Combinable Extensions of Abelian Groups

The design of decision procedures for combinations of theories sharing some arithmetic fragment is a challenging problem in verification. One possible solution is to apply a combination method à la Nelson-Oppen, like the one developed by Ghilardi for unions of non-disjoint theories. We show how to apply this non-disjoint combination method with the theory of abelian groups as shared theory. We consider the completeness and the effectiveness of this non-disjoint combination method. For the completeness, we show that the theory of abelian groups can be embedded into a theory admitting quantifier elimination. For achieving effectiveness, we rely on a superposition calculus modulo abelian groups that is shown complete for theories of practical interest in verification

From Non-Disjoint Combination to Satisfiability and Model-Checking of Infinite State Systems

In the first part of our contribution, we review recent results on combined constraint satisfiability for first order theories in the non-disjoint signatures case: this is done mainly in view of the applications to temporal satisfiability and model-checking covered by the second part of our talk, but we also illustrate in more detail some case-study where non-disjoint combination arises. The first case deals with extensions of the theory of arrays where indexes are endowed with a Presburger arithmetic structure and a length expressing `dimension\u27 is added; the second case deals with the algebraic counterparts of fusion in modal logics. We then recall the basic features of the Nelson-Oppen method and investigate sufficient conditions for it to be complete and terminating in the non-disjoint signatures case: for completeness we rely on a model-theoretic $T_0$-compatibility condition (generalizing stable infiniteness) and for termination we impose a noetherianity requirement on positive constraints chains. We finally supply examples of theories matching these combinability hypotheses. In the second part of our contribution, we develop a framework for integrating first-order logic (FOL) and discrete Linear time Temporal Logic (LTL). Manna and Pnueli have extensively shown how a mixture of FOL and LTL is sufficient to precisely state verification problems for the class of reactive systems: theories in FOL model the (possibly infinite) data structures used by a reactive system while LTL specifies its (dynamic) behavior. Our framework for the integration is the following: we fix a theory $T$ in a first-order signature $Sigma$ and consider as a temporal model a sequence $cM_1, cM_2, dots$ of standard (first-order) models of $T$ and assume such models to share the same carrier (or, equivalently, the domain of the temporal model to be `constant\u27). Following Plaisted, we consider symbols from a subsignature $Sigma_r$ of $Sigma$ to be emph{rigid}, i.e. in a temporal model $cM_1, cM_2, dots$, the $Sigma_r$-restrictions of the $cM_i$\u27s must coincide. The symbols in $Sigmasetminus Sigma_r$ are called `flexible\u27 and their interpretation is allowed to change over time (free variables are similarly divided into `rigid\u27 and `flexible\u27). For model-checking, the emph{initial states} and the emph{transition relation} are represented by first-order formulae, whose role is that of (non-deterministically) restricting the temporal evolution of the model. In the quantifier-free case, we obtain sufficient conditions for %undecidability and decidability for both satisfiability and model-checking of safety properties emph{by lifting combination methods} for emph{non-disjoint} theories in FOL: noetherianity and $T_0$-compatibility (where $T_0$ is the theory axiomatizing the rigid subtheory) gives decidability of satisfiability, whereas $T_0$-compatibility and local finiteness give safety model-checking decidability. The proofs of these decidability results suggest how decision procedures for the constraint satisfiability problem of theories in FOL and algorithms for checking the satisfiability of propositional LTL formulae can be integrated. This paves the way to employ efficient Satisfiability Modulo Theories solvers in the model-checking of infinite state systems. We illustrate our techniques on some examples and discuss further work in the area

Data Structures with Arithmetic Constraints: a Non-disjoint Combination

version courte de inria-00397080 (INRIA RR-6963)International audienceWe apply an extension of the Nelson-Oppen combination method to develop a decision procedure for the non-disjoint union of theories modeling data structures with a counting operator and fragments of arithmetic. We present some data structures and some fragments of arithmetic for which the combination method is complete and effective. To achieve effectiveness, the combination method relies on particular procedures to compute sets that are representative of all the consequences over the shared theory. We show how to compute these sets by using a superposition calculus for the theories of the considered data structures and various solving and reduction techniques for the fragments of arithmetic we are interested in, including Gauss elimination, Fourier-Motzkin elimination and Groebner bases computation

Data Structures with Arithmetic Constraints: a Non-Disjoint Combination

We apply an extension of the Nelson-Oppen combination method to develop a decision procedure for the non-disjoint union of theories modeling data structures with a counting operator and fragments of arithmetic. We present some data structures and some fragments of arithmetic for which the combination method is complete and effective. To achieve effectiveness, the combination method relies on particular procedures to compute sets that are representative of all the consequences over the shared theory. We show how to compute these sets by using a superposition calculus for the theories of the considered data structures and various solving and reduction techniques for the fragments of arithmetic we are interested in, including Gauss elimination, Fourier-Motzkin elimination and Groebner bases computation

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population