The current status and future of andrology: A consensus report from the Cairo workshop group

Background In attempting to formulate potential WHO guidelines for the diagnosis of male infertility, the Evidence Synthesis Group noted a paucity of high-quality data on which to base key recommendations. As a result, a number of authors suggested that key areas of research/evidence gaps should be identified, so that appropriate funding and policy actions could be undertaken to help address key questions. Objectives The overall objective of this Consensus workshop was to clarify current knowledge and deficits in clinical laboratory andrology, so that clear paths for future development could be navigated. Materials and Methods Following a detailed literature review, each author, prior to the face-to-face meeting, prepared a summary of their topic and submitted a PowerPoint presentation. The topics covered were (a) Diagnostic testing in male fertility and infertility, (b) Male fertility/infertility in the modern world, (c) Clinical management of male infertility, and (d) The overuse of ICSI. At the meeting in Cairo on February 18, 2019, the evidence was presented and discussed and a series of consensus points agreed. Results The paper presents a background and summary of the evidence relating to these four topics and addresses key points of significance. Following discussion of the evidence, a total of 36 consensus points were agreed. Discussion The Discussion section presents areas where there was further debate and key areas that were highlighted during the day. Conclusion The consensus points provide clear statements of evidence gaps and/or potential future research areas/topics. Appropriate funding streams addressing these can be prioritized and consequently, in the short and medium term, answers provided. By using this strategic approach, andrology can make the rapid progress necessary to address key scientific, clinical, and societal challenges that face our discipline now and in the near future

Anti-Müllerian hormone measurement for the diagnosis of polycystic ovary syndrome

Objective: Anti-Müllerian hormone (AMH) is derived from the small antral follicles, and an elevated level has been suggested to add value to the Rotterdam criteria for the diagnosis of PCOS in cases of diagnostic uncertainty. Therefore, the role of AMH in the classical phenotype of PCOS was defined within a Caucasian population. Design: This was a cross-sectional study. Patients: Sixty Five women without PCOS and 110 women with PCOS fulfilling all 3 diagnostic Rotterdam criteria. Measurements: The main outcomes were the utility of serum AMH for the diagnosis of PCOS and its relationship to the metabolic parameters. Results: Anti-Müllerian hormone was increased in PCOS compared to controls (P  < .001). Areas under the receiver operator curve showed AMH to be predictive of PCOS (0.76) using a cut-off AMH of 46 pmol/L, which is derived from the 95 th percentile of the controls that gave a 41% sensitivity and 86% specificity; an AMH cut-off of 35 pmol/L gave a 55% sensitivity and 79% specificity. Age- and BMI-adjusted multiple logistic regression showed that AMH was more predictive of PCOS independently of either serum testosterone (T) (OR = 4.04; 95% CI 1.42-11.11; P =.007) or free androgen index (FAI) (OR = 3.90; 95% CI 1.40-10.83; P =.009). Conclusion: Whilst an elevated AMH has poor sensitivity, it is fourfold more likely to be associated with a diagnosis of PCOS, and supplementary to biochemical parameters will make a positive diagnosis of PCOS in 22% of patients when neither serum testosterone nor FAI is elevated

AIDS-Related Mycoses: Current Progress in the Field and Future Priorities.

Opportunistic fungal infections continue to take an unacceptably heavy toll on the most disadvantaged living with HIV-AIDS, and are a major driver for HIV-related deaths. At the second EMBO Workshop on AIDS-Related Mycoses, clinicians and scientists from around the world reported current progress and key priorities for improving outcomes from HIV-related mycoses

The Polycystic Ovary Syndrome Quality of Life scale (PCOSQOL): Development and preliminary validation

Polycystic ovary syndrome is an endocrine disorder amongst women, which can negatively impact quality of life. Research proposes that a more sensitive PCOS quality of life measure is needed. This study aims to develop and initially validate a quality of life scale for women with the condition in the United Kingdom. Women with PCOS (n = 714) took part in the development and initial validation of the 35-item polycystic ovary syndrome quality of life scale (PCOSQOL)(α = .95). Subscales include Impact of PCOS (α = .95), Infertility (α = .95), Hirsutism (α = .97) and Mood (α = .89). The PCOSQOL scale represents aspects of quality of life important to women with PCOS and may be more sensitive for use in the clinical and research settings

Boson-boson scattering and Higgs production at the LHC from a six fermion point of view: four jets + lν\nu processes at \O(\alpha_{em}^6)

Boson-boson scattering and Higgs production in boson-boson fusion hold the key to electroweak symmetry breaking. In order to analyze these essential features of the Standard Model we have performed a partonic level study of all processes $q_1 q_2 \to q_3 q_4 q_5 q_6 l \nu$ at the LHC using the exact matrix elements at \O(\alpha_{em}^6) provided by \Phase, a new MC generator. These processes include also three boson production and the purely electroweak contribution to \toptop production as well as all irreducible backgrounds. Kinematical cuts have been studied in order to enhance the VV scattering signal over background. \Phase has been compared with different Monte Carlo's showing that a complete calculation is necessary for a correct description of the process.Comment: 26 pages, 19 figure

PNAS plus: plasmodium falciparum responds to amino acid starvation by entering into a hibernatory state

The human malaria parasite Plasmodium falciparum is auxotrophic for most amino acids. Its amino acid needs are met largely through the degradation of host erythrocyte hemoglobin; however the parasite must acquire isoleucine exogenously, because this amino acid is not present in adult human hemoglobin. We report that when isoleucine is withdrawn from the culture medium of intraerythrocytic P. falciparum, the parasite slows its metabolism and progresses through its developmental cycle at a reduced rate. Isoleucine-starved parasites remain viable for 72 h and resume rapid growth upon resupplementation. Protein degradation during starvation is important for maintenance of this hibernatory state. Microarray analysis of starved parasites revealed a 60% decrease in the rate of progression through the normal transcriptional program but no other apparent stress response. Plasmodium parasites do not possess a TOR nutrient-sensing pathway and have only a rudimentary amino acid starvation-sensing eukaryotic initiation factor 2α (eIF2α) stress response. Isoleucine deprivation results in GCN2-mediated phosphorylation of eIF2α, but kinase-knockout clones still are able to hibernate and recover, indicating that this pathway does not directly promote survival during isoleucine starvation. We conclude that P. falciparum, in the absence of canonical eukaryotic nutrient stress-response pathways, can cope with an inconsistent bloodstream amino acid supply by hibernating and waiting for more nutrient to be provided

The UTfit Collaboration Report on the Status of the Unitarity Triangle beyond the Standard Model I. Model-independent Analysis and Minimal Flavour Violation

Starting from a (new physics independent) tree level determination of rhobar and etabar, we perform the Unitarity Triangle analysis in general extensions of the Standard Model with arbitrary new physics contributions to loop-mediated processes. Using a simple parameterization, we determine the allowed ranges of non-standard contributions to |Delta F|=2 processes. Remarkably, the recent measurements from B factories allow us to determine with good precision the shape of the Unitarity Triangle even in the presence of new physics, and to derive stringent constraints on non-standard contributions to |Delta F|=2 processes. Since the present experimental constraints favour models with Minimal Flavour Violation, we present the determination of the Universal Unitarity Triangle that can be defined in this class of extensions of the Standard Model. Finally, we perform a combined fit of the Unitarity Triangle and of new physics contributions in Minimal Flavour Violation, reaching a sensitivity to a new physics scale of about 5 TeV. We also extrapolate all these analyses into a "year 2010" scenario for experimental and theoretical inputs in the flavour sector. All the results presented in this paper are also available at the URL http://www.utfit.org, where they are continuously updated.Comment: 29 pages, 56 figure