The Complexity of Approximately Solving Influence Diagrams

Influence diagrams allow for intuitive and yet precise description of complex situations involving decision making under uncertainty. Unfortunately, most of the problems described by influence diagrams are hard to solve. In this paper we discuss the complexity of approximately solving influence diagrams. We do not assume no-forgetting or regularity, which makes the class of problems we address very broad. Remarkably, we show that when both the treewidth and the cardinality of the variables are bounded the problem admits a fully polynomial-time approximation scheme.

A sedimentologic and 14C dating study of five eastern Australian upper continental slope submarine landslides

Sedimentologic and AMS 14C age data are reported for calcareous hemipelagic mud samples taken from gravity cores collected at sites within, or adjacent to five submarine landslides identified with multibeam bathymetry data on the Nerrang Plateau segment and surrounding canyons of eastern Australia's continental slope (Bribie Bowl, Coolangatta-2, Coolangatta-1, Cudgen and Byron). Sediments are comprised of mixtures of calcareous and terrigenous clay (10-20%), silt (50-65%) and sand (15-40%) and are generally uniform in appearance. Their carbonate contents vary between and 17% and 22% by weight while organic carbon contents are less than 10% by weight. Dating of conformably deposited material identified in ten of the twelve cores indicates a range of sediment accumulation rates between 0.017mka-1 and 0.2 mka-1 which are consistent with previous estimates reported for this area. One slide-adjacent core, and four within-landslide cores present depositional hiatus surfaces located at depths of 0.8 to 2.2 meters below the present-day seafloor and identified by a sharp, colour-change boundary; discernable but small increases in sediment stiffness; and a slight increase in sediment bulk density of 0.1 gcm-3. Distinct gaps in AMS 14C age of at least 20ka are recorded across these boundary surfaces. Examination of sub-bottom profiler records of transects through three of the within-slide core-sites and their nearby landslide scarps available for the Coolangatta-1 and Cudgen slides indicate that: 1) the youngest identifiable sediment layer reflectors upslope of these slides, terminate on and are truncated by slide rupture surfaces; and 2) there is no obvious evidence in the sub-bottom profiles for a post-slide sediment layer draped over or otherwise burying slide ruptures or exposed slide detachment surfaces. This suggests that both these submarine landslides are geologically recent and suggests that the hiatus surfaces identified in Coolangatta-1's and Cudgen's within-slide cores are either: a) erosional features that developed after the occurrence of the landslide in which case the hiatus surface age provides a minimum age for landslide occurrence or b) detachment surfaces from which slabs of near-surface sediment were removed during landsliding in which case the post-hiatus sediment dates indicates approximately when landsliding occurred. In either case, it is reasonable to suggest that these two spatially adjacent slides occurred penecontemporaneously approximately 20,000 years ago.

A study protocol for a pilot randomised trial of a structured education programme for the self-management of type 2 diabetes for adults with intellectual disabilities

BACKGROUND: The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmes are not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID. This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrative details.

METHODS/DESIGN: This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical, psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial.

DISCUSSION: The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are significant benefits to be gained globally, if structured education programmes are adapted and shown to be successful for people with ID and other cognitive impairments.

TRIAL REGISTRATION: Registered with International Standard Randomised Controlled Trial (identifier: ISRCTN93185560 ) on 10 November 2014.

Genetically Determined Height and Coronary Artery Disease

Background: The nature and underlying mechanisms of an inverse association between adult height and the risk of coronary artery disease (CAD) are unclear. 
Methods: We used a genetic approach to investigate the association between height and CAD, using 180 height-associated genetic variants. We tested the association between a change in genetically determined height of 1 SD (6.5 cm) with the risk of CAD in 65,066 cases and 128,383 controls. Using individual-level genotype data from 18,249 persons, we also examined the risk of CAD associated with the presence of various numbers of height-associated alleles. To identify putative mechanisms, we analyzed whether genetically determined height was associated with known cardiovascular risk factors and performed a pathway analysis of the height-associated genes. 
Results: We observed a relative increase of 13.5% (95% confidence interval [CI], 5.4 to 22.1; P<0.001) in the risk of CAD per 1-SD decrease in genetically determined height. There was a graded relationship between the presence of an increased number of height-raising variants and a reduced risk of CAD (odds ratio for height quartile 4 versus quartile 1, 0.74; 95% CI, 0.68 to 0.84; P<0.001). Of the 12 risk factors that we studied, we observed significant associations only with levels of low-density lipoprotein cholesterol and triglycerides (accounting for approximately 30% of the association). We identified several overlapping pathways involving genes associated with both development and atherosclerosis. 
Conclusions: There is a primary association between a genetically determined shorter height and an increased risk of CAD, a link that is partly explained by the association between shorter height and an adverse lipid profile. Shared biologic processes that determine achieved height and the development of atherosclerosis may explain some of the association. (Funded by the British Heart Foundation and others.)