Magnetic phase transition of monolayer chromium trihalides investigated with machine learning: toward a universal magnetic Hamiltonian.

The prediction of magnetic phase transitions often requires model Hamiltonians to describe the necessary magnetic interactions. The advance of machine learning provides an opportunity to build a unified approach that can treat various magnetic systems without proposing new model Hamiltonians. Here, we develop such an approach by proposing a novel set of descriptors that describes the magnetic interactions and training the artificial neural network (ANN) that plays the role of a universal magnetic Hamiltonian. We then employ this approach and Monte Carlo simulation to investigate the magnetic phase transition of two-dimensional monolayer chromium trihalides using the trained ANNs as energy calculator. We show that the machine-learning-based approach shows advantages over traditional methods in the investigation of ferromagnetic and antiferromagnetic phase transitions, demonstrating its potential for other magnetic systems.

Acute Respiratory Failure and Mechanical Ventilation in Women With COVID-19 During Pregnancy: Best Clinical Practices.

Symptomatic pregnant women with coronavirus disease-2019 (COVID-19) are at increased risk of severe disease and death compared with symptomatic nonpregnant females of reproductive age. Among those who become critically ill, profound acute hypoxemic respiratory failure is the dominant finding. Significant morbidity and mortality from COVID-19 are largely due to acute viral pneumonia that evolves to acute respiratory distress syndrome. Admission of these patients with critical disease to an intensive care unit and initiation of invasive mechanical ventilation may be indicated. Effective ventilatory support can be challenging in the COVID-19 patient population, even more so when the need occurs in a woman during pregnancy. Key respiratory changes during pregnancy are reviewed. Principles related to maternal-fetal oxygen transport, assessment of ventilation and oxygenation status, and oxygenation goals are also reviewed. Selected concepts related to mechanical ventilatory support for the woman with COVID-19 and acute respiratory failure during pregnancy are presented including indications for ventilatory support, noninvasive support, and invasive ventilator management. Challenges in providing care to this patient population are identified as well as strategies to address them going forward.

Rootstock mediates transcriptional regulation of citrulline metabolism in grafted watermelon / Mediação do porta-enxerto na regulação transcricional do metabolismo da citrulina na melancia enxertada

Abstract Citrulline is a non-essential amino acid, involved in key biological functions in plants and humans. Rootstocks have a major impact on citrulline accumulation in grafted watermelon. Information regarding rootstock induced changes in citrulline metabolism is elusive. To understand the regulatory mechanism, parallel changes in the expression profiles of citrulline metabolic genes and citrulline content of watermelon were monitored during the development of self-rooted watermelon and watermelon grafted onto pumpkin, wild and bottle gourd rootstocks. Results demonstrated that rootstocks regulated the expression profiles in different ways to influence the citrulline content. GAT, NAGPR, ASS3 ASS2 and Asl2 showed the negative correlation with citrulline content in pumpkin grafted watermelon. Pumpkin rootstock promoted the citrulline content by high down-regulation and synergistic effect of ASS2, ASS3, ASL1 and ASl2 genes. In wild grafted watermelon, citrulline was accumulated as a result of down regulation of GAT, NAGS and ASL2 genes, which showed an inverse correlation with citrulline. In gourd grafted watermelon, changes in citrulline content were observed to be linked with lower expressions of GAT, NAGK, ASS2, ASS3, ASL1 and ARG which were negatively correlated with citrulline content. Our study will provide the basis to understand the molecular mechanism of citrulline accumulation in various rootstocks.

Resumo A citrulina é um aminoácido não essencial, envolvida em importantes funções biológicas de plantas e seres humanos. Os porta-enxertos têm um grande impacto no acúmulo de citrulina na melancia enxertada. Informações sobre alterações induzidas por porta-enxertos no metabolismo da citrulina ainda não foram descritas. Para entender o mecanismo regulatório, foram monitoradas mudanças paralelas nos perfis de expressão dos genes metabólicos de citrulina e no teor de citrulina da melancia durante o desenvolvimento da melancia e da melancia enxertada em porta-enxertos de abóbora, silvestre e cabaça. Os resultados demonstraram que o porta-enxerto regulou os perfis de expressão de diferentes maneiras para influenciar no conteúdo de citrulina. GAT, NAGPR, ASS3, ASS2 e ASL2 apresentaram correlação negativa com o teor de citrulina em melancia enxertada de abóbora. O porta-enxerto de abóbora promoveu o conteúdo de citrulina por meio de baixa regulação e efeito sinérgico de duas famílias de genes ASS e ASL. Na melancia enxertada, a acumulação de citrulina resultou na regulação negativa de GAT, NAGS e ASL2, que mostraram uma correlação inversa com a citrulina. Na melancia enxertada, observou-se que as alterações no conteúdo de citrulina foram associadas a menores expressões de GAT, NAGK, ASS2, ASS3, ASL1 e ARG, que foram negativamente correlacionadas com o conteúdo de citrulina. Esses resultados fornecem a base para identificar o mecanismo molecular do acúmulo de citrulina em vários porta-enxertos.

Rootstock mediates transcriptional regulation of citrulline metabolism in grafted watermelon.

Citrulline is a non-essential amino acid, involved in key biological functions in plants and humans. Rootstocks have a major impact on citrulline accumulation in grafted watermelon. Information regarding rootstock induced changes in citrulline metabolism is elusive. To understand the regulatory mechanism, parallel changes in the expression profiles of citrulline metabolic genes and citrulline content of watermelon were monitored during the development of self-rooted watermelon and watermelon grafted onto pumpkin, wild and bottle gourd rootstocks. Results demonstrated that rootstocks regulated the expression profiles in different ways to influence the citrulline content. GAT, NAGPR, ASS3 ASS2 and Asl2 showed the negative correlation with citrulline content in pumpkin grafted watermelon. Pumpkin rootstock promoted the citrulline content by high down-regulation and synergistic effect of ASS2, ASS3, ASL1 and ASl2 genes. In wild grafted watermelon, citrulline was accumulated as a result of down regulation of GAT, NAGS and ASL2 genes, which showed an inverse correlation with citrulline. In gourd grafted watermelon, changes in citrulline content were observed to be linked with lower expressions of GAT, NAGK, ASS2, ASS3, ASL1 and ARG which were negatively correlated with citrulline content. Our study will provide the basis to understand the molecular mechanism of citrulline accumulation in various rootstocks.

[Research progress on chemical constituents, pharmacological action and quality control of Scutellaria barbata].

Scutellaria barbata is a recognized anti-cancer traditional Chinese medicine, with the effects of clearing heat and detoxi-fication, dispelling blood stasis and stopping bleeding, diuresis and detumescence. At present, terpenoids, flavonoids, polysaccharides and volatile oils have been isolated from S. barbata, which have many pharmacological effects, such as resisting tumor, virus, bacteria and oxidation, and immunomodulation. This paper reviews the studies on the chemical constituents, pharmacological action and quality control of S. barbata, in the expectation of providing ideas and references for the further development and studies of S. barbata.

Statistical considerations for the analysis of massively parallel reporter assays data.

Noncoding DNA contains gene regulatory elements that alter gene expression, and the function of these elements can be modified by genetic variation. Massively parallel reporter assays (MPRA) enable high-throughput identification and characterization of functional genetic variants, but the statistical methods to identify allelic effects in MPRA data have not been fully developed. In this study, we demonstrate how the baseline allelic imbalance in MPRA libraries can produce biased results, and we propose a novel, nonparametric, adaptive testing method that is robust to this bias. We compare the performance of this method with other commonly used methods, and we demonstrate that our novel adaptive method controls Type I error in a wide range of scenarios while maintaining excellent power. We have implemented these tests along with routines for simulating MPRA data in the Analysis Toolset for MPRA (@MPRA), an R package for the design and analyses of MPRA experiments. It is publicly available at http://github.com/redaq/atMPRA.

Genetic variants in the folate metabolic pathway genes predict cutaneous melanoma-specific survival.

BACKGROUND: Folate metabolism plays an important role in DNA methylation and nucleic acid synthesis and thus may function as a regulatory factor in cancer development. Genome-wide association studies (GWASs) have identified some single-nucleotide polymorphisms (SNPs) associated with cutaneous melanoma-specific survival (CMSS), but no SNPs were found in genes involved in the folate metabolic pathway. OBJECTIVES: To examine associations between SNPs in folate metabolic pathway genes and CMSS. METHODS: We comprehensively evaluated 2645 (422 genotyped and 2223 imputed) common SNPs in folate metabolic pathway genes from a published GWAS of 858 patients from The University of Texas MD Anderson Cancer Center and performed the validation in another GWAS of 409 patients from the Nurses' Health Study and Health Professionals Follow-up Study, in which 95/858 (11·1%) and 48/409 (11·7%) patients died of cutaneous melanoma, respectively. RESULTS: We identified two independent SNPs (MTHFD1 rs1950902 G>A and ALPL rs10917006 C>T) to be associated with CMSS in both datasets, and their meta-analysis yielded an allelic hazards ratio of 1·75 (95% confidence interval 1·32-2·32, P = 9·96 × 10-5 ) and 2·05 (1·39-3·01, P = 2·84 × 10-4 ), respectively. The genotype-phenotype correlation analyses provided additional support for the biological plausibility of these two variants' roles in tumour progression, suggesting that variation in SNP-related mRNA expression levels is likely to be the mechanism underlying the observed associations with CMSS. CONCLUSIONS: Two possibly functional genetic variants, MTHFD1 rs1950902 and ALPL rs10917006, were likely to be independently or jointly associated with CMSS, which may add to personalized treatment in the future, once further validated. What is already known about this topic? Existing data show that survival rates vary among patients with melanoma with similar clinical characteristics; therefore, it is necessary to identify additional complementary biomarkers for melanoma-specific prognosis. A hypothesis-driven approach, by pooling the effects of single-nucleotide polymorphisms (SNPs) in a specific biological pathway as genetic risk scores, may provide a prognostic utility, and genetic variants of genes in folate metabolism have been reported to be associated with cancer risk. What does this study add? Two genetic variants in the folate metabolic pathway genes, MTHFD1 rs1950902 and ALPL rs10917006, are significantly associated with cutaneous melanoma-specific survival (CMSS). What is the translational message? The identification of genetic variants will make a risk-prediction model possible for CMSS. The SNPs in the folate metabolic pathway genes, once validated in larger studies, may be useful in the personalized management and treatment of patients with cutaneous melanoma.

Effects of exercise intervention on visceral fat in obese children and adolescents.

INTRODUCTION: This meta-analysis study was aimed to assess the effects of exercise intervention on visceral fat in obese children and adolescents. EVIDENCE ACQUISITION: Electronic database searches were performed in Academic Search Complete, CINAHL, Healthsource, MEDLINE, and SportDiscus, and from the earliest record to November 2017. Keywords included "exercise or training," "visceral fat," and "child or adolescent or youth." The inclusion criteria for eligible studies were as follows: 1) subjects were obese at baseline; 2) aged 6-19 years; 3) visceral fat was reported at baseline and after an intervention; and 4) studies were published in peer-reviewed journals written in English. EVIDENCE SYNTHESIS: A total of 207 studies were observed at the initial search and 73 effect sizes (ESs) were derived from the 34 selected studies. The overall exercise intervention effect was large (Cohen's d [ES]=-1.003, 95% CI=-1.114, -0.892). Moderator analyses results showed that gender (Qb=8.23, df=2, P=0.016), exercise type (Qb=10.68, df=2, P=0.005), and intervention length (Qb=24.71, df=2, P<0.001) influenced the overall ES. CONCLUSIONS: The group of both boys and girls (ES=-0.95) who participated combined exercise program (Aerobic + Resistance training; ES=-1.17) for 12 months (ES=-1.24) appeared to be the most effective exercise strategy for reducing visceral fat in obese youth.

Physiologic and Hemodynamic Changes During Pregnancy.

Substantial physiologic changes accompany pregnancy, the most profound of which involve the cardiovascular system. These changes affect maternal hemodynamic and oxygen transport status. This article describes cardiovascular changes that occur during pregnancy including blood volume, heart rate, stroke volume, cardiac output, vascular resistance, and colloid osmotic pressure. Alterations in factors related to maternal oxygen transport including oxygen affinity, delivery, and consumption also are described. Concepts related to fetal oxygen transport and adaptive responses to hypoxemia are presented. Technical considerations regarding assessment of maternal hemodynamic and oxygen transport status during pregnancy are described and assessment findings during labor, birth, and the immediate postpartum period are interpreted. A maternal hemodynamic and oxygen transport profile is presented to illustrate these principles in clinical practice.

Maternal Mortality and Morbidity in the United States: Classification, Causes, Preventability, and Critical Care Obstetric Implications.

The United States has experienced a steady rise in pregnancy-related deaths over the last 3 decades. The rate of severe maternal morbidity has also increased. It is estimated that approximately 50% of maternal deaths are preventable. National, multidisciplinary, collaborative efforts are required to effectively address this problem. The complex nature of certain conditions and the concomitant risk of significant maternal morbidity and mortality have yielded a subset of women who require obstetric critical care. Institutions and clinicians face challenges as they identify a framework within which to provide this specialized level of care. Systematic, multidisciplinary review of maternal morbidity and mortality events continues to generate meaningful data and recommendations for improvement. The purpose of this article was to describe important concepts related to maternal mortality including the classification and leading causes of maternal death in the United States. The preventability of maternal mortality is also explored including evidence-based best practices and strategies.

[Wry nose and rhinolith: a case report].

This report described a case of the wry nose and rhinolith patients. A 25 years old female patient complained a sense of persistent left side of nasal congestion runny with 10 years. During the 10 years the symptom repeatedly occurrence, aggravated with peculiar smell of 1 months. A combined treatment including endoscopic sinus surgery with correction of the deviated nose and removal of nasal stone was performed in the patient.Three monthsafter operation, the patient recovered well, without recurrence, external nasal deformity, foreign bodies remain.

Rootstock mediates transcriptional regulation of citrulline metabolism in grafted watermelon

Abstract Citrulline is a non-essential amino acid, involved in key biological functions in plants and humans. Rootstocks have a major impact on citrulline accumulation in grafted watermelon. Information regarding rootstock induced changes in citrulline metabolism is elusive. To understand the regulatory mechanism, parallel changes in the expression profiles of citrulline metabolic genes and citrulline content of watermelon were monitored during the development of self-rooted watermelon and watermelon grafted onto pumpkin, wild and bottle gourd rootstocks. Results demonstrated that rootstocks regulated the expression profiles in different ways to influence the citrulline content. GAT, NAGPR, ASS3 ASS2 and Asl2 showed the negative correlation with citrulline content in pumpkin grafted watermelon. Pumpkin rootstock promoted the citrulline content by high down-regulation and synergistic effect of ASS2, ASS3, ASL1 and ASl2 genes. In wild grafted watermelon, citrulline was accumulated as a result of down regulation of GAT, NAGS and ASL2 genes, which showed an inverse correlation with citrulline. In gourd grafted watermelon, changes in citrulline content were observed to be linked with lower expressions of GAT, NAGK, ASS2, ASS3, ASL1 and ARG which were negatively correlated with citrulline content. Our study will provide the basis to understand the molecular mechanism of citrulline accumulation in various rootstocks.

Resumo A citrulina é um aminoácido não essencial, envolvida em importantes funções biológicas de plantas e seres humanos. Os porta-enxertos têm um grande impacto no acúmulo de citrulina na melancia enxertada. Informações sobre alterações induzidas por porta-enxertos no metabolismo da citrulina ainda não foram descritas. Para entender o mecanismo regulatório, foram monitoradas mudanças paralelas nos perfis de expressão dos genes metabólicos de citrulina e no teor de citrulina da melancia durante o desenvolvimento da melancia e da melancia enxertada em porta-enxertos de abóbora, silvestre e cabaça. Os resultados demonstraram que o porta-enxerto regulou os perfis de expressão de diferentes maneiras para influenciar no conteúdo de citrulina. GAT, NAGPR, ASS3, ASS2 e ASL2 apresentaram correlação negativa com o teor de citrulina em melancia enxertada de abóbora. O porta-enxerto de abóbora promoveu o conteúdo de citrulina por meio de baixa regulação e efeito sinérgico de duas famílias de genes ASS e ASL. Na melancia enxertada, a acumulação de citrulina resultou na regulação negativa de GAT, NAGS e ASL2, que mostraram uma correlação inversa com a citrulina. Na melancia enxertada, observou-se que as alterações no conteúdo de citrulina foram associadas a menores expressões de GAT, NAGK, ASS2, ASS3, ASL1 e ARG, que foram negativamente correlacionadas com o conteúdo de citrulina. Esses resultados fornecem a base para identificar o mecanismo molecular do acúmulo de citrulina em vários porta-enxertos.

Morbidly Adherent Placenta: Interprofessional Management Strategies for the Intrapartum Period.

"Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus. A multidisciplinary approach to care throughout pregnancy is essential. This article describes the classification of morbidly adherent placenta, risk factors, methods of diagnosis, potential maternal and fetal complications, and intrapartum clinical management strategies to optimize outcomes.

Predictive Mortality Index for Community-Dwelling Elderly Koreans.

There are very few predictive indexes for long-term mortality among community-dwelling elderly Asian individuals, despite its importance, given the rapid and continuous increase in this population. We aimed to develop 10-year predictive mortality indexes for community-dwelling elderly Korean men and women based on routinely collected clinical data.We used data from 2244 elderly individuals (older than 60 years of age) from the southwest Seoul Study, a prospective cohort study, for the development of a prognostic index. An independent longitudinal cohort of 679 elderly participants was selected from the Korean Genome Epidemiology Study in Ansan City for validation.During a 10-year follow-up, 393 participants (17.5%) from the development cohort died. Nine risk factors were identified and weighed in the Cox proportional regression model to create a point scoring system: age, male sex, smoking, diabetes, systolic blood pressure, triglyceride, total cholesterol, white blood cell count, and hemoglobin. In the development cohort, the 10-year mortality risk was 6.6%, 14.8%, 18.2%, and 38.4% among subjects with 1 to 4, 5 to 7, 8 to 9, and ≥10 points, respectively. In the validation cohort, the 10-year mortality risk was 5.2%, 12.0%, 16.0%, and 16.0% according to these categories. The C-statistic for the point system was 0.73 and 0.67 in the development and validation cohorts, respectively.The present study provides valuable information for prognosis among elderly Koreans and may guide individualized approaches for appropriate care in a rapidly aging society.

[The invasive fungal rhino-sinusitis cased by aspergillus nidulans: one case report].

This report described a case of the invasive fungal sinusitis cased by asperigillus. A 51 years old women patient complained a sense of welling on right facial, mild pain. No complain of facial numbness and toothache. During the 2 months the symptom repeatedly occurrence. A combined treatment including endoscopic sinus surgery (ESS) and anti fungal therapy was performed in a patient with invasive fungal rhino sinusitis. After 3 months of operation, the patient recovered well. No recurrence, no jaw facial pain and swelling, no eye movement disorder.

Cardiomyopathy During Pregnancy.

Cardiomyopathy is an acquired cardiac disorder that, although rare, accounts for a rising proportion of reported pregnancy-related deaths in the United States. During pregnancy, cardiomyopathy may be divided into 2 groups. The first group is peripartum cardiomyopathy; the second group is stratified according to 3 classically defined pathophysiologic presentations: hypertrophic, dilated, or restrictive. Within this second group, the cardiomyopathy can be either idiopathic or due to a specific identified cause. This disorder poses significant risks of morbidity and/or mortality to the pregnant woman and fetus/neonate. This article describes types of cardiomyopathy during pregnancy, perinatal risks, and general management principles with a focus on intrapartum care. Hemodynamic and oxygen transport data are presented to illustrate interpretation of patient assessment findings and the effects of interventions for abnormal maternal and fetal findings.

Cardiovascular risk profiles in relation to newly diagnosed type 2 diabetes diagnosed by either glucose or HbA1c criteria in Chinese adults in Qingdao, China.

AIMS: To study the cardiovascular disease risk profiles in newly diagnosed diabetes diagnosed by either glucose or/and HbA(1c) criteria in Chinese adults. METHODS: Two population-based cross-sectional studies were conducted in 2006 and 2009, respectively. Data from 1987 men and 2815 women aged 35-74 years were analysed. Newly diagnosed diabetes was defined according to either glucose (fasting and/or 2-h glucose), HbA(1c) or both criteria. RESULTS: Ageing, positive family history of diabetes, elevated levels of waist circumference, systolic blood pressure, total cholesterol, triglycerides and γ-glutamyl transferase were independently associated with newly diagnosed diabetes defined by glucose criterion alone, but not for diabetes defined by HbA(1c) criterion alone. Only waist circumference, total cholesterol and smoking were significantly associated with the presence of diabetes defined by HbA(1c) criterion alone. CONCLUSIONS: Cardiovascular disease risk profiles were different in patients with newly diagnosed diabetes defined by the two diagnostic criteria for diabetes. This may have certain clinical implications on diabetes management and research.