Age-related oral changes

<p>Age-related oral changes are seen in the oral hard and soft tissues as well as in bone, the temporomandibular joints and the oral mucosa. As older patients retain their natural teeth for longer, the clinical picture consists of normal physiological age changes in combination with pathological and iatrogenic effects.</p><p>CLINICAL RELEVANCE: With an ageing population retaining more of its natural teeth for longer, dental professionals should expect to observe oral age changes more frequently.</p>

The Equiprobability Bias from a Mathematical and Psychological Perspective

<p>The equiprobability bias (EB) is a tendency to believe that every process in which randomness is involved corresponds to a fair distribution, with equal probabilities for any possible outcome. The EB is known to affect both children and adults, and to increase with probability education. Because it results in probability errors resistant to pedagogical interventions, it has been described as a deep misconception about randomness: the erroneous belief that randomness implies uniformity. In the present paper, we show that the EB is actually not the result of a conceptual error about the definition of randomness. On the contrary, the mathematical theory of randomness does imply uniformity. However, the EB is still a bias, because people tend to assume uniformity even in the case of events that are not random. The pervasiveness of the EB reveals a paradox: The combination of random processes is not necessarily random. The link between the EB and this paradox is discussed, and suggestions are made regarding educational design to overcome difficulties encountered by students as a consequence of the EB.</p>

Probabilistic Inference in Credal Networks: New Complexity Results

Credal networks are graph-based statistical models whose parameters take values in a set, instead of being sharply specified as in traditional statistical models (e.g., Bayesian networks). The computational complexity of inferences on such models depends on the irrelevance/independence concept adopted. In this paper, we study inferential complexity under the concepts of epistemic irrelevance and strong independence. We show that inferences under strong independence are NP-hard even in trees with binary variables except for a single ternary one. We prove that under epistemic irrelevance the polynomial-time complexity of inferences in credal trees is not likely to extend to more general models (e.g., singly connected topologies). These results clearly distinguish networks that admit efficient inferences and those where inferences are most likely hard, and settle several open questions regarding their computational complexity. We show that these results remain valid even if we disallow the use of zero probabilities. We also show that the computation of bounds on the probability of the future state in a hidden Markov model is the same whether we assume epistemic irrelevance or strong independence, and we prove an analogous result for inference in Naive Bayes structures. These inferential equivalences are important for practitioners, as hidden Markov models and Naive Bayes networks are used in real applications of imprecise probability.

A tree augmented classifier based on Extreme Imprecise Dirichlet Model

We present TANC, a TAN classifier (tree-augmented naive) based on imprecise probabilities. TANC models prior near-ignorance via the Extreme Imprecise Dirichlet Model (EDM). A first contribution of this paper is the experimental comparison between EDM and the global Imprecise Dirichlet Model using the naive credal classifier (NCC), with the aim of showing that EDM is a sensible approximation of the global IDM. TANC is able to deal with missing data in a conservative manner by considering all possible completions (without assuming them to be missing-at-random), but avoiding an exponential increase of the computational time. By experiments on real data sets, we show that TANC is more reliable than the Bayesian TAN and that it provides better performance compared to previous TANs based on imprecise probabilities. Yet, TANC is sometimes outperformed by NCC because the learned TAN structures are too complex; this calls for novel algorithms for learning the TAN structures, better suited for an imprecise probability classifier.

Generalized loopy 2U: A new algorithm for approximate inference in credal networks

Credal networks generalize Bayesian networks by relaxing the requirement of precision of probabilities. Credal networks are considerably more expressive than Bayesian networks, but this makes belief updating NP-hard even on polytrees. We develop a new efficient algorithm for approximate belief updating in credal networks. The algorithm is based on an important representation result we prove for general credal networks: that any credal network can be equivalently reformulated as a credal network with binary variables; moreover, the transformation, which is considerably more complex than in the Bayesian case, can be implemented in polynomial time. The equivalent binary credal network is then updated by L2U, a loopy approximate algorithm for binary credal networks. Overall, we generalize L2U to non-binary credal networks, obtaining a scalable algorithm for the general case, which is approximate only because of its loopy nature. The accuracy of the inferences with respect to other state-of-the-art algorithms is evaluated by extensive numerical tests.

Semi-Qualitative Probabilistic Networks in Computer Vision Problems

This paper explores the application of semi-qualitative probabilistic networks (SQPNs) that combine numeric and qualitative information to computer vision problems. Our version of SQPN allows qualitative influences and imprecise probability measures using intervals. We describe an Imprecise Dirichlet model for parameter learning and an iterative algorithm for evaluating posterior probabilities, maximum a posteriori and most probable explanations. Experiments on facial expression recognition and image segmentation problems are performed using real data.

Algorithms for Hidden Markov Models With Imprecisely Specified Parameters

Hidden Markov models (HMMs) are widely used models for sequential data. As with other probabilistic graphical models, they require the specification of precise probability values, which can be too restrictive for some domains, especially when data are scarce or costly to acquire. We present a generalized version of HMMs, whose quantification can be done by sets of, instead of single, probability distributions. Our models have the ability to suspend judgment when there is not enough statistical evidence, and can serve as a sensitivity analysis tool for standard non-stationary HMMs. Efficient inference algorithms are developed to address standard HMM usage such as the computation of likelihoods and most probable explanations. Experiments with real data show that the use of imprecise probabilities leads to more reliable inferences without compromising efficiency.

Decision Making by Credal Nets

Credal nets are probabilistic graphical models which extend Bayesian nets to cope with sets of distributions. This feature makes the model particularly suited for the implementation of classifiers and knowledge-based systems. When working with sets of (instead of single) probability distributions, the identification of the optimal option can be based on different criteria, some of them eventually leading to multiple choices. Yet, most of the inference algorithms for credal nets are designed to compute only the bounds of the posterior probabilities. This prevents some of the existing criteria from being used. To overcome this limitation, we present two simple transformations for credal nets which make it possible to compute decisions based on the maximality and E-admissibility criteria without any modification in the inference algorithms. We also prove that these decision problems have the same complexity of standard inference, being NP^PP-hard for general credal nets and NP-hard for polytrees.

A Tree Augmented Classifier Based on Extreme Imprecise Dirichlet Model

In this paper we present TANC, i.e., a tree-augmented naive credal classifier based on imprecise probabilities; it models prior near-ignorance via the Extreme Imprecise Dirichlet Model (EDM) (Cano et al., 2007) and deals conservatively with missing data in the training set, without assuming them to be missing-at-random. The EDM is an approximation of the global Imprecise Dirichlet Model (IDM), which considerably simplifies the computation of upper and lower probabilities; yet, having been only recently introduced, the quality of the provided approximation needs still to be verified. As first contribution, we extensively compare the output of the naive credal classifier (one of the few cases in which the global IDM can be exactly implemented) when learned with the EDM and the global IDM; the output of the classifier appears to be identical in the vast majority of cases, thus supporting the adoption of the EDM in real classification problems. Then, by experiments we show that TANC is more reliable than the precise TAN (learned with uniform prior), and also that it provides better performance compared to a previous (Zaffalon, 2003) TAN model based on imprecise probabilities. TANC treats missing data by considering all possible completions of the training set, but avoiding an exponential increase of the computational times; eventually, we present some preliminary results with missing data.

Generalized Loopy 2U: A New Algorithm for Approximate Inference in Credal Networks

Credal nets generalize Bayesian nets by relaxing the requirement of precision of probabilities. Credal nets are considerably more expressive than Bayesian nets, but this makes belief updating NP-hard even on polytrees. We develop a new efficient algorithm for approximate belief updating in credal nets. The algorithm is based on an important representation result we prove for general credal nets: that any credal net can be equivalently reformulated as a credal net with binary variables; moreover, the transformation, which is considerably more complex than in the Bayesian case, can be implemented in polynomial time. The equivalent binary credal net is updated by L2U, a loopy approximate algorithm for binary credal nets. Thus, we generalize L2U to non-binary credal nets, obtaining an accurate and scalable algorithm for the general case, which is approximate only because of its loopy nature. The accuracy of the inferences is evaluated by empirical tests.

Inference in Credal Networks Through Integer Programming

A credal network associates a directed acyclic graph with a collection of sets of probability measures; it offers a compact representation for sets of multivariate distributions. In this paper we present a new algorithm for inference in credal networks based on an integer programming reformulation. We are concerned with computation of lower/upper probabilities for a variable in a given credal network. Experiments reported in this paper indicate that this new algorithm has better performance than existing ones for some important classes of networks.

The Inferential Complexity of Bayesian and Credal Networks

This paper presents new results on the complexity of graph-theoretical models that represent probabilities (Bayesian networks) and that represent interval and set valued probabilities (credal networks). We define a new class of networks with bounded width, and introduce a new decision problem for Bayesian networks, the maximin a posteriori. We present new links between the Bayesian and credal networks, and present new results both for Bayesian networks (most probable explanation with observations, maximin a posteriori) and for credal networks (bounds on probabilities a posteriori, most probable explanation with and without observations, maximum a posteriori).

Propositional and Relational Bayesian Networks Associated with Imprecise and Qualitative Probabilistic Assessments

This paper investigates a representation language with flexibility inspired by probabilistic logic and compactness inspired by relational Bayesian networks. The goal is to handle propositional and first-order constructs together with precise, imprecise, indeterminate and qualitative probabilistic assessments. The paper shows how this can be achieved through the theory of credal networks. New exact and approximate inference algorithms based on multilinear programming and iterated/loopy propagation of interval probabilities are presented; their superior performance, compared to existing ones, is shown empirically.

Inference in credal networks using multilinear programming

A credal network is a graphical tool for representation and manipulation of uncertainty, where probability values may be imprecise or indeterminate. A credal network associates a directed acyclic graph with a collection of sets of probability measures; in this context, inference is the computation of tight lower and upper bounds for conditional probabilities. In this paper we present new algorithms for inference in credal networks based on multilinear programming techniques. Experiments indicate that these new algorithms have better performance than existing ones, in the sense that they can produce more accurate results in larger networks.

Rapid detection of health-care-associated bloodstream infection in critical care using multipathogen real-time polymerase chain reaction technology: a diagnostic accuracy study and systematic review

<p>Background: There is growing interest in the potential utility of real-time polymerase chain reaction (PCR) in diagnosing bloodstream infection by detecting pathogen deoxyribonucleic acid (DNA) in blood samples within a few hours. SeptiFast (Roche Diagnostics GmBH, Mannheim, Germany) is a multipathogen probe-based system targeting ribosomal DNA sequences of bacteria and fungi. It detects and identifies the commonest pathogens causing bloodstream infection. As background to this study, we report a systematic review of Phase III diagnostic accuracy studies of SeptiFast, which reveals uncertainty about its likely clinical utility based on widespread evidence of deficiencies in study design and reporting with a high risk of bias. </p><p>Objective: Determine the accuracy of SeptiFast real-time PCR for the detection of health-care-associated bloodstream infection, against standard microbiological culture. </p><p>Design: Prospective multicentre Phase III clinical diagnostic accuracy study using the standards for the reporting of diagnostic accuracy studies criteria. </p><p>Setting: Critical care departments within NHS hospitals in the north-west of England. </p><p>Participants: Adult patients requiring blood culture (BC) when developing new signs of systemic inflammation. </p><p>Main outcome measures: SeptiFast real-time PCR results at species/genus level compared with microbiological culture in association with independent adjudication of infection. Metrics of diagnostic accuracy were derived including sensitivity, specificity, likelihood ratios and predictive values, with their 95% confidence intervals (CIs). Latent class analysis was used to explore the diagnostic performance of culture as a reference standard. </p><p>Results: Of 1006 new patient episodes of systemic inflammation in 853 patients, 922 (92%) met the inclusion criteria and provided sufficient information for analysis. Index test assay failure occurred on 69 (7%) occasions. Adult patients had been exposed to a median of 8 days (interquartile range 4–16 days) of hospital care, had high levels of organ support activities and recent antibiotic exposure. SeptiFast real-time PCR, when compared with culture-proven bloodstream infection at species/genus level, had better specificity (85.8%, 95% CI 83.3% to 88.1%) than sensitivity (50%, 95% CI 39.1% to 60.8%). When compared with pooled diagnostic metrics derived from our systematic review, our clinical study revealed lower test accuracy of SeptiFast real-time PCR, mainly as a result of low diagnostic sensitivity. There was a low prevalence of BC-proven pathogens in these patients (9.2%, 95% CI 7.4% to 11.2%) such that the post-test probabilities of both a positive (26.3%, 95% CI 19.8% to 33.7%) and a negative SeptiFast test (5.6%, 95% CI 4.1% to 7.4%) indicate the potential limitations of this technology in the diagnosis of bloodstream infection. However, latent class analysis indicates that BC has a low sensitivity, questioning its relevance as a reference test in this setting. Using this analysis approach, the sensitivity of the SeptiFast test was low but also appeared significantly better than BC. Blood samples identified as positive by either culture or SeptiFast real-time PCR were associated with a high probability (&gt; 95%) of infection, indicating higher diagnostic rule-in utility than was apparent using conventional analyses of diagnostic accuracy. </p><p>Conclusion: SeptiFast real-time PCR on blood samples may have rapid rule-in utility for the diagnosis of health-care-associated bloodstream infection but the lack of sensitivity is a significant limiting factor. Innovations aimed at improved diagnostic sensitivity of real-time PCR in this setting are urgently required. Future work recommendations include technology developments to improve the efficiency of pathogen DNA extraction and the capacity to detect a much broader range of pathogens and drug resistance genes and the application of new statistical approaches able to more reliably assess test performance in situation where the reference standard (e.g. blood culture in the setting of high antimicrobial use) is prone to error.</p>