280 research outputs found

    Axiomatizing proof tree concepts in Bounded Arithmetic

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    We construct theories of Cook-Nguyen style two-sort bounded arithmetic whose provably total functions are exactly those in LOGCFL and LOGDCFL. Axiomatizations of both theories are based on the proof tree size characterizations of these classes. We also show that our theory for LOGCFL proves a certain formulation of the pumping lemma for context-free languages

    Linear algebra in bounded arithmetic (Theory and Applications of Proof and Computation)

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    On matrix rank function over bounded arithmetics

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    In arXiv:1811.04313, a definition of determinant is formalized in the bounded arithmetic VNC2VNC^{2}. Following the presentation of [Gathen, 1993], we can formalize a definition of matrix rank in the same bounded arithmetic. In this article, we define a bounded arithmetic LAPPDLAPPD, and show that LAPPDLAPPD seems to be a natural arithmetic theory formalizing the treatment of rank function following Mulmuley's algorithm. Furthermore, we give a formalization of rank in VNC2VNC^{2} by interpreting LAPPDLAPPD by VNC2VNC^{2}.Comment: 60 pages, section 4 added for readability, typos modified, acknowledgement revised, results unchanged, no figur

    Computational Method for Arbitrarily-Shaped Elastic Objects in Free-Surface Flows

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    Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

    Clinical impact of lipid injectable emulsion in internal medicine inpatients exclusively receiving parenteral nutrition: a propensity score matching analysis from a Japanese medical claims database

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    Background Although guidelines recommend lipid injectable emulsions (ILEs) be used as a part of parenteral nutrition, many patients in Japan receive lipid-free parenteral nutrition. Furthermore, little is known about the effect of ILEs on clinical outcomes in medical inpatients managed with parenteral nutrition. The aim of this study was to investigate the clinical impact of ILEs on internal medicine inpatients receiving parenteral nutrition. Methods A propensity score matching (PSM) analysis was performed using a medical claims database covering 451 hospitals in Japan. Participants included the following internal medicine inpatients, ages >= 18 years, fasting > 10 days, and receiving exclusively parenteral nutrition, between 2011 and 2020. Participants were divided into 2 groups: those who did and did not receive ILEs. The primary endpoint was in-hospital mortality. The secondary endpoints included intravenous catheter infection, activities of daily living (ADL), hospital length of stay (LOS), and total medical costs. To adjust for energy doses, logistic or multiple regression analyses were performed using energy dose as an additional explanatory variable. Results After PSM, 19,602 matched pairs were formed out of 61,437 patients. The ILE group had significantly lower incidences than the non-ILE group of in-hospital mortality (20.3% vs. 26.9%; odds ratio [OR], 0.69; 95% confidence interval [CI], 0.66-0.72; p < 0.001), deteriorated ADL (10.8% vs. 12.5%; OR, 0.85; 95% CI, 0.79-0.92; p < 0.001), and shorter LOS (regression coefficient, - 0.8; 95% CI, - 1.6-0.0; p = 0.045). After adjusting for energy dose, these ORs or regression coefficients demonstrated the same tendencies and statistical significance. The mean total medical costs were 21,009intheILEgroupand21,009 in the ILE group and 21,402 in the non-ILE group (p = 0.08), and the adjusted regression coefficient for the ILE vs. the non-ILE group was - 860(95860 (95% CI, - 1252 to - $47). Conclusions ILE use was associated with improved clinical outcomes, including lower in-hospital mortality, in internal medicine inpatients receiving parenteral nutrition

    Laparoscopic and Endoscopic Cooperative Surgery for Gastric Submucosal Tumor Near Esophagogastric Junction With Sliding Hiatal Hernia

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    The usefulness of laparoscopic and endoscopic cooperative surgery (LECS) for gastric submucosal tumors in the cardiac region has been reported in recent years. However, LECS for submucosal tumors at the esophagogastric junction with hiatal sliding esophageal hernia has not been reported, and its validity as a treatment method is unknown. The patient was a 51-year-old man with a growing submucosal tumor in the cardiac region. Surgical resection was indicated because a definitive diagnosis of the tumor was not determined. The lesion was a luminal protrusion tumor, located on the posterior wall of the stomach 20 mm from the esophagogastric junction, and had a maximum diameter of 16.3 mm on endoscopic ultrasound examination. Because of the hiatal hernia, the lesion could not be detected from the gastric side by endoscopy. Local resection was considered to be feasible because the resection line did not extend into the esophageal mucosa and the resection site could be less than half the circumference of the lumen. The submucosal tumor was resected completely and safely by LECS. The tumor was diagnosed as a gastric smooth muscle tumor finally. Nine months after surgery, a follow-up endoscopy showed reflux esophagitis. LECS was a useful technique for submucosal tumors of the cardiac region with hiatal hernia, but fundoplication might be considered for preventing backflow of gastric acid

    Dose-Dependent Effects of Amino Acids on Clinical Outcomes in Adult Medical Inpatients Receiving Only Parenteral Nutrition: A Retrospective Cohort Study Using a Japanese Medical Claims Database

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    The majority of inpatients requiring parenteral nutrition (PN) do not receive adequate amino acid, which may negatively impact clinical outcomes. We investigated the influence of amino acid doses on clinical outcomes in medical adult inpatients fasting >10 days and receiving only PN, using Japanese medical claims database. The primary endpoint was in-hospital mortality, and the secondary endpoints included deterioration of activities of daily living (ADL), intravenous catheter infection, hospital readmission, hospital length of stay (LOS), and total medical costs. Patients were divided into four groups according to their mean prescribed daily amino acid doses from Days 4 to 10 of fasting: Adequate (>= 0.8 g/kg/day), Moderate (>= 0.6-= 0.4-<0.6 g/kg/day), and Very low (<0.4 g/kg/day). Multivariate logistic or multiple regression analyses were performed with adjustments for patient characteristics (total n = 86,702). The Adequate group was used as the reference in all analyses. For the Moderate, Low, and Very low groups, adjusted ORs (95% CI) of in-hospital mortality were 1.20 (1.14-1.26), 1.43 (1.36-1.51), and 1.72 (1.62-1.82), respectively, and for deterioration of ADL were 1.21 (1.11-1.32), 1.34 (1.22-1.47), and 1.22 (1.09-1.37), respectively. Adjusted regression coefficients (95% CI) of hospital LOS were 1.2 (0.4-2.1), 1.5 (0.6-2.4), and 2.9 (1.8-4.1), respectively. Lower prescribed doses of amino acids were associated with worse clinical outcomes including higher in-hospital mortality
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