Use of ECMO for Cardiogenic Shock in Pediatric Population

In children with severe advanced heart failure where medical management has failed, mechanical circulatory support in the form of veno-arterial extracorporeal membrane oxygenation (VA ECMO) or ventricular assist device represents life-sustaining therapy. This review provides an overview of VA ECMO used for cardiovascular support including medical and surgical heart disease. Indications, contraindications, and outcomes of VA ECMO in the pediatric population are discussed.VA ECMO provides biventricular and respiratory support and can be deployed in rapid fashion to rescue patient with failing physiology. There have been advances in conduct and technologic aspects of VA ECMO, but survival outcomes have not improved. Stringent selection and optimal timing of deployment are critical to improve mortality and morbidity of the patients supported with VA ECMO.

Delayed Recognition: A Co-Citation Perspective

A Sleeping Beauty is a publication that is apparently unrecognized by citation for some period of time before experiencing a burst of recognition. Various reasons, including resistance to new ideas, have been attributed to such delayed recognition. We study this phenomenon in the special case of co-citations, which represent new ideas generated through the combination of existing ones. Using relatively stringent selection criteria derived from the work of others, we analyze a very large dataset of over 940 million unique co-cited article pairs, and identify 1,196 cases of delayed co-citations. We further classify these 1,196 cases with respect to amplitude, rate of citation, and disciplinary origin.

120 High variation in prediction of developmental competence of bovine oocytes based on visual examination

The quality of an oocyte is often represented by its morphological characteristics. Stringent selection of bovine cumulus–oocyte complexes (COCs) for invitro embryo production (IVP) is regularly based on parameters such as colour and granulation of the ooplasm, density of the surrounding cumulus cells, brightness of the zona pellucida, among other less common parameters. The link between developmental competence and morphology of the COC has been demonstrated in literature in group culture system. However, this has not been yet examined in an individual invitro production system. This study investigates the ability of IVP researchers to predict whether an oocyte will develop into a blastocyst at Day 8 of invitro culture in an individual production system. A set of 29 pictures of immature bovine COCs was presented in duplicates to eight bovine IVP researchers with different institutional backgrounds. The observers were asked if they would select each oocyte for further IVP processing, assuming that only the oocytes with the highest developmental potential can proceed, and thus a stringent selection is warranted. These 29 immature oocytes were matured, fertilized, and cultured individually invitro (using conventional methods) so that their ability to develop into a blastocyst at Day 8 post-fertilization was known. The ability to reach the blastocyst stage was stated as the gold standard and compared with the answers of the observers using kappa statistics and sensitivity (Se) and specificity (Sp) tests. Kappa (κ) for interobserver agreement was κ=0.01 (Se=50%, Sp=53%; positive predictive value=14%, negative predictive value=87%) with 50% accuracy of prediction. The intraobserver agreement was κ=0.69, with κ=1 referring to 100% agreement (Se=87%, Sp=83%), with an accuracy of 85%. The ability of trained embryologists to predict the fate of oocytes’ developmental competence was accurate for only half of the presented oocytes. Additionally, the proportion of false positive (1 − Sp) and false negative (1−Se) predictions was equally distributed. The low positive predictive value might be due to the lower development rates in individual culture systems versus group culture systems, whereas observers are mainly trained to select oocytes for group culture. This study demonstrated the subjective nature of the oocyte selection process that is based on visual examination of COC morphology because interobserver agreement was almost nonexistent. Interpretation of the morphology within an observer remains consequent, represented by the high intraobserver agreement. Consequently, there is a need to develop a new model for the objective determination of oocyte quality for individual IVP. The implementation of machine learning algorithms could objectively enhance oocyte selection and artificial reproductive technologies in extension.

China will stymie India’s UN Security Council agenda

Significance The United States, the United Kingdom, France, Russia and China are the body’s five permanent members. India wants to join that group. Impacts India-China border tensions could surge in early 2021, worsening bilateral relations. Delhi will deepen security ties with Washington and its other partners in the ‘Quad’ grouping, Tokyo and Canberra. India will push for more stringent selection of UN peacekeepers.

Memorial

Hector Alfredo Alfonso Acero received his civil engineering degree from the Universidad Nacional de Colombia in 1987. In 1988, as he began eyeing the labor market, he was attracted by an opportunity offered by Ecopetrol where young professionals from various disciplines were invited to participate in a scientific training program in collaboration with the Colorado School of Mines. After a stringent selection process, he was admitted to a program that would convert him into a geophysical exploration expert. There he began a 30-year career that would lead him to be an authority on geophysics for the Colombian National Oil Company.

Identification of Non-Pleiotropic Loci in Flowering and Maturity Control in Soybean

Pleiotropy is considered to have a significant impact on multi-trait evolution, but its roles in the evolution of domestication-related traits in crop species have been unclear. In soybean, several known quantitative trait loci (QTL) controlling maturity, called the maturity loci, are known to have major effects on both flowering and maturity in a highly correlated pleiotropic manner. Aiming at the identification of non-pleiotropic QTLs that independently control flowering and maturity and dissecting the effects of pleiotropy in these important agronomic traits, we conducted a QTL mapping experiment by creating a population from a cross between domesticated soybean G. max and its wild ancestor G. soja that underwent stringent selection for non-pleiotropy in flowering and maturity. Our QTL mapping analyses using the experimental population revealed novel loci that acted in a non-pleiotropic manner: R1-1 controlled primarily flowering and R8-1 and R8-2 controlled maturity, while R1-1 overlapped with QTL, affecting other agronomic traits. Our results suggest that pleiotropy in flowering and maturity can be genetically separated, while artificial selection during soybean domestication and diversification may have favored pleiotropic loci such as E loci that control both flowering and maturity. The non-pleiotropic loci identified in this study will help to identify valuable novel genes to optimize soybean’s life history traits and to improve soybean’s yield potential under diverse environments and cultivation schemes.

An overview of the current genetic and phenotypical selection strategies to reduce the prevalence of feline hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a common and potentially lethal heart disease in cats. To reduce its prevalence, breeding cats are frequently screened on the basis of their phenotype or genotype. Although echocardiography is the most reliable phenotypical method, its efficacy is limited by the incomplete penetrance of HCM and by difficulties in distinguishing primary HCM from other causes of left ventricular hypertrophy. On the other hand, genetic testing is hampered by the genetic heterogeneity of the disease. Genetic tests are currently only available for Maine Coons and Ragdolls. Because of the high prevalence of HCM, stringent selection may have a negative impact on the genetic diversity of a breed. A more optimal selection would therefore be a slow and careful exclusion of phenotypically and/or genetically positive cats.

Stringent Selection of Knobby Plasmodium falciparum-Infected Erythrocytes during Cytoadhesion at Febrile Temperature

Changes in the erythrocyte membrane induced by Plasmodium falciparum invasion allow cytoadhesion of infected erythrocytes (IEs) to the host endothelium, which can lead to severe complications. Binding to endothelial cell receptors (ECRs) is mainly mediated by members of the P. falciparum erythrocyte membrane protein 1 (PfEMP1) family, encoded by var genes. Malaria infection causes several common symptoms, with fever being the most apparent. In this study, the effects of febrile conditions on cytoadhesion of predominately knobless erythrocytes infected with the laboratory isolate IT4 to chondroitin-4-sulfate A (CSA), intercellular adhesion molecule 1 (ICAM-1), and CD36 were investigated. IEs enriched for binding to CSA at 40 °C exhibited significantly increased binding capacity relative to parasites enriched at 37 °C. This interaction was due to increased var2csa expression and trafficking of the corresponding PfEMP1 to the IE surface as well as to a selection of knobby IEs. Furthermore, the enrichment of IEs to ICAM-1 at 40 °C also led to selection of knobby IEs over knobless IEs, whereas enrichment on CD36 did not lead to a selection. In summary, these findings demonstrate that knobs are crucial for parasitic survival in the host, especially during fever episodes, and thus, that selection pressure on the formation of knobs could be controlled by the host.