Social disparities in the use of ART treatment: a national register-based cross-sectional study among women in Denmark.

STUDY QUESTION: How are educational level, labor market attachment and income associated with receiving a first ART treatment in either the public or private healthcare sector among women in Denmark? SUMMARY ANSWER: Higher educational level and income as well as labor market attachment were associated with higher probability of initiating ART treatment at public and private fertility clinics among women in Denmark. WHAT IS KNOWN ALREADY: Infertility is common in populations worldwide, and the approach to this issue differs between societies and healthcare systems. In the public Danish healthcare system, ART treatment is free of charge, and the direct cost for patients is therefore low. In the private healthcare sector in Denmark, ART treatment is self-financed. There is limited knowledge about the association between socioeconomic factors and seeking ART treatment, although previous studies have indicated that higher socioeconomic status is associated with seeking ART treatment. STUDY DESIGN, SIZE, DURATION: Women undergoing ART treatment during 1994-2016 registered in the Danish IVF register were individually linked with data from sociodemographic population registers using the Danish Personal Identification number. The study population consisted of 69 018 women treated with ART and 670 713 age-matched comparison women from the background population with no previous history of ART treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS: The women included in the analyses were aged 18-45 years. The associations between attained educational level, labor market attachment and income and receiving a first ART treatment attempt were investigated for women either initiating treatment in the public sector or in the private sector, respectively. Information on age and origin was included as potential confounders, and odds ratios (ORs) were estimated in logistic regression models. In addition, analyses were stratified by age group to investigate potential differences across the age span. MAIN RESULTS AND THE ROLE OF CHANCE: Adjusted results showed increased odds of receiving a first ART treatment in either the public or private sector among women with a higher educational level. Furthermore, women in employment were more likely to receive a first ART treatment in the public or private sector compared to women outside the workforce. The odds of receiving a first ART treatment increased with increasing income level. Surprisingly, income level had a greater impact on the odds of receiving a first ART treatment in the public sector than in the private sector. Women in the highest income group had 10 times higher odds of receiving a first ART treatment in the public sector (OR: 10.53 95% CI: 10.13, 10.95) compared to women in the lowest income group. Sub-analyses in different age groups showed significant associations between ART treatment and income level and labor market attachment in all age groups. LIMITATIONS, REASONS FOR CAUTION: Our study does not include non-ART treatments, as the national IVF register did not register these types of fertility treatments before 2007. WIDER IMPLICATIONS OF THE FINDINGS: In Denmark, there is equal access to medically assisted reproduction treatment in the publicly funded healthcare system, and since there is no social inequality in the prevalence of infertility, social inequality in the use of ART treatment would not be expected as such. However, our results show that social inequality is found for a first ART treatment attempt across publicly and privately funded ART treatment across the socioeconomic indicators, educational level, labor market attachment and income. STUDY FUNDING/COMPETING INTEREST(S): The funding for the establishment of the Danish National ART-Couple II Cohort (DANAC II Cohort) was obtained from the Rosa Ebba Hansen Foundation. The authors have no conflict of interest to declare. TRIAL REGISTRATION NUMBER: N/A.

Lethal and sublethal effects of insecticides on the survival and reproduction of Brevipalpus yothersi (Acari: Tenuipalpidae).

The overuse of insecticides to control vector insects such as Diaphorina citri Kuwayama in citrus groves has altered the population dynamics of pest mites. Among phytophagous mites, population outbreaks of citrus leprosis mite, Brevipalpus yothersi Baker, have been increasingly intense and frequent in Brazilian citrus groves. Despite the great importance of the B. yothersi mite for citrus production, the lethal and sublethal effects of insecticides on this mite have not yet been studied. Therefore, in this study, the effects of insecticides commonly used for D. citri control on B. yothersi mortality, reproduction, and instantaneous growth rate were assessed. For this, two experiments were carried out, one under controlled conditions and another in a greenhouse. The insecticides tested were beta-cyfluthrin, bifenthrin, buprofezin, chlorpyrifos, dimethoate, pyriproxyfen, and thiamethoxam at 0 (control), 0.0625, 0.125, 0.25, 0.5, 1, and twofold the recommended insecticide concentration for D. citri control. The pyriproxyfen insecticide provided high mortality of B. yothersi even at low concentrations. Furthermore, this insecticide negatively interfered with the reproduction of this mite. Beta-cyfluthrin, bifenthrin, buprofezin, chlorpyrifos, dimethoate, and thiamethoxam, in the tested concentrations, showed low impact on citrus leprosis mite. Regarding the reproduction of the mite, no significant increase in fecundity was observed on B. yothersi females exposed to insecticide residues, regardless of the concentration tested. Therefore, the application of these insecticides in the management of pest insects is unlikely to promote an increase in the citrus leprosis mite population.

Live yeast in juvenile diet induces species-specific effects on Drosophila adult behaviour and fitness.

The presence and the amount of specific yeasts in the diet of saprophagous insects such as Drosophila can affect their development and fitness. However, the impact of different yeast species in the juvenile diet has rarely been investigated. Here, we measured the behavioural and fitness effects of three live yeasts (Saccharomyces cerevisiae = SC; Hanseniaspora uvarum = HU; Metschnikowia pulcherrima = MP) added to the diet of Drosophila melanogaster larvae. Beside these live yeast species naturally found in natural Drosophila populations or in their food sources, we tested the inactivated "drySC" yeast widely used in Drosophila research laboratories. All flies were transferred to drySC medium immediately after adult emergence, and several life traits and behaviours were measured. These four yeast diets had different effects on pre-imaginal development: HU-rich diet tended to shorten the "egg-to-pupa" period of development while MP-rich diet induced higher larval lethality compared to other diets. Pre- and postzygotic reproduction-related characters (copulatory ability, fecundity, cuticular pheromones) varied according to juvenile diet and sex. Juvenile diet also changed adult food choice preference and longevity. These results indicate that specific yeast species present in natural food sources and ingested by larvae can affect their adult characters crucial for fitness.

Life history tradeoffs in humans: increased life expectancy with sperm count reduction.

Although not without controversy, as a general trend, the human sperm count is declining world-wide. One major reason for such a decline is an increase in the human life-span.  According to the life history tradeoff theory, fecundity is inversely related to the lifespan; the longer the lifespan, the lower the fecundity. This is essential to the maintainance of diversity and balance of different species. Such a corrleation validated by experimental data that show that the extension of life in Caenorhabditis elegans, Drosophila and Rodents is  associated with reduction in fecundity. The demographic data from a public data source, shows that the total fertility rate is positively correlated with the infant death rate, it is inversely correlated with the life expectancy. We postulate that the fall in spermatogenesis might be regulated by the neuroendocrine system that underlie human longevity.

Factors affecting prevailing population levels of Brevipalpus yothersi (Acari: Tenuipalpidae) in citrus areas affected by citrus leprosis in the State of Sao Paulo, Brazil.

Brevipalpus yothersi Baker (Acari: Tenuipalpidae) was recently confirmed as one of the main vectors of citrus leprosis. Knowledge about this mite's biology is essential to understand its population dynamics, in order to solve management issues in citrus orchards and explain why citrus leprosis is more severe in some regions. This paper aimed to study biological factors affecting prevailing population levels of B. yothersi and incidence of citrus leprosis. Mites were sampled from orchards in the south, north and northwestern regions of São Paulo State, Brazil. We assessed duration of the developmental stages, oviposition, incubation period, egg viability, longevity, net reproductive rate (Ro), mean generation time (T), intrinsic rate of increase (rm) and finite rate of increase (λ). There were small differences in parameter values between the three populations. Our results indicated that the various measures adopted in the control of the three populations did not lead to major biological differences between populations for the evaluated parameters.

The leprosarium of Saint-Thomas d'Aizier: The cementochronological proof of the medieval decline of Hansen disease in Europe?

This study compares the adult survivorship profiles of people interred in the Saint-Thomas d'Aizier leprosarium, estimated by cementochronology, to eight archaeological series in northern France dated from Late Antiquity to the Late Middle Ages, periods of significant visibility for Hansen's disease (leprosy). The goals are to understand the impact of leprosy on various social groups and to explore the cause of leprosy's decline by analyzing male and female fertility. Survival rates differed between medieval leprosy-free sites and the Saint-Thomas d'Aizier leprosarium, although this difference was statistically significant only for the female leprosarium sample. The selective female frailty, a consequence of social exclusion and the collapse of the quality of life, combined with the infertility of lepromatous couples, offer a multi-causal explanation to the end of the expansion and then decline of leprosy in southern and western European countries.

Menstrual irregularities, fertility status, and ovarian function in female patients with leprosy in India.

BACKGROUND: Gonadal involvement in males in lepromatous leprosy is not uncommon, but there is a paucity of literature on the involvement of gonads in female patients with leprosy. This study was undertaken to determine if there is any menstrual dysfunction, alteration in fertility status and circulating luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and estradiol in female patients with paucibacillary (PB) and multibacillary (MB) leprosy. MATERIALS AND METHODS: In a cross-sectional study, 229 patients with leprosy (79 with PB leprosy and 150 with MB leprosy) and 100 age-matched non-leprosy controls were evaluated for menstrual function, fertility status, and circulating sex hormones. RESULTS: Twenty percent of patients with MB leprosy had menstrual irregularities post-dating the onset of leprosy in comparison to 6.3% patients with PB leprosy, and this difference was statistically significant (P < 0.001). However, the fertility profile of patients with PB leprosy was comparable to that of patients with MB leprosy (P > 0.05). A significantly higher number of patients with MB leprosy (9.3%) had elevation of circulating FSH, LH, and prolactin vis-à-vis patients with PB leprosy (1.3%), and this difference was statistically significant (P < 0.05). Similarly, the mean levels of LH, FSH, and prolactin were significantly elevated in patients with MB leprosy vis-à-vis patients with PB leprosy and controls (P < 0.05). CONCLUSIONS: Multibacillary leprosy may be associated with menstrual irregularities and elevation of gonadotropin hormones, indicating an ovarian dysfunction.

Consequences of transfer of an in vitro-produced embryo for the dam and resultant calf.

No reports exist on consequences of in vitro production (IVP) of embryos for the postnatal development of the calf or on postparturient function of the dam of the calf. Three hypotheses were evaluated: calves born as a result of transfer of an IVP embryo have reduced neonatal survival and altered postnatal growth, fertility, and milk yield compared with artificial insemination (AI) calves; cows giving birth to IVP calves have lower milk yield and fertility and higher incidence of postparturient disease than cows giving birth to AI calves; and the medium used for IVP affects the incidence of developmental abnormalities. In the first experiment, calves were produced by AI using conventional semen or by embryo transfer (ET) using a fresh or vitrified embryo produced in vitro with X-sorted semen. Gestation length was longer for cows receiving a vitrified embryo than for cows receiving a fresh embryo or AI. The percentage of dams experiencing calving difficulty was higher for ET than AI. We observed a tendency for incidence of retained placenta to be higher for ET than AI but found no significant effect of treatment on incidence of prolapse or metritis, pregnancy rate at first service, services per conception, or any measured characteristic of milk production in the subsequent lactation. Among Holstein heifers produced by AI or ET, treatment had no effect on birth weight but the variance tended to be greater in the ET groups. More Holstein heifer calves tended to be born dead, died, or were euthanized within the first 20d of life for the ET groups than for AI. Similarly, the proportion of Holstein heifer calves that either died or were culled for poor health after 20d of age was greater for the ET groups than for AI. We observed no effect of ET compared with AI on age at first service or on the percentage of heifers pregnant at first service, calf growth, or milk yield or composition in the first 120d in milk of the first lactation. In a second experiment, embryos were produced using 1 of 2 culture media: synthetic oviductal fluid-bovine embryo 1 (SOF-BE1) or Block-Bonilla-Hansen 7 (BBH7). We detected no difference between cows receiving an SOF-BE1 or BBH7 embryo in gestation length, the percentage of cows in which parturition was induced, or the percentage of cows that experienced calving difficulty, retained placenta, prolapse, or metritis. Among Holstein heifers, birth weight was higher for BBH7 calves than for SOF-BE1 calves. Treatment had no significant effect on calf death. Results indicate that calves born as a result of IVP-ET are more likely to experience alterations in birth weight and increased death in early life but that there were few consequences to the dam of carrying a fetus derived by IVP-ET.

Desenvolvimento e fecundidade no Brasil: reversão da fecundidade para municípios mais desenvolvidos? / Development and fertility in Brazil : fertility reversion for more developed municipalities? / Desarrollo y fecundidad en Brasil : reversión de la fecundidad para municipios más desarrollados?

Durante o último século, vários países observaram um aumento rápido no desenvolvimento econômico com declínio simultâneo nas taxas de crescimento da fecundidade e da população. Utilizando uma análise de regressão limiar, como proposto por Hansen (2000), este artigo investiga a associação negativa entre o desenvolvimento econômico e a fecundidade para os municípios brasileiros, utilizando dados do Censo de 2000 e do ínidice de desenvolvimento humano. Os resultados não demonstram nenhuma evidência para apoiar a existência de uma relação em forma de J invertido entre desenvolvimento e fecundidade como encontrado por Furuoka (2010) para os Estados Unidos, ao contrário dos resultados sugeridos por Myrskylä et al. (2009). Além disso, observaram-se quatro regimes diferentes, todos estatisticamente significativos, e há evidências de que a intensidade da relação no terceiro regime é mais fraca que os outros como é encontrada por Furuoka (2009).

During the last century, several countries observed a rapid increase in economic development with simultaneous decline in fertility and population growth rates. Using a threshold regression analysis as proposed by Hansen (2000), this article investigates the negative association between economic development and fertility for Brazilian Municipalities using 2000 census and human development data. Results show no evidence to support the existence of an inverse J-shaped development-fertility as found by Furuoka (2010) to the United States, in opposite to the results suggested by Myrskylä et al. (2009). Moreover, we found four different regimes, all statistically significant, and there is evidence that the intensity of the relation in the third regime is weaker than others as is found by Furuoka (2009).

Durante el siglo pasado, varios países se observó un aumento rápido en el desarrollo económico con la disminución simultánea de las tasas de fecundidad y el crecimiento de la población. Utilizando un análisis de regresión del umbral propuesto por Hansen (2000), este artículo investiga la asociación negativa entre el desarrollo económico y la fecundidad de los municipios brasileños con los datos del censo de 2000 y los datos de desarrollo humano. Los resultados muestran ninguna evidencia que apoye la existencia de una relación inversa entre el desarrollo en forma de J de la fecundidad que se encuentran por Furuoka (2010) a los Estados Unidos, de manera opuesta a los resultados sugeridos por Myrskylä et al. (2009). Además, se encontraron cuatro regímenes diferentes, todos estadísticamente significativos, y no hay evidencia de que la intensidad de la relación en el tercer régimen es más débil que los demás como se han encontrado los Furuoka (2009).

Paternity analysis-based inference of pollen dispersal patterns, male fecundity variation, and influence of flowering tree density and general flowering magnitude in two dipterocarp species.

BACKGROUND AND AIMS: Knowledge of pollen dispersal patterns and variation of fecundity is essential to understanding plant evolutionary processes and to formulating strategies to conserve forest genetic resources. Nevertheless, the pollen dispersal pattern of dipterocarp, main canopy tree species in palaeo-tropical forest remains unclear, and flowering intensity variation in the field suggests heterogeneity of fecundity. METHODS: Pollen dispersal patterns and male fecundity variation of Shorea leprosula and Shorea parvifolia ssp. parvifolia on Peninsular Malaysian were investigated during two general flowering seasons (2001 and 2002), using a neighbourhood model modified by including terms accounting for variation in male fecundity among individual trees to express heterogeneity in flowering. KEY RESULTS: The pollen dispersal patterns of the two dipterocarp species were affected by differences in conspecific tree flowering density, and reductions in conspecific tree flowering density led to an increased selfing rate. Active pollen dispersal and a larger number of effective paternal parents were observed for both species in the season of greater magnitude of general flowering (2002). CONCLUSIONS: The magnitude of general flowering, male fecundity variation, and distance between pollen donors and mother trees should be taken into account when attempting to predict the effects of management practices on the self-fertilization and genetic structure of key tree species in tropical forest, and also the sustainability of possible management strategies, especially selective logging regimes.

[Biology of Agistemus brasiliensis Matioli, Ueckermann & Oliveira (Acari: Stigmaeidae) and its predation potential on Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpidae)]. / Biologia de Agistemus brasiliensis Matioli, Ueckermann & Oliveira (Acari: Stigmaeidae) e sua potencialidade de predação sobre Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpidae).

The present work aimed to study the biology of Agistemus brasiliensis Matioli, Ueckermann & Oliveira at the following temperatures, namely 15, 20, 25, 30 and 35 degrees C, fed with Brevipalpus phoenicis (Geijskes) and Typha pollen, in laboratory conditions. Life tables were calculated to evaluate the biological parameters. The optimal development of A. brasiliensis took place at 29 degrees C. The values of T (time of generation - days), R0 and r m at 30 degrees C were, 13.95, 16.25 and 0.20, respectively. The prey consumption of A. brasiliensis was studied at the densities of 5, 10, 20, 40 and 60 leprosis mite females per cage (3 cm in diameter) on citrus fruits at 29 degrees C. The maximum prey, namely 7.6 B. phoenicis females per day, were consumed at a density of 20 leprosis mites. At densities of above 40 leprosis mites per cage, A. brasiliensis oviposits 4.7 eggs per day, in comparison to 2.5 eggs per day at 20 mites per cage.

Reproductive performance of the mite Brevipalpus phoenicis (Geijskes, 1939) on citrus and coffee, using life table parameters.

The flat-mite Brevipalpus phoenicis (Geijskes, 1939) (Acari: Tenuipalpidae) is considered important in citrus (Citrus spp.) and coffee plants (Coffea spp.) in Brazil, and is known as the leprosis and coffee ring spot mite, as being a vector of the Citrus Leprosis Rhabdovirus - CitLV and Coffee Ring Spot Virus - CoRSV. The objective of this work is to find out about the reproductive success of B. phoenicis on citric fruits and coffee leaves by fertility life table parameters and its biology. The experiments were carried out in laboratory conditions at 25 +/- 2 degrees C, 70 +/- 10% of relative humidity and 14 h of photophase. The lengths of embryonic and post-embryonic periods were different due to the host where the mite was reared. B. phoenicis showed better development and higher survival and fecundity in citric fruits than coffee leaves. The intrinsic rate of the population increase (r(m)) was 0.128 and 0.090 - females/female/day on citric fruits and coffee leaves, respectively. The citric fruits were more appropriate for the development of B. phoenicis than coffee leaves.

Reproductive performance of the mite Brevipalpus phoenicis (Geijskes, 1939) on citrus and coffee, using life table parameters / Desempenho reprodutivo do ácaro Brevipalpus phoenicis (Geijskes, 1939) em citros e em cafeeiro, utilizando parâmetros de tabela de vida

The flat-mite Brevipalpus phoenicis (Geijskes, 1939) (Acari: Tenuipalpidae) is considered important in citrus (Citrus spp.) and coffee plants (Coffea spp.) in Brazil, and is known as the leprosis and coffee ring spot mite, as being a vector of the Citrus Leprosis Rhabdovirus - CitLV and Coffee Ring Spot Virus - CoRSV. The objective of this work is to find out about the reproductive success of B. phoenicis on citric fruits and coffee leaves by fertility life table parameters and its biology. The experiments were carried out in laboratory conditions at 25 ± 2 °C, 70 ± 10 percent of relative humidity and 14 h of photophase. The lengths of embryonic and post-embryonic periods were different due to the host where the mite was reared. B. phoenicis showed better development and higher survival and fecundity in citric fruits than coffee leaves. The intrinsic rate of the population increase (r m) was 0.128 and 0.090 - females/female/day on citric fruits and coffee leaves, respectively. The citric fruits were more appropriate for the development of B. phoenicis than coffee leaves.

O ácaro Brevipalpus phoenicis (Geijskes, 1939) (Acari: Tenuipalpidae) é considerado importante em citros (Citrus spp.) e cafeeiro (Coffea spp.) no Brasil, sendo conhecido como ácaro da leprose e da mancha-anular, por ser vetor dos vírus causadores da leprose em citros,Citrus Leprosis Rhabdovirus - CitLV, e da mancha-anular em cafeeiro,Coffee Ring Spot Virus - CoRSV. O objetivo deste trabalho foi avaliar o sucesso reprodutivo de B. phoenicis, em frutos cítricos e em folhas de cafeeiro, por meio de parâmetros calculados a partir da tabela de vida,de fertilidade e da biologia. Os experimentos foram realizados em laboratório a 25 ± 2 °C, 70 ± 10 por cento de umidade relativa e 14 h de fotofase. Os períodos embrionário e pós-embrionário apresentaram diferenças em função do hospedeiro em que o ácaro foi criado.B. phoenicis teve melhor desenvolvimento, maior sobrevivência e maior fertilidade específica em frutos cítricos do que em folhas de cafeeiro. A taxa intrínseca de crescimento populacional (rm) foi de 0,128 e 0,090 fêmeas/fêmea/dia em frutos cítricos e em folhas de cafeeiro, respectivamente. Os frutos cítricos mostraram-se mais adequados ao desenvolvimento de B. phoenicis do que as folhas de cafeeiro.

Pregnancy and leprosy: a comprehensive literature review.

The interaction between pregnancy, leprosy and leprosy reactions was examined in a systematic literature review. Several retrospective case series and one retrospective cohort study but only one prospective cohort study were identified in the English literature. Type 1 (reversal) reactions were particularly likely to occur during the post partum. This temporal association was also present for both overt and silent neuritis. Type 2 (erythema nodosum leprosum) reactions occur throughout pregnancy and during lactation, and may be severe and recurrent. No prospective, controlled studies were found that documented the complications of pregnancy in women treated with multidrug therapy regimens. Our study highlights the need for such studies, with appropriate controls, on women throughout pregnancy and lactation so that risk factors for reaction and neuritis during pregnancy can be identified and quantified.

Hanseniase e gravidez: prognostico materno-fetal / ?

O autor estudou 196 gestacoes em 151 pacientes com hanseniase, no Hospital Padre Bento, Guarulhos, da Secretaria da Saude de Sao Paulo, no periodo de janeiro de 1965 a junho de 1984. As pacientes foram seguidas no ambulatorio de Pre-Natal deste hospital e internadas quando apresentaram complicacoes da gravidez ou da hanseniase. A morbidade materna foi aumentada na hanseniase pelas altas prevalencias de anemia, infeccao urinaria, infeccao puerperal, amniorrexe prematura, dibates mellitus e hipertensao arterial. A morbidade perinatal foi aumentada na hanseniase pelas altas prevalencias de prematuridade (27,84 por cento), de baixo peso (39,93 por cento) e infeccao neo-natal (8,52 por cento). A incidencia de parto cesareo foi aumentada (51,43 por cento). A associacao hanseniase e gravidez e de alto risco, necessitando pre-natal cuidadoso e correto acompanhamento clinco-obstetrico e pediatrico

Leprosy and female reproductive organs.

Thirty-five adult female patients with bacillary positive leprosy were studied to determine its effect on menarche, menstrual cycle, fertility, and menopause. Endometrial biopsies studied in 26 patients showed no evidence of leprosy bacilli granuloma or tubercle bacilli on culture. Menstrual blood examined in six patients with bacillemia did not reveal leprosy bacilli. Products of conception examined from two patients were negative for granulomata or leprosy bacilli. Leprosy was found to have no direct effect on menarche, menstruation, fertility, and menopause.

Leprosy and fertility

There is evidence that infection with Mycobacterium leprae lowers fertility of some leprosy patients. To test this hypothesis age-specific birth rates of leprous and healthly individuals were compared in a completely ascertained Philippine population in which leprosy is endemic. The fertility of lepromatous males and females after, but not before, and of females during the five-years preceding the onset of leprosy was significantly lower than that of the healthly population. these differences were not seen when the fertility of those with tuberculoid leprosy was compared with that of the healthly population. The implications of these findings for discovering causes and significance of reduced fertility of male and female victims of lepromatous leprosy are discussed.