bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reinforcement learning based mainline dynamic speed limit adjustment of expressway off‐ramp upstream under connected and autonomous vehicles environment
Authors: Xiao Daiquan , Kang Shengyang , Xu Xuecai , Shen Zhenwu 
Published: June 2022

AbstractWith the rapid progress of urbanization and continuous increasing of automobiles, expressway on‐ and off‐ramp area becomes the bottleneck, and recurrent congestion occurs frequently. In order to solve the problem of traffic jam caused around off‐ramps, various methods have been employed. Among all, mainline variable speed limit (VSL) control accounts for some proportion. In this study, mainline VSL adjustment of off‐ramp upstream is investigated with the reinforcement learning algorithm under the connected vehicles environment to alleviate the traffic congestion. First, the assumptions are made to be suitable for the traffic conditions of mainline VSL control on off‐ramp upstream, and then VSL algorithm based on reinforcement learning is presented, and Q‐learning is chosen as the main algorithm. Next, the state space, action space, and reward function required by Q‐learning are constructed orderly, and the related parameters are labelled. After that, according to the platform based on Python and VISSIM, three schemes, free control (Scheme 0), mainline VSL adjustment of off‐ramp upstream based on rule (Scheme 1), and mainline VSL adjustment of off‐ramp upstream based on Q‐learning algorithm (Scheme 2), are designed, and the three schemes are simulated and compared quantitatively to reflect the off‐ramp travel efficiency. The results indicate that mainline dynamic VSL adjustment of off‐ramp upstream based on Q‐learning algorithm performs the best in terms of general and specific indexes. The results provide potential insights for relieving the traffic congestion and traffic flow control under CAVs environment.
Locating dust and molecules in the inner circumstellar environment of R Sculptoris with MATISSE
Authors: Drevon J. , Millour F. , Cruzalèbes P. , Paladini C. , Hron J. , Meilland A. , Allouche F. , Hofmann K.-H. , Lagarde S. , Lopez B. , Matter A. , Petrov R. , Robbe-Dubois S. , Schertl D. , Scicluna P. , Wittkowski M. , Zins G. , Ábrahám P. , Antonelli P. , Beckmann U. , Berio P. , Bettonvil F. , Glindemann A. , Graser U. , Heininger M. , Henning Th. , Isbell J. W. , Jaffe W. , Labadie L. , Leinert C. , Lehmitz M. , Morel S. , Meisenheimer K. , Soulain A. , Varga J. , Weigelt G. , Woillez J. , Augereau J.-C. , van Boekel R. , Burtscher L. , Danchi W. C. , Dominik C. , Gámez Rosas V. , Hocdé V. , Hogerheijde M. R. , Klarmann L. , Kokoulina E. , Leftley J. , Stee P. , Vakili F. , Waters R. , Wolf S. , Yoffe G. 
Published: June 2022

Context. Asymptotic giant branch (AGB) stars are one of the main sources of dust production in the Galaxy. However, it is not yet clear what this process looks like and where the dust happens to be condensing in the circumstellar environment.
Aims. By characterizing the location of the dust and the molecules in the close environment of an AGB star, we aim to achieve a better understanding the history of the dust formation process.
Methods. We observed the carbon star R Scl with the thermal-infrared VLTI/MATISSE instrument in L- and N-bands. The high angular resolution of the VLTI observations (as small as 4.4 mas in the L-band and 15 mas in the N-band with ATs), combined with a large uv-plane coverage allowed us to use image reconstruction methods. To constrain the dust and molecules’ location, we used two different methods: one using MIRA image reconstruction algorithm and the second using the 1D code RHAPSODY.
Results. We found evidence of C2H2 and HCN molecules between 1 and 3.4 R* which is much closer to the star than the location of the dust (between 3.8 and 17.0 R*). We also estimated a mass-loss rate of 1.2 ± 0.4 × 10−6 M⊙ yr−1. In the meantime, we confirmed the previously published characteristics of a thin dust shell, composed of amorphous carbon (amC) and silicon carbide (SiC). However, no clear SiC feature has been detected in the MATISSE visibilities. This might be caused by molecular absorption that can affect the shape of the SiC band at 11.3 µm.
Conclusions. The appearance of the molecular shells is in good agreement with predictions from dynamical atmosphere models. For the first time, we co-located dust and molecules in the environment of an AGB star. We confirm that the molecules are located closer to the star than the dust. The MIRA images unveil the presence of a clumpy environment in the fuzzy emission region beyond 4.0 R*. Furthermore, with the available dynamic range and angular resolution, we did not detect the presence of a binary companion. To solve this problem, additional observations combining MATISSE and SAM-VISIR instrument should enable this detection in future studies.
Maximal growth rate of the ascending phase of a sunspot cycle for predicting its amplitude
Authors: Podladchikova Tatiana , Jain Shantanu , Veronig Astrid M. , Sutyrina Olga , Dumbović Mateja , Clette Frédéric , Pötzi Werner 
Published: June 2022

Context. Forecasting the solar cycle amplitude is important for a better understanding of the solar dynamo as well as for many space weather applications. Different empirical relations of solar cycle parameters with the peak amplitude of the upcoming solar cycle have been established and used for solar cycle forecasts, as, for instance, the Waldmeier rule relating the cycle rise time with its amplitude, the polar fields at previous minimum, and so on. Recently, a separate consideration of the evolution of the two hemispheres revealed even tighter relations.
Aims. We aim to introduce the maximal growth rate of sunspot activity in the ascending phase of a cycle as a new and reliable precursor of a subsequent solar cycle amplitude. We also intend to investigate whether the suggested precursor provides benefits for the prediction of the solar cycle amplitude when using the sunspot indices (sunspot numbers, sunspot areas) derived separately for the two hemispheres compared to the total sunspot indices describing the entire solar disc.
Methods. We investigated the relationship between the maximal growth rate of sunspot activity in the ascending phase of a cycle and the subsequent cycle amplitude on the basis of four data sets of solar activity indices: total sunspot numbers, hemispheric sunspot numbers from the new catalogue from 1874 onwards, total sunspot areas, and hemispheric sunspot areas.
Results. For all the data sets, a linear regression based on the maximal growth rate precursor shows a significant correlation. Validation of predictions for cycles 1–24 shows high correlations between the true and predicted cycle amplitudes reaching r = 0.93 for the total sunspot numbers. The lead time of the predictions varies from 2 to 49 months, with a mean value of 21 months. Furthermore, we demonstrated that the sum of maximal growth rate indicators determined separately for the north and the south hemispheric sunspot numbers provides more accurate predictions than that using total sunspot numbers. The advantages reach 27% and 11% on average in terms of rms and correlation coefficient, respectively. The superior performance is also confirmed with hemispheric sunspot areas with respect to total sunspot areas.
Conclusions. The maximal growth rate of sunspot activity in the ascending phase of a solar cycle serves as a reliable precursor of the subsequent cycle amplitude. Furthermore, our findings provide a strong foundation for supporting regular monitoring, recording, and predictions of solar activity with hemispheric sunspot data, which capture the asymmetric behaviour of the solar activity and solar magnetic field and enhance solar cycle prediction methods.
High-Throughput Screening of Epigenetic Inhibitors in Meningiomas Identifies HDAC, G9a, and Jumonji-Domain Inhibition as Potential Therapies
Authors: Tatman Philip D. , Wroblewski Tadeusz H. , Fringuello Anthony R. , Scherer Samuel R. , Foreman William B. , Damek Denise M. , Youssef A. Samy , Lillehei Kevin O. , Jensen Randy L. , Graner Michael W. , Ormond D. Ryan 
Published: June 2022

Abstract
Background Epigenetics may predict treatment sensitivity and clinical course for patients with meningiomas more accurately than histopathology. Nonetheless, targeting epigenetic mechanisms is understudied for pharmacotherapeutic development for these tumors. The bio-molecular insights and potential therapeutic development of meningioma epigenetics led us to investigate epigenetic inhibition in meningiomas.
Methods We screened a 43-tumor cohort using a 139-compound epigenetic inhibitor library to assess sensitivity of relevant meningioma subgroups to epigenetic inhibition. The cohort was composed of 5 cell lines and 38 tumors cultured directly from surgery; mean patient age was 56.6 years ± 13.9 standard deviation. Tumor categories: 38 primary tumors, 5 recurrent; 33 from females, 10 from males; 32 = grade 1; 10 = grade 2; 1 = grade 3.
Results Consistent with our previous results, histone deacetylase inhibitors (HDACi) were the most efficacious class. Panobinostat significantly reduced cell viability in 36 of 43 tumors; 41 tumors had significant sensitivity to some HDACi. G9a inhibition and Jumonji-domain inhibition also significantly reduced cell viability across the cohort; tumors that lost sensitivity to panobinostat maintained sensitivity to either G9a or Jumonji-domain inhibition. Sensitivity to G9a and HDAC inhibition increased with tumor grade; tumor responses did not separate by gender. Few differences were found between recurrent and primary tumors, or between those with prior radiation versus those without.
Conclusions Few efforts have investigated the efficacy of targeting epigenetic mechanisms to treat meningiomas, making the clinical utility of epigenetic inhibition largely unknown. Our results suggest that epigenetic inhibition is a targetable area for meningioma pharmacotherapy.
Applying Automated Machine Learning to Predict Mode of Delivery Using Ongoing Intrapartum Data in Laboring Patients
Authors: Wong Melissa S. , Wells Matthew , Zamanzadeh Davina , Akre Samir , Pevnick Joshua M. , Bui Alex A.T. , Gregory Kimberly D. 
Published: June 2022

Objective This study aimed to develop and validate a machine learning (ML) model to predict the probability of a vaginal delivery (Partometer) using data iteratively obtained during labor from the electronic health record.
Study Design A retrospective cohort study of deliveries at an academic, tertiary care hospital was conducted from 2013 to 2019 who had at least two cervical examinations. The population was divided into those delivered by physicians with nulliparous term singleton vertex (NTSV) cesarean delivery rates <23.9% (Partometer cohort) and the remainder (control cohort). The cesarean rate among this population of lower risk patients is a standard metric by which to compare provider rates; <23.9% was the Healthy People 2020 goal. A supervised automated ML approach was applied to generate a model for each population. The primary outcome was accuracy of the model developed on the Partometer cohort at 4 hours from admission to labor and delivery. Secondary outcomes included discrimination ability (receiver operating characteristics–area under the curve [ROC-AUC]), precision-recall AUC, and calibration of the Partometer. To assess generalizability, we compared the performance and clinical predictors identified by the Partometer to the control model.
Results There were 37,932 deliveries during the study period; after exclusions, 9,385 deliveries were included in the Partometer cohort and 19,683 in the control cohort. Accuracy of predicting vaginal delivery at 4 hours was 87.1% for the Partometer (ROC-AUC: 0.82). Clinical predictors of greatest importance in the stacked Intrapartum Partometer Model included the Admission Model prediction and ongoing measures of dilatation and station which mirrored those found in the control population.
Conclusion Using automated ML and intrapartum factors improved the accuracy of prediction of probability of a vaginal delivery over both previously published models based on logistic regression. Harnessing real-time data and ML could represent the bridge to generating a truly prescriptive tool to augment clinical decision-making, predict labor outcomes, and reduce maternal and neonatal morbidity.
Key Points
Leaving the Placenta In Situ in Placenta Accreta Spectrum Disorders: A Single-Center Case Series
Authors: Pineles Beth L. , Coselli Jennie , Ghorayeb Tala , Fishel Bartal Michal , Zvavanjanja Rodrick C. , Blackwell Sean C. , Papanna Ramesha , Sibai Baha M. 
Published: June 2022

Objective The most common treatment for placenta accreta spectrum (PAS) disorders is planned primary cesarean hysterectomy. However, other management strategies may improve outcomes and/or allow fertility preservation. The objective of this study was to describe the course and outcomes of patients with PAS managed by leaving the placenta in situ.
Study Design This is a series of 11 patients with PAS managed by leaving the placenta in situ at a single academic center in the United States from 2015 to 2022. The approach described involves delivery of the fetus via cesarean, no attempt at placental removal, closure of the hysterotomy, prophylactic intravenous antibiotics for up to 1 week, and close outpatient follow-up until the uterus is empty.
Results The uterus was successfully preserved in six (55%), minimally invasive hysterectomy was performed in four (36%), and abdominal hysterectomy was performed in 1 (9%). During cesarean delivery, the median estimated blood loss was 650mL (range: 200–1,000mL). The majority of patients had no vaginal discharge for several weeks after delivery, followed by brown or bloody discharge, and intermittent mild-to-moderate cramping. The median time to resolution of PAS was 18 weeks in patients with successful uterine preservation (range: 5–25 weeks). Indications for hysterectomy included hemorrhage (n=1), coagulopathy (n=1), endomyometritis (n=2), and pain (n=1), and these occurred at a median of 5 weeks postpartum (range: 1–25 weeks). Four patients had subsequent pregnancies of whom three were live births at or near term and one was a spontaneous abortion at 19 weeks.
Conclusion Leaving the placenta in situ may be an appropriate management strategy for some carefully selected and counseled patients with PAS.
Key Points
Dual-Energy X-Ray Absorptiometry and Anthropometry for Assessment of Nutritional Status at Diagnosis in Children with Cancer: A Single-Center Experience from India
Authors: Priyanka Soni , Sandeep Jain , Gauri Kapoor , Gayatri Vishwakarma 
Published: June 2022

Background The survival of children with cancer has improved owing to advances in chemotherapy and better supportive care, and nutritional support is an important component of the latter especially in low- and middle-income countries like India.
Materials and Methods A prospective observational study of 137 newly diagnosed children with cancer aged less than 18 years was planned. Nutritional assessment was done using dual-energy X-ray absorptiometry (DXA), anthropometry, and serum albumin. Patients were followed for 3 months for assessment of treatment-related morbidity.
Results Lean body mass (LBM; DXA), mid-upper arm circumference (MUAC), and body mass index detected undernutrition in 44, 45, and 14% patients, respectively. Combination of arm anthropometry (MUAC and triceps skinfold thickness) with serum albumin categorized patients as adequately nourished (32%), moderately depleted (18%), and severely depleted (49%). Patients with hematological malignancy had a higher prevalence of undernutrition but there was no difference in morbidities between the undernourished and adequately nourished children by any parameter. Hypoalbuminemia observed in 25% patients was associated with significant chemotherapy delays (p, 0.01) and interval admissions (p, 0.03). Using LBM as a criterion, linear regression analysis revealed MUAC (R
2 = 0.681) as the best predictor of undernutrition with lowest standard error.
Conclusion Our study reports undernutrition among two-fifths of newly diagnosed patients of childhood cancer associated with high prevalence of sarcopenia and adiposity. These findings are of utmost clinical relevance in planning interventional strategies.
Influence of New FIGO 2018 Staging on Treatment Outcomes in Early-Stage Cervical Cancer: A Single-Center Study
Authors: Kaur Satinder , Garg Hemlata , Nandwani Megha , Kalita Manoj , Bansal Satish , Singh Randeep 
Published: June 2022

Purpose The aim of this article was to study survival outcomes of early-stage cervical cancer patients and impact on survival after restaging them as per International Federation of Gynecology and Obstetrics (FIGO) 2018.
Materials and Methods A retrospective study was conducted from June 1, 2013 to May 31, 2018 in a tertiary care hospital in North India. One-hundred patients of early-stage cervical cancer (as per FIGO 2009 staging) who had been treated by surgery followed by risk based tailored adjuvant therapy in our hospital were evaluated. The clinicopathological features and survival outcomes of these patients were analyzed. These patients were then restaged as per new FIGO 2018 staging and survival outcomes between two FIGO classifications were compared.
Results The median age of the study population was 52.5 years with median follow-up of 62.1 months. Ninety percent of our patients had more than 2 years follow-up and 59% had more than 5 years follow-up. The overall survival and relapse-free survival were 87.5 and 91.4%, respectively. The study population was then reclassified according to new FIGO 2018 staging. It was seen that the patients with stage IB1and IB2 cervical cancer had overall survival of 91.1 and 90%, respectively. The overall survival of stage IB3 was 80% and the survival of stage IIIC1 was only 60%.
Conclusion The new FIGO 2018 classification has a significant effect on survival outcome and in prognostication of patients with cervical cancer.
Continuous Hepatogonodal and Splenogonogal Fusion: A Rare Cause of Bilateral Intra-Abdominal Testis in an 18-Month-Old Boy
Authors: Durmuş Gül , Boybeyi-Turer Ozlem , Özcan Hatice Nursun , Gözmen Onur , Demirbilek Hüseyin , Soyer Tutku 
Published: June 2022

AbstractThe fusion of gonadal structures with internal organs is very rare. The close proximity between the left gonad and spleen during embryogenesis may result in splenogonadal fusion (SGF). Moreover, the trapping of hepatocyte-destined mesenchyme cells in gonads is defined as hepatogonadal fusion (HGF). The fusion of gonads with intra-abdominal organs may be continuous and may impair testicular descent during the prenatal period. We herein report an 18-month-old boy presented with bilateral nonpalpable testis due to concomitant continuous HGF and SGF. To our knowledge, this is the first case of concomitant HGF and SGF in a boy with bilateral intra-abdominal testis. Laparoscopic excision of fibrous cords and orchidopexy can be achieved despite continuous fusions.
Larotrectinib as an Effective Therapy in Congenital Infantile Fibrosarcoma: Report of Two Cases
Authors: Lapeña Lucas Moratilla , Caldas Maria Carmen Sarmiento , Ramírez Carla , Basilio María San , Junco Paloma Triana , Rodríguez-Laguna Lara , Martínez-González Victor , Marín-Manzano Elena , Perez-Martinez Antonio , Lopez-Gutierrez Juan Carlos 
Published: June 2022

AbstractCongenital infantile fibrosarcoma (CIF) is a rare tumor in children that occurs in the first years of life. It usually arises in the extremities but some cases affect the trunk, neck, abdomen, or retroperitoneum. Surgical resection has been traditionally the treatment of choice but the development of genomic analysis and targeted therapies has shed light on new therapeutic options.We present two patients with a congenital mass, one in the abdominal cavity (1-month-old) and the second in the left lower extremity respectively (2-months-old). In both cases, the clinical and radiological findings showed heterogeneous masses with rapidly progressive growth. MRI in the first patient exhibited an abdominal mass surrounding the aorta and inferior vena cava associated with a giant infrarenal aortic aneurysm. CT-guided biopsy was performed with pathological findings of fibrosarcoma and ETV6-NTRK3 gene fusion. The second patient underwent open biopsy also with histopathological diagnosis of fibrosarcoma and the same mutation in the TRK gene (NTRK3). Targeted therapy with a specific TRK inhibitor, larotrectinib, was started in both patients. Periodical controls were made by ultrasound or MRI, and after a few weeks of treatment, both children showed significant decrease in the mass. By the second and third months after starting the treatment, both tumors disappeared. The first patient is now 15-months-old and the second one is 8-months-old.Larotrectinib is a novel targeted therapy with excellent results in CIF but long-term outcomes are limited to establish it as a gold standard treatment.
Correlation of ROS1 (D4D6) Immunohistochemistry with ROS1 Fluorescence In Situ Hybridization Assay in a Contemporary Cohort of Pulmonary Adenocarcinomas
Authors: Sharma Shivani , Mishra Sourav K. , Bhardwaj Mohit , Jha Shilpy , Geller Matthew , Dewan Aditi , Jain Ekta , Dixit Mallika , Jain Deepika , Munjal Gauri , Kumar Shivmurti , Mohanty Sambit K. 
Published: June 2022

Objective Repressor of Silencing (ROS1) gene rearrangement in the lung adenocarcinomas is one of the targetable mutually exclusive genomic alteration. Fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), next-generation sequencing, and reverse transcriptase polymerase chain reaction assays are generally used to detect ROS1 gene alterations. We evaluated the correlation between ROS1 IHC and FISH analysis considering FISH as the gold standard method to determine the utility of IHC as a screening method for lung adenocarcinoma.
Materials and Methods A total of 374 advanced pulmonary adenocarcinoma patients were analyzed for ROS1 IHC on Ventana Benchmark XT platform using D4D6 rabbit monoclonal antibody. FISH assay was performed in parallel in all these cases using the Vysis ROS1 Break Apart FISH probe.
Statistical Analysis The sensitivity, specificity, positive and negative likelihood ratios, positive and negative predictive values, and accuracy were evaluated.
Results A total of 17 tumors were positive either by IHC or FISH analysis or both (true positive). Four tumors were positive by IHC (H-score range: 120–270), while negative on FISH analysis (false positive by IHC). One tumor was IHC negative, but positive by FISH analysis (false negative). The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, and accuracy were 94.4% (confidence interval [CI]: 72.71–99.86%), 63.6% (CI: 30.79–89.07%), 2.6 (CI: 1.18–5.72), 0.09 (CI: 0.01–0.62), 80.95% (CI: 65.86–90.35%), 87.5% (CI: 49.74–98.02%), and 82.76%, respectively.
Conclusion ROS1 IHC has high sensitivity at a cost of lower specificity for the detection of ROS1 gene rearrangement. All IHC positive cases should undergo a confirmatory FISH test as this testing algorithm stands as a reliable and economic tool to screen ROS1 rearrangement in lung adenocarcinomas.