Factors associated with failed treatment : an analysis of 121,744 women embarking on their first IVF cycles

Peer reviewedPublisher PD

Induction of Protective Immunity against Chlamydia muridarum Intravaginal Infection with a Chlamydial Glycogen Phosphorylase

We evaluated 7 C. muridarum ORFs for their ability to induce protection against chlamydial infection in a mouse intravaginal infection model. These antigens, although encoded in C. muridarum genome, are transcriptionally regulated by a cryptic plasmid that is known to contribute to C. muridarum pathogenesis. Of the 7 plasmid-regulated ORFs, the chlamydial glycogen phosphorylase or GlgP, when delivered into mice intramuscularly, induced the most pronounced protective immunity against C. muridarum intravaginal infection. The GlgP-immunized mice displayed a significant reduction in vaginal shedding of live organisms on day 14 after infection. The protection correlated well with a robust C. muridarum-specific antibody and a Th1-dominant T cell responses, which significantly reduced the severity but not overall incidence of hydrosalpinx. The GlgP-induced partial protection against upper genital tract pathology suggests that GlgP may be considered a component for a multi-subunit vaccine. These results have demonstrated that intramuscular immunization of mice with purified proteins can be used to identify vaccine antigens for preventing intravaginal infection with C. trachomatis in humans

Age-related natural fertility outcomes in women over 35 years : a systematic review and individual participant data meta-analysis

STUDY FUNDING/COMPETING INTEREST(S) S.J.C. received funding from the University of Adelaide Summer Research Scholarship. B.W.M. is supported by a NHMRC Investigator grant (GNT1176437), B.W.M. reports consultancy for ObsEva, Merck, Merck KGaA, iGenomix and Guerbet. B.W.M. reports research support by Merck and Guerbet.Peer reviewedPostprin

Of all foods bread is the most noble: Carl von Linné (Carl Linneaus) on bread1

Carl von Linné was interested in dietetics, which in his time covered all aspects of a healthy life. As a utilitarian he understood the importance of private economy and paid attention to bread in many of his publications. Two texts, Ceres noverca arctoum and De pane diaetetico, were wholly devoted to bread and bread-making. Linné classified different types of bread, and described their nutritional value and health-related aspects, as well as milling, baking and storing, in detail. While discussing the food habits of social classes Linné accepted as a fact that the peasants and the poor should eat less tasty bread than the rich. The less palatable bread had, however, many nutritional and health advantages. Linné paid much attention to substitutes for grain to be used in times of famine, an important topic in eighteenth century Sweden. He regarded flour made of pine bark or water arum roots as excellent famine food, was enthusiastic about the new plant, maize, but considered potato only as a poor substitute for grain. Linné and his followers praised bread not only as the core component of diet, but also for its versatile role both in health and in disease

Evaluating housing quality, health and safety using an Internet-based data collection and response system: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Typically housing and health surveys are not integrated together and therefore are not representative of population health or national housing stocks. In addition, the existing channels for distributing information about housing and health issues to the general public are limited. The aim of this study was to develop a data collection and response system that would allow us to assess the Finnish housing stock from the points of view of quality, health and safety, and also to provide a tool to distribute information about important housing health and safety issues.</p> <p>Methods</p> <p>The data collection and response system was tested with a sample of 3000 adults (one per household), who were randomly selected from the Finnish Population Register Centre. Spatial information about the exact location of the residences (i.e. coordinates) was included in the database inquiry. People could participate either by completing and returning a paper questionnaire or by completing the same questionnaire via the Internet. The respondents did not receive any compensation for their time in completing the questionnaire.</p> <p>Results</p> <p>This article describes the data collection and response system and presents the main results of the population-based testing of the system. A total of 1312 people (response rate 44%) answered the questionnaire, though only 80 answered via the Internet. A third of the respondents had indicated they wanted feedback. Albeit a majority (>90%) of the respondents reported being satisfied or quite satisfied with their residence, there were a number of prevalent housing issues identified that can be related to health and safety.</p> <p>Conclusions</p> <p>The collected database can be used to evaluate the quality of the housing stock in terms of occupant health and safety, and to model its association with occupant health and well-being. However, it must be noted that all the health outcomes gathered in this study are self-reported. A follow-up study is needed to evaluate whether the occupants acted on the feedback they received. Relying solely on an Internet-based questionnaire for collecting data would not appear to provide an adequate response rate for random population-based surveys at this point in time.</p

Standardizing definitions and reporting guidelines for the infertility core outcome set : an international consensus development study

Acknowledgments We would like to thank the consensus development meeting participants and colleagues at the Cochrane Gynaecology and Fertility Group, University of Auckland, New Zealand. Funding This research was funded by the Catalyst Fund, Royal Society of New Zealand, Auckland Medical Research Fund and Maurice and Phyllis Paykel Trust. The funder had no role in the design and conduct of the study, the collection, management, analysis or interpretation of data or manuscript preparation. Siladitya Bhattacharya was supported by the University of Auckland Foundation Seelye Travelling Fellowship. B.W.M. is supported by a National Health and Medical Research Council Practitioner Fellowship (GNT1082548) This article has not been externally peer reviewed. This article has been published simultaneously in Fertility and SterilityPeer reviewedPublisher PD

Preconception Care and Treatment with Assisted Reproductive Technologies

Couples with fertility problems seeking treatment with assisted reproductive technologies (ART) such as in vitro fertilization should receive preconception counseling on all factors that are provided when counseling patients without fertility problems. Additional counseling should address success rates and possible risks from ART therapies. Success rates from ART are improving, with the highest live birth rates averaging about 40% per cycle among women less than 35 years old. A woman’s age lowers the chance of achieving a live birth, as do smoking, obesity, and infertility diagnoses such as hydrosalpinx, uterine leiomyoma, or male factor infertility. Singletons conceived with ART may have lower birth weights. Animal studies suggest that genetic imprinting disorders may be induced by certain embryo culture conditions. The major risk from ovarian stimulation is multiple gestation. About one-third of live-birth deliveries from ART have more than one infant, and twins represent 85% of these multiple-birth children. There are more complications in multiple gestation pregnancies, infants are more likely to be born preterm and with other health problems, and families caring for multiples experience more stress. Transferring fewer embryos per cycle reduces the multiple birth rate from ART, but the patient may have to pay for additional cycles of ART because of a lower likelihood of pregnancy

Enriching the PhD experience through international doctoral student seminars

Background: Nursing doctoral programs exist in varying models around the world. While there are many measures of success for these programs, one way is through the collaborative opportunities a program provides and the success of the students in maximizing these collaborative efforts (Edwards, Rayman, Diffenderfer, & Stidham, 2016). Doctorally prepared nurses value opportunities to learn from each other and form professional contacts as they prepare for their future careers (Jairam & Kahl, 2012). Seeking international peers through a web-based platform can be used to increase collaboration and peer support. Purpose: The purpose of this presentation is to describe an international doctoral student seminar and the lessons learned in the first year in order to support the development of other international collaborative partnerships by 1) describing the establishment of the group and 2) identifying benefits and barriers to the process. Methods: The International Doctoral Student Collaboration was initiated by two faculty members from King s College London (United Kingdom) following a meeting of The International Scientific Advisory Board (ISAB). After establishing an internal interest in the project, invitations were extended to Johns Hopkins University (USA) and University of Turku (Finland). These collaborators were initially chosen on the basis of their established links between the faculties at these institutions. A steering group comprised of doctoral students from the faculties of Nursing from each University was established to lead on this initiative. The inaugural seminar was held in September 2015 and hosted by King s College London with further seminars hosted in turn by University of Turku and Johns Hopkins University. Due to the success of these seminars, the collaboration has been extended to include doctoral students from University of North Carolina at Chapel Hill (USA). Meetings continue to be held in rotation, with topics of the seminars jointly determined by the participating Universities. The host University then identifies a suitable expert on the chosen subject to facilitate the seminar. Each seminar is conducted via videoconferencing. Between seminars, students continue to network and communicate via other multi-media platforms. Results: Twenty-three students and faculty across the four universities participate in the seminar. Presentations in the first year have focused on how to build an international research profile, how to be involved with the peer review process in academic journals, and how to effectively engage in social media as a researcher. Benefits to the students have included being visiting scholars at each other s university, building a professional network, and utilizing peer support . Students have taken opportunities to meet each other through mutual attendance at conferences and trainings, further strengthening the collaborations. Additionally, the group is currently collaborating on a manuscript for submission. Some of the challenges encountered in the first year have included navigating international time zones and different academic schedules. Also, a lack of shared web-based conference platforms meant that as each institution hosted a seminar, a new system had to be accessed. Discussion: International student collaboration presents a unique opportunity by allowing the student to create a community of support, develop leadership skills, and form an international professional network (Rautenbach & Black-Hughes, 2012). Shared team leadership, with each university taking rotating responsibility for content, has been linked with higher success of virtual teams (Hoch & Kozlowski, 2014). Additionally, researchers have suggested a framework for the enhancement of international scholarship by collaborative learning through a web-based initiative (Wihlbord & Friberg, 2016). This collaboration provides a unique opportunity for doctoral students to form an international professional network and a community of support among peers. Conclusion: In the first year of this international doctoral student collaboration, key benefits to members have been the development of a professional network, leadership skills and peer support. Participation in the seminar encourages early engagement in career building with a focus on supporting international research

Developing a core outcome set for future infertility research : an international consensus development study

Acknowledgements: We would like to thank the Delphi survey and consensus development meeting participants and colleagues at the Cochrane Gynaecology and Fertility Group, University of Auckland, New Zealand. Funding: This research was funded by the Catalyst Fund, Royal Society of New Zealand, Auckland Medical Research Fund, and Maurice and Phyllis Paykel Trust. The funder had no role in the design and conduct of the study, the collection, management, analysis, or interpretation of data, or manuscript preparation. Ben Mol is supported by a National Health and Medical Research Council Practitioner Fellowship (GNT1082548). Siladitya Bhattacharya was supported by University of Auckland Foundation Seelye Travelling Fellowship. This article has not been externally peer reviewed. This article has been published simultaneously in Human ReproductionPeer reviewe

Nitric oxide synthases and tubal ectopic pregnancies induced by Chlamydia infection: basic and clinical insights

Human ectopic pregnancy (EP) remains a common cause of pregnancy-related first trimester death. Nitric oxide (NO) is synthesized from L-arginine by three NO synthases (NOS) in different tissues, including the Fallopian tube. Studies of knockout mouse models have improved our understanding of the function of NOS isoforms in reproduction, but their roles and specific mechanisms in infection-induced tubal dysfunction have not been fully elucidated. Here, we provide an overview of the expression, regulation and possible function of NOS isoforms in the Fallopian tube, highlighting the effects of infection-induced changes in the tubal cellular microenvironment (imbalance of NO production) on tubal dysfunction and the potential involvement of NOS isoforms in tubal EP after Chlamydia trachomatis genital infection. The non-equivalent regulation of tubal NOS isoforms during the menstrual cycle suggests that endogenous ovarian steroid hormones regulate NOS in an isoform-specific manner. The current literature suggests that infection with C. trachomatis induces an inflammatory response that eventually leads to tubal epithelial destruction and functional impairment, caused by a high NO output mediated by inducible NOS (iNOS). Therefore, tissue-specific therapeutic approaches to suppress iNOS expression may help to prevent ectopic implantation in patients with prior C. trachomatis infection of the Fallopian tube