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Water market is a contemporary marketplace for water trading and is deemed to one of the most efficient instruments to improve the social welfare. In modern water markets, the two widely used trading systems are an improved pair-wise trading, and a 'smart market' or common pool method. In comparison with the economic model, this paper constructs a conceptual mathematic model through the HARA utility functions. Mirroring the concepts such as Nash Equilibrium, Pareto optimal and stable matching in economy, three significant propositions are acquired which illustrate the advantages of the common pool method compared with the improved pair-wise trading.

Background and purpose: Radiation-induced erectile dysfunction (RiED) is commonly seen in prostate cancer patients. Clinical trials have been developed in multiple institutions to investigate whether dose-sparing to the internal-pudendal-arteries (IPA) will improve retention of sexual potency. The IPA is usually not considered a conventional organ-at-risk (OAR) due to segmentation difficulty. In this work, we propose a deep learning (DL)-based auto-segmentation model for the IPA that utilizes CT and MRI or CT alone as the input image modality to accommodate variation in clinical practice. Materials and methods: 86 patients with CT and MRI images and noisy IPA labels were recruited in this study. We split the data into 42/14/30 for model training, testing, and a clinical observer study, respectively. There were three major innovations in this model: 1) we designed an architecture with squeeze-and-excite blocks and modality attention for effective feature extraction and production of accurate segmentation, 2) a novel loss function was used for training the model effectively with noisy labels, and 3) modality dropout strategy was used for making the model capable of segmentation in the absence of MRI. Results: The DSC, ASD, and HD95 values for the test dataset were 62.2%, 2.54mm, and 7mm, respectively. AI segmented contours were dosimetrically equivalent to the expert physician's contours. The observer study showed that expert physicians' scored AI contours (mean=3.7) higher than inexperienced physicians' contours (mean=3.1). When inexperienced physicians started with AI contours, the score improved to 3.7. Conclusion: The proposed model achieved good quality IPA contours to improve uniformity of segmentation and to facilitate introduction of standardized IPA segmentation into clinical trials and practice.

When a pre-trained general auto-segmentation model is deployed at a new institution, a support framework in the proposed Prior-guided DDL network will learn the systematic difference between the model predictions and the final contours revised and approved by clinicians for an initial group of patients. The learned style feature differences are concatenated with the new patients (query) features and then decoded to get the style-adapted segmentations. The model is independent of practice styles and anatomical structures. It meta-learns with simulated style differences and does not need to be exposed to any real clinical stylized structures during training. Once trained on the simulated data, it can be deployed for clinical use to adapt to new practice styles and new anatomical structures without further training. To show the proof of concept, we tested the Prior-guided DDL network on six different practice style variations for three different anatomical structures. Pre-trained segmentation models were adapted from post-operative clinical target volume (CTV) segmentation to segment CTVstyle1, CTVstyle2, and CTVstyle3, from parotid gland segmentation to segment Parotidsuperficial, and from rectum segmentation to segment Rectumsuperior and Rectumposterior. The mode performance was quantified with Dice Similarity Coefficient (DSC). With adaptation based on only the first three patients, the average DSCs were improved from 78.6, 71.9, 63.0, 52.2, 46.3 and 69.6 to 84.4, 77.8, 73.0, 77.8, 70.5, 68.1, for CTVstyle1, CTVstyle2, and CTVstyle3, Parotidsuperficial, Rectumsuperior, and Rectumposterior, respectively, showing the great potential of the Priorguided DDL network for a fast and effortless adaptation to new practice styles

We evaluated the temporal performance of a deep learning (DL) based artificial intelligence (AI) model for auto segmentation in prostate radiotherapy, seeking to correlate its efficacy with changes in clinical landscapes. Our study involved 1328 prostate cancer patients who underwent definitive radiotherapy from January 2006 to August 2022 at the University of Texas Southwestern Medical Center. We trained a UNet based segmentation model on data from 2006 to 2011 and tested it on data from 2012 to 2022 to simulate real world clinical deployment. We measured the model performance using the Dice similarity coefficient (DSC), visualized the trends in contour quality using exponentially weighted moving average (EMA) curves. Additionally, we performed Wilcoxon Rank Sum Test to analyze the differences in DSC distributions across distinct periods, and multiple linear regression to investigate the impact of various clinical factors. The model exhibited peak performance in the initial phase (from 2012 to 2014) for segmenting the prostate, rectum, and bladder. However, we observed a notable decline in performance for the prostate and rectum after 2015, while bladder contour quality remained stable. Key factors that impacted the prostate contour quality included physician contouring styles, the use of various hydrogel spacer, CT scan slice thickness, MRI-guided contouring, and using intravenous (IV) contrast. Rectum contour quality was influenced by factors such as slice thickness, physician contouring styles, and the use of various hydrogel spacers. The bladder contour quality was primarily affected by using IV contrast. This study highlights the challenges in maintaining AI model performance consistency in a dynamic clinical setting. It underscores the need for continuous monitoring and updating of AI models to ensure their ongoing effectiveness and relevance in patient care.

The ongoing exploration of the ambiguous boundary between the quantum and the classical worlds has spurred substantial developments in quantum science and technology. Recently, the nonclassicality of dynamical processes has been proposed from a quantum-information-theoretic perspective, in terms of witnessing nonclassical correlations with Hamiltonian ensemble simulations. To acquire insights into the quantum-dynamical mechanism of the process nonclassicality, here we propose to investigate the nonclassicality of the electron spin free-induction-decay process associated with an NV$^-$ center. By controlling the nuclear spin precession dynamics via an external magnetic field and nuclear spin polarization, it is possible to manipulate the dynamical behavior of the electron spin, showing a transition between classicality and nonclassicality. We propose an explanation of the classicality-nonclassicality transition in terms of the nuclear spin precession axis orientation and dynamics. We have also performed a series of numerical simulations supporting our findings. Consequently, we can attribute the nonclassical trait of the electron spin dynamics to the behavior of nuclear spin precession dynamics., Comment: 23 pages, 9 figures

Adaptive radiotherapy (ART), especially online ART, effectively accounts for positioning errors and anatomical changes. One key component of online ART is accurately and efficiently delineating organs at risk (OARs) and targets on online images, such as CBCT, to meet the online demands of plan evaluation and adaptation. Deep learning (DL)-based automatic segmentation has gained great success in segmenting planning CT, but its applications to CBCT yielded inferior results due to the low image quality and limited available contour labels for training. To overcome these obstacles to online CBCT segmentation, we propose a registration-guided DL (RgDL) segmentation framework that integrates image registration algorithms and DL segmentation models. The registration algorithm generates initial contours, which were used as guidance by DL model to obtain accurate final segmentations. We had two implementations the proposed framework--Rig-RgDL (Rig for rigid body) and Def-RgDL (Def for deformable)--with rigid body (RB) registration or deformable image registration (DIR) as the registration algorithm respectively and U-Net as DL model architecture. The two implementations of RgDL framework were trained and evaluated on seven OARs in an institutional clinical Head and Neck (HN) dataset. Compared to the baseline approaches using the registration or the DL alone, RgDL achieved more accurate segmentation, as measured by higher mean Dice similarity coefficients (DSC) and other distance-based metrics. Rig-RgDL achieved a DSC of 84.5% on seven OARs on average, higher than RB or DL alone by 4.5% and 4.7%. The DSC of Def-RgDL is 86.5%, higher than DIR or DL alone by 2.4% and 6.7%. The inference time took by the DL model to generate final segmentations of seven OARs is less than one second in RgDL. The resulting segmentation accuracy and efficiency show the promise of applying RgDL framework for online ART., Comment: 16 pages, 6 figures

Automatic segmentation of anatomical structures is critical for many medical applications. However, the results are not always clinically acceptable and require tedious manual revision. Here, we present a novel concept called artificial intelligence assisted contour revision (AIACR) and demonstrate its feasibility. The proposed clinical workflow of AIACR is as follows given an initial contour that requires a clinicians revision, the clinician indicates where a large revision is needed, and a trained deep learning (DL) model takes this input to update the contour. This process repeats until a clinically acceptable contour is achieved. The DL model is designed to minimize the clinicians input at each iteration and to minimize the number of iterations needed to reach acceptance. In this proof-of-concept study, we demonstrated the concept on 2D axial images of three head-and-neck cancer datasets, with the clinicians input at each iteration being one mouse click on the desired location of the contour segment. The performance of the model is quantified with Dice Similarity Coefficient (DSC) and 95th percentile of Hausdorff Distance (HD95). The average DSC/HD95 (mm) of the auto-generated initial contours were 0.82/4.3, 0.73/5.6 and 0.67/11.4 for three datasets, which were improved to 0.91/2.1, 0.86/2.4 and 0.86/4.7 with three mouse clicks, respectively. Each DL-based contour update requires around 20 ms. We proposed a novel AIACR concept that uses DL models to assist clinicians in revising contours in an efficient and effective way, and we demonstrated its feasibility by using 2D axial CT images from three head-and-neck cancer datasets.

Typically, the current dose prediction models are limited to small amounts of data and require re-training for a specific site, often leading to suboptimal performance. We propose a site-agnostic, 3D dose distribution prediction model using deep learning that can leverage data from any treatment site, thus increasing the total data available to train the model. Applying our proposed model to a new target treatment site requires only a brief fine-tuning of the model to the new data and involves no modifications to the model input channels or its parameters. Thus, it can be efficiently adapted to a different treatment site, even with a small training dataset.

Inter-observer variation is a significant problem in clinical target volume(CTV) segmentation in postoperative settings, where there is no gross tumor present. In this scenario, the CTV is not an anatomically established structure, but one determined by the physician based on the clinical guideline used, the preferred tradeoff between tumor control and toxicity, their experience and training background, and other factors. This results in high inter-observer variability between physicians. This variability has been considered an issue, but the absence of multiple physician CTV contours for each patient and the significant amount of time required for dose planning have made it impractical to study its dosimetric consequences. In this study, we analyze the impact that variations in physician style have on dose to organs-at-risk(OAR) by simulating the clinical workflow via deep learning. For a given patient previously treated by one physician, we use deep learning-based tools to simulate how other physicians would contour the CTV and how the corresponding dose distributions would look for this patient. To simulate multiple physician styles, we use a previously developed in-house CTV segmentation model that can produce physician style-aware segmentations. The corresponding dose distribution is predicted using another in-house deep learning tool, which, can predict dose within 3% of the prescription dose, on average, on the test data. For every test patient, four different physician style CTVs are considered, and four different dose distributions are analyzed. OAR dose metrics are compared, showing that even though physician style variations result in organs getting different doses, all the important dose metrics except Maximum Dose point are within the clinically acceptable limit.