Bias and prejudice, or simply ignorance, can lead to isolation, vulnerability, disadvantage and discrimination at school, at work, in stores and other services, or even where people live. Trans people living in smaller towns or rural communities may even be more isolated.
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As the most important male hormone, testosterone has an impact on almost all organs and body functions. The biological effects of testosterone and the testes have been known since antiquity, long before testosterone was identified as the active agent. Practical applications of this knowledge were castration of males to produce obedient servants, for punishment, for preservation of the prepubertal soprano voice and even for treatment of diseases. Testes were used in organotherapy and transplanted as treatment for symptoms of hypogonadism on a large scale, although these practices had only placebo effects. In reaction to such malpractice in the first half of the 20th century science and the young pharmaceutical industry initiated the search for the male hormone. After several detours together with their teams in 1935, Ernst Laqueur (Amsterdam) isolated and Adolf Butenandt (Gdansk) as well as Leopold Ruzicka (Zürich) synthesized testosterone. Since then testosterone has been available for clinical use. However, when given orally, testosterone is inactivated in the liver, so that parenteral forms of administration or modifications of the molecule had to be found. Over 85 years the testosterone preparations have been slowly improved so that now physiological serum levels can be achieved.
Extirpation and transplantation of endocrine glands are among the earliest tools in experimental and applied endocrinology. The testes, in their exposed position, are vulnerable and easily accessible to manipulation including both accidental trauma and forceful removal. Loss of virility and fertility are easily recognizable, not only by physicians but also by laymen, so that the results of loss of the testes or testicular function were known since antiquity and long before the discovery of sperm and their function in the 17th and 18th century, and long before testosterone, as the active agent, was isolated and synthesized in the 20th century (1). Although even present-day endocrinologists often assume that the discovery and synthesis of this important hormone must have been honoured by a Nobel Prize; this assumption is not completely correct. This article deals with the history of testosterone and tries to explain this misunderstanding. In order to understand why the road to testosterone was so long and convoluted, we will briefly describe what was known about the physiological role of the testes and how this knowledge was translated into practical applications over centuries, before, at the beginning of the 20th century, the hype surrounding testis transplantation and organotherapy challenged academic research and industrial enterprise to isolate and synthesize testosterone in successful cooperation; an account of the development of testosterone preparations for clinical use follows.
As steroid biochemistry progressed, the great breakthroughs were the discovery of the ring structure of steroids and bile acids at the National Institute of Medical Research in London in 1932 (25) and at the Bavarian Academy of Sciences in Munich also in 1932 (26). A heated discussion ensued whether there were three of four rings in the steroid structure and, if four rings, whether the fourth had five or six C-atoms. Under the sponsorship of the Health Organisation of the League of Nations (the predecessor of WHO) highly recognized chemists including Edmund A Doisy, Adolf Butenandt and Guy Marrian assembled at University College London and reached a consensus that steroids had four rings and the fourth ring had five C-atoms (26) (Fig. 1). Shortly before, these eminent researchers, including Ernest Laqueur, had isolated pregnandiol and estrone from pregnant mare urine provided by various drug companies co-operating with scientists. In 1934 Butenandt as well as three further teams added progesterone to the array of sex steroids (28). Their purpose was to replace the miscredited organotherapy and to make proper steroid substitution available to patients (Table 1) (29).
However, patients with other causes of an elevated TSH (i.e. recovery from non-thyroidal illness, recovery from thyroiditis, specific types of medication, assay interference due to for example macro-TSH or heterophilic antibodies, severe obesity) will not benefit from treatment (20). It is, therefore, essential to make a distinction between true subclinical hypothyroidism and other causes of isolated hyperthyrotropenemia. This is even more important in elderly patients, since a widening of the reference range has been described in elderly persons living in regions with historical iodine sufficiency as part of the physiologic adaptation to aging (36, 37). For practical reasons, virtually all studies investigating the treatment of SCH use a purely biochemical diagnosis, without using an age-adjusted reference range for TSH for example (23). This may have contributed to the normal quality of life at baseline in subjects participating in the TRUST and IEMO trials (21, 22). For the above-mentioned reasons, it is essential to clearly establish a good clinical diagnosis and use the full patient context to interpret the biochemical results. This is particularly relevant in case of a mildly elevated TSH, since the majority of other causes mentioned above cause only a slightly elevated TSH.
This is a fun game in communication skills that will also give team members some creative freedom. They will need to communicate those creative ideas to one another, but also engage in joint decision-making for the activity to be a success. And that activity is to create a comic together, using their complementary skills and communication to realize a shared vision.
Opinion 16-05 A full-time judge may participate in non-commercial podcasts about New York legal issues, or science fiction and comic book characters and legal issues that may arise in fictional works, subject to generally applicable limitations on judicial speech and conduct, such as the public comment rule. The judge may be identified as a judge, but his/her participation must not be used to promote or market the podcast.
In December 2019, a cluster of pneumonia cases, caused by a newly identified β-coronavirus, occurred in Wuhan, China. This coronavirus, was initially named as the 2019-novel coronavirus (2019-nCoV) on 12 January 2020 by World Health Organization (WHO). WHO officially named the disease as coronavirus disease 2019 (COVID-19) and Coronavirus Study Group (CSG) of the International Committee proposed to name the new coronavirus as SARS-CoV-2, both issued on 11 February 2020. The Chinese scientists rapidly isolated a SARS-CoV-2 from a patient within a short time on 7 January 2020 and came out to genome sequencing of the SARS-CoV-2 [1]. As of 1 March 2020, a total of 79,968 cases of COVID-19 have been confirmed in mainland China including 2873 deaths [2]. Studies estimated the basic reproduction number (R0) of SARS-CoV-2 to be around 2.2 [3], or even more (range from 1.4 to 6.5) [4], and familial clusters of pneumonia [5] outbreaks add to evidence of the epidemic COVID-19 steadily growing by human-to-human transmission.
Trees is a science fiction comic book series by Warren Ellis and Jason Howard, published by American company Image Comics. The first issue was published May 28, 2014. The narrative begins ten years after the arrival of massive and silent alien presences who stand on the surface of the earth like the "Trees" of the title, not moving and seeming to take no account of human life and society. While a high concept science fiction story, the series also concerns itself with a cross-section of social and cultural issues as experienced by the characters, including police states, feminism, economic disparity, and transgender identity.
The third volume Three Fates focuses on Klara Voranova, a police sergeant in the small Russian town of Toska.[2] A murdered body found at the base of a Tree sets off an investigation into the forces and corruption that control the isolated town. At the same time, a ghost from Klara's past gives some clues to the purpose of the Trees.
Speaker Bio: Maya Espersen (she/her or they/them) has been the Cataloging Coordinator at the Aurora Public Library in Aurora, Colorado since October 2021. They received their MLIS in 2012 from the University at Albany, SUNY, and was briefly a Resource Sharing and Reserves Associate for the University from 2012 to 2015. They are one of three co-chairs for the Gender and Sexuality SACO Funnel. Their areas of interest include: inclusive language in metadata and description; graphic novels, comics, and manga; copy editing; and the evolution of fan culture in creative spaces. 2ff7e9595c
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