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ETD Availability

After you have submitted your electronic thesis or dissertation and The Graduate School has approved it, it will be available as follows:

• The full text will be openly available in  DukeSpace , Duke University Libraries’ digital repository, at a unique, permanent URL.
• A description will appear in the library catalog, with a link to the text in DukeSpace.
• Your thesis or dissertation will be indexed and available through search engines such as Google.

Open access to your thesis or dissertation as described above does not affect your copyright or ownership of the content of your thesis or dissertation.

Restricting Access to an ETD (Embargo)

While open access is the default, you will be offered several options for restricting access (referred to as an embargo) when submitting your thesis or dissertation through ProQuest. These same embargoes will be applied to the copy made available through DukeSpace. Embargo options should be discussed with your adviser, and both the adviser and the thesis or dissertation author must sign the availability options section of the  Nonexclusive Distribution License and Thesis/Dissertation Availability Agreement (PDF) .

When to Consider an Embargo

Some scenarios when you might want to restrict access to your thesis or dissertation:

• If your work is based on data generated through research that will support other publications from people on the research team (such as your adviser), it may be necessary to refrain from releasing that data, as it underlies your dissertation, while other publications are prepared. The embargo options in these situations should be discussed with your committee and research team.
• If you plan to apply for a patent based on research that is discussed in your dissertation, you should be aware of the rules governing prior publication of material for which a patent is sought. Generally, once patent applicants publish their ideas or invention, they have a one-year window. After one year, the applicant’s own publication may be considered “prior art” that could prevent the issuance of a patent. Since electronic distribution of your dissertation through either ProQuest or DukeSpace is publication for this purpose, an embargo will delay the beginning of this one-year time clock against a potential patent application. By selecting a two-year embargo, therefore, you will have a total of three years (two-year embargo plus one-year window after publication) to submit a patent application.
• If your thesis or dissertation contains data or material that was generated pursuant to a grant or contract and the thesis or dissertation is subject to review by the sponsor or grantor prior to publication, you should select at least a six-month embargo. If you are unsure whether your research falls into this area, contact Export Controls at the Office of Research Support (919-668-2711).

If you are planning to publish all or part of your thesis/dissertation and know that publishers in your field consider open access electronic thesis/dissertations to be a prior publication, you may want to consider an embargo or check on their open access policy before submitting your thesis or dissertation. For more information, see the ETD Availability page .

Embargo Lengths

Duke offers three embargo options: six months, one year, and two years. These options are available when you are  uploading your PDF to ProQuest . The embargo period begins from the date The Graduate School approves your thesis or dissertation and lasts for the selected time period. If you select an embargo, your thesis or dissertation will not be available through DukeSpace or ProQuest until the end of the embargo period. The title, abstract, attribution information, and subject classification will be available during and after the embargo in DukeSpace and the Library catalog.

Extending an embargo on DukeSpace

If you choose to embargo your thesis or dissertation when you submit it, and if at any time during the embargo period you subsequently decide that you wish to extend the embargo on electronic access to your thesis or dissertation on DukeSpace, write a brief e-mail requesting an extension to The Graduate School's Office of Academic Affairs ( [email protected] ). Provide your full name, the title of your thesis or dissertation, your graduation date, and your e-mail address.  Note that embargo extension requests should be initiated six weeks prior to the expiration of the existing embargo period.

If you exercise an extension, open electronic access to your thesis or dissertation through DukeSpace will not be available until five years after your defense. Be aware that this does not affect your embargo selection with ProQuest (six months, one year, two years), which is a separate distribution contract between the author (you) and ProQuest.

Paper copies

While the electronic copy is the official university copy kept by Duke University Libraries and University Archives, you still have several options if you, your family members, or your adviser would like a paper copy.

• Order a bound copy (paper or hardback) through ProQuest
• Take a paper copy to the University Bookstore, where it can be bound with a library-style binding
• Have a local copy center bind it for you

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• ProQuest Dissertations & Theses Global This link opens in a new window

A comprehensive collection of over 5 million dissertations and theses from around the world, spanning from 1743 to the present day. It includes full text for graduate works added since 1997 and selected full text for works written prior to 1997.

Most useful for :

• Finding unpublished/grey literature on a topic that is not indexed in other databases

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Basic Searching Instructions

Proquest Dissertations & Theses Global does not have subject headings. You can search single topics in Basic Search, but Advanced Search allows you to combine topics easily.

Searching with Basic Search

1. Enter words or phrases that describe your topic in the search box.

2. Click the magnifying glass or press Enter to search.

Combining your search terms in Recent Searches

OR will find references with any of the search terms. Use OR to broaden your search.

AND will find references with all the search terms. Use AND to narrow your search.

Search History (Combining search results)

1. Click on the Recent Searches link (under the search boxes) to display your searches or search sets.

2. Combine searches using the number of each search line with either AND or OR in between in the box above the search history, and then click Search .

Searching with Advanced Search

1. Enter your search terms in the boxes. If you need additional rows, click "add row."

2. Click Search .

Proquest Dissertations and Theses Global has limited filtering options. Common filters include publication date and language .

Saving your Searches via My Research Account

1. With an account, you can save and retrieve a search strategy, set up an e-mail alert to receive new references on your topic, store references in permanent folders for future use, and share your results with colleagues within your institution.

2. To set up a personal account, click on the person-shaped icon in the top right corner, and then click Create My Research Account .

3. To save the search to your account, click on Save search/alert to the top right of the results box.

4. Name your search, and it will appear in your account under Searches . You can combine saved searches, create alerts, or get a link to share the search.

5. To save handpicked citations from the results list, select the radio buttons for the documents you want and click the folder icon to Save to My Research Account . They will be saved in the " Documents " folder in My Research Account. You can also create subfolders to organize your saved documents.

Steps to Find Full-Text Articles

• 1. Look for full-text in Duke collections
• 2. Look for free full-text
• 3. Place an interlibrary loan request

• Duke Libraries Search Widget If you were unable to get to the full-text through the database you were searching, try using the Duke Libraries Search Widget. Search the full title of the article and try any of the full-text links. If there are none, you can try looking for free full text (Step #2).
• E-Journals If you were unable to get to the full-text through the database you were searching via the widget, you can search for the specific E-Journal to see if Duke has access. (NOTE: You will need the article citation to look for full-text access.) Search the name of the journal; then, browse to determine if the library subscribes to the specific year. Select the first link that includes the year the article was published. Each publisher website will look different. Find the specific year, volume, and issue that you need and then look for your specific article title.

If you are unable to find full-text articles using the links below, you will need to order it via InterLibrary Loan (Step #3).

• Google Scholar This link opens in a new window 1. Make sure your Google Scholar is connected to Duke, as this will give you the Get It @ Duke button. To do this: In Google Scholar > Settings > Library links > Search for Duke > Check all that apply and Save. 2. If you are retrieving too many results, try putting the article title in quotes and / or adding the author last name.
• Google For difficult to find citations, try regular Google. 1. Use the same techniques of putting the title in quotes and adding author information if needed.

Before making a request for full-text articles through Interlibrary Loan (ILL), please try steps #1 and #2 to search for the full-text. This allows our service to focus on articles that are not available for free nor via our Duke subscriptions. Our Interlibrary Loan service is no charge to Duke borrowers for all article requests. If there are copyright or other fees associated with your article request, we will contact you.

• Find the article citation in a database:  If you aren't already in a database, go back to PubMed or other database such as CINAHL, Embase, or Web of Science to look up the article. Why? Because our Get it @ Duke button will fill out the ILL form for you with all the article information – this saves you time and ensures greater citation accuracy.

• Log on with your DHE / NetID username and password:  This will take you to the ILL form. The article information will be filled into the form automatically. Scroll to the bottom, verify accuracy, and click submit.

If you can't find the citation in a database or you don't see a GetIt@Duke button, you can place a request manually through our interlibrary loan service. Follow the steps below.

• Interlibrary Loan & Document Delivery Request page First, log in with your DHE Active directory username and password (NetID/pw). Next, in the left hand menu, click New Request > Article/Chapter  Finally, fill out the required fields; please take care to ensure accuracy as incorrect citations may cause your order to be delayed or cancelled.  

Questions about Interlibrary Loan?  All interlibrary loan questions should go to Louis Wiethe, Document Delivery & Interlibrary Loan Manager, 919.660.1179 or  [email protected]

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• Honors Theses

Duke maintains an active list of Undergraduate Honors Theses and student papers within its DukeSpace hub. Here, you can search through and access summaries, full documents, authors, subjects, advisors and more. 

By utilizing this hub, you can learn more about projects related to areas of research you're interested in, plus learn more about the advisor to see if that faculty member could be a good fit for your project.

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Depositing to the DukeSpace Repository

• Introduction to DukeSpace
• Polices for Scholarly Works
• Depositing Scholarly Works
• FAQ for Scholarly Works
• Electronic Theses & Dissertations (ETDs) via ProQuest
• Polices for Master's Projects
• Preparing Your Materials
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• Policies for Undergraduates
• FAQ for Student Work

Terminology

A quick reference for terms used with DukeSpace.

Institutional Repository - an archive for collecting, preserving, and disseminating digital copies of the intellectual output of an institution, particularly a research institution.

Open Access - a set of principles and practices through which research outputs are distributed online, technological or cost barriers. Generally for the purpose of maximizing its accessibility, usage, and citation impact.

"Green" Open Access - the practice of sharing scholarly works openly in an institutional or disciplinary repository  free of article processing charges, done by the author at their discretion and free of article processing charges.

Self-Archiving - the author of a scholarly work depositing a free copy of an electronic document online in order to provide open access to it.

Public Access - the term used by the U.S. Federal Government to refer to its requirement to provide free and open access to all research outputs produced by researchers funded by federal agencies. See the 2022 Memorandum on Public Access to Research from the Office of Science and Technology Policy. Depositing work to DukeSpace does not necessarily meet the requirements for federal public access.

About DukeSpace

DukeSpace is an online, open-access repository for works authored by Duke faculty, staff, and students.  This guide describes the processes for depositing each category of work into DukeSpace.  All submissions must be made by a Duke-affiliated author.

What type of works can you add to DukeSpace?

• Scholarly publications
• Electronic theses and dissertations (ETDs)
• Graduate capstone projects
• Undergraduate honors theses

What types of work are out of scope for DukeSpace?

• Works that must remain permanently restricted or require customized access settings
• Works to which authors do not own copyright
• Please note : Supplementary files may be included with deposits, but DukeSpace cannot accommodate deposits with large numbers of files or complex file arrangements.  Researchers seeking to deposit datasets should refer to the Duke Research Data Repository .  

How to Deposit

• Scholarly publications  ( via Elements)
• ETDs  (via ProQuest)
• Graduate capstone projects  (self-deposit)
• Undergraduate honors theses  (self-deposit)

Benefits of sharing your work in DukeSpace

Make your work more visible, open access to your research and scholarship enables more people to find and read it, removing technological and cost barriers (such as database subscriptions). your work in dukespace is visible to anyone with an internet connection and is indexed by google scholar and other search engines. by sharing it in dukespace, you can increase its overall reach, impact, and citation., assign a permanent link.

DukeSpace provides each item with a persistent and stable handle link , making it easy to find and cite. You can put handle links on your personal websites, CVs, and professional profiles.

Note: The handle is different from the link that appears in your browser's address bar, so when sharing or citing a resource, be sure to use the stable handle listed as the permanent link.

Preserve your work

DukeSpace is maintained by the Duke University Libraries. Unlike websites or repositories run by private companies, DukeSpace is part of the university infrastructure and is highly stable as a hosting platform for your work. DUL is committed to the long-term preservation and discoverability of Duke scholarship in DukeSpace.  For more information about digital preservation at Duke, visit the Digital Preservation Guide .

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Honors Info Session

Oct 30, 6pm, Perkins Link Classroom 6

Recording of the Spring, '24 Info Session  

Slides from Info Session

Forms 

Online Independent Study Application Honors Candidate Application Form Honors Abstract and Advisor Approval Form Honors Thesis Submission Form   (Do not submit without first submitting the abstract and advisor approval form.) Poster Session Submission Form

Deadlines 

For fall 2024 graduates.

September 6, 2024:   Submit Honors Candidate Application Form  with advisor approval December 2, 2024: Submit completed honors thesis ONLINE.

For Spring 2025 Graduates

October 13, 2024:   Honors Candidate Application Form with advisor approval. April 3, 2025:   Honor Thesis Abstract and Advisor Approval Form   April 11, 2025:   Completed Honors Thesis Form online by 4pm . April 17, 2025: Poster Session Submission Form online by 4pm. April 22, 2025: Honors poster session 5pm-7pm. Location TBD.

Instructions & Formatting Information

Download Instructions for Formatting and Submitting Honors Thesis (pdf - 294.34 KB)

Download Standards for Honors Posters: Formatting & Submitting (pdf - 147.39 KB)

Davies Fellowships

Honors candidates may be eligible to receive a  Davies Fellowship (link opens in a new window/tab) . These fellowships are intended to financially support promising undergraduates in the summer between their junior and senior years, so that they may be free to further their pursuit of independent research under the direction of a faculty mentor and through the Honors Program. A sponsoring faculty mentor must nominate candidates for the Davies Fellowship.

Travel Grants

This grant is primarily intended to fund students who have been invited to present their original research at professional conferences.  Exceptions may be made for cases in which the student’s research supervisor believes that attendance at a particular conference is essential to the successful completion of the student’s original research paper or project.

This grant may be used to pay for lodging and domestic (U.S.) travel by air, train, or bus.  Please note that taxi, ridesharing or other private car or limousine services are not covered by this grant. 

Data Grants

This grant is intended to enable students to obtain access to data sets that they will analyze as part of their honors theses or other original research projects.  Priority will be given to the purchases of datasets that may be kept permanently and may be used by multiple students. 

Past Honors Theses

The Department of Economics maintains an archive of past Honors Program theses and data sets, when available. Students may want to refer to past papers to further inform their research questions and gain an understanding of the expectations and standards for a typical honors thesis.

• Honors Theses Archive

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APA Style Guide Style: 10 Lessons in Clarity and Grace    

Honors Papers

Getting Started

How to Write a Paper  

The Introduction

Literature Reviews

Documentation and Sources

Tables, Graphs, and Figures

Book Reviews

History Papers

Writing Itself

Tutoring is provided by the university's  Writing Studio . If your native language is not English and you want help with English-language problems, please schedule an appointment with the Writing Studio. The Writing Studio has an English as a Second Language (ESL) specialist on staff.

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Duke Law Scholarship Repository

Duke Law > Duke Law Scholarship Repository > Student Works > Judicial Studies

Duke Law Master of Judicial Studies Theses

Theses submitted by students enrolled in the MJS program are collected and made accessible through this series. Work is in progress to collect and make available a complete historical collection of these materials. Visit the MJS web page at the Bolch Judicial Institute .

Theses from 2018 2018

Judicial Externships: Sharing Current Practices , Dinah Lennon Archambeault

A Comparison of the American Model and French (-Inspired) Appellate Model , Frederic Blockx

Choosing Leadership Judges by State Supreme Court Appointment: Analysis of a Court Reform , Robert M. Brutinel

“Re-evaluating Competence to Stand Trial” , David Collins

Innovative Justice: Federal Reentry Drug Courts – How Should We Measure Success? , Timothy D. DeGiusti

When the Rule of Law Breaks Down: Implications of the 1866 Memphis Massacre for the Passage of the Fourteenth Amendment , Bernice Bouie Donald

Savings—the Missing Element in Chapter 13 Bankruptcy Cases? , David R. Jones

Certification of Legal Questions to the Utah Supreme Court , David Nuffer

Black Robes, White Judges: The Lack of Diversity on the Magistrate Judge Bench , Jennifer Thurston

The Influence of Re-Selection on Independent Decision Making in State Supreme Courts , Ann A. Scott Timmer

Mass Incarceration: The Obstruction of Judges , Tracie A. Todd

Theses from 2016 2016

Are We Insane? The Quest for Proportionality in the Discovery Rules of the Federal Rules of Civil Procedure , Paul W. Grimm

Enhancing Judicial Institutions: Enhancing Economic Development , Stephane Alia Haisley

Would United States Judges Benefit From More Graduate Training? , Nancy Joseph

Designated Hitters, Pinch Hitters, and Bat Boys: Judges Dealing with Judgment and Inexperience, Career Clerks or Term Clerks , Donald W. Molloy

Beware of Judging a Book Just by Its Cover: Are the German Rules of Civil Procedure, in Their Practical Application, Really as Capable to Facilitate a Speedy and Fair Trial as One Might Think? , Julia Prahl

It’s So Hard to Say Goodbye: Why Article III Judges Leave (or Don’t) , Johnnie Blakeney Rawlinson

What Judges Say and Do in Deciding National Security Cases: The Example of the State Secrets Privilege , Anthony John Trenga

Theses from 2014 2014

Ghana’s Jury System on Trial , Dennis D. Adjei

Dissent Aversion at the Court of Justice of the European Union , Marsha C. Erb

Leadership and Management Training in the North Carolina Judicial System: An Examination of Identified Need , James E. Hardin Jr.

Do Non-Partisan, Publically Financed Judicial Elections Enhance Relative Judicial Independence? , Robert N. Hunter Jr.

How Important Are the Unwritten Customs and Norms of an Appellate Court? , Renee Cohn Jubelirer

United States Magistrate Judges: Present but Unaccounted for , Philip M. Pro

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Masters Theses

Permanent uri for this collection, recent submissions.

Surface guided radiation therapy (SGRT) is an emerging technology that uses non-ionizing methods for patient positioning and motion tracking during radiotherapy delivery. However, the use of radiotherapy boluses, which are tissue-equivalent materials placed on the skin to increase surface dose, has been shown to interfere with SGRT systems due to reflections from the bolus surface. This thesis presents the development and validation of an opaque and non-glossy radiotherapy bolus called the "Surface Guidance Optimized" (SGO), which is a variation of the previously developed transparent Clearsight bolus.The Surface Guidance Optimized bolus was rendered opaque by adding 0.6% titanium dioxide and given a matte finish using matte release paper. Spectroscopy measurements confirmed optimal opaqueness, while gloss meter readings verified a non-glossy surface. The bolus density was quantified to be 0.853 g/cm3 using water displacement and CT methods. Dosimetric characterization through direct surface dose measurements and Monte Carlo simulations demonstrated the SGO bolus mimics the dose deposition of water-equivalent materials when accounting for density differences. Compatibility testing with the AlignRT SGRT system showed the bolus allowed accurate surface reconstruction and submillimeter tracking (within 0.4 mm) under different lighting conditions. Overall, the SGO bolus mitigates issues of transparency and glossiness that interfered with SGRT systems, while maintaining desirable dosimetric properties for clinical use as a radiotherapy bolus compatible with modern surface guided techniques.

This paper seeks to contribute to the study of early postwar Japanese women’s history by focusing on rural women, a group that has received relatively less attention in recent scholarship. It aims to understand the changes in the lives and worldviews of Japanese farm women from 1945 to 1950 as shaped by the ambitious initiatives of the Supreme Commander for the Allied Powers (SCAP), the Japanese government, and the local reception and internalization of new ideologies. Through the lens of women-and-lifestyle-related content in Ie no hikari 家の光 (Light of the Home), the most influential rural family magazine in prewar and postwar Japan, this paper intends to explore how the magazine tailored official campaigns to the rural context with the help of local activists and farm women themselves, leaving both tangible and intangible impacts on the daily lives of women and their families. It also investigates the various ways in which local women responded to and interacted with the official new life campaigns that promised them concrete improvements in material lives and social status. As the magazine served as a middle ground where top-down initiatives intersected with local efforts to internalize official languages in the late 1940s, it also provides access to the local voices of farm women at the time. These precious voices, however limited, allow us to better situate rural women within the tabulating social milieu of early postwar Japan and to delve deeper into their daily lives.

This thesis presents a comprehensive study on nonparametric Bayesian density estimation using Gaussian processes (GP). We explore the logistic Gaussian Process (LGP) and introduce an innovative approach termed the tree-logistic-link Gaussian process (TLLGP). This method aims to improve computational efficiency while maintaining modeling flexibility. We address the computational challenges traditionally associated with LGP by implementing a novel tree-based strategy, thereby reducing the complexity of posterior computations. Through a series of numerical experiments, we demonstrate the effectiveness of TLLGP in various scenarios, comparing its performance with other methods. The results highlight the advantages of our approach in terms of computational speed and accuracy in density estimation tasks. This work contributes to the fields of Bayesian statistics and machine learning by providing a more efficient tool for density estimation, especially beneficial for large high-dimensional data where traditional methods fall short due to their computational demands.

Introduction: The current head-and-neck (HN) fluence map generator tends to producehighly modulated fluence maps and therefore high monitor units (MUs) for each beam, which leads to more delivery uncertainty and leakage dose. This project implements diffu- sion into the training process and modifies the loss functions to mitigate this effect.

Methods: The dataset consists of 200 head-and-neck (HN) patients receiving intensity mod-ulated radiation therapy (IMRT) for training, 16 for validation, and 15 for testing. Two models were trained, one with-diffusion and one without. The original model was a con- ditional generative adversarial network (GAN) written in TensorFlow, the model without diffusion was written to be the PyTorch equivalent of the original model. After confirming the model was properly converted to PyTorch by comparing outputs, both new models were modified to use binary cross entropy for the GAN loss and mean absolute error as a third loss function for the generator. Hyperparameters were carefully selected based on the training script for the original model, and further tuned with trial and error. The diffusion was implemented based on Diffusion-GAN and the associated GitHub repository. The two new models were compared by plotting training loss vs epoch over 500 epochs. The two models were compared to the original model by comparing the output fluence maps to the ground truth using similarity index and comparing DVH statistics among the three models.

Results: The with-diffusion model and no-diffusion model achieved similar training loss.The diffusion model and no-diffusion model consistently delivered better parotid sparing than the original model and delivered less dose to four of the six tested OAR. The with- diffusion model delivered less dose to five of the six tested OAR. The diffusion model had the least MUs: 23% less than the original model and 3% less than the no-diffusion model. The diffusion model had lower D2cc: 4% less than the original model and 1% less than the no-diffusion model on average. All three plans deliver 95% of the prescription dose to nearly the same percentage of PTV volume.

Conclusion: Implementing diffusion does not provide a significant impact on training timeand training loss. However, it does enable comparable dose performance to both the no- diffusion and original models, while significantly reducing the total MU’s and 3D max 2cc relative to the original model and slightly reducing these metrics relative to the no-diffusion model, indicating smoother fluence modulation. In addition, both new models reduced dose to the right and left parotids relative to the original model, and to four of six tested OAR total, while the with-diffusion model consistently delivers less dose to OAR than the no- diffusion model. This indicates that both the new loss functions and diffusion reduce the overall dose to the OARs while preserving dose conformity around the target.

Purpose: Currently, the Magnetization Prepared Rapid Gradient Echo (MPRAGE) Magnetic Resonance Imaging (MRI) sequence is frequently used for brain tissue segmentation in the clinic due to its high image contrast. However, one of the limitations of the MPRAGE sequence lies in its susceptibility to metal artifacts, while the Turbo Spin Echo (TSE) sequences, can resist metal artifacts. Previous studies have shown that for patients with metal implants, metal-artifact-reduced MPRAGE images can be generated from TSE images. Conventional brain segmentation methods on MPRAGE images, such as FreeSurfer, are time-consuming. Therefore, the purpose of this study was to investigate a fast brain segmentation method via deep learning-based frameworks for patients with metal implants, using TSE images as input.Materials and Methods: A dataset consisting of 369 patients in total was used. Each patient contained 160 two-dimensional slices of T1-weighted (T1WI), T2-weighted (T2WI), and PD-weighted (PDWI) TSE brain MR images, respectively. The matrix size of the original images was 240 × 240. Two types of MPRAGE as intermediate steps were synthesized from T1WI, T2WI, and PDWI using mathematical calculations or Conditional Generative Adversarial Network (cGAN) algorithms. FreeSurfer software was used to generate brain segmentations on the MPRAGE, which were considered as the ground truth for deep-learning network training and eventual evaluation. Two research aims were investigated. Aim 1 was to utilize three-channel TSE images (T1WI, T2WI, and PDWI) to first mathematically synthesize MPRAGE images, and then perform segmentation via deep learning-based models. Aim 2 was to use single-channel TSE images as input directly or indirectly to achieve brain segmentation using deep learning-based models. Both UNet and UNet++ models were examined. The Dice coefficient was used to evaluate the performance of the above-mentioned segmentation aims. Results: For Aim 1, the Dice coefficient between the ground truth and the cortex segmentations generated by the UNet++ network using three-channel TSE images as original input and mathematically synthesized MPRAGE as direct input was 0.919 ± 0.03. For Aim 2, the Dice coefficient between the ground truth and the cortex segmentations generated by the UNet network using single-channel TSE images directly as input was 0.602 ± 0.06. The Dice coefficient between the ground truth and the cortex segmentations generated by the single-channel TSE images as original input and cGAN-synthesized MPRAGE as direct input using the UNet++ network was 0.766 ± 0.07. Conclusion: Two aims using three-channel or single-channel TSE images as original input and brain segmentation as output were investigated in this study. Three-channel TSE images as original input, and mathematically synthesized MPRAGE as direct input to the UNet++ network showed superior results. Single-channel TSE images as original input and cGAN-synthesized MPRAGE as direct input to the UNet++ network showed relatively lower performance. Further research is warranted to improve the performance of single-channel TSE-based deep-learning segmentation methods. Keywords: UNet++, MRI, Brain Image, Segmentation, TSE, MPRAGE

AbstractPurpose: DW-MRI and their derived apparent diffusion coefficient (ADC) maps have been shown to be beneficial in the diagnosis and treatment of various cancer types. This work determines the potential role of DW-MRI and ADC maps in GTV delineation for gynecological cancer patients undergoing external beam radiation therapy (EBRT) and brachytherapy. Our study also looked at the longitudinal changes in DWI/ADC values during the course of external beam treatments, as well as during the five brachytherapy fractions. Methods: The first aspect of this study involved validating the console-derived DW image sets and ADC maps using an in-house Matlab code designed for this purpose. Next, the b-value, which describes the sensitivity of the imaging sequence to diffusion, was optimized through a quantitative and qualitative analysis. The quantitative analysis involved maximizing the contrast-to-noise ratios between the tumor and various structures, including the endocervical canal, endometrium, myometrium, and gluteal subcutaneous fat. The qualitative analysis had two radiation oncologists ranking different DWI sets at various b-values based on tumor conspicuity and total image quality on a scale of 1-5, 1 being the best and 5 being the worst. After determining the optimal b-value for DW image calculation, an analysis of GTV contouring was performed in Medical Image Merge (MIM). This involved a radiation oncologist contouring GTVs on three image sets; axial T2 MRI, axial T2 MRI fused with DWI at b=1300 s/mm2, and axial T2 MRI fused with ADC at b=0, 1000 s/mm2. This was done for 16 patients, 5 of whom had pre-EBRT and pre-brachytherapy scans and 11 of whom had only pre-brachytherapy scans. The contours between the three sets were compared on each scan using the Hausdorff distance, Jaccard index, DICE coefficient, and mean pixel value, all of which were calculated in MIM. The final portion of this study was a longitudinal look at the CTVHRs throughout the course of brachytherapy. The CTVHRs were analyzed on the axial T2 MRI, DWI, and ADC maps. Results: The contrast-to-noise ratios of the endocervical canal, endometrium, myometrium, and gluteal subcutaneous fat all compared to tumor were optimized at either b=1300, 1600, or 1800 s/mm2. DW images at b=1300s/mm2 were ranked the best by both physicians in terms of total image quality and tumor conspicuity for the qualitative analysis for b-value optimization. For GTN analysis, the volumes of the GTVs contoured with the help of the DW images and with the help of the ADC maps were not significantly different (p=0.23404). The Dice coefficients, Hausdorff distances, and Jaccard indices calculated with respect to the reference GTVs were not significantly different between the GTVs contoured with the help of the DW images and the GTVs contoured with the help of the ADC maps. The p-values were 0.84148, 0.56868, and 0.95216, respectively. The volumes of the reference GTVs compared to the volumes of the GTVs contoured with the help of DWI and ADC maps were not statistically significant with p-values of 0.6672 and 0.42372, respectively. The mean pixel values in the reference GTVs compared to the mean pixel values in the GTVs contoured with the help of DWI and ADC maps were not statistically significant with p-values of 0.17384 and 0.68916. The mean pixel values within the GTV contoured with the help of DWI were almost significantly lower than the mean pixel values within the GTV contoured with the help of the ADC maps (p=0.0536). Looking to artifact quantification, no significant artifacts were seen in the axial T2 MRI, DWI, or ADC map outside of the tandem contour in the ice water phantom experiment. In the longitudinal analysis of the CTVHRs, the percent difference between the largest and smallest average of the mean pixel values in Figure 7 is 17.4% with no apparent trend along fractions. The percent difference between the largest and smallest average of the mean pixel values in Figure 8 and Figure 9 are 27.3% and 6.5%, respectively. There is no apparent trend for the average of the mean pixel values when looking at the ADC maps, but the average of mean pixel values decreases throughout the brachytherapy fractions when looking at the DW images. The average standard deviation of the pixel values within each CTVHR on the axial T2 MR and DW image sets generally decreases throughout the course of brachytherapy, while the average standard deviation on ADC generally increases along fractions. However, the percent difference between the largest and smallest average standard deviation on the axial T2 MR image set, the DW image set, and the ADC maps is 18.5%, 43.4%, and 4.9%, respectively. Therefore, while the standard deviation on the ADC maps is generally increasing, it is to a small extent. Conclusion: The results of this study indicate the potential of using ADC maps in tandem with axial T2 MRI to increase the accuracy of GTV delineation in cervical cancer patients undergoing EBRT and brachytherapy. However, a larger sample size is needed to provide more insight into their use during the contouring workflow.

Due to a high burden of disease of pneumonia in Vietnam, the country not including the pneumococcal conjugate vaccine (PCV) in its National Expanded Programme of Immunization (EPI), and the scarce data on PCV vaccine coverage or caregivers’ behavior within the country, it is imperative to assess the Knowledge, Attitude and Practice (KAP) of the caregivers’ community, to further explore ways to increase PCV uptake. The purpose of this study is to understand the KAP of caregivers towards PCV inoculation for children in Hanoi, VietnamMethodology: 338 respondents fulfilled the Qualtrics questionnaire and 26 respondents (16 caregivers and 10 health workers) were interviewed in Hanoi, Vietnam, using semi-structured interviews in June-December 2023. Materials and data were transcribed between Vietnamese and English, and analyzed according to selected themes. Discussion/Conclusions: Although the findings suggest that caregivers in Hanoi have limited knowledge on PCV, support for attitude and practice on accepting PCV exists, especially from caregivers with high socio-economic status. This study wished to contribute to a better understanding of the KAP factors regarding childhood vaccines, which may support decision-making about vaccine policies, and be utilized for creating suitable vaccine promotion materials for child caregivers.

As the twenty-first century has entered an era of catastrophes, post-catastrophic trauma writings in world literature bear witness and give testimonies to the moments of crisis. With a comparative literary study of the post-catastrophic trauma writings and other forms of representations that respond to the 9/11 terrorism in the United States and the Covid-19 pandemic outbreaks in China, this research explores the question of how the collective traumas develop dynamic relationships with individuality and influence individuals’ mental lives affectively. In the catastrophic aftermath, the collective traumas shared by the individuals act on their interiority and form a sense of collective isolation, which means that an individual staying in a collectivity remains unconsciously isolated affects. The research will illustrate the embodiments of collective isolation at an individual level and delve into its social causes at a collective level. On an individual level, collective isolation is recognized as a traumatized subject’s sense of detachment from the chronological present, showing a dislocation with time. On a collective level, collective isolation is an exteriorization of a traumatized society by two types of violence: subjective violence and objective violence. The intensive conflicts around subjective violence directly by catastrophes may transform into invisible objective violence, which constantly and implicitly influences politics, cultures, and human affects. This research would land at the point that collectivity and individuality as two spatial concepts could be interpenetrated through affects, illustrating that the collective traumas represent dynamic relationships among violence, affects, public spheres, and the individual’s mental world.

Background: Cervical cancer is a common gynecological malignancy among women worldwide. Among the primary modalities for treating cervical cancer, radiation therapy occupies a central role. Using Cone-Beam Computed Tomography (CBCT) scans obtained prior to treatment for target registration and alignment holds critical significance for precision radiation therapy. Accurately contouring targets and critical-organs-at risk (OARs) is the most time-consuming task for radiation oncologists. The OAR contouring in CBCT plays a crucial role in the radiotherapy of cervical cancer. Specifically, the location and volume of the rectum and bladder can significantly impact the precision of cervical cancer treatment, as the patients need to drink certain amount of water to fill the bladder prior to the treatment for target localization. The resulting change in position of rectum and bladder may lead to alterations in the target dose. Further, changes in radiation dose to these two OARs can directly affect the severity of the acute and late radiation induced damage. Therefore, the OAR contouring not only allows for better localization before each radiotherapy session, but also provides valuable reference for clinicians when they need to adjust the treatment plan.Purpose: The objective of this study is to evaluate the capabilities of four deep-learning models for contouring OARs in CBCT images of cervical cancer patients. Materials and Methods: The study dataset comprising 40 sets of CBCT images were collected from the Fujian Provincial Cancer Hospital in China. Two experienced radiation oncologists meticulously delineated 10 groups of OARs (Body, Bladder, Bone Marrow, Bowel Bag, Femoral Head L, Femoral Head R, Femoral Head and Neck L, Femoral Head and Neck R, Rectum, Spinal Canal) on the CBCT images as reference/ground truth. Subsequently, the 24 sets of CBCT reference were used to train the CBCT model, and the unedited CBCT images of the remaining 16 sets were used for comparing with their reference to test the four models. The only difference between these four models is the adoption of different neural network structures. They are classic U-Net, Flex U-Net, Attention U-Net (ATT), and SegResNet respectively. The evaluation of contouring quality for the four models was performed using the metrics such as 95 percentile Hausdorff Distance (HD95), Dice Similarity Coefficient (DICE), Average Symmetric Surface Distance (ASSD), Maximum Symmetric Surface Distance (MSSD), and Relative Absolute Volume Difference (RAVD), respectively. Results: The average DICE was 0.86 for bladder contouring among four models. The average DICE for rectum on CBCT image was 0.84 for four models. Conclusion: According to the quantitative analysis, classic U-Net neural network architecture with minor adjustments can obtain competitive segmentation on CBCT images.

Objective: This dissertation investigates therapists' perceptions and expectations of technology application in non-pharmaceutical therapies (NPT) for individuals with Mild Cognitive Impairment (MCI) and Dementia, emphasizing the role of Information and Communication Technology (ICT).

Methods: Adopting a qualitative research framework, this study utilizes methodology comprising semi-structured interviews, and participatory observations. Semi-structured interviews employed convenience sampling to engage experienced therapists in in-depth discussions, while participatory observations offered a firsthand examination of therapeutic settings and methodologies, including music therapy, and reminiscence therapy.

Results: Integrating insights from therapist interviews, and immersive participatory observations, the study elucidates the ambivalent nature of ICT’s role in NPT for treating dementia patients. Challenges identified include older patients’ resistance to new technologies and the difficulty in quantifying the therapeutic outcomes of ICT applications. Despite these hurdles, therapists exhibit a collective optimism toward the potential of rapidly evolving technology to enhance the overall efficacy of NPT in the recovery processes for dementia patients.

Conclusion: The research underscores a complex landscape where the integration of ICT in NPT presents both opportunities and challenges. Therapists’ hopeful outlook signals a broader consensus on the potential transformative impact of technology in dementia intervention, suggesting a need for further innovation and research in this domain. This study contributes to the dialogue on integrating ICT in therapeutic practices, offering a nuanced understanding of its implications for enhancing dementia intervention.

Background: Population aging and rural urbanization were two major trends in China. Past researches had shown that relocation and displacement could have a negative impact on the mental health of senior adults. Land expropriation and increasing rural migration due to China's urbanization process had created a growing but understudied group of "landless farmers." This study explored the impact of relocation from rural villages urban resettlement on the mental health of older adults in China in terms of depression.Method: The mixed-method study collected survey data from 219 adults aged ≥60 years in one relocated village (Zhangjia) and one non-relocated village (Xicheng) in Jinhua City, Zhejiang Province, China. Mental health measures included the Geriatric Depression Scale. Semi-structured interviews with 10 relocated older residents provided qualitative data. Quantitative analyses examined differences in social networks, amenities, and levels of depression between groups. Logistic regression analyzed predictors of depressive symptoms. Qualitative data were analyzed using thematic analysis. Result: No significant difference in depression was found between the two communities, but the social network scores of older adults in the resettlement community were significantly lower than those in the original village. Poor living facilities were associated with a higher rate of depression in both communities. In addition, a good social network was an important protective factor against depression in the relocated population. Qualitative findings revealed feelings of boredom, reduced social interaction, and changes in family relationships following the move. In summary, quantitative and qualitative data suggested that the disruption of living habits and isolation caused by relocation may have a negative impact on the mental health of older adults in rural China. Discussion: Quantitative and qualitative data suggested that the disruption of living habits and isolation caused by relocation may have a negative impact on the mental health of older adults in rural China. Conclusion: The study emphasized the need for targeted interventions to support mental well-being in this vulnerable population undergoing relocation.

AbstractIntroduction：This study evaluates a new proton therapy filter designed to eliminate the need for energy adjustments. Utilizing the machine's maximum energy, the filter ensures sufficient tumor coverage through the Bragg-peak, potentially improving treatment efficiency by shortening delivery time. Methods：Implemented on the matRad platform, each plan utilized a single arc composed of 72 beams, each spaced 5 degrees apart. Open-access datasets, including TG-119 C-shape, a prostate case, and a liver case, were employed. The prescribed doses for these cases were 50Gy in 25 fractions, 68Gy in 34 fractions, and 45Gy in 25 fractions, respectively. Simplifying from multiple energy layers to a single energy layer for each beam can reduce treatment delivery time. Maintaining spot coverage with a single energy layer for each beam is a critical optimization aspect. The spot coverage, P(i,j), is optimized to maximize spot coverage and the optimization is called mono energy optimization. However, considering spot coverage alone is insufficient; the energy level must also be considered. Higher energy levels indicate a thinner range shifter, which reduces scatter and attenuation caused by range shifters. The new optimization process, called higher mono energy optimization, gave priority to deeper layers and larger spot sizes, using a function that normalizes input energy and combines it with alpha and beta coefficients to optimize the energy function E(i,j) and spot coverage P(i,j). The optimal energy layers were selected, and the initial beam energy was set at 236MeV. All beamlet was adjusted to specific energy levels with a custom-designed PMMA filter based on stopping power, facilitating a smooth transition to the desired energy levels. The effectiveness of this approach was evaluated by comparing dose metrics with those from the Intensity Modulated Proton Therapy (IMPT) method using two or three beams. Results: PTV coverages were relatively close between the IMPT and range filter plans. Organs at Risk (OAR) experienced a dose increase due to enhanced scattering. Simulated treatment delivery times for the three tested range filter plans demonstrated the efficiency, with prostate at 360s, liver at 340s, and TG119 at 390s. Conclusions: Mono-energy with range filters proton therapy is a feasible approach for expediting treatment delivery without compromising the quality of the treatment plan.

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