Experimental tests that could be useful in the future include tests to measure semen and prostate fluid cytokine levels. Various studies have shown increases in markers for inflammation such as elevated levels of cytokines, myeloperoxidase, and chemokines.
For chronic nonbacterial prostatitis (Cat III), also known as pelvic myoneuropathy or CP/CPPS, which makes up the majority of men diagnosed with "prostatitis", a treatment called the Stanford Protocol, developed by Stanford University Professor of Urology Rodney Anderson and psychologist David Wise in 1996, has recently been published. This is a combination of medication (using tricyclic antidepressants and benzodiazepines), psychological therapy (paradoxical relaxation, an advancement and adaptation, specifically for pelvic pain, of a type of progressive relaxation technique developed by Edmund Jacobson during the early 20th century), and physical therapy (trigger point release therapy on pelvic floor and abdominal muscles, and also yoga-type exercises with the aim of relaxing pelvic floor and abdominal muscles). While these studies are encouraging, definitive proof of efficacy would require a randomized, sham controlled, blinded study, which is not as easy to do with physical therapy as with drug therapy.
Cat. III prostatitis may have no initial trigger other than anxiety, often with an element of Obsessive Compulsive Disorder or other anxiety-spectrum problem. This is theorized to leave the pelvic area in a sensitized condition resulting in a loop of muscle tension and heightened neurological feedback (neural wind-up). Current protocols largely focus on stretches to release overtensed muscles in the pelvic or anal area (commonly referred to as trigger points), physical therapy to the area, and progressive relaxation therapy to reduce causative stress. Biofeedback physical therapy to relearn how to control pelvic floor muscles may be useful.
Aerobic exercise can help those sufferers who are not also suffering from Chronic Fatigue Syndrome (CFS) or whose symptoms are not exacerbated by exercise.
Anecdotal evidence suggests that food allergies and intolerances may have a role in exacerbating CP/CPPS, perhaps through mast cell mediated mechanisms. Specifically patients with gluten intolerance or celiac disease report severe symptom flares after sustained gluten ingestion. Patients may therefore find an exclusion diet helpful in lessening symptoms by identifying problem foods. Studies are lacking in this area.
There is a substantial list of medications used to treat this disorder.
Alpha blockers (tamsulosin, alfuzosin) are moderately helpful for many men with CPPS; duration of therapy needs to be at least 3 months.
Quercetin has shown effective in a randomized, placebo-controlled trial in chronic prostatitis using 500 mg twice a day for 4 weeks. Subsequent studies showed that quercetin, a mast cell inhibitor, reduces inflammation and oxidative stress in the prostate.
Pollen extract (Cernilton)] has also been shown effective in randomized placebo controlled trials.
Commonly used therapies that have not been properly evaluated in clinical trials are dietary modification, gabapentin, and amitriptyline.
Therapies shown to be "ineffective" by randomized placebo/sham controlled trials: levaquin (antibiotics), alpha blockers for 6 weeks or less, transurethral needle ablation of the prostate (TUNA).
At least one study suggests that multi-modal therapy (aimed at different pathways such as inflammation and neuromuscular dysfunction simultaneously) is better long term than monotherapy.
In recent years the prognosis for CP/CPPS has improved greatly with the advent of multimodal treatment, phytotherapy and protocols aimed at quieting the pelvic nerves through myofascial trigger point release and anxiety control.
These patients have no history of genitourinary pain complaints, but leukocytosis or bacteria have been noted during evaluation for other conditions.
Diagnosis is through tests of semen, EPS or urine that reveal inflammation in the absence of symptoms.
No treatment required. It is standard practice for men with infertility and category IV prostatitis to be given a trial of antibiotics and/or anti-inflammatories however evidence for efficacy are weak. Since signs of asymptomatic prostatic inflammation may sometimes be associated with prostate cancer, this can be addressed by tests that assess the ratio of free-to-total PSA. The results of these tests were significantly different in prostate cancer and category IV prostatitis in one study.
The Descent of Man
The Descent of Man, and selection in relation to sex is a book by Charles Darwin, first published in 1871.
It was Darwin's second great book on evolutionary theory, with the first being his 1859 work, "On the Origin of Species".
Darwin had said almost nothing about human beings in the "Origin", except a single sentence:
""Light will be thrown on the origin of man and his history"".
In "The Descent of Man", Darwin applies evolutionary theory to human evolution, and also explains his theory of sexual selection. He thought the two topics were closely connected.
In the nearly 12 years between the "Origin" and the "Descent of Man", several writers had written works on the subject. Noteworthy were:
Both were published in 1863.
The starting point for sexual selection is the observation that males differ from females, not just in sexual apparatus, but in many other traits. This is true of many animals, and the question is why this happens. The answer given by Darwin, and followed by many other biologists, is that the selection on males is different from the selection on females.
Sexual selection is the theory proposed by Charles Darwin that states that certain evolutionary traits can be explained by intraspecific competition (competition between members of the same species).
Darwin defined sexual selection as the effects of the "struggle between the individuals of one sex, generally the males, for the possession of the other sex".
Biologists today distinguish between "male to male combat" or "intrasexual selection" (it is usually males that fight each other), "mate choice" or "intersexual selection" (usually female choice of male mates) and sexual conflict.
Secondary sex characteristics are features that distinguish the two sexes of a species, but are not directly part of the reproductive system. They are believed to be the product of sexual selection for traits which give an individual an advantage over its rivals in courtship and fighting.
Traits selected by male combat are called "weapons"; and traits selected by mate choice are called "ornaments".
Fearne Cotton
Fearne Cotton (born 3 September 1981) is an English television and radio presenter. She is known for presenting a number of popular TV programmes such as "Top of the Pops" and the "Red Nose Day" "telethon". Cotton joined BBC Radio 1 in September 2005. In 2007, she became the first regular female presenter of BBC Radio 1's "Chart Show". She now presents BBC Radio 1's weekday mid-morning programme. In 2008 Cotton moved to the United States to present "The Guinness Book of Records - Live". In 2015, Cotton returned to children’s television by voicing a Voice Trumpet in the 2015 reboot of Teletubbies.
Minecraft
"This is about mainly Java Edition. For Bedrock Edition, see Minecraft Bedrock Edition."
Minecraft is an open world sandbox video game originally created by Markus "Notch" Persson. It was run by a company called Mojang before being sold to Microsoft in 2014 for USD $2.5 billion. It is the best-selling video game of all time, and over 200 million copies of the game have been sold.