Suchergebnisse

Objective: Dyspnea perception is distorted in patients with medically unexplained dyspnea. The goals of this study were 1) to replicate these results in patients with fibromyalgia and/or chronic fatigue syndrome (CFS), and 2) to investigate predictors of distorted symptom perception within the patient group, with a focus on negative affectivity (NA), psychiatric comorbidity and somatic symptom severity. Methods: Seventy-three patients diagnosed with fibromyalgia and/or CFS and 38 healthy controls (HC) completed a rebreathing paradigm, consisting of a baseline (60s of room air), a rebreathing phase (150s, gradually increasing ventilation, partial pressure of CO2 in the blood, and self-reported dyspnea), and a recovery phase (150s of room air). Dyspnea, respiratory flow and FetCO2 levels were measured continuously. Results: Patients reported more dyspnea than HC in the recovery phase (p = 0.039), but no differences between patients and HC were found in the baseline (p = 0.07) or rebreathing phase (p = 0.17). No significant differences between patients and HC were found in physiological reactivity. Within the patient group, the effect in the recovery phase was predicted by somatic symptom severity (p = 0.046), but not by negative affectivity or by the number of psychiatric comorbidities. Conclusion: This study extended earlier findings in patients with medically unexplained dyspnea to patients with fibromyalgia and CFS. This suggests that altered symptom perception is a non-symptom-specific mechanism underlying functional somatic syndromes in general, particularly in patients with high levels of somatic symptom severity . The results are discussed in a predictive coding framework of symptom perception. ; The authors would like to thank the physicians and psychologists at the Psychiatry Departments of UZ Gasthuisberg, ZOL Genk, and at the Rheumatology Center in Genk for their help with the recruitment of patients; Mathijs Franssen for his help with data processing; and Katrien Coremans, Lotte Ceuterick, and Celine Samaey for their help with data collection. This research was funded by the Center for Excellence on Generalization Research (GRIP*TT; University of Leuven grant PF/10/005) and by Asthenes, a long-term structural funding-Methusalem grant (METH/15/011) by the FWO-Vlaanderen, Flemish Government, Belgium. The study was further supported by infrastructure grants from the Herculesstichting, Belgium (AKUL/13/07 and AKUL/11/08).

Background: Several studies have shown that patients with functional somatic syndromes have, on average, deficient endogenous pain modulation (EPM), as well as elevated levels of negative affectivity and high comorbidity with depression and reduced resting heart rate variability (HRV) compared to healthy controls. The goals of this study were 1) to replicate these findings and 2) to investigate the moderating role of negative affectivity, depression and resting HRV in EPM efficiency within a patient group with fibromyalgia and/or chronic fatigue syndrome. Resting HRV was quantified as the root mean square of successive differences between inter-beat intervals (RMSSD) in rest, a vagally-mediated time domain measure of HRV. Methods: Seventy-eight patients with fibromyalgia and/or chronic fatigue syndrome and 33 healthy controls completed a counter-irritation paradigm as a measure of EPM efficiency. Participants rated the painfulness of electrocutaneous stimuli (of individually calibrated intensity) on the ankle before (baseline phase), during (counter-irritation phase) and after (recovery phase) the application of a cold pain stimulus on the forearm. A larger reduction in pain in the counter-irritation phase compared to the baseline phase reflects a more efficient EPM. Results: In contrast to our expectations, there was no difference between pain ratings in the baseline compared to counter-irritation phase for both patients and healthy controls. Therefore, reliable conclusions on the moderating effect of negative affectivity, depression and RMSSD could not be made. Surprisingly, patients reported more pain in the recovery compared to the counter-irritation and baseline phase, while HC did not. This latter effect was more pronounced in patients with comorbid depression, patients who rated the painfulness of the counter-irritation stimulus as high and patients who rated the painfulness of the electrocutaneous stimuli as low. Conclusion: We did not manage to successfully replicate the counter-irritation effect in healthy controls or FSS patients. Therefore, no valid conclusions on the association between RMSSD, depression, negative affectivity and EPM efficiency can be drawn from this study. Possible reasons for the lack of the counter-irritation effect are discussed. ; This work was supported by the Center for Excellence on Generalization Research (GRIP*TT; University of Leuven grant PF/10/005) and by Asthenes, a Long-Term Structural Funding-Methusalem grant by the FWO-Vlaanderen, Flemish Government, Belgium. The study was further supported by infrastructure grants from the Herculesstichting, Belgium (AKUL/13/07 and AKUL/11/08).

OBJECTIVE: Induction of negative affective states can enhance bodily symptoms in high habitual symptom reporters among healthy persons and in patients with irritable bowel syndrome. The aims of this study were to replicate this effect in patients with fibromyalgia and chronic fatigue syndrome and to investigate the role of moderators, focusing on alexithymia, negative affectivity, and absorption. METHODS: Patients with fibromyalgia and/or chronic fatigue syndrome (n = 81) and HCs (n = 41) viewed series of neutral, positive, and negative affective pictures. After every picture series, participants filled out a somatic symptom checklist and rated emotions experienced during the picture series on valence, arousal, and perceived control. RESULTS: Patients reported more somatic symptoms after viewing negative pictures (least square mean [LSM] = 19.40, standard error (SE) = 0.50) compared with neutral (LSM = 17.59, SE = 0.42, p < .001) or positive (LSM = 17.04, SE = 0.41, p < .001) pictures, whereas somatic symptom ratings of HCs after viewing negative picture series (LSM = 12.07, SE = 0.71) did not differ from ratings after viewing neutral (LSM = 11.07, SE = 0.59, p = .065) or positive (LSM = 11.10, SE = 0.58, p = .93) pictures. Negative affectivity did not moderate the symptom-enhancing effect of negative affective pictures, whereas the alexithymia factor "difficulty identifying feelings" and absorption did (p = .016 and p = .006, respectively). CONCLUSION: Negative affective states elicit elevated somatic symptom reports in patients experiencing fibromyalgia and/or chronic fatigue syndrome. This symptom-enhancing effect is greater in patients having higher difficulty to identify feelings and higher absorption scores. The results are discussed in a predictive coding framework of symptom perception. ; This study was supported by the Center for Excellence on Generalization Research (GRIP*TT; University of Leuven Grant PF/10/005) and by Asthenes, a long-term structural funding-Methusalem grant by the FWO-Vlaanderen, Flemish Government, Belgium. The study was further supported by infrastructure grants from the Herculesstichting, Belgium (AKUL/13/07 and AKUL/11/08). The authors report no conflicts of interest.

A number of governance mechanisms address socio-environmental challenges associated with commodity agriculture in tropical forested countries. Governance mechanisms that prove effective in one agricultural sector are often applied to other sectors as well. For example, voluntary certification programs have been adopted by producers of commodities as diverse as beef, coffee, palm oil, and soy. However, there are substantial differences in the extent to which governance mechanisms scale up and achieve impact in different sectors. This paper analyzes how the potential for scaling up a particular governance mechanism is influenced by environmental, market, and social geographies that differ between sectors. Through stakeholder interviews, farm-level surveys, and a literature review, we examine two types of voluntary governance mechanisms (third-party certification, and sustainable intensification programs) in the coffee and cattle sectors in Brazil, to understand why the two governance mechanisms have scaled differently between these two sectors. We find that third-party certification programs have scaled up relatively well in Brazil's coffee sector, more so than its cattle sector, in part owing to differences in sustainability priorities, market orientations, supply chain traceability, and social networks between the two sectors. We also find that pilot sustainable intensification programs in the cattle sector have had more success than certification in engaging farmers, in part because they involve less investment from participating farmers. We conclude that the distribution and quality of environmental resources, markets, knowledge, actors, and networks can play an important role in the ability of a governance mechanism to effectively take root.

A number of governance mechanisms address socio-environmental challenges associated with commodity agriculture in tropical forested countries. Governance mechanisms that prove effective in one agricultural sector are often applied to other sectors as well. For example, voluntary certification programs have been adopted by producers of commodities as diverse as beef, coffee, palm oil, and soy. However, there are substantial differences in the extent to which governance mechanisms scale up and achieve impact in different sectors. This paper analyzes how the potential for scaling up a particular governance mechanism is influenced by environmental, market, and social geographies that differ between sectors. Through stakeholder interviews, farm-level surveys, and a literature review, we examine two types of voluntary governance mechanisms (third-party certification, and sustainable intensification programs) in the coffee and cattle sectors in Brazil, to understand why the two governance mechanisms have scaled differently between these two sectors. We find that third-party certification programs have scaled up relatively well in Brazil's coffee sector, more so than its cattle sector, in part owing to differences in sustainability priorities, market orientations, supply chain traceability, and social networks between the two sectors. We also find that pilot sustainable intensification programs in the cattle sector have had more success than certification in engaging farmers, in part because they involve less investment from participating farmers. We conclude that the distribution and quality of environmental resources, markets, knowledge, actors, and networks can play an important role in the ability of a governance mechanism to effectively take root.

A number of governance mechanisms address socio-environmental challenges associated with commodity agriculture in tropical forested countries. Governance mechanisms that prove effective in one agricultural sector are often applied to other sectors as well. For example, voluntary certification programs have been adopted by producers of commodities as diverse as beef, coffee, palm oil, and soy. However, there are substantial differences in the extent to which governance mechanisms scale up and achieve impact in different sectors. This paper analyzes how the potential for scaling up a particular governance mechanism is influenced by environmental, market, and social geographies that differ between sectors. Through stakeholder interviews, farm-level surveys, and a literature review, we examine two types of voluntary governance mechanisms (third-party certification, and sustainable intensification programs) in the coffee and cattle sectors in Brazil, to understand why the two governance mechanisms have scaled differently between these two sectors. We find that third-party certification programs have scaled up relatively well in Brazil's coffee sector, more so than its cattle sector, in part owing to differences in sustainability priorities, market orientations, supply chain traceability, and social networks between the two sectors. We also find that pilot sustainable intensification programs in the cattle sector have had more success than certification in engaging farmers, in part because they involve less investment from participating farmers. We conclude that the distribution and quality of environmental resources, markets, knowledge, actors, and networks can play an important role in the ability of a governance mechanism to effectively take root. (C) 2018 The Authors. Published by Elsevier Ltd.

BACKGROUND: Carbapenem-resistant Acinetobacter baumannii is considered a top priority pathogen by the World Health Organization for combatting increasing antibiotic resistance and development of new drugs. Since it was originally reported in Klebsiella pneumoniae in 2009, the quick spread of the bla(NDM-1) gene encoding a New-Delhi metallo-beta-lactamase-1 (NDM-1) is increasingly recognized as a serious threat. This gene is usually carried by large plasmids and has already been documented in diverse bacterial species, including A. baumannii. Here, we report the first detection of a NDM-1-producing A. baumannii strain isolated in Benin. CASE PRESENTATION: A 31-year-old woman was admitted to a surgical unit with a diagnosis of post-cesarean hematoma. An extensively-drug resistant A. baumannii strain solely susceptible to amikacin, colistin and ciprofloxacin, and resistant to several other antibiotics including ceftazidime, imipenem, meropenem, gentamicin, tobramycin, ceftazidime/avibactam, and sulfamethoxazole-trimethoprim, was isolated from the wound. Production of NDM-1 was demonstrated by immunochromatographic testing. Whole genome sequencing of the isolate confirmed the presence of bla(NDM-1), but also antibiotic resistance genes against multiple beta-lactamases and other classes of antibiotics, in addition to several virulence genes. Moreover, the bla(NDM-1) gene was found to be present in a Tn125 transposon integrated on a plasmid. CONCLUSIONS: The discovery of this extensively-drug resistant A. baumannii strain carrying bla(NDM-1) in Benin is worrying, especially because of its high potential risk of horizontal gene transfer due to being integrated into a transposon located on a plasmid. Strict control and prevention measures should be taken, once NDM-1 positive A. baumannii has been identified to prevent transfer of this resistance gene to other Enterobacterales. Capacity building is required by governmental agencies to provide suitable antibiotic treatment options and strategies, in combination with ...

Background: Carbapenem-resistant Acinetobacter baumannii is considered a top priority pathogen by the World Health Organization for combatting increasing antibiotic resistance and development of new drugs. Since it was originally reported in Klebsiella pneumoniae in 2009, the quick spread of the blaNDM-1 gene encoding a New-Delhi metallo-beta-lactamase-1 (NDM-1) is increasingly recognized as a serious threat. This gene is usually carried by large plasmids and has already been documented in diverse bacterial species, including A. baumannii. Here, we report the first detection of a NDM-1-producing A. baumannii strain isolated in Benin. Case presentation: A 31-year-old woman was admitted to a surgical unit with a diagnosis of post-cesarean hematoma. An extensively-drug resistant A. baumannii strain solely susceptible to amikacin, colistin and ciprofloxacin, and resistant to several other antibiotics including ceftazidime, imipenem, meropenem, gentamicin, tobramycin, ceftazidime/ avibactam, and sulfamethoxazole-trimethoprim, was isolated from the wound. Production of NDM-1 was demonstrated by immunochromatographic testing. Whole genome sequencing of the isolate confirmed the presence of blaNDM-1, but also antibiotic resistance genes against multiple beta-lactamases and other classes of antibiotics, in addition to several virulence genes. Moreover, the blaNDM-1 gene was found to be present in a Tn125 transposon integrated on a plasmid. Conclusions: The discovery of this extensively-drug resistant A. baumannii strain carrying blaNDM-1 in Benin is worrying, especially because of its high potential risk of horizontal gene transfer due to being integrated into a transposon located on a plasmid. Strict control and prevention measures should be taken, once NDM-1 positive A. baumannii has been identified to prevent transfer of this resistance gene to other Enterobacterales. Capacity building is required by governmental agencies to provide suitable antibiotic treatment options and strategies, in combination with strengthening laboratory services for detection and surveillance of this pathogen.

Background: Carbapenem-resistant Acinetobacter baumannii is considered a top priority pathogen by the World Health Organization for combatting increasing antibiotic resistance and development of new drugs. Since it was originally reported in Klebsiella pneumoniae in 2009, the quick spread of the blaNDM-1 gene encoding a New-Delhi metallo-beta-lactamase-1 (NDM-1) is increasingly recognized as a serious threat. This gene is usually carried by large plasmids and has already been documented in diverse bacterial species, including A. baumannii. Here, we report the first detection of a NDM-1-producing A. baumannii strain isolated in Benin. Case presentation: A 31-year-old woman was admitted to a surgical unit with a diagnosis of post-cesarean hematoma. An extensively-drug resistant A. baumannii strain solely susceptible to amikacin, colistin and ciprofloxacin, and resistant to several other antibiotics including ceftazidime, imipenem, meropenem, gentamicin, tobramycin, ceftazidime/ avibactam, and sulfamethoxazole-trimethoprim, was isolated from the wound. Production of NDM-1 was demonstrated by immunochromatographic testing. Whole genome sequencing of the isolate confirmed the presence of blaNDM-1, but also antibiotic resistance genes against multiple beta-lactamases and other classes of antibiotics, in addition to several virulence genes. Moreover, the blaNDM-1 gene was found to be present in a Tn125 transposon integrated on a plasmid. Conclusions: The discovery of this extensively-drug resistant A. baumannii strain carrying blaNDM-1 in Benin is worrying, especially because of its high potential risk of horizontal gene transfer due to being integrated into a transposon located on a plasmid. Strict control and prevention measures should be taken, once NDM-1 positive A. baumannii has been identified to prevent transfer of this resistance gene to other Enterobacterales. Capacity building is required by governmental agencies to provide suitable antibiotic treatment options and strategies, in combination with strengthening laboratory services for detection and surveillance of this pathogen.

Multidrug resistant Acinetobacter baumannii and its closely related species A. pittii and A. nosocomialis, all members of the Acinetobacter calcoaceticus-baumannii (Acb) complex, are a major cause of hospital acquired infection. In the burn wound center of the Queen Astrid military hospital in Brussels, 48 patients were colonized or infected with Acb complex over a 52-month period. We report the molecular epidemiology of these organisms, their clinical impact and infection control measures taken. A representative set of 157 Acb complex isolates was analyzed using repetitive sequence-based PCR (rep-PCR) (DiversiLab) and a multiplex PCR targeting OXA-51-like and OXA-23-like genes. We identified 31 rep-PCR genotypes (strains). Representatives of each rep-type were identified to species by rpoB sequence analysis: 13 types to A. baumannii, 10 to A. pittii, and 3 to A. nosocomialis. It was assumed that isolates that belonged to the same rep-type also belonged to the same species. Thus, 83.4% of all isolates were identified to A. baumannii, 9.6% to A. pittii and 4.5% to A. nosocomialis. We observed 12 extensively drug resistant Acb strains (10 A. baumannii and 2 A. nosocomialis), all carbapenem-non-susceptible/colistin-susceptible and imported into the burn wound center through patients injured in North Africa. The two most prevalent rep-types 12 and 13 harbored an OXA-23-like gene. Multilocus sequence typing allocated them to clonal complex 1 corresponding to EU (international) clone I. Both strains caused consecutive outbreaks, interspersed with periods of apparent eradication. Patients infected with carbapenem resistant A. baumannii were successfully treated with colistin/rifampicin. Extensive infection control measures were required to eradicate the organisms. Acinetobacter infection and colonization was not associated with increased attributable mortality.

Multidrug resistant Acinetobacter baumannii and its closely related species A. pittii and A. nosocomialis, all members of the Acinetobacter calcoaceticus-baumannii (Acb) complex, are a major cause of hospital acquired infection. In the burn wound center of the Queen Astrid military hospital in Brussels, 48 patients were colonized or infected with Acb complex over a 52-month period. We report the molecular epidemiology of these organisms, their clinical impact and infection control measures taken. A representative set of 157 Acb complex isolates was analyzed using repetitive sequence-based PCR (rep-PCR) (DiversiLab) and a multiplex PCR targeting OXA-51-like and OXA-23-like genes. We identified 31 rep-PCR genotypes (strains). Representatives of each rep-type were identified to species by rpoB sequence analysis: 13 types to A. baumannii, 10 to A. pittii, and 3 to A. nosocomialis. It was assumed that isolates that belonged to the same rep-type also belonged to the same species. Thus, 83.4% of all isolates were identified to A. baumannii, 9.6% to A. pittii and 4.5% to A. nosocomialis. We observed 12 extensively drug resistant Acb strains (10 A. baumannii and 2 A. nosocomialis), all carbapenem-non-susceptible/colistin-susceptible and imported into the burn wound center through patients injured in North Africa. The two most prevalent rep-types 12 and 13 harbored an OXA-23-like gene. Multilocus sequence typing allocated them to clonal complex 1 corresponding to EU (international) clone I. Both strains caused consecutive outbreaks, interspersed with periods of apparent eradication. Patients infected with carbapenem resistant A. baumannii were successfully treated with colistin/rifampicin. Extensive infection control measures were required to eradicate the organisms. Acinetobacter infection and colonization was not associated with increased attributable mortality.

Context: Interventions targeting maternal obesity are a healthcare and public health priority. Objective: The objective of this review was to evaluate the adequacy and effectiveness of the methodological designs implemented in dietary intervention trials for obesity in pregnancy. Data Sources: A systematic review of the literature, consistent with PRISMA guidelines, was performed as part of the International Weight Management in Pregnancy collaboration. Study Selection: Thirteen randomized controlled trials, which aimed to modify diet and physical activity in overweight and obese pregnant women, were identified. Data Synthesis: There was significant variability in the content, delivery, and dietary assessment methods of the dietary interventions examined. A number of studies demonstrated improved dietary behavior in response to diet and/or lifestyle interventions. Nine studies reduced gestational weight gain. Conclusion: This review reveals large methodological variability in dietary interventions to control gestational weight gain and improve clinical outcomes in overweight and obese pregnant women. This lack of consensus limits the ability to develop clinical guidelines and apply the evidence in clinical practice. ; National Institute for Health Research Health Technology Assessment UK program ; European Union ; EarlyNutrition ; Tommy's Charity ; Kings Coll London, Womens Hlth Acad Ctr, Sch Med, Diabet & Nutr Sci Div, London, England ; Kings Coll London, Womens Hlth Acad Ctr, Div Womens Hlth, London, England ; Early Life Nutr, Nutricia, Trowbridge, Wilts, England ; Univ London Imperial Coll Sci Technol & Med, Dept Cardiovasc Med, London, England ; Kings Coll London, Sch Med, Diabet & Nutr Sci Div, London, England ; Queen Mary Univ London, Barts & London Sch Med & Dent, Womens Hlth Res Unit & Multidisciplinary Evidence, London, England ; Vrije Univ Amsterdam, Med Ctr, EMGO Inst Hlth & Care Res, Dept Publ & Occupat Hlth, Amsterdam, Netherlands ; Queen Mary Univ London, Barts & London Sch Med & Dent, Womens Hlth Res Unit, London, England ; Univ N Carolina, Sch Nursing, Chapel Hill, NC USA ; Univ Politecn Madrid, Fac Ciencias Actividad Fis & Deporte INEF, Madrid, Spain ; Univ Coll Leuven Limburg, Dept Obstet & Gynaecol, Div Mother & Child, Antwerp, Belgium ; Univ Antwerp, Fac Med & Hlth Sci, B-2020 Antwerp, Belgium ; Univ Estadual Campinas, Sch Med Sci, Dept Obstet & Gynecol, Campinas, Brazil ; Univ Adelaide, Sch Paediat & Reprod Hlth, Robinson Inst, Adelaide, SA 5005, Australia ; Katholieke Univ Leuven, Dept Dev & Regenerat, Leuven, Belgium ; Univ Hosp Leuven, Dept Obstet & Gynecol, Leuven, Belgium ; Monash Univ, Sch Publ Hlth, Monash Ctr Hlth Res & Implementat, Melbourne, Vic 3004, Australia ; Norwegian Sch Sport Sci, Dept Sports Med, Oslo, Norway ; Mazandaran Univ, Fac Phys Educ & Sport Sci, Dept Sport Physiol, Babol Sar, Iran ; Oslo Univ Hosp, Dept Obstet & Gynaecol, N-0450 Oslo, Norway ; UKK Inst Hlth Promot Res, Tampere, Finland ; Univ Western Australia, Sch Sport Sci Exercise & Hlth, Perth, WA 6009, Australia ; Univ Modena & Reggio Emilia, Mother Infant Dept, Modena, Italy ; Calif Polytech State Univ San Luis Obispo, Dept Kinesiol, San Luis Obispo, CA 93407 USA ; Sao Paulo Fed Univ Unifesp, Dept Hlth Sci, Phys Therapy Course, Santos, Brazil ; Tech Univ Munich, Klinikum Rechts Isar, Inst Nutr Med, D-80290 Munich, Germany ; Univ Copenhagen, Hvidovre Hosp, Dept Obstet, Copenhagen, Denmark ; Univ Copenhagen, Hvidovre Hosp, Dept Gynecol, Copenhagen, Denmark ; Univ Southern Denmark, Odense Univ Hosp, Dept Obstet & Gynecol, Odense, Denmark ; Sorlandet Hosp, Dept Obstet & Gynecol, Kristiansand, Norway ; Norwegian Univ Sci & Technol, Fac Med, Dept Publ Hlth & Gen Practice, N-7034 Trondheim, Norway ; Univ Copenhagen, Fac Sci, Dept Nutr Exercise & Sports, Copenhagen, Denmark ; Copenhagen Univ Hosp, Nutr Res Unit, Herlev, Denmark ; Natl Matern Hosp, Univ Coll Dublin, Sch Med & Med Sci, UCD Obstet & Gynaecol, Dublin 2, Ireland ; Sao Paulo Fed Univ Unifesp, Dept Hlth Sci, Phys Therapy Course, Santos, Brazil ; EarlyNutrition: 289346 ; Tommy's Charity: 1060508 ; Web of Science

Drosophila melanogaster is a leading model in population genetics and genomics, and a growing number of whole-genome datasets from natural populations of this species have been published over the last years. A major challenge is the integration of disparate datasets, often generated using different sequencing technologies and bioinformatic pipelines, which hampers our ability to address questions about the evolution of this species. Here we address these issues by developing a bioinformatics pipeline that maps pooled sequencing (Pool-Seq) reads from D. melanogaster to a hologenome consisting of fly and symbiont genomes and estimates allele frequencies using either a heuristic (PoolSNP) or a probabilistic variant caller (SNAPE-pooled). We use this pipeline to generate the largest data repository of genomic data available for D. melanogaster to date, encompassing 271 previously published and unpublished population samples from over 100 locations in > 20 countries on four continents. Several of these locations have been sampled at different seasons across multiple years. This dataset, which we call Drosophila Evolution over Space and Time (DEST), is coupled with sampling and environmental meta-data. A web-based genome browser and web portal provide easy access to the SNP dataset. We further provide guidelines on how to use Pool-Seq data for model-based demographic inference. Our aim is to provide this scalable platform as a community resource which can be easily extended via future efforts for an even more extensive cosmopolitan dataset. Our resource will enable population geneticists to analyze spatio-temporal genetic patterns and evolutionary dynamics of D. melanogaster populations in unprecedented detail. ; DrosEU is funded by a Special Topic Networks (STN) grant from the European Society for Evolutionary Biology (ESEB). MK (M. Kapun) was supported by the Austrian Science Foundation (grant no. FWF P32275); JG by the European Research Council (ERC) under the European Union's Horizon 2020 research and ...

STUDY QUESTION: What are the reported data on cycles in ART, IUI and fertility preservation (FP) interventions in 2016 as compared to previous years, as well as the main trends over the years? SUMMARY ANSWER: The 20th ESHRE report on ART and IUI shows a progressive increase in reported treatment cycle numbers in Europe, with a decrease in the number of transfers with more than one embryo causing a reduction of multiple delivery rates (DR), as well as higher pregnancy rates and DR after frozen embryo replacement (FER) compared to fresh IVF and ICSI cycles, while the outcomes for IUI cycles remained stable. WHAT IS KNOWN ALREADY: Since 1997, ART aggregated data generated by national registries, clinics or professional societies have been collected, analysed by the European IVF-monitoring Consortium (EIM) and reported in 19 manuscripts published in Human Reproduction and Human Reproduction Open. STUDY DESIGN, SIZE, DURATION: Yearly collection of European medically assisted reproduction (MAR) data by EIM for ESHRE. The data on treatments performed between 1 January and 31 December 2016 in 40 European countries were provided by either National Registries or registries based on personal initiatives of medical associations and scientific organizations. PARTICIPANTS/MATERIALS, SETTING, METHODS: In all, 1347 clinics offering ART services in 40 countries reported a total of 918 159 treatment cycles, involving 156 002 with IVF, 407 222 with ICSI, 248 407 with FER, 27 069 with preimplantation genetic testing, 73 927 with egg donation (ED), 654 with IVM of oocytes and 4878 cycles with frozen oocyte replacement (FOR). European data on IUI using husband/partner's semen (IUI-H) and donor semen (IUI-D) were reported from 1197 institutions offering IUI in 29 and 24 countries, respectively. A total of 162 948 treatments with IUI-H and 50 467 treatments with IUI-D were included. A total of 13 689 FP interventions from 11 countries including oocyte, ovarian tissue, semen and testicular tissue banking in pre-and postpubertal patients were reported. MAIN RESULTS AND THE ROLE OF CHANCE: In 20 countries (18 in 2015) with a total population of approximately 325 million inhabitants, in which all ART clinics reported to the registry, a total of 461 401 treatment cycles were performed, corresponding to a mean of 1410 cycles per million inhabitants (range 82–3088 per million inhabitants). In the 40 reporting countries, after IVF the clinical pregnancy rates (PR) per aspiration and per transfer in 2016 were similar to those observed in 2015 (28.0% and 34.8% vs 28.5% and 34.6%, respectively). After ICSI, the corresponding rates were also similar to those achieved in 2015 (25% and 33.2% vs 26.2% and 33.2%). After FER with own embryos, the PR per thawing is still on the rise, from 29.2% in 2015 to 30.9% in 2016. After ED, the PR per fresh embryo transfer was 49.4% (49.6% in 2015) and per FOR 43.6% (43.4% in 2015). In IVF and ICSI together, the trend towards the transfer of fewer embryos continues with the transfer of 1, 2, 3 and 4 embryos in 41.5%, 51.9%, 6.2% and 0.4% of all treatments, respectively (corresponding to 37.7%, 53.9%, 7.9% and 0.5% in 2015). This resulted in a proportion of singleton, twin and triplet DRs of 84.8%, 14.9% and 0.3%, respectively (compared to 83.1%, 16.5% and 0.4%, respectively in 2015). Treatments with FER in 2016 resulted in twin and triplet DR of 11.9% and 0.2%, respectively (vs 12.3% and 0.3% in 2015). After IUI, the DRs remained similar at 8.9% after IUI-H (7.8% in 2015) and at 12.4% after IUI-D (12.0% in 2015). Twin and triplet DRs after IUI-H were 8.8% and 0.3%, respectively (in 2015: 8.9% and 0.5%) and 7.7% and 0.4% after IUI-D (in 2015: 7.3% and 0.6%). The majority of FP interventions included the cryopreservation of ejaculated sperm (n¼7877 from 11 countries) and of oocytes (n¼4907 from eight countries). LIMITATIONS, REASONS FOR CAUTION: As the methods of data collection and levels of completeness of reported data vary among European countries, the results should be interpreted with caution. A number of countries failed to provide adequate data about the number of initiated cycles and deliveries. WIDER IMPLICATIONS OF THE FINDINGS: The 20th ESHRE report on ART and IUI shows a continuous increase of reported treatment numbers and MAR-derived livebirths in Europe. Being already the largest data collection on MAR in Europe, continuous efforts to stimulate data collection and reporting strive for future quality control of the data, transparency and vigilance in the field of reproductive medicine. ; The study has no external funding and all costs were covered by ESHRE. ; peer-reviewed