In vitro fertilization with single euploid blastocyst transfer: a randomized controlled trial

ObjectiveTo determine whether performing comprehensive chromosome screening (CCS) and transferring a single euploid blastocyst can result in an ongoing pregnancy rate that is equivalent to transferring two untested blastocysts while reducing the risk of multiple gestation.DesignRandomized, noninferiority trial.SettingAcademic center for reproductive medicine.Patient(s)Infertile couples (n = 205) with a female partner less than 43 years old having a serum anti-Müllerian hormone level ≥1.2 ng/mL and day 3 FSH <12 IU/L.Intervention(s)Randomization occurred when at least two blastocysts were suitable for trophectoderm biopsy. The study group (n = 89) had all viable blastocysts biopsied for real-time, polymerase chain reaction–based CCS and single euploid blastocyst transfer. The control group (n = 86) had their two best-quality, untested blastocysts transferred.Main Outcome Measure(s)The ongoing pregnancy rate to ≥24 weeks (primary outcome) and the multiple gestation rate.Result(s)The ongoing pregnancy rate per randomized patient after the first ET was similar between groups (60.7% after single euploid blastocyst transfer vs. 65.1% after untested two-blastocyst transfer; relative risk [RR], 0.9; 95% confidence interval [CI], 0.7–1.2). A difference of greater than 20% in favor of two-blastocyst transfer was excluded. The risk of multiple gestation was reduced after single euploid blastocyst transfer (53.4% to 0%), and patients were nearly twice as likely to have an ongoing singleton pregnancy (60.7% vs. 33.7%; RR, 1.8; 95% CI, 1.3–2.5).Conclusion(s)In women ≤42 years old, transferring a single euploid blastocyst results in ongoing pregnancy rates that are the same as transferring two untested blastocysts while dramatically reducing the risk of twins.Clinical Trial Registration NumberNCT01408433

A Multi-Stage Process to Develop Quality Indicators for Community-Based Palliative Care Using interRAI Data

Background: Individuals receiving palliative care (PC) are generally thought to prefer to receive care and die in their homes, yet little research has assessed the quality of home- and community-based PC. This project developed a set of valid and reliable quality indicators (QIs) that can be generated using data that are already gathered with interRAI assessments-an internationally validated set of tools commonly used in North America for home care clients. The QIs can serve as decision-support measures to assist providers and decision makers in delivering optimal care to individuals and their families. Methods: The development efforts took part in multiple stages, between 2017-2021, including a workshop with clinicians and decision-makers working in PC, qualitative interviews with individuals receiving PC, families and decision makers and a modified Delphi panel, based on the RAND/ULCA appropriateness method. Results: Based on the workshop results, and qualitative interviews, a set of 27 candidate QIs were defined. They capture issues such as caregiver burden, pain, breathlessness, falls, constipation, nausea/vomiting and loneliness. These QIs were further evaluated by clinicians/decision makers working in PC, through the modified Delphi panel, and five were removed from further consideration, resulting in 22 QIs. Conclusions: Through in-depth and multiple-stakeholder consultations we developed a set of QIs generated with data already collected with interRAI assessments. These indicators provide a feasible basis for quality benchmarking and improvement systems for care providers aiming to optimize PC to individuals and their families

A new era for space life science: international standards for space omics processing

10 p.-2 fig.Space agencies have announced plans for human missions to the Moon to prepare for Mars. However, the space environment presents stressors that include radiation, microgravity, and isolation. Understanding how these factors affect biology is crucial for safe and effective crewed space exploration. There is a need to develop countermeasures, to adapt plants and microbes for nutrient sources and bioregenerative life support, and to limit pathogen infection. Scientists across the world are conducting space omics experiments on model organisms and, more recently, on humans. Optimal extraction of actionable scientific discoveries from these precious datasets will only occur at the collective level with improved standardization. To address this shortcoming, we established ISSOP (International Standards for Space Omics Processing), an international consortium of scientists who aim to enhance standard guidelines between space biologists at a global level. Here we introduce our consortium and share past lessons learned and future challenges related to spaceflight omics.European (D.B., H.C., N.J.S., R.H., and S. Giacomello) contribution is supported by ESA Topical Team “Space Omics: Towards an integrated ESA/NASA –omics database for spaceflight and ground facilities experiments” grant 4000131202/20/NL/PG/pt to R.H. S. Giacomello is supported by Formas grant 2017-01066_3. H.C. is supported by the Horizon Centre for Doctoral Training at the University of Nottingham (UKRI grant no. EP/S023305/1) and by the NASA GeneLab Animal Analysis Working Group. N.J.S. is supported by the National Aeronautics and Space Administration (NNX15AL16G). NASA GeneLab members (J.M.G., S.V.C., S.S.R., L.D., S. Gebre) are supported by the NASA Space Biology program within the NASA Science Mission Directorate's (SMD) Biological and Physical Sciences (BPS) Division. R.B. and S. Gilroy are supported by NASA (80NSSC19K0132). L.R. and M.M. represent the Omics Subgroup of Japan Society for the Promotion of Science (JSPS) KAKENHI funding group Living in Space and are supported by JP15K21745, JP15H05940, and JP20H03234. L.R. is supported by JSPS postdoctoral fellowship P20382. D.T. is supported by the Department of Biomedical and Health Informatics and The Children’s Hospital of Philadelphia Research Institute. K.F. is supported by the UC San Diego Department of Medicine and National Institutes of Health, grant UL1TR001442 of CTSA (Clinical and Translational Science Awards). C.E.M. is funded from the WorldQuant Foundation, The Pershing Square Sohn Cancer Research Alliance, and the National Institutes of Health (R01MH117406).Peer reviewe

Different higher order kinematics between star-forming and quiescent galaxies based on the SAMI, MAGPI, and LEGA-C surveys

We present the first statistical study of spatially integrated non-Gaussian stellar kinematics spanning 7 Gyr in cosmic time. We use deep, rest-frame optical spectroscopy of massive galaxies (stellar mass ⁠) at redshifts z = 0.05, 0.3, and 0.8 from the SAMI, MAGPI, and LEGA-C surveys, to measure the excess kurtosis h4 of the stellar velocity distribution, the latter parametrized as a Gauss–Hermite series. We find that at all redshifts where we have large enough samples, h4 anticorrelates with the ratio between rotation and dispersion, highlighting the physical connection between these two kinematic observables. In addition, and independently from the anticorrelation with rotation-to-dispersion ratio, we also find a correlation between h4 and M⋆, potentially connected to the assembly history of galaxies. In contrast, after controlling for mass, we find no evidence of independent correlation between h4 and aperture velocity dispersion or galaxy size. These results hold for both star-forming and quiescent galaxies. For quiescent galaxies, h4 also correlates with projected shape, even after controlling for the rotation-to-dispersion ratio. At any given redshift, star-forming galaxies have lower h4 compared to quiescent galaxies, highlighting the link between kinematic structure and star-forming activity

Evolution in the orbital structure of quiescent galaxies from MAGPI, LEGA-C, and SAMI surveys: direct evidence for merger-driven growth over the last 7 Gyr

We present the first study of spatially integrated higher-order stellar kinematics over cosmic time. We use deep rest-frame optical spectroscopy of quiescent galaxies at redshifts z = 0.05, 0.3, and 0.8 from the SAMI, MAGPI, and LEGA-C surveys to measure the excess kurtosis h4 of the stellar velocity distribution, the latter parametrized as a Gauss-Hermite series. Conservatively using a redshift-independent cut in stellar mass (⁠⁠) and matching the stellar-mass distributions of our samples, we find 7σ evidence of h4 increasing with cosmic time, from a median value of 0.019 ± 0.002 at z = 0.8 to 0.059 ± 0.004 at z = 0.06. Alternatively, we use a physically motivated sample selection based on the mass distribution of the progenitors of local quiescent galaxies as inferred from numerical simulations; in this case, we find 10σ evidence. This evolution suggests that, over the last 7 Gyr, there has been a gradual decrease in the rotation-to-dispersion ratio and an increase in the radial anisotropy of the stellar velocity distribution, qualitatively consistent with accretion of gas-poor satellites. These findings demonstrate that massive galaxies continue to accrete mass and increase their dispersion support after becoming quiescent

A raison d'être for making a reggae opera as a pedagogical tool for psychic emancipation in (post)colonial Jamaica

Critical participatory action research is a form of community engagement and knowledge generation which, when represented semiotically, may promote social transformation. In this paper, I describe a critical participatory action research project I undertook as a liberation psychologist and researcher in (post)colonial Jamaica. I summarise a narrative psychological portrait of downpressing produced by analysing participant's relationship to state violence using a voice-centred method of analysis. Denied racism and classism are found to dominate the way in which downpressors relate to others they inferiorise. I discuss the raison d'être for animating the psychology of the downpressor in a performance piece, a reggae opera. Such a piece of community art could be a pedagogical tool for psychic emancipation. Finally, I describe challenges and potentials encountered in an effort to forge an aesthetic synthesis among multiple pieces of conscious art

The Pediatric Cell Atlas:Defining the Growth Phase of Human Development at Single-Cell Resolution

Single-cell gene expression analyses of mammalian tissues have uncovered profound stage-specific molecular regulatory phenomena that have changed the understanding of unique cell types and signaling pathways critical for lineage determination, morphogenesis, and growth. We discuss here the case for a Pediatric Cell Atlas as part of the Human Cell Atlas consortium to provide single-cell profiles and spatial characterization of gene expression across human tissues and organs. Such data will complement adult and developmentally focused HCA projects to provide a rich cytogenomic framework for understanding not only pediatric health and disease but also environmental and genetic impacts across the human lifespan

Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools related to participant preferences and consent, variant classification, disclosure and management of primary and secondary findings, health outcomes, and integration with electronic health records. Future research directions will refine measures of clinical utility of CGES in both germline and somatic testing, evaluate the use of CGES for screening in healthy individuals, explore the penetrance of pathogenic variants through extensive phenotyping, reduce discordances in public databases of genes and variants, examine social and ethnic disparities in the provision of genomics services, explore regulatory issues, and estimate the value and downstream costs of sequencing. The CSER consortium has established a shared community of research sites by using diverse approaches to pursue the evidence-based development of best practices in genomic medicine

System-wide transcriptome damage and tissue identity loss in COVID-19 patients

The molecular mechanisms underlying the clinical manifestations of coronavirus disease 2019 (COVID-19), and what distinguishes them from common seasonal influenza virus and other lung injury states such as acute respiratory distress syndrome, remain poorly understood. To address these challenges, we combine transcriptional profiling of 646 clinical nasopharyngeal swabs and 39 patient autopsy tissues to define body-wide transcriptome changes in response to COVID-19. We then match these data with spatial protein and expression profiling across 357 tissue sections from 16 representative patient lung samples and identify tissue-compartment-specific damage wrought by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, evident as a function of varying viral loads during the clinical course of infection and tissue-type-specific expression states. Overall, our findings reveal a systemic disruption of canonical cellular and transcriptional pathways across all tissues, which can inform subsequent studies to combat the mortality of COVID-19 and to better understand the molecular dynamics of lethal SARS-CoV-2 and other respiratory infections., • Across all organs, fibroblast, and immune cell populations increase in COVID-19 patients • Organ-specific cell types and functional markers are lost in all COVID-19 tissue types • Lung compartment identity loss correlates with SARS-CoV-2 viral loads • COVID-19 uniquely disrupts co-occurrence cell type clusters (different from IAV/ARDS) , Park et al. report system-wide transcriptome damage and tissue identity loss wrought by SARS-CoV-2, influenza, and bacterial infection across multiple organs (heart, liver, lung, kidney, and lymph nodes) and provide a spatiotemporal landscape of COVID-19 in the lung

ngVLA Key Science Goal 5 Understanding the Formation and Evolution of Black Holes in the Era of Multi-Messenger Astronomy

The next-generation Very Large Array (ngVLA) will be a powerful telescope for finding and studying black holes across the entire mass range. High-resolution imaging abilities will allow the separation of low-luminosity black holes in the local Universe from background sources, thereby providing critical constraints on the mass function, formation, and growth of black holes. Its combination of sensitivity and angular resolution will provide new constraints on the physics of black hole accretion and jet formation. Combined with facilities across the spectrum and gravitational wave observatories, the ngVLA will provide crucial constraints on the interaction of black holes with their environments, with specific implications for the relationship between evolution of galaxies and the emission of gravitational waves from in-spiraling supermassive black holes and potential implications for stellar mass and intermediate mass black holes. The ngVLA will identify the radio counterparts to transient sources discovered by electromagnetic, gravitational wave, and neutrino observatories, and its high-resolution, fast-mapping capabilities will make it the preferred instrument to pinpoint electromagnetic counterparts to events such as supermassive black hole mergers. The National Radio Astronomy Observatory is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc. Part of this research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration