Cutlines: UM Graduates

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care. Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB. Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide OB care, through fliers at emergency departments/urgent cares or posters in clinic waiting rooms; 2) keeping at least one same-day visit for OB patients; 3) distributing standard OB note templates to residents/faculty; and 4) placing patient educational handouts at each clinic. Patients, residents and faculty were reassessed at 9 months postintervention. Surveys were analyzed with Fisher’s exact tests. Results: Respondents to the preintervention survey included 83 patients, 26 residents and 19 faculty; 61 patients, 23 residents and 21 faculty responded to the postintervention survey. On both pre- and post-surveys, patients knew that their providers delivered babies (59% vs 57%, respectively; P = 0.86). However, only 22% and 33% of patients, respectively, had a doctor at our clinics deliver their baby or partner’s baby (P = 0.25). Even so, 95% and 100% of patients, respectively, would recommend their friends or family to our family practice clinics if they became pregnant (P = 0.14). On the pre-survey, 38% of residents felt clinic OB numbers were adequate versus 70% following intervention (P \u3c 0.05). On both pre- and post-surveys, residents planned on incorporating obstetric or prenatal care into their future practice (42% vs 52%, respectively; P = 0.57). On both pre- and post-surveys, faculty felt comfortable with OB skills and knowledge (53% vs 62%, respectively; P = 0.75). Lifestyle was the most common reason faculty gave for why they stopped doing deliveries (37% vs 33%, respectively). Conclusion: Implementation of changes to our OB workflow resulted in non-statistically significant improvements in viewpoints toward OB. Resident feelings of OB number adequacy significantly improved following intervention. Further study in multiple clinics could confirm the effectiveness and reasons for success of our interventions

Encoding monomorphic and polymorphic types

Most automatic theorem provers are restricted to untyped logics, and existing translations from typed logics are bulky or unsound. Recent research proposes monotonicity as a means to remove some clutter. Here we pursue this approach systematically, analysing formally a variety of encodings that further improve on efficiency while retaining soundness and completeness. We extend the approach to rank-1 polymorphism and present alternative schemes that lighten the translation of polymorphic symbols based on the novel notion of “cover”. The new encodings are implemented, and partly proved correct, in Isabelle/HOL. Our evaluation finds them vastly superior to previous schemes

Logic-based schedulability analysis for compositional hard real-time embedded systems

This is the author's version of the work. It is posted here by permission of ACM for your personal use. Not for redistribution. The definitive version was published in SIGBED Review, VOL.12, ISS.1, http://doi.acm.org/10.1145/2752801.2752808Over the past decades several approaches for schedu- lability analysis have been proposed for both uniprocessor and multi-processor real-time systems. Although different techniques are employed, very little has been put forward in using formal specifications, with the consequent possibility for misinterpretations or ambiguities in the problem statement. Using a logic based approach to schedulability analysis in the design of hard real-time systems eases the synthesis of correct-by- construction procedures for both static and dynamic verification processes. In this paper we propose a novel approach to schedulability analysis based on a timed temporal logic with time durations. Our approach subsumes classical methods for uniprocessor scheduling analysis over compositional resource models by providing the developer with counter-examples, and by ruling out schedules that cause unsafe violations on the system. We also provide an example showing the effectiveness of our proposal.This work was partially supported by National Funds through FCT (Portuguese Foundation for Science and Technology) and by ERDF (European Regional Development Fund) through COMPETE (Operational Programme ’Thematic Fac- tors of Competitiveness’), within projects Ref. FCOMP-01- 0124-FEDER-022701 (CISTER), FCOMP-01-0124-FEDER- 015006 (VIPCORE) and FCOMP-01-0124-FEDER-020486 (AVIACC)

A Formally Verified Floating-Point Implementation of the Compact Position Reporting Algorithm

The Automatic Dependent Surveillance-Broadcast (ADS-B) system allows aircraft to communicate their current state, including position and velocity information, to other aircraft in their vicinity and to ground stations. The Compact Position Reporting (CPR) algorithm is the ADS-B module responsible for the encoding and decoding of aircraft positions. CPR is highly sensitive to computer arithmetic since it heavily relies on functions that are intrinsically unstable such as floor and modulo. In this paper, a formally-verified double-precision floating-point implementation of the CPR algorithm is presented. The verification proceeds in three steps. First, an alternative version of CPR, which reduces the floating-point rounding error is proposed. Then, the Prototype Verification System (PVS) is used to formally prove that the ideal real-number counterpart of the improved algorithm is mathematically equivalent to the standard CPR definition. Finally, the static analyzer Frama-C is used to verify that the double-precision implementation of the improved algorithm is correct with respect to its operational requirement. The alternative algorithm is currently being considered for inclusion in the revised version of the ADS-B standards document as the reference implementation of the CPR algorithm

A Reduction from Unbounded Linear Mixed Arithmetic Problems into Bounded Problems

We present a combination of the Mixed-Echelon-Hermite transformation and the Double-Bounded Reduction for systems of linear mixed arithmetic that preserve satisfiability and can be computed in polynomial time. Together, the two transformations turn any system of linear mixed constraints into a bounded system, i.e., a system for which termination can be achieved easily. Existing approaches for linear mixed arithmetic, e.g., branch-and-bound and cuts from proofs, only explore a finite search space after application of our two transformations. Instead of generating a priori bounds for the variables, e.g., as suggested by Papadimitriou, unbounded variables are eliminated through the two transformations. The transformations orient themselves on the structure of an input system instead of computing a priori (over-)approximations out of the available constants. Experiments provide further evidence to the efficiency of the transformations in practice. We also present a polynomial method for converting certificates of (un)satisfiability from the transformed to the original system

Satisfiability Checking and Symbolic Computation

Symbolic Computation and Satisfiability Checking are viewed as individual research areas, but they share common interests in the development, implementation and application of decision procedures for arithmetic theories. Despite these commonalities, the two communities are currently only weakly connected. We introduce a new project SC-square to build a joint community in this area, supported by a newly accepted EU (H2020-FETOPEN-CSA) project of the same name. We aim to strengthen the connection between these communities by creating common platforms, initiating interaction and exchange, identifying common challenges, and developing a common roadmap. This abstract and accompanying poster describes the motivation and aims for the project, and reports on the first activities.Comment: 3 page Extended Abstract to accompany an ISSAC 2016 poster. Poster available at http://www.sc-square.org/SC2-AnnouncementPoster.pd

Cognitive disorders in patients with chronic kidney disease: Approaches to prevention and treatment

Background: Cognitive impairment is common in patients with chronic kidney disease (CKD), and early intervention may prevent the progression of this condition. Methods: Here, we review interventions for the complications of CKD (anemia, secondary hyperparathyroidism, metabolic acidosis, harmful effects of dialysis, the accumulation of uremic toxins) and for prevention of vascular events, interventions that may potentially be protective against cognitive impairment. Furthermore, we discuss nonpharmacological and pharmacological methods to prevent cognitive impairment and/or minimize the latter's impact on CKD patients' daily lives. Results: A particular attention on kidney function assessment is suggested during work-up for cognitive impairment. Different approaches are promising to reduce cognitive burden in patients with CKD but the availabe dedicated data are scarce. Conclusions: There is a need for studies assessing the effect of interventions on the cognitive function of patients with CKD

Evaluation of lung MDCT nodule annotation across radiologists and methods

RATIONALE AND OBJECTIVES: Integral to the mission of the National Institutes of Health–sponsored Lung Imaging Database Consortium is the accurate definition of the spatial location of pulmonary nodules. Because the majority of small lung nodules are not resected, a reference standard from histopathology is generally unavailable. Thus assessing the source of variability in defining the spatial location of lung nodules by expert radiologists using different software tools as an alternative form of truth is necessary. MATERIALS AND METHODS: The relative differences in performance of six radiologists each applying three annotation methods to the task of defining the spatial extent of 23 different lung nodules were evaluated. The variability of radiologists’ spatial definitions for a nodule was measured using both volumes and probability maps (p-map). Results were analyzed using a linear mixed-effects model that included nested random effects. RESULTS: Across the combination of all nodules, volume and p-map model parameters were found to be significant at P < .05 for all methods, all radiologists, and all second-order interactions except one. The radiologist and methods variables accounted for 15% and 3.5% of the total p-map variance, respectively, and 40.4% and 31.1% of the total volume variance, respectively. CONCLUSION: Radiologists represent the major source of variance as compared with drawing tools independent of drawing metric used. Although the random noise component is larger for the p-map analysis than for volume estimation, the p-map analysis appears to have more power to detect differences in radiologist-method combinations. The standard deviation of the volume measurement task appears to be proportional to nodule volume

Why3 — Where Programs Meet Provers

Abstract. We present Why3, a tool for deductive program verification, and WhyML, its programming and specification language. WhyML is a first-order language with polymorphic types, pattern matching, and inductive predicates. Programs can make use of record types with mutable fields, type invariants, and ghost code. Verification conditions are discharged by Why3 with the help of various existing automated and interactive theorem provers. To keep verification conditions tractable and comprehensible, WhyML imposes a static control of aliases that obviates the use of a memory model. A user can write WhyML programs directly and get correct-by-construction OCaml programs via an automated extraction mechanism. WhyML is also used as an intermediate language for the verification of C, Java, or Ada programs. We demonstrate the benefits of Why3 and WhyML on nontrivial examples of program verification.

The Geometry of Types

We show that time complexity analysis of higher-order functional programs can be effectively reduced to an arguably simpler (although computationally equivalent) verification problem, namely checking first-order inequalities for validity. This is done by giving an efficient inference algorithm for linear dependent types which, given a PCF term, produces in output both a linear dependent type and a cost expression for the term, together with a set of proof obligations. Actually, the output type judgement is derivable iff all proof obligations are valid. This, coupled with the already known relative completeness of linear dependent types, ensures that no information is lost, i.e., that there are no false positives or negatives. Moreover, the procedure reflects the difficulty of the original problem: simple PCF terms give rise to sets of proof obligations which are easy to solve. The latter can then be put in a format suitable for automatic or semi-automatic verification by external solvers. Ongoing experimental evaluation has produced encouraging results, which are briefly presented in the paper