BACKGROUND

For a number of reasons, the results of previous meta-analyses may not fully reflect the mental health status of the average woman suffering from polycystic ovary syndrome (PCOS), or the causes of this distress. Our objective was to examine emotional distress and its associated features in women with PCOS.

METHODS

A comprehensive meta-analysis of comparative studies reporting measures of depression, anxiety or emotional-subscales of quality of life (emoQoL) was performed. PubMed, Embase, PsychInfo and the Cochrane trial register databases were searched up to November 2011 (see Supplementary Data for PUBMED search string). Unpublished data obtained through contact with authors were also included. The standardized mean difference (SMD) of distress scores was calculated. Subgroup analyses and meta-regression analysis of methodological and PCOS-related features were performed.

RESULTS

Twenty-eight studies (2384 patients and 2705 control women) were included. Higher emotional distress was consistently found for women with PCOS compared with control populations [main outcomes: depression: 26 studies, SMD 0.60 (95% confidence interval (CI) 0.47–0.73), anxiety: 17 studies, SMD of 0.49 (95% CI 0.36–0.63), emoQoL: 8 studies, SMD –0.66 (95% CI –0.92 to –0.41)]. However, heterogeneity was present (I² 52–76%). Methodological and clinical aspects only partly explained effect size variation.

CONCLUSIONS

Women with PCOS exhibit significantly more emotional distress compared with women without PCOS. However, distress scores mostly remain within the normal range. The cause of emotional distress could only partly be explained by methodological or clinical features. Clinicians should be aware of the emotional aspects of PCOS, discuss these with patients and refer for appropriate support where necessary and in accordance with patient preference.

Source:
http://humupd.oxfordjournals.org/cgi/content/short/18/6/638?rss=1

BACKGROUND

Chances of achieving parenthood are high for couples who undergo fertility treatment. However, many choose to discontinue before conceiving. A systematic review was conducted to investigate patients' stated reasons for and predictors of discontinuation at five fertility treatment stages.

METHODS

Six databases were systematically searched. Search-terms referred to fertility treatment and discontinuation. Studies reporting on patients' stated reasons for or predictors of treatment discontinuation were included. A list of all reasons for discontinuation presented in each study was made, different categories of reasons were defined and the percentage of selections of each category was calculated. For each predictor, it was noted how many studies investigated it and how many found a positive and/or negative association with discontinuation.

RESULTS

The review included 22 studies that sampled 21 453 patients from eight countries. The most selected reasons for discontinuation were: postponement of treatment (39.18%, postponement of treatment or unknown 19.17%), physical and psychological burden (19.07%, psychological burden 14%, physical burden 6.32%), relational and personal problems (16.67%, personal reasons 9.27%, relational problems 8.83%), treatment rejection (13.23%) and organizational (11.68%) and clinic (7.71%) problems. Some reasons were common across stages (e.g. psychological burden). Others were stage-specific (e.g. treatment rejection during workup). None of the predictors reported were consistently associated with discontinuation.

CONCLUSIONS

Much longitudinal and theory led research is required to explain discontinuation. Meanwhile, treatment burden should be addressed by better care organization and support for patients. Patients should be well informed, have the opportunity to discuss values and worries about treatment and receive advice to decide about continuing treatment.

Source:
http://humupd.oxfordjournals.org/cgi/content/short/18/6/652?rss=1

BACKGROUND

This paper explores recent developments in female contraception, using them to illustrate how adaptation of existing methods, improved service delivery and understanding contraceptive behaviour might increase contraceptive uptake and correct and consistent use, and how the development of new methods holds some promise for capitalizing on the potential non-contraceptive benefits.

METHODS

Searches were performed in Medline and other databases. Selection criteria included high-quality studies and studies relevant to clinical reproductive medicine. Summaries were presented and discussed by the European Society of Human Reproduction and Embryology (ESHRE) Workshop Group.

RESULTS

The topics discussed include: adapted regimens for combined oral contraceptive pills, non-invasive methods of female sterilization, the need to improve the awareness of pregnancy risk to increase the use of emergency contraception, improvements in the evidence base for the safety and service delivery of intrauterine methods, emphasis on the potential benefits of combined oral contraceptives for women with hirsutism and acne, the potential of female sterilization to prevent ovarian cancer, and the promise of anti-progesterones and new approaches to dual protection.

CONCLUSIONS

Although great strides have been made in recent years in increasing contraceptive use among women in many countries where contraceptive prevalence is low or there is a high unmet need for contraception, much more can, and needs to, be done.

Source:
http://humupd.oxfordjournals.org/cgi/content/short/18/6/670?rss=1

Cross-species liaisons occurred as Stone Age wound down

Web edition : 9:41 am

A new study suggests that present-day Europeans share more genes with now-extinct Neandertals than do living Africans, at least partly because of interbreeding that took place between 37,000 and 86,000 years ago.

Cross-species mating occurred when Stone Age humans left Africa and encountered Neandertals, or possibly a close Neandertal relative, upon reaching the Middle East and Europe in the latter part of the Stone Age, says a team led by geneticist Sriram Sankararaman of Harvard Medical School.

The new study, published online October 4 in PLOS Genetics, indicates that at least some interbreeding must have occurred between Homo sapiens and Neandertals, Sankararaman says. But its not yet possible to estimate how much of the Neandertal DNA found in modern humans comes from that interbreeding and how much derives from ancient African hominid populations ancestral to both groups.

A separate analysis of gene variants in Neandertals and in people from different parts of the world also found signs of Stone Age interbreeding outside Africa. That study, published online April 18 in Molecular Biology and Evolution, was led by evolutionary geneticist Melinda Yang of the University of California, Berkeley.

Results from Sankararaman and Yangs groups convincingly show that the finding of a higher proportion of Neandertal DNA in non-Africans compared to Africans can be best explained by gene flow from Neandertals into modern humans, says evolutionary geneticist Johannes Krause of the University of Tbingen in Germany.

Other studies have found that ancient interbreeding may not be necessary to explain the presence of Neandertal DNA in modern humans. It may be possible that African populations ancestral to both H. sapiens and Neandertals possessed some genes that became part of both species genomes. Evolutionary ecologists Anders Eriksson and Andrea Manica of the University of Cambridge recently demonstrated the plausibility of this scenario using a model based on more than 100 populations of human-Neandertal ancestors spread across Africa, Europe and West Asia.

Sankararamans analysis assumes that the common ancestors of humans and Neandertals more than 230,000 years ago consisted of two African populations and one population outside Africa. Its not clear whether a more complex model that includes 100 or more populations of human-Neandertal ancestors would yield any signs of late Stone Age interbreeding, says Cambridges Manica.

Sankararaman and his colleagues measured the lengths of DNA segments shared by Neandertals and present-day Europeans. Since genetic reshuffling via sexual reproduction reduces the size of such segments over time, lengths of Neandertal-related chunks of DNA in people today can be used to calculate the time since those chunks entered the human genome.

Original post:
Human-Neandertal mating gets a new date

BACKGROUND

Angiogenesis, i.e. the development of new blood vessels from pre-existing ones, represents an integral part in the pathogenesis of endometriosis. During the last decade, an increasing number of studies have therefore focused on the anti-angiogenic treatment of the disease. The present review provides a systematic overview of these studies and critically discusses the future role of anti-angiogenic therapy in the multimodal management of endometriosis.

METHODS

Literature searches were performed in PubMed, MEDLINE and ISI Web of Knowledge for original articles published before the end of March 2012, written in the English language and focusing on anti-angiogenic approaches for the therapy of endometriosis. The searches included both animal and human studies.

RESULTS

Numerous compounds of different substance groups have been shown to exert anti-angiogenic effects on endometriotic lesions under experimental in vitro and in vivo conditions. These include growth factor inhibitors, endogenous angiogenesis inhibitors, fumagillin analogues, statins, cyclo-oxygenase-2 inhibitors, phytochemical compounds, immunomodulators, dopamine agonists, peroxisome proliferator-activated receptor agonists, progestins, danazol and gonadotropin-releasing hormone (GnRH) agonists. However, clinical evidence for their efficacy in anti-angiogenic endometriosis therapy is still lacking.

CONCLUSIONS

Anti-angiogenic compounds hold great promise for the future treatment of endometriosis because they may inhibit the establishment of new endometriotic lesions in early stages of the disease or after surgical treatment. Further experimental studies, controlled clinical trials in particular, are required now to clarify which compounds fulfil these expectations without inducing severe side effects in patients with endometriosis.

Source:
http://humupd.oxfordjournals.org/cgi/content/short/18/6/682?rss=1

By Rick Nauert PhD Senior News Editor Reviewed by John M. Grohol, Psy.D. on October 4, 2012

A new EU study provides a comprehensive evaluation of the different stress points that challenge women as they struggle to become pregnant.

Researchers looked at the stress of not being able to naturally conceive and the stress associated with the difficult decision to undergo and then receive fertility treatments.

In the study, published in the journal Human Reproduction, researchers examined experiences of patients in four countries with the highest number of cases of assisted reproduction cycles in Europe: France, Germany, Italy and Spain.

Researchers acknowledge that the inability to normally conceive is extremely stressful for women who want to have a family.

Infertility causes a series of varied emotions that have a negative impact on important aspects of a womans life, said Dr. Juan Garca Velasco, one of the authors of the study. It is linked to depression, anxiety, anger, cognitive imbalance and low self-esteem.

Researchers analyzed the emotional impact of infertility and also identified aspects of fertility treatments that contribute to the physical and psychological stress suffered by many women.

Investigators studied 445 women, between the ages of 18 and 44 years, who were experiencing difficulties in conceiving. While some had never undergone any fertility treatment, others were receiving it at the time or had already received it in the past two years.

Almost one-third of the participants said they began to worry from the momentthey started trying to get pregnant, and nearly half claimed to have felt ashamed or like a failure as a woman.

Researchers determined that anxiety toward injections and the deterioration of their relationship with their partner were the main causes of stress for the women.

See the rest here:
Study Details Stresses Tied to Fertility Treatments

Reaching a long-sought milestone, Japanese researchers have demonstrated in mice that eggs and sperm can be grown from stem cells and combined to produce healthy offspring, pointing to new treatments for infertility.

If the achievement can be repeated in humans and experts said they are optimistic that such efforts will ultimately succeed the technique could make it easier for women in their 30s or 40s to become mothers. It could also help men and women whose reproductive organs have been damaged by cancer treatments or other causes.

About one in 10 American women of childbearing age have trouble becoming or staying pregnant, and more than one-third of infertile couples must contend with a medical problem related to the prospective father, according to the national Centers for Disease Control and Prevention in Atlanta.

Using current technology, only about one-third of attempts at assisted reproduction result in live births, CDC data show. Scientists, doctors and patients would like to boost that percentage.

"These studies provide that next level of evidence that in the future fertility could be managed with stem cell intervention," said Teresa Woodruff, chief of fertility preservation at Northwestern University Feinberg School of Medicine.

The prospect of using stem cells to grow new eggs is particularly tantalizing, since women are born with a set number and don't make more once they are gone. In a sense, the therapy would allow them to turn back their biological clocks, said Stanford stem cell researcher Renee A. Reijo Pera, who studies reproduction.

"This is a get-them-back strategy," she said.

Dr. Mitinori Saitou and colleagues at Kyoto University detailed how they generated the functional mouse eggs in a report published online Thursday by the journal Science. Last year, the researchers reported in the journal Cell that they had done the same thing with mouse sperm.

In both cases, the team started with embryonic stem cells, which have the potential to develop into all of the different types of cells in the body.

The scientists exposed the embryonic stem cells to stimuli that coaxed them to become egg and sperm precursors.

See the article here:
Mouse stem cells used to produce eggs, Japanese scientists say

Either ignored or plainly blindsided by her educational policymakers, multiculturalism and the infusion of the practices of multicultural education is absent, even though it is clear that politics and education cannot be taken as separate disciplines in order to understand the nature and future of national development.

Malaysias survival as a nation depends primarily on the re-crafting of an education system philosophically, systemically, and pedagogically sound enough to bridge the gaps between the socio-economic and cultural deficiencies brought about by the legacy of Mahathirism; one based on the use of race ideology to sustain control and to design hegemony of the Malay-Muslim race.

Education as the only means for personal, social, cultural, and even spiritual and ecumenical progress can only be achieved if one goes back to the its philosophical foundations and re-look at the conception of human nature itself.

In Malaysia, a legacy of British colonial policy and its tool of social reproduction, i.e. schooling, has paved the way for Malaysias neo-colonialist strategy of a hidden system of apartheid, to ensure that the races are still separated in an unequal way.

Issues and institutions in such a scenario reflect the ideology of dominance - of one race over others or the rest - blinding educationalists and policy-makers to see beyond race and religion in making sure that the gentle profession and humanistic enterprise called education is driven fundamentally by the almost ideologically-bankrupt United Malays National Organisations (Umnos) idea of education and nation-building.

Pre-schools, primary schools, secondary schools and even universities take the nature of racial educational exclusivity.

Shinning examples of this apartheid-isation of education are any all-racial schools, Mara Junior Science Colleges, and the Universiti Teknologi Mara system - all these in addition to the already apartheid-ised Malaysian Civil Service, albeit de facto in nature, whose existence is shackled by the ideology of an endangered ruling class of Malay-dominated politicians, in all its ignorance of the meaning of education, claimed superior knowledge to what that enterprise solely means.

New breed of educational policymakers needed

Malaysia needs not only a new educational direction, detouring from the road of further apartheid-isation of education it is happily traversing but also a new breed of cosmopolitanistic-thinking educational policymakers and practitioners.

Beyond these, Malaysia needs most logically a regime change in toto - to allow a new political will to an educational hope for the nation; anything short of these, will bring Malaysia to a pariah or a failed state educationally and economically in an increasingly predatorily globalised state. What then must Malaysians do?

Read more:
Dismantle our apartheid education system

ScienceDaily (Oct. 3, 2012) Fertility treatment has a strong emotional impact on women who want to have children. A study of European countries with the highest number of assisted reproduction cycles identifies which aspects of reproduction treatment contribute to psychological stress.

Inability to conceive is extremely stressful for women who want to have a family. This notion is shown by a study published in the 'Human Reproduction' journal on patients in four countries with the highest number of cases of assisted reproduction cycles in Europe: France, Germany, Italy and Spain.

"Infertility causes a series of varied emotions that have a negative impact on important aspects of a woman's life," as explained by Juan Garca Velasco, one of the authors of the study, who is also director of the Infertility Institute of Valencia and lecturer in Obstetrics and Gynaecology at the Rey Juan Carlos de Madrid University. "It is linked to depression, anxiety, anger, cognitive imbalance and low self-esteem," he adds.

The study not only analyses the emotional impact of infertility on women but also identifies those aspects of ovary stimulation that contribute to the physical and psychological stress suffered by many patients.

The 445 women between the ages of 18 and 44 years taking part in the study had experienced difficulties in conceiving. While some had never undergone any fertility treatment, others were receiving it at the time or had already received it in the past two years. Almost a third of the participants said they began to worry from the moment in which they started trying to get pregnant and nearly half claimed to have felt ashamed or like a failure as a woman.

It was found that anxiety toward injections and the deterioration of their relationship with their partner were the main causes of stress. In this respect, the women who actually received treatment said that they got closer to their partner (33% compared to 19%). The majority of participants felt that their partner supported them, especially those that received fertility therapy (63%).

Women undergoing treatment said they were more anxious when it comes to sex and negative emotions, such as impatience or frustration. Whereas those not having treatment said they felt "confused" and those undergoing treatment claimed to mostly feel "vulnerable and exhausted."

Despite being aware of the limitations of age, 68% never thought they would have a problem conceiving. According to Garca Velasco, "in order to overcome the physical and psychological challenges that such treatment implies, some form of protocol would be necessary that involves a minimal number of injections and an increase in readily available information in order to reduce stress and increase patient satisfaction."

Waiting two years to start treatment

Garca Velasco outlines that "infertility can significantly affect women's lives and their personal relationships." "However, despite its negative impact, many of those women trying to conceive do not seek medical help."

Read the original here:
Fear of treatment puts stress on women undergoing fertility therapy

BASEL.- With the exhibition Feeding, Fleeing, Fighting, Reproduction Kunsthalle Basel presents the latest project by Swiss artist Pamela Rosenkranz (*1979). This exhibition is her first institutional solo show in German-speaking Switzerland.

Rosenkranz is interested in evolutionary mechanisms and processes, that seem to be the basis of how people are organized in a society. The artist is interested in the differences between body and mind, in human interactions, and in mens relationship to nature. Rosenkranz explores these interests, utilizing scientific explanations that contradict our current notions of what it means to be human.

Rosenkranz uses a variety of materials. The emphasis is on the naturalness of these materials, and to that end even PET (Polyethylene terephthalate) can be seen as a natural product. Even though they claim to be the most evolved of all organisms, human beings are just one of many elements on our planet. Everything created by humans is natural; in this way, the concept of artificiality is called into question. Rosenkranz thinking is influenced by a materialistic perspective that calls the subject into question. The artist annuls identity and gender differences; her position as a woman is likewise rendered meaningless.

Rosenkranz works explore the various ways in which we define ourselves as human. They address fundamental human qualities, highlighting these and placing them in a partly new, partly familiar context. Even though the exhibition consists of individual works, it can be understood as one overall examination by Rosenkranz in which, themes and elements recur throughout the rooms of the Kunsthalle. In the first space of the Kunsthalle, the artist has installed a sink, which is the same as those found in the restrooms of the Campari Bar located in the adjacent rooms. The faucet is open and blue colored water flows permanently; its splashing against the ceramic sink makes a sound which superimposes itself upon the silence in the rooms. Strolling through the rooms, visitors will realize that the color blue is a recurring element. The evolutionary perception of blue within our visible spectrum was created at a pre-evolutionary stage when creatures only existed under the sea. Our sensitivity to this color has barely changed throughout the course of the history of humankind and we are still highly sensible for the wavelengths of blue than of all the other colors of the visible spectrum.

On large-format prints behind plexiglass, Rosenkranz presents monotone blue surfaces based on the IKB works (International Klein Blue) by Yves Klein that were created at the end of the 1950s and downloaded by her as JPEGs from the internet; for these monochrome paintings produced by the French artist, he invented and patented a specific blue tone, which increases the brilliance of ultramarine blue. The color of Rosenkranz pigment inkjet prints is based on the data information which contains colors that are subject to prevailing light conditions, scan settings, or photochemical conditions, etc. The prints are hand-mounted and due to the manual operation bubbles arise undermining Yves Klein's idea of an intangible heaven, and the immateriality of the sky: as the bubbles become objects they challenge the concept of air being immaterial.

In contrast with the color blue as Wild Blue Yonder (the fascination with the vastness of the sky) the color red represents physicality and the body. The color of blood next to genetic skin pigmentation is primarily responsible for skin tone. The red also shines through the white walls of the Kunsthalle, which have been painted with standard dispersion mixed with fake or real blood. A bottle of SmartWater filled with a liquid is set close to the pink wall. Is the content water or sillicon? Is it skin color? The work does not spell it out, and yet it refers to our desire to look fresh and eternally young. It is about the preservation of beauty, of purity as physical criteria of perfection. Health and fitness are two issues often recurring in Rosenkranz exhibitions, and here they come to the fore once again.

Another new work in the exhibition focuses on the influence of color in decision-making. A seemingly random sequence of gigantic expanses of color is projected in the two last exhibition spaces of the Kunsthalle. The projection is accompanied by a computer-generated voice called Heather. This voice repeats the words Yes and No agreement and rejection in every conceivable intonation available for the range of meanings offered by the voice program. At this point this work refers to a specific way in which colors have been used in the domain of science, especially in the so-called Brainbow project. This specific color spectrum is used by scientists and was developed while conducting experiments on mice to make their brain activity visible. The RGB color spectrum was used to color-code their neurons. Rosenkranz project in turn, is interested in knowing how existential human emotions can also be color-coded and how they can then be contemplated and categorized in a manner that is strictly analogous to colors.

Pamela Rosenkranz approach is not based on a scientific interest as such. She works with findings and speculations culled not only from the natural sciences, but also from politics, history, philosophy, and popular culture. The exhibition Feeding, Fleeing, Fighting, Reproduction therefore can be thought of as a self-contained project that revolves around the conflict between scientific description and subjective experience. Furthermore, she also criticizes a conception of art, which puts the focus on the artists subjectivity, and she does this by confronting statements and explanations from contemporary science with prevailing notions of art, thereby radically negating the use of terms like experience, identity, and gender.

Pamela Rosenkranz (*1979, Altdorf, CH) lives and works in Zrich, CH and Amsterdam. Rosenkranz graduated from the Academy of Fine Arts Bern with the Master of Fine Arts in 2004 and studied Comparative Literature at the University of Zurich in 2005. In 2010 she participated at the Independent Residency Program at the Rijksakademie, Amsterdam.

Solo exhibitions (selection): To you I would like to be Who, Tongewlbe T25, Ingolstadt (2011); This Is Not My Color / The Seven Habits of Highly Effective People, mit Nikolas Gambaroff, Swiss Institute, New York (2011); Untouched by Man, Kunstverein Braunschweig, Braunschweig (2010); No Core, Centre dArt Contemporain Genve, Geneva (2010); Our Sun, Swiss Institute, Venice (2009); High Purity, Amden, Switzerland (2009); Unfade, Nuit Blanche, Centre Culturel Suisse, Paris (2008); Enter (Projectspace), Kunstmuseum Thun, Thun. Group exhibitions (selec-tion): Man in the Holecene, MIT, List Visual Arts Center, Cambridge (2012); Insight - Outsight II, Stdtische Galerie im Park, Viersen, Germany (2012); The Greater Cloud, Netherlands Media Art Institute, Amsterdam (2011); He disappeared into complete silence, De Hallen Haarlem, Haarlem, The Netherlands (2011); Unbounding and Crossing Over as Art, Kunstmuseum Liechtenstein, Liechtenstein (2011); Open Studio, Rijksakademie, Amsterdam (2011); How to Work (More for) Less, Kunsthalle Basel, Basel (2011); How to Work, Kunsthalle Basel, Basel (2011); Poste Restante, Artspeak, Vancouver (2011); Une Ide, une Forme, un tre - Posie/Politique du cor-porel, Migrosmuseum fr Gegenwartskunst, Zurich (2010); The Real Thing, Tate Britain, London (2010); Big Minis, Fetishes of Crisis, Muse d'Art Contemporain, Bordeaux (2010); Declaracin Anual de Personas Morales 2010, House of Gaga, Mexiko City (2010); Exhibition, Exhibition, Castello di Rivoli, Turin (2010); Fax, Art Museum Torrance, Torrance, California (2010); Of Ob-jects Fields and Mirrors, Kunsthaus Glarus, Glarus (2010); Fax, Drawing Center, New York (2009); Reduction and Suspense, Kunstverein Bregenz, Bregenz, Austria (2009); Dragged Down into Lowercase, Zentrum Paul Klee, Bern (2008); Principle Hope, Manifesta7, Rovereto, Italy (2008); NoLeftovers, Kunsthalle Bern, Bern (2008); Vertrautes Terrain, ZKM Karlsruhe, Karlsruhe (2008); Shifting Identities, Kunsthaus Zurich, Zurich (2008); When Things cast no Shadow, 5th Berlin Biennale, Neue Nationalgalerie, Berlin (2008).

Go here to see the original:
Feeding, Fleeing, Fighting, Reproduction: Pamela Rosenkranz' solo show opens at Kunsthalle Basel

State health officials are warning residents to protect themselves from mosquito bites as more cases of West Nile virus crop up across the state.

On Wednesday, a Newton woman was recovering from West Nile the fourth confirmed human infection in Massachusetts. While mosquitoes detected with eastern equine encephalitis (EEE) have fallen off slightly, detection of West Nile is on the rise, according to an official at the Department of Public Health.

So far this season, four people have been infected with West Nile, and one with EEE, according to state health officials.

West Nile cases are also on the rise nationally, according to a Department of Public Health official. In Massachusetts, state health officials have found infected mosquitoes in 93 communities.

"Over the last three weeks or so, West Nile has been dramatically increasing," said Dr. Catherine Brown, state public health veterinarian. "It is very high."

Brown said the "bad news" is the number of communities with West Nile-infected mosquitoes could be much higher some communities are not tested. Only communities that are a part of one of the nine mosquito control projects test.

"What this tells us is there is a lot of West Nile everywhere," Brown said. "At this point, people should consider that West Nile virus is present throughout the state."

West Nile virus was first found in Massachusetts in 2000. There were bad outbreaks in 2002-2003, with 22 and 18 human infection cases respectively. Since then, the number of cases hasnt hit those levels, according to Brown.

The summers high temperatures and dry conditions created ideal conditions for mosquito-borne infections.

"The heat, not only does it speed up mosquito reproduction, it also speeds up the virus multiplication. The mosquitoes infect the birds; the birds infect more mosquitoes," Brown said. "That whole cycle between the birds and the mosquitoes is called virus amplification."

Read more:
Mass. health official says West Nile virus all over the state

STUDY QUESTION

Are different dietary patterns associated with semen parameters in young men?

STUDY ANSWER

The consumption of a Prudent dietary pattern was significantly associated with higher progressive sperm motility and unrelated to sperm concentration and morphology. The consumption of a Western dietary pattern was unrelated to conventional semen quality parameters.

WHAT IS KNOWN ALREADY

Over the past decades there has been evidence of a concomitant decline in sperm and diet quality. Yet whether diet composition influences semen quality remains largely unexplored.

STUDY DESIGN, SIZE, DURATION

The Rochester Young Men's Study (n= 188) was a cross-sectional study conducted between 2009 and 2010 at the University of Rochester.

PARTICIPANTS, SETTING, METHODS

Men aged 18–22 years were included in this analysis. Diet was assessed via food frequency questionnaire and dietary patterns were identified by factor analysis. Linear regression was used to analyze the relation between diet patterns and conventional semen quality parameters (sperm concentration, progressive motility and morphology) adjusting for abstinence time, multivitamin use, race, smoking status, BMI, recruitment period, moderate-to-intense exercise and total calorie intake.

RESULTS

Two dietary patterns were identified by factor analysis. The ‘Western’ pattern was characterized by high intake of red and processed meat, refined grains, pizza, snacks, high-energy drinks and sweets. The ‘Prudent’ pattern was characterized by high intake of fish, chicken, fruit, vegetables, legumes and whole grains. The Prudent pattern was positively associated with percent progressively motile sperm in multivariate models (P-trend = 0.04). Men in the highest quartile of the Prudent diet had 11.3% (95% CI 1.3, 21.3) higher % progressively motile sperm compared with men in the lowest quartile. The Prudent pattern was unrelated to sperm concentration and morphology. The Western pattern was not associated with any semen parameter.

LIMITATIONS

This was a cross-sectional and observational study, which limited our ability to determine causality of diet on semen quality parameters.

WIDER IMPLICATIONS OF THE FINDINGS

Our findings support the suggestion that a diet rich in fruits, vegetables, chicken, fish and whole grains may be an inexpensive and safe way to improve at least one measure of semen quality.

STUDY FUNDING/COMPETING INTERESTS

The authors are supported by NIH grant T32DK007703-16 and P30DK46200 and European Union DEER Grant 212844. The authors have no competing interests to declare.

Source:
http://humrep.oxfordjournals.org/rss/current.xml

STUDY QUESTION

Is there an association between high levels of sperm DNA damage and miscarriage?

SUMMARY ANSWER

Miscarriage rates are positively correlated with sperm DNA damage levels.

WHAT IS KNOWN ALREADY

Most ejaculates contain a subpopulation of sperm with DNA damage, also referred to as DNA fragmentation, in the form of double or single-strand breaks which have been induced in the DNA prior to or following ejaculation. This DNA damage may be particularly elevated in some subfertile men, hence several studies have examined the link between sperm DNA damage levels and conception and miscarriage rates.

STUDY DESIGN, SIZE, DURATION

A systematic review and meta-analysis of studies which examined the effect of sperm DNA damage on miscarriage rates was performed. Searches were conducted on MEDLINE, EMBASE and the Cochrane Library without any language restrictions from database inception to January 2012.

PARTICIPANTS/MATERIALS, SETTING, METHODS

We used the terms ‘DNA damage’ or ‘DNA fragmentation’ combined with ‘miscarriage’, ‘abortion’ or ‘pregnancy’ to generate a set of relevant citations. Data extraction was performed by two reviewers. Study quality was assessed using the Newcastle–Ottawa Scale. Meta-analysis of relative risks of miscarriage was performed with a random effects model. Subgroup analyses were performed by the type of DNA damage test, whether the sperm examined were prepared or from raw semen and for pregnancies resulting from IVF or ICSI treatment.

MAIN RESULTS AND THE ROLE OF CHANCE

We identified 16 cohort studies (2969 couples), 14 of which were prospective. Eight studies used acridine orange-based assays, six the TUNEL assay and two the COMET assay. Meta-analysis showed a significant increase in miscarriage in patients with high DNA damage compared with those with low DNA damage [risk ratio (RR) = 2.16 (1.54, 3.03), P < 0.00001)]. A subgroup analysis showed that the miscarriage association is strongest for the TUNEL assay (RR = 3.94 (2.45, 6.32), P < 0.00001).

LIMITATIONS, REASONS FOR CAUTION

There is some variation in study characteristics, including the use of different assays and different thresholds for DNA damage and the definition of pregnancy loss.

WIDER IMPLICATIONS OF THE FINDINGS

The use of methods which select sperm without DNA damage for use in assisted conception treatment may reduce the risk of miscarriage. This finding indicates that assays detecting DNA damage could be considered in those suffering from recurrent pregnancy loss. Further research is necessary to study the mechanisms of DNA damage and the potential therapeutic effects of antioxidant therapy.

STUDY FUNDING/COMPETING INTEREST(S)

None.

Source:
http://humrep.oxfordjournals.org/rss/current.xml

STUDY QUESTION

Is there an association between sex chromosome disomy and semen concentration, motility and morphology?

SUMMARY ANSWER

Higher rates of XY disomy were associated with a significant increase in abnormal semen parameters, particularly low semen concentration.

WHAT IS KNOWN ALREADY

Although some prior studies have shown associations between sperm chromosomal abnormalities and reduced semen quality, results of others are inconsistent. Definitive findings have been limited by small sample sizes and lack of adjustment for potential confounders.

STUDY DESIGN, SIZE AND DURATION

Cross-sectional study of men from subfertile couples presenting at the Massachusetts General Hospital Fertility Clinic from January 2000 to May 2003.

PARTICIPANTS/MATERIALS, SETTING, METHODS

With a sample of 192 men, multiprobe fluorescence in situ hybridization for chromosomes X, Y and 18 was used to determine XX, YY, XY and total sex chromosome disomy in sperm nuclei. Sperm concentration and motility were measured using computer-assisted sperm analysis; morphology was scored using strict criteria. Logistic regression models were used to evaluate the odds of abnormal semen parameters [as defined by World Health Organization (WHO)] as a function of sperm sex chromosome disomy.

MAIN RESULTS AND THE ROLE OF CHANCE

The median percentage disomy was 0.3 for XX and YY, 0.9 for XY and 1.6 for total sex chromosome disomy. Men who had abnormalities in all three semen parameters had significantly higher median rates of XX, XY and total sex chromosome disomy than controls with normal semen parameters (0.43 versus 0.25%, 1.36 versus 0.87% and 2.37 versus 1.52%, respectively, all P< 0.05). In logistic regression models, each 0.1% increase in XY disomy was associated with a 7% increase (odds ratio: 1.07, 95% confidence interval: 1.02–1.13) in the odds of having below normal semen concentration (<20 million/ml) after adjustment for age, smoking status and abstinence time. Increases in XX, YY and total sex chromosome disomy were not associated with an increase in the odds of a man having abnormal semen parameters. In addition, autosomal chromosome disomy (1818) was not associated with abnormal semen parameters.

LIMITATIONS, REASONS FOR CAUTION

A potential limitation of this study, as well as those currently in the published literature, is that it is cross-sectional. Cross-sectional analyses by nature do not lend themselves to inference about directionality for any observed associations; therefore, we cannot determine which variable is the cause and which one is the effect. Additionally, the use of WHO cutoff criteria for dichotomizing semen parameters may not fully define fertility status; however, in this study, fertility status was not an outcome we were attempting to assess.

WIDER IMPLICATIONS OF THE FINDINGS

This is the largest study to date seeking to understand the association between sperm sex chromosome disomy and semen parameters, and the first to use multivariate modeling to understand this relationship. The findings are similar to those in the published literature and highlight the need for mechanistic studies to better characterize the interrelationships between sex chromosome disomy and standard indices of sperm health.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by grants from NIOSH (T42 OH008416) and NIEHS (R01 ES009718, P30 ES000002 and R01 ES017457). The authors declare no competing interests. At the time this work was conducted and the initial manuscript written, MEM was affiliated with the Environmental Health Department at the Harvard School of Public Health. Currently, MEM is employed by Millennium: The Takeda Oncology Company.

TRIAL REGISTRATION NUMBER

N/A.

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STUDY QUESTION

Is the presence of nuclear vacuoles really a negative parameter?

SUMMARY ANSWER

As sperm vacuoles are associated with acrosomal and capacitation status, they appear to be a reflection of normal sperm physiology.

WHAT IS KNOWN ALREADY

The selection of sperm under a high magnification has been proposed as a strategy to increase the success rates of ICSI, through a better selection of sperm for injection. The presence of vacuoles on the sperm head is said to be a negative parameter.

STUDY DESIGN, SIZE, DURATION

We incubated processed sperm for 90 min with two strong inducers of acrosome reaction (AR), i.e. hyaluronic acid (HA) and follicular fluid (FF) and studied the evolution of nuclear vacuoles, sperm morphology and chromatin compaction.

PARTICIPANTS/MATERIALS, SETTING, METHODS

We tested the effect of incubating sperm samples with HA and FF for 90 min at 37°C on nuclear vacuoles.

MAIN RESULTS AND THE ROLE OF CHANCE

Both HA and FF strongly induce AR after 90 min, without significantly modifying sperm nuclear condensation and morphology (Bartoov's criteria). We simultaneously observed a highly significant decrease in the presence of vacuoles.

LIMITATIONS, REASONS FOR CAUTION

This is a descriptive study based on in vitro manipulations.

WIDER IMPLICATIONS OF THE FINDINGS

Although intracytoplasmic morphologically selected sperm injection may be of benefit for couples with specific treatment indications, the results of this study make it difficult to justify its large-scale application.

STUDY FUNDING/COMPETING INTEREST(S)

Funding was granted by Laboratoire d'Eylau, Unilabs.

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STUDY QUESTION

What is the effect of pravastatin on antiphospholipid antibody (aPL) modulation of human first trimester trophoblast function?

SUMMARY ANSWER

Pravastatin does not prevent the effects of aPL on human first trimester trophoblast cell function.

WHAT IS KNOWN ALREADY

Antiphospholipid syndrome (APS) is associated with recurrent pregnancy loss and late pregnancy complications, such as pre-eclampsia, owing to direct targeting of the placenta by aPL. While treatment with heparin reduces the rate of pregnancy loss, the risk for severe pre-eclampsia remains high. Thus, there is a need to find alternative treatments for the prenatal management of patients with APS. Statins have recently been shown to prevent aPL-mediated fetal loss in mice but their effects on a human pregnancy model of APS have not yet been studied.

DESIGN, DATA COLLECTION, METHODS

The human first trimester trophoblast cell line, HTR8, and human first trimester trophoblast primary cultures were incubated with or without a mouse anti-human beta 2 glycoprotein I (β₂GPI) monoclonal antibody in the presence or absence of pravastatin. Cytokine and angiogenic factor secretion were measured by enzyme-linked immunosorbent assay and multiplex analysis. Cell migration was measured using a colorimetric two-chamber migration assay.

MAIN FINDINGS

Using the human first trimester trophoblast cell line, HTR8, pravastatin significantly augmented, compared with no treatment, aPL-dependent secretion of interleukin (IL)-8 (P< 0.05), IL-1β (P< 0.05) and soluble endoglin (P< 0.01) but had no effect on aPL-induced up-regulation of vascular endothelial growth factor, placenta growth factor or growth-related oncogene alpha secretion. Furthermore, pravastatin alone limited basal HTR8 cell migration (P< 0.01), and did not mitigate the adverse effect of aPL on trophoblast migration. Pravastatin also had no impact on the secretion of pro-inflammatory cytokines and angiogenic factors by primary human first trimester trophoblast cells exposed to aPL.

LIMITATIONS AND WIDER IMPLICATIONS OF THE FINDINGS

While our in vitro findings suggest that pravastatin may not be effective in preventing pregnancy complications in patients with APS, the in vivo condition may be more complex, and thus, more studies are needed to determine the effectiveness of pravastatin in the prevention of aPL-associated pregnancy complications in humans.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by the American Heart Association.

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STUDY QUESTION

What is the potential physiopathological role of tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) in recurrent miscarriage (RM), characterized by at least three consecutive pregnancy losses.

SUMMARY ANSWER

The levels of serum TRAIL immediately after miscarriage in RM patients are significantly elevated with respect to that in first-trimester normal pregnant women, and recombinant TRAIL inhibits the adhesion and migration of HTR8 trophoblastic cells in vitro.

WHAT IS KNOWN ALREADY

Both TRAIL and its trans-membrane receptors (TRAIL-R1, TRAIL-R2, TRAIL-R3 and TRAIL-R4) have been documented in the placenta, but their physiopathological role is incompletely understood.

STUDY DESIGN, SIZE, DURATION

The study populations consisted of RM patients (n = 80) and first-trimester normal pregnant women (n = 80). Blood samples were obtained within 24 h after abortion (RM) or at gestational 12-week (normal pregnant women). As additional controls, third-trimester normal pregnant women (n = 28) were examined before (within 72 h) and after (within 24 h) partum.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The concentrations of TRAIL were analysed in serum samples by ELISA. In parallel, the effect of soluble recombinant TRAIL (0.1–1000 ng/ml) was analysed on the survival of primary extravillus trophoblasts (EVTs) and on the survival, proliferation, adhesion and migration of trophoblastic HTR8 cells.

MAIN RESULTS AND THE ROLE OF CHANCE

The circulating levels of TRAIL in RM women (median: 52.5 pg/ml; mean and SD: 55.5 ± 24.4 pg/ml) were significantly higher with respect to first-trimester normal pregnant women (median: 44.9 pg/ml; mean and SD: 47 ± 15.1 pg/ml) and third-trimester normal pregnant women, as assessed before (median: 45.1 pg/ml; mean and SD: 46 ± 12.4 pg/ml) and after partum (median: 35.4 pg/ml; mean and SD: 38 + 17.5 pg/ml). Both primary EVT and HTR8 cells expressed detectable levels of TRAIL death receptors, but exposure to soluble recombinant TRAIL did not induce cell death of trophoblastic cells. On the other hand, TRAIL dose-dependently inhibited the adhesion of HTR8 cells to decidual endothelial cells (DEC) as well as the migration of HTR8 in transwell assays using either fibronectin or DEC.

LIMITATIONS, REASONS FOR CAUTION

Although this study suggests that TRAIL might have a pathogenic role in RM by inhibiting both the adhesion and migration capabilities of first trimester trophoblastic cells, there is a possibility that the elevated serum levels of TRAIL in RM are not cause but rather the result of RM.

WIDER IMPLICATIONS OF THE FINDINGS

Our current findings together with data of other authors suggest that circulating TRAIL should be further analysed as a potential important biomarker in different physiopathological settings.

STUDY FUNDING/COMPETING INTEREST(S)

This study was funded by FIRB projects (RBAP11Z4Z9_002 to Giorgio Zauli and RBAP10447J_002 to Paola Secchiero). The authors have no competing interests to declare.

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STUDY QUESTION

What is the methylation status of the Nanog and Oct4 promoters in human gametes and ICSI embryos and is abnormal reprogramming of their methylation associated with developmental failure of ICSI embryos?

SUMMARY ANSWER

Developmental failure of human ICSI embryos is associated with high methylation of the Oct4 promoter.

WHAT IS KNOWN ALREADY

Nanog and Oct4 genes play critical roles in the establishment and maintenance of pluripotency during normal early embryonic development, and both are negatively regulated through the methylation of their promoters.

STUDY DESIGN, SIZE AND DURATION

We analysed the methylation profile of Nanog and Oct4 promoters in 5 control sperm from normally fertile men, 70 metaphase II oocytes, 21 4-cell control ICSI embryos, 7 control blastocysts and 45 ICSI embryos arrested at 2- to 8-cell stage following prolonged culture.

PARTICIPANTS, MATERIALS, SETTING AND METHODS

Embryos and gametes were donated for research by patients from the Department of Reproductive Medicine at the Hôpital Femme Mère Enfant (Bron, France) and the Clinique du Tonkin (Villeurbanne, France) after giving their informed consent.

MAIN RESULTS

For both promoters, high methylation was observed in sperm cells. Although, in general, the promoters were unmethylated in oocytes, the methylation of some alleles was observed, particularly in oocytes from women with known infertility. Both gene promoters were hypomethylated in control blastocyst ICM (inner cell mass) and in control 2–8-cells embryos obtained from 6 out of 8 couples. However, they appeared highly methylated in embryos obtained from the other two couples. In most arrested ICSI embryos, the Nanog promoter was unmethylated while the Oct4 promoter was highly methylated. High methylation of the Oct4 promoter was significantly more pronounced in embryos from couples where a male factor was the only known cause of infertility. When the embryos were heterozygous for a G/A single nucleotide polymorphism, both alleles could be methylated, each likely representing a paternally inherited or a maternally inherited copy.

LIMITATIONS AND REASONS FOR CAUTION

The study was done on a limited number of oocytes and embryos and the gametes of the couples were not available.

WIDER IMPLICATIONS OF THE FINDINGS

These results provide new insight regarding the roles of epigenetic abnormalities in early developmental failure in humans.

STUDY FUNDING/COMPETING INTEREST(S)

No external funding was obtained for this study. There was no competing interest.

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BACKGROUND

Current non-invasive diagnostic methods for endometriosis lack sensitivity and specificity. In search for new diagnostic biomarkers for ovarian endometriosis, we used a hypothesis-generating targeted metabolomics approach.

METHODS

In a case–control study, we collected plasma of study participants and analysed their metabolic profiles. We selected a group of 40 patients with ovarian endometriosis who underwent laparoscopic surgery and a control group of 52 healthy women who underwent sterilization at the University Clinical Centre Ljubljana, Slovenia. Over 140 targeted analytes included glycerophospholipids, sphingolipids and acylcarnitines. The analytes were quantified by electrospray ionization tandem mass spectrometry. For assessing the strength of association between the metabolite or metabolite ratios and the disease, we used crude and adjusted odds ratios. A stepwise logistic regression procedure was used for selecting the best combination of biomarkers.

RESULTS

Eight lipid metabolites were identified as endometriosis-associated biomarkers due to elevated levels in patients compared with controls. A model containing hydroxysphingomyelin SMOH C16:1 and the ratio between phosphatidylcholine PCaa C36:2 to ether-phospholipid PCae C34:2, adjusted for the effect of age and the BMI, resulted in a sensitivity of 90.0%, a specificity of 84.3% and a ratio of the positive likelihood ratio to the negative likelihood ratio of 48.3.

CONCLUSIONS

Our results suggest that endometriosis is associated with elevated levels of sphingomyelins and phosphatidylcholines, which might contribute to the suppression of apoptosis and affect lipid-associated signalling pathways. Our findings suggest novel potential routes for therapy by specifically blocking highly up-regulated isoforms of phosphpolipase A2 and lysophosphatidylcholine acyltransferase 4.

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BACKGROUND

Dizygotic twin pregnancies after IVF treatment are the result of multiple embryos transferred into the uterine cavity, followed by successful double implantation. Factors that increase the chance of multiple implantation after IVF are relatively unknown. The present study aimed to investigate whether features of body composition, such as maternal height, weight and body mass index (BMI) are associated with an increased chance of dizygotic twinning after IVF with double embryo transfer (DET).

METHODS

This study was conducted using data from a large Dutch nationwide cohort that comprised 19 861 women who had IVF or ICSI treatment between 1983 and 1995 (OMEGA study). First ‘fresh’ IVF and ICSI cycles with DET resulting in a delivery of a singleton or twin (living as well as stillborn) were selected. A multivariable logistic regression analysis was performed, with the delivery of a singleton or twin as the dependent variable and height, weight, BMI, maternal age, number of retrieved oocytes, use of alcohol, smoking, highest level of education and parity as independent variables.

RESULTS

Of the 6598 women who completed their first IVF or ICSI cycle, 2375 had DET, resulting in 496 deliveries of 371 singletons and 125 twins. Multivariable regression analysis revealed that tall women (>1.74 cm) and women with a high number of retrieved oocytes (>8) had an increased chance of dizygotic twinning [OR: 1.8 (95% CI: 1.0–3.4) and OR: 2.2 (95% CI: 1.3–3.8), respectively].

CONCLUSIONS

Our data demonstrate that tall stature and increased number of retrieved oocytes independently increase the chance of dizygotic twinning after IVF with DET.

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