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Transposable elements are molecular parasites that persist in their host genome by generating new copies to outpace natural selection. Transposable elements exert a large influence on host genome evolution, in some cases providing adaptive changes. Here we measure the fitness effect of the transposable element insertions in the fission yeast Schizosaccharomyces pombe type strain by removing all insertions of its only native transposable element family, the long terminal repeat retrotransposon Tf2. We show that Tf2 elements provide a positive fitness contribution to its host. Tf2 ablation results in changes to the regulation of a mitochondrial gene and, consistently, the fitness effect are sensitive to growth conditions. We propose that Tf2 influences host fitness in a directed manner by dynamically rewiring the transcriptional response to metabolic stress. [ABSTRACT FROM AUTHOR]

Colleges increasingly are recognized as student workplaces, inspiring campus leaders to create healthier campus environments. Yet challenging this vision is burgeoning research regarding the health risks of sedentary behavior, an under-studied college health concern that implies deleterious health outcomes and, by extension, academic impediments as well. Can movement be incorporated into academic activities such as studying or reading? This question—particularly relevant to libraries due to their increasing use as study spaces—requires the expansion of standard methods of evaluating student health needs and behaviors. We propose Post-Occupancy Evaluation (POE) methods as a novel way to investigate sedentary behaviors in a campus library and identify designs and practices to help promote movement. In 2012 and 2013, as part of an undergraduate architecture class, we conducted two POEs of Berkeley's newest library to learn how the space is used and, inspired by new research about the perils of sedentary behavior, we also considered how the library could be used. Through our findings we confirmed the changing role of campus libraries as study spaces, observed social and built environment contexts of sedentary behaviors in library settings, and identified possible interventions to introduce postural variation and physical activity into observed patterns of library use. [ABSTRACT FROM AUTHOR]

In the present commentary, we raise the question whether the COVID-19 pandemic should be seen as just the dress rehearsal for what awaits us in the impending climate crisis. Many factors have helped us navigate the challenge of this coronavirus pandemic and continue to do so. These include: recognizing scientific expertise, medical education, and digitalization as important driving forces, providing us with key information about the SARS-CoV-2 virus, as well as integrating it into our curricula and promoting action-oriented research. However, the "premiere of the climate pandemic" will, in all likelihood, confront us with even greater challenges, difficulties, and threats. Adhering to scientific findings, promoting medical education about the effects of global warming and using the power of digitalization, as well as consciously engaging in our role as medical caregivers and leaders will make a decisive contribution to providing impetus for climate action. [ABSTRACT FROM AUTHOR]

Human milk spoils due to bacterial, yeast, or mold contamination. Current domestic methods of assessing milk spoilage are subjective or rely on time and temperature‐based guidelines. A key unmet food safety need remains the objective assessment of human milk spoilage. Experiments were conducted using a simplified human milk spoilage model based on goat's milk as a human milk surrogate, spiked with a single bacterial strain (Staphylococcus epidermidis), in which pH and carbon dioxide (CO2) concentration were measured along with bacteria count over 160 hr. Bacteria count correlated highly with CO2 but not with pH. A 0.21% CO2 concentration threshold could be defined for milk spoilage (correlating to a bacteria count threshold of 105 CFU/ml), with sensitivity and specificity above 84%. These findings suggest that CO2 measurement is a promising method to detect S. epidermidis growth in milk which merits further investigation for the objective and quantitative assessment of milk spoilage. [ABSTRACT FROM AUTHOR]

This article explores how the motif of Uzziah's צרעת‎ in 2 Kgs. 15:1-7 has inspired the Chronicler, Josephus, and rabbinic commentators. In the Book of Kings, Uzziah's disorder is used to explain an abnormal political arrangement in which the crown prince served as co-regent. The Chronicler, by contrast, takes Uzziah's disorder as an opportunity to expound on the king's sacrilegious behavior. The Chronistic tradition is further developed by Josephus and the rabbis who reinterpret Uzziah's צרעת‎ as sign of an abnormal emotional life. Consequently, each source displays its own understanding of צרעת‎ and its implications concerning the king's conduct and character. These differences in the depiction of Uzziah's disease point to dissimilar frameworks of interpretation which are motivated by different attitudes toward the temple and the Davidic Dynasty. [ABSTRACT FROM AUTHOR]

There seems to be a common perception among medical educators that curiosity is untapped or even subjugated in medical education. This review aims to summarize research on curiosity across the fields of psychology, neuroscience, and education and report its potential to advance medical education. For this narrative review multiple online libraries were searched using variations of the terms curiosity and school/education/learning. Additional studies were reviewed using the reference lists of included studies, and all studies were assessed for quality and relevance. This review of previous research on curiosity shows that curiosity can significantly impact characteristics relevant to medical education, particularly mental health and learning. In addition, the authors outline how curiosity is linked to other epistemic emotions such as anxiety, novelty, surprise, and uncertainty. Finally, an epistemic-emotion-framework (EEF) is proposed to help educators encourage curiosity in medical students. By drawing from other research fields, medical educators can learn valuable lessons about the importance of curiosity and how to influence it. This review provides an overview of current research and a framework for how the potential of curiosity can be harnessed to play an important role in students' medical education. [ABSTRACT FROM AUTHOR]

Scholars tend to view the healing of Naaman and the subsequent affliction of Gehazi in 2 Kgs 5 as polemic against magic and non-Israelite ideas about disease and healing. However, in analyzing the motif of öøòú as literary device it can be demonstrated that 2 Kgs 5 is not opposed to magic. My paper will show instead how the consultation between the Aramean and the Israelite kings, the depiction of Naaman's healing, as well as the circumstances of Gehazi's affliction draw from generic ideas about magic to bring into sharper focus the power of the prophet and the presence of Yahweh in the land of Israel. [ABSTRACT FROM AUTHOR]

In 2 Chr 16:12b, King Asa is criticized for turning to physicians in his time of sickness. Scholars disagree about the reasons for the Chronicler's disapproval of Asa's behavior. In this essay, I argue that Asa's mistake consisted of turning to physicians alone when he should also have consulted priests and prophets. Support for this reading can be found in Sir 38:1-15, which describes the role of physicians in consideration of priestly and prophetic roles in healing and mediating between humans and God. Careful analysis of Sir 38:1-15 illustrates that physicians are endowed with divine wisdom but cannot represent God directly. Consequently, Asa's ill-fated consultation with the physicians demonstrates that their service should always be combined with prayer and sacrifices. [ABSTRACT FROM AUTHOR]

For almost a century biblical scholars have commented on the magical nature of Zechariah’s curse vision (Zechariah 5,1–4). In this vision, the prophet witnesses a flying scroll which represents a curse pronounced by God (Zech 5,1–4). Recent insights concerning the rationale of magic and the function of curses allow us to take a new look at this vision and evaluate how the prophetic author matched the elements of writing and speech to create a sense of magic. For this purpose, Zechariah 5,1–4 will be read against the backdrop of ancient Near Eastern, Levantine and biblical curse traditions. This paper shows how the prophetic author drew on curse traditions of the past to shape his ideas about God’s role in an ideal future in which the wicked would become subject to divine punishment. [ABSTRACT FROM AUTHOR]

As the United States adjusts to the necessity of ecological sustainability, buildings play an important role because of their use of resources--and because they are potent nonverbal symbols of new societal values. The David Brower Center in Berkeley, California, strives to be a model for sustainability. Environmental impact is often the focus of those concerned with sustainability, but here, additionally, the designers aim to raise public awareness of sustainability through the building. For this reason, this building became the site for a postoccupancy evaluation class exercise; architecture students analyzed the building and what it communicates about sustainability from the perspective of its users. Findings indicate that many people did not adequately read the building's green design characteristics: Social and symbolic communication could be improved by increasing signage and evolving clearer symbolism for "green." [ABSTRACT FROM AUTHOR]

The Priestly Source makes no explicit reference to the demonic when describing pollution which supposedly sets it apart from non-biblical conceptualizations of impurity. Most scholars explain the Priestly disregard for demons by referring to the advance of monotheism and the subsequent eradication of supernatural forces other than God. Depending on whether monotheism is viewed as gradual process or as the foundation of Israelite religion, commentators either detect a weakened demonic quality in Priestly pollution or claim that the Priestly Source has always been of a non-demonic nature. However, in recent years the idea that monotheism pervades most hooks of the Hebrew Bible has been increasingly called into question. At the same time, the extensive publication of Assyro-Babylonian ritual texts allows for better understanding of Assyro-Babylonian conceptualizations of impurity. These developments necessitate the reevaluation of the current views on Priestly pollution by examining Assyro-Babylonian texts pertaining to impurity and the demonic. Special attention is given to context and dating of the cuneiform sources used to exemplify the non-demonic nature of Priestly impurity. This renewed comparison of Priestly and Assyro-Babylonian impurity highlights how the Priestly writer frames the concepts of pollution within the context of the sanctuary and its maintenance. The Assyro-Babylonian texts dealing with impurity and demons, by contrast, focus on the individual and his/her relationship to the personal god rather than temple maintenance. Likewise, cuneiform texts that deal with pollution and temple maintenance do not concern themselves with demonic affliction. Consequently, it can be argued that the non-demonic nature of impurity in the Priestly Source is the result of the Priestly focus on the sanctuary and does not give witness to an underlying theological ideal. [ABSTRACT FROM AUTHOR]

Tropomyosin, a coiled-coil protein that binds along the length of the actin filament, is a universal regulator of the actin cytoskeleton. We have taken a bioinformatics/proteomic approach to studying structure-function relationships in this protein. The presence of a single, essential tropomyosin gene, cdc8, in fission yeast, Schizosaccharomyces pombe, enables a systems-based approach to define the residues that are important for cellular functions. Using molecular evolution methodologies we identified the most conserved residues and related them to the coiled coil structure. Mutants in which one or more of 21 of the most conserved surface residues was mutated to Ala were tested for the ability to rescue growth of a temperature-sensitive cdc8 mutant when overexpressed at the restrictive temperature. Based on altered morphology of the septum and actin cytoskeleton, we selected three sets of mutations for construction of mutant cdc8 strains using marker reconstitution mutagenesis and analysis of recombinant protein in vitro: D16A.K30A, V114S.E117A.H118A and R121A.D131A.E138A. The mutations have sequence-specific effects on cellular morphology including cell length, organization of cytoskeletal structures (actin patches, actin cables and contractile rings), and in vitro actin affinity, lending credence to the proteomic approach introduced here. We propose that bioinformatics is a valid analysis tool for defining structure-function relationships in conserved proteins in this model organism. [ABSTRACT FROM AUTHOR]

Background: Alveolar echinococcosis (AE) is a serious parasitic zoonotic disease that resembles malignancy with clinically silent infiltrative growth predominantly involving the liver. AE patients show high levels of comorbid psychological burden and fear of disease progression. This study aimed to examine AE patients' perspective on their disease-related psychosocial burden using qualitative methods. Methods: We conducted N = 12 semi-structured interviews with AE patients focusing on their disease-related psychosocial burden, coping strategies, information seeking behavior, and subjective illness concepts. To this end, AE patients from a previous quantitative cross-sectional study were invited to participate. After verbatim transcription, interviews were analyzed thematically. Results: After analysis, data was grouped into five main themes: A) Perceived disease-related burden, B) Coping with disease-related burden, C) Disease-related impact on their social environment, D) Facing the future with the disease, and E) Disease-related information seeking behavior and subjective illness concepts. All participants perceived AE as a severe disease with inextricably linked biological, psychological, and social effects. Key positive influences reported included the provision of information and access to informal and formal support, including the ability to lead active personal and professional lives for as long as possible. Self-directed, web-based information seeking often led to increased feelings of hopelessness and anxiety. Conclusion: Our findings underscore the need to consider psychosocial morbidity in AE patient management. To reduce psychological burden, address disease-related apprehensions, and to prevent stigmatization, health professionals need to provide AE patients with comprehensive disease-related information to improve patient and social awareness. Author summary: Alveolar echinococcosis (AE) is a serious parasitic zoonotic disease that resembles malignancy with clinically silent infiltrative growth predominantly involving the liver. Semi-structured interviews were conducted with N = 12 AE patients focusing on their disease-related psychosocial burden, coping strategies, information seeking behavior, and subjective illness concepts. All participants perceived AE as a severe disease with inextricably linked biological, psychological, and social effects. Key positive influences reported included the provision of information and access to informal and formal support, including the ability to lead active personal and professional lives for as long as possible. Self-directed, web-based information seeking often led to increased feelings of hopelessness and anxiety. Disease-related apprehensions, and to prevent stigmatization, health professionals need to provide AE patients with comprehensive disease-related information to improve patient and social awareness. [ABSTRACT FROM AUTHOR]

An introduction to the journal, which focuses on research related to social issues in urban design, is presented.

Abstract: ClpA is an Hsp100 chaperone that uses the chemical energy of ATP to remodel various protein substrates to prepare them for degradation. It comprises two AAA+ modules and the N-domain, which is attached N-terminally to the first AAA+ module through a linker. On the basis of cryo-electron microscopic and X-ray crystallographic data it has been suggested that the linker confers mobility to the N-domain. In order to define the role of the N-domain in ClpAP-dependent substrate degradation we have generated a ΔN variant at the protein level by introducing a protease cleavage site. The ClpA molecule generated in this way lacks the N-domain and the associated linker but is impaired only slightly in the processing of substrates that are degraded independently of ClpS. In fact, it shows increased catalytic efficiency in the degradation of ssrA-tagged GFP compared to ClpAwt. The role of the linker attaching the N-domain to the bulk of the molecule was probed by characterizing variants with different lengths of the linker. The degradation efficiency of a ClpS-dependent N-end rule substrate, FRliGFP, is reduced for linkers that are shorter or longer than natural linkers but remains the same for the variant where the linker is replaced by an engineered sequence of equivalent length. These results suggest that the flexible attachment of the N-domains to ClpA allows their recruitment to the pore on demand for certain substrates, while allowing them to move out of the way for substrates binding directly to the pore. [Copyright &y& Elsevier]

Reports on the list of opportunities for the self-care industry after the revision of the pharmaceutical legislation. Benefits of economic and public health values for self-care; Support of several politicians on the importance of self-medication; Recognition of self-medication for the preparation of the legislation's revision.

Basic leucine zipper (bZIP) transcription factors are dimeric proteins that recognize dyadic and mostly palindromic DNA sites. Dimerization of bZIP transcription factor GCN4 is linked to the folding of its C-terminal leucine zipper domain. However, monomeric GCN4, lacking a folded leucine zipper, also recognizes the DNA site with dimerization taking place on the DNA. Here we report the kinetics of DNA recognition by unfolded monomeric and folded dimeric derivatives of GCN4 using a 19 bp double-stranded DNA containing a palindromic CRE site. The rate of DNA binding of both monomeric and dimeric GCN4 has a bimolecular rate constant of 3-5 &times 10[sup8] M[sup-1] s[sup-1], which is near the diffusion limit. Because the rate of dimerization of GCN4 is slower (1.7 × 10[sup7] M[sup-1] s[sup-1]) than the rate of DNA association, the formation of the dimeric GCN4-DNA complex through consecutive binding of two monomers (monomer pathway) is faster when starting from free monomers. Thus, the results presented here support facilitated and rapid target recognition by the monomeric transcription factor. However, DNA binding of preformed folded dimeric GCN4 is as rapid as complex formation through the monomer pathway. Therefore, the monomer and dimer pathways are kinetically equivalent if monomeric and dimeric GCN4 are at equilibrium. Hence, the dimer pathway may also have a role under in vivo conditions. The lower affinity of GCN4 in which two DNA contacting residues have been mutated is due exclusively to the faster dissociation of the mutant protein-DNA complex and not to slower complex formation. [ABSTRACT FROM AUTHOR]

Examines the site-directed mutagenesis at the DNA binding cleft of the EcoRV enzyme DNA-(adenine-N6)-methyltransferase. Specificity of EcoRV enzyme during molecular evolution; Amino acid residues of the enzyme; Mechanism of DNA recognition; Evolutionary pathway for changing specificity.

Presents an overview of the market for herbal medicinal products in Europe. Organization representing the manufacturers of non-prescription drugs; Situation of herbal medicinal products; Herbal products as medicines; Political support for herbal medicinal products; Activities on herbal medicinal products.

Plants have always been an important source of treatment. The important contribution of phytotherapy became particularly recognised through European Directive 2004/24/EC ( Directive 2004/24/EC, 2004 ), which set up a new Committee dedicated to herbal medicinal products at the European Medicines Agency (EMA). In addition, it created a new status for traditional herbal medicinal products by making possible their simplified “registration” based on plausible level of efficacy. Nearly 10 years after the creation of this new framework, an impressive number of monographs were established. However, implementation remains a challenge. There is also a critical need to encourage innovation and research and to ensure that new pieces of legislation are applied to herbal medicinal products taking due account of their characteristics. This article reflects the concerns and expectations of the European manufacturers of herbal medicines. [ABSTRACT FROM AUTHOR]

Chordae tendineae rupture (CTR) is a potentially life-threatening cardiac event often resulting in Acute mitral regurgitation (AMR). We assessed Post-traumatic stress disorder (PTSD), depression, and anxiety symptoms in n = 21 CTR patients with AMR (age 82.3 ± 4.2 years; 66.7% men) and compared them to n = 23 CTR patients with Chronic mitral regurgitation (CMR) and n = 35 Myocardial infraction (MI) patients. Regression analyses revealed that PTSD scores were significantly higher in CTR patients with AMR than in CTR patients with CMR or MI patients. CTR patients with CMR had the lowest levels of PTSD-symptoms. Depression and anxiety scores were elevated across all three groups. Our results suggest that psychosocial factors need to be considered in CTR patients' care. [ABSTRACT FROM AUTHOR]

The article offers information on the 2slides4future, an initiative launched by a group of medical university hospital staff in May 2019 for teachers and lecturers advocating climate change education and teacher-learner dialogue. Topics covered include the problems that were addressed by the initiative, how the initiative was implemented, and the lessons that were learned by the students from the initiative.

A letter to the editor is presented that responds to an article in volume 526 of the journal on pharmaceutical pollution.

Curiosity, which has been called the third pillar of academic achievement and positively predicts academic performance (von Stumm et al., 2011), is widely recognized as an important factor in acquiring knowledge and skills in medical training, and may be critical for students' sound mental health. Medical educators have advocated that curiosity should play a more significant role in medical training and have criticized didactic barriers impeding student curiosity. However, in medical training, curiosity is understudied partly due to a lack of methods for measuring curiosity. Therefore, this study was designed to develop and validate a scale to measure medical curiosity. After reviewing the literature and interviewing a panel of experts (n = 7), 25 preliminary items assessing medical curiosity were developed and administered to n = 305 medical students (n = 163 female and n = 142 male) at Heidelberg University across all medical school years. Following exploratory factor analysis (EFA) with oblique (promax) rotation, we measured medical curiosity in a medical student sample. We have identified two distinct factors: intellectual medical curiosity (IMC) and social medical curiosity (SMC). IMC describes the desire to acquire medical knowledge for curiosity's sake, while SMC refers to curiosity about human nature and, in particular, patient health. Both factors showed good psychometric properties, with eigenvalues of 6.7 and 3.5, explaining 26.6% and 14.0% of the variance and internal consistencies of 0.796 and 0.866, respectively, and high convergent and discriminant validity. While first-year students showed significantly higher IMC scores than final-year medical students, SMC scores remained stable and tended to increase throughout medical school. This study has succeeded in developing the first scale to measure aspects of medical curiosity and, thus, lays the groundwork for future studies examining medical students' curiosity. A deeper understanding of medical students' curiosity can help to foster this curiosity effectively. [ABSTRACT FROM AUTHOR]

Long terminal repeat (LTR) retrotransposons are an abundant class of genomic parasites that replicate by insertion of new copies into the host genome. Fungal LTR retrotransposons prevent mutagenic insertions through diverse targeting mechanisms that avoid coding sequences, but conserved principles guiding their target site selection have not been established. Here, we show that insertion of the fission yeast LTR retrotransposon Tf1 is guided by the DNA binding protein Sap1 and that the efficiency and location of the targeting depend on the activity of Sap1 as a replication fork barrier. We propose that Sap1 and the fork arrest it causes guide insertion of Tf1 by tethering the integration complex to target sites. [ABSTRACT FROM AUTHOR]

Pregnant refugees and new mothers are at high risk of developing mental health problems. Previous research has highlighted an increase in adverse pre‐, peri‐ and postpartum outcomes in refugee women and their newborns. This descriptive study aimed to present the characteristics and needs of refugee women who attended a psychosocial walk‐in clinic addressing pregnant refugees' and new mothers' maternity mental healthcare needs in a state registration and reception centre in Germany. We assessed all patients that consulted the clinic and received interventions during the first 28 weeks after it opened, collecting information on symptoms, diagnoses, attitudes towards and experience of pregnancy, birth, obstetric care and applied psychosocial interventions during consultations. Between November 2017 and May 2018, N = 120 pregnant refugees and new mothers attended the clinic. Most patients were diagnosed with post‐traumatic stress‐, adjustment‐ or depressive disorder. While 69.6% of the women reported physical and mental health problems during pregnancy, 87.4% experienced obstetric complications. Trauma‐informed and psychoeducational interventions were primarily used during counselling sessions. Our data underpin the glaring disparities in refugee maternal healthcare in Germany. Maternal care designed to meet the specific needs of pregnant refugees and mothers is essential. More targeted, evidence‐based and cost‐effective interventions are needed. Our psychosocial walk‐in clinic is a first step towards ensuring primary care delivery for refugee women during the particularly vulnerable period of pregnancy and early motherhood. [ABSTRACT FROM AUTHOR]

This article introduces the university initiative "Heidelberg Clinical Standards", a project that provides medical students with standardized clinical-practical and communication skills using training videos and manuals. Medical students from more than 20 medical faculties in Germany, Austria, and Switzerland can access the manuals' e-versions and the corresponding training videos via our e-learning platform. Accordingly, the Heidelberg teaching and examination standards have become an important reference for teaching clinical practical skills to medical students in German-speaking countries. [ABSTRACT FROM AUTHOR]

Aim: Medical training is undergoing a dramatic shift toward alternative training methods due to the SARS-CoV-2 pandemic. This study is the first to examine medical students' expectations, experiences, and mental burden related to volunteering in COVID-19 patient support and treatment services using semi-structured interviews. Methods: In May 2020, all 194 Heidelberg University Medical School students involved in volunteer COVID-19 support and treatment services were invited to participate in a cross-sectional, qualitative interview study. The semi-structured interviews were digitally recorded, transcribed, and then analyzed using Mayring's principles for content analysis. Results: We interviewed 12 medical students (8 female, mean age 23.2 years, mean medical training 3.7 years) working in Heidelberg COVID-19 crises management services, i.e., the Heidelberg Medical Hospital COVID-19 inpatient and outpatient units. The analysis revealed two key themes: "Expectations and structural barriers" and "Experiences and mental burden". The participants reported uncertainty and apprehension before starting their voluntary work. Although they initially found volunteering to be somewhat disorganized, their roles became clearer with time. In addition, they reported good team cohesion, which helped reduce initial concerns and uncertainties. The participants also felt that working in the field had helped them maintain their professional identification while standard medical classes and bedside learning were suspended due to the COVID-19 crises. Overall, they reported little volunteer work-related mental burden. Conclusions: The participants felt that volunteering during the COVID-19 crisis had benefited their professional development. A designated liaison person, psychosocial support, and introductory and accompanying courses could help alleviate initial concerns and interim difficulties in future crisis-related assignments. [ABSTRACT FROM AUTHOR]

Background: Emergency call-takers and dispatchers (ECDs) field emergency calls and dispatch the appropriate emergency services. Exposure to the callers' traumatic experiences can lead to psychological stress and even to secondary traumatic stress (STS). In addition, previous studies suggest that ECDs may also suffer from posttraumatic stress disorder (PTSD), depression and anxiety disorders. Objectives: To investigate the prevalence of STS and to screen for PTSD, depression and anxiety disorders in ECDs. We further aimed to identify sociodemographic variables and attachment styles as possible risk factors for higher STS symptom load in ECDs. Methods: STS and PTSD regarding lifetime traumatic events, as well as depression and anxiety disorders, were investigated in N = 71 ECDs. Multiple regression analysis was performed to identify possible risk factors for higher STS symptom load. Results: The analysis determined a prevalence of 8.5% for moderate STS and 2.8% for severe STS. A total of 11.3% of the ECDs screened positive for PTSD, 15.5% for depression and 7.0% for anxiety disorders. A higher number of children and the absence of a secure attachment style were identified to be significantly associated with higher STS symptom load. Conclusions: STS resulting from exposure to traumatic emergency caller content is a common phenomenon among ECDs. Specific sociodemographic variables and the attachment style are significant risk factors of STS symptom load. ECDs should receive regular psychoeducational interventions and supervision to identify and mitigate mental distress at an early stage. [ABSTRACT FROM AUTHOR]

Background: Assisted reproduction techniques can minimize the risk of infection and treat possible sterility associated with serodiscordant couples.Methods: We assessed the efficacy of these techniques in 57 couples in which at least one partner had human immunodeficiency virus (HIV-1) infection that was currently under control (47 men and 10 women). The semen of seropositive men was prepared and tested for viruses. Assisted reproduction techniques included intrauterine insemination (IUI), IVF and especially ICSI, with ovarian stimulation that used a long agonist protocol and recombinant FSH. Embryos were transferred on day 3 after oocyte retrieval.Results: For couples with seropositive men, five IUI and 49 IVF or ICSI attempts were perfomed, whilst for seropositive women these numbers were three IUI and 12 IVF or ICSI. No pregnancy occurred following the eight IUI trials. Seroconversion was not observed in any partners of seropositive men. Efficacy of treatment for these couples with ICSI was good, the clinical pregnancy rate per embryo transfer was 48.8%. The results for seropositive women were disappointing, with a clinical pregnancy rate per embryo transfer of 9.1%. Fourteen babies from 47 treated couples have so far been born and no pregnancies from IUI.Conclusions: Assisted reproduction techniques and particularly ICSI provide HIV-1-seropositive men with a safe and highly effective means of fathering children. These techniques may be less effective for seropositive women. [ABSTRACT FROM AUTHOR]

BACKGROUND: Assisted reproduction techniques can minimize the risk of infection and treat possible sterility associated with serodiscordant couples. METHODS: We assessed the efficacy of these techniques in 57 couples in which at least one partner had human immunodeficiency virus (HIV-1) infection that was currently under control (47 men and 10 women). The semen of seropositive men was prepared and tested for viruses. Assisted reproduction techniques included intrauterine insemination (IUI), IVF and especially ICSI, with ovarian stimulation that used a long agonist protocol and recombinant FSH. Embryos were transferred on day 3 after oocyte retrieval. RESULTS: For couples with seropositive men, five IUI and 49 IVF or ICSI attempts were perfomed, whilst for seropositive women these numbers were three IUI and 12 IVF or ICSI. No pregnancy occurred following the eight IUI trials. Seroconversion was not observed in any partners of seropositive men. Efficacy of treatment for these couples with ICSI was good, the clinical pregnancy rate per embryo transfer was 48.8%. The results for seropositive women were disappointing, with a clinical pregnancy rate per embryo transfer of 9.1%. Fourteen babies from 47 treated couples have so far been born and no pregnancies from IUI. CONCLUSIONS: Assisted reproduction techniques and particularly ICSI provide HIV-1-seropositive men with a safe and highly effective means of fathering children. These techniques may be less effective for seropositive women. [ABSTRACT FROM AUTHOR]