration uncertainty, and enhance the model optimization efficiency. There are, however, some shortcomings in classical approaches, including the long duration of time and high computation cost required to quantitatively assess the sensitivity of a multiple-parameter hydrological model. For this reason, a two-step statistical evaluation framework using global techniques is presented. It is based on (1 a screening method (Morris for qualitative ranking of parameters, and (2 a variance-based method integrated with a meta-model for quantitative sensitivity analysis, i.e., the Sobol method integrated with the response surface model (RSMSobol. First, the Morris screening method was used to qualitatively identify the parameters' sensitivity, and then ten parameters were selected to quantify the sensitivity indices. Subsequently, the RSMSobol method was used to quantify the sensitivity, i.e., the first-order and total sensitivity indices based on the response surface model (RSM were calculated. The RSMSobol method can not only quantify the sensitivity, but also reduce the computational cost, with good accuracy compared to the classical approaches. This approach will be effective and reliable in the global sensitivity analysis of a complex large-scale distributed hydrological model.

Numeric, Agent-based or System dynamics model? Which modeling approach is the best for vast population simulation?

Science.gov (United States)

Cimler, Richard; Tomaskova, Hana; Kuhnova, Jitka; Dolezal, Ondrej; Pscheidl, Pavel; Kuca, Kamil

2018-02-01

Alzheimer's disease is one of the most common mental illnesses. It is posited that more than 25 % of the population is affected by some mental disease during their lifetime. Treatment of each patient draws resources from the economy concerned. Therefore, it is important to quantify the potential economic impact. Agent-based, system dynamics and numerical approaches to dynamic modeling of the population of the European Union and its patients with Alzheimer's disease are presented in this article. Simulations, their characteristics, and the results from different modeling tools are compared. The results of these approaches are compared with EU population growth predictions from the statistical office of the EU by Eurostat. The methodology of a creation of the models is described and all three modeling approaches are compared. The suitability of each modeling approach for the population modeling is discussed. In this case study, all three approaches gave us the results corresponding with the EU population prediction. Moreover, we were able to predict the number of patients with AD and, based on the modeling method, we were also able to monitor different characteristics of the population. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

HLA similarities indicate shared genetic risk in 21-hydroxylase autoantibody positive South African and United States Addison's disease.

Science.gov (United States)

Ross, I L; Babu, S; Armstrong, T; Zhang, L; Schatz, D; Pugliese, A; Eisenbarth, G; Baker Ii, P

2014-10-01

Genetic similarities between patients from the United States and South African (SA) Addison's Disease (AD) strengthen evidence for genetic association. SA-AD (n = 73), SA healthy controls (N = 78), and US-AD patients (N = 83) were genotyped for DQA1, DQB1, DRB1, and HLA-B alleles. Serum was tested for the quantity of 21OH-AA and IFNα-AA at the Barbara Davis Center. Although not as profound as in US-AD, in SA-AD 21OH-AA + subjects the predominantly associated risk haplotypes were DRB1*0301-DQB1*0201 (DR3), DRB1*04xx-DQB1*0302 (DR4), and the combined DR3/4 genotype. DQB1*0302 associated DRB1*04xx haplotypes conferred higher risk than those DRB1*04xx haplotypes associated with other DQB1 alleles. We found negative association in 21OH-AA + SA-AD for DQA1*0201-DQB1*0202 and DQA1*0101-DQB1*0501 vs SA controls, and positive association for DQA1*0401-DQB1*0402 vs US-AD. Apart from the class II DR3 haplotype, HLA-B8 did not have an independent effect; however together DR3 and HLA-B8 conferred the highest risk vs 21OH-AA negative SA-AD and SA-controls. HLA-B7 (often with DR4) conferred novel risk in 21OH-AA + SA-AD vs controls. This study represents the first comparison between South African and United States AD populations utilizing genotyping and serology performed at the same center. SA-AD and US-AD 21OH-AA + patients share common HLA risk haplotypes including DR4 (with HLA-B7) and DR3 (with HLA-B8), strengthening previously described HLA associations and implicating similar genetic etiology. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Simple Heuristic Approach to Introduction of the Black-Scholes Model

Science.gov (United States)

Yalamova, Rossitsa

2010-01-01

A heuristic approach to explaining of the Black-Scholes option pricing model in undergraduate classes is described. The approach draws upon the method of protocol analysis to encourage students to "think aloud" so that their mental models can be surfaced. It also relies upon extensive visualizations to communicate relationships that are…

A Knowledge Model Sharing Based Approach to Privacy-Preserving Data Mining

OpenAIRE

Hongwei Tian; Weining Zhang; Shouhuai Xu; Patrick Sharkey

2012-01-01

Privacy-preserving data mining (PPDM) is an important problem and is currently studied in three approaches: the cryptographic approach, the data publishing, and the model publishing. However, each of these approaches has some problems. The cryptographic approach does not protect privacy of learned knowledge models and may have performance and scalability issues. The data publishing, although is popular, may suffer from too much utility loss for certain types of data mining applications. The m...

A new approach to Naturalness in SUSY models

CERN Document Server

Ghilencea, D M

2013-01-01

We review recent results that provide a new approach to the old problem of naturalness in supersymmetric models, without relying on subjective definitions for the fine-tuning associated with {\\it fixing} the EW scale (to its measured value) in the presence of quantum corrections. The approach can address in a model-independent way many questions related to this problem. The results show that naturalness and its measure (fine-tuning) are an intrinsic part of the likelihood to fit the data that {\\it includes} the EW scale. One important consequence is that the additional {\\it constraint} of fixing the EW scale, usually not imposed in the data fits of the models, impacts on their overall likelihood to fit the data (or chi^2/ndf, ndf: number of degrees of freedom). This has negative implications for the viability of currently popular supersymmetric extensions of the Standard Model.

A Set Theoretical Approach to Maturity Models

DEFF Research Database (Denmark)

Lasrado, Lester; Vatrapu, Ravi; Andersen, Kim Normann

2016-01-01

characterized by equifinality, multiple conjunctural causation, and case diversity. We prescribe methodological guidelines consisting of a six-step procedure to systematically apply set theoretic methods to conceptualize, develop, and empirically derive maturity models and provide a demonstration......Maturity Model research in IS has been criticized for the lack of theoretical grounding, methodological rigor, empirical validations, and ignorance of multiple and non-linear paths to maturity. To address these criticisms, this paper proposes a novel set-theoretical approach to maturity models...

An integrated modeling approach to age invariant face recognition

Science.gov (United States)

Alvi, Fahad Bashir; Pears, Russel

2015-03-01

This Research study proposes a novel method for face recognition based on Anthropometric features that make use of an integrated approach comprising of a global and personalized models. The system is aimed to at situations where lighting, illumination, and pose variations cause problems in face recognition. A Personalized model covers the individual aging patterns while a Global model captures general aging patterns in the database. We introduced a de-aging factor that de-ages each individual in the database test and training sets. We used the k nearest neighbor approach for building a personalized model and global model. Regression analysis was applied to build the models. During the test phase, we resort to voting on different features. We used FG-Net database for checking the results of our technique and achieved 65 percent Rank 1 identification rate.

Variational approach to chiral quark models

Energy Technology Data Exchange (ETDEWEB)

Futami, Yasuhiko; Odajima, Yasuhiko; Suzuki, Akira

1987-03-01

A variational approach is applied to a chiral quark model to test the validity of the perturbative treatment of the pion-quark interaction based on the chiral symmetry principle. It is indispensably related to the chiral symmetry breaking radius if the pion-quark interaction can be regarded as a perturbation.

Distributed simulation a model driven engineering approach

CERN Document Server

Topçu, Okan; Oğuztüzün, Halit; Yilmaz, Levent

2016-01-01

Backed by substantive case studies, the novel approach to software engineering for distributed simulation outlined in this text demonstrates the potent synergies between model-driven techniques, simulation, intelligent agents, and computer systems development.

Learning the Task Management Space of an Aircraft Approach Model

Science.gov (United States)

Krall, Joseph; Menzies, Tim; Davies, Misty

2014-01-01

Validating models of airspace operations is a particular challenge. These models are often aimed at finding and exploring safety violations, and aim to be accurate representations of real-world behavior. However, the rules governing the behavior are quite complex: nonlinear physics, operational modes, human behavior, and stochastic environmental concerns all determine the responses of the system. In this paper, we present a study on aircraft runway approaches as modeled in Georgia Tech's Work Models that Compute (WMC) simulation. We use a new learner, Genetic-Active Learning for Search-Based Software Engineering (GALE) to discover the Pareto frontiers defined by cognitive structures. These cognitive structures organize the prioritization and assignment of tasks of each pilot during approaches. We discuss the benefits of our approach, and also discuss future work necessary to enable uncertainty quantification.

Gray-box modelling approach for description of storage tunnel

DEFF Research Database (Denmark)

Harremoës, Poul; Carstensen, Jacob

1999-01-01

The dynamics of a storage tunnel is examined using a model based on on-line measured data and a combination of simple deterministic and black-box stochastic elements. This approach, called gray-box modeling, is a new promising methodology for giving an on-line state description of sewer systems...... of the water in the overflow structures. The capacity of a pump draining the storage tunnel is estimated for two different rain events, revealing that the pump was malfunctioning during the first rain event. The proposed modeling approach can be used in automated online surveillance and control and implemented...

A study of multidimensional modeling approaches for data warehouse

Science.gov (United States)

Yusof, Sharmila Mat; Sidi, Fatimah; Ibrahim, Hamidah; Affendey, Lilly Suriani

2016-08-01

Data warehouse system is used to support the process of organizational decision making. Hence, the system must extract and integrate information from heterogeneous data sources in order to uncover relevant knowledge suitable for decision making process. However, the development of data warehouse is a difficult and complex process especially in its conceptual design (multidimensional modeling). Thus, there have been various approaches proposed to overcome the difficulty. This study surveys and compares the approaches of multidimensional modeling and highlights the issues, trend and solution proposed to date. The contribution is on the state of the art of the multidimensional modeling design.

Modelling efficient innovative work: integration of economic and social psychological approaches

Directory of Open Access Journals (Sweden)

Babanova Yulia

2017-01-01

Full Text Available The article deals with the relevance of integration of economic and social psychological approaches to the solution of enhancing the efficiency of innovation management. The content, features and specifics of the modelling methods within each of approaches are unfolded and options of integration are considered. The economic approach lies in the generation of the integrated matrix concept of management of innovative development of an enterprise in line with the stages of innovative work and the use of the integrated vector method for the evaluation of the innovative enterprise development level. The social psychological approach lies in the development of a system of psychodiagnostic indexes of activity resources within the scope of psychological innovative audit of enterprise management and development of modelling methods for the balance of activity trends. Modelling the activity resources is based on the system of equations accounting for the interaction type of psychodiagnostic indexes. Integration of two approaches includes a methodological level, a level of empirical studies and modelling methods. There are suggested options of integrating the economic and psychological approaches to analyze available material and non-material resources of the enterprises’ innovative work and to forecast an optimal option of development based on the implemented modelling methods.

Intelligent Transportation and Evacuation Planning A Modeling-Based Approach

CERN Document Server

Naser, Arab

2012-01-01

Intelligent Transportation and Evacuation Planning: A Modeling-Based Approach provides a new paradigm for evacuation planning strategies and techniques. Recently, evacuation planning and modeling have increasingly attracted interest among researchers as well as government officials. This interest stems from the recent catastrophic hurricanes and weather-related events that occurred in the southeastern United States (Hurricane Katrina and Rita). The evacuation methods that were in place before and during the hurricanes did not work well and resulted in thousands of deaths. This book offers insights into the methods and techniques that allow for implementing mathematical-based, simulation-based, and integrated optimization and simulation-based engineering approaches for evacuation planning. This book also: Comprehensively discusses the application of mathematical models for evacuation and intelligent transportation modeling Covers advanced methodologies in evacuation modeling and planning Discusses principles a...

Benchmarking novel approaches for modelling species range dynamics.

Science.gov (United States)

Zurell, Damaris; Thuiller, Wilfried; Pagel, Jörn; Cabral, Juliano S; Münkemüller, Tamara; Gravel, Dominique; Dullinger, Stefan; Normand, Signe; Schiffers, Katja H; Moore, Kara A; Zimmermann, Niklaus E

2016-08-01

Increasing biodiversity loss due to climate change is one of the most vital challenges of the 21st century. To anticipate and mitigate biodiversity loss, models are needed that reliably project species' range dynamics and extinction risks. Recently, several new approaches to model range dynamics have been developed to supplement correlative species distribution models (SDMs), but applications clearly lag behind model development. Indeed, no comparative analysis has been performed to evaluate their performance. Here, we build on process-based, simulated data for benchmarking five range (dynamic) models of varying complexity including classical SDMs, SDMs coupled with simple dispersal or more complex population dynamic models (SDM hybrids), and a hierarchical Bayesian process-based dynamic range model (DRM). We specifically test the effects of demographic and community processes on model predictive performance. Under current climate, DRMs performed best, although only marginally. Under climate change, predictive performance varied considerably, with no clear winners. Yet, all range dynamic models improved predictions under climate change substantially compared to purely correlative SDMs, and the population dynamic models also predicted reasonable extinction risks for most scenarios. When benchmarking data were simulated with more complex demographic and community processes, simple SDM hybrids including only dispersal often proved most reliable. Finally, we found that structural decisions during model building can have great impact on model accuracy, but prior system knowledge on important processes can reduce these uncertainties considerably. Our results reassure the clear merit in using dynamic approaches for modelling species' response to climate change but also emphasize several needs for further model and data improvement. We propose and discuss perspectives for improving range projections through combination of multiple models and for making these approaches

Quasirelativistic quark model in quasipotential approach

CERN Document Server

Matveev, V A; Savrin, V I; Sissakian, A N

2002-01-01

The relativistic particles interaction is described within the frames of quasipotential approach. The presentation is based on the so called covariant simultaneous formulation of the quantum field theory, where by the theory is considered on the spatial-like three-dimensional hypersurface in the Minkowski space. Special attention is paid to the methods of plotting various quasipotentials as well as to the applications of the quasipotential approach to describing the characteristics of the relativistic particles interaction in the quark models, namely: the hadrons elastic scattering amplitudes, the mass spectra and widths mesons decays, the cross sections of the deep inelastic leptons scattering on the hadrons

A model-data based systems approach to process intensification

DEFF Research Database (Denmark)

Gani, Rafiqul

. Their developments, however, are largely due to experiment based trial and error approaches and while they do not require validation, they can be time consuming and resource intensive. Also, one may ask, can a truly new intensified unit operation be obtained in this way? An alternative two-stage approach is to apply...... a model-based synthesis method to systematically generate and evaluate alternatives in the first stage and an experiment-model based validation in the second stage. In this way, the search for alternatives is done very quickly, reliably and systematically over a wide range, while resources are preserved...... for focused validation of only the promising candidates in the second-stage. This approach, however, would be limited to intensification based on “known” unit operations, unless the PI process synthesis/design is considered at a lower level of aggregation, namely the phenomena level. That is, the model-based...

A novel approach of modeling continuous dark hydrogen fermentation.

Science.gov (United States)

Alexandropoulou, Maria; Antonopoulou, Georgia; Lyberatos, Gerasimos

2018-02-01

In this study a novel modeling approach for describing fermentative hydrogen production in a continuous stirred tank reactor (CSTR) was developed, using the Aquasim modeling platform. This model accounts for the key metabolic reactions taking place in a fermentative hydrogen producing reactor, using fixed stoichiometry but different reaction rates. Biomass yields are determined based on bioenergetics. The model is capable of describing very well the variation in the distribution of metabolic products for a wide range of hydraulic retention times (HRT). The modeling approach is demonstrated using the experimental data obtained from a CSTR, fed with food industry waste (FIW), operating at different HRTs. The kinetic parameters were estimated through fitting to the experimental results. Hydrogen and total biogas production rates were predicted very well by the model, validating the basic assumptions regarding the implicated stoichiometric biochemical reactions and their kinetic rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

An interdisciplinary approach for earthquake modelling and forecasting

Science.gov (United States)

Han, P.; Zhuang, J.; Hattori, K.; Ogata, Y.

2016-12-01

Earthquake is one of the most serious disasters, which may cause heavy casualties and economic losses. Especially in the past two decades, huge/mega earthquakes have hit many countries. Effective earthquake forecasting (including time, location, and magnitude) becomes extremely important and urgent. To date, various heuristically derived algorithms have been developed for forecasting earthquakes. Generally, they can be classified into two types: catalog-based approaches and non-catalog-based approaches. Thanks to the rapid development of statistical seismology in the past 30 years, now we are able to evaluate the performances of these earthquake forecast approaches quantitatively. Although a certain amount of precursory information is available in both earthquake catalogs and non-catalog observations, the earthquake forecast is still far from satisfactory. In most case, the precursory phenomena were studied individually. An earthquake model that combines self-exciting and mutually exciting elements was developed by Ogata and Utsu from the Hawkes process. The core idea of this combined model is that the status of the event at present is controlled by the event itself (self-exciting) and all the external factors (mutually exciting) in the past. In essence, the conditional intensity function is a time-varying Poisson process with rate λ(t), which is composed of the background rate, the self-exciting term (the information from past seismic events), and the external excitation term (the information from past non-seismic observations). This model shows us a way to integrate the catalog-based forecast and non-catalog-based forecast. Against this background, we are trying to develop a new earthquake forecast model which combines catalog-based and non-catalog-based approaches.

Constructing a justice model based on Sen's capability approach

OpenAIRE

Yüksel, Sevgi; Yuksel, Sevgi

2008-01-01

The thesis provides a possible justice model based on Sen's capability approach. For this goal, we first analyze the general structure of a theory of justice, identifying the main variables and issues. Furthermore, based on Sen (2006) and Kolm (1998), we look at 'transcendental' and 'comparative' approaches to justice and concentrate on the sufficiency condition for the comparative approach. Then, taking Rawls' theory of justice as a starting point, we present how Sen's capability approach em...

Biotic interactions in the face of climate change: a comparison of three modelling approaches.

Directory of Open Access Journals (Sweden)

Anja Jaeschke

Full Text Available Climate change is expected to alter biotic interactions, and may lead to temporal and spatial mismatches of interacting species. Although the importance of interactions for climate change risk assessments is increasingly acknowledged in observational and experimental studies, biotic interactions are still rarely incorporated in species distribution models. We assessed the potential impacts of climate change on the obligate interaction between Aeshna viridis and its egg-laying plant Stratiotes aloides in Europe, based on an ensemble modelling technique. We compared three different approaches for incorporating biotic interactions in distribution models: (1 We separately modelled each species based on climatic information, and intersected the future range overlap ('overlap approach'. (2 We modelled the potential future distribution of A. viridis with the projected occurrence probability of S. aloides as further predictor in addition to climate ('explanatory variable approach'. (3 We calibrated the model of A. viridis in the current range of S. aloides and multiplied the future occurrence probabilities of both species ('reference area approach'. Subsequently, all approaches were compared to a single species model of A. viridis without interactions. All approaches projected a range expansion for A. viridis. Model performance on test data and amount of range gain differed depending on the biotic interaction approach. All interaction approaches yielded lower range gains (up to 667% lower than the model without interaction. Regarding the contribution of algorithm and approach to the overall uncertainty, the main part of explained variation stems from the modelling algorithm, and only a small part is attributed to the modelling approach. The comparison of the no-interaction model with the three interaction approaches emphasizes the importance of including obligate biotic interactions in projective species distribution modelling. We recommend the use of

Top-down approach to unified supergravity models

International Nuclear Information System (INIS)

Hempfling, R.

1994-03-01

We introduce a new approach for studying unified supergravity models. In this approach all the parameters of the grand unified theory (GUT) are fixed by imposing the corresponding number of low energy observables. This determines the remaining particle spectrum whose dependence on the low energy observables can now be investigated. We also include some SUSY threshold corrections that have previously been neglected. In particular the SUSY threshold corrections to the fermion masses can have a significant impact on the Yukawa coupling unification. (orig.)

A robust Bayesian approach to modeling epistemic uncertainty in common-cause failure models

International Nuclear Information System (INIS)

Troffaes, Matthias C.M.; Walter, Gero; Kelly, Dana

2014-01-01

In a standard Bayesian approach to the alpha-factor model for common-cause failure, a precise Dirichlet prior distribution models epistemic uncertainty in the alpha-factors. This Dirichlet prior is then updated with observed data to obtain a posterior distribution, which forms the basis for further inferences. In this paper, we adapt the imprecise Dirichlet model of Walley to represent epistemic uncertainty in the alpha-factors. In this approach, epistemic uncertainty is expressed more cautiously via lower and upper expectations for each alpha-factor, along with a learning parameter which determines how quickly the model learns from observed data. For this application, we focus on elicitation of the learning parameter, and find that values in the range of 1 to 10 seem reasonable. The approach is compared with Kelly and Atwood's minimally informative Dirichlet prior for the alpha-factor model, which incorporated precise mean values for the alpha-factors, but which was otherwise quite diffuse. Next, we explore the use of a set of Gamma priors to model epistemic uncertainty in the marginal failure rate, expressed via a lower and upper expectation for this rate, again along with a learning parameter. As zero counts are generally less of an issue here, we find that the choice of this learning parameter is less crucial. Finally, we demonstrate how both epistemic uncertainty models can be combined to arrive at lower and upper expectations for all common-cause failure rates. Thereby, we effectively provide a full sensitivity analysis of common-cause failure rates, properly reflecting epistemic uncertainty of the analyst on all levels of the common-cause failure model

Unraveling the Mechanisms of Manual Therapy: Modeling an Approach.

Science.gov (United States)

Bialosky, Joel E; Beneciuk, Jason M; Bishop, Mark D; Coronado, Rogelio A; Penza, Charles W; Simon, Corey B; George, Steven Z

2018-01-01

Synopsis Manual therapy interventions are popular among individual health care providers and their patients; however, systematic reviews do not strongly support their effectiveness. Small treatment effect sizes of manual therapy interventions may result from a "one-size-fits-all" approach to treatment. Mechanistic-based treatment approaches to manual therapy offer an intriguing alternative for identifying patients likely to respond to manual therapy. However, the current lack of knowledge of the mechanisms through which manual therapy interventions inhibit pain limits such an approach. The nature of manual therapy interventions further confounds such an approach, as the related mechanisms are likely a complex interaction of factors related to the patient, the provider, and the environment in which the intervention occurs. Therefore, a model to guide both study design and the interpretation of findings is necessary. We have previously proposed a model suggesting that the mechanical force from a manual therapy intervention results in systemic neurophysiological responses leading to pain inhibition. In this clinical commentary, we provide a narrative appraisal of the model and recommendations to advance the study of manual therapy mechanisms. J Orthop Sports Phys Ther 2018;48(1):8-18. doi:10.2519/jospt.2018.7476.

A Model-Driven Approach to e-Course Management

Science.gov (United States)

Savic, Goran; Segedinac, Milan; Milenkovic, Dušica; Hrin, Tamara; Segedinac, Mirjana

2018-01-01

This paper presents research on using a model-driven approach to the development and management of electronic courses. We propose a course management system which stores a course model represented as distinct machine-readable components containing domain knowledge of different course aspects. Based on this formally defined platform-independent…

Modelling the Heat Consumption in District Heating Systems using a Grey-box approach

DEFF Research Database (Denmark)

Nielsen, Henrik Aalborg; Madsen, Henrik

2006-01-01

identification of an overall model structure followed by data-based modelling, whereby the details of the model are identified. This approach is sometimes called grey-box modelling, but the specific approach used here does not require states to be specified. Overall, the paper demonstrates the power of the grey......-box approach. (c) 2005 Elsevier B.V. All rights reserved....

Circadian hormone profiles and insulin sensitivity in patients with Addison's disease: a comparison of continuous subcutaneous hydrocortisone infusion with conventional glucocorticoid replacement therapy.

Science.gov (United States)

Björnsdottir, Sigridur; Øksnes, Marianne; Isaksson, Magnus; Methlie, Paal; Nilsen, Roy M; Hustad, Steinar; Kämpe, Olle; Hulting, Anna-Lena; Husebye, Eystein S; Løvås, Kristian; Nyström, Thomas; Bensing, Sophie

2015-07-01

Conventional glucocorticoid replacement therapy in patients with Addison's disease (AD) is unphysiological with possible adverse effects on mortality, morbidity and quality of life. The diurnal cortisol profile can likely be restored by continuous subcutaneous hydrocortisone infusion (CSHI). The aim of this study was to compare circadian hormone rhythms and insulin sensitivity in conventional thrice-daily regimen of glucocorticoid replacement therapy with CSHI treatment in patients with AD. An open, randomized, two-period, 12-week crossover multicentre trial in Norway and Sweden. Ten Norwegian patients were admitted for 24-h sampling of hormone profiles. Fifteen Swedish patients underwent euglycaemic-hyperinsulinaemic clamp. Thrice-daily regimen of oral hydrocortisone (OHC) and CSHI treatment. We measured the circadian rhythm of cortisol, adrenocorticotropic hormone (ACTH), growth hormone (GH), insulin-like growth factor-1, (IGF-1), IGF-binding protein-3 (IGFBP-3), glucose, insulin and triglycerides during OHC and CSHI treatment. Euglycaemic-hyperinsulinaemic clamp was used to assess insulin sensitivity. Continuous subcutaneous hydrocortisone infusion provided a more physiological circadian cortisol curve including a late-night cortisol surge. ACTH levels showed a near normal circadian variation for CSHI. CSHI prevented a continuous decrease in glucose during the night. No difference in insulin sensitivity was observed between the two treatment arms. Continuous subcutaneous hydrocortisone infusion replacement re-established a circadian cortisol rhythm and normalized the ACTH levels. Patients with CSHI replacement had a more stable night-time glucose level compared with OHC without compromising insulin sensitivity. Thus, restoring night-time cortisol levels might be advantageous for patients with AD. © 2015 John Wiley & Sons Ltd.

Modeling energy fluxes in heterogeneous landscapes employing a mosaic approach

Science.gov (United States)

Klein, Christian; Thieme, Christoph; Priesack, Eckart

2015-04-01

Recent studies show that uncertainties in regional and global climate and weather simulations are partly due to inadequate descriptions of the energy flux exchanges between the land surface and the atmosphere. One major shortcoming is the limitation of the grid-cell resolution, which is recommended to be about at least 3x3 km² in most models due to limitations in the model physics. To represent each individual grid cell most models select one dominant soil type and one dominant land use type. This resolution, however, is often too coarse in regions where the spatial diversity of soil and land use types are high, e.g. in Central Europe. An elegant method to avoid the shortcoming of grid cell resolution is the so called mosaic approach. This approach is part of the recently developed ecosystem model framework Expert-N 5.0. The aim of this study was to analyze the impact of the characteristics of two managed fields, planted with winter wheat and potato, on the near surface soil moistures and on the near surface energy flux exchanges of the soil-plant-atmosphere interface. The simulated energy fluxes were compared with eddy flux tower measurements between the respective fields at the research farm Scheyern, North-West of Munich, Germany. To perform these simulations, we coupled the ecosystem model Expert-N 5.0 to an analytical footprint model. The coupled model system has the ability to calculate the mixing ratio of the surface energy fluxes at a given point within one grid cell (in this case at the flux tower between the two fields). This approach accounts for the differences of the two soil types, of land use managements, and of canopy properties due to footprint size dynamics. Our preliminary simulation results show that a mosaic approach can improve modeling and analyzing energy fluxes when the land surface is heterogeneous. In this case our applied method is a promising approach to extend weather and climate models on the regional and on the global scale.

Cardiovascular Risk Factors in Patients with Addison's Disease: A Comparative Study of South African and Swedish Patients

Science.gov (United States)

Ross, Ian Louis; Bergthorsdottir, Ragnhildur; Levitt, Naomi; Dave, Joel Alex; Schatz, Desmond; Marais, David; Johannsson, Gudmundur

2014-01-01

Background Patients with Addison's disease (AD) in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD). Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. Methods In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden) matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP) and adiponectin were studied. Results All patients were Caucasian and the majority were women N = 36 (65.5%). Mean (standard deviation; SD) ages of the Swedish and South African patients were 52.9 (13.0) and 52.6 (14.4) years and BMI 25.3 (3.2) and 25.8 (4.1) kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1) versus 24.3 (8.0) mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR) triglycerides (TG) [1.59 (1.1–2.46) versus 0.96 (0.74–1.6) mmol/l; p<0.001], total cholesterol (TC) [6.02(1.50) versus 5.13 (0.87) mmol/l; p<0.001], LDL-C [4.43 (1.44) versus 2.75 (0.80) mmol/l; p<0.001] and median hs-CRP [2.15 (0.93–5.45) versus 0.99 (0.57–2.10) mg/L; p<0.003] and lower HDL-C [0.80 (0.40) versus 1.86 (0.46) mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. Conclusions South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors. PMID:24603607

Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.

Directory of Open Access Journals (Sweden)

Ian Louis Ross

Full Text Available BACKGROUND: Patients with Addison's disease (AD in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD. Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. METHODS: In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP and adiponectin were studied. RESULTS: All patients were Caucasian and the majority were women N = 36 (65.5%. Mean (standard deviation; SD ages of the Swedish and South African patients were 52.9 (13.0 and 52.6 (14.4 years and BMI 25.3 (3.2 and 25.8 (4.1 kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1 versus 24.3 (8.0 mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR triglycerides (TG [1.59 (1.1-2.46 versus 0.96 (0.74-1.6 mmol/l; p<0.001], total cholesterol (TC [6.02(1.50 versus 5.13 (0.87 mmol/l; p<0.001], LDL-C [4.43 (1.44 versus 2.75 (0.80 mmol/l; p<0.001] and median hs-CRP [2.15 (0.93-5.45 versus 0.99 (0.57-2.10 mg/L; p<0.003] and lower HDL-C [0.80 (0.40 versus 1.86 (0.46 mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. CONCLUSIONS: South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors.

A Pharmacokinetic Model of a Tissue Implantable Cortisol Sensor.

Science.gov (United States)

Lee, Michael A; Bakh, Naveed; Bisker, Gili; Brown, Emery N; Strano, Michael S

2016-12-01

Cortisol is an important glucocorticoid hormone whose biochemistry influences numerous physiological and pathological processes. Moreover, it is a biomarker of interest for a number of conditions, including posttraumatic stress disorder, Cushing's syndrome, Addison's disease, and others. An implantable biosensor capable of real time monitoring of cortisol concentrations in adipose tissue may revolutionize the diagnosis and treatment of these disorders, as well as provide an invaluable research tool. Toward this end, a mathematical model, informed by the physiological literature, is developed to predict dynamic cortisol concentrations in adipose, muscle, and brain tissues, where a significant number of important processes with cortisol occur. The pharmacokinetic model is applied to both a prototypical, healthy male patient and a previously studied Cushing's disease patient. The model can also be used to inform the design of an implantable sensor by optimizing the sensor dissociation constant, apparent delay time, and magnitude of the sensor output versus system dynamics. Measurements from such a sensor would help to determine systemic cortisol levels, providing much needed insight for proper medical treatment for various cortisol-related conditions. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Designing water demand management schemes using a socio-technical modelling approach.

Science.gov (United States)

Baki, Sotiria; Rozos, Evangelos; Makropoulos, Christos

2018-05-01

Although it is now widely acknowledged that urban water systems (UWSs) are complex socio-technical systems and that a shift towards a socio-technical approach is critical in achieving sustainable urban water management, still, more often than not, UWSs are designed using a segmented modelling approach. As such, either the analysis focuses on the description of the purely technical sub-system, without explicitly taking into account the system's dynamic socio-economic processes, or a more interdisciplinary approach is followed, but delivered through relatively coarse models, which often fail to provide a thorough representation of the urban water cycle and hence cannot deliver accurate estimations of the hydrosystem's responses. In this work we propose an integrated modelling approach for the study of the complete socio-technical UWS that also takes into account socio-economic and climatic variability. We have developed an integrated model, which is used to investigate the diffusion of household water conservation technologies and its effects on the UWS, under different socio-economic and climatic scenarios. The integrated model is formed by coupling a System Dynamics model that simulates the water technology adoption process, and the Urban Water Optioneering Tool (UWOT) for the detailed simulation of the urban water cycle. The model and approach are tested and demonstrated in an urban redevelopment area in Athens, Greece under different socio-economic scenarios and policy interventions. It is suggested that the proposed approach can establish quantifiable links between socio-economic change and UWS responses and therefore assist decision makers in designing more effective and resilient long-term strategies for water conservation. Copyright © 2017 Elsevier B.V. All rights reserved.

A Constructive Neural-Network Approach to Modeling Psychological Development

Science.gov (United States)

Shultz, Thomas R.

2012-01-01

This article reviews a particular computational modeling approach to the study of psychological development--that of constructive neural networks. This approach is applied to a variety of developmental domains and issues, including Piagetian tasks, shift learning, language acquisition, number comparison, habituation of visual attention, concept…

Modular Modelling and Simulation Approach - Applied to Refrigeration Systems

DEFF Research Database (Denmark)

Sørensen, Kresten Kjær; Stoustrup, Jakob

2008-01-01

This paper presents an approach to modelling and simulation of the thermal dynamics of a refrigeration system, specifically a reefer container. A modular approach is used and the objective is to increase the speed and flexibility of the developed simulation environment. The refrigeration system...

Comparison of two novel approaches to model fibre reinforced concrete

NARCIS (Netherlands)

Radtke, F.K.F.; Simone, A.; Sluys, L.J.

2009-01-01

We present two approaches to model fibre reinforced concrete. In both approaches, discrete fibre distributions and the behaviour of the fibre-matrix interface are explicitly considered. One approach employs the reaction forces from fibre to matrix while the other is based on the partition of unity

Merits of a Scenario Approach in Dredge Plume Modelling

DEFF Research Database (Denmark)

Pedersen, Claus; Chu, Amy Ling Chu; Hjelmager Jensen, Jacob

2011-01-01

Dredge plume modelling is a key tool for quantification of potential impacts to inform the EIA process. There are, however, significant uncertainties associated with the modelling at the EIA stage when both dredging methodology and schedule are likely to be a guess at best as the dredging...... contractor would rarely have been appointed. Simulation of a few variations of an assumed full dredge period programme will generally not provide a good representation of the overall environmental risks associated with the programme. An alternative dredge plume modelling strategy that attempts to encapsulate...... uncertainties associated with preliminary dredging programmes by using a scenario-based modelling approach is presented. The approach establishes a set of representative and conservative scenarios for key factors controlling the spill and plume dispersion and simulates all combinations of e.g. dredge, climatic...

An approach to multiscale modelling with graph grammars.

Science.gov (United States)

Ong, Yongzhi; Streit, Katarína; Henke, Michael; Kurth, Winfried

2014-09-01

Functional-structural plant models (FSPMs) simulate biological processes at different spatial scales. Methods exist for multiscale data representation and modification, but the advantages of using multiple scales in the dynamic aspects of FSPMs remain unclear. Results from multiscale models in various other areas of science that share fundamental modelling issues with FSPMs suggest that potential advantages do exist, and this study therefore aims to introduce an approach to multiscale modelling in FSPMs. A three-part graph data structure and grammar is revisited, and presented with a conceptual framework for multiscale modelling. The framework is used for identifying roles, categorizing and describing scale-to-scale interactions, thus allowing alternative approaches to model development as opposed to correlation-based modelling at a single scale. Reverse information flow (from macro- to micro-scale) is catered for in the framework. The methods are implemented within the programming language XL. Three example models are implemented using the proposed multiscale graph model and framework. The first illustrates the fundamental usage of the graph data structure and grammar, the second uses probabilistic modelling for organs at the fine scale in order to derive crown growth, and the third combines multiscale plant topology with ozone trends and metabolic network simulations in order to model juvenile beech stands under exposure to a toxic trace gas. The graph data structure supports data representation and grammar operations at multiple scales. The results demonstrate that multiscale modelling is a viable method in FSPM and an alternative to correlation-based modelling. Advantages and disadvantages of multiscale modelling are illustrated by comparisons with single-scale implementations, leading to motivations for further research in sensitivity analysis and run-time efficiency for these models.

A fuzzy approach for modelling radionuclide in lake system

International Nuclear Information System (INIS)

Desai, H.K.; Christian, R.A.; Banerjee, J.; Patra, A.K.

2013-01-01

Radioactive liquid waste is generated during operation and maintenance of Pressurised Heavy Water Reactors (PHWRs). Generally low level liquid waste is diluted and then discharged into the near by water-body through blowdown water discharge line as per the standard waste management practice. The effluents from nuclear installations are treated adequately and then released in a controlled manner under strict compliance of discharge criteria. An attempt was made to predict the concentration of 3 H released from Kakrapar Atomic Power Station at Ratania Regulator, about 2.5 km away from the discharge point, where human exposure is expected. Scarcity of data and complex geometry of the lake prompted the use of Heuristic approach. Under this condition, Fuzzy rule based approach was adopted to develop a model, which could predict 3 H concentration at Ratania Regulator. Three hundred data were generated for developing the fuzzy rules, in which input parameters were water flow from lake and 3 H concentration at discharge point. The Output was 3 H concentration at Ratania Regulator. These data points were generated by multiple regression analysis of the original data. Again by using same methodology hundred data were generated for the validation of the model, which were compared against the predicted output generated by using Fuzzy Rule based approach. Root Mean Square Error of the model came out to be 1.95, which showed good agreement by Fuzzy model of natural ecosystem. -- Highlights: • Uncommon approach (Fuzzy Rule Base) of modelling radionuclide dispersion in Lake. • Predicts 3 H released from Kakrapar Atomic Power Station at a point of human exposure. • RMSE of fuzzy model is 1.95, which means, it has well imitated natural ecosystem

Data Analysis A Model Comparison Approach, Second Edition

CERN Document Server

Judd, Charles M; Ryan, Carey S

2008-01-01

This completely rewritten classic text features many new examples, insights and topics including mediational, categorical, and multilevel models. Substantially reorganized, this edition provides a briefer, more streamlined examination of data analysis. Noted for its model-comparison approach and unified framework based on the general linear model, the book provides readers with a greater understanding of a variety of statistical procedures. This consistent framework, including consistent vocabulary and notation, is used throughout to develop fewer but more powerful model building techniques. T

Validation of an employee satisfaction model: A structural equation model approach

OpenAIRE

Ophillia Ledimo; Nico Martins

2015-01-01

The purpose of this study was to validate an employee satisfaction model and to determine the relationships between the different dimensions of the concept, using the structural equation modelling approach (SEM). A cross-sectional quantitative survey design was used to collect data from a random sample of (n=759) permanent employees of a parastatal organisation. Data was collected using the Employee Satisfaction Survey (ESS) to measure employee satisfaction dimensions. Following the steps of ...

Experiments in Knowledge Refinement for a Large Rule-Based System

Science.gov (United States)

1993-08-01

empirical analysis to refine expert system knowledge bases. Aritificial Intelligence , 22:23-48, 1984. *! ...The Addison- Weslev series in artificial intelligence . Addison-Weslev. Reading, Massachusetts. 1981. Cooke, 1991: ttoger M. Cooke. Experts in...ment for classification systems. Artificial Intelligence , 35:197-226, 1988. 14 Overall, we believe that it will be possible to build a heuristic system

Data and Dynamics Driven Approaches for Modelling and Forecasting the Red Sea Chlorophyll

KAUST Repository

Dreano, Denis

2017-01-01

concentration and have practical applications for fisheries operation and harmful algae blooms monitoring. Modelling approaches can be divided between physics- driven (dynamical) approaches, and data-driven (statistical) approaches. Dynamical models are based

High dimensions - a new approach to fermionic lattice models

International Nuclear Information System (INIS)

Vollhardt, D.

1991-01-01

The limit of high spatial dimensions d, which is well-established in the theory of classical and localized spin models, is shown to be a fruitful approach also to itinerant fermion systems, such as the Hubbard model and the periodic Anderson model. Many investigations which are probability difficult in finite dimensions, become tractable in d=∞. At the same time essential features of systems in d=3 and even lower dimensions are very well described by the results obtained in d=∞. A wide range of applications of this new concept (e.g., in perturbation theory, Fermi liquid theory, variational approaches, exact results, etc.) is discussed and the state-of-the-art is reviewed. (orig.)

Bayesian Multi-Energy Computed Tomography reconstruction approaches based on decomposition models

International Nuclear Information System (INIS)

Cai, Caifang

2013-01-01

Multi-Energy Computed Tomography (MECT) makes it possible to get multiple fractions of basis materials without segmentation. In medical application, one is the soft-tissue equivalent water fraction and the other is the hard-matter equivalent bone fraction. Practical MECT measurements are usually obtained with polychromatic X-ray beams. Existing reconstruction approaches based on linear forward models without counting the beam poly-chromaticity fail to estimate the correct decomposition fractions and result in Beam-Hardening Artifacts (BHA). The existing BHA correction approaches either need to refer to calibration measurements or suffer from the noise amplification caused by the negative-log pre-processing and the water and bone separation problem. To overcome these problems, statistical DECT reconstruction approaches based on non-linear forward models counting the beam poly-chromaticity show great potential for giving accurate fraction images.This work proposes a full-spectral Bayesian reconstruction approach which allows the reconstruction of high quality fraction images from ordinary polychromatic measurements. This approach is based on a Gaussian noise model with unknown variance assigned directly to the projections without taking negative-log. Referring to Bayesian inferences, the decomposition fractions and observation variance are estimated by using the joint Maximum A Posteriori (MAP) estimation method. Subject to an adaptive prior model assigned to the variance, the joint estimation problem is then simplified into a single estimation problem. It transforms the joint MAP estimation problem into a minimization problem with a non-quadratic cost function. To solve it, the use of a monotone Conjugate Gradient (CG) algorithm with suboptimal descent steps is proposed.The performances of the proposed approach are analyzed with both simulated and experimental data. The results show that the proposed Bayesian approach is robust to noise and materials. It is also

Post-closure biosphere assessment modelling: comparison of complex and more stylised approaches.

Science.gov (United States)

Walke, Russell C; Kirchner, Gerald; Xu, Shulan; Dverstorp, Björn

2015-10-01

Geological disposal facilities are the preferred option for high-level radioactive waste, due to their potential to provide isolation from the surface environment (biosphere) on very long timescales. Assessments need to strike a balance between stylised models and more complex approaches that draw more extensively on site-specific information. This paper explores the relative merits of complex versus more stylised biosphere models in the context of a site-specific assessment. The more complex biosphere modelling approach was developed by the Swedish Nuclear Fuel and Waste Management Co (SKB) for the Formark candidate site for a spent nuclear fuel repository in Sweden. SKB's approach is built on a landscape development model, whereby radionuclide releases to distinct hydrological basins/sub-catchments (termed 'objects') are represented as they evolve through land rise and climate change. Each of seventeen of these objects is represented with more than 80 site specific parameters, with about 22 that are time-dependent and result in over 5000 input values per object. The more stylised biosphere models developed for this study represent releases to individual ecosystems without environmental change and include the most plausible transport processes. In the context of regulatory review of the landscape modelling approach adopted in the SR-Site assessment in Sweden, the more stylised representation has helped to build understanding in the more complex modelling approaches by providing bounding results, checking the reasonableness of the more complex modelling, highlighting uncertainties introduced through conceptual assumptions and helping to quantify the conservatisms involved. The more stylised biosphere models are also shown capable of reproducing the results of more complex approaches. A major recommendation is that biosphere assessments need to justify the degree of complexity in modelling approaches as well as simplifying and conservative assumptions. In light of

Synthesis of industrial applications of local approach to fracture models

International Nuclear Information System (INIS)

Eripret, C.

1993-03-01

This report gathers different applications of local approach to fracture models to various industrial configurations, such as nuclear pressure vessel steel, cast duplex stainless steels, or primary circuit welds such as bimetallic welds. As soon as models are developed on the basis of microstructural observations, damage mechanisms analyses, and fracture process, the local approach to fracture proves to solve problems where classical fracture mechanics concepts fail. Therefore, local approach appears to be a powerful tool, which completes the standard fracture criteria used in nuclear industry by exhibiting where and why those classical concepts become unvalid. (author). 1 tab., 18 figs., 25 refs

CFD Modeling of Wall Steam Condensation: Two-Phase Flow Approach versus Homogeneous Flow Approach

International Nuclear Information System (INIS)

Mimouni, S.; Mechitoua, N.; Foissac, A.; Hassanaly, M.; Ouraou, M.

2011-01-01

The present work is focused on the condensation heat transfer that plays a dominant role in many accident scenarios postulated to occur in the containment of nuclear reactors. The study compares a general multiphase approach implemented in NEPTUNE C FD with a homogeneous model, of widespread use for engineering studies, implemented in Code S aturne. The model implemented in NEPTUNE C FD assumes that liquid droplets form along the wall within nucleation sites. Vapor condensation on droplets makes them grow. Once the droplet diameter reaches a critical value, gravitational forces compensate surface tension force and then droplets slide over the wall and form a liquid film. This approach allows taking into account simultaneously the mechanical drift between the droplet and the gas, the heat and mass transfer on droplets in the core of the flow and the condensation/evaporation phenomena on the walls. As concern the homogeneous approach, the motion of the liquid film due to the gravitational forces is neglected, as well as the volume occupied by the liquid. Both condensation models and compressible procedures are validated and compared to experimental data provided by the TOSQAN ISP47 experiment (IRSN Saclay). Computational results compare favorably with experimental data, particularly for the Helium and steam volume fractions.

Application of declarative modeling approaches for external events

International Nuclear Information System (INIS)

Anoba, R.C.

2005-01-01

Probabilistic Safety Assessments (PSAs) are increasingly being used as a tool for supporting the acceptability of design, procurement, construction, operation, and maintenance activities at Nuclear Power Plants. Since the issuance of Generic Letter 88-20 and subsequent IPE/IPEEE assessments, the NRC has issued several Regulatory Guides such as RG 1.174 to describe the use of PSA in risk-informed regulation activities. Most PSA have the capability to address internal events including internal floods. As the more demands are being placed for using the PSA to support risk-informed applications, there has been a growing need to integrate other eternal events (Seismic, Fire, etc.) into the logic models. Most external events involve spatial dependencies and usually impact the logic models at the component level. Therefore, manual insertion of external events impacts into a complex integrated fault tree model may be too cumbersome for routine uses of the PSA. Within the past year, a declarative modeling approach has been developed to automate the injection of external events into the PSA. The intent of this paper is to introduce the concept of declarative modeling in the context of external event applications. A declarative modeling approach involves the definition of rules for injection of external event impacts into the fault tree logic. A software tool such as the EPRI's XInit program can be used to interpret the pre-defined rules and automatically inject external event elements into the PSA. The injection process can easily be repeated, as required, to address plant changes, sensitivity issues, changes in boundary conditions, etc. External event elements may include fire initiating events, seismic initiating events, seismic fragilities, fire-induced hot short events, special human failure events, etc. This approach has been applied at a number of US nuclear power plants including a nuclear power plant in Romania. (authors)

BioModels: expanding horizons to include more modelling approaches and formats.

Science.gov (United States)

Glont, Mihai; Nguyen, Tung V N; Graesslin, Martin; Hälke, Robert; Ali, Raza; Schramm, Jochen; Wimalaratne, Sarala M; Kothamachu, Varun B; Rodriguez, Nicolas; Swat, Maciej J; Eils, Jurgen; Eils, Roland; Laibe, Camille; Malik-Sheriff, Rahuman S; Chelliah, Vijayalakshmi; Le Novère, Nicolas; Hermjakob, Henning

2018-01-04

BioModels serves as a central repository of mathematical models representing biological processes. It offers a platform to make mathematical models easily shareable across the systems modelling community, thereby supporting model reuse. To facilitate hosting a broader range of model formats derived from diverse modelling approaches and tools, a new infrastructure for BioModels has been developed that is available at http://www.ebi.ac.uk/biomodels. This new system allows submitting and sharing of a wide range of models with improved support for formats other than SBML. It also offers a version-control backed environment in which authors and curators can work collaboratively to curate models. This article summarises the features available in the current system and discusses the potential benefit they offer to the users over the previous system. In summary, the new portal broadens the scope of models accepted in BioModels and supports collaborative model curation which is crucial for model reproducibility and sharing. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

Object-Oriented Approach to Modeling Units of Pneumatic Systems

Directory of Open Access Journals (Sweden)

Yu. V. Kyurdzhiev

2014-01-01

Full Text Available The article shows the relevance of the approaches to the object-oriented programming when modeling the pneumatic units (PU.Based on the analysis of the calculation schemes of aggregates pneumatic systems two basic objects, namely a cavity flow and a material point were highlighted.Basic interactions of objects are defined. Cavity-cavity interaction: ex-change of matter and energy with the flows of mass. Cavity-point interaction: force interaction, exchange of energy in the form of operation. Point-point in-teraction: force interaction, elastic interaction, inelastic interaction, and inter-vals of displacement.The authors have developed mathematical models of basic objects and interactions. Models and interaction of elements are implemented in the object-oriented programming.Mathematical models of elements of PU design scheme are implemented in derived from the base class. These classes implement the models of flow cavity, piston, diaphragm, short channel, diaphragm to be open by a given law, spring, bellows, elastic collision, inelastic collision, friction, PU stages with a limited movement, etc.A numerical integration of differential equations for the mathematical models of PU design scheme elements is based on the Runge-Kutta method of the fourth order. On request each class performs a tact of integration i.e. calcu-lation of the coefficient method.The paper presents an integration algorithm of the system of differential equations. All objects of the PU design scheme are placed in a unidirectional class list. Iterator loop cycle initiates the integration tact of all the objects in the list. One in four iteration makes a transition to the next step of integration. Calculation process stops when any object shows a shutdowns flag.The proposed approach was tested in the calculation of a number of PU designs. With regard to traditional approaches to modeling, the authors-proposed method features in easy enhancement, code reuse, high reliability

Mathematical Modeling in Mathematics Education: Basic Concepts and Approaches

Science.gov (United States)

Erbas, Ayhan Kürsat; Kertil, Mahmut; Çetinkaya, Bülent; Çakiroglu, Erdinç; Alacaci, Cengiz; Bas, Sinem

2014-01-01

Mathematical modeling and its role in mathematics education have been receiving increasing attention in Turkey, as in many other countries. The growing body of literature on this topic reveals a variety of approaches to mathematical modeling and related concepts, along with differing perspectives on the use of mathematical modeling in teaching and…

Integrating UML, the Q-model and a Multi-Agent Approach in Process Specifications and Behavioural Models of Organisations

Directory of Open Access Journals (Sweden)

Raul Savimaa

2005-08-01

Full Text Available Efficient estimation and representation of an organisation's behaviour requires specification of business processes and modelling of actors' behaviour. Therefore the existing classical approaches that concentrate only on planned processes are not suitable and an approach that integrates process specifications with behavioural models of actors should be used instead. The present research indicates that a suitable approach should be based on interactive computing. This paper examines the integration of UML diagrams for process specifications, the Q-model specifications for modelling timing criteria of existing and planned processes and a multi-agent approach for simulating non-deterministic behaviour of human actors in an organisation. The corresponding original methodology is introduced and some of its applications as case studies are reviewed.

A rule-based approach to model checking of UML state machines

Science.gov (United States)

Grobelna, Iwona; Grobelny, Michał; Stefanowicz, Łukasz

2016-12-01

In the paper a new approach to formal verification of control process specification expressed by means of UML state machines in version 2.x is proposed. In contrast to other approaches from the literature, we use the abstract and universal rule-based logical model suitable both for model checking (using the nuXmv model checker), but also for logical synthesis in form of rapid prototyping. Hence, a prototype implementation in hardware description language VHDL can be obtained that fully reflects the primary, already formally verified specification in form of UML state machines. Presented approach allows to increase the assurance that implemented system meets the user-defined requirements.

A comprehensive dynamic modeling approach for giant magnetostrictive material actuators

International Nuclear Information System (INIS)

Gu, Guo-Ying; Zhu, Li-Min; Li, Zhi; Su, Chun-Yi

2013-01-01

In this paper, a comprehensive modeling approach for a giant magnetostrictive material actuator (GMMA) is proposed based on the description of nonlinear electromagnetic behavior, the magnetostrictive effect and frequency response of the mechanical dynamics. It maps the relationships between current and magnetic flux at the electromagnetic part to force and displacement at the mechanical part in a lumped parameter form. Towards this modeling approach, the nonlinear hysteresis effect of the GMMA appearing only in the electrical part is separated from the linear dynamic plant in the mechanical part. Thus, a two-module dynamic model is developed to completely characterize the hysteresis nonlinearity and the dynamic behaviors of the GMMA. The first module is a static hysteresis model to describe the hysteresis nonlinearity, and the cascaded second module is a linear dynamic plant to represent the dynamic behavior. To validate the proposed dynamic model, an experimental platform is established. Then, the linear dynamic part and the nonlinear hysteresis part of the proposed model are identified in sequence. For the linear part, an approach based on axiomatic design theory is adopted. For the nonlinear part, a Prandtl–Ishlinskii model is introduced to describe the hysteresis nonlinearity and a constrained quadratic optimization method is utilized to identify its coefficients. Finally, experimental tests are conducted to demonstrate the effectiveness of the proposed dynamic model and the corresponding identification method. (paper)

Bystander Approaches: Empowering Students to Model Ethical Sexual Behavior

Science.gov (United States)

Lynch, Annette; Fleming, Wm. Michael

2005-01-01

Sexual violence on college campuses is well documented. Prevention education has emerged as an alternative to victim-- and perpetrator--oriented approaches used in the past. One sexual violence prevention education approach focuses on educating and empowering the bystander to become a point of ethical intervention. In this model, bystanders to…

Accurate phenotyping: Reconciling approaches through Bayesian model averaging.

Directory of Open Access Journals (Sweden)

Carla Chia-Ming Chen

Full Text Available Genetic research into complex diseases is frequently hindered by a lack of clear biomarkers for phenotype ascertainment. Phenotypes for such diseases are often identified on the basis of clinically defined criteria; however such criteria may not be suitable for understanding the genetic composition of the diseases. Various statistical approaches have been proposed for phenotype definition; however our previous studies have shown that differences in phenotypes estimated using different approaches have substantial impact on subsequent analyses. Instead of obtaining results based upon a single model, we propose a new method, using Bayesian model averaging to overcome problems associated with phenotype definition. Although Bayesian model averaging has been used in other fields of research, this is the first study that uses Bayesian model averaging to reconcile phenotypes obtained using multiple models. We illustrate the new method by applying it to simulated genetic and phenotypic data for Kofendred personality disorder-an imaginary disease with several sub-types. Two separate statistical methods were used to identify clusters of individuals with distinct phenotypes: latent class analysis and grade of membership. Bayesian model averaging was then used to combine the two clusterings for the purpose of subsequent linkage analyses. We found that causative genetic loci for the disease produced higher LOD scores using model averaging than under either individual model separately. We attribute this improvement to consolidation of the cores of phenotype clusters identified using each individual method.

A hybrid modeling approach for option pricing

Science.gov (United States)

Hajizadeh, Ehsan; Seifi, Abbas

2011-11-01

The complexity of option pricing has led many researchers to develop sophisticated models for such purposes. The commonly used Black-Scholes model suffers from a number of limitations. One of these limitations is the assumption that the underlying probability distribution is lognormal and this is so controversial. We propose a couple of hybrid models to reduce these limitations and enhance the ability of option pricing. The key input to option pricing model is volatility. In this paper, we use three popular GARCH type model for estimating volatility. Then, we develop two non-parametric models based on neural networks and neuro-fuzzy networks to price call options for S&P 500 index. We compare the results with those of Black-Scholes model and show that both neural network and neuro-fuzzy network models outperform Black-Scholes model. Furthermore, comparing the neural network and neuro-fuzzy approaches, we observe that for at-the-money options, neural network model performs better and for both in-the-money and an out-of-the money option, neuro-fuzzy model provides better results.

Modelling of ductile and cleavage fracture by local approach

International Nuclear Information System (INIS)

Samal, M.K.; Dutta, B.K.; Kushwaha, H.S.

2000-08-01

This report describes the modelling of ductile and cleavage fracture processes by local approach. It is now well known that the conventional fracture mechanics method based on single parameter criteria is not adequate to model the fracture processes. It is because of the existence of effect of size and geometry of flaw, loading type and rate on the fracture resistance behaviour of any structure. Hence, it is questionable to use same fracture resistance curves as determined from standard tests in the analysis of real life components because of existence of all the above effects. So, there is need to have a method in which the parameters used for the analysis will be true material properties, i.e. independent of geometry and size. One of the solutions to the above problem is the use of local approaches. These approaches have been extensively studied and applied to different materials (including SA33 Gr.6) in this report. Each method has been studied and reported in a separate section. This report has been divided into five sections. Section-I gives a brief review of the fundamentals of fracture process. Section-II deals with modelling of ductile fracture by locally uncoupled type of models. In this section, the critical cavity growth parameters of the different models have been determined for the primary heat transport (PHT) piping material of Indian pressurised heavy water reactor (PHWR). A comparative study has been done among different models. The dependency of the critical parameters on stress triaxiality factor has also been studied. It is observed that Rice and Tracey's model is the most suitable one. But, its parameters are not fully independent of triaxiality factor. For this purpose, a modification to Rice and Tracery's model is suggested in Section-III. Section-IV deals with modelling of ductile fracture process by locally coupled type of models. Section-V deals with the modelling of cleavage fracture process by Beremins model, which is based on Weibulls

Repetitive Identification of Structural Systems Using a Nonlinear Model Parameter Refinement Approach

Directory of Open Access Journals (Sweden)

Jeng-Wen Lin

2009-01-01

Full Text Available This paper proposes a statistical confidence interval based nonlinear model parameter refinement approach for the health monitoring of structural systems subjected to seismic excitations. The developed model refinement approach uses the 95% confidence interval of the estimated structural parameters to determine their statistical significance in a least-squares regression setting. When the parameters' confidence interval covers the zero value, it is statistically sustainable to truncate such parameters. The remaining parameters will repetitively undergo such parameter sifting process for model refinement until all the parameters' statistical significance cannot be further improved. This newly developed model refinement approach is implemented for the series models of multivariable polynomial expansions: the linear, the Taylor series, and the power series model, leading to a more accurate identification as well as a more controllable design for system vibration control. Because the statistical regression based model refinement approach is intrinsically used to process a “batch” of data and obtain an ensemble average estimation such as the structural stiffness, the Kalman filter and one of its extended versions is introduced to the refined power series model for structural health monitoring.

Towards a Semantic E-Learning Theory by Using a Modelling Approach

Science.gov (United States)

Yli-Luoma, Pertti V. J.; Naeve, Ambjorn

2006-01-01

In the present study, a semantic perspective on e-learning theory is advanced and a modelling approach is used. This modelling approach towards the new learning theory is based on the four SECI phases of knowledge conversion: Socialisation, Externalisation, Combination and Internalisation, introduced by Nonaka in 1994, and involving two levels of…

Mathematical models for therapeutic approaches to control HIV disease transmission

CERN Document Server

Roy, Priti Kumar

2015-01-01

The book discusses different therapeutic approaches based on different mathematical models to control the HIV/AIDS disease transmission. It uses clinical data, collected from different cited sources, to formulate the deterministic as well as stochastic mathematical models of HIV/AIDS. It provides complementary approaches, from deterministic and stochastic points of view, to optimal control strategy with perfect drug adherence and also tries to seek viewpoints of the same issue from different angles with various mathematical models to computer simulations. The book presents essential methods and techniques for students who are interested in designing epidemiological models on HIV/AIDS. It also guides research scientists, working in the periphery of mathematical modeling, and helps them to explore a hypothetical method by examining its consequences in the form of a mathematical modelling and making some scientific predictions. The model equations, mathematical analysis and several numerical simulations that are...

A security modeling approach for web-service-based business processes

DEFF Research Database (Denmark)

Jensen, Meiko; Feja, Sven

2009-01-01

a transformation that automatically derives WS-SecurityPolicy-conformant security policies from the process model, which in conjunction with the generated WS-BPEL processes and WSDL documents provides the ability to deploy and run the complete security-enhanced process based on Web Service technology.......The rising need for security in SOA applications requires better support for management of non-functional properties in web-based business processes. Here, the model-driven approach may provide valuable benefits in terms of maintainability and deployment. Apart from modeling the pure functionality...... of a process, the consideration of security properties at the level of a process model is a promising approach. In this work-in-progress paper we present an extension to the ARIS SOA Architect that is capable of modeling security requirements as a separate security model view. Further we provide...

Query Language for Location-Based Services: A Model Checking Approach

Science.gov (United States)

Hoareau, Christian; Satoh, Ichiro

We present a model checking approach to the rationale, implementation, and applications of a query language for location-based services. Such query mechanisms are necessary so that users, objects, and/or services can effectively benefit from the location-awareness of their surrounding environment. The underlying data model is founded on a symbolic model of space organized in a tree structure. Once extended to a semantic model for modal logic, we regard location query processing as a model checking problem, and thus define location queries as hybrid logicbased formulas. Our approach is unique to existing research because it explores the connection between location models and query processing in ubiquitous computing systems, relies on a sound theoretical basis, and provides modal logic-based query mechanisms for expressive searches over a decentralized data structure. A prototype implementation is also presented and will be discussed.

Merging Digital Surface Models Implementing Bayesian Approaches

Science.gov (United States)

Sadeq, H.; Drummond, J.; Li, Z.

2016-06-01

In this research different DSMs from different sources have been merged. The merging is based on a probabilistic model using a Bayesian Approach. The implemented data have been sourced from very high resolution satellite imagery sensors (e.g. WorldView-1 and Pleiades). It is deemed preferable to use a Bayesian Approach when the data obtained from the sensors are limited and it is difficult to obtain many measurements or it would be very costly, thus the problem of the lack of data can be solved by introducing a priori estimations of data. To infer the prior data, it is assumed that the roofs of the buildings are specified as smooth, and for that purpose local entropy has been implemented. In addition to the a priori estimations, GNSS RTK measurements have been collected in the field which are used as check points to assess the quality of the DSMs and to validate the merging result. The model has been applied in the West-End of Glasgow containing different kinds of buildings, such as flat roofed and hipped roofed buildings. Both quantitative and qualitative methods have been employed to validate the merged DSM. The validation results have shown that the model was successfully able to improve the quality of the DSMs and improving some characteristics such as the roof surfaces, which consequently led to better representations. In addition to that, the developed model has been compared with the well established Maximum Likelihood model and showed similar quantitative statistical results and better qualitative results. Although the proposed model has been applied on DSMs that were derived from satellite imagery, it can be applied to any other sourced DSMs.

MERGING DIGITAL SURFACE MODELS IMPLEMENTING BAYESIAN APPROACHES

Directory of Open Access Journals (Sweden)

H. Sadeq

2016-06-01

Full Text Available In this research different DSMs from different sources have been merged. The merging is based on a probabilistic model using a Bayesian Approach. The implemented data have been sourced from very high resolution satellite imagery sensors (e.g. WorldView-1 and Pleiades. It is deemed preferable to use a Bayesian Approach when the data obtained from the sensors are limited and it is difficult to obtain many measurements or it would be very costly, thus the problem of the lack of data can be solved by introducing a priori estimations of data. To infer the prior data, it is assumed that the roofs of the buildings are specified as smooth, and for that purpose local entropy has been implemented. In addition to the a priori estimations, GNSS RTK measurements have been collected in the field which are used as check points to assess the quality of the DSMs and to validate the merging result. The model has been applied in the West-End of Glasgow containing different kinds of buildings, such as flat roofed and hipped roofed buildings. Both quantitative and qualitative methods have been employed to validate the merged DSM. The validation results have shown that the model was successfully able to improve the quality of the DSMs and improving some characteristics such as the roof surfaces, which consequently led to better representations. In addition to that, the developed model has been compared with the well established Maximum Likelihood model and showed similar quantitative statistical results and better qualitative results. Although the proposed model has been applied on DSMs that were derived from satellite imagery, it can be applied to any other sourced DSMs.

Box-wing model approach for solar radiation pressure modelling in a multi-GNSS scenario

Science.gov (United States)

Tobias, Guillermo; Jesús García, Adrián

2016-04-01

The solar radiation pressure force is the largest orbital perturbation after the gravitational effects and the major error source affecting GNSS satellites. A wide range of approaches have been developed over the years for the modelling of this non gravitational effect as part of the orbit determination process. These approaches are commonly divided into empirical, semi-analytical and analytical, where their main difference relies on the amount of knowledge of a-priori physical information about the properties of the satellites (materials and geometry) and their attitude. It has been shown in the past that the pre-launch analytical models fail to achieve the desired accuracy mainly due to difficulties in the extrapolation of the in-orbit optical and thermic properties, the perturbations in the nominal attitude law and the aging of the satellite's surfaces, whereas empirical models' accuracies strongly depend on the amount of tracking data used for deriving the models, and whose performances are reduced as the area to mass ratio of the GNSS satellites increases, as it happens for the upcoming constellations such as BeiDou and Galileo. This paper proposes to use basic box-wing model for Galileo complemented with empirical parameters, based on the limited available information about the Galileo satellite's geometry. The satellite is modelled as a box, representing the satellite bus, and a wing representing the solar panel. The performance of the model will be assessed for GPS, GLONASS and Galileo constellations. The results of the proposed approach have been analyzed over a one year period. In order to assess the results two different SRP models have been used. Firstly, the proposed box-wing model and secondly, the new CODE empirical model, ECOM2. The orbit performances of both models are assessed using Satellite Laser Ranging (SLR) measurements, together with the evaluation of the orbit prediction accuracy. This comparison shows the advantages and disadvantages of

A computational approach to compare regression modelling strategies in prediction research.

Science.gov (United States)

Pajouheshnia, Romin; Pestman, Wiebe R; Teerenstra, Steven; Groenwold, Rolf H H

2016-08-25

It is often unclear which approach to fit, assess and adjust a model will yield the most accurate prediction model. We present an extension of an approach for comparing modelling strategies in linear regression to the setting of logistic regression and demonstrate its application in clinical prediction research. A framework for comparing logistic regression modelling strategies by their likelihoods was formulated using a wrapper approach. Five different strategies for modelling, including simple shrinkage methods, were compared in four empirical data sets to illustrate the concept of a priori strategy comparison. Simulations were performed in both randomly generated data and empirical data to investigate the influence of data characteristics on strategy performance. We applied the comparison framework in a case study setting. Optimal strategies were selected based on the results of a priori comparisons in a clinical data set and the performance of models built according to each strategy was assessed using the Brier score and calibration plots. The performance of modelling strategies was highly dependent on the characteristics of the development data in both linear and logistic regression settings. A priori comparisons in four empirical data sets found that no strategy consistently outperformed the others. The percentage of times that a model adjustment strategy outperformed a logistic model ranged from 3.9 to 94.9 %, depending on the strategy and data set. However, in our case study setting the a priori selection of optimal methods did not result in detectable improvement in model performance when assessed in an external data set. The performance of prediction modelling strategies is a data-dependent process and can be highly variable between data sets within the same clinical domain. A priori strategy comparison can be used to determine an optimal logistic regression modelling strategy for a given data set before selecting a final modelling approach.

Our Hidden Prejudices, on Trial

Science.gov (United States)

Glenn, David

2008-01-01

In October 2006, a New Hampshire police officer named Michael Briggs was shot to death in an alley. His accused killer, Michael Addison, has been charged with capital murder. It is the state's first death-penalty case in more than 30 years, and it is racially fraught: Addison is African-American, and Briggs was white. New Hampshire has a long list…

Numerical modeling of hydrodynamics and sediment transport—an integrated approach

Science.gov (United States)

Gic-Grusza, Gabriela; Dudkowska, Aleksandra

2017-10-01

Point measurement-based estimation of bedload transport in the coastal zone is very difficult. The only way to assess the magnitude and direction of bedload transport in larger areas, particularly those characterized by complex bottom topography and hydrodynamics, is to use a holistic approach. This requires modeling of waves, currents, and the critical bed shear stress and bedload transport magnitude, with a due consideration to the realistic bathymetry and distribution of surface sediment types. Such a holistic approach is presented in this paper which describes modeling of bedload transport in the Gulf of Gdańsk. Extreme storm conditions defined based on 138-year NOAA data were assumed. The SWAN model (Booij et al. 1999) was used to define wind-wave fields, whereas wave-induced currents were calculated using the Kołodko and Gic-Grusza (2015) model, and the magnitude of bedload transport was estimated using the modified Meyer-Peter and Müller (1948) formula. The calculations were performed using a GIS model. The results obtained are innovative. The approach presented appears to be a valuable source of information on bedload transport in the coastal zone.

A multiscale modeling approach for biomolecular systems

Energy Technology Data Exchange (ETDEWEB)

Bowling, Alan, E-mail: bowling@uta.edu; Haghshenas-Jaryani, Mahdi, E-mail: mahdi.haghshenasjaryani@mavs.uta.edu [The University of Texas at Arlington, Department of Mechanical and Aerospace Engineering (United States)

2015-04-15

This paper presents a new multiscale molecular dynamic model for investigating the effects of external interactions, such as contact and impact, during stepping and docking of motor proteins and other biomolecular systems. The model retains the mass properties ensuring that the result satisfies Newton’s second law. This idea is presented using a simple particle model to facilitate discussion of the rigid body model; however, the particle model does provide insights into particle dynamics at the nanoscale. The resulting three-dimensional model predicts a significant decrease in the effect of the random forces associated with Brownian motion. This conclusion runs contrary to the widely accepted notion that the motor protein’s movements are primarily the result of thermal effects. This work focuses on the mechanical aspects of protein locomotion; the effect ATP hydrolysis is estimated as internal forces acting on the mechanical model. In addition, the proposed model can be numerically integrated in a reasonable amount of time. Herein, the differences between the motion predicted by the old and new modeling approaches are compared using a simplified model of myosin V.

An approach for activity-based DEVS model specification

DEFF Research Database (Denmark)

Alshareef, Abdurrahman; Sarjoughian, Hessam S.; Zarrin, Bahram

2016-01-01

Creation of DEVS models has been advanced through Model Driven Architecture and its frameworks. The overarching role of the frameworks has been to help develop model specifications in a disciplined fashion. Frameworks can provide intermediary layers between the higher level mathematical models...... and their corresponding software specifications from both structural and behavioral aspects. Unlike structural modeling, developing models to specify behavior of systems is known to be harder and more complex, particularly when operations with non-trivial control schemes are required. In this paper, we propose specifying...... activity-based behavior modeling of parallel DEVS atomic models. We consider UML activities and actions as fundamental units of behavior modeling, especially in the presence of recent advances in the UML 2.5 specifications. We describe in detail how to approach activity modeling with a set of elemental...

Multirule Based Diagnostic Approach for the Fog Predictions Using WRF Modelling Tool

Directory of Open Access Journals (Sweden)

Swagata Payra

2014-01-01

Full Text Available The prediction of fog onset remains difficult despite the progress in numerical weather prediction. It is a complex process and requires adequate representation of the local perturbations in weather prediction models. It mainly depends upon microphysical and mesoscale processes that act within the boundary layer. This study utilizes a multirule based diagnostic (MRD approach using postprocessing of the model simulations for fog predictions. The empiricism involved in this approach is mainly to bridge the gap between mesoscale and microscale variables, which are related to mechanism of the fog formation. Fog occurrence is a common phenomenon during winter season over Delhi, India, with the passage of the western disturbances across northwestern part of the country accompanied with significant amount of moisture. This study implements the above cited approach for the prediction of occurrences of fog and its onset time over Delhi. For this purpose, a high resolution weather research and forecasting (WRF model is used for fog simulations. The study involves depiction of model validation and postprocessing of the model simulations for MRD approach and its subsequent application to fog predictions. Through this approach model identified foggy and nonfoggy days successfully 94% of the time. Further, the onset of fog events is well captured within an accuracy of 30–90 minutes. This study demonstrates that the multirule based postprocessing approach is a useful and highly promising tool in improving the fog predictions.

Information as a Measure of Model Skill

Science.gov (United States)

Roulston, M. S.; Smith, L. A.

2002-12-01

Physicist Paul Davies has suggested that rather than the quest for laws that approximate ever more closely to "truth", science should be regarded as the quest for compressibility. The goodness of a model can be judged by the degree to which it allows us to compress data describing the real world. The "logarithmic scoring rule" is a method for evaluating probabilistic predictions of reality that turns this philosophical position into a practical means of model evaluation. This scoring rule measures the information deficit or "ignorance" of someone in possession of the prediction. A more applied viewpoint is that the goodness of a model is determined by its value to a user who must make decisions based upon its predictions. Any form of decision making under uncertainty can be reduced to a gambling scenario. Kelly showed that the value of a probabilistic prediction to a gambler pursuing the maximum return on their bets depends on their "ignorance", as determined from the logarithmic scoring rule, thus demonstrating a one-to-one correspondence between data compression and gambling returns. Thus information theory provides a way to think about model evaluation, that is both philosophically satisfying and practically oriented. P.C.W. Davies, in "Complexity, Entropy and the Physics of Information", Proceedings of the Santa Fe Institute, Addison-Wesley 1990 J. Kelly, Bell Sys. Tech. Journal, 35, 916-926, 1956.

A Composite Modelling Approach to Decision Support by the Use of the CBA-DK Model

DEFF Research Database (Denmark)

Barfod, Michael Bruhn; Salling, Kim Bang; Leleur, Steen

2007-01-01

This paper presents a decision support system for assessment of transport infrastructure projects. The composite modelling approach, COSIMA, combines a cost-benefit analysis by use of the CBA-DK model with multi-criteria analysis applying the AHP and SMARTER techniques. The modelling uncertaintie...

A Bayesian approach for parameter estimation and prediction using a computationally intensive model

International Nuclear Information System (INIS)

Higdon, Dave; McDonnell, Jordan D; Schunck, Nicolas; Sarich, Jason; Wild, Stefan M

2015-01-01

Bayesian methods have been successful in quantifying uncertainty in physics-based problems in parameter estimation and prediction. In these cases, physical measurements y are modeled as the best fit of a physics-based model η(θ), where θ denotes the uncertain, best input setting. Hence the statistical model is of the form y=η(θ)+ϵ, where ϵ accounts for measurement, and possibly other, error sources. When nonlinearity is present in η(⋅), the resulting posterior distribution for the unknown parameters in the Bayesian formulation is typically complex and nonstandard, requiring computationally demanding computational approaches such as Markov chain Monte Carlo (MCMC) to produce multivariate draws from the posterior. Although generally applicable, MCMC requires thousands (or even millions) of evaluations of the physics model η(⋅). This requirement is problematic if the model takes hours or days to evaluate. To overcome this computational bottleneck, we present an approach adapted from Bayesian model calibration. This approach combines output from an ensemble of computational model runs with physical measurements, within a statistical formulation, to carry out inference. A key component of this approach is a statistical response surface, or emulator, estimated from the ensemble of model runs. We demonstrate this approach with a case study in estimating parameters for a density functional theory model, using experimental mass/binding energy measurements from a collection of atomic nuclei. We also demonstrate how this approach produces uncertainties in predictions for recent mass measurements obtained at Argonne National Laboratory. (paper)

A Bayesian Approach to Model Selection in Hierarchical Mixtures-of-Experts Architectures.

Science.gov (United States)

Tanner, Martin A.; Peng, Fengchun; Jacobs, Robert A.

1997-03-01

There does not exist a statistical model that shows good performance on all tasks. Consequently, the model selection problem is unavoidable; investigators must decide which model is best at summarizing the data for each task of interest. This article presents an approach to the model selection problem in hierarchical mixtures-of-experts architectures. These architectures combine aspects of generalized linear models with those of finite mixture models in order to perform tasks via a recursive "divide-and-conquer" strategy. Markov chain Monte Carlo methodology is used to estimate the distribution of the architectures' parameters. One part of our approach to model selection attempts to estimate the worth of each component of an architecture so that relatively unused components can be pruned from the architecture's structure. A second part of this approach uses a Bayesian hypothesis testing procedure in order to differentiate inputs that carry useful information from nuisance inputs. Simulation results suggest that the approach presented here adheres to the dictum of Occam's razor; simple architectures that are adequate for summarizing the data are favored over more complex structures. Copyright 1997 Elsevier Science Ltd. All Rights Reserved.

A survey on computational intelligence approaches for predictive modeling in prostate cancer

OpenAIRE

Cosma, G; Brown, D; Archer, M; Khan, M; Pockley, AG

2017-01-01

Predictive modeling in medicine involves the development of computational models which are capable of analysing large amounts of data in order to predict healthcare outcomes for individual patients. Computational intelligence approaches are suitable when the data to be modelled are too complex forconventional statistical techniques to process quickly and eciently. These advanced approaches are based on mathematical models that have been especially developed for dealing with the uncertainty an...

A modelling approach for improved implementation of information technology in manufacturing systems

DEFF Research Database (Denmark)

Larsen, Michael Holm; Langer, Gilad; Kirkby, Lars Phillip

2000-01-01

concept into practice. The paper demonstrates the use of the approach in a practical case, which involves modelling of the shop floor activities and control system at the aluminium parts production at a Danish manufacturer of state-of-the-art audio-video equipment and telephones.......The paper presents a modelling approach, which is based on the multiple view perspective of Soft Systems Methodology and an encapsulation of these perspectives into an object orientated model. The approach provides a structured procedure for putting theoretical abstractions of a new production...

Evaluation of various modelling approaches in flood routing simulation and flood area mapping

Science.gov (United States)

Papaioannou, George; Loukas, Athanasios; Vasiliades, Lampros; Aronica, Giuseppe

2016-04-01

An essential process of flood hazard analysis and mapping is the floodplain modelling. The selection of the modelling approach, especially, in complex riverine topographies such as urban and suburban areas, and ungauged watersheds may affect the accuracy of the outcomes in terms of flood depths and flood inundation area. In this study, a sensitivity analysis implemented using several hydraulic-hydrodynamic modelling approaches (1D, 2D, 1D/2D) and the effect of modelling approach on flood modelling and flood mapping was investigated. The digital terrain model (DTMs) used in this study was generated from Terrestrial Laser Scanning (TLS) point cloud data. The modelling approaches included 1-dimensional hydraulic-hydrodynamic models (1D), 2-dimensional hydraulic-hydrodynamic models (2D) and the coupled 1D/2D. The 1D hydraulic-hydrodynamic models used were: HECRAS, MIKE11, LISFLOOD, XPSTORM. The 2D hydraulic-hydrodynamic models used were: MIKE21, MIKE21FM, HECRAS (2D), XPSTORM, LISFLOOD and FLO2d. The coupled 1D/2D models employed were: HECRAS(1D/2D), MIKE11/MIKE21(MIKE FLOOD platform), MIKE11/MIKE21 FM(MIKE FLOOD platform), XPSTORM(1D/2D). The validation process of flood extent achieved with the use of 2x2 contingency tables between simulated and observed flooded area for an extreme historical flash flood event. The skill score Critical Success Index was used in the validation process. The modelling approaches have also been evaluated for simulation time and requested computing power. The methodology has been implemented in a suburban ungauged watershed of Xerias river at Volos-Greece. The results of the analysis indicate the necessity of sensitivity analysis application with the use of different hydraulic-hydrodynamic modelling approaches especially for areas with complex terrain.

Experimental Validation of Various Temperature Modells for Semi-Physical Tyre Model Approaches

Science.gov (United States)

Hackl, Andreas; Scherndl, Christoph; Hirschberg, Wolfgang; Lex, Cornelia

2017-10-01

With increasing level of complexity and automation in the area of automotive engineering, the simulation of safety relevant Advanced Driver Assistance Systems (ADAS) leads to increasing accuracy demands in the description of tyre contact forces. In recent years, with improvement in tyre simulation, the needs for coping with tyre temperatures and the resulting changes in tyre characteristics are rising significantly. Therefore, experimental validation of three different temperature model approaches is carried out, discussed and compared in the scope of this article. To investigate or rather evaluate the range of application of the presented approaches in combination with respect of further implementation in semi-physical tyre models, the main focus lies on the a physical parameterisation. Aside from good modelling accuracy, focus is held on computational time and complexity of the parameterisation process. To evaluate this process and discuss the results, measurements from a Hoosier racing tyre 6.0 / 18.0 10 LCO C2000 from an industrial flat test bench are used. Finally the simulation results are compared with the measurement data.

Setting conservation management thresholds using a novel participatory modeling approach.

Science.gov (United States)

Addison, P F E; de Bie, K; Rumpff, L

2015-10-01

We devised a participatory modeling approach for setting management thresholds that show when management intervention is required to address undesirable ecosystem changes. This approach was designed to be used when management thresholds: must be set for environmental indicators in the face of multiple competing objectives; need to incorporate scientific understanding and value judgments; and will be set by participants with limited modeling experience. We applied our approach to a case study where management thresholds were set for a mat-forming brown alga, Hormosira banksii, in a protected area management context. Participants, including management staff and scientists, were involved in a workshop to test the approach, and set management thresholds to address the threat of trampling by visitors to an intertidal rocky reef. The approach involved trading off the environmental objective, to maintain the condition of intertidal reef communities, with social and economic objectives to ensure management intervention was cost-effective. Ecological scenarios, developed using scenario planning, were a key feature that provided the foundation for where to set management thresholds. The scenarios developed represented declines in percent cover of H. banksii that may occur under increased threatening processes. Participants defined 4 discrete management alternatives to address the threat of trampling and estimated the effect of these alternatives on the objectives under each ecological scenario. A weighted additive model was used to aggregate participants' consequence estimates. Model outputs (decision scores) clearly expressed uncertainty, which can be considered by decision makers and used to inform where to set management thresholds. This approach encourages a proactive form of conservation, where management thresholds and associated actions are defined a priori for ecological indicators, rather than reacting to unexpected ecosystem changes in the future. © 2015 The

A generalized approach for historical mock-up acquisition and data modelling: Towards historically enriched 3D city models

Science.gov (United States)

Hervy, B.; Billen, R.; Laroche, F.; Carré, C.; Servières, M.; Van Ruymbeke, M.; Tourre, V.; Delfosse, V.; Kerouanton, J.-L.

2012-10-01

Museums are filled with hidden secrets. One of those secrets lies behind historical mock-ups whose signification goes far behind a simple representation of a city. We face the challenge of designing, storing and showing knowledge related to these mock-ups in order to explain their historical value. Over the last few years, several mock-up digitalisation projects have been realised. Two of them, Nantes 1900 and Virtual Leodium, propose innovative approaches that present a lot of similarities. This paper presents a framework to go one step further by analysing their data modelling processes and extracting what could be a generalized approach to build a numerical mock-up and the knowledge database associated. Geometry modelling and knowledge modelling influence each other and are conducted in a parallel process. Our generalized approach describes a global overview of what can be a data modelling process. Our next goal is obviously to apply this global approach on other historical mock-up, but we also think about applying it to other 3D objects that need to embed semantic data, and approaching historically enriched 3D city models.

A review of function modeling: Approaches and applications

OpenAIRE

Erden, M.S.; Komoto, H.; Van Beek, T.J.; D'Amelio, V.; Echavarria, E.; Tomiyama, T.

2008-01-01

This work is aimed at establishing a common frame and understanding of function modeling (FM) for our ongoing research activities. A comparative review of the literature is performed to grasp the various FM approaches with their commonalities and differences. The relations of FM with the research fields of artificial intelligence, design theory, and maintenance are discussed. In this discussion the goals are to highlight the features of various classical approaches in relation to FM, to delin...

Positive autoantibodies to ZnT8 indicate elevated risk for additional autoimmune conditions in patients with Addison's disease.

Science.gov (United States)

Fichna, Marta; Rogowicz-Frontczak, Anita; Żurawek, Magdalena; Fichna, Piotr; Gryczyńska, Maria; Zozulińska-Ziółkiewicz, Dorota; Ruchała, Marek

2016-07-01

Autoimmune Addison's disease (AAD) associates with exceptional susceptibility to develop other autoimmune conditions, including type 1 diabetes (T1D), marked by positive serum autoantibodies to insulin (IAA), glutamic acid decarboxylase (GADA) and insulinoma-associated protein 2 (IA-2A). Zinc transporter 8 (ZnT8) is a new T1D autoantigen, encoded by the SLC30A8 gene. Its polymorphic variant rs13266634C/T seems associated with the occurrence of serum ZnT8 antibodies (ZnT8A). This study was designed to determine the prevalence of serum ZnT8A and their clinical implication in 140 AAD patients. Other beta cell and thyroid-specific autoantibodies were also investigated, and ZnT8A results were confronted with the rs13266634 genotype. ZnT8A were detectable in 8.5 %, GADA in 20.7 %, IA-2A in 5.7 %, IAA in 1.6 % and various anti-thyroid antibodies in 7.1-67.8 % individuals. Type 1 diabetes was found in 10 % AAD patients. ZnT8A were positive in 57.1 % of T1D patients and 3.4 % non-diabetic AAD. Analysis of ZnT8A enabled to identify autoimmunity in two (14.3 %) T1D individuals previously classified as autoantibody-negative. ZnT8A-positive patients revealed significantly higher number of autoimmune conditions (p < 0.001), increased prevalence of T1D (p < 0.001) and other beta cell-specific autoantibodies. Carriers of the rs13266634 T-allele displayed increased frequency (p = 0.006) and higher titres of ZnT8A (p = 0.002). Our study demonstrates high incidence of ZnT8A in AAD patients. ZnT8A are associated with coexisting T1D and predictive of T1D in non-diabetic subjects. Moreover, positive ZnT8A in AAD indicate elevated risk for additional autoimmune conditions. Autoantibodies to beta cell antigens, comprising ZnT8, could be included in routine screening panels in AAD.

Extracting business vocabularies from business process models: SBVR and BPMN standards-based approach

Science.gov (United States)

Skersys, Tomas; Butleris, Rimantas; Kapocius, Kestutis

2013-10-01

Approaches for the analysis and specification of business vocabularies and rules are very relevant topics in both Business Process Management and Information Systems Development disciplines. However, in common practice of Information Systems Development, the Business modeling activities still are of mostly empiric nature. In this paper, basic aspects of the approach for business vocabularies' semi-automated extraction from business process models are presented. The approach is based on novel business modeling-level OMG standards "Business Process Model and Notation" (BPMN) and "Semantics for Business Vocabularies and Business Rules" (SBVR), thus contributing to OMG's vision about Model-Driven Architecture (MDA) and to model-driven development in general.

A distributed delay approach for modeling delayed outcomes in pharmacokinetics and pharmacodynamics studies.

Science.gov (United States)

Hu, Shuhua; Dunlavey, Michael; Guzy, Serge; Teuscher, Nathan

2018-04-01

A distributed delay approach was proposed in this paper to model delayed outcomes in pharmacokinetics and pharmacodynamics studies. This approach was shown to be general enough to incorporate a wide array of pharmacokinetic and pharmacodynamic models as special cases including transit compartment models, effect compartment models, typical absorption models (either zero-order or first-order absorption), and a number of atypical (or irregular) absorption models (e.g., parallel first-order, mixed first-order and zero-order, inverse Gaussian, and Weibull absorption models). Real-life examples were given to demonstrate how to implement distributed delays in Phoenix ® NLME™ 8.0, and to numerically show the advantages of the distributed delay approach over the traditional methods.

A novel approach for modelling complex maintenance systems using discrete event simulation

International Nuclear Information System (INIS)

Alrabghi, Abdullah; Tiwari, Ashutosh

2016-01-01

Existing approaches for modelling maintenance rely on oversimplified assumptions which prevent them from reflecting the complexity found in industrial systems. In this paper, we propose a novel approach that enables the modelling of non-identical multi-unit systems without restrictive assumptions on the number of units or their maintenance characteristics. Modelling complex interactions between maintenance strategies and their effects on assets in the system is achieved by accessing event queues in Discrete Event Simulation (DES). The approach utilises the wide success DES has achieved in manufacturing by allowing integration with models that are closely related to maintenance such as production and spare parts systems. Additional advantages of using DES include rapid modelling and visual interactive simulation. The proposed approach is demonstrated in a simulation based optimisation study of a published case. The current research is one of the first to optimise maintenance strategies simultaneously with their parameters while considering production dynamics and spare parts management. The findings of this research provide insights for non-conflicting objectives in maintenance systems. In addition, the proposed approach can be used to facilitate the simulation and optimisation of industrial maintenance systems. - Highlights: • This research is one of the first to optimise maintenance strategies simultaneously. • New insights for non-conflicting objectives in maintenance systems. • The approach can be used to optimise industrial maintenance systems.

A variational approach to chiral quark models

International Nuclear Information System (INIS)

Futami, Yasuhiko; Odajima, Yasuhiko; Suzuki, Akira.

1987-01-01

A variational approach is applied to a chiral quark model to test the validity of the perturbative treatment of the pion-quark interaction based on the chiral symmetry principle. It is indispensably related to the chiral symmetry breaking radius if the pion-quark interaction can be regarded as a perturbation. (author)

Time series modeling by a regression approach based on a latent process.

Science.gov (United States)

Chamroukhi, Faicel; Samé, Allou; Govaert, Gérard; Aknin, Patrice

2009-01-01

Time series are used in many domains including finance, engineering, economics and bioinformatics generally to represent the change of a measurement over time. Modeling techniques may then be used to give a synthetic representation of such data. A new approach for time series modeling is proposed in this paper. It consists of a regression model incorporating a discrete hidden logistic process allowing for activating smoothly or abruptly different polynomial regression models. The model parameters are estimated by the maximum likelihood method performed by a dedicated Expectation Maximization (EM) algorithm. The M step of the EM algorithm uses a multi-class Iterative Reweighted Least-Squares (IRLS) algorithm to estimate the hidden process parameters. To evaluate the proposed approach, an experimental study on simulated data and real world data was performed using two alternative approaches: a heteroskedastic piecewise regression model using a global optimization algorithm based on dynamic programming, and a Hidden Markov Regression Model whose parameters are estimated by the Baum-Welch algorithm. Finally, in the context of the remote monitoring of components of the French railway infrastructure, and more particularly the switch mechanism, the proposed approach has been applied to modeling and classifying time series representing the condition measurements acquired during switch operations.

A qualitative evaluation approach for energy system modelling frameworks

DEFF Research Database (Denmark)

Wiese, Frauke; Hilpert, Simon; Kaldemeyer, Cord

2018-01-01

properties define how useful it is in regard to the existing challenges. For energy system models, evaluation methods exist, but we argue that many decisions upon properties are rather made on the model generator or framework level. Thus, this paper presents a qualitative approach to evaluate frameworks...

Systems and context modeling approach to requirements analysis

Science.gov (United States)

Ahuja, Amrit; Muralikrishna, G.; Patwari, Puneet; Subhrojyoti, C.; Swaminathan, N.; Vin, Harrick

2014-08-01

Ensuring completeness and correctness of the requirements for a complex system such as the SKA is challenging. Current system engineering practice includes developing a stakeholder needs definition, a concept of operations, and defining system requirements in terms of use cases and requirements statements. We present a method that enhances this current practice into a collection of system models with mutual consistency relationships. These include stakeholder goals, needs definition and system-of-interest models, together with a context model that participates in the consistency relationships among these models. We illustrate this approach by using it to analyze the SKA system requirements.

A global sensitivity analysis approach for morphogenesis models

KAUST Repository

Boas, Sonja E. M.

2015-11-21

Background Morphogenesis is a developmental process in which cells organize into shapes and patterns. Complex, non-linear and multi-factorial models with images as output are commonly used to study morphogenesis. It is difficult to understand the relation between the uncertainty in the input and the output of such ‘black-box’ models, giving rise to the need for sensitivity analysis tools. In this paper, we introduce a workflow for a global sensitivity analysis approach to study the impact of single parameters and the interactions between them on the output of morphogenesis models. Results To demonstrate the workflow, we used a published, well-studied model of vascular morphogenesis. The parameters of this cellular Potts model (CPM) represent cell properties and behaviors that drive the mechanisms of angiogenic sprouting. The global sensitivity analysis correctly identified the dominant parameters in the model, consistent with previous studies. Additionally, the analysis provided information on the relative impact of single parameters and of interactions between them. This is very relevant because interactions of parameters impede the experimental verification of the predicted effect of single parameters. The parameter interactions, although of low impact, provided also new insights in the mechanisms of in silico sprouting. Finally, the analysis indicated that the model could be reduced by one parameter. Conclusions We propose global sensitivity analysis as an alternative approach to study the mechanisms of morphogenesis. Comparison of the ranking of the impact of the model parameters to knowledge derived from experimental data and from manipulation experiments can help to falsify models and to find the operand mechanisms in morphogenesis. The workflow is applicable to all ‘black-box’ models, including high-throughput in vitro models in which output measures are affected by a set of experimental perturbations.

A global sensitivity analysis approach for morphogenesis models.

Science.gov (United States)

Boas, Sonja E M; Navarro Jimenez, Maria I; Merks, Roeland M H; Blom, Joke G

2015-11-21

Morphogenesis is a developmental process in which cells organize into shapes and patterns. Complex, non-linear and multi-factorial models with images as output are commonly used to study morphogenesis. It is difficult to understand the relation between the uncertainty in the input and the output of such 'black-box' models, giving rise to the need for sensitivity analysis tools. In this paper, we introduce a workflow for a global sensitivity analysis approach to study the impact of single parameters and the interactions between them on the output of morphogenesis models. To demonstrate the workflow, we used a published, well-studied model of vascular morphogenesis. The parameters of this cellular Potts model (CPM) represent cell properties and behaviors that drive the mechanisms of angiogenic sprouting. The global sensitivity analysis correctly identified the dominant parameters in the model, consistent with previous studies. Additionally, the analysis provided information on the relative impact of single parameters and of interactions between them. This is very relevant because interactions of parameters impede the experimental verification of the predicted effect of single parameters. The parameter interactions, although of low impact, provided also new insights in the mechanisms of in silico sprouting. Finally, the analysis indicated that the model could be reduced by one parameter. We propose global sensitivity analysis as an alternative approach to study the mechanisms of morphogenesis. Comparison of the ranking of the impact of the model parameters to knowledge derived from experimental data and from manipulation experiments can help to falsify models and to find the operand mechanisms in morphogenesis. The workflow is applicable to all 'black-box' models, including high-throughput in vitro models in which output measures are affected by a set of experimental perturbations.

Vector-model-supported approach in prostate plan optimization

International Nuclear Information System (INIS)

Liu, Eva Sau Fan; Wu, Vincent Wing Cheung; Harris, Benjamin; Lehman, Margot; Pryor, David; Chan, Lawrence Wing Chi

2017-01-01

Lengthy time consumed in traditional manual plan optimization can limit the use of step-and-shoot intensity-modulated radiotherapy/volumetric-modulated radiotherapy (S&S IMRT/VMAT). A vector model base, retrieving similar radiotherapy cases, was developed with respect to the structural and physiologic features extracted from the Digital Imaging and Communications in Medicine (DICOM) files. Planning parameters were retrieved from the selected similar reference case and applied to the test case to bypass the gradual adjustment of planning parameters. Therefore, the planning time spent on the traditional trial-and-error manual optimization approach in the beginning of optimization could be reduced. Each S&S IMRT/VMAT prostate reference database comprised 100 previously treated cases. Prostate cases were replanned with both traditional optimization and vector-model-supported optimization based on the oncologists' clinical dose prescriptions. A total of 360 plans, which consisted of 30 cases of S&S IMRT, 30 cases of 1-arc VMAT, and 30 cases of 2-arc VMAT plans including first optimization and final optimization with/without vector-model-supported optimization, were compared using the 2-sided t-test and paired Wilcoxon signed rank test, with a significance level of 0.05 and a false discovery rate of less than 0.05. For S&S IMRT, 1-arc VMAT, and 2-arc VMAT prostate plans, there was a significant reduction in the planning time and iteration with vector-model-supported optimization by almost 50%. When the first optimization plans were compared, 2-arc VMAT prostate plans had better plan quality than 1-arc VMAT plans. The volume receiving 35 Gy in the femoral head for 2-arc VMAT plans was reduced with the vector-model-supported optimization compared with the traditional manual optimization approach. Otherwise, the quality of plans from both approaches was comparable. Vector-model-supported optimization was shown to offer much shortened planning time and iteration

Vector-model-supported approach in prostate plan optimization

Energy Technology Data Exchange (ETDEWEB)

Liu, Eva Sau Fan [Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane (Australia); Department of Health Technology and Informatics, The Hong Kong Polytechnic University (Hong Kong); Wu, Vincent Wing Cheung [Department of Health Technology and Informatics, The Hong Kong Polytechnic University (Hong Kong); Harris, Benjamin [Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane (Australia); Lehman, Margot; Pryor, David [Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane (Australia); School of Medicine, University of Queensland (Australia); Chan, Lawrence Wing Chi, E-mail: wing.chi.chan@polyu.edu.hk [Department of Health Technology and Informatics, The Hong Kong Polytechnic University (Hong Kong)

2017-07-01

Lengthy time consumed in traditional manual plan optimization can limit the use of step-and-shoot intensity-modulated radiotherapy/volumetric-modulated radiotherapy (S&S IMRT/VMAT). A vector model base, retrieving similar radiotherapy cases, was developed with respect to the structural and physiologic features extracted from the Digital Imaging and Communications in Medicine (DICOM) files. Planning parameters were retrieved from the selected similar reference case and applied to the test case to bypass the gradual adjustment of planning parameters. Therefore, the planning time spent on the traditional trial-and-error manual optimization approach in the beginning of optimization could be reduced. Each S&S IMRT/VMAT prostate reference database comprised 100 previously treated cases. Prostate cases were replanned with both traditional optimization and vector-model-supported optimization based on the oncologists' clinical dose prescriptions. A total of 360 plans, which consisted of 30 cases of S&S IMRT, 30 cases of 1-arc VMAT, and 30 cases of 2-arc VMAT plans including first optimization and final optimization with/without vector-model-supported optimization, were compared using the 2-sided t-test and paired Wilcoxon signed rank test, with a significance level of 0.05 and a false discovery rate of less than 0.05. For S&S IMRT, 1-arc VMAT, and 2-arc VMAT prostate plans, there was a significant reduction in the planning time and iteration with vector-model-supported optimization by almost 50%. When the first optimization plans were compared, 2-arc VMAT prostate plans had better plan quality than 1-arc VMAT plans. The volume receiving 35 Gy in the femoral head for 2-arc VMAT plans was reduced with the vector-model-supported optimization compared with the traditional manual optimization approach. Otherwise, the quality of plans from both approaches was comparable. Vector-model-supported optimization was shown to offer much shortened planning time and iteration

Model selection and inference a practical information-theoretic approach

CERN Document Server

Burnham, Kenneth P

1998-01-01

This book is unique in that it covers the philosophy of model-based data analysis and an omnibus strategy for the analysis of empirical data The book introduces information theoretic approaches and focuses critical attention on a priori modeling and the selection of a good approximating model that best represents the inference supported by the data Kullback-Leibler information represents a fundamental quantity in science and is Hirotugu Akaike's basis for model selection The maximized log-likelihood function can be bias-corrected to provide an estimate of expected, relative Kullback-Leibler information This leads to Akaike's Information Criterion (AIC) and various extensions and these are relatively simple and easy to use in practice, but little taught in statistics classes and far less understood in the applied sciences than should be the case The information theoretic approaches provide a unified and rigorous theory, an extension of likelihood theory, an important application of information theory, and are ...

An integrated approach to permeability modeling using micro-models

Energy Technology Data Exchange (ETDEWEB)

Hosseini, A.H.; Leuangthong, O.; Deutsch, C.V. [Society of Petroleum Engineers, Canadian Section, Calgary, AB (Canada)]|[Alberta Univ., Edmonton, AB (Canada)

2008-10-15

An important factor in predicting the performance of steam assisted gravity drainage (SAGD) well pairs is the spatial distribution of permeability. Complications that make the inference of a reliable porosity-permeability relationship impossible include the presence of short-scale variability in sand/shale sequences; preferential sampling of core data; and uncertainty in upscaling parameters. Micro-modelling is a simple and effective method for overcoming these complications. This paper proposed a micro-modeling approach to account for sampling bias, small laminated features with high permeability contrast, and uncertainty in upscaling parameters. The paper described the steps and challenges of micro-modeling and discussed the construction of binary mixture geo-blocks; flow simulation and upscaling; extended power law formalism (EPLF); and the application of micro-modeling and EPLF. An extended power-law formalism to account for changes in clean sand permeability as a function of macroscopic shale content was also proposed and tested against flow simulation results. There was close agreement between the model and simulation results. The proposed methodology was also applied to build the porosity-permeability relationship for laminated and brecciated facies of McMurray oil sands. Experimental data was in good agreement with the experimental data. 8 refs., 17 figs.

Addison's disease. Challenges in treatment and follow up

NARCIS (Netherlands)

Smans, L.C.C.J.

2015-01-01

In the first part of this thesis we discuss a concise stepwise approach for the diagnostic evaluation of adrenal insufficiency (AI), taking into account the possible pitfalls associated with the different tests. The second part describes the history of replacement therapy, discusses the current

Bridging process-based and empirical approaches to modeling tree growth

Science.gov (United States)

Harry T. Valentine; Annikki Makela; Annikki Makela

2005-01-01

The gulf between process-based and empirical approaches to modeling tree growth may be bridged, in part, by the use of a common model. To this end, we have formulated a process-based model of tree growth that can be fitted and applied in an empirical mode. The growth model is grounded in pipe model theory and an optimal control model of crown development. Together, the...

Policy harmonized approach for the EU agricultural sector modelling

Directory of Open Access Journals (Sweden)

G. SALPUTRA

2008-12-01

Full Text Available Policy harmonized (PH approach allows for the quantitative assessment of the impact of various elements of EU CAP direct support schemes, where the production effects of direct payments are accounted through reaction prices formed by producer price and policy price add-ons. Using the AGMEMOD model the impacts of two possible EU agricultural policy scenarios upon beef production have been analysed – full decoupling with a switch from historical to regional Single Payment scheme or alternatively with re-distribution of country direct payment envelopes via introduction of EU-wide flat area payment. The PH approach, by systematizing and harmonizing the management and use of policy data, ensures that projected differential policy impacts arising from changes in common EU policies reflect the likely actual differential impact as opposed to differences in how “common” policies are implemented within analytical models. In the second section of the paper the AGMEMOD model’s structure is explained. The policy harmonized evaluation method is presented in the third section. Results from an application of the PH approach are presented and discussed in the paper’s penultimate section, while section 5 concludes.;

Initial assessment of a multi-model approach to spring flood forecasting in Sweden

Science.gov (United States)

Olsson, J.; Uvo, C. B.; Foster, K.; Yang, W.

2015-06-01

Hydropower is a major energy source in Sweden and proper reservoir management prior to the spring flood onset is crucial for optimal production. This requires useful forecasts of the accumulated discharge in the spring flood period (i.e. the spring-flood volume, SFV). Today's SFV forecasts are generated using a model-based climatological ensemble approach, where time series of precipitation and temperature from historical years are used to force a calibrated and initialised set-up of the HBV model. In this study, a number of new approaches to spring flood forecasting, that reflect the latest developments with respect to analysis and modelling on seasonal time scales, are presented and evaluated. Three main approaches, represented by specific methods, are evaluated in SFV hindcasts for three main Swedish rivers over a 10-year period with lead times between 0 and 4 months. In the first approach, historically analogue years with respect to the climate in the period preceding the spring flood are identified and used to compose a reduced ensemble. In the second, seasonal meteorological ensemble forecasts are used to drive the HBV model over the spring flood period. In the third approach, statistical relationships between SFV and the large-sale atmospheric circulation are used to build forecast models. None of the new approaches consistently outperform the climatological ensemble approach, but for specific locations and lead times improvements of 20-30 % are found. When combining all forecasts in a weighted multi-model approach, a mean improvement over all locations and lead times of nearly 10 % was indicated. This demonstrates the potential of the approach and further development and optimisation into an operational system is ongoing.

Model-independent approach for dark matter phenomenology

Indian Academy of Sciences (India)

We have studied the phenomenology of dark matter at the ILC and cosmic positron experiments based on model-independent approach. We have found a strong correlation between dark matter signatures at the ILC and those in the indirect detection experiments of dark matter. Once the dark matter is discovered in the ...

Model-independent approach for dark matter phenomenology ...

Indian Academy of Sciences (India)

Abstract. We have studied the phenomenology of dark matter at the ILC and cosmic positron experiments based on model-independent approach. We have found a strong correlation between dark matter signatures at the ILC and those in the indirect detec- tion experiments of dark matter. Once the dark matter is discovered ...

A new modelling approach for zooplankton behaviour

Science.gov (United States)

Keiyu, A. Y.; Yamazaki, H.; Strickler, J. R.

We have developed a new simulation technique to model zooplankton behaviour. The approach utilizes neither the conventional artificial intelligence nor neural network methods. We have designed an adaptive behaviour network, which is similar to BEER [(1990) Intelligence as an adaptive behaviour: an experiment in computational neuroethology, Academic Press], based on observational studies of zooplankton behaviour. The proposed method is compared with non- "intelligent" models—random walk and correlated walk models—as well as observed behaviour in a laboratory tank. Although the network is simple, the model exhibits rich behavioural patterns similar to live copepods.

HEDR modeling approach: Revision 1

International Nuclear Information System (INIS)

Shipler, D.B.; Napier, B.A.

1994-05-01

This report is a revision of the previous Hanford Environmental Dose Reconstruction (HEDR) Project modeling approach report. This revised report describes the methods used in performing scoping studies and estimating final radiation doses to real and representative individuals who lived in the vicinity of the Hanford Site. The scoping studies and dose estimates pertain to various environmental pathways during various periods of time. The original report discussed the concepts under consideration in 1991. The methods for estimating dose have been refined as understanding of existing data, the scope of pathways, and the magnitudes of dose estimates were evaluated through scoping studies

Crime Modeling using Spatial Regression Approach

Science.gov (United States)

Saleh Ahmar, Ansari; Adiatma; Kasim Aidid, M.

2018-01-01

Act of criminality in Indonesia increased both variety and quantity every year. As murder, rape, assault, vandalism, theft, fraud, fencing, and other cases that make people feel unsafe. Risk of society exposed to crime is the number of reported cases in the police institution. The higher of the number of reporter to the police institution then the number of crime in the region is increasing. In this research, modeling criminality in South Sulawesi, Indonesia with the dependent variable used is the society exposed to the risk of crime. Modelling done by area approach is the using Spatial Autoregressive (SAR) and Spatial Error Model (SEM) methods. The independent variable used is the population density, the number of poor population, GDP per capita, unemployment and the human development index (HDI). Based on the analysis using spatial regression can be shown that there are no dependencies spatial both lag or errors in South Sulawesi.

Development of flexible process-centric web applications: An integrated model driven approach

NARCIS (Netherlands)

Bernardi, M.L.; Cimitile, M.; Di Lucca, G.A.; Maggi, F.M.

2012-01-01

In recent years, Model Driven Engineering (MDE) approaches have been proposed and used to develop and evolve WAs. However, the definition of appropriate MDE approaches for the development of flexible process-centric WAs is still limited. In particular, (flexible) workflow models have never been

A Modelling Approach for Improved Implementation of Information Technology in Manufacturing Systems

DEFF Research Database (Denmark)

Langer, Gilad; Larsen, Michael Holm; Kirkby, Lars Phillip

1997-01-01

The paper presents a modelling approach which is based on the multiple view perspective of Soft Systems Methodology and an encapsulation of these perspectives into an object orientated model. The approach provide a structured procedure for putting theoretical abstractions of a new production conc...

Mechatronics by bond graphs an object-oriented approach to modelling and simulation

CERN Document Server

Damić, Vjekoslav

2015-01-01

This book presents a computer-aided approach to the design of mechatronic systems. Its subject is an integrated modeling and simulation in a visual computer environment. Since the first edition, the simulation software changed enormously, became more user-friendly and easier to use. Therefore, a second edition became necessary taking these improvements into account. The modeling is based on system top-down and bottom-up approach. The mathematical models are generated in a form of differential-algebraic equations and solved using numerical and symbolic algebra methods. The integrated approach developed is applied to mechanical, electrical and control systems, multibody dynamics, and continuous systems. .

Modeling flow in fractured medium. Uncertainty analysis with stochastic continuum approach

International Nuclear Information System (INIS)

Niemi, A.

1994-01-01

For modeling groundwater flow in formation-scale fractured media, no general method exists for scaling the highly heterogeneous hydraulic conductivity data to model parameters. The deterministic approach is limited in representing the heterogeneity of a medium and the application of fracture network models has both conceptual and practical limitations as far as site-scale studies are concerned. The study investigates the applicability of stochastic continuum modeling at the scale of data support. No scaling of the field data is involved, and the original variability is preserved throughout the modeling. Contributions of various aspects to the total uncertainty in the modeling prediction can also be determined with this approach. Data from five crystalline rock sites in Finland are analyzed. (107 refs., 63 figs., 7 tabs.)

A Simple Approach to Account for Climate Model Interdependence in Multi-Model Ensembles

Science.gov (United States)

Herger, N.; Abramowitz, G.; Angelil, O. M.; Knutti, R.; Sanderson, B.

2016-12-01

Multi-model ensembles are an indispensable tool for future climate projection and its uncertainty quantification. Ensembles containing multiple climate models generally have increased skill, consistency and reliability. Due to the lack of agreed-on alternatives, most scientists use the equally-weighted multi-model mean as they subscribe to model democracy ("one model, one vote").Different research groups are known to share sections of code, parameterizations in their model, literature, or even whole model components. Therefore, individual model runs do not represent truly independent estimates. Ignoring this dependence structure might lead to a false model consensus, wrong estimation of uncertainty and effective number of independent models.Here, we present a way to partially address this problem by selecting a subset of CMIP5 model runs so that its climatological mean minimizes the RMSE compared to a given observation product. Due to the cancelling out of errors, regional biases in the ensemble mean are reduced significantly.Using a model-as-truth experiment we demonstrate that those regional biases persist into the future and we are not fitting noise, thus providing improved observationally-constrained projections of the 21st century. The optimally selected ensemble shows significantly higher global mean surface temperature projections than the original ensemble, where all the model runs are considered. Moreover, the spread is decreased well beyond that expected from the decreased ensemble size.Several previous studies have recommended an ensemble selection approach based on performance ranking of the model runs. Here, we show that this approach can perform even worse than randomly selecting ensemble members and can thus be harmful. We suggest that accounting for interdependence in the ensemble selection process is a necessary step for robust projections for use in impact assessments, adaptation and mitigation of climate change.

A fuzzy-logic-based approach to qualitative safety modelling for marine systems

International Nuclear Information System (INIS)

Sii, H.S.; Ruxton, Tom; Wang Jin

2001-01-01

Safety assessment based on conventional tools (e.g. probability risk assessment (PRA)) may not be well suited for dealing with systems having a high level of uncertainty, particularly in the feasibility and concept design stages of a maritime or offshore system. By contrast, a safety model using fuzzy logic approach employing fuzzy IF-THEN rules can model the qualitative aspects of human knowledge and reasoning processes without employing precise quantitative analyses. A fuzzy-logic-based approach may be more appropriately used to carry out risk analysis in the initial design stages. This provides a tool for working directly with the linguistic terms commonly used in carrying out safety assessment. This research focuses on the development and representation of linguistic variables to model risk levels subjectively. These variables are then quantified using fuzzy sets. In this paper, the development of a safety model using fuzzy logic approach for modelling various design variables for maritime and offshore safety based decision making in the concept design stage is presented. An example is used to illustrate the proposed approach

Classical Michaelis-Menten and system theory approach to modeling metabolite formation kinetics.

Science.gov (United States)

Popović, Jovan

2004-01-01

When single doses of drug are administered and kinetics are linear, techniques, which are based on the compartment approach and the linear system theory approach, in modeling the formation of the metabolite from the parent drug are proposed. Unlike the purpose-specific compartment approach, the methodical, conceptual and computational uniformity in modeling various linear biomedical systems is the dominant characteristic of the linear system approach technology. Saturation of the metabolic reaction results in nonlinear kinetics according to the Michaelis-Menten equation. The two compartment open model with Michaelis-Menten elimination kinetics is theorethicaly basic when single doses of drug are administered. To simulate data or to fit real data using this model, one must resort to numerical integration. A biomathematical model for multiple dosage regimen calculations of nonlinear metabolic systems in steady-state and a working example with phenytoin are presented. High correlation between phenytoin steady-state serum levels calculated from individual Km and Vmax values in the 15 adult epileptic outpatients and the observed levels at the third adjustment of phenytoin daily dose (r=0.961, p<0.01) were found.

Tornadoes and related damage costs: statistical modeling with a semi-Markov approach

OpenAIRE

Corini, Chiara; D'Amico, Guglielmo; Petroni, Filippo; Prattico, Flavio; Manca, Raimondo

2015-01-01

We propose a statistical approach to tornadoes modeling for predicting and simulating occurrences of tornadoes and accumulated cost distributions over a time interval. This is achieved by modeling the tornadoes intensity, measured with the Fujita scale, as a stochastic process. Since the Fujita scale divides tornadoes intensity into six states, it is possible to model the tornadoes intensity by using Markov and semi-Markov models. We demonstrate that the semi-Markov approach is able to reprod...

A novel approach for runoff modelling in ungauged catchments by Catchment Morphing

Science.gov (United States)

Zhang, J.; Han, D.

2017-12-01

Runoff prediction in ungauged catchments has been one of the major challenges in the past decades. However, due to the tremendous heterogeneity of hydrological catchments, obstacles exist in deducing model parameters for ungauged catchments from gauged ones. We propose a novel approach to predict ungauged runoff with Catchment Morphing (CM) using a fully distributed model. CM is defined as by changing the catchment characteristics (area and slope here) from the baseline model built with a gauged catchment to model the ungauged ones. The advantages of CM are: (a) less demand of the similarity between the baseline catchment and the ungauged catchment, (b) less demand of available data, and (c) potentially applicable in varied catchments. A case study on seven catchments in the UK has been used to demonstrate the proposed scheme. To comprehensively examine the CM approach, distributed rainfall inputs are utilised in the model, and fractal landscapes are used to morph the land surface from the baseline model to the target model. The preliminary results demonstrate the feasibility of the approach, which is promising in runoff simulation for ungauged catchments. Clearly, more work beyond this pilot study is needed to explore and develop this new approach further to maturity by the hydrological community.

Modeling of phase equilibria with CPA using the homomorph approach

DEFF Research Database (Denmark)

Breil, Martin Peter; Tsivintzelis, Ioannis; Kontogeorgis, Georgios

2011-01-01

For association models, like CPA and SAFT, a classical approach is often used for estimating pure-compound and mixture parameters. According to this approach, the pure-compound parameters are estimated from vapor pressure and liquid density data. Then, the binary interaction parameters, kij, are ...

An information theory-based approach to modeling the information processing of NPP operators

International Nuclear Information System (INIS)

Kim, Jong Hyun; Seong, Poong Hyun

2002-01-01

This paper proposes a quantitative approach to modeling the information processing of NPP operators. The aim of this work is to derive the amount of the information processed during a certain control task. The focus will be on i) developing a model for information processing of NPP operators and ii) quantifying the model. To resolve the problems of the previous approaches based on the information theory, i.e. the problems of single channel approaches, we primarily develop the information processing model having multiple stages, which contains information flows. Then the uncertainty of the information is quantified using the Conant's model, a kind of information theory

Approaches to modeling landscape-scale drought-induced forest mortality

Science.gov (United States)

Gustafson, Eric J.; Shinneman, Douglas

2015-01-01

Drought stress is an important cause of tree mortality in forests, and drought-induced disturbance events are projected to become more common in the future due to climate change. Landscape Disturbance and Succession Models (LDSM) are becoming widely used to project climate change impacts on forests, including potential interactions with natural and anthropogenic disturbances, and to explore the efficacy of alternative management actions to mitigate negative consequences of global changes on forests and ecosystem services. Recent studies incorporating drought-mortality effects into LDSMs have projected significant potential changes in forest composition and carbon storage, largely due to differential impacts of drought on tree species and interactions with other disturbance agents. In this chapter, we review how drought affects forest ecosystems and the different ways drought effects have been modeled (both spatially and aspatially) in the past. Building on those efforts, we describe several approaches to modeling drought effects in LDSMs, discuss advantages and shortcomings of each, and include two case studies for illustration. The first approach features the use of empirically derived relationships between measures of drought and the loss of tree biomass to drought-induced mortality. The second uses deterministic rules of species mortality for given drought events to project changes in species composition and forest distribution. A third approach is more mechanistic, simulating growth reductions and death caused by water stress. Because modeling of drought effects in LDSMs is still in its infancy, and because drought is expected to play an increasingly important role in forest health, further development of modeling drought-forest dynamics is urgently needed.

The Matrix model, a driven state variables approach to non-equilibrium thermodynamics

NARCIS (Netherlands)

Jongschaap, R.J.J.

2001-01-01

One of the new approaches in non-equilibrium thermodynamics is the so-called matrix model of Jongschaap. In this paper some features of this model are discussed. We indicate the differences with the more common approach based upon internal variables and the more sophisticated Hamiltonian and GENERIC

Towards a model-based development approach for wireless sensor-actuator network protocols

DEFF Research Database (Denmark)

Kumar S., A. Ajith; Simonsen, Kent Inge

2014-01-01

Model-Driven Software Engineering (MDSE) is a promising approach for the development of applications, and has been well adopted in the embedded applications domain in recent years. Wireless Sensor Actuator Networks consisting of resource constrained hardware and platformspecific operating system...... induced due to manual translations. With the use of formal semantics in the modeling approach, we can further ensure the correctness of the source model by means of verification. Also, with the use of network simulators and formal modeling tools, we obtain a verified and validated model to be used...

Agent-based modeling: a new approach for theory building in social psychology.

Science.gov (United States)

Smith, Eliot R; Conrey, Frederica R

2007-02-01

Most social and psychological phenomena occur not as the result of isolated decisions by individuals but rather as the result of repeated interactions between multiple individuals over time. Yet the theory-building and modeling techniques most commonly used in social psychology are less than ideal for understanding such dynamic and interactive processes. This article describes an alternative approach to theory building, agent-based modeling (ABM), which involves simulation of large numbers of autonomous agents that interact with each other and with a simulated environment and the observation of emergent patterns from their interactions. The authors believe that the ABM approach is better able than prevailing approaches in the field, variable-based modeling (VBM) techniques such as causal modeling, to capture types of complex, dynamic, interactive processes so important in the social world. The article elaborates several important contrasts between ABM and VBM and offers specific recommendations for learning more and applying the ABM approach.

Data and Dynamics Driven Approaches for Modelling and Forecasting the Red Sea Chlorophyll

KAUST Repository

Dreano, Denis

2017-05-31

Phytoplankton is at the basis of the marine food chain and therefore play a fundamental role in the ocean ecosystem. However, the large-scale phytoplankton dynamics of the Red Sea are not well understood yet, mainly due to the lack of historical in situ measurements. As a result, our knowledge in this area relies mostly on remotely-sensed observations and large-scale numerical marine ecosystem models. Models are very useful to identify the mechanisms driving the variations in chlorophyll concentration and have practical applications for fisheries operation and harmful algae blooms monitoring. Modelling approaches can be divided between physics- driven (dynamical) approaches, and data-driven (statistical) approaches. Dynamical models are based on a set of differential equations representing the transfer of energy and matter between different subsets of the biota, whereas statistical models identify relationships between variables based on statistical relations within the available data. The goal of this thesis is to develop, implement and test novel dynamical and statistical modelling approaches for studying and forecasting the variability of chlorophyll concentration in the Red Sea. These new models are evaluated in term of their ability to efficiently forecast and explain the regional chlorophyll variability. We also propose innovative synergistic strategies to combine data- and physics-driven approaches to further enhance chlorophyll forecasting capabilities and efficiency.

A diagnosis method for physical systems using a multi-modeling approach

International Nuclear Information System (INIS)

Thetiot, R.

2000-01-01

In this thesis we propose a method for diagnosis problem solving. This method is based on a multi-modeling approach describing both normal and abnormal behavior of a system. This modeling approach allows to represent a system at different abstraction levels (behavioral, functional and teleological. Fundamental knowledge is described according to a bond-graph representation. We show that bond-graph representation can be exploited in order to generate (completely or partially) the functional models. The different models of the multi-modeling approach allows to define the functional state of a system at different abstraction levels. We exploit this property to exonerate sub-systems for which the expected behavior is observed. The behavioral and functional descriptions of the remaining sub-systems are exploited hierarchically in a two steps process. In a first step, the abnormal behaviors explaining some observations are identified. In a second step, the remaining unexplained observations are used to generate conflict sets and thus the consistency based diagnoses. The modeling method and the diagnosis process have been applied to a Reactor Coolant Pump Sets. This application illustrates the concepts described in this thesis and shows its potentialities. (authors)

An approach to ductile fracture resistance modelling in pipeline steels

Energy Technology Data Exchange (ETDEWEB)

Pussegoda, L.N.; Fredj, A. [BMT Fleet Technology Ltd., Kanata (Canada)

2009-07-01

Ductile fracture resistance studies of high grade steels in the pipeline industry often included analyses of the crack tip opening angle (CTOA) parameter using 3-point bend steel specimens. The CTOA is a function of specimen ligament size in high grade materials. Other resistance measurements may include steady state fracture propagation energy, critical fracture strain, and the adoption of damage mechanisms. Modelling approaches for crack propagation were discussed in this abstract. Tension tests were used to calibrate damage model parameters. Results from the tests were then applied to the crack propagation in a 3-point bend specimen using modern 1980 vintage steels. Limitations and approaches to overcome the difficulties associated with crack propagation modelling were discussed.

The Intersystem Model of Psychotherapy: An Integrated Systems Treatment Approach

Science.gov (United States)

Weeks, Gerald R.; Cross, Chad L.

2004-01-01

This article introduces the intersystem model of psychotherapy and discusses its utility as a truly integrative and comprehensive approach. The foundation of this conceptually complex approach comes from dialectic metatheory; hence, its derivation requires an understanding of both foundational and integrational constructs. The article provides a…

Conceptual Model and Numerical Approaches for Unsaturated Zone Flow and Transport

International Nuclear Information System (INIS)

H.H. Liu

2004-01-01

The purpose of this model report is to document the conceptual and numerical models used for modeling unsaturated zone (UZ) fluid (water and air) flow and solute transport processes. This work was planned in ''Technical Work Plan for: Unsaturated Zone Flow Model and Analysis Report Integration'' (BSC 2004 [DIRS 169654], Sections 1.2.5, 2.1.1, 2.1.2 and 2.2.1). The conceptual and numerical modeling approaches described in this report are mainly used for models of UZ flow and transport in fractured, unsaturated rock under ambient conditions. Developments of these models are documented in the following model reports: (1) UZ Flow Model and Submodels; (2) Radionuclide Transport Models under Ambient Conditions. Conceptual models for flow and transport in unsaturated, fractured media are discussed in terms of their applicability to the UZ at Yucca Mountain. The rationale for selecting the conceptual models used for modeling of UZ flow and transport is documented. Numerical approaches for incorporating these conceptual models are evaluated in terms of their representation of the selected conceptual models and computational efficiency; and the rationales for selecting the numerical approaches used for modeling of UZ flow and transport are discussed. This report also documents activities to validate the active fracture model (AFM) based on experimental observations and theoretical developments. The AFM is a conceptual model that describes the fracture-matrix interaction in the UZ of Yucca Mountain. These validation activities are documented in Section 7 of this report regarding use of an independent line of evidence to provide additional confidence in the use of the AFM in the UZ models. The AFM has been used in UZ flow and transport models under both ambient and thermally disturbed conditions. Developments of these models are documented

Interfacial Fluid Mechanics A Mathematical Modeling Approach

CERN Document Server

Ajaev, Vladimir S

2012-01-01

Interfacial Fluid Mechanics: A Mathematical Modeling Approach provides an introduction to mathematical models of viscous flow used in rapidly developing fields of microfluidics and microscale heat transfer. The basic physical effects are first introduced in the context of simple configurations and their relative importance in typical microscale applications is discussed. Then,several configurations of importance to microfluidics, most notably thin films/droplets on substrates and confined bubbles, are discussed in detail.  Topics from current research on electrokinetic phenomena, liquid flow near structured solid surfaces, evaporation/condensation, and surfactant phenomena are discussed in the later chapters. This book also:  Discusses mathematical models in the context of actual applications such as electrowetting Includes unique material on fluid flow near structured surfaces and phase change phenomena Shows readers how to solve modeling problems related to microscale multiphase flows Interfacial Fluid Me...

Comparison of two model approaches in the Zambezi river basin with regard to model reliability and identifiability

Directory of Open Access Journals (Sweden)

H. C. Winsemius

2006-01-01

Full Text Available Variations of water stocks in the upper Zambezi river basin have been determined by 2 different hydrological modelling approaches. The purpose was to provide preliminary terrestrial storage estimates in the upper Zambezi, which will be compared with estimates derived from the Gravity Recovery And Climate Experiment (GRACE in a future study. The first modelling approach is GIS-based, distributed and conceptual (STREAM. The second approach uses Lumped Elementary Watersheds identified and modelled conceptually (LEW. The STREAM model structure has been assessed using GLUE (Generalized Likelihood Uncertainty Estimation a posteriori to determine parameter identifiability. The LEW approach could, in addition, be tested for model structure, because computational efforts of LEW are low. Both models are threshold models, where the non-linear behaviour of the Zambezi river basin is explained by a combination of thresholds and linear reservoirs. The models were forced by time series of gauged and interpolated rainfall. Where available, runoff station data was used to calibrate the models. Ungauged watersheds were generally given the same parameter sets as their neighbouring calibrated watersheds. It appeared that the LEW model structure could be improved by applying GLUE iteratively. Eventually, it led to better identifiability of parameters and consequently a better model structure than the STREAM model. Hence, the final model structure obtained better represents the true hydrology. After calibration, both models show a comparable efficiency in representing discharge. However the LEW model shows a far greater storage amplitude than the STREAM model. This emphasizes the storage uncertainty related to hydrological modelling in data-scarce environments such as the Zambezi river basin. It underlines the need and potential for independent observations of terrestrial storage to enhance our understanding and modelling capacity of the hydrological processes. GRACE

River Export of Plastic from Land to Sea: A Global Modeling Approach

Science.gov (United States)

Siegfried, Max; Gabbert, Silke; Koelmans, Albert A.; Kroeze, Carolien; Löhr, Ansje; Verburg, Charlotte

2016-04-01

Plastic is increasingly considered a serious cause of water pollution. It is a threat to aquatic ecosystems, including rivers, coastal waters and oceans. Rivers transport considerable amounts of plastic from land to sea. The quantity and its main sources, however, are not well known. Assessing the amount of macro- and microplastic transport from river to sea is, therefore, important for understanding the dimension and the patterns of plastic pollution of aquatic ecosystems. In addition, it is crucial for assessing short- and long-term impacts caused by plastic pollution. Here we present a global modelling approach to quantify river export of plastic from land to sea. Our approach accounts for different types of plastic, including both macro- and micro-plastics. Moreover, we distinguish point sources and diffuse sources of plastic in rivers. Our modelling approach is inspired by global nutrient models, which include more than 6000 river basins. In this paper, we will present our modelling approach, as well as first model results for micro-plastic pollution in European rivers. Important sources of micro-plastics include personal care products, laundry, household dust and car tyre wear. We combine information on these sources with information on sewage management, and plastic retention during river transport for the largest European rivers. Our modelling approach may help to better understand and prevent water pollution by plastic , and at the same time serves as 'proof of concept' for future application on global scale.

Towards a CPN-Based Modelling Approach for Reconciling Verification and Implementation of Protocol Models

DEFF Research Database (Denmark)

Simonsen, Kent Inge; Kristensen, Lars Michael

2013-01-01

Formal modelling of protocols is often aimed at one specific purpose such as verification or automatically generating an implementation. This leads to models that are useful for one purpose, but not for others. Being able to derive models for verification and implementation from a single model...... is beneficial both in terms of reduced total modelling effort and confidence that the verification results are valid also for the implementation model. In this paper we introduce the concept of a descriptive specification model and an approach based on refining a descriptive model to target both verification...... how this model can be refined to target both verification and implementation....

A GOCE-only global gravity field model by the space-wise approach

DEFF Research Database (Denmark)

Migliaccio, Frederica; Reguzzoni, Mirko; Gatti, Andrea

2011-01-01

The global gravity field model computed by the spacewise approach is one of three official solutions delivered by ESA from the analysis of the GOCE data. The model consists of a set of spherical harmonic coefficients and the corresponding error covariance matrix. The main idea behind this approach...... the orbit to reduce the noise variance and correlation before gridding the data. In the first release of the space-wise approach, based on a period of about two months, some prior information coming from existing gravity field models entered into the solution especially at low degrees and low orders...... degrees; the second is an internally computed GOCE-only prior model to be used in place of the official quick-look model, thus removing the dependency on EIGEN5C especially in the polar gaps. Once the procedure to obtain a GOCE-only solution has been outlined, a new global gravity field model has been...

An approach for modelling interdependent infrastructures in the context of vulnerability analysis

International Nuclear Information System (INIS)

Johansson, Jonas; Hassel, Henrik

2010-01-01

Technical infrastructures of the society are becoming more and more interconnected and interdependent, i.e. the function of an infrastructure influences the function of other infrastructures. Disturbances in one infrastructure therefore often traverse to other dependent infrastructures and possibly even back to the infrastructure where the failure originated. It is becoming increasingly important to take these interdependencies into account when assessing the vulnerability of technical infrastructures. In the present paper, an approach for modelling interdependent technical infrastructures is proposed. The modelling approach considers structural properties, as employed in graph theory, as well as functional properties to increase its fidelity and usefulness. By modelling a fictional electrified railway network that consists of five systems and interdependencies between the systems, it is shown how the model can be employed in a vulnerability analysis. The model aims to capture both functional and geographic interdependencies. It is concluded that the proposed modelling approach is promising and suitable in the context of vulnerability analyses of interdependent systems.

An evaluation of gas release modelling approaches as to their applicability in fuel behaviour models

International Nuclear Information System (INIS)

Mattila, L.J.; Sairanen, R.T.

1980-01-01

The release of fission gas from uranium oxide fuel to the voids in the fuel rod affects in many ways the behaviour of LWR fuel rods both during normal operating conditions including anticipated transients and during off-normal and accident conditions. The current trend towards significantly increased discharge burnup of LWR fuel will increase the importance of fission gas release considerations both from the design and safety viewpoints. In the paper fission gas release models are classified to 5 categories on the basis of complexity and physical sophistication. For each category, the basic approach common to the models included in the category is described, a few representative models of the category are singled out and briefly commented in some cases, the advantages and drawbacks of the approach are listed and discussed and conclusions on the practical feasibility of the approach are drawn. The evaluation is based on both literature survey and our experience in working with integral fuel behaviour models. The work has included verification efforts, attempts to improve certain features of the codes and engineering applications. The classification of fission gas release models regarding their applicability in fuel behaviour codes can of course be done only in a coarse manner. The boundaries between the different categories are vague and a model may be well refined in a way which transfers it to a higher category. Some current trends in fuel behaviour research are discussed which seem to motivate further extensive efforts in fission product release modelling and are certain to affect the prioritizing of the efforts. (author)

Wave Resource Characterization Using an Unstructured Grid Modeling Approach

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Wei-Cheng Wu

2018-03-01

Full Text Available This paper presents a modeling study conducted on the central Oregon coast for wave resource characterization, using the unstructured grid Simulating WAve Nearshore (SWAN model coupled with a nested grid WAVEWATCH III® (WWIII model. The flexibility of models with various spatial resolutions and the effects of open boundary conditions simulated by a nested grid WWIII model with different physics packages were evaluated. The model results demonstrate the advantage of the unstructured grid-modeling approach for flexible model resolution and good model skills in simulating the six wave resource parameters recommended by the International Electrotechnical Commission in comparison to the observed data in Year 2009 at National Data Buoy Center Buoy 46050. Notably, spectral analysis indicates that the ST4 physics package improves upon the ST2 physics package’s ability to predict wave power density for large waves, which is important for wave resource assessment, load calculation of devices, and risk management. In addition, bivariate distributions show that the simulated sea state of maximum occurrence with the ST4 physics package matched the observed data better than with the ST2 physics package. This study demonstrated that the unstructured grid wave modeling approach, driven by regional nested grid WWIII outputs along with the ST4 physics package, can efficiently provide accurate wave hindcasts to support wave resource characterization. Our study also suggests that wind effects need to be considered if the dimension of the model domain is greater than approximately 100 km, or O (102 km.

A fuzzy approach for modelling radionuclide in lake system.

Science.gov (United States)

Desai, H K; Christian, R A; Banerjee, J; Patra, A K

2013-10-01

Radioactive liquid waste is generated during operation and maintenance of Pressurised Heavy Water Reactors (PHWRs). Generally low level liquid waste is diluted and then discharged into the near by water-body through blowdown water discharge line as per the standard waste management practice. The effluents from nuclear installations are treated adequately and then released in a controlled manner under strict compliance of discharge criteria. An attempt was made to predict the concentration of (3)H released from Kakrapar Atomic Power Station at Ratania Regulator, about 2.5 km away from the discharge point, where human exposure is expected. Scarcity of data and complex geometry of the lake prompted the use of Heuristic approach. Under this condition, Fuzzy rule based approach was adopted to develop a model, which could predict (3)H concentration at Ratania Regulator. Three hundred data were generated for developing the fuzzy rules, in which input parameters were water flow from lake and (3)H concentration at discharge point. The Output was (3)H concentration at Ratania Regulator. These data points were generated by multiple regression analysis of the original data. Again by using same methodology hundred data were generated for the validation of the model, which were compared against the predicted output generated by using Fuzzy Rule based approach. Root Mean Square Error of the model came out to be 1.95, which showed good agreement by Fuzzy model of natural ecosystem. Copyright © 2013 Elsevier Ltd. All rights reserved.

Modeling of correlated data with informative cluster sizes: An evaluation of joint modeling and within-cluster resampling approaches.

Science.gov (United States)

Zhang, Bo; Liu, Wei; Zhang, Zhiwei; Qu, Yanping; Chen, Zhen; Albert, Paul S

2017-08-01

Joint modeling and within-cluster resampling are two approaches that are used for analyzing correlated data with informative cluster sizes. Motivated by a developmental toxicity study, we examined the performances and validity of these two approaches in testing covariate effects in generalized linear mixed-effects models. We show that the joint modeling approach is robust to the misspecification of cluster size models in terms of Type I and Type II errors when the corresponding covariates are not included in the random effects structure; otherwise, statistical tests may be affected. We also evaluate the performance of the within-cluster resampling procedure and thoroughly investigate the validity of it in modeling correlated data with informative cluster sizes. We show that within-cluster resampling is a valid alternative to joint modeling for cluster-specific covariates, but it is invalid for time-dependent covariates. The two methods are applied to a developmental toxicity study that investigated the effect of exposure to diethylene glycol dimethyl ether.

Model-Assisted Estimation of Tropical Forest Biomass Change: A Comparison of Approaches

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Nikolai Knapp

2018-05-01

Full Text Available Monitoring of changes in forest biomass requires accurate transfer functions between remote sensing-derived changes in canopy height (ΔH and the actual changes in aboveground biomass (ΔAGB. Different approaches can be used to accomplish this task: direct approaches link ΔH directly to ΔAGB, while indirect approaches are based on deriving AGB stock estimates for two points in time and calculating the difference. In some studies, direct approaches led to more accurate estimations, while, in others, indirect approaches led to more accurate estimations. It is unknown how each approach performs under different conditions and over the full range of possible changes. Here, we used a forest model (FORMIND to generate a large dataset (>28,000 ha of natural and disturbed forest stands over time. Remote sensing of forest height was simulated on these stands to derive canopy height models for each time step. Three approaches for estimating ΔAGB were compared: (i the direct approach; (ii the indirect approach and (iii an enhanced direct approach (dir+tex, using ΔH in combination with canopy texture. Total prediction accuracies of the three approaches measured as root mean squared errors (RMSE were RMSEdirect = 18.7 t ha−1, RMSEindirect = 12.6 t ha−1 and RMSEdir+tex = 12.4 t ha−1. Further analyses revealed height-dependent biases in the ΔAGB estimates of the direct approach, which did not occur with the other approaches. Finally, the three approaches were applied on radar-derived (TanDEM-X canopy height changes on Barro Colorado Island (Panama. The study demonstrates the potential of forest modeling for improving the interpretation of changes observed in remote sensing data and for comparing different methodologies.

A nationwide modelling approach to decommissioning - 16182

International Nuclear Information System (INIS)

Kelly, Bernard; Lowe, Andy; Mort, Paul

2009-01-01

In this paper we describe a proposed UK national approach to modelling decommissioning. For the first time, we shall have an insight into optimizing the safety and efficiency of a national decommissioning strategy. To do this we use the General Case Integrated Waste Algorithm (GIA), a universal model of decommissioning nuclear plant, power plant, waste arisings and the associated knowledge capture. The model scales from individual items of plant through cells, groups of cells, buildings, whole sites and then on up to a national scale. We describe the national vision for GIA which can be broken down into three levels: 1) the capture of the chronological order of activities that an experienced decommissioner would use to decommission any nuclear facility anywhere in the world - this is Level 1 of GIA; 2) the construction of an Operational Research (OR) model based on Level 1 to allow rapid what if scenarios to be tested quickly (Level 2); 3) the construction of a state of the art knowledge capture capability that allows future generations to learn from our current decommissioning experience (Level 3). We show the progress to date in developing GIA in levels 1 and 2. As part of level 1, GIA has assisted in the development of an IMechE professional decommissioning qualification. Furthermore, we describe GIA as the basis of a UK-Owned database of decommissioning norms for such things as costs, productivity, durations etc. From level 2, we report on a pilot study that has successfully tested the basic principles for the OR numerical simulation of the algorithm. We then highlight the advantages of applying the OR modelling approach nationally. In essence, a series of 'what if...' scenarios can be tested that will improve the safety and efficiency of decommissioning. (authors)

Understanding complex urban systems multidisciplinary approaches to modeling

CERN Document Server

Gurr, Jens; Schmidt, J

2014-01-01

Understanding Complex Urban Systems takes as its point of departure the insight that the challenges of global urbanization and the complexity of urban systems cannot be understood – let alone ‘managed’ – by sectoral and disciplinary approaches alone. But while there has recently been significant progress in broadening and refining the methodologies for the quantitative modeling of complex urban systems, in deepening the theoretical understanding of cities as complex systems, or in illuminating the implications for urban planning, there is still a lack of well-founded conceptual thinking on the methodological foundations and the strategies of modeling urban complexity across the disciplines. Bringing together experts from the fields of urban and spatial planning, ecology, urban geography, real estate analysis, organizational cybernetics, stochastic optimization, and literary studies, as well as specialists in various systems approaches and in transdisciplinary methodologies of urban analysis, the volum...

CM5: A pre-Swarm magnetic field model based upon the comprehensive modeling approach

DEFF Research Database (Denmark)

Sabaka, T.; Olsen, Nils; Tyler, Robert

2014-01-01

We have developed a model based upon the very successful Comprehensive Modeling (CM) approach using recent CHAMP, Ørsted, SAC-C and observatory hourly-means data from September 2000 to the end of 2013. This CM, called CM5, was derived from the algorithm that will provide a consistent line of Leve...

A multi-model ensemble approach to seabed mapping

Science.gov (United States)

Diesing, Markus; Stephens, David

2015-06-01

Seabed habitat mapping based on swath acoustic data and ground-truth samples is an emergent and active marine science discipline. Significant progress could be achieved by transferring techniques and approaches that have been successfully developed and employed in such fields as terrestrial land cover mapping. One such promising approach is the multiple classifier system, which aims at improving classification performance by combining the outputs of several classifiers. Here we present results of a multi-model ensemble applied to multibeam acoustic data covering more than 5000 km2 of seabed in the North Sea with the aim to derive accurate spatial predictions of seabed substrate. A suite of six machine learning classifiers (k-Nearest Neighbour, Support Vector Machine, Classification Tree, Random Forest, Neural Network and Naïve Bayes) was trained with ground-truth sample data classified into seabed substrate classes and their prediction accuracy was assessed with an independent set of samples. The three and five best performing models were combined to classifier ensembles. Both ensembles led to increased prediction accuracy as compared to the best performing single classifier. The improvements were however not statistically significant at the 5% level. Although the three-model ensemble did not perform significantly better than its individual component models, we noticed that the five-model ensemble did perform significantly better than three of the five component models. A classifier ensemble might therefore be an effective strategy to improve classification performance. Another advantage is the fact that the agreement in predicted substrate class between the individual models of the ensemble could be used as a measure of confidence. We propose a simple and spatially explicit measure of confidence that is based on model agreement and prediction accuracy.

Validation of Slosh Modeling Approach Using STAR-CCM+

Science.gov (United States)

Benson, David J.; Ng, Wanyi

2018-01-01

Without an adequate understanding of propellant slosh, the spacecraft attitude control system may be inadequate to control the spacecraft or there may be an unexpected loss of science observation time due to higher slosh settling times. Computational fluid dynamics (CFD) is used to model propellant slosh. STAR-CCM+ is a commercially available CFD code. This paper seeks to validate the CFD modeling approach via a comparison between STAR-CCM+ liquid slosh modeling results and experimental, empirically, and analytically derived results. The geometries examined are a bare right cylinder tank and a right cylinder with a single ring baffle.

Modified multiblock partial least squares path modeling algorithm with backpropagation neural networks approach

Science.gov (United States)

Yuniarto, Budi; Kurniawan, Robert

2017-03-01

PLS Path Modeling (PLS-PM) is different from covariance based SEM, where PLS-PM use an approach based on variance or component, therefore, PLS-PM is also known as a component based SEM. Multiblock Partial Least Squares (MBPLS) is a method in PLS regression which can be used in PLS Path Modeling which known as Multiblock PLS Path Modeling (MBPLS-PM). This method uses an iterative procedure in its algorithm. This research aims to modify MBPLS-PM with Back Propagation Neural Network approach. The result is MBPLS-PM algorithm can be modified using the Back Propagation Neural Network approach to replace the iterative process in backward and forward step to get the matrix t and the matrix u in the algorithm. By modifying the MBPLS-PM algorithm using Back Propagation Neural Network approach, the model parameters obtained are relatively not significantly different compared to model parameters obtained by original MBPLS-PM algorithm.

Anthropomorphic Coding of Speech and Audio: A Model Inversion Approach

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W. Bastiaan Kleijn

2005-06-01

Full Text Available Auditory modeling is a well-established methodology that provides insight into human perception and that facilitates the extraction of signal features that are most relevant to the listener. The aim of this paper is to provide a tutorial on perceptual speech and audio coding using an invertible auditory model. In this approach, the audio signal is converted into an auditory representation using an invertible auditory model. The auditory representation is quantized and coded. Upon decoding, it is then transformed back into the acoustic domain. This transformation converts a complex distortion criterion into a simple one, thus facilitating quantization with low complexity. We briefly review past work on auditory models and describe in more detail the components of our invertible model and its inversion procedure, that is, the method to reconstruct the signal from the output of the auditory model. We summarize attempts to use the auditory representation for low-bit-rate coding. Our approach also allows the exploitation of the inherent redundancy of the human auditory system for the purpose of multiple description (joint source-channel coding.

A modal approach to modeling spatially distributed vibration energy dissipation.

Energy Technology Data Exchange (ETDEWEB)

Segalman, Daniel Joseph

2010-08-01

The nonlinear behavior of mechanical joints is a confounding element in modeling the dynamic response of structures. Though there has been some progress in recent years in modeling individual joints, modeling the full structure with myriad frictional interfaces has remained an obstinate challenge. A strategy is suggested for structural dynamics modeling that can account for the combined effect of interface friction distributed spatially about the structure. This approach accommodates the following observations: (1) At small to modest amplitudes, the nonlinearity of jointed structures is manifest primarily in the energy dissipation - visible as vibration damping; (2) Correspondingly, measured vibration modes do not change significantly with amplitude; and (3) Significant coupling among the modes does not appear to result at modest amplitudes. The mathematical approach presented here postulates the preservation of linear modes and invests all the nonlinearity in the evolution of the modal coordinates. The constitutive form selected is one that works well in modeling spatially discrete joints. When compared against a mathematical truth model, the distributed dissipation approximation performs well.

Consequence Based Design. An approach for integrating computational collaborative models (Integrated Dynamic Models) in the building design phase

DEFF Research Database (Denmark)

Negendahl, Kristoffer

relies on various advancements in the area of integrated dynamic models. It also relies on the application and test of the approach in practice to evaluate the Consequence based design and the use of integrated dynamic models. As a result, the Consequence based design approach has been applied in five...... and define new ways to implement integrated dynamic models for the following project. In parallel, seven different developments of new methods, tools and algorithms have been performed to support the application of the approach. The developments concern: Decision diagrams – to clarify goals and the ability...... affect the design process and collaboration between building designers and simulationists. Within the limits of applying the approach of Consequence based design to five case studies, followed by documentation based on interviews, surveys and project related documentations derived from internal reports...

Design of laser-generated shockwave experiments. An approach using analytic models

International Nuclear Information System (INIS)

Lee, Y.T.; Trainor, R.J.

1980-01-01

Two of the target-physics phenomena which must be understood before a clean experiment can be confidently performed are preheating due to suprathermal electrons and shock decay due to a shock-rarefaction interaction. Simple analytic models are described for these two processes and the predictions of these models are compared with those of the LASNEX fluid physics code. We have approached this work not with the view of surpassing or even approaching the reliability of the code calculations, but rather with the aim of providing simple models which may be used for quick parameter-sensitivity evaluations, while providing physical insight into the problems

On Approaches to Analyze the Sensitivity of Simulated Hydrologic Fluxes to Model Parameters in the Community Land Model

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Jie Bao

2015-12-01

Full Text Available Effective sensitivity analysis approaches are needed to identify important parameters or factors and their uncertainties in complex Earth system models composed of multi-phase multi-component phenomena and multiple biogeophysical-biogeochemical processes. In this study, the impacts of 10 hydrologic parameters in the Community Land Model on simulations of runoff and latent heat flux are evaluated using data from a watershed. Different metrics, including residual statistics, the Nash–Sutcliffe coefficient, and log mean square error, are used as alternative measures of the deviations between the simulated and field observed values. Four sensitivity analysis (SA approaches, including analysis of variance based on the generalized linear model, generalized cross validation based on the multivariate adaptive regression splines model, standardized regression coefficients based on a linear regression model, and analysis of variance based on support vector machine, are investigated. Results suggest that these approaches show consistent measurement of the impacts of major hydrologic parameters on response variables, but with differences in the relative contributions, particularly for the secondary parameters. The convergence behaviors of the SA with respect to the number of sampling points are also examined with different combinations of input parameter sets and output response variables and their alternative metrics. This study helps identify the optimal SA approach, provides guidance for the calibration of the Community Land Model parameters to improve the model simulations of land surface fluxes, and approximates the magnitudes to be adjusted in the parameter values during parametric model optimization.

Geographic and temporal validity of prediction models: Different approaches were useful to examine model performance

NARCIS (Netherlands)

P.C. Austin (Peter); D. van Klaveren (David); Y. Vergouwe (Yvonne); D. Nieboer (Daan); D.S. Lee (Douglas); E.W. Steyerberg (Ewout)

2016-01-01

textabstractObjective: Validation of clinical prediction models traditionally refers to the assessment of model performance in new patients. We studied different approaches to geographic and temporal validation in the setting of multicenter data from two time periods. Study Design and Setting: We

Beyond GLMs: a generative mixture modeling approach to neural system identification.

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Lucas Theis

Full Text Available Generalized linear models (GLMs represent a popular choice for the probabilistic characterization of neural spike responses. While GLMs are attractive for their computational tractability, they also impose strong assumptions and thus only allow for a limited range of stimulus-response relationships to be discovered. Alternative approaches exist that make only very weak assumptions but scale poorly to high-dimensional stimulus spaces. Here we seek an approach which can gracefully interpolate between the two extremes. We extend two frequently used special cases of the GLM-a linear and a quadratic model-by assuming that the spike-triggered and non-spike-triggered distributions can be adequately represented using Gaussian mixtures. Because we derive the model from a generative perspective, its components are easy to interpret as they correspond to, for example, the spike-triggered distribution and the interspike interval distribution. The model is able to capture complex dependencies on high-dimensional stimuli with far fewer parameters than other approaches such as histogram-based methods. The added flexibility comes at the cost of a non-concave log-likelihood. We show that in practice this does not have to be an issue and the mixture-based model is able to outperform generalized linear and quadratic models.

A Model-Driven Approach for Telecommunications Network Services Definition

Science.gov (United States)

Chiprianov, Vanea; Kermarrec, Yvon; Alff, Patrick D.

Present day Telecommunications market imposes a short concept-to-market time for service providers. To reduce it, we propose a computer-aided, model-driven, service-specific tool, with support for collaborative work and for checking properties on models. We started by defining a prototype of the Meta-model (MM) of the service domain. Using this prototype, we defined a simple graphical modeling language specific for service designers. We are currently enlarging the MM of the domain using model transformations from Network Abstractions Layers (NALs). In the future, we will investigate approaches to ensure the support for collaborative work and for checking properties on models.

Linear mixed-effects modeling approach to FMRI group analysis.

Science.gov (United States)

Chen, Gang; Saad, Ziad S; Britton, Jennifer C; Pine, Daniel S; Cox, Robert W

2013-06-01

Conventional group analysis is usually performed with Student-type t-test, regression, or standard AN(C)OVA in which the variance-covariance matrix is presumed to have a simple structure. Some correction approaches are adopted when assumptions about the covariance structure is violated. However, as experiments are designed with different degrees of sophistication, these traditional methods can become cumbersome, or even be unable to handle the situation at hand. For example, most current FMRI software packages have difficulty analyzing the following scenarios at group level: (1) taking within-subject variability into account when there are effect estimates from multiple runs or sessions; (2) continuous explanatory variables (covariates) modeling in the presence of a within-subject (repeated measures) factor, multiple subject-grouping (between-subjects) factors, or the mixture of both; (3) subject-specific adjustments in covariate modeling; (4) group analysis with estimation of hemodynamic response (HDR) function by multiple basis functions; (5) various cases of missing data in longitudinal studies; and (6) group studies involving family members or twins. Here we present a linear mixed-effects modeling (LME) methodology that extends the conventional group analysis approach to analyze many complicated cases, including the six prototypes delineated above, whose analyses would be otherwise either difficult or unfeasible under traditional frameworks such as AN(C)OVA and general linear model (GLM). In addition, the strength of the LME framework lies in its flexibility to model and estimate the variance-covariance structures for both random effects and residuals. The intraclass correlation (ICC) values can be easily obtained with an LME model with crossed random effects, even at the presence of confounding fixed effects. The simulations of one prototypical scenario indicate that the LME modeling keeps a balance between the control for false positives and the sensitivity

Interleukin-2 and subunit alpha of its soluble receptor in autoimmune Addison's disease--an association study and expression analysis.

Science.gov (United States)

Fichna, Marta; Żurawek, Magdalena; Bratland, Eirik; Husebye, Eystein S; Kasperlik-Załuska, Anna; Czarnocka, Barbara; Januszkiewicz-Lewandowska, Danuta; Nowak, Jerzy

2015-03-01

Autoimmune Addison's disease (AAD) results from T cell-mediated destruction of the adrenal cortex, commonly accompanied by autoantibodies to 21-hydroxylase (21OH). In order to gain insight into the obscure aetiology of this disease, we investigated the roles of the IL2 and IL2RA genes, encoding interleukin-2 and subunit alpha of its receptor (IL2Ra), respectively. The association of AAD with IL2 and IL2RA polymorphisms (rs6822844, rs2069762, rs3136534, rs11594656, rs3118470 and rs2104286) was tested in 223 patients and 672 healthy controls. Functional studies consisted of gene expression analysis in cultured PBMCs exposed to 21OH and evaluation of serum interleukin by ELISA assays. The frequency of the minor C allele of rs3136534 was significantly decreased in AAD subjects compared to controls (OR 0.71; 95%CI 0.561-0.887; p = 0.003). Only AAD cells responded to 21OH with an elevated IL2 and IL2RA mRNA synthesis (p = 0.004 and p = 0.009 versus controls, respectively), paralleled by increased supernatant levels of both cytokines (p = 0.031 and p = 0.001 versus controls). IL2 mRNA level in 21OH-stimulated AAD PBMCs correlated negatively with age (p = 0.036) and positively with serum antibodies to 21OH (p = 0.006). Carriers of the rs2104286 AA genotype demonstrated higher IL2RA mRNA (p = 0.022) and soluble IL2Ra secretion (p = 0.029) upon 21OH stimulation. Serum interleukin-2 in AAD subjects was significantly higher compared to controls (4.61 ± 4.3 versus 1.71 ± 3.2 pg/mL, p < 0.001), whereas sIL2Ra levels remained similar in both groups (p = 0.885). In conclusion, the study reveals an association between AAD and IL2 locus. It confirms specific 21OH-directed reactivity of the peripheral AAD lymphocytes, which display increased synthesis of interleukin-2 and sIL2Ra.

Effective use of integrated hydrological models in basin-scale water resources management: surrogate modeling approaches

Science.gov (United States)

Zheng, Y.; Wu, B.; Wu, X.

2015-12-01

Integrated hydrological models (IHMs) consider surface water and subsurface water as a unified system, and have been widely adopted in basin-scale water resources studies. However, due to IHMs' mathematical complexity and high computational cost, it is difficult to implement them in an iterative model evaluation process (e.g., Monte Carlo Simulation, simulation-optimization analysis, etc.), which diminishes their applicability for supporting decision-making in real-world situations. Our studies investigated how to effectively use complex IHMs to address real-world water issues via surrogate modeling. Three surrogate modeling approaches were considered, including 1) DYCORS (DYnamic COordinate search using Response Surface models), a well-established response surface-based optimization algorithm; 2) SOIM (Surrogate-based Optimization for Integrated surface water-groundwater Modeling), a response surface-based optimization algorithm that we developed specifically for IHMs; and 3) Probabilistic Collocation Method (PCM), a stochastic response surface approach. Our investigation was based on a modeling case study in the Heihe River Basin (HRB), China's second largest endorheic river basin. The GSFLOW (Coupled Ground-Water and Surface-Water Flow Model) model was employed. Two decision problems were discussed. One is to optimize, both in time and in space, the conjunctive use of surface water and groundwater for agricultural irrigation in the middle HRB region; and the other is to cost-effectively collect hydrological data based on a data-worth evaluation. Overall, our study results highlight the value of incorporating an IHM in making decisions of water resources management and hydrological data collection. An IHM like GSFLOW can provide great flexibility to formulating proper objective functions and constraints for various optimization problems. On the other hand, it has been demonstrated that surrogate modeling approaches can pave the path for such incorporation in real