The predictive value of sperm motility parameters obtained by computer-assisted semen analysis (CASA) was evaluated for the fertility of men from general population. In a prospective study with couples stopping use of contraception in order to try to conceive, CASA was performed on semen samples from 358 men. A recently developed CASA system, Copenhagen Rigshospitalet Image house sperm Motility Analysis System (CRISMAS) was used for assessment of motility parameters. This system has an editing function which allows correction of tracks made by the computer. Probably due to this function, the concentration assessment made by CRISMAS was very close to that made by the technician (median difference <5%) in all concentration ranges. Correlation between CASA parameters and fertility of normal couples (measured as probability of achieving pregnancy) was examined by the Cox regression model. In univariate models ln(sperm concentration) [beta = 0.331, risk ratio (RR) = 1.392, P = 0.0001], ln(total sperm count) (beta = 0.252, RR = 1.286, P = 0.0007) and percentage motile spermatozoa (beta = 0.014, RR = 1.014, P = 0.0004) were most significant predictors for fertility. In a multivariate analysis ln(sperm concentration) (beta = 0.268, RR = 1.307, P = 0.0016) and percentage motile spermatozoa (beta = 0.010, RR = 1.010, P = 0.011) but even more significantly the combined parameter, ln(concentration of motile spermatozoa) (beta = 0.329, RR = 1.389, P = 0.0001), were the only parameters of predictive value for fertility of men in the general population. In conclusion, these parameters obtained by CASA measurements can be used for prediction of fertility potential in normal men. This appears to be the first study showing the value of CASA in prediction of fertility in the general male population.

Background Burgeoning evidence suggests that exercise improves physical and mental health in people with schizophrenia. However, little is known about the feasibility and acceptability of high-intensity training in patients with first-episode psychosis. This qualitative study explored motivation, social interaction and experiences of participants and instructors in relation to an eight-week moderate to high intensity exercise training programme in a clinical trial including patients with first-episode psychosis. Methods The study used a combination of method, source and investigator triangulation. Data were collected by means of semi-structured individual interviews with participants at baseline ( n = 16) and at follow-up ( n = 9), as well as by means of participant observations during the programme (8 sessions × 1.5 h, 12 h in total) and focus group discussions with participants ( n = 3) and instructors ( n = 4), respectively, after the programme. Data were analysed using thematic analysis as described by Braun and Clarke. Results Three main themes and ten subthemes emerged during the analysis: 1) motivation and expectations for enrolment (subthemes: routines and structure, social obligation, goal setting and self-worth); 2) new demands and opportunities (subthemes: practicalities of the training, an understanding exercise setting, and alone and together); and 3) looking ahead – reflections on impact (subthemes: restored sleep and circadian rhythm, energy and sense of achievement, changed everyday life, and hope of finding a new path). Findings suggest that the programme was appealing to, and appreciated by, the participants because of its potential to create an equally challenging and caring non-clinical environment. Conclusions This study indicates that supervised, group-based, moderate to high intensity exercise training complementary to early intervention in psychosis is acceptable. Specifically, the intervention appeared to provide patients an opportunity to integrate the notion of being a young individual along with being a patient with a psychiatric diagnosis, thus supporting and promoting recovery. Trial registration ClinicalTrials.gov identifier: NCT03409393. Registered January 24, 2018.

Social anxiety disorder (SAD) is a highly prevalent and impairing disorder. Current best practice is cognitive behavioral therapy (CBT), but there are several challenges associated with performing exposure therapy. Virtual reality exposure (VRE) may improve treatment efficacy of SAD in a group therapy context, because it allows for greater control, flexibility, and individualization of the exposure stimuli. However, to date no study has investigated the use of VRE for SAD in a group context. In the present study, nine patients who had undergone group CBT with VRE for SAD and three therapists responsible for the treatment were interviewed about their experiences. The objective of the study was to investigate the practical and therapeutic challenges of using VRE in a group therapy context. Thematic analysis was used to analyze the data. The results showed that it was difficult for the patients to engage with the VRE in a group therapy context and that there were several practical challenges. However, all participants found the VRE exercises to be meaningful, because it gave them a medium to practice and understand typically avoided social situations. The latter has not previously been described as a treatment mechanism for anxiety through virtual reality. However, the appropriateness of VRE in group therapy remains unclear. Implications are discussed.What is the significance of this article for the general public? Anxiety disorders are increasingly common and represent a growing economic burden in most developed countries. Group therapy that focuses on building skills, facing fears, and changing unhelpful habits is an often used and efficacious treatment. Virtual reality has been used to help people with anxiety face their fears in a safe and flexible environment. However, it has never been investigated if virtual reality can be used in group therapy. The present study is the first to examine the use of virtual reality in group therapy, by interviewing patients and therapists. Several challenges to the treatment format were discovered and recommendations to meet them are proposed. It remains uncertain if virtual reality is a meaningful addition to group therapy.