cssi/SciSciGPT-SciSciNet huggingface dataset:
TH-CD-202-11: Implications for Online Adaptive and Non-Adaptive Radiotherapy of Gastic and Gastroesophageal Junction Cancers Using MRI-Guided Radiotherapy

Purpose: Radiotherapy for gastric and gastroesophageal junction (GEJ) tumors commonly requires large margins due to deformation, motion and variable changes of the stomach anatomy, at the risk of increased normal tissue toxicities. This work quantifies the interfraction variation of stomach deformation from daily MRI-guided radiotherapy to allow for a more targeted determination of margin expansion in the treatment of gastric and GEJ tumors. Methods: Five patients treated for gastric (n=3) and gastroesophageal junction (n=2) cancers with conventionally fractionated radiotherapy underwent daily MR imaging on a clinical MR-IGRT system. Treatment planning and contours were performed based on the MR simulation. The stomach was re-contoured on each daily volumetric setup MR. Dice similarity coefficients (DSC) of the daily stomach were computed to evaluate the stomach interfraction deformation. To evaluate the stomach margin, the maximum Hausdorff distance (HD) between the initial and fractional stomach surface was measured for each fraction. The margin expansion, needed to encompass all fractions, was evaluated from the union of all fractional stomachs. Results: In total, 94 fractions with daily stomach contours were evaluated. For the interfraction stomach differences, the average DSC was 0.67±0.1 for gastric and 0.62±0.1 for GEJ cases. The maximum HD of each fraction was 3.5±2.0cm (n=94) with mean HD of 0.8±0.4cm (across all surface voxels for all fractions). The margin expansion required to encompass all individual fractions (averaged across 5 patients) was 1.4 cm(superior), 2.3 cm(inferior), 2.5 cm(right), 3.2 cm(left), 3.7 cm(anterior), 3.4 cm(posterior). Maximum observed difference for margin expansion was 8.7cm(posterior) among one patient. Conclusion: We observed a notable interfractional change in daily stomach shape (i.e., mean DSC of 0.67, p<0.0001) in both gastric and GEJ patients, for which adaptive radiotherapy is indicated. A minimum PTV margin of 3 cm is indicated to account for interfraction stomach changes when adaptive radiotherapy is not available. M. Bassetti: Travel funding from ViewRay, Inc.
Look it up in Your Gut

Andre Breton points out that humor is rare in the history of Western art, with notable exceptions in the work of artists such as Goya, Hogarth, and the barely contained neurosis of Seurat. Yet these anomalies pale against the wave of absurd and forceful images in Dada and Surrealism. Rising from the tragic and unlikely context of the European World Wars, Breton writes that, "In visual art we must consider the triumph of humor in its manifest state a much more recent phenomenon." Indeed since then humor has played a persistent but also evolving role. Today's artists must perhaps specifically negotiate the legacy of irony. This paper considers a selection of work by Dieter Roth, Hilja Keading, Vito Acconci, John Divola, and Kara Walker. Through their diverse images, we explore a kind of humor found nestled at the unlikely intersection of material reality and abstract thought. How does this humor operate? What are its concerns and intentions? And can it offer a release from the spent nihilism of postmodern practice?
Integrated Inductor and Capacitor With Co-Located Electric and Magnetic Fields

Passive components such as inductors and capacitors are fundamental components of nearly all power electronic conversion systems. This paper presents an innovative approach to highly integrated inductor ( L ) and capacitor ( C ) design by storing magnetic and electric field energy in a common volume, constituting a dual energy core (DEC). This is dissimilar from other integrated designs that primarily exploit a distributed parasitic capacitance between planar inductor windings, ultimately parsing electric, and magnetic fields into separate locations unnecessarily. The DEC enables a four terminal integrated LC device that may be applied in series, parallel, or in separate parts of the circuit, since its terminal characteristics appear as decoupled lumped elements. The fields in the core geometry are analytically modeled and the effects and tradeoffs of selecting different core parameters/dimensions are explored. Proof of concept prototypes of toroidal form factor demonstrate techniques for fabricating DEC integrated devices, and experimental measurements correlate with the analytical models used in the design process. A boost converter is constructed and tested with a prototype integrated device to demonstrate decoupled operation of the fields in the core on a large signal basis.
Vascular development in primate retina: comparison of laminar plexus formation in monkey and human.

PURPOSE: The temporal and spatial sequence of development of laminar vascular plexuses was determined qualitatively and quantitatively in monkey and human retina. METHODS: Histologic and cytochemical methods were used to study Macaca monkey eyes from fetal day 55 (F55d; birth = F168d) to 17 years, and human retina from fetal 21 weeks to adult. RESULTS: In monkey retina, spindle-shaped, presumed vascular precursor, cells appear at F55d in the nerve fiber layer (NFL) adjacent to the optic nerve. The vascular plexuses in the NFL-ganglion cell layer appear first and form in the presence of spindle cells. Nerve fiber layer vessels extended radially to reach the temporal ora at F95d and nasal ora at F110d. The capillary plexus at the inner border of the inner nuclear layer (INL) appears at F120d near the optic disc, whereas the plexus at the outer INL border appears at F130d. Both reach their final position before birth. The INL plexuses form by endothelial budding from more vitread vessels in the absence of spindle cells. In the NFL, vessel growth to match retinal growth at the ora also involves endothelial budding. The growth rate of all plexuses was approximately 225 microns/day. The central fovea and the most peripheral retina adjacent to the ora serrata remained avascular throughout development. Differences between humans and monkeys include: Human vessels complete maturation after birth; human vessels reach the nasal ora earlier than the temporal ora; and spindle cells are more abundant and dispersed over a greater area within human NFL. Growth rates of human plexuses were comparable to those in monkeys. CONCLUSION: In both primates, deeper capillary plexuses form only by extension from existing vessels (angiogenesis). In the NFL, early vessel formation involves spindle precursor cells (vasculogenesis). The main difference between monkey and human in these processes is that the mature monkey vascular pattern is established well before birth.
The United States Constitution: A Semiotic Interpretation

One problem which legal semiotics addresses is the manner in which legal systems “represent” social institutions and, conversely, the manner in which societies reflect their legal structures (Kevelson 1986:191–198). The creation and preservation of the United States Constitution is an ideal topic for the legal semiotician, as it offers us a chance to view statesmen as semioticians. At few times in history have men had the opportunity to construct a nation from the beginning, to frame a new, fundamental legal code in accordance with experience and reason largely unencumbered by existing institutions. The United States was not a political entity until 1776, and possessed no established church, aristocracy, standing army, or concentrations of economic power. “We exhibit,” George Washington informed an English correspondent, “the novel and astonishing spectacle of a whole people deliberating calmly on what form of government will be most conducive to their happiness” (Farrand 3:339). Because America’s source of nationhood was political--arising out of revolutionary unification--the Constitution was framed specifically to represent the needs of its culturally diverse society.
Automatic segmentation of the right ventricle from cardiac MRI using a learning‐based approach

Author(s): Avendi, Michael R; Kheradvar, Arash; Jafarkhani, Hamid | Abstract: PurposeThis study aims to accurately segment the right ventricle (RV) from cardiac MRI using a fully automatic learning-based method.MethodsThe proposed method uses deep learning algorithms, i.e., convolutional neural networks and stacked autoencoders, for automatic detection and initial segmentation of the RV chamber. The initial segmentation is then combined with the deformable models to improve the accuracy and robustness of the process. We trained our algorithm using 16 cardiac MRI datasets of the MICCAI 2012 RV Segmentation Challenge database and validated our technique using the rest of the dataset (32 subjects).ResultsAn average Dice metric of 82.5% along with an average Hausdorff distance of 7.85 mm were achieved for all the studied subjects. Furthermore, a high correlation and level of agreement with the ground truth contours for end-diastolic volume (0.98), end-systolic volume (0.99), and ejection fraction (0.93) were observed.ConclusionOur results show that deep learning algorithms can be effectively used for automatic segmentation of the RV. Computed quantitative metrics of our method outperformed that of the existing techniques participated in the MICCAI 2012 challenge, as reported by the challenge organizers. Magn Reson Med 78:2439-2448, 2017. © 2017 International Society for Magnetic Resonance in Medicine.
Pierre Bourdieu: theorizing the digital

Pierre Bourdieu is known for his research in the areas of education and cultural stratification that led to a number of theoretical contributions informing the social sciences. Bourdieu’s interrela...
Chemoselective Alteration of Fluorophore Scaffolds as a Strategy for the Development of Ratiometric Chemodosimeters

Ratiometric sensors generally couple binding events or chemical reactions at a distal site to changes in the fluorescence of a core fluorophore scaffold. However, such approaches are often hindered by spectral overlap of the product and reactant species. We provide a strategy to design ratiometric sensors that display dramatic spectral shifts by leveraging the chemoselective reactivity of novel functional groups inserted within fluorophore scaffolds. As a proof-of-principle, fluorophores containing a borinate (RF620) or silanediol (SiOH2R) functionality at the bridging position of the xanthene ring system are developed as endogenous H2O2 sensors. Both these fluorophores display far-red to near-infrared excitation and emission prior to reaction. Upon oxidation by H2O2 both sensors are chemically converted to tetramethylrhodamine, producing significant (≥66 nm) blue-shifts in excitation and emission maxima. This work provides a new concept for the development of ratiometric probes.
The Role of Informal Support Networks in Teaching the Nature of Science

This study reports the participation of 13 secondary science teachers in informal support networks and how that participation was associated with their nature of science (NOS) teaching practices 2 to 5 years after having graduated from the same science teacher education program. The nine teachers who participated in informal support networks taught the NOS at high/medium levels, while the four non-participating teachers taught the NOS at low levels. The nine high/medium NOS implementation teachers credited the informal support networks for maintaining/heightening their sense of responsibility for teaching NOS and for helping them navigate institutional constraints that impede effective NOS instruction. Several high/medium NOS instruction implementers initially struggled to autonomously frame and resolve the complexities experienced in schools and thus drew from the support networks to engage in more sophisticated forms of teacher decision-making. In contrast, the NOS pedagogical decisions of the four teachers not participating in support networks were governed primarily by the expectations and constraints experienced in their schools. Implications of this study include the need for reconsidering the structure of teacher mentorship programs to ensure they do not promote archaic science teaching practices that are at odds with reform efforts in science education.
Political Communication Theory and Research: An Overview 1976 – 1977

(1978). Political Communication Theory and Research: An Overview 1976 – 1977. Annals of the International Communication Association: Vol. 2, Communication Yearbook 2, pp. 375-389.
Mechanical specific energy versus depth of cut in rock cutting and drilling

Abstract The relationship between Mechanical Specific Energy (MSE) and the Rate of Penetration (ROP), or equivalently the depth of cut per revolution, provides an important measure for strategizing a drilling operation. This study explores how MSE evolves with depth of cut, and presents a concerted effort that encompasses analytical, computational and experimental approaches. A simple model for the relationship between MSE and cutting depth is first derived with consideration of the wear progression of a circular cutter. This is an extension of Detournay and Defourny's phenomenological cutting model. Wear is modeled as a flat contact area at the bottom of a cutter referred to as a wear flat, and that wear flat in the past is often considered to be fixed during cutting. But during a drilling operation by a full bit that consists of multiple circular cutters, the wear flat length may increase because of various wear mechanisms involved. The wear progression of cutters generally results in reduced efficiency with either increased MSE or decreased ROP. Also, an accurate estimate of removed rock volume is found important for the evaluation of MSE. The derived model is compared with experiment results from a single circular cutter, for cutting soft rock under ambient pressure with actual depth measured through a micrometer, and for cutting high strength rock under high pressure with actual cutting area measured by a confocal microscope. Finally, the model is employed to interpret the evolution of MSE with depth of cut for a full drilling bit under confining pressure. The general form of equation of the developed model is found to describe well the experiment data and can be applied to interpret the drilling data for a full bit.
What is a Symbol

Focusing my discussion on the sixteenth and seventeenth centuries, I argue that the symbolic notation under development at the time reveals connections with rhetorical and poetic aesthetics. In the first section, I show how the mathematical strategies that notation facilitated rely on prudential rhetoric’s sense of the opportune moment, also known as kairos or decorum. In the second, I show how the necessary balance within notation between compression and lucidity similarly relies on an aesthetic judgment that is essentially prudential. In the last section, I show how notation’s ability to accommodate disjunctive values within a general symbol corresponds to similar capabilities in the poetic symbol. Through etymological analysis of the polysemy of its terminology, I demonstrate the philological orientation of early modern algebra.
The relationship between urinary genistein levels and serum alanine aminotransferase levels in adults in the USA: National Health and Nutrition Examination Survey 1999-2010.

BACKGROUND Genistein, a phytoestrogen with similarities to female sex hormones, has been shown to protect against oxidative stress and fibrosis in nonalcoholic fatty liver injury in animal studies. However, few studies have examined genistein's effects on liver function in humans. PARTICIPANTS AND METHODS We analyzed data from the National Health and Nutrition Examination Survey from 1999 to 2010. Individuals younger than 21 years, with viral hepatitis, or with serum alanine aminotransferase (ALT) at the extremes of distribution (5% on each extreme) were excluded. Urinary genistein was normalized by urinary creatinine levels. The relationship between normalized urinary genistein (nUG) and serum ALT was examined using linear regression models with and without adjustment for potential confounders, and the differential effect of sex was examined using an interaction term. RESULTS Of the 9864 participants, 52% were female, 50% were White, 24% were elderly, 36% had hypertension, 12% had diabetes, and 8.1% were heavy alcohol drinkers. Serum ALT was significantly lower in the highest quartile compared with the lowest quartile of nUG (22.3 vs. 23.5 U/l; P<0.001). In adjusted models, individuals in the highest quartile had 0.75 U/l lower ALT levels than those in the lowest quartile (P=0.02). We found a significant difference in ALT levels between the lowest and highest quartiles of nUG in males, but not in females (difference in differences=1.77 U/l, interaction P=0.04). CONCLUSION We found a statistically significant association between higher nUG and lower serum ALT in males, but not in females. The sex-specific role of genistein in mitigating liver disease merits further study.
Association of a Proactive Swallowing Rehabilitation Program With Feeding Tube Placement in Patients Treated for Pharyngeal Cancer.

Importance A proactive speech and language pathology (SLP) program is an important component of the multidisciplinary care of patients with head and neck squamous cell carcinoma (HNSCC). Swallowing rehabilitation can reduce the rate of feeding tube placement, thereby significantly improving quality of life. Objective To evaluate the initiation of a proactive SLP rehabilitation program at a single institution and its association with rates of feeding tube placement and dietary intake in patients with HNSCC. Design, Setting, and Participants Cohort study at a tertiary care and referral center for patients with HNSCC serving the northern Chicago region. Patients were treated for squamous cell carcinomas of the hypopharynx, oropharynx, and nasopharynx from 2004 to 2015 with radiation or chemoradiation therapy in the definitive or adjuvant setting. Patients who received less than 5000 cGy radiation or underwent reirradiation were excluded. Interventions A proactive SLP program for patients with HNSCC was initiated in 2011. Study cohorts were divided into 2 groups: 2004 through 2010 and 2011 through 2015. Main Outcomes and Measures Primary outcome variables were SLP referral placement and timing of the referral. Secondary outcomes were feeding tube placement and ability to tolerate any oral intake. Results A total of 254 patients met inclusion criteria (135 before and 119 after implementation of SLP program; median age, 60 years [range, 14-94 years]; 77% male). With the initiation of a proactive SLP program, pretreatment evaluations increased from 29 (21.5%) to 70 (58.8%; risk ratio [RR], 2.74; 95% CI, 1.92-3.91), and rate of referral overall at any time increased from 60.0% to 79.8% (RR, 1.33; 95% CI, 1.13-1.57). Feeding tube placement rates decreased from 45.9% (n = 62) to 29.4% (n = 35; RR, 0.64; 95% CI, 0.46-0.89). Among patients receiving a swallow evaluation, feeding tube requirements were less frequent for those receiving a pretreatment evaluation (31 of 99 [31%]) than for those referred during (11 of 18 [61%]) or after (38 of 59 [64%]) treatment. The rate of tolerating any oral intake at the end of treatment improved from 71.1% (n = 96) in the preimplementation period to 82.4% (n = 98; RR, 1.16; 95% CI, 1.01-1.33). Conclusions and Relevance A proactive SLP program can be successfully established as part of the multidisciplinary care of patients with HNSCC and improve patient quality of life.
Case Study #7: Satellite Reorientation Control

Chapter 12 presents HSSPFC applied to a slewing spacecraft problem. The specific slewing spacecraft problem is a Multi-Input-Multi-Output (MIMO) three-axis spacecraft that employs Proportional-Integral-Derivative (PID) tracking control with numerical simulation results. This problem provides an interesting complication due to the three-axis rigid body rotation sequence.
The Narcissism Spectrum Model: A Spectrum Perspective on Narcissistic Personality

The narcissism spectrum model synthesizes extensive personality, social-psychological, and clinical evidence, to address three key, interrelated problems that have plagued narcissism scholarship for over a century. These problems can be summarized as: What are the key features of narcissism, how are they organized and interlinked, and why are they organized that way? By viewing narcissism as manifested in transactional processes between individuals and their social environments, this model integrates existing measurement and theoretical perspectives on narcissism and provides a guiding framework for future examination of its developmental pathways. Specifically, narcissism is defined as entitled self-importance, with an inflated sense of importance and deservingness marking the core phenotype. However, differences in entitlement reflect two distinct functional patterns of influence, based on approach-dominant (bold) and avoidance-dominant (reactive) personality orientations supported by reinforcing social experiences. Critically, these distinct patterns of influence yield distinct dimensions of narcissistic grandiosity (hubris and exhibitionism) and narcissistic vulnerability (resentment and defensiveness). The narcissism spectrum model builds common terminology regarding core features of narcissism, is grounded in a shared set of observations about the empirical structure of narcissistic traits, and provides a novel and comprehensive framework for integrating scholarship of narcissism with that of personality and psychopathology more broadly.
Applying Machine Learning to Predict Software Fault Proneness Using Change Metrics, Static Code Metrics, and a Combination of Them

Predicting software fault proneness is very important as the process of fixing these faults after the release is very costly and time-consuming. In order to predict software fault proneness, many machine learning algorithms (e.g., Logistic regression, Naive Bayes, and J48) were used on several datasets, using different metrics as features. The question is what algorithm is the best under which circumstance and what metrics should be applied. Related works suggested that using change metrics leads to the highest accuracy in prediction. In addition, some algorithms perform better than others in certain circumstances. In this work, we use three machine learning algorithms (i.e., logistic regression, Naive Bayes, and J48) on three Eclipse releases (i.e., 2.0, 2.1, 3.0). The results showed that accuracy is slightly better and false positive rates are lower, when we use the reduced set of metrics compared to all change metrics set. However, the recall and the G score are better when we use the complete set of change metrics. Furthermore, J48 outperformed the other classifiers with respect to the G score for the reduced set of change metrics, as well as in almost all cases when the complete set of change metrics, static code metrics, and the combination of both were used.
Serving the Stigmatized: Working Within the Incarcerated Environment

The intersectionality of substance use disorders, mental health disorders, and the criminal justice system highlights the importance of providing information on prisons and prison-based programming...
INCIDENCE OF NON-ACUTE CORONARY SYNDROME DIAGNOSES IN PATIENTS WITH MILDLY ABNORMAL HIGH-SENSITIVITY TROPONIN: A REAL-WORLD US EXPERIENCE

Utilizing a high sensitivity troponin (hs-cTn) assay, patients with suspected acute coronary syndromes (ACS) can be promptly classified into “rule-in”, “rule-out” and “observation” groups based on initial and 1 hour test results. In the United States, the yield for diagnosing ACS in the
Late elevation in serum bromsulfalein in Dubin-Johnson syndrome. A comparative case study.

A 45-year-old man with Dubin-Johnson syndrome had a delayed elevation in serum BSP. This phenomenon has been reported in previous patients with this syndrome. It did not occur in a patient with the closely related Rotor's syndrome, or in 4 patients with jaundice due to cirrhosis, cholestasis, chronic viral hepatitis, and cholangiolitic hepatitis. This finding may be useful in the diagnosis of the Dubin-Johnson syndrome, particularly if liver biopsy is not possible or is contraindicated. It may also aid in defining the indication for liver biopsy in family studies.
Reconsidering asymmetries in voice-mismatched VP-ellipsis

Previous research on VP-ellipsis has revealed the existence of a Mismatch Asymmetry, whereby cases with passive voice ellipsis clauses and active antecedent clauses are less acceptable than cases with active ellipsis clauses and passive antecedents. According to the memory-based explanation offered by the Recycling Hypothesis (RH; Arregui et al. 2006), this effect arises because passive clauses are more prone to be misremembered as active than the other way around, and hence passive-active mismatches are more likely to create an “illusion of grammaticality”. This paper describes three experiments that explore the source of the asymmetry, with particular attention to the predictions of the RH account on previously unexamined cases. The findings are inconsistent with the predictions of memory-based explanations such as the RH, and instead point to the existence of a penalty against passive ellipsis clauses in subject focus environments, one that applies to both matched and mismatched cases of VP-ellipsis and in both anaphoric and cataphoric discourse configurations. A possible explanation for the penalty is offered as a subject for future work.
A formulation of unifiable multi-commodity kinematic wave model with relative speed ratios

Abstract Observations suggest that the First-In-First-Out (FIFO) principle is usually violated on multi-lane roads. Jin (2017) formulated and solved unifiable multi-commodity kinematic wave models, when different commodities have the same contributions to overall traffic congestion (unifiable) but may travel at different speeds (non-FIFO). However, the construction of unifiable multi-commodity fundamental diagrams and the assumption of concave or convex commodity flow proportion functions are purely mathematical and lack behavioral explanations. Thus the existing formulation is only of pure mathematical and theoretical interests and too complicated for real-world calibration, validation, or applications. In this study, we present a new formulation of unifiable multi-commodity kinematic wave models to address the aforementioned limitations. We first introduce a new variable for the relative speed ratios of different commodities and particularly discuss constant relative speed ratios. The relative speed ratios are physically, behaviorally, and economically meaningful since they characterize drivers’ relative aggressiveness, values of times, and other features. We then present unifiable multi-commodity fundamental diagrams based on the relative speed ratios, which can be used to derive the mathematical generating functions in Jin (2017). Then we show that non-FIFO multi-commodity kinematic wave model is a system of non-strictly hyperbolic conservation laws and solve the Riemann problem for a two-commodity system with constant relative speed ratios, in which the commodity flow proportion function is either concave or convex. We also present an empirical evidence for the existence of unifiable multi-commodity fundamental diagrams with constant relative speed ratios, which help to demonstrate the advantage of the new formulation. In summary, the new formulation is as general as the original formulation, but physically more meaningful, theoretically easier to solve, and empirically simpler to calibrate. Finally we conclude the study with discussions on potential future applications.
Mitraclip Plus Medical Therapy Versus Medical Therapy Alone for Functional Mitral Regurgitation: A Meta-Analysis.

The purpose of this meta-analysis is to compare the efficacy of MitraClip plus medical therapy versus medical therapy alone in patients with functional mitral regurgitation (FMR). FMR caused by left ventricular dysfunction is associated with poor prognosis. Whether MitraClip improves clinical outcomes in this patient population remains controversial. We conducted an electronic database search of PubMed, CINAHL, Cochrane Central, Scopus, Google Scholar, and Web of Science databases for randomized control trials (RCTs) and observational studies with propensity score matching (PSM) that compared MitraClip plus medical therapy with medical therapy alone for patients with FMR and reported on subsequent mortality, heart failure re-hospitalization, and other outcomes of interest. Event rates were compared using a random-effects model with odds ratio as the effect size. Five studies (n = 1513; MitraClip = 796, medical therapy = 717) were included in the final analysis. MitraClip plus medical therapy compared to medical therapy alone was associated with a significant reduction in overall mortality (OR = 0.66, 95% CI = 0.44–0.99, P = 0.04) and heart failure (HF) re-hospitalization rates (OR = 0.57, 95% CI = 0.36–0.91, P = 0.02). There was reduced need for heart transplantation or mechanical support requirement (OR = 0.48, 95% CI = 0.25–0.91, P = 0.02) and unplanned mitral valve surgery (OR = 0.21, 95% CI = 0.07–0.61, P = 0.004) in the MitraClip group. No effect was observed on cardiac mortality (P = 0.42) between the two groups. MitraClip plus medical therapy improves overall mortality and reduces HF re-hospitalization rates compared to medical therapy alone in patients with FMR.
Experimental investigation of steel fiber RC hollow columns under eccentric loading

Abstract an investigation was conducted to identify the behavior of steel fiber reinforced concrete columns with an opening under eccentricity loading, focusing on square hollow columns section having different square hole sizes and various steel fiber dosages were cast and tested. The holes pass longitudinally at the center of the cross-section of the columns. The research includes a test of nine columns of dimensions (200 × 200 × 1600 mm). Test parameters were the steel fiber contents (0.5%, 1.0% and 1.5% volume fraction) and opening ratio (10% and 20% hollow ratio) with load eccentricity (eccentricity/column depth ratio is 0.75). The compressive strength cylinder tests are conducted for various steel fiber dosages in terms of volume fraction. First cracking load, lateral displacement and ultimate load for each column are calculated and compared with similar columns made of ordinary reinforced concrete with and without a hole. The experimental results show that for concrete columns with hollow ratios 10% and 20% (C2-I, C-II) and without steel fibers, the first cracking load reduction was 28.88% and 49.70% respectively compared with the solid column (C1-I, C1-II). The addition of steel fibers significantly improves the mechanical response of the tested specimens especially the cracking load. The cracking load for specimen C5-I (10% opening ratio with 1.5% steel fibers volume fraction) increased 2.346 times the cracking load for specimen C2-I (10% opening ratio without steel fibers) and for a specimen with a 20% opening ratio and 1.5% steel fibers volume fraction (C5-II), the cracking load increased 2.181 times the same specimen without adding steel fibers. The ultimate load-carrying capacity for specimen C5-I (10% opening ratio with 1.5% steel fibers volume fraction) increased 1.094 times the cracking load for specimen C2-I (10% opening ratio without steel fibers) and for a specimen with a 20% opening ratio and 1.5% steel fibers volume fraction (C5-II), the ultimate load-carrying capacity increased 1.23 times the same specimen without adding steel fibers. The test results indicate the addition of steel fiber enhanced the strength capacity, ductility and allowing these columns to absorb more energy compared with a similar column with ordinary reinforced concrete.
Preventing migraine: The old and the new.

Migraine is a highly prevalent and debilitating condition that significantly impairs quality of life. It affects people during their childbearing and most economically productive years.[1][1] Preventing migraine by pharmacologic means has long been a goal of both physicians and the pharmaceutical
Measuring Vallecular Volume on Flexible Endoscopic Evaluation of Swallowing: A Proof of Concept Study

Currently, no method exists to measure the size of pharyngeal and laryngeal structures on endoscopy. Imaging for dysphagia diagnostic techniques, for the most part, still relies on qualitative assumptions and cursory visual examinations to induce patients’ swallowing safety and function. In this proof of concept study, we measured vallecular cavity volume using simultaneous modified barium swallows (MBS) and flexible endoscopic evaluation of swallowing (FEES). Similar to the three-dimensional image compilation fields of facial reconstruction, medical imagery, and forensic science, this proposed methodology combines the two-dimensional images yielded in FEES and MBS videos to calculate estimates of the valleculae in a 3D perspective. A tracking tool was used to measure distances on MBS, while endoscopic specifications were used to find distances on FEES. This combination of ratio measurements allowed for measurement on both the MBS and FEES. In a sample of n = 37 dysphagia patients referred for MBS/FEES studies, the mean distance from the tip of endoscope to the closest point of epiglottis was 25.38 mm, the mean vallecular area outlined on MBS video was 84.72 mm2, the mean epiglottal width was 18.16 mm, and the mean vallecular volume was 1.55 mL. Future application could include tracking growth of tumors, glottic opening, volume of residue and tracking of any other important outcome involving movement, size, and targets of interest with higher precision.
Characteristics Associated with Trust in and Disclosure of Sexual Behavior to Primary Care Providers among Gay, Bisexual, and Other Men Who Have Sex with Men in the United States

Purpose: Characteristics associated with having a primary care provider (PCP), patient–provider trust, and sexual behavior disclosure were examined among men who have sex with men (MSM). Methods: M...
Strategies to Mitigate Clinician Implicit Bias Against Sexual and Gender Minority Patients.

Abstract Background Implicit bias is an ingrained, unconscious cultural stereotype that can negatively affect a person's interactions with members of stigmatized groups, including sexual and gender minorities. Clinician implicit biases may negatively impact the quality of patient care. Methods This article uses 4 case scenarios to illustrate how implicit bias among psychiatrists and other clinicians can affect patient-clinician communication and diminish the quality of health care provided to sexual and gender minority people. We offer strategies for clinicians to recognize, challenge, and address implicit bias. Discussion Through continuing education, self-reflection, and practice, psychiatrists and other clinicians can improve communication and foster more affirming care experiences for their sexual and gender minority patients, with the goal of addressing and ultimately eliminating sexual and gender minority health disparities.
Market Exchanges, Negative Externalities and Sustainability:

Lusch (2017), in an insightful article published posthumously, enumerated and elaborated on four macro observations concerning Homo sapiens and exchange. He noted that Homo sapiens massively (1) en...
Weighing Lives in War: Domestic versus Foreign

I argue that the lives of domestic and enemy civilians should not receive equal weight in our proportionality calculations. Rather, the lives of enemy civilians ought to be “partially discounted” relative to the lives of domestic civilians. We ought to partially discount the lives of enemy civilians for the following reason. When our military wages a just war, we as civilians vest our right to self-defense in our military. This permits our military to weigh our lives more heavily. Before arguing for this view I first explain why recent accounts attempting to show the opposite – that enemy civilians ought to be weighed more heavily – are mistaken.
GPU implementation of photoacoustic short-lag spatial coherence imaging for improved image-guided interventions.

Significance: Photoacoustic-based visual servoing is a promising technique for surgical tool tip tracking and automated visualization of photoacoustic targets during interventional procedures. However, one outstanding challenge has been the reliability of obtaining segmentations using low-energy light sources that operate within existing laser safety limits. Aim: We developed the first known graphical processing unit (GPU)-based real-time implementation of short-lag spatial coherence (SLSC) beamforming for photoacoustic imaging and applied this real-time algorithm to improve signal segmentation during photoacoustic-based visual servoing with low-energy lasers. Approach: A 1-mm-core-diameter optical fiber was inserted into ex vivo bovine tissue. Photoacoustic-based visual servoing was implemented as the fiber was manually displaced by a translation stage, which provided ground truth measurements of the fiber displacement. GPU-SLSC results were compared with a central processing unit (CPU)-SLSC approach and an amplitude-based delay-and-sum (DAS) beamforming approach. Performance was additionally evaluated with in vivo cardiac data. Results: The GPU-SLSC implementation achieved frame rates up to 41.2 Hz, representing a factor of 348 speedup when compared with offline CPU-SLSC. In addition, GPU-SLSC successfully recovered low-energy signals (i.e., ≤268 μJ) with mean ± standard deviation of signal-to-noise ratios of 11.2 ± 2.4 (compared with 3.5 ± 0.8 with conventional DAS beamforming). When energies were lower than the safety limit for skin (i.e., 394.6 μJ for 900-nm wavelength laser light), the median and interquartile range (IQR) of visual servoing tracking errors obtained with GPU-SLSC were 0.64 and 0.52 mm, respectively (which were lower than the median and IQR obtained with DAS by 1.39 and 8.45 mm, respectively). GPU-SLSC additionally reduced the percentage of failed segmentations when applied to in vivo cardiac data. Conclusions: Results are promising for the use of low-energy, miniaturized lasers to perform GPU-SLSC photoacoustic-based visual servoing in the operating room with laser pulse repetition frequencies as high as 41.2 Hz.
Impact of Value-Based Reimbursement on Health-Care Disparities for Total Joint Arthroplasty Candidates.

As the U.S. Centers for Medicare & Medicaid Services (CMS) implements value-based reimbursement models based on predetermined outcome measures, access to total joint arthroplasty (TJA) is jeopardized for patients who are disproportionately affected by conditions that predispose them to higher odds of complications. Obesity, depression, and chronic illness, each of which occur at disproportionately higher rates in minorities or individuals in lower socioeconomic brackets, are individually associated with worse TJA postoperative outcomes, including longer hospital lengths of stay and higher rates of readmission within 90 days. Medicaid may even be considered an independent risk factor for worse outcome measures with TJA as enrollees have higher rates of postoperative mortality and complications and longer lengths of stay than patients on Medicare or with private insurance. As same-day discharge for TJA becomes more common, eligibility requirements for the procedure tighten, and existing disparities in access to the procedure will be further exacerbated. The current CMS uniform quality metrics endanger access to TJA for patients in certain racial and socioeconomic groups and oblige physicians who treat more complex patients to jeopardize their reimbursement.
An Analytic Model for Negative Obstacle Detection with Lidar and Numerical Validation Using Physics-Based Simulation.

Negative obstacles have long been a challenging aspect of autonomous navigation for ground vehicles. However, as terrestrial lidar sensors have become lighter and less costly, they have increasingly been deployed on small, low-flying UAV, affording an opportunity to use these sensors to aid in autonomous navigation. In this work, we develop an analytical model for predicting the ability of UAV or UGV mounted lidar sensors to detect negative obstacles. This analytical model improves upon past work in this area because it takes the sensor rotation rate and vehicle speed into account, as well as being valid for both large and small view angles. This analytical model is used to predict the influence of velocity on detection range for a negative obstacle and determine a limiting speed when accounting for vehicle stopping distance. Finally, the analytical model is validated with a physics-based simulator in realistic terrain. The results indicate that the analytical model is valid for altitudes above 10 m and show that there are drastic improvements in negative obstacle detection when using a UAV-mounted lidar. It is shown that negative obstacle detection ranges for various UAV-mounted lidar are 60–110 m, depending on the speed of the UAV and the type of lidar used. In contrast, detection ranges for UGV mounted lidar are found to be less than 10 m.
What Is Jewish Law? A Conceptual View from U.S. Courts

By and large, United States courts treat Jewish law—and the obligations Jewish law generates for its adherent—as religion. That Jewish law has made recurring appearances in U.S. courts is far from surprising. Jews and Jewish communities have been features of American life since before the founding. Courts have been most clear when Jewish law and legal obligation have been implicated in cases with underlying public law considerations. This sort of conception of Judaism and Jewishness solely through the prism of religion is deeply modern. While this unremarkable underlying assumption—that Jewish practices qualify as religion—remains consistent in the high-profile landscape of religious liberty litigation, it also has significant consequences for how U.S. courts treat—and don’t treat—Jewish law. The underlying assumption is that the Establishment Clause has prohibited—and continues to prohibit—courts from interrogating the content of Jewish law; and to the extent a dispute requires that sort of inquiry, a court must dismiss the case pursuant to the religious question doctrine. Detail is provided on two strategic alternatives pursued by litigants. The first is to leverage the neutral principles of law framework, which aims to identify alternative methods to resolve religious disputes that focus solely on “objective, well-established concepts of . . . law familiar to lawyers and judges.” The second is what I term the reclassification strategy, which refers to attempts by litigants to rebrand Jewish law as something other than religion—whether it be law or history or sociology. Of these strategies, the first is sometimes successful, albeit infrequently; the second has, for all intent and purposes, been rejected by courts. And together, the judicial reaction to such strategies demonstrates the powerful consequences of treating Jewish law as religion—and therefore subject to the religious question doctrine. Given the current jurisprudential trajectory, Jewish law is and will likely continue to be treated as religion whether it be for religious liberty protections under the First Amendment or for purposes of contract interpretation. And all told, Jewish law as a concept—with its multifarious doctrines and disputes—will remain a black box to the American legal system.
Immediate Post-Concussion and Cognitive Testing (ImPACT): Effects of Data Integration Strategies on Classification Accuracy.

OBJECTIVE The current study aimed to evaluate varying data integration procedures and their effects on the classification accuracy of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). SETTING Data were collected from an independent secondary school that included students in grades 9 to 12. PARTICIPANTS The study examined 300 consecutive ImPACT score reports generated by secondary school students between 2010 and 2015. DESIGN To appraise ImPACT's utility as a serialized measure, standardized regression-based equations were formulated to compute reliable change index scores. Discriminant function analyses (DFAs) consisting of varying combinations of ImPACT composite scores were conducted and their accuracy was compared to that produced by the standard interpretive procedure. MAIN MEASURES Varying combinations of scores produced on Verbal Memory, Visual Memory, Visual Motor Speed, Reaction Speed, and the Postconcussion Symptom Scale were included in analyses. RESULTS DFAs yielded sensitivities ranging from 31% to 49%, specificities from 88% to 95%, positive predictive values (PPVs) from 61% to 83%, and negative predictive values (NPVs) from 67% to 75%. Conversely, the standard interpretive procedure yielded a sensitivity of 73%, specificity of 43%, PPV of 45%, and NPV of 72%. CONCLUSION The standard interpretive procedure produced a higher sensitivity than the DFAs; however, its PPV did not exceed chance levels. Conversely, DFA equations produced superior PPVs; however, their sensitivity hovered around 50%, leaving a substantial proportion of individuals with concussion undetected. Cognitive composite scores did not appear to offer significant incremental utility in relation to symptom self-report. Base rate conditions and psychometric factors appeared to contribute to ImPACT's limited classification accuracy.
Induction of androgen receptor by a novel nitroacridine, C-1748: Implications for its role as a chemotherapeutic agent in hormone independent prostate cancer

5885 Development of a chemotherapeutic regimen against prostate cancer (CaP) is a challenge. We have identified a novel nitroacridine, C-1748 (Capridine-β) that has pronounced antitumor activity in human prostate cancer xenograft models and its activity was comparable in both hormone dependent (LnCaP) and hormone independent (DU-145) models. In an effort to delineate the molecular targets of C-1748, we found a marked induction of androgen receptor (AR) in C-1748 treated hormone independent DU-145 cells. The induction of the androgen receptor was observed starting at 6 hours after treatment with 5 nM C-1748 and continued to increase till 24 hours as measured by western blot analysis. These observations were further confirmed by immunoflourescence studies which showed a dose dependent enhancement of AR in response to C-1748 in DU-145 cells. We also examined the steady state level of ERβ which showed a dose dependent down regulation consistent with the anticancer effect of ERβ in prostate cancer. The functional consequence of C-1748 mediated AR induction in hormone independent CaP was analyzed by examining the synergistic effect of the anti-androgen flutamide and C-1748 on DU-145 and LnCaP cells by XTT assays. We observed marked synergistic activity between C-1748 and flutamide in DU-145 cells suggesting that the andogen receptor induced by C-1748 was functional. In LnCaP, flutamide inhibited cell proliferation but no synergism with C-1748 was observed. We conclude that androgen receptor mediated signal transduction is one of the targets of C-1748 that is presumably restricted to hormone independent cells. This implies that C-1748 can be incorporated synergistically in an antiandrogen based treatment regimen for hormone independent, highly aggressive prostate cancer.