The descriptive epidemiology of congenital and acquired cryptorchidism in a UK infant cohort.

INTRODUCTION: Recent studies in other European countries suggest that the prevalence of congenital cryptorchidism continues to increase. This study aimed to explore the prevalence and natural history of congenital cryptorchidism in a UK centre. METHODS: Between October 2001 and July 2008, 784 male infants were born in the prospective Cambridge Baby Growth Study. 742 infants were examined by trained research nurses at birth; testicular position was assessed using standard techniques. Follow-up assessments were completed at ages 3, 12, 18 and 24 months in 615, 462, 393 and 326 infants, respectively. RESULTS: The prevalence of cryptorchidism at birth was 5.9% (95% CI 4.4% to 7.9%). Congenital cryptorchidism was associated with earlier gestational age (p<0.001), lower birth weight (p<0.001), birth length (p<0.001) and shorter penile length at birth (p<0.0001) compared with other infants, but normal size after age 3 months. The prevalence of cryptorchidism declined to 2.4% at 3 months, but unexpectedly rose again to 6.7% at 12 months as a result of new cases. The cumulative incidence of "acquired cryptorchidism" by age 24 months was 7.0% and these cases had shorter penile length during infancy than other infants (p = 0.003). CONCLUSIONS: The prevalence of congenital cryptorchidism was higher than earlier estimates in UK populations. Furthermore, this study for the first time describes acquired cryptorchidism or "ascending testis" as a common entity in male infants, which is possibly associated with reduced early postnatal androgen activity.

Assessing the responsiveness of existing production operations

Production responsiveness refers to the ability of a production system to achieve its operational goals in the presence of supplier, internal and customer disturbances, where disturbances are those sources of change which occur independently of the system's intentions. A set of audit tools for assessing the responsiveness of production operations is being prepared as part of an EPSRC funded investigation. These tools are based on the idea that the ability to respond is linked to: the nature of the disturbances or changes requiring a response; their impact on production goals; and the inherent response capabilities of the operation. These response capabilities include information gathering and processing (to detect disturbances and production conditions), decision processes (which initiate system responses to disturbances) and various types of process flexibilities and buffers (which provide the physical means of dealing with disturbances). The paper discusses concepts and issues associated with production responsiveness, describes the audit tools that have been developed and illustrates their use in the context of a steel manufacturing plant.