Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS)

<p>Abstract</p> <p>Background</p> <p>While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition.</p> <p>Methods</p> <p>Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model.</p> <p>Results</p> <p>A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence.</p> <p>Conclusions</p> <p>This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use.</p

Algorithms for ordinal arithmetic

Abstract. Proofs of termination are essential for establishing the correct behavior of computing systems. There are various ways of establishing termination, but the most general involves the use of ordinals. An example of a theorem proving system in which ordinals are used to prove termination is ACL2. In ACL2, every function defined must be shown to terminate using the ordinals up to ɛ0. We use a compact notation for the ordinals up to ɛ0 (exponentially more succinct than the one used by ACL2) and define efficient algorithms for ordinal addition, subtraction, multiplication, and exponentiation. In this paper we describe our notation and algorithms, prove their correctness, and analyze their complexity.

Automated Synthesis of Induction Axioms for Programs with Second-Order Recursion

In order to support the verification of programs, verification tools such as ACL2 or Isabelle try to extract suitable induction axioms from the definitions of terminating, recursively defined procedures. How-ever, these extraction techniques have difficulties with procedures that are defined by second-order recursion: There a first-order procedure f passes itself as an argument to a second-order procedure like map, every, foldl, etc., which leads to indirect recursive calls. For instance, second-order recursion is commonly used in algorithms on data structures such as terms (variadic trees). We present a method to automatically extract induction axioms from such procedures. Furthermore, we describe how the induction axioms can be optimized (i. e., generalized and simplified). An implementation of our methods demonstrates that the approach facilitates straightforward inductive proofs in a verification tool

IFNL3 genotype is associated with pulmonary fibrosis in patients with systemic sclerosis

Fibrosis across different organs and tissues is likely to share common pathophysiological mechanisms and pathways. Recently, a polymorphism (rs12979860) near the interferon lambda gene (IFNL3) was shown to be associated with fibrosis in liver across multiple disease etiologies. We determined whether this variant is a risk factor for pulmonary fibrosis (PF) and worsening cutaneous fibrosis in systemic sclerosis (SSc). Caucasian patients with SSc (n = 733) were genotyped to test for association with the presence of PF and worsening of skin fibrosis. Serum IFN-λ3 levels from 200 SSc cases were evaluated. An association of the IFNL3 polymorphism with PF was demonstrated (OR: 1.66 (95% CI: 1.142-2.416, p = 0.008). The IFNL3 variant was not a risk factor for worsening of skin fibrosis. Functionally, IFN-λ3 serum levels were higher among subjects with PF compared to those unaffected (P < 0.0001). In conclusion, IFNL3 serum levels and the genetic variant known to be associated with liver fibrosis are similarly linked to PF, but not to worsening of skin fibrosis in SSc. These data highlight both common fibrosis pathways operating between organs, as well as differential effects within the same disease.Mayada Metwally, Khaled Thabet ... Susan Lester, Maureen Rischmueller ... Pravin Hissaria ... Susanna Proudman ... et al

CD4+ T cells support cytotoxic T lymphocyte priming by controlling lymph node input

Rapid induction of CD8+ cytotoxic T lymphocyte (CTL) responses is critical to combat acute infection with intracellular pathogens. CD4+ T cells help prime antigen-specific CTLs in secondary lymphoid organs after infection in the periphery. Although the frequency of naïve precursors is very low, the immune system is able to efficiently screen for cognate CTLs through mechanisms that are not well understood. Here we examine the role of CD4+ T cells in early phases of the immune response. We show that CD4+ T cells help optimal CTL expansion by facilitating entry of naïve polyclonal CD8+ T cells into the draining lymph node (dLN) early after infection or immunization. CD4+ T cells also facilitate input of naïve B cells into reactive LNs. Such “help” involves expansion of the arteriole feeding the dLN and enlargement of the dLN through activation of dendritic cells. In an antigen- and CD40-dependent manner, CD4+ T cells activate dendritic cells to support naïve lymphocyte recruitment to the dLN. Our results reveal a previously unappreciated mode of CD4+ T-cell help, whereby they increase the input of naïve lymphocytes to the relevant LN for efficient screening of cognate CD8+ T cells

Decision procedures for sat, sat modulo theories and beyond. the barcelogictools

Abstract. An overview is given of a number of recent developments in SAT and SAT Modulo Theories (SMT). In particular, based on our framework of Abstract DPLL and Abstract DPLL modulo Theories, we explain our DPLL(T) approach to SMT. Experimental results and future projects are discussed within BarcelogicTools, a set of logic-based tools developed by our research group in Barcelona. At the 2005 SMT competition, BarcelogicTools won all four categories it participated in (out of the seven existing categories).

Verification Condition Generation via Theorem Proving

Abstract. We present a method to convert (i) an operational semantics for a given machine language, and (ii) an off-the-shelf theorem prover, into a high assurance verification condition generator (VCG). Given a program annotated with assertions at cutpoints, we show how to use the theorem prover directly on the operational semantics to generate verification conditions analogous to those produced by a custom-built VCG. Thus no separate VCG is necessary, and the theorem prover can be employed both to generate and to discharge the verification conditions. The method handles both partial and total correctness. It is also compositional in that the correctness of a subroutine needs to be proved once, rather than at each call site. The method has been used to verify several machine-level programs using the ACL2 theorem prover.