An open-label clinical trial to investigate the efficacy and safety of corifollitropin alfa combined with hCG in adult men with hypogonadotropic hypogonadism

Subject disposition. (EPS 1138 kb

APHRODITE criteria:addressing male patients with hypogonadism and/or infertility owing to altered idiopathic testicular function

Research question: Can a novel classification system of the infertile male - 'APHRODITE' (Addressing male Patients with Hypogonadism and/or infeRtility Owing to altereD, Idiopathic TEsticular function) - stratify different subgroups of male infertility to help scientists to design clinical trials on the hormonal treatment of male infertility, and clinicians to counsel and treat the endocrinological imbalances in men and, ultimately, increase the chances of natural and assisted conception?Design: A collaboration between andrologists, reproductive urologists and gynaecologists, with specialization in reproductive medicine and expertise in male infertility, led to the development of the APHRODITE criteria through an iterative consensus process based on clinical patient descriptions and the results of routine laboratory tests, including semen analysis and hormonal testing.Results: Five patient groups were delineated according to the APHRODITE criteria; (1) Hypogonadotrophic hypogonadism (acquired and congenital); (2) Idiopathic male infertility with lowered semen analysis parameters, normal serum FSH and normal serum total testosterone concentrations; (3) A hypogonadal state with lowered semen analysis parameters, normal FSH and reduced total testosterone concentrations; (4) Lowered semen analysis parameters, elevated FSH concentrations and reduced or normal total testosterone concentrations; and (5) Unexplained male infertility in the context of unexplained couple infertility.Conclusion: The APHRODITE criteria offer a novel and standardized patient stratification system for male infertility independent of aetiology and/or altered spermatogenesis, facilitating communication among clinicians, researchers and patients to improve reproductive outcomes following hormonal therapy. APHRODITE is proposed as a basis for future trials of the hormonal treatment of male infertility.</p

Quantum Phase Transition of Randomly-Diluted Heisenberg Antiferromagnet on a Square Lattice

Ground-state magnetic properties of the diluted Heisenberg antiferromagnet on a square lattice are investigated by means of the quantum Monte Carlo method with the continuous-time loop algorithm. It is found that the critical concentration of magnetic sites is independent of the spin size S, and equal to the two-dimensional percolation threshold. However, the existence of quantum fluctuations makes the critical exponents deviate from those of the classical percolation transition. Furthermore, we found that the transition is not universal, i.e., the critical exponents significantly depend on S.Comment: RevTeX, 4 pages including 5 EPS figure

APHRODITE criteria:addressing male patients with hypogonadism and/or infertility owing to altered idiopathic testicular function

Research question: Can a novel classification system of the infertile male - 'APHRODITE' (Addressing male Patients with Hypogonadism and/or infeRtility Owing to altereD, Idiopathic TEsticular function) - stratify different subgroups of male infertility to help scientists to design clinical trials on the hormonal treatment of male infertility, and clinicians to counsel and treat the endocrinological imbalances in men and, ultimately, increase the chances of natural and assisted conception?Design: A collaboration between andrologists, reproductive urologists and gynaecologists, with specialization in reproductive medicine and expertise in male infertility, led to the development of the APHRODITE criteria through an iterative consensus process based on clinical patient descriptions and the results of routine laboratory tests, including semen analysis and hormonal testing.Results: Five patient groups were delineated according to the APHRODITE criteria; (1) Hypogonadotrophic hypogonadism (acquired and congenital); (2) Idiopathic male infertility with lowered semen analysis parameters, normal serum FSH and normal serum total testosterone concentrations; (3) A hypogonadal state with lowered semen analysis parameters, normal FSH and reduced total testosterone concentrations; (4) Lowered semen analysis parameters, elevated FSH concentrations and reduced or normal total testosterone concentrations; and (5) Unexplained male infertility in the context of unexplained couple infertility.Conclusion: The APHRODITE criteria offer a novel and standardized patient stratification system for male infertility independent of aetiology and/or altered spermatogenesis, facilitating communication among clinicians, researchers and patients to improve reproductive outcomes following hormonal therapy. APHRODITE is proposed as a basis for future trials of the hormonal treatment of male infertility.</p

Classical Correlation-Length Exponent in Non-Universal Quantum Phase Transition of Diluted Heisenberg Antiferromagnet

Critical behavior of the quantum phase transition of a site-diluted Heisenberg antiferromagnet on a square lattice is investigated by means of the quantum Monte Carlo simulation with the continuous-imaginary-time loop algorithm. Although the staggered spin correlation function decays in a power law with the exponent definitely depending on the spin size $S$, the correlation-length exponent is classical, i.e., $\nu=4/3$. This implies that the length scale characterizing the non-universal quantum phase transition is nothing but the mean size of connected spin clusters.Comment: 4 pages, 3 figure

Rare region effects at classical, quantum, and non-equilibrium phase transitions

Rare regions, i.e., rare large spatial disorder fluctuations, can dramatically change the properties of a phase transition in a quenched disordered system. In generic classical equilibrium systems, they lead to an essential singularity, the so-called Griffiths singularity, of the free energy in the vicinity of the phase transition. Stronger effects can be observed at zero-temperature quantum phase transitions, at nonequilibrium phase transitions, and in systems with correlated disorder. In some cases, rare regions can actually completely destroy the sharp phase transition by smearing. This topical review presents a unifying framework for rare region effects at weakly disordered classical, quantum, and nonequilibrium phase transitions based on the effective dimensionality of the rare regions. Explicit examples include disordered classical Ising and Heisenberg models, insulating and metallic random quantum magnets, and the disordered contact process.Comment: Topical review, 68 pages, 14 figures, final version as publishe

Testosterone treatment is not associated with increased risk of adverse cardiovascular events: results from the Registry of Hypogonadism in Men (RHYME).

SummaryAims The aim of this study was to assess cardiovascular (CV) safety of testosterone replacement therapy (TRT) in a large, diverse cohort of European men with hypogonadism (HG). Methods The Registry of Hypogonadism in Men (RHYME) was designed as a multi-national, longitudinal disease registry of men diagnosed with hypogonadism (HG) at 25 clinical sites in six European countries. Data collection included a complete medical history, physical examination, blood sampling and patient questionnaires at multiple study visits over 2–3 years. Independent adjudication was performed on all mortalities and CV outcomes. Results Of 999 patients enrolled with clinically diagnosed HG, 750 (75%) initiated some form of TRT. Registry participants, including both treated and untreated patients, contributed 23 900 person-months (99.6% of the targeted) follow-up time. A total of 55 reported CV events occurred in 41 patients. Overall, five patients died of CV-related causes (3 on TRT, 2 untreated) and none of the deaths were adjudicated as treatment-related. The overall CV incidence rate was 1522 per 100 000 person-years. CV event rates for men receiving TRT were not statistically different from untreated men (P=.70). Regardless of treatment assignment, CV event rates were higher in older men and in those with increased CV risk factors or a prior history of CV events. Conclusions Age and prior CV history, not TRT use, were predictors of new-onset CV events in this multi-national, prospective hypogonadism registry

The Medicine Tree: Unsettling palaeoecological perceptions of past environments and human activity

In this paper, we consider palaeoecological approaches to past landscapes and reflect upon how these are relevant to archaeological themes concerning concepts of environmental change and the role of past and present human communities in these processes. In particular, we highlight the importance of local context in the perception and understanding of landscape. Utilising a case study from Nepal, we look to ‘unsettle’ a conventional palaeoecological interpretation of a pollen record, originally constructed on western ecological principles, and instead draw on an interpretative perspective rooted in local Buddhist ecological knowledge, or a ‘folk taxonomy’, known as ‘The Medicine Tree’. We discuss how the interpretations of patterns and processes of vegetation change from a pollen record are not necessarily absolute. In particular, we outline how the palaeoecological frame of enquiry and reference is rooted in an essentially Eurocentric, Western scientific paradigm, which, in turn, shapes how we perceive and conceive of past landscapes and the role of ‘anthropogenic impact’ on vegetation. The aim of this is not to suggest that scientific approaches to the ‘reconstruction’ of past landscapes are necessarily invalid, but to illustrate how ‘empirical’ scientific methods and interpretations in archaeological science are contingent upon specific social and cultural frames of reference. We discuss the broader relevance of this, such as how we interpret past human activity and perception of landscape change, the ways in which we might look to mobilise research in the context of contemporary problems, issues concerning ‘degraded landscapes’ and how we incorporate local and archaeological perspectives with palaeoecology within an interconnected and iterative process

From Monasteries to Multinationals (and Back): A Historical Review of the Beer Economy

This article reviews beer production, consumption and the industrial organization of breweries throughout history. Monasteries were the centers of the beer economy in the early Middle Ages. Innovation and increased demand later induced the growth of commercial breweries. Globalization and scientific discoveries transfirmed the beer industry and increased competition from the 16th through the 19th century. The 20th century was characterized by dramatic (domestic and international) consolidation, major shifts in consumption patterns, and the re-emergence of small breweries