Case-Analysis for Rippling and Inductive Proof

Rippling is a heuristic used to guide rewriting and is typically used for inductive theorem proving. We introduce a method to support case-analysis within rippling. Like earlier work, this allows goals containing if-statements to be proved automatically. The new contribution is that our method also supports case-analysis on datatypes. By locating the case-analysis as a step within rippling we also maintain the termination. The work has been implemented in IsaPlanner and used to extend the existing inductive proof method. We evaluate this extended prover on a large set of examples from Isabelle’s theory library and from the inductive theorem proving literature. We find that this leads to a significant improvement in the coverage of inductive theorem proving. The main limitations of the extended prover are identified, highlight the need for advances in the treatment of assumptions during rippling and when conjecturing lemmas

Is treatment of depression cost-effective in people with diabetes? A systematic review of the economic evidence

PublishedJournal ArticleResearch Support, Non-U.S. Gov'tReviewOBJECTIVES: Depression is common in diabetes and linked to a wide range of adverse outcomes. UK policy indicates that depression should be treated using conventional psychological treatments in a stepped care framework. This review aimed to identify current economic evidence of psychological treatments for depression among people with diabetes. METHOD: Electronic search strategies (conducted in MEDLINE, EMBASE, PsycINFO, CINAHL, NHS EED) combined clinical and economic search terms to identify full economic evaluations of the relevant interventions. Prespecified screening and inclusion criteria were used. Standardized data extraction and critical appraisal were conducted and the results summarized qualitatively. RESULTS: Excluding duplicates, 1,516 studies for co-morbid depression and diabetes were screened. Four economic evaluations were identified. The studies found that the interventions improved health status, reduced depression and were cost-effective compared with usual care. The studies were all U.S.-based and evaluated collaborative care programs that included psychological therapies. Critical appraisal indicated limitations with the study designs, analysis and results for all studies. CONCLUSIONS: The review highlighted the paucity of evidence in this area. The four studies indicated the potential of interventions to reduce depression and be cost-effective compared with usual care. Two studies reported costs per QALY gained of USD 267 to USD 4,317, whilst two studies reported the intervention dominated usual care, with net savings of USD 440 to USD 612 and net gains in patient free days or QALYs

Rasch analysis of a new Patient Reported Outcome Measure for Psoriasis Treatment (PROMPT)

OBJECTIVES A draft patient-reported outcome measure for psoriasis treatment (PROMPT) was developed through patient interviews and comprised 91 items across seven core domains. This study aimed to evaluate the scaling properties and construct validity of the draft measure using the Rasch measurement model. METHODS Patients with chronic plaque psoriasis were identified and recruited according to pre-defined inclusion and exclusion criteria through psoriasis-specific secondary care clinics in the United Kingdom and two national patient organizations. Patients completed the draft measure at two time points, 14 days apart. Respondents with ≥40% of missing data were removed from the final analyses. Data from each sub-scale were analyzed separately using RUMM2030 software to explore Rasch model fit, item difficulty, local dependence, item category thresholds, and differential item functioning (DIF) by age and gender. Where necessary, items were removed individually and the scale iteratively reassessed for fit and unidimensionality. RESULTS A sample of n=209 patients with chronic plaque psoriasis completed the draft measure. Initial fit to the model was poor; disordered category thresholds were identified for items in all scales. Post-hocre-scoring from a 5-point Likert scale to a 3-point Likert scale improved model fit. Items which showed local dependence were removed in context of qualitative findings. Following removal of 11 items, all 7 scales demonstrated acceptable fit with the Rasch model (Chi Sq = 0.09 to 0.2) There was no evidence of DIF by age and gender. CONCLUSIONS The new measure, PROMPT, comprised 80 items in 6 independent, unidimensional scales, free from age or gender bias, with acceptable fit to the Rasch model. As such, the measure is considered to show initial promise for use with patients with chronic plaque psoriasis in a clinical setting. The psychometric properties and scoring of the measure should be explored further and confirmed in future studies

Nonuniform high-gamma (60-500 Hz) power changes dissociate cognitive task and anatomy in human cortex

High-gamma-band (\u3e60 Hz) power changes in cortical electrophysiology are a reliable indicator of focal, event-related cortical activity. Despite discoveries of oscillatory subthreshold and synchronous suprathreshold activity at the cellular level, there is an increasingly popular view that high-gamma-band amplitude changes recorded from cellular ensembles are the result of asynchronous firing activity that yields wideband and uniform power increases. Others have demonstrated independence of power changes in the low- and high-gamma bands, but to date, no studies have shown evidence of any such independence above 60 Hz. Based on nonuniformities in time-frequency analyses of electrocorticographic (ECoG) signals, we hypothesized that induced high-gamma-band (60-500 Hz) power changes are more heterogeneous than currently understood. Using single-word repetition tasks in six human subjects, we showed that functional responsiveness of different ECoG high-gamma sub-bands can discriminate cognitive task (e.g., hearing, reading, speaking) and cortical locations. Power changes in these sub-bands of the high-gamma range are consistently present within single trials and have statistically different time courses within the trial structure. Moreover, when consolidated across all subjects within three task-relevant anatomic regions (sensorimotor, Broca\u27s area, and superior temporal gyrus), these behavior- and location-dependent power changes evidenced nonuniform trends across the population. Together, the independence and nonuniformity of power changes across a broad range of frequencies suggest that a new approach to evaluating high-gamma-band cortical activity is necessary. These findings show that in addition to time and location, frequency is another fundamental dimension of high-gamma dynamics

Defining Reasoning, Reflective Practice, and Evidence-Based Practice in Occupational Therapy Education: A Delphi Study

Reasoning, reflective practice, and evidence-based practice are essential skills for occupational therapy practitioners, but it is unclear how these skills are defined in occupational therapy education. We used Delphi methodology to explore educator conceptualizations of clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Eligible participants on the Delphi expert panel were required to have been an educator in an occupational therapy program for at least three years at the master’s level or higher, to be a current occupational therapy educator, based in the United States, and available across multiple survey rounds. Nine participants completed all three survey rounds. Among members of the expert panel there was continued moderate disagreement about terminology related to reasoning and there were some discrepancies between expert perspectives and the occupational therapy literature. However, these educators largely agreed on key features of the complex constructs. Consistency about the use of these terms will support both education and research related to essential professional skills

Relationships Between Reasoning, Reflective Practice, and Evidence-Based Practice: Educators’ Perspectives

Many models of professional thinking exist within occupational therapy, but the relationships among reasoning, reflective practice, and evidence-based practice as essential skills for practice are not clear. Because occupational therapy educators impart these skills to students, understanding how educators conceptualize relationships among skills is necessary. We used Delphi methodology to explore educator conceptualizations of the relationships among clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Inclusion criteria were: an educator in an occupational therapy program for at least three years at the master’s level or higher, currently an occupational therapy educator based in the United States, and available across multiple survey rounds. Nine participants completed all three survey rounds. Participants agreed that the four skills are reciprocally related to one another, with some discrepancies surrounding differing conceptualizations of clinical and professional reasoning. Additionally, relationships were understood to be non-linear and complex. Continued exploration of how these essential skills are related to one another is needed to support future exploration of how they are integrated in occupational therapy education and how this influences practice

Special Purpose, but Domain Independent, Inference Mechanisms

vie describe a number of special purpose, but domain independent, inference mechanisms. While these rl1echanisms are limited to certain kinds of inference and illference rules, they do not rely on special properties of the domain, but on logical properties of predicates and rules, ~Ihich make them equally applicable to other domains. These logical properties include: transitivity, functionality and unarit.y. The union of the~e mechanisms handles nearly all the inference required in the Mecho project for solving mechanics problems stated in English

Identification and characterisation of enteroaggregative Escherichia coli subtypes associated with human disease

Enteroaggregative E. coli (EAEC) are a major cause of diarrhoea worldwide. Due to their heterogeneity and carriage in healthy individuals, identification of diagnostic virulence markers for pathogenic strains has been difficult. In this study, we have determined phenotypic and genotypic differences between EAEC strains of sequence types (STs) epidemiologically associated with asymptomatic carriage (ST31) and diarrhoeal disease (ST40). ST40 strains demonstrated significantly enhanced intestinal adherence, biofilm formation, and pro-inflammatory interleukin-8 secretion compared with ST31 isolates. This was independent of whether strains were derived from diarrhoea patients or healthy controls. Whole genome sequencing revealed differences in putative virulence genes encoding aggregative adherence fimbriae, E. coli common pilus, flagellin and EAEC heat-stable enterotoxin 1. Our results indicate that ST40 strains have a higher intrinsic potential of human pathogenesis due to a specific combination of virulence-related factors which promote host cell colonization and inflammation. These findings may contribute to the development of genotypic and/or phenotypic markers for EAEC strains of high virulence

Adaptive Optics Imaging of QSOs with Double-Peaked Narrow Lines: Are they Dual AGNs?

Active galaxies hosting two accreting and merging super-massive black holes (SMBHs) -- dual Active Galactic Nuclei (AGN) -- are predicted by many current and popular models of black hole-galaxy co-evolution. We present here the results of a program that has identified a set of probable dual AGN candidates based on near Infra-red (NIR) Laser Guide-Star Adaptive Optics (LGS AO) imaging with the Keck II telescope. These candidates are selected from a complete sample of radio-quiet Quasi-stellar Objects (QSOs) drawn from the Sloan Digital Sky Survey (SDSS), which show double-peaked narrow AGN emission lines. Of the twelve AGNs imaged, we find six with double galaxy structure, of which four are in galaxy mergers. We measure the ionization of the two velocity components in the narrow AGN lines to test the hypothesis that both velocity components come from an active nucleus. The combination of a well-defined parent sample and high-quality imaging allows us to place constraints on the fraction of SDSS QSOs that host dual accreting black holes separated on kiloparsec (kpc) scales: ~0.3%-0.65%. We derive from this fraction the time spent in a QSO phase during a typical merger and find a value that is much lower than estimates that arise from QSO space densities and galaxy merger statistics. We discuss possible reasons for this difference. Finally, we compare the SMBH mass distributions of single and dual AGN and find little difference between the two within the limited statistics of our program, hinting that most SMBH growth happens in the later stages of a merger process.Comment: 9 pages, 4 figures, 1 table; accepted to the Astrophysical Journa