![]() ![]() Testosterone regulates gene expression in most extra-genital tissues, including muscle and bone, and modulates the immune system. Testosterone, the major androgen in men, is necessary for fetal male sexual differentiation, pubertal development, and the maintenance of adult secondary sex characteristics and spermatogenesis. Centers for Disease Control have voluntary Hormone Standardization Programs to help clinical, research, and public health laboratories maintain and enhance the quality and comparability of their results. The College of American Pathologists and the U.S. Endocrine Society has spearheaded efforts towards standardizing the methods by which testosterone assays are validated ( 1), and several societies have provided guidelines and recommendations to physicians who order and interpret the results of androgen assays ( 2- 4). In recognition of these potential shortcomings, the U.S. Endocrinologists should examine the protocols for each assay, and discuss them with the laboratory director. Unfortunately, these expectations are not always fulfilled. We expect the reference ranges to be based on large normal control populations, and for some assays, normative data must be stratified by age. Endocrinologists rely on clinical laboratories to provide accurate and precise, and in some cases highly sensitive assays for accurate diagnoses. ![]() Laboratory tests are an essential component of almost all evaluations, and proper interpretation of the results obtained requires an understanding of methodology as well as an awareness of the impact of endocrine rhythms, age, race, body composition, drug exposure, co-morbidities, other illnesses, and nutrition on tests of endocrine testicular function. The evaluation of men for suspected hypogonadism begins with a detailed medical history and a careful physical examination. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text, INTRODUCTION Other tests such as estradiol, inhibin-B, and Mullerian inhibitory hormone, and provocative endocrine tests using hCG, GnRH or its analogs, or antiandrogens or antiestrogens, and semen analysis in the subfertile male are discussed. With many disorders, however, both the testes and the hypothalamic-pituitary unit are affected. If testosterone deficiency is confirmed, the next step is to differentiate between primary and secondary hypogonadism by measuring LH and FSH. In these men, tests for the free (or non-SHBG/bioavailable) testosterone fraction testosterone) are helpful for an accurate diagnosis. Moreover, many men who present with adult onset testosterone deficiency have a low level of sex hormone-binding globulin (SHBG) associated with obesity, insulin resistance, and type 2 diabetes. The laboratory diagnosis of hypogonadism is based on a consistent and unequivocally low serum total testosterone level measured in blood samples obtained in the early morning, but normal ranges vary with different methods and among laboratories. 10-40.Since the symptoms of hypogonadism are nonspecific, and the signs of testosterone deficiency can be subtle and slow to develop, the assessment of testicular function relies heavily on laboratory testing. (2023), "Manufacturing strategy 4.0: a framework to usher towards industry 4.0 implementation for digital transformation", Industrial Management & Data Systems, Vol. CitationÄohale, V., Verma, P., Gunasekaran, A. Finally, the authors appreciate the support provided by the Digital Manufacturing Lab (DML), NITIE, Mumbai, for providing the facility to conduct this research. The authors are immensely grateful to the experts for their continuous suggestions and active involvement that makes this work complete. The authors express their sincerest gratitude to the anonymous reviewers, guest editors and EIC for their constant feedback on the improvement of the manuscript. MS 4.0, to implement I4.0 technologies through a manufacturing strategic lens. This study is the first of its kind in the body of knowledge to formulate a digital transformation strategy, i.e.
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