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PTSD/TBI Treatments Getting SMARTer
CESAMH Investigators are exploring new approaches to understand the relationships between the brain and combat-related conditions. LEARN MORE >>
Understanding TBI through Blood-Based Biomarkers
More than 360,000 armed service members sustained a traumatic brain injury (TBI) during combat and training between 2000 and 2016. Veterans with TBI often require healthcare for years after the initial injury. Therefore, having a way to aid in the diagnosis, prognosis, and treatment of TBI is very important. There are blood tests that can detect whether TBI has occurred, but these tests cannot provide details about TBI symptoms. CESAMH Associate Director of Neuroscience, Dr. Victoria Risbrough, and her collaborator Dr. Robert Rissman were awarded a $1.4 million VA Merit Grant to investigate new biomarkers from blood samples that may provide helpful information about TBI symptoms. They will study "exosomes," which are vesicles (pouches containing proteins and genetic material, such as RNA) that are released from most types of cells, including brain cells. Exosomes can be used to understand the health of brain cells. Exosomes are readily detectable in blood and are promising tools for aiding diagnosis of disorders associated with nerve cell damage. Results of this study may help improve the detection and treatment for deployment-related TBI.
A Different Approach to Treating Combat-Related Conditions
Combat stress can lead to a number of impactful emotional and cognitive conditions, such as Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and mild Traumatic Brain Injury (mTBI). Because symptoms of these disorders tend to overlap, they are often managed with similar medications. The most commonly prescribed medication for these conditions is Sertraline, but it has not been fully successful. To help improve treatment response, CESAMH investigators are exploring a different approach to understanding and treating the symptoms of combat-related conditions.
Instead of using a diagnosis to determine treatment, CESAMH researchers are looking to identify the brain areas involved in producing symptoms associated with PTSD, MDD and mTBI. Their approach is to identify individuals with similar patterns in brain activity. They theorize that understanding the brain areas involved may provide more useful information about successful treatments than using traditional clinical diagnoses. This study is one of the first to link clinical research and clinical practice to best benefit our Veterans.
Soldiers who experience brain trauma in combat are more likely to experience symptoms of post traumatic stress disorder, a four-year study of Marines found. Researchers from San Diego and the U.S. Department of Veterans Affairs, studied…
Research Findings Offer New Insights into Pathophysiology of PTSD
Researchers at the Veterans Affairs San Diego Healthcare System and University of California, San Diego School of Medicine, with colleagues in New York and the United Kingdom, have identified genetic markers, derived from blood samples…
Gene Variant May Increase Psychiatric Risk After TBI
A variant of the APOE gene may be linked to worse psychiatric symptoms in people who have had a traumatic brain injury, found a VA San Diego Healthcare System study. Study participants with both the gene variant and at least one TBI had more severe symptoms of PTSD, anxiety, and depression than comparison participants.
Treating TBI and PTSD together
Researchers are combining an evidence-based PTSD treatment called cognitive processing therapy (CPT) with a relatively new approach to mTBI called Cognitive Symptom Management and Rehabilitation Therapy, or CogSMART for short.
Seeking New Coping Tools for Veterans with TBI
One of the most effective tools to manage a mild traumatic brain injury (mTBI), is a smartphone calendar app, say VA researchers. Considered the signature injury of the Iraq and Afghanistan wars, mTBI can result in memory loss, mood disturbances and other potentially disabling symptoms. For some, the injury can prove life-altering.
Local Vets Cope with Challenges of Traumatic Brain Injury
Once a soldier, George never expected some of his hardest battles would be fought after he got out of the military. At an afternoon class with other Veterans at the VA Oceanside Clinic, he goes…
Brain Injuries Can Lead to PTSD
Military personnel who suffer traumatic brain injuries during active duty are much more likely to suffer post-traumatic stress disorder (PTSD) over time, according to a recent study by a team of San Diego-area scientists.


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Following the earlier callout and standby, later in the afternoon around 17:45, the team was called to assist the ambulance service with an evacuation of a climber who had fallen 15m whilst leading on a route on Chudleigh Rocks.
Unfortunately his protection had failed resulting in him hitting the ground, catching his head on a rock. Because he was wearing a helmet, which sustained a large dent in the fall, his injuries were a lot less severe than they would have been.
Team members and the ambulance service worked together to evacuate him on a spinal board to the waiting ambulance for evacuation to hospital. We wish him a very speedy recovery.

subset: commoncrawl


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Maroon and gold to look a little green on diamond
As painful as it may seem, the time has come to officially let go of that special season.
With Jordan Phillips the only holdover remaining from Deer Park High School's state championship baseball team of two seasons ago, there's nary a physical connection anymore to that team.
Yes, echoes of the past will always be there as will the tradition, but the 2019 team must begin putting its own stamp on the program.
Head coach Chris Rupp and his staff may from time to time wear a state championship T-shirt, but until another state title comes along, this spring's team and all others have to let go of the apron strings.
And when the 2019 team begins foraging on its own, they'll be doing it with a roster that will be pretty green.
"We've got a lot of new names, quite a few guys that don't have much varsity experience. We've got lots of guys who haven't played at this level enough. It showed Monday (Feb. 18) when we opened up against Westside. We're still trying to find out who our team is and try to get a little identity," said Rupp, prior to a game against Clear Brook at Barbers Hill High School Saturday afternoon.
That contest saw Deer Park commit seven errors, en route to a 4-2 loss. Oh, the growing pains. Now the question comes up, how long and how severe will those growing pains be?
Those District 21-6A adversaries, especially La Porte, could care less about reigning champion Deer Park's growing pains.
Quality pitching is always crucial but moreso than ever now. It's very green on the mound thanks to graduation claiming unanimous First Team hurler Mark Barrow along with Jaden Otts and Connor Williams.
Bottom line, all of the pitchers who worked innings for the state championship team have moved on.
Barrow, who went 6-0 and threw the district's only no-hitter last spring, finished with a crisp 1.30 ERA in leading the team to a 12-2 district record and 25-8 season ledger.
Pitching coach Donnie Elliott needs to find another Mark Barrow. At the moment, Elliott is working with the trio of Zach Young, Matthew Potts and Brodie Wilson as starters. Wilson has a few varsity innings under his belt.
Young and his 6-foot-6 frame are making their varsity debut this year.
"He's a mid 80s, but he'll get it up to 88 (mph) on occasion. He'll give you a different arm angle because he's so tall. He's really come along. He beat a good team today so I was really pleased with that," said Elliott, referring to Young defeating Clear Springs earlier on Saturday.
"My defense was behind me the entire game. They came out and competed today. I've got a two-seam fastball, a slider and a change-up," said Young, believing his slider was exceptionally good as was his fastball.
Wilson worked a bit on the mound in the 2018 playoffs.
"He's going to be a guy we're going to rely heavily on. He's not a tall kid but he throws hard. He's got a good slider, competes," said Elliott, the former San Diego Padres pitcher.
As for Potts, the only downside to this youngster is his youthfulness. Everything else is there for something special to unfold.
"He's a real crafty lefty. We worked on picking up his pace a little bit between pitches and not being so slow and methodical. We want to speed up the pace. He's got tons of poise, a lot of command, baseball savvy so-to-speak. He's a leader, but he's a quiet leader. He's not a rah-rah guy. He's probably going to be the varsity quarterback next season," Elliott said.
There's more upside to Potts. Southpaws have a knack for picking off runners at first and Potts did that in Saturday's game. After hitting the eight-hole batter, Potts picked him off, resulting in a 1-3-4 out.
In getting the starting nod against Clear Brook, Potts opened the game by surrendering four straight hits. With the help of three errors, all four runners scored, before the southpaw pitched two-hit ball over the next 3 and 2/3 innings.
"I just focused on locating the ball a little more, trusting the defense is a big part of pitching. You're pitching for contact. That's the main thing about pitching. When we're out there making errors, mental mistakes, as a pitcher you just gotta get up there and continue to throw strikes. One mistake doesn't define who a player is. You know they're going to come back and step up and make another great play for you," Potts said.
Bryce Mead, a returner, came on in relief versus Clear Brook and was effective. Mead pitched three innings of no-hit ball, forcing the Wolverines to strand two in scoring position, keeping the team in the game.
As for the rest of the positions, lots of new faces as well. The short list are the returners. First baseman Alex Olivo, who led 22-6A with a .559 batting average, is back at the bag as is Phillips in right field, who hit .341 and Mead, who hit .333. Toss in catcher Colton Bedford and Tyler Weir and that's it. Weir was 11-for-35 for a .314 battng average last spring.
The newcomers feature Wilson at third when not pitching, shortstop Jake Haring and either Dylan Stone or Noah Ramirez at second base.
In the outfield, Drew Baggerly will patrol in center, Arnoldo Perez or Dylan Heim in left and Phillips in right.
The Deer hit .362 to lead 22-6A last spring. The team clouted a district-best nine homers, 32 doubles, scored 141 runs and tallied 122 RBIs. It's debatable if those numbers can be repeated in the new district, but the offense has to help out that green pitching staff. If it doesn't, the Deer will have to ask the defense to carry the load.
"I think we'll be all right once we settle down and get a few innings under their belt," said Rupp, who has begun his 35th year coaching at either the high school or college level.


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How I Edit Instagram Posts
When I'm editing a photo from my iPhone, I like to edit it not only to get the original photo to fit the aesthetic of my page, but to make it look less like an iPhone photo and more like a professional photo.
[Bear in mind that these edits and photos look different on a laptop screen than a phone screen. They are all edited to look good with my instagram feed on my phone]
Here I'm going to edit a selfie and a standing photo for you.
With the selfie, I first want to clean up any acne on my face. I don't think of this kind of touching to be unfair. Blemishes aren't freckles, they go away! So once that zit is gone, we don't want to look back at a picture to be reminded of it!
I use the Airbrush app for this kind of retouching.
After the acne is gone and my face is smoothed out (just a bit, you don't want to over smooth anything EVER), I start whitening anyyything that should be white in the photo (i.e. my teeth, eye balls and in this case, T-shirt. The whitening just makes anything "white" stand out more and in my opinion, it helps the photo altogether to reallly whiten your whites.
When all is done here, I head over to App #2, Lightroom!
Ah how convenient it is having the Lightroom App! This guy is my fav of all time. I won't be using it too much for this photo but I'll give you the idea.
I typically adjust the general lighting in my iPhone photos but since this photo HAS perfect lighting, I let the exposure, brightness and contrast alone.
Here, I only edited the blacks to make them slightly blacker and the whites to make them slightly lighter.
Next up, I add the color back in my skin that I lost while messing with the black and whites by clicking the orange and adding saturation. I also added more color to my eyes with the blue setting. I LOVE these selective color settings, definitely my favorite part of this app.
Lastly I usually like to add "detail" or "sharpen" the photos but I'll do that with the next because this one does't need it.
Next I'm doing a full body photo and the changes will be far more significant than with the selfie.
First tool I'm going to utilize with this photo is the smoothening tool on Airbrush. It'll be the only feature I use in airbrush for this particular photo. I'm only smoothening out my skin because my iPhone camera sucks and when you zoom in, my skin looks pixelated (yuck!)
Next, I head to LR to fix the colors. I didn't do too much light adjusting here because it's pretty nice to begin with but I did turn up the exposure and lighten the lights and darken the darks as I always like to do with my photos.
Afterwards, I tweaked the colors to give the blues a more tropical look and the color correct my skin tone.
Lastly, I use the detail setting (on low) to give the edges more definition.
As always, babes, if you have any questions, drop them below! I hope you found this tutorial useful!


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We all have a journey. And, whether we like it or not, the journey isn't always pretty.
Somehow, LeBron's middle school 8th-grade yearbook got leaked, and it shows the perfect example of a cringe-worthy part of LeBron's amazing life story. It's not really his fault, to be fair, but it is definitely causing waves on the internet today.
Not only did LeBron James' 8th-grade yearbook mix up his name, but he didn't even win "Most Athletic" 😂😂😂
(h/t @redapples) pic.twitter.com/4EZyoSt1nZ
— Sports Illustrated (@SInow) December 30, 2018
So, to recap, not only did the yearbook screw up the spelling of James's name, calling him "LaBron," they also listed him under the wrong picture. Instead, the basketball phenom was listed under the name "Michael Quinn."
To make matters even worse, LeBron didn't win the school's "Most Athletic" award, instead deciding to give it to a guy named Virgil Robinson.
That's a yikes if I've ever seen one. Honestly, there's no recovering from those mistakes. Fortunately, it has given everyone a good laugh more than anything.


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School Bus Crash - Interior
It's time for seat belts on school buses. No more excuses. www.safeguard4kids.com
This video contains interior shots of our crash test from the SafeGuard: School Bus Safety 101 event. To see the exterior shots, click here: automobilrevue.net/v/NzN1ZkcxSmRBS3c
More info: safeguardseat.com/school-bus-safety-101
It's time for seat belts on school buses. In this video you can see what happens to students that are belted in lap-shoulder belts versus those that are not... and those that are not sitting in their seats the correct way.
0:47 he has a baby!!!
That kids stomach get super errect.
that's why I think that school buses should have seatbelts in them like Florida does
This is why I try my best to get the 1 Seat towards the front with the seatbelt
i can only imagine the horror of having to make sure 30-40 elementary students are wearing their seatbelts and having to stop every time one them takes it off, or hitting another student with the buckle of the belt
the kids should always ware the seatbelt
at 0:10 through 0:12dab
mabey we should all be wearing a harnest on the school bus
Why are kids sitting sideways and backwards on their knees? Wrong way to ride a school bus!
Jalen Dyer it was to test in case a kid was in. that position when a crash happened
I see a whole lot of potential neck and head injuries with this "safety" system. especially with the larger kids.
Sense when do buses have seat belts


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Bitter pill for trainer Ron Stubbs after Yousay Bolt ruled out of Country Championship qualifier
RON Stubbs has been around training long enough to know how fickle the racing game can be.
But the experienced horseman would be hard-pressed to find a more trying week than the one just gone.
At the start of the week Stubbs was highly anticipating the Country Championships qualifier with his two-pronged attack of Yousay Bolt and Lost Command.
"There is always other races but there is not too many $150,000 races at Albury on your home track.Ron Stubbs
Yousay Bolt was one of the leading fancies and was set to battle out favouritism for the lucrative feature.
But on Wednesday Stubbs was forced to withdraw his stable star because of a temperature and immediately sent her to the spelling paddock.
Then at yesterday's barrier draw, salt was rubbed into his wounds when second-stringer Lone Command drew barrier 18.
Stubbs took a philosophical approach to his horror 48 hours.
"That's racing and I can't do much about it," Stubbs said.
"The timing couldn't be worse though.
"There is always other races but there is not too many $150,000 races at Albury on your home track.
"Then you also miss out on the chance of qualifying for the big egg ($500,000 final).
"But there nothing I can do about it - if she is not well, she is not well."
Lone Command is one of four horses who will be aiming to win the Country Championship qualifier first-up from a spell.
Apprentice jockey Lachlan King has been booked to ride the seven-year-old mare.
Lone Command boasts a handy fresh record, finishing runner-up on three occasions from four previous attempts.
"After the barrier draw I won't have to give the jockey too many instructions will I?," Stubbs joked.
"He will just have to ride her as it happens.
"Hopefully it turns out to be a blessing in disguise and she can surprise a few.
"I think there will be plenty of pace on so my horse should be able to slot across from the outside barrier and find the fence without too much trouble.
"I know a lot of punters would have written her off because of the draw but I still give her a chance if she can produce her best on the day.
"There is a few strong chances in the race but it evens out fairly quickly and my mare can certainly run a cheeky race."
Favourite for the qualifier after yesterday's draw was the Geoff Duryea-trained News Girl who is quoted as a $2.50-chance.
News Girl is also nominated for races at Moonee Valley tonight and Caulfield the following day.
Duryea was leaning towards a Caulfield start for his stable star.
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And, for some reason, I would like to get very, very nasty (the hell with proper etiquette) with Juan Monaco (do not ask! In the game where Fed served for the match, Djokovic also mocked the crowd and Fed by repeatedly striking his frame to ridicule the crowd cheering a great shot by Fed (Yes, Fed did frame a shot earlier in the rally.)"r21 - Wasn't that Hingis who called Mauresmo "half a man?
" Davenport is no delicate flower herself.r23 - I didn't know that about Mauresmo needing extra security. I wouldn't have thought she'd be well known enough in the States to attract the attention of the crazies.
Davenport said about Mauresmo that "it was like playing a man" out there, or something to that effect, in reference to how hard Amelie hit. I watched that match, and no one with a brain would think Nole was being a bad sport taking his time in an exhausting match.
She called Amelie and apologized after the remark was pounced on by the media. The crowd didn't seem to think he did anything seriously offensive either, and in fact, he didn't - he knew after his one incident at the Open years earlier he wanted to be on their best side. Regarding that very match, it was Roger who received substantial criticism for his pissy unsportsmanlike attitude after the match. Loving that Wozinacki is out in the first round at Eastbourne.
As though Lindsay was some delicate flower herself. She would say anything about anybody, but she did it with a smile. I felt very bad for the official that got kicked by David. Sam does have those guns--just like Rafa (when will these people be outed for PEDs?
Some people liked it because of the drama but to me she came across as very insecure and bratty. Although, I'm sure that some part of the nickname was inspired by her bulbous, movie screen forehead. The man looked shocked, and was SUPER pissed when he walked off of the court with blood dripping down his leg. )R34 that "objective" analysis of lack of sportsmanship is pathetic if that's the best you can do.
That will probably be the case again tomorrow, but I'm really hoping that he can take a 5-hour Energy and really take it to Roger.[quote]So in my book, he deserves a different level of disdain - since I do think he is gay. but what if Gasquet isn't gay despite what you believe? He was kind of an arrogant prick when he was younger, but seems to have matured over the years. I and the others that think Gasquet is gay may well be wrong. And since I don't know, I'm not saying that I hold any bad feelings toward him. I'm just saying that he would be worthy of some wrath if he actually is gay vs. He had many incidents that would disprove the gentleman image but they were ignored.
It is so painfully obvious that Gasquet and Stosur are gay but they won't come out because they fear a loss of sponsorship and support...which is a real shame in 2012.
The most obnoxious was claiming that a "trained" professional would not take a risky shot on match point and just swing at the ball and that Nole was "lucky" to win. Christina Mc Hale kept it together and pulled it out. Kvitova, Stosur, and Radwanska all out in the first round too...
R42-you don't seem to understand the rules of the game, but etiquette is supremely important in tennis, there are very strict rules.
I think Nole is a nice guy but I can't stand how he celebrates his wins (e.g., when he tore his shirt off after winning the US Open). I do, however, think Nole exhibits better sportsmanship than that petulant little Federer. He was clearly pissed at Roddick for things he'd said about him.
A personal tiff with Roddick 5 years ago should not be used to forever characterize Djokovic as an "ungracious winner". I really miss tennisplayers like: Mc Enroe, Agassi, Becker, Ivanisevic, Rafter, etc.


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text: TRIBAL COUNCIL AGENDA CY2018-112 FINALTuesday, June 05, 2018 Tribal Council Officers / Members: Cheryle A. Kennedy, Chairwoman Kathleen George, Council Member Michael Langley, Council MemberChris Mercier, Vice-Chair Jack Giffen, Jr., Council Member Lisa Leno, Council MemberJon A. George, Secretary Denise Harvey, Council Member Brenda Tuomi, Council Member I. National Congress of American Indians Mid-Year Conference Location: Kansas City, MO Oregon Tribal Summit on Opioids and Other Drugs Location: Warm Springs, OR Men's Health Event Location: Tribal Community Center II. Call to Order / Invocation / Morning Roll Call Item(s) from Chair and Tribal Council 9:00 a.m. to 9:20 a.m. III. Legislative Action Committee 9:20 a.m. to Conclusion Consent Items: Previous Minutes Approve/Amend • May 08, 2018 Legislative Action Committee As Amended • May 17, 2018 Discussion Notes/Work Session Minutes • May 22, 2018 Legislative Action Committee May 29, 2018 Legislative Action Committee • May 29, 2018 Work Session Consent Items: Directives Introduced BIA Tribal Resilience Grant Applications Raven Loop Repair and Paint Project Behavioral Health Addition Contract Oregon Emergency Management Performance Grant Application Enrollment Infant Determinations – Executive Session V. Work Session Fee-to-Trust Regulation Comments Tribal Committee/SEB Appointments – Executive Session Plankhouse Thin Logging Unit VI. Opioid Litigation Brief VII. Afternoon Roll Call /Work Session Direct Report Evaluations – Executive Session Adjourn


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Jabs fly in Palin contract dust-up
TURLOCK — Leland Yee and Hamid Shirvani on Thursday continued their verbal sparring over a contract to bring Sarah Palin to California State University, Stanislaus.
State Sen. Yee, D-San Francisco, accused university President Shirvani of "double-talk" for saying the school had no documents related to the former governor of Alaska's June visit, then accusing students or employees of taking parts of the contract from the recycling can in the office of a university vice president.
Shirvani shot back that Yee "is conveniently using a legal response from the university for further political gain." He said the contract between the Washington Speakers Bureau, which represents Palin, and the university's foundation is private.
"Vice President for University Advancement Susana Gajic-Bruyea also serves as executive director of the foundation and, in that role, was responsible for reviewing draft and final versions of the foundation's contract with the Washington Speakers Bureau," Shirvani added in a statement issued Thursday.
Students said they found the documents in a Dumpster outside the administration building last Friday, a furlough day for most employees. Shirvani said the draft copies of the contract had been in the bin inside Gajic-Bruyea's office.
Yee and others have been trying to find out how much it cost to bring Palin to campus for a black-tie fund-raiser June 25. Foundation officials said they are bound by a confidentiality clause in the contract and don't have to release it because private donations are paying the fee.
Yee cited a 2001 court case involving the foundation at CSU, Fresno, that found documents held at a university must be made public.
"The law is clear and the courts have ruled — foundation documents are to be made public if they are held by the university, which by the administration's own admission, is the case here," Yee said in a news release.
Yee's office obtained an e-mail regarding the Palin visit that Gajic-Bruyea sent to other campus administrators and faculty over the university's public system. Yee said that demonstrated a clear violation of the California Public Records Act because the school did not provide it to him when he asked for documents pertaining to Palin's speech.
Attorney General Jerry Brown has launched an investigation into the foundation's finances and records.
The university has launched its own investigation, working with the Turlock Police Department and the Stanislaus County district attorney's office, into how the contract came into the students' hands.
Bee staff writer Patty Guerra can be reached at email@example.com or 578-2343.


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Engineering Journal
Experimental Investigation of a Steel-Framed Building for Disproportionate Collapse
Format: PDF
Experimental Investigation of a Steel-Framed Building for Disproportionate Collapse
Akah, E.; Wood, C.; Li, K.; Sezen, H. (2018). "Experimental Investigation of a Steel-Framed Building for Disproportionate Collapse," Engineering Journal, American Institute of Steel Construction, Vol. 55, pp. 143-159.
This paper presents the experimental and numerical investigation of the progressive collapse vulnerability of an existing steel building, Haskett Hall, on the Ohio State University campus. The building was tested by removing one of the first-story columns to observe its collapse resistance and to evaluate the effectiveness of current modeling and analysis guidelines. Progressive collapse is a relatively large partial or complete collapse of a structure due to the loss of a vertical load-carrying element—a column in this case. Few researchers have been able to conduct full-scale experiments to understand the progressive collapse mechanism. In this research, deflections and deformations of steel structural components were measured during the field experiment. Computational models and simulations were examined and compared with the experimental data from the field tests. The contribution and effects of infill walls to progressive collapse resistance of frame structures were investigated. The test data collected in this research can be used to help develop recommendations for improved procedures for progressive collapse analysis of frame buildings.
- Published: 2018, Quarter 3
Ebiji Akah, Curtis Wood, Kai Li and Halil Sezen


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Little Street Yoga Co-op
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Southeast Atlanta Lady MOB (My Own Boss!) Holiday Artist Market
Friday December 7, 2018 06:00 pm EST
Categories: Artist Market
Venue: Little Street Yoga Coop, 289 Little Street SE, Atlanta GA 30315The local, women's networking group Southeast Lady MOB will be hosting their second annual holiday gift market on Friday, December 7 from 6:00 – 9:00 at the Little Street Yoga Coop. Come shop for a varie...
Cost: Free


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Apparently You Also Make These Kinds Of Mistakes With FG-4592 !
Children with longer insults tended to have damage both to the deep grey matter and to the subcortical white matter. Barkovich's group in San Francisco21 have impressive experience of MRI, studying over 6000 cases of neonatal encephalopathy in term and near-term babies. Their carefully performed and sequential MRI studies, which include spectroscopy, were targeted at determining when the insult occurred, not how long it lasted. These interesting serial studies show that some babies probably Quetiapine sustain their brain damage 2�C3 days before birth but they do not shed much light on the duration of insult required to damage the neonatal brain. A review of the literature22 reporting fetal survival after maternal cardiac arrest reveals that few infants delivered >10 minutes after maternal collapse requiring resuscitation survive to be healthy individuals, although there were some normal survivors in the group delivered between 11�C15 minutes afterwards. Uterine rupture can be a catastrophic event for the fetus, particularly if it results in extrusion from the uterus; the human fetus is probably exposed to a situation that is close to that of the primate experiments. In a retrospective study23 of 106 cases Selleckchem BIRB 796 of uterine rupture between 1983 and 1992, five babies were diagnosed as having asphyxia (there was no long-term follow up or MRI). A prolonged deceleration was defined as a fetal heart rate <90 for more than a minute, but there was only one such case in the asphyxiated group that did not have prior CTG abnormalities. The authors concluded that fetuses who were exposed to prolonged deceleration could survive without asphyxia if they were delivered before 17 minutes had elapsed, but several babies developed neonatal morbidity after 10 minutes of a prolonged deceleration if there had been previous late FG-4592 clinical trial decelerations (range 36�C90 minutes). These data support the evidence provided by the primate studies regarding a worse outcome if an acute near-total insult is superimposed on a previous episode of partial hypoxia. More recently, a study of 23 cases of complete uterine rupture in Quebec24 showed that a diagnosis of hypoxic ischaemic encephalopathy was made in three and a further baby died. The three babies with hypoxic ischaemic encephalopathy were delivered 15,16 and 23 minutes after the onset of a prolonged fetal heart rate deceleration; all three were completely extruded from the uterus, had a metabolic acidosis at birth and developed motor delay. Phelan and Ahn25 found that permanent brain injury occurred after 18 minutes with a heart rate <60 bpm (this was the shortest known duration of insult in this study). Pasternak and Gorey5 describe a baby born after a uterine rupture and 10�C15 minutes of bradycardia who never developed the ability to feed and who died before discharge.
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1 Variations of the Traveling Salesman Problem
- Esther Noreen Cummings
- 1 years ago
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1 Stanford University CS26: Optimization Handout 3 Luca Trevisan January, 20 Lecture 3 In which we prove the equivalence of three versions of the Traveling Salesman Problem, we provide a 2-approximate algorithm, we review the notion of Eulerian cycle, we think of the TSP as the problem of finding a minimum-cost connected Eulerian graph, and we revisit the 2-approximate algorithm from this perspective. Variations of the Traveling Salesman Problem Recall that an input of the Traveling Salesman Problem is a set of points X and a nonnegative, symmetric, distance function d : X X R such that d(x, y) = d(y, x) 0 for every x, y X. The goal is to find a cycle C = v 0 v v 2 v m v m = v 0 that reaches every vertex and that has minimal total length cost d (C) := m i=0 d(v i, v i+ ). There are different versions of this problem depending on whether we require d(, ) to satisfy the triangle inequality or not, and whether we allow the loop to pass through the same point more than once.. General TSP without repetitions (General TSP-NR): we allow arbitrary symmetric distance functions, and we require the solution to be a cycle that contains every point exactly once; 2. General TSP with repetitions (General TSP-R): we allow arbitrary symmetric distance functions, and we allow all cycles as an admissible solution, even those that contain some point more than once; 3. Metric TSP without repetitions (Metric TSP-NR): we only allow inputs in which the distance function d(, ) satisfies the triangle inequality, that is x, y, z X. d(x, z) d(x, y) + d(y, z) and we only allow solutions in which each point is reached exactly once;
2 4. Metric TSP with repetitions (Metric TSP-R): we only allow inputs in which the distance function satisfies the triangle inequality, and we allow all cycles as admissible solutions, even those that contain some point more than once. If we allow arbitrary distance functions, and we require the solution to be a cycle that reaches every point exactly once, then we have a problem for which no kind of efficient approximation is possible. Fact If P NP then there is no polynomial-time constant-factor approximation algorithm for General TSP-NR. More generally, if there is a function r : N N such that r(n) can be computable in time polynomial in n (for example, r(n) = n2 ), and a polynomial time algorithm that, on input an instance (X, d) of General TSP-NR with n points finds a solution of cost at most r(n) times the optimum, then P = NP. The other three versions, however, are completely equivalent from the point of view of approximation and, as we will see, can be efficiently approximated reasonably well. Lemma 2 For every c, there is a polynomial time c-approximate algorithm for Metric TSP-NR if and only if there is a polynomial time c-approximate approximation algorithm for Metric TSP-R. In particular:. If (X, d) is a Metric TSP input, then the cost of the optimum is the same whether or not we allow repetitions. 2. Every c-approximate algorithm for Metric TSP-NR is also a c-approximate algorithm for Metric TSP-R. 3. Every c-approximate algorithm for Metric TSP-R can be turned into a c-approximate algorithm for Metric TSP-NR after adding a linear-time post-processing step. Proof: Let opt T SP R (X, d) be the cost of an optimal solution for (X, d) among all solutions with or without repetitions, and opt T SP NR (X, d) be the cost of an optimal solution for (X, d) among all solutions without repetitions. Then clearly in the former case we are minimizing over a larger set of possible solutions, and so opt T SP R (X, d) opt T SP NR (X, d) Consider now any cycle, possibly with repetitions, C = v 0 v v 2 v m v m = v 0. Create a new cycle C from C by removing from C all the repeated occurrences of any vertex. (With the special case of v 0 which is repeated at the end.) For 2
3 example, the cycle C = a c b a d b a becomes a c b d a. Because of the triangle inequality, the total length of C is at most the total length of C, and C is a cycle with no repetitions. If we apply the above process by taking C to be the optimal solution of (X, d) allowing repetitions, we see that opt T SP R (X, d) opt T SP NR (X, d) and so we have proved our first claim that opt T SP R (X, d) = opt T SP NR (X, d). Regarding the second claim, suppose that we have a c-approximate algorithm for Metric TSP-NR. Then, given an input (X, d) the algorithm finds a cycle C with no repetitions such that cost d (C) c opt T SP NR (X, d) but C is also an admissible solution for the problem Metric TSP-R, and cost d (C) c opt T SP NR (X, d) = c opt T SP R (X, d) and so our algorithm is also a c-approximate algorithm for opt T SP NR. To prove the third claim, suppose we have a c-approximate algorithm for Metric TSP-R. Then, given an input (X, d) the algorithm finds a cycle C, possibly with repetitions, such that cost d (C) c opt T SP R (X, d) Now, convert C to a solution C that has no repetitions and such that cost d (C ) cost d (C) as described above, and output the solution C. We have just described a c-approximate algorithm for Metric TSP-NR, because cost d (C ) cost d (C) c opt T SP R (X, d) = c opt T SP NR (X, d) Lemma 3 For every c, there is a polynomial time c-approximate algorithm for Metric TSP-NR if and only if there is a polynomial time c-approximate approximation algorithm for General TSP-R. In particular:. Every c-approximate algorithm for General TSP-R is also a c-approximate algorithm for Metric TSP-R. 3
4 2. Every c-approximate algorithm for Metric TSP-R can be turned into a c-approximate algorithm for General TSP-R after adding polynomial-time pre-processing and post-processing steps. Proof: The first claim just follows from the fact that General and Metric TSP-R are the same problem, except that in the general problem we allow a larger set of admissible inputs. The proof of the second claim is similar to the proof that an approximation algorithm for Metric Steiner Tree can be converted to an approximation algorithm for General Steiner Tree. Consider the following algorithm: on input an instance (X, d) of General TSP-R, we compute the new distance function d (, ) such that d (x, y) is the length of a shortest path from x to y in a weighted graph that has vertex set X and weights d(, ). Note that d (, ) is a distance function that satisfies the triangle inequality. We also compute the shortest path between any pair x, y. We then pass the input (X, d ) to our c-approximate algorithm for Metric TSP-R, and find a cycle C such that cost d (C ) c opt T SP R (X, d ) Note that, for every pair of points (x, y), we have d (x, y) d(x, y) and so this implies that opt T SP R (X, d ) opt T SP R (X, d) Finally, we construct a cycle C by replacing each transition x y in C by the shortest path from x to y according to d(, ). Because of the definition of d (, ), we have cost d (C) = cost d (C ) and, combining the inequalities we have proved so far, cost d (C) c opt T SP R (X, d) meaning that the algorithm that we have described is a c-approximate algorithm for General TSP-R. 4
5 2 A 2-approximate Algorithm When discussing approximation algorithms for the Minimum Steiner Tree problem in the last lecture, we proved (without stating it explicitly) the following result. Lemma 4 Let T (X, E) be a tree over a set of vertices X, and d : X X R 0 a symmetric distance function. Then there is a cycle C = v 0 v v m = v 0 that reaches every vertex at least once, and such that cost d (C) = 2 cost d (T ) where cost d (C) = i=0,...m d(v i, v i+ ) and cost d (T ) = (x,y) E d(x, y). The proof is simply to consider a DFS visit of the tree, starting at the root; we define C to be the order in which vertices are visited, counting both the beginning of the recursive call in which they are reached, and also the time when we return at a vertex after the end of a recursive call originated at the vertex. For example, revisiting an example from the last lecture, from the tree a 2 e g h d f c b We get the cycle a e a g d g f g a h c b h a, in which every point is visited at least once (indeed, a number of times equal to its degree in the tree) and every edge is traversed precisely twice. Theorem 5 There is a polynomial-time 2-approximate algorithm for General TSP- R. (And hence for Metric TSP-NR and Metric TSP-R.) Proof: The algorithm is very simple: on input a (X, d) we find a minimum spanning tree T of the weighted graph with vertex set X and weights d, and then we find the cycle C of cost 2cost d (T ) as in Lemma 4. 5
6 It remains to prove that opt T SP R (X, d) opt MST (X, d) = cost d (T ), which will then imply that we have found a solution whose cost is 2 opt T SP R (X, d), and that our algorithm is 2-approximate. Let C be an optimal solution for (X, d), and consider the set of edges E which are used in the cycle, then (X, E ) is a connected graph; take any spanning tree T = (X, E ) of the graph (X, E ), then cost d (T ) cost d (C ) = opt T SP R (X, d) because T uses a subset of the edges of C. On the other hand, T is a spanning tree, and so So we have cost d (T ) opt MST (X, d) opt T SP R (X, d) opt MST (X, d) from which it follows that our algorithm achieves a 2-approximation. 3 Eulerian Cycles In this section we review the definition of Eulerian cycle. In the next section, we will use this notion to give a new view of the 2-approximate algorithm of the previous section, and we willnote that this new perspective suggests a potentially better algorithm, that we will analyze in the next lecture. In this section, it will be convenient to work with multi-graphs instead of graphs. In an undirected multi-graph G = (V, E), E is a multi-set of pairs of vertices, that is, the same pair (u, v) can appear more than once in E. Graphically, we can represent a multi-graph in which there are k edges between u and v by drawing k parallel edges between u and v. The degree of a vertex in a multigraph is the number of edges of the graph that have that vertex as an endpoint, counting multiplicities. Definition 6 (Eulerian Cycle) An Eulerian cycle in a multi-graph G = (V, E) is a cycle v 0 v v m = v 0 such that the number of edges (u, v) in E is equal to the number of times (u, v) is used in the cycle. In a standard graph, a Eulerian cycle is a cycle that uses every edge of the graph exactly once. 6
7 Theorem 7 A multi-graph G = (V, E) has an Eulerian cycle if and only if every vertex has even degree and the vertices of positive degree are connected. Furthermore, there is a polynomial time algorithm that, on input a connected graph in which every vertex has even degree, outputs an Eulerian cycle. Proof: If G is Eulerian, then the cycle gives a way to go from every vertex to every other vertex, except the vertices of zero degree. Furthermore, if a vertex v appears k times in the cycle, then there are 2k edges involving v in the cycle (because, each time v is reached, there is an edge used to reach v and one to leave from v); since the cycle contains all the edges of the graph, it follows that v has degree 2k, thus all vertices have even degree. This shows that if a graph contains an Eulerian cycle, then every vertex has even degree and all the vertices of non-zero degree are connected. For the other direction, we will prove by induction a slightly stronger statement, that is we will prove that if G is a graph in which every vertex has even degree, then every connected component of G with more than one vertex has a Eulerian cycle. We will proceed by induction on the number of edges. If there are zero edges, then every connected component has only one vertex and so there is nothing to prove. This is the base case of the induction. If we have a graph G = (V, E) with a non-empty set of edges and in which every vertex has even degree, then let V,..., V m be the connected components of G that have at least two vertices. If m 2, then every connected component has strictly fewer vertices than G, and so we can apply the inductive hypothesis and find Eulerian cycles in each of V,...,V m. It remains to consider the case in which the set V of vertices of positive degree of G are all in the same connected component. Let G = (V, E ) be the restriction of G to the vertices of V. Since every vertex of G has degree 2, there must be a cycle in G. This is because if a connected graph with n vertices has no cycles, then it is a tree, and so it has n edges; but in a graph in which there are n vertices and every vertex has degree 2, the number of edges is at least 2 n = n. Let C be a 2 simple cycle (that is, a cycle with no vertices repeated) in G, and let G be the graph obtained from G by removing the edges of C. Since we have removed two edges from every vertex, we have that G is still a graph in which every vertex has even degree. Since G has fewer edges than G we can apply the induction hypothesis, and find a Eulerian cycle in each non-trivial connected component (a connected component is trivial if it contains only an isolated vertex of degree zero) of G. We can then patch together these Eulerian cycles with C as follows: we traverse C, starting from any vertex; the first time we reach one of the non-trivial connected components of G, we stop traversing C, and we traverse the Eulerian cycle of the component, then continue on C, until we reach for the first time one of the non-trivial connected components of G that we haven t traversed yet, and so on. This describes a Eulerian path into all of G 7
8 Finally, we note that this inductive argument can be converted into a recursive algorithm. The main computation is to find the connected components of a graph, which can be done in linear time, and to find a cycle in a given graph, which can also be done in linear time using a DFS. Hence the algorithm runs in polynomial time. 4 Eulerian Cycles and TSP Approximation Let (X, d) be an instance of General TSP-R. Suppose that G = (X, E) is a connected multi-graph with vertex set X that admits an Eulerian cycle C. Then the Eulerian cycle C is also an admissible solution for the TSP problem, and its cost is (u,v) E d(u, v). Conversely, if we take any cycle which is a TSP-R solution for the input (X, d), and we let E be the multiset of edges used by the cycle (if the cycle uses the same edge more than once, we put as many copies of the edge in E as the number of times it appears in the cycle), then we obtain a graph G = (X, E) which is connected and which admits an Eulerian cycle. In other words, we can think of the General TSP-R as the following problem: given a set of points X and a symmetric distance function d(, ), find the multi-set of edges E such that the graph G = (V, E) is connected and Eulerian, and such that (u,v) E d(u, v) is minimized. The approach that we took in our 2-approximate algorithm was to start from a spanning tree, which is guaranteed to be connected, and then take every edge of the spanning tree twice, which guarantees that every vertex has even degree, and hence that an Eulerian cycle exists. The reader should verify that if we take a tree, double all the edges, and then apply to the resulting multigraph the algorithm of Theorem 7, we get the same cycle as the one obtained by following the order in which the vertices of the tree are traversed in a DFS, as in the proof of Lemma 4. From this point of view, the 2-approximate algorithm seems rather wasteful: once we have a spanning tree, our goal is to add edges so that we obtain an Eulerian graph in which every vertex has even degree. Doubling every edge certainly works, but it is a rather brute force approach: for example if a vertex has degree in the tree, we are going to add another edges incident on that vertex, while we could have fixed the degree of that vertex by just adding one more edge. We will see next time that there is a way to implement this intuition and to improve the factor of 2 approximation. 8
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" THERE isn't just one Central Park," a young man said Saturday. "Everybody has his own. I can move into any world I want here -- all sorts of little hidden worlds." Over the weekend, the last of the summer, unc ounted thousands of New Yorkers were finding the park they wanted some where between 59th and 110th Streets. View Full Article in Timesmachine »Continue reading the main story
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