4,392 research outputs found
Making time for what's important:what elements should we value when planning practice-based professional training?
Your Proof Fails? Testing Helps to Find the Reason
Applying deductive verification to formally prove that a program respects its
formal specification is a very complex and time-consuming task due in
particular to the lack of feedback in case of proof failures. Along with a
non-compliance between the code and its specification (due to an error in at
least one of them), possible reasons of a proof failure include a missing or
too weak specification for a called function or a loop, and lack of time or
simply incapacity of the prover to finish a particular proof. This work
proposes a new methodology where test generation helps to identify the reason
of a proof failure and to exhibit a counter-example clearly illustrating the
issue. We describe how to transform an annotated C program into C code suitable
for testing and illustrate the benefits of the method on comprehensive
examples. The method has been implemented in STADY, a plugin of the software
analysis platform FRAMA-C. Initial experiments show that detecting
non-compliances and contract weaknesses allows to precisely diagnose most proof
failures.Comment: 11 pages, 10 figure
Predictive validity of the CriSTAL tool for short-term mortality in older people presenting at Emergency Departments: a prospective study
© 2018, The Author(s). Abstract: To determine the validity of the Australian clinical prediction tool Criteria for Screening and Triaging to Appropriate aLternative care (CRISTAL) based on objective clinical criteria to accurately identify risk of death within 3 months of admission among older patients. Methods: Prospective study of ≥ 65 year-olds presenting at emergency departments in five Australian (Aus) and four Danish (DK) hospitals. Logistic regression analysis was used to model factors for death prediction; Sensitivity, specificity, area under the ROC curve and calibration with bootstrapping techniques were used to describe predictive accuracy. Results: 2493 patients, with median age 78–80 years (DK–Aus). The deceased had significantly higher mean CriSTAL with Australian mean of 8.1 (95% CI 7.7–8.6 vs. 5.8 95% CI 5.6–5.9) and Danish mean 7.1 (95% CI 6.6–7.5 vs. 5.5 95% CI 5.4–5.6). The model with Fried Frailty score was optimal for the Australian cohort but prediction with the Clinical Frailty Scale (CFS) was also good (AUROC 0.825 and 0.81, respectively). Values for the Danish cohort were AUROC 0.764 with Fried and 0.794 using CFS. The most significant independent predictors of short-term death in both cohorts were advanced malignancy, frailty, male gender and advanced age. CriSTAL’s accuracy was only modest for in-hospital death prediction in either setting. Conclusions: The modified CriSTAL tool (with CFS instead of Fried’s frailty instrument) has good discriminant power to improve prognostic certainty of short-term mortality for ED physicians in both health systems. This shows promise in enhancing clinician’s confidence in initiating earlier end-of-life discussions
Error and attack tolerance of complex networks
Many complex systems, such as communication networks, display a surprising
degree of robustness: while key components regularly malfunction, local
failures rarely lead to the loss of the global information-carrying ability of
the network. The stability of these complex systems is often attributed to the
redundant wiring of the functional web defined by the systems' components. In
this paper we demonstrate that error tolerance is not shared by all redundant
systems, but it is displayed only by a class of inhomogeneously wired networks,
called scale-free networks. We find that scale-free networks, describing a
number of systems, such as the World Wide Web, Internet, social networks or a
cell, display an unexpected degree of robustness, the ability of their nodes to
communicate being unaffected by even unrealistically high failure rates.
However, error tolerance comes at a high price: these networks are extremely
vulnerable to attacks, i.e. to the selection and removal of a few nodes that
play the most important role in assuring the network's connectivity.Comment: 14 pages, 4 figures, Late
Faecal neutrophil elastase-antiprotease balance reflects colitis severity
Given the global burden of diarrheal diseases on healthcare it is surprising how little is known about the drivers of disease severity. Colitis caused by infection and inflammatory bowel disease (IBD) is characterised by neutrophil infiltration into the intestinal mucosa and yet our understanding of neutrophil responses during colitis is incomplete. Using infectious (Citrobacter rodentium) and chemical (dextran sulphate sodium; DSS) murine colitis models, as well as human IBD samples, we find that faecal neutrophil elastase (NE) activity reflects disease severity. During C. rodentium infection intestinal epithelial cells secrete the serine protease inhibitor SerpinA3N to inhibit and mitigate tissue damage caused by extracellular NE. Mice suffering from severe infection produce insufficient SerpinA3N to control excessive NE activity. This activity contributes to colitis severity as infection of these mice with a recombinant C. rodentium strain producing and secreting SerpinA3N reduces tissue damage. Thus, uncontrolled luminal NE activity is involved in severe colitis. Taken together, our findings suggest that NE activity could be a useful faecal biomarker for assessing disease severity as well as therapeutic target for both infectious and chronic inflammatory colitis
How UK climate change policy has been made sustainable
UK climate change policy is based on the advice of the Committee on Climate Change established under the Climate Change Act 2008. This Committee is an independent, expert agency established as part of the reconceiving of the regulatory state as a response to the neo-liberal critique of older forms of regulation. But the quality of the advice given in the Committee’s recent Fourth Carbon Budget Review is so tendentious as to barely be able to be described as advice at all. This grave shortcoming poses the most serious questions for contemporary constitutional and regulatory processes
An exploratory cluster randomised trial of a university halls of residence based social norms marketing campaign to reduce alcohol consumption among 1st year students
<p>Aims: This exploratory trial examines the feasibility of implementing a social norms marketing campaign to reduce student drinking in universities in Wales, and evaluating it using cluster randomised trial methodology.</p>
<p>Methods: Fifty residence halls in 4 universities in Wales were randomly assigned to intervention or control arms. Web and paper surveys were distributed to students within these halls (n = 3800), assessing exposure/contamination, recall of and evaluative responses to intervention messages, perceived drinking norms and personal drinking behaviour. Measures included the Drinking Norms Rating Form, the Daily Drinking Questionnaire and AUDIT-C.</p>
<p>Results: A response rate of 15% (n = 554) was achieved, varying substantially between sites. Intervention posters were seen by 80% and 43% of students in intervention and control halls respectively, with most remaining materials seen by a minority in both groups. Intervention messages were rated as credible and relevant by little more than half of students, though fewer felt they would influence their behaviour, with lighter drinkers more likely to perceive messages as credible. No differences in perceived norms were observed between intervention and control groups. Students reporting having seen intervention materials reported lower descriptive and injunctive norms than those who did not.</p>
<p>Conclusions: Attention is needed to enhancing exposure, credibility and perceived relevance of intervention messages, particularly among heavier drinkers, before definitive evaluation can be recommended. A definitive evaluation would need to consider how it would achieve sufficient response rates, whilst hall-level cluster randomisation appears subject to a significant degree of contamination.</p>
Risk assessment for the spread of Serratia marcescens within dental-unit waterline systems using Vermamoeba vermiformis
Vermamoeba vermiformis is associated with the biofilm ecology of dental-unit waterlines (DUWLs). This study investigated whether V. vermiformis is able to act as a vector for potentially pathogenic bacteria and so aid their dispersal within DUWL systems. Clinical dental water was initially examined for Legionella species by inoculating it onto Legionella selective-medium plates. The molecular identity/profile of the glassy colonies obtained indicated none of these isolates were Legionella species. During this work bacterial colonies were identified as a non-pigmented Serratia marcescens. As the water was from a clinical DUWL which had been treated with Alpron™ this prompted the question as to whether S. marcescens had developed resistance to the biocide. Exposure to Alpron™ indicated that this dental biocide was effective, under laboratory conditions, against S. marcescens at up to 1x108 colony forming units/millilitre (cfu/ml). V. vermiformis was cultured for eight weeks on cells of S. marcescens and Escherichia coli. Subsequent electron microscopy showed that V. vermiformis grew equally well on S. marcescens and E. coli (p = 0.0001). Failure to detect the presence of S. marcescens within the encysted amoebae suggests that V. vermiformis is unlikely to act as a vector supporting the growth of this newly isolated, nosocomial bacterium
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Modelling Parallel Oracle for Performance Prediction
Commission of the European Union Framework IV programme (Mercury project ESPRIT IV 20089); EPSRC PSTPA programme (GR/K40345)
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