Against Imperialism in Legal Concepts

The authority of government—and that of its politicians, judges, regulators, and other specific authorities—continues to grow more imperialistic. This is partly due to the imperialism of legal concepts as facilitated by Wittgenstein’s famously non-essentialist treatment of concepts through family resemblance theory. Although non-essentialism or anti-essentialism can be highly valuable in forming religious and literary concepts, and in describing the sometimes incoherent everyday usage of concepts and terms, all legal concepts should be scientific-style essentialist concepts. Such essentialism combats the broad discretion granted and obscured by non-essentialist approaches that allow concepts to absorb contradictory elements and harmfully hold them together, thus allowing legal authorities to choose from among only those elements that suit their purposes in any given case. Instead of arguing for the total exclusion of family resemblance and similar theories from use in legal concepts, I argue for translating non-essentialist concepts into essentialist ones while still using the former’s theory forms. Precise essentialist concepts, with core and non-contradictory properties clearly delineated, are necessary for maximizing the rational and moral legitimacy of law, which coercively regulates the behavior of ordinary citizens at the command of political and legal authorities. Legal rules and commands must be as clear and consistent as reasonably possible not only for optimal rationality and morality, but also for legitimacy in the eyes of those subject to law. This is especially important in an increasingly diverse society of incompatible perspectives and decreasing conscious and unconscious adherence to the Anglo-American legal tradition

Press-pulse: a novel therapeutic strategy for the metabolic management of cancer

Background A shift from respiration to fermentation is a common metabolic hallmark of cancer cells. As a result, glucose and glutamine become the prime fuels for driving the dysregulated growth of tumors. The simultaneous occurrence of “Press-Pulse” disturbances was considered the mechanism responsible for reduction of organic populations during prior evolutionary epochs. Press disturbances produce chronic stress, while pulse disturbances produce acute stress on populations. It was only when both disturbances coincide that population reduction occurred. Methods This general concept can be applied to the management of cancer by creating chronic metabolic stresses on tumor cell energy metabolism (press disturbance) that are coupled to a series of acute metabolic stressors that restrict glucose and glutamine availability while also stimulating cancer-specific oxidative stress (pulse disturbances). The elevation of non-fermentable ketone bodies protect normal cells from energy stress while further enhancing energy stress in tumor cells that lack the metabolic flexibility to use ketones as an efficient energy source. Mitochondrial abnormalities and genetic mutations make tumor cells vulnerable metabolic stress. Results The press-pulse therapeutic strategy for cancer management is illustrated with calorie restricted ketogenic diets (KD-R) used together with drugs and procedures that create both chronic and intermittent acute stress on tumor cell energy metabolism, while protecting and enhancing the energy metabolism of normal cells. Conclusions Optimization of dosing, timing, and scheduling of the press-pulse therapeutic strategy will facilitate the eradication of tumor cells with minimal patient toxicity. This therapeutic strategy can be used as a framework for the design of clinical trials for the non-toxic management of most cancers

Dark Sky: Assessing the Feasibility of Bar Harbor Becoming an International Dark Sky Community

The purpose of this project was for the Worcester Polytechnic Institute (WPI) 2017 Dark Sky team to assess the feasibility of the town of Bar Harbor applying for an International Dark Sky Community (IDSC) status. The team found it is possible for Bar Harbor to become an IDSC in future years. Recognition from the IDA will be mutually beneficial for the team’s sponsor Acadia National Park and the town itself. Bar Harbor already meets approximately 46% of the IDSC guidelines. The biggest factors that need to be changed, are the town’s lighting ordinances and implementation of fully shielded compliant street lights

Prediction of cardiovascular outcomes with machine learning techniques: application to the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study.

Background: Data derived from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study were analyzed in an effort to employ machine learning methods to predict the composite endpoint described in the original study. Methods: We identified 573 CORAL subjects with complete baseline data and the presence or absence of a composite endpoint for the study. These data were subjected to several models including a generalized linear (logistic-linear) model, support vector machine, decision tree, feed-forward neural network, and random forest, in an effort to attempt to predict the composite endpoint. The subjects were arbitrarily divided into training and testing subsets according to an 80%:20% distribution with various seeds. Prediction models were optimized within the CARET package of R. Results: The best performance of the different machine learning techniques was that of the random forest method which yielded a receiver operator curve (ROC) area of 68.1%±4.2% (mean ± SD) on the testing subset with ten different seed values used to separate training and testing subsets. The four most important variables in the random forest method were SBP, serum creatinine, glycosylated hemoglobin, and DBP. Each of these variables was also important in at least some of the other methods. The treatment assignment group was not consistently an important determinant in any of the models. Conclusion: Prediction of a composite cardiovascular outcome was difficult in the CORAL population, even when employing machine learning methods. Assignment to either the stenting or best medical therapy group did not serve as an important predictor of composite outcome. Clinical Trial Registration: ClinicalTrials.gov, NCT00081731

Workload Associated With Nuclear Power Plant Main Control Room Tasks

Nuclear Power Plant (NPP) operators complete a variety of tasks to ensure the NPP is running safely and efficiently. However, the levels and types of workload associated with the different task types are not yet fully understood. The present investigation examined workload levels and types for three common NPP Main Control Room (MCR) tasks in a controlled experimental environment using a variety of subjective, physiological, and performance measures of workload. The results suggest that the three task types differ in the levels and types of workload. These findings can be used to better understand the types of NPP tasks that induce workload and the type of workload they induce. The full results of these experiments will be captured in future articles and technical reports

Renal Artery Stent Outcomes: Effect of Baseline Blood Pressure, Stenosis Severity, and Translesion Pressure Gradient

Background Multiple randomized clinical trials comparing renal artery stent placement plus medical therapy with medical therapy alone have not shown any benefit of stent placement. However, debate continues whether patients with extreme pressure gradients, stenosis severity, or baseline blood pressure benefit from stent revascularization. Objectives The study sought to test the hypothesis that pressure gradients, stenosis severity, and/or baseline blood pressure affects outcomes after renal artery stent placement. Methods Using data from 947 patients with a history of hypertension or chronic kidney disease from the largest randomized trial of renal artery stent placement, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) study, we performed exploratory analyses to determine if subsets of patients experienced better outcomes after stent placement than the overall cohort. We examined baseline stenosis severity, systolic blood pressure, and translesion pressure gradient (peak systolic and mean) and performed interaction tests and Cox proportional hazards analyses for the occurrence of the primary endpoint through all follow-up, to examine the effect of these variables on outcomes by treatment group. Results There were no statistically significant differences in outcomes based on the examined variables nor were there any consistent nonsignificant trends. Conclusions Based on data from the CORAL randomized trial, there is no evidence of a significant treatment effect of the renal artery stent procedure compared with medical therapy alone based on stenosis severity, level of systolic blood pressure elevation, or according to the magnitude of the trans-stenotic pressure gradient. (Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions [CORAL]; NCT00081731

Early Rapid Decline in Kidney Function in Medically Managed Patients With Atherosclerotic Renal Artery Stenosis

Background Early rapid declines of kidney function may occur in patients with atherosclerotic renal artery stenosis with institution of medical therapy. The causes and consequences are not well understood. Methods and Results Patients enrolled in the medical therapy–only arm of the CORAL (Cardiovascular Outcomes With Renal Artery Lesions) study were assessed for a rapid decline (RD) in estimated glomerular filtration rate (eGFR), defined as a ≥30% decrease from baseline to either 3 months, 6 months, or both. In the medical therapy–only cohort, eGFR was available in 359 subjects at all time points, the subjects were followed for a median of 4.72 years, and 66 of 359 (18%) subjects experienced an early RD. Baseline log cystatin C (odds ratio, 1.78 [1.11–2.85]; P=0.02), age (odds ratio, 1.04 [1.00–1.07]; P\u3c0.05), and Chronic Kidney Disease Epidemiology Collaboration creatinine eGFR (odds ratio, 1.86 [1.15–3.0]; P=0.01) were associated with an early RD. Despite continued medical therapy only, the RD group had an improvement in eGFR at 1 year (6.9%; P=0.04). The RD and nondecline groups were not significantly different for clinical events and all‐cause mortality (P=0.78 and P=0.76, respectively). Similarly, renal replacement therapy occurred in 1 of 66 (1.5%) of the RD patients and in 6 of 294 (2%) of the nondecline patients. The regression to the mean of improvement in eGFR at 1 year in the RD group was estimated at 5.8±7.1%. Conclusions Early rapid declines in kidney function may occur in patients with renal artery stenosis when medical therapy is initiated, and their clinical outcomes are comparable to those without such a decline, when medical therapy only is continued