Embryo selection with artificial intelligence: how to evaluate and compare methods?

Journal of Assisted Reproduction and Genetics - Embryo selection within in vitro fertilization (IVF) is the process of evaluating qualities of fertilized oocytes (embryos) and selecting the best...     

Male sexual dysfunction and infertility associated with neurological disorders

Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments including medications, injection therapy and the surgical insertion of a penile implant. Retrograde ejaculation is managed by medications to reverse the condition in mild cases and in bladder harvest of semen after ejaculation in more severe cases. Anejaculation might also be managed by medication in mild cases while assisted ejaculatory techniques including penile vibratory stimulation and electroejaculation are used in more severe cases. If these measures fail, surgical sperm retrieval can be attempted. Ejaculation with penile vibratory stimulation can be done by some spinal cord injured men and their partners at home, followed by in-home insemination if circumstances and sperm quality are adequate. The other options always require assisted reproductive techniques including intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. The method of choice depends largely on the number of motile sperm in the ejaculate.     

Collaborative relationship in preventive home visits to older people

yamada y., vass m., hvas l., igarashi a., hendriksen c. & avlund k. (2010) Collaborative relationship in preventive home visits to older people. International Journal of Older People Nursing 6 , 33–40
doi: 10.1111/j.1748‐3743.2010.00213.x Aim. To describe what characterizes preventive home visits with collaborative relationships among non‐disabled home‐dwelling older people in Japan. Background. Preventive home visits have the potential to result in improved health outcomes among older people. Collaboration, mutual understanding and trust between visitor and the visited person seem to work as a vehicle, but little is known about which part of the encounters contributes to a collaborative relationship. Methods. We performed a retrospective qualitative analysis of visiting records written by preventive home visitors immediately after the visits were made. A collaborative relationship was predefined as a favourable change in behaviour seen in the visited person during the study period. Visitor characteristics were analysed from 248 records where 37 cases of collaborative relationships were documented. Results. The three most important elements associated with a collaborative relationship were (i) visitor communication skills i.e. mastering ‘enhancing motivation’ and ‘having patience and coping with frustrations’ in difficult and problematic situations, (ii) professionalism, which includes ‘professional instruction and guidance’ based on documented knowledge in health and social domains combined with an overall ‘caring approach’ and (iii) practical actions which imply an ‘immediate concrete response to identified needs or problems’ and ‘individually tailored advice’ to suit the older person’s daily life. Conclusions. Preventive home visitor communication skills and professionalism, and practical actions after the visits characterized cases, where favourable changes in behaviour were obtained in non‐disabled home‐dwelling older people in Japan. Relevance to clinical practice. Education should be emphasized, because preventive home visitor competence may be the most important element of proactive assessment schemes to obtain beneficial outcomes.