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This paper summarizes our efforts to aid human reasoning when verification fails through the use of two distinct Formalization Integrated Development Environments (F-IDEs) that we have developed. Both environments are modular and facilitate reasoning about the full behavior of object-based code. The first environment, referred to as the web-IDE, has been used for several years to teach aspects of formal specification and verification, including why and where verification conditions (VCs) arise and how to use them when verification fails. The second F-IDE, RESOLVE Studio, remains experimental, but is a more fully-fledged environment backed by a sequent-based VC generator that produces VCs with fewer extraneous givens. While the environments and VC generation techniques are necessarily language specific, the principles of alternative VC generation methods, F-IDE features, and observations about their impact on novices and experienced users are more generally applicable., In Proceedings AppFM 2021, arXiv:2111.07538

The aim of the current cohort study was to explore the relationship between return to work (RTW) after cervical cancer treatment and different medical and occupational covariates. We also investigated the effect of RTW on all-cause mortality and survival outcomes of cervical cancer survivors. Data were collected between 2004 and 2015 from the database of the Taiwan Cancer Registry, Labor Insurance Database, and National Health Insurance Research Database. The associations between independent variables and RTW were analyzed by Cox proportional hazard models. A total of 4945 workers (82.3%) who returned to work within 5 years after being diagnosed with cervical cancer. Patients who underwent surgical treatment were more likely to RTW by the 5th year compared to other groups, with a hazard ratio (HR) of 1.21 (95% CI: 1.01~1.44). Small company size and a monthly income greater than NT 38,200 were inversely associated with RTW (HR = 0.91, 95% CI: 0.84~0.98 and HR = 0.48, 95% CI: 0.44~0.53). Furthermore, RTW showed a statistically significant decrease in the risk of all-cause mortality in the fully adjusted HR, (HR = 0.42, p &lt, 0.001). Some medical and occupational factors are associated with RTW in cervical cancer survivors. Returning to work may have a beneficial effect on the survival of patients with cervical cancer.

Accumulating evidence indicates the association between obesity and lung function. However, no previous study has examined whether obesity affects lung function in normal weight participants with high body fat. We hypothesized that subjects with normal weight obesity (NWO) were inversely associated with lung function in Taiwan. The study sample was composed of participants who attended health examinations at the Tri-Service General Hospital from 2010 to 2016. A total of 7801 eligible participants who were classified as NWO were divided into quartiles by percentage body fat (PBF), which was measured by bioelectrical impedance analysis (BIA). A multivariable linear regression was performed to assess the association between PBF quartiles and pulmonary function. The relationship between PBF and the presence of obstructive and restrictive lung diseases was analyzed by a logistic regression. PBF quartiles were closely associated with reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in all adjusted models. This relationship remained significant in the male population, and a dose-dependent effect was observed. Increased PBF was associated with increased risks for the presence of restrictive lung diseases. These results presented a novel finding that body fat exhibited an inverse association with pulmonary function in NWO subjects. More comprehensive management of subjects with normal weight but high body fat, which might contribute to metabolic dysfunction and impaired pulmonary function, is needed.

Osteoporosis is one of the major complications in chronic hepatitis B virus (HBV) and hepatitis C (HCV) infection. However, few studies had examined the relationship between hepatic viral infection with bone loss. Our aim was to investigate the association between hepatic viral infection with bone mineral density (BMD) in a cross-sectional study. Participants who attended the health examinations at the Tri-Service General Hospital (TSGH), Taiwan, were enrolled in the study. Diagnosis of viral hepatitis was confirmed by the serum viral markers of hepatitis B surface antigen (HBsAg) and anti-HCV, and BMD measurement was performed by the bone densitometry. Subjects were divided into four groups by the presence of viral markers. The association between hepatic viral infection and BMD was examined by a multivariate linear regression model. HBV infection was inversely associated with BMD after full adjusting with β values of −0.17 (95% CI: −0.29, −0.05) (p β = −0.16, 95% CI = −0.31, −0.01) (p

Coronavirus disease 2019 was first seen in December 2019. Due to the insidious and complex nature of the disease, the list of symptoms is rapidly expanding. So far, few studies have reported sudden sensorineural hearing loss as a possible symptom of coronavirus disease 2019.A 60-year-old woman with a complaint of sudden sensorineural hearing loss and subjective severe tinnitus presented to the ENT clinic. Coronavirus disease 2019 was subsequently confirmed with a polymerase chain reaction test. At the time of presentation, she was treated with intra-tympanic dexamethasone. Improvements in hearing threshold and speech perception, and a subjective reduction in tinnitus, were observed after treatment.This case report supports evidence from other case reports of a possible association between coronavirus disease 2019 and sudden sensorineural hearing loss. Sudden sensorineural hearing loss may be a symptom of this disease that behaves as an underlying aggravating factor. Intra-tympanic injection of corticosteroids is recommended for managing these patients during the pandemic.

Background Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker’s oral health. Methods From 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health. Results The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR = 2.32, 95% CI 1.03–5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN. Conclusion Our study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.

Object-based development using design-by-contract (DbC) is broadly taught and practiced. Students must be able to read and write symbolic DbC assertions that are sufficiently precise and be able to use these assertions to trace program code. This paper summarizes the results of using an automated tool to pinpoint fine-grain difficulties students face in learning to symbolically trace code involving objects. The pilots were conducted in an undergraduate software engineering course. Quantitative results show that data collected by the tool can help to identify and classify learning obstacles. Qualitative findings help validate student misunderstandings underlying these difficulties. Analysis of exam questions helps understand the persistence of student learning to read and write simple assertions about code behavior. Together, these results provide directions for intervention.

Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants primarily from the incomplete combustion of organic materials. Myriads of studies have reported the associations between PAH exposure with several adverse health outcomes. However, no previous study had explored the relationship between PAH exposure with muscle strength in the elderly population. In the present study, we included 473 elderly adults who were obtained from the US National Health and Nutrition Examination Survey (NHANES) (2001–2006). PAH metabolites were measured in urine samples. Muscle strength was determined as the isokinetic strength of the quadriceps. Pertinent variables were analyzed by various standard measurements. The association between PAH exposure and muscle strength was examined using multivariable linear regression models. After fully adjusting for covariables, PAH metabolites had a negative relationship with muscle strength, especially 3-fluorene (β = –0.021, 95% CI: –0.042, 0.000) and 2-fluorene (β = –0.020, 95% CI: –0.034, –0.005). Notably, the relationship remained significant in males, but not in females. PAH exposure is associated with decreased muscle strength in the US elderly population. Further studies are needed to bring to light the underlying mechanisms for these findings. In addition, it is important to provide interventions and determine strategies for treating the adverse impact of PAH exposure on dynapenia.Novelty PAH exposure is associated with decreased muscle strength in elderly adults. The adverse impact remains in males.

The association between anthropometric indices with chronic kidney disease (CKD) was examined previously. However, the effect of body fat on renal function was not determined clearly. Our aim was to investigate the association of percent body fat (PBF) and renal function in adult population from health examination in Tri-Service General Hospital (2010–2016). 35087 participants aged 20 years and older were enrolled in the study. PBF was measured by bioelectrical impedance analysis (BIA). Estimation of renal function was performed by Taiwanese MDRD equation. Optimal cut-off values of PBF was accessed by a receiver–operator characteristic (ROC) curve analysis. Multivariate regression models were used in the relationship among changes of PBF, renal function, and future CKD. In terms of baseline PBF for CKD, optimal cut-off values of PBF in males and females were 21.55 and 40.75. The changes of PBF were more closely associated with renal function decline than waist circumference (WC) with β values of −0.173 (95% CI: −0.233, −0.112) and −0.077 (95% CI: −0.104, −0.049), respectively. After stratified by gender, this relationship remained significant in male population with β values of −0.276 (95% CI: −0.371, −0.181) and −0.159 (95% CI: −0.207, −0.112), respectively. Female subjects with increased baseline PBF over cut-off values had increased risk for predicting the future CKD with odd ratios (ORs) of 2.298 (95% CI: 1.006–5.252). Body fat had detrimental impact on renal function and development of CKD in adult population. Measurement of PBF for surveillance of renal function impairment was warranted.

Objective To explore the prediction of aerobic exercise and resistance training on incidental metabolic syndrome (MetS) and diabetes in a Taiwanese cohort. Methods The participant underwent annual health examinations and physical fitness tests, including 2-min push-up, 2-min sit-up, and endurance 3000-m none weight-bearing running exercise test from 2013 to 2015, were recruited. The cohort study involved 27,787 participants aged ≥20 years in military services. Multivariate logistic regression odd ratios models were used to explore the associations between the performance of physical fitness and the development of MetS and diabetes. Results The male participants without MetS at baseline with poor performance in aerobic and resistance exercise tests were likely to develop the MetS and diabetes two years later; while the female participants did not show the same results in statistical significance. Additionally, only poor performance measuring by resistance training exercise test was significantly associated with increased risk of metabolic components numbers at follow-up in all subjects without MetS (all P Conclusions The poor performance in aerobic and resistance exercise tests might be predicting tools for MetS and diabetes in Taiwanese men without MetS at baseline. And resistance exercise displayed a substantial predicting ability in development of metabolic abnormality, MetS and diabetes in our study.

Background Loss of soft tissue in heel-calcaneal region is frequently caused by trauma, infection, or tumors. Limited availability of similar tissue becomes challenging, therefore, the use of free tissue transfer offers a solution. Our aim is to describe long term functional outcome of different free tissue transfers for these defects. Patients and methods We retrospectively reviewed 24 consecutive cases of the heel-calcaneal defect between January 2009 and December 2014. The free fasciocutaneous perforator (FCP) flaps were performed in 14 cases and free muscle flaps with skin graft in 10 cases. The postoperative complications, range of motion and ability of ambulation or exercise were administered to evaluate functional results. Results The average follow-up period was 26.5 months. The survival of free flap was 100%. Early complication included venous thrombosis, infection and edge dehiscence was noted in 8 cases. Late complication with insensate ulcers developed in 3 cases (1 cases in FCP flap, 2 cases in muscle flap). All ulcers healed spontaneously without surgical intervention. The postoperative average range of motion of ankle regained 52.79 degree in FCP flap group and 56.4 degree in muscle flap group. The ability of ambulation or exercise returned in 13 cases in FCP group (13/14) and 9 cases in muscle flap group (9/10). No differences of complication rate (P = .403), ROM (P = .363) or functional evaluation (P = .803) could be found between these two groups. Conclusions Both FCP flap and muscle flaps provided the similar and excellent functional results in resurfacing of heel-calcaneal defects after long term follow up.

Objectives The effects of serum uric acid (UA) level on a variety of diseases were found from experimental and observational studies via oxidative stress and anti-oxidants. However, research on the association of UA and hearing thresholds is relatively sparse. We investigated this issue in the U.S. general population to evaluate the relationship of serum UA levels and pure tone threshold of hearing. Methods Forty four thousand eighty four eligible participants aged 20 to 69 years who have serum UA data and received Audiometry Examination Component were enrolled from the National Health and Nutrition Examination Survey 1999–2004. Hearing thresholds (dB) as a pure tone average at low frequencies (0.5, 1, 2 kHz) and at high frequencies (3, 4, 6, and 8 kHz) were computed. Multivariate linear regression models and tertile-based analysis with an extended-model approach for covariates adjustment were used to assess the correlation between serum UA level and hearing thresholds. Results In the adjusted mode of tertile-based analysis, the regression coefficients elucidated as the change of log-transformed mean hearing thresholds upon comparing participants in the highest tertile of serum UA to those in the lowest tertile were –0.067 (P=0.023) in high frequency and –0.058 (P=0.054) in low frequency. After adjusting for multiple pertinent covariates, inverse association between tertiles of serum UA and hearing thresholds remained essentially unchanged. The negative trends between serum UA and hearing thresholds were statistically significant (P for trends

Background Tartrate-resistant phosphatase isoform 5a is expressed in tumor-associated macrophages and is a biomarker of chronic inflammation. Herein, we correlated serum tartrate-resistant phosphatase isoform 5a levels with metabolic syndrome status and made comparisons with traditional markers of inflammation, including c-reactive protein and interleukin-6. Methods One hundred healthy volunteers were randomly selected, and cut-off points for metabolic syndrome related inflammatory biomarkers were determined using receiver operating characteristic curves. Linear and logistic regression models were subsequently used to correlate inflammatory markers with the risk of metabolic syndrome. Results Twenty-two participants met the criteria for metabolic syndrome, and serum tartrate-resistant phosphatase isoform 5a levels of >5.8 μg/L were associated with metabolic syndrome (c-statistics, 0.730; p = 0.001; 95% confidence interval, 0.618-0.842). In addition, 1 μg/L increases in tartrate-resistant phosphatase isoform 5a levels were indicative of a 1.860 fold increase in the risk of metabolic syndrome (p = 0.012). Conclusions Elevated serum tartrate-resistant phosphatase isoform 5a levels are associated with the risk of metabolic syndrome, with a cut-off level of 5.8 μg/L.

A great number of pipelines in China are in unsatisfactory condition and faced with problems of corrosion and cracking, but there are very few approaches for underwater pipeline detection. Pipeline detection autonomous underwater vehicle (PDAUV) is hereby designed to solve these problems when working with advanced optical, acoustical and electrical sensors for underwater pipeline detection. PDAUV is a test bed that not only examines the logical rationality of the program, effectiveness of the hardware architecture, accuracy of the software interface protocol as well as the reliability and stability of the control system but also verifies the effectiveness of the control system in tank experiments and sea trials. The motion control system of PDAUV, including both the hardware and software architectures, is introduced in this work. The software module and information flow of the motion control system of PDAUV and a novel neural network-based control (NNC) are also covered. Besides, a real-time identification method based on neural network is used to realize system identification. The tank experiments and sea trials are carried out to verify the feasibility and capability of PDAUV control system to complete underwater pipeline detection task.

Based on the traditional boring bar, a boring bar with friction damper is proposed in the paper. Firstly, the frequency response under different pressures is computed primarily based on the theory, which shows that the proposed boring bar has a certain vibration reduction effect. Secondly, the finite element model of the boring bar is built, and the first 6-order modes are computed, whose results are compared with the experimental value. As a result, the virtual reality of the boring bar is achieved. They are consistent with each other, which show that the finite element model is reliable. Then, the experimental cutting process of the boring bar is researched, which is compared with the simulation model with good coincidence. It is found from the result that the cutting simulation model of the boring bar is effective. Later, based on the verified simulation model, the positive pressure between the friction vibrator and boring bar, cutting speed, feed rate, back cutting depth and other parameters are changed to study the vibration reduction effects of the boring bar with friction damper. PSO (particle swarm optimization)-BP (backpropagation) neural network is then used to optimize the cutting process of the boring bar, and the optimal cutting parameters can be obtained. Finally, these optimized parameters are applied in the boring bar, the vibration reduction effect of the boring bar is verified by means of experiments, and the corresponding result shows that the proposed optimization in this paper is feasible. We can obtain higher quality work piece when we use this boring bar in the actual engineering.

The prevalence of obesity was increasing and became a growing problem worldwide. Obesity increased the risk of developing metabolic abnormalities and was associated adverse health outcomes. Our aim was to examine the associations among different combinations of obesity phenotypes (high body mass index > 27 kg/m2 (O), high waist circumference (male > 90 cm, female > 80 cm) (W), fatty liver (F) and percentage body fat in top 40% (P)) and cardiometabolic diseases (type 2 diabetes mellitus (DM), hypertension (HTN), metabolic syndrome (MetS)). A total of 48426 eligible subjects were categorized based on the different definitions. After adjusting for all covariables, participants with O + F + P combination were more likely associated with the presence of DM. Participants with O + W combination were more associated with the presence of HTN than others. Participants with O + W + F + P had higher risk for the presence of MetS than others. The study addressed the associations between different obesity phenotypes and DM and HTN in the adult population. Better understanding the pathophysiological mechanisms underlined individual vulnerability and progression of cardiometabolic insults.

Several research studies have shown the benefits of code tracing to promote student understanding of program behavior. While code tracing on specific input values is a useful starting point, students ultimately need to be able to reason rigorously and logically about the correctness of their code on all (i.e., arbitrary) inputs. Otherwise, they may make false generalizations and may achieve only a shallow understanding. Results of a multi-semester experiment to answer the following research questions: (1) With or without steps, can students learn the basics of tracing code on symbolic input values using an online tool? And how important is classroom instruction? (2) What is the impact of motivation on student attitudes in learning to reason with such a tool? Data was obtained from 297 subjects who used the online reasoning tool in a second-year software development course for CS majors. Analysis indicates that students can do symbolic reasoning to trace code and that instruction and motivation have significant impact.

Emerging studies have shed light on the association between Helicobacter pylori (HP) infection and cardiometabolic risk. However, there is no evidence to support a causal link for the relationship in the general population. Our aim was to determine whether HP infection is associated with the risks of incident type II diabetes mellitus (DM) in a population-based cohort consisting of adults from the general population. A total of 69235 adults enrolled in the study obtained health examinations at the Tri-Service General Hospital in Taiwan from 2010 to 2016. HP infection detection was performed by rapid urease tests (RUTs), and endoscopic examinations were used to diagnose gastroesophageal reflux disease (GERD), gastric ulcers (GUs) and duodenal ulcers (DUs). Cross-sectional and longitudinal analyses were performed to examine the association between HP infection and cardiometabolic diseases using logistic regression and Cox regression in a large population-based study. HP infection was significantly associated with the presence of metabolic syndrome (MetS) (OR = 1.26, 95%CI: 1.00-1.57) and DM (OR = 1.59, 95%CI: 1.17-2.17) only in male subjects, and abnormal endoscopic findings were also correlated with cardiometabolic diseases. Our findings demonstrated that participants with HP infection had an elevated risk of developing incident DM (HR = 1.54, 95%CI: 1.11-2.13). In addition, endoscopic findings of a DU (HR = 1.63, 95%CI: 1.02-2.63), rather than GERD or a GU, were also predictive of incident DM. In this cohort, HP infection was a statistically significant predictor of incident DM among male population.

Background: Vitamin D deficiency became increasingly common worldwide and was related to various disorders. However, there was little information concerning the relationship between serum 25-hydroxyvitamin D (25(OH) D) level and shift work. The aim of this paper was to investigate the relation between serum 25(OH) D level and shift work in the American citizens. Methods: From the 2005–2006 NHANES, a total of 3025 participants were included. The relation between serum 25(OH) D level and shift work was investigated through the regression models. Results: There was an inverse relationship between serum 25(OH) D level and female shift worker in the fully adjusted models (β coefficient = −8.774, 95% confidence intervals [CI] = −16.83–−0.71, P = 0.03). Additionally, a negative correlation was presented between serum 25OHD level and Mexican American (β coefficient = −9.825, 95% CI = −19.31–−0.33, P = 0.04). No significant differences in serum 25(OH) D level were presented among indoor/outdoor works or manual/nonmanual works. However, long working hours (>40 h/week) were remarkably correlated with low serum 25(OH) D level (β coefficient = −8.007, 95% CI = −15.32–−0.68, P = 0.03). Conclusions: Our study concluded there was an inverse correlation between serum 25(OH) D level and shift work, especially in female population.

Autonomous Underwater Vehicles (AUVs) generally work in complex marine environments. Any fault in AUVs may cause significant losses. Thus, system reliability and automatic fault diagnosis are important. To address the actuator failure of AUVs, a fault diagnosis method based on the Gaussian particle filter is proposed in this study. Six free-space motion equation mathematical models are established in accordance with the actuator configuration of AUVs. The value of the control (moment) loss parameter is adopted on the basis of these models to represent underwater vehicle malfunction, and an actuator failure model is established. An improved Gaussian particle filtering algorithm is proposed and is used to estimate the AUV failure model and motion state. Bayes algorithm is employed to perform robot fault detection. The sliding window method is adopted for fault magnitude estimation. The feasibility and validity of the proposed method are verified through simulation experiments and experimental data.

Family history was one of the major risk factors for developing adverse health outcomes such as metabolic syndrome (MetS), type 2 diabetes mellitus (DM) and hypertension (HTN). Our aim was to examine the relationship between different family histories and cardiometabolic events, including DM, stroke, myocardial infarction (MI), and HTN. Participants who attended the health examinations at the Tri-Service General Hospital from 2010 to 2016 were enrolled in the study and were categorized into four groups by representing different family history. A multivariable logistic regression model was used for the associations between various family history with the cardiometabolic events. Subjects with family history of DM were divided into quartiles by percentage body fat (PBF) to be analyzed for these adverse outcomes. In the cross-sectional analysis, subjects with family history of DM had significant association with MetS (OR = 1.34 [95%CI: 1.17–1.54]) and DM (OR = 3.03 [95%CI: 2.44–3.76]), and those with family history of HTN were positively associated with HTN (OR = 1.60 [95%CI: 1.41–1.81]). Notably, those with family history of DM in higher PBF quartiles had substantially increased association of cardiometabolic events (MetS: OR = 15.20 [95%CI: 9.87–23.39]; DM: OR = 3.35 [95%CI: 1.91–5.90]; HTN: 2.81 [95%CI: 1.84–4.29]). Individuals with family history of DM were positively associated with MetS and DM, and those with family history of HTN was associated with HTN. Family history assessment was requested especially in obese population for screening adverse health outcomes.

CS students can typically reason about what a piece of code does on specific inputs. While this is a useful starting point, graduates must also be able to logically analyze, comprehend, and predict the behavior of their code in more general terms, no matter what the inputs are. Results of data collection and analysis from an online educational system show it can help to pinpoint the difficulties in doing this for individual students and groups, and to partition the groups in terms of their difficulties so that instructional interventions may be better targeted. Unlike traditional debugging, this online system helps reveal difficulties in reasoning in more general terms because it is equipped with a verification engine.

Fibrocystic breast change (FBC) is extremely common and occurrs in 90% of women during their lives. The association between body composition and risk of breast cancer is well established. We hypothesized that the effect might exist during the development of FBC. Our aim was to examine the relationships of total lean mass (TLM) and percent body fat (PBF) with FBC in a general female population. In total, 8477 female subjects aged 20 years or older were enrolled in the study at the Tri-Service General Hospital in Taiwan from 2011 to 2016. Comprehensive examinations including biochemical data, measurements of body composition and breast ultrasound were performed. PBF was positively associated with the presence of FBC (OR = 1.039, 95%CI: 1.018–1.060), and TLM showed the opposite result (OR = 0.893, 95%CI: 0.861–0.926). Condition of metabolic syndrome (MetS), diabetes (DM) and fatty liver modified the association between PBF and FBC (P