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インドネシア語

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インドネシア語

Snow is water that falls from the clouds that had been frozen into a solid and like rain. Snow consists of particles of water vapor that then cools the air above, then fell to the earth as a piece of soft, white, and like crystals. Starting from the water vapor in Earth's atmosphere are assembled, a collection of water vapor cools to the point of condensation and then coagulates to form clouds. Set the steam continues to grow and merge into the cloud, so that at some point the air can no longer hold it. The clouds broke and the water particles fell to Earth. Particles falling water is pure water. To make pure water needed frozen temperatures lower than 0 degrees CelciusTapi, low temperature alone is not enough to create snow. When particles of pure water is in contact with air, the pure water is contaminated by other particles. So the water particles join together with others to form larger crystals. If the air temperature not to melt the ice crystals, ice crystals fall to the ground. And this is the snow! If not, the ice crystals melt and to the ground in the form of rain water.

英語

simple present tense

最終更新: 2015-09-08
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インドネシア語

Snow is water that falls from the clouds that had been frozen into a solid and like rain. Snow consists of particles of water vapor that then cools the air above, then fell to the earth as a piece of soft, white, and like crystals. Starting from the water vapor in Earth's atmosphere are assembled, a collection of water vapor cools to the point of condensation and then coagulates to form clouds. Set the steam continues to grow and merge into the cloud, so that at some point the air can no longer hold it. The clouds broke and the water particles fell to Earth. Particles falling water is pure water. To make pure water needed frozen temperatures lower than 0 degrees CelciusTapi, low temperature alone is not enough to create snow. When particles of pure water is in contact with air, the pure water is contaminated by other particles. So the water particles join together with others to form larger crystals. If the air temperature not to melt the ice crystals, ice crystals fall to the ground. And this is the snow! If not, the ice crystals melt and to the ground in the form of rain water.

英語

simple past tense

最終更新: 2015-09-08
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インドネシア語

String yang menyatakan bagaimana bagian dari nama berkas yang terlalu panjang mesti diganti dengan elipsis, bergantung kepada tingkat perbesaran. Setiap entri daftar dalam bentuk "Tingkat Perbesaran:Bilangan Bulat". Untuk setiap tingkat perbesaran, bila bilangan bulat yang diberikan lebih dari 0, nama berkas tidak akan melampaui cacah baris yang dinyatakan. Bila bilangan bulat adalah 0 atau kurang, tidak ada batas yang dipaksakan pada tingkat perbesaran yang dinyatakan. Entri baku dengan bentuk "Bilangan Bulat" tanpa menyatakan tingkat perbesaran juga diperbolehkan. Itu mendefinisikan cacah baris maksimum bagi semua tingkat perbesaran lainnya. Contoh: 0 - selalu tampilkan nama berkas panjang; 3 - pendekkan nama berkas apabila melebihi 3 baris; smallest:5,smaller:4,0 - pendekkan nama berkas apabila melebihi lima baris pada tingkat perbesaran "smallest". Pendekkan nama berkas apabila melebihi empat baris pada tingkat perbesaran "smaller". Jangan menyingkat nama berkas pada tingkat perbesaran lain. Tingkat perbesaran yang tersedia: smallest (33%), smaller (50%), small (66%), standard (100%), large (150%), larger (200%), largest (400%)

英語

A string specifying how parts of overlong file names should be replaced by ellipses, depending on the zoom level. Each of the list entries is of the form "Zoom Level:Integer". For each specified zoom level, if the given integer is larger than 0, the file name will not exceed the given number of lines. If the integer is 0 or smaller, no limit is imposed on the specified zoom level. A default entry of the form "Integer" without any specified zoom level is also allowed. It defines the maximum number of lines for all other zoom levels. Examples: 0 - always display overlong file names; 3 - shorten file names if they exceed three lines; smallest:5,smaller:4,0 - shorten file names if they exceed five lines for zoom level "smallest". Shorten file names if they exceed four lines for zoom level "smaller". Do not shorten file names for other zoom levels. Available zoom levels: smallest (33%), smaller (50%), small (66%), standard (100%), large (150%), larger (200%), largest (400%)

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インドネシア語

1 Predicting Australian Takeover Targets: A Logit Analysis Maurice Peat* Maxwell Stevenson* * Discipline of Finance, School of Finance, The University of Sydney Abstract Positive announcement-day adjusted returns to target shareholders in the event of a takeover are well documented. Investors who are able to accurately predict firms that will be the subject of a takeover attempt should be able to earn these excess returns. In this paper a series of probabilistic regression models were developed that use financial statement variables suggested by prior research as explanatory variables. The models, applied to in-sample and out-of-sample data, led to predictions of takeover targets that were better than chance in all cases. The economic outcome resulting from holding a portfolio of the predicted targets over the prediction period are also analysed. Keywords: takeovers, targets, prediction, classification, logit analysis JEL Codes: G11, G17, G23, G34 This is a draft copy and not to be quoted. 2 1. Introduction In this paper our aim is to accurately predict companies that will become takeover targets. Theoretically, if it is possible to predict takeovers with accuracy greater than chance, it should be possible to generate abnormal returns from holding a portfolio of the predicted targets. Evidence of abnormal returns of 20% to 30% made by shareholders of firms on announcement of a takeover bid is why prediction of these events is of interest to academics and practitioners alike. The modelling approach adopted in this study was based on the discrete choice approach used by Palepu (1986) and Barnes (1999). The models were based on financial statement information, using variables suggested by the numerous theories that have been put forward to explain takeover activity. The performance of the models was evaluated using statistical criteria. Further, the predictions from the models were rated against chance and economic criteria through the formation and tracking of a portfolio of predicted targets. Positive results were found under both evaluation criteria. Takeover prediction studies are a logical extension of the work of Altman (1968) who used financial statement information to explain corporate events. Early studies by Simkowitz and Monroe (1971) and Stevens (1973) were based on the Multiple Discriminant Analysis (MDA) technique. Stevens (1973) coupled MDA with factor analysis to eliminate potential multicollinearity problems and reported a predictive accuracy of 67.5%, suggesting that takeover prediction was viable. Belkaoui (1978) and Rege (1984) conducted similar analyses in Canada with Belkaoui (1978) confirming the results of these earlier researchers and reporting a predictive accuracy of 85% . Concerns were raised by Rege (1984) who was unable to predict with similar accuracy. These concerns were also raised in research by others such as Singh (1971) and Fogelberg, Laurent, and McCorkindale (1975). Reacting to the wide criticism of the MDA method, researchers began to use discrete choice models as the basis of their research. Harris et al. (1984) used probit analysis to develop a model and found that it had extremely high explanatory power, but were unable to discriminate between target and non-target firms with any degree of accuracy. Dietrich and Sorensen (1984) continued this work using a logit model and achieved a classification accuracy rate of 90%. Palepu (1986) addressed a number of methodological problems in takeover prediction. He suggested the use of statebased prediction samples where a number of targets were matched with non-targets 3 for the same sample period. While this approach was appropriate for the estimation sample, it exaggerated accuracies within the predictive samples because the estimated error rates in these samples were not indicative of error rates within the population of firms. He also proposed the use of an optimal cut-off point derivation which considered the decision problem at hand. On the basis of this rectified methodology, along with the application of a logit model to a large sample of US firms, Palepu (1986) provided evidence that the ability of the model was no better than a chance selection of target and non-target firms. Barnes (1999) also used the logit model and a modified version of the optimal cut-off rule on UK data. His results indicated that a portfolio of predicted targets may have been consistent with Palepu’s finding, but he was unable to document this in the UK context due to model inaccuracy. In the following section the economic explanations underlying takeover activity are discussed. Section 3 outlines our takeover hypotheses and describes the explanatory variables that are used in the modelling procedure. The modelling framework and data used in the study is contained in Section 4, while the results of our model estimation, predictions, classification accuracy and portfolio economic outcomes are found in Section 5. We conclude in Section 6. 2. Economic explanations of takeover activity Economic explanations of takeover activity have suggested the explanatory variables that were included in this discrete choice model development study. Jensen and Meckling (1976) posited that agency problems occurred when decision making and risk bearing were separated between management and stakeholders1, leading to management inefficiencies. Manne (1965) and Fama (1980) theorised that a mechanism existed that ensured management acted in the interests of the vast number of small non-controlling shareholders2. They suggested that a market for corporate control existed in which alternative management teams competed for the rights to control corporate assets. The threat of acquisition aligned management objectives with those of stakeholders as managers are terminated in the event of an acquisition in order to rectify inefficient management of the firm’s assets. Jensen and Ruback (1983) suggested that both capital gains and increased dividends are available to an 1 Stakeholders are generally considered to be both stock and bond holders of a corporation. 2 We take the interests of shareholders to be in the maximization of the present value of the firm. 4 acquirer who could eliminate the inefficiencies created by target management, with the attractiveness of the firm for takeover increasing with the level of inefficiency. Jensen (1986) looked at the agency costs of free cash flow, another form of management inefficiency. In this case, free cash flow referred to cash flows in excess of positive net present value (NPV) investment opportunities and normal levels of financial slack (retained earnings). The agency cost of free cash flow is the negative NPV value that arises from investing in negative NPV projects rather than returning funds to investors. Jensen (1986) suggested that the market value of the firm should be discounted by the expected agency costs of free cash flow. These, he argued, were the costs that could be eliminated either by issuing debt to fund an acquisition of stock, or through merger with, or acquisition of a growing firm that had positive NPV investments and required the use of these excess funds. Smith and Kim (1994) combined the financial pecking order argument of Myers and Majluf (1984) with the free cash flow argument of Jensen (1986) to create another motivational hypothesis that postulated inefficient firms forgo profitable investment opportunities because of informational asymmetries. Further, Jensen (1986) argued that, due to information asymmetries that left shareholders less informed, management was more likely to undertake negative NPV projects rather than returning funds to investors. Smith and Kim (1994) suggested that some combination of these firms, like an inefficient firm and an efficient acquirer, would be the optimal solution to the two respective resource allocation problems. This, they hypothesised, would result in a market value for the combined entity that exceeded the sum of the individual values of the firms. This is one form of financial synergy that can arise in merger situations. Another form of financial synergy is that which results from a combination of characteristics of the target and bidding firms. Jensen (1986) suggested that an optimal capital structure exists, whereby the marginal benefits and marginal costs of debt are equal. At this point, the cost of capital for a firm is minimised. This suggested that increases in leverage will only be viable for those firms who have free cash flow excesses, and not for those which have an already high level of debt. Lewellen (1971) proposed that in certain situations, financial efficiencies may be realized without the realization of operational efficiencies. These efficiencies relied on a simple Miller and Modigliani (1964) model. It proposed that, in the absence of corporate taxes, an increase in a firm’s leverage to reasonable levels would increase the value of the equity share of the company due to a lower cost of capital. By a 5 merger of two firms, where either one or both had not utilised their borrowing capacity, would result in a financial gain. This financial gain would represent a valuation gain above that of the sum of the equity values of the individual firms. However, this result is predicated on the assumption that the firms need to either merge or be acquired in order to achieve this result. Merger waves are well documented in the literature. Gort (1969) suggested that industry disturbances are the source of these merger waves, his argument being that they occurred in response to discrepancies between the valuation of a firm by shareholders and potential acquirers. As a consequence of economic shocks (such as deregulation, changes in input or output prices, etc.), expectations concerning future cash flow became more variable. This results in an increased probability that the value the acquirer places on a potential target is greater than its current owner’s valuation. The result is a possible offer and subsequent takeover. Mitchell and Mulherin (1996), in their analysis of mergers and acquisitions in the US during the 1980s, provided evidence that mergers and acquisitions cluster by industries and time. Their analysis confirmed the theoretical and empirical evidence provided by Gort (1969) and provided a different view suggesting that mergers, acquisitions, and leveraged buyouts were the least cost method of adjusting to the economic shocks borne by an industry. These theories suggested a clear theoretical base on which to build takeover prediction models. As a result, eight main hypotheses for the motivation of a merger or acquisition have been formulated, along with twenty three possible explanatory variables to be incorporated predictive models. 3. Takeover hypotheses and explanatory variables The most commonly accepted motivation for takeovers is the inefficient management hypothesis.3 The hypothesis states that inefficiently managed firms will be acquired by more efficiently managed firms. Accordingly, H1: Inefficient management will lead to an increased likelihood of acquisition. Explanatory variables suggested by this hypothesis as candidates to be included in the specifications of predictive models included: 1. ROA (EBIT/Total Assets – Outside Equity Interests) 3 It is also known as the disciplinary motivation for takeovers. 6 2. ROE (Net Profit After Tax / Shareholders Equity – Outside Equity Interests) 3. Earnings Before Interest and Tax Margin (EBIT/Operating Revenue) 4. EBIT/Shareholders Equity 5. Free Cash Flow (FCF)/Total Assets 6. Dividend/Shareholders Equity 7. Growth in EBIT over past year, along with an activity ratio, 8. Asset Turnover (Net Sales/Total Assets) While there are competing explanations for the effect that a firm’s undervaluation has on the likelihood of its acquisition by a bidder, there is consistent agreement across all explanations that the greater the level of undervaluation then the greater the likelihood a firm will be acquired. The hypothesis that embodies the impact of these competing explanations is as follows: H2: Undervaluation of a firm will lead to an increased likelihood of acquisition. The explanatory variable suggested by this hypothesis is: 9. Market to book ratio (Market Value of Securities/Net Assets) The Price Earnings (P/E) ratio is closely linked to the undervaluation and inefficient management hypotheses. The impact of the P/E ratio on the likehood of acquisition is referred to as the P/E hypothesis: H3: A high Price to Earnings Ratio will lead to a decreased likelihood of acquisition. It follows from this hypothesis that the P/E ratio is a likely candidate as an explanatory variable for inclusion in models for the prediction of potential takeover targets. 10. Price/Earnings Ratio The growth resource mismatch hypothesis is the fourth hypothesis. However, the explanatory variables used in models specified to examine this hypothesis capture growth and resource availability separately. This gives rise to the following: H4: Firms which possess low growth / high resource combinations or, alternatively, high growth / low resource combinations will have an increased likelihood of acquisition. The following explanatory variables suggested by this hypothesis are: 7 11. Growth in Sales (Operating Revenue) over the past year 12. Capital Expenditure/Total Assets 13. Current Ratio (Current Assets/Current Liabilities) 14. (Current Assets – Current Liabilities)/Total Assets 15. Quick Assets (Current Assets – Inventory)/Current Liabilities The behaviour of some firms to pay out less of their earnings in order to maintain enough financial slack (retained earnings) to exploit future growth opportunities as they arise, has led to the dividend payout hypothesis: H5: High payout ratios will lead to a decreased likelihood of acquisition. The obvious explanatory variable suggested by this hypothesis is: 16. Dividend Payout Ratio Rectification of capital structure problems is an obvious motivation for takeovers. However, there has been some argument as to the impact of low or high leverage on acquisition likelihood. This paper proposes a hypothesis known as the inefficient financial structure hypothesis from which the following hypothesis is derived. H6: High leverage will lead to a decreased likelihood of acquisition. The explanatory variables suggested by this hypothesis include: 17. Net Gearing (Short Term Debt + Long Term Debt)/Shareholders Equity 18. Net Interest Cover (EBIT/Interest Expense) 19. Total Liabilities/Total Assets 20. Long Term Debt/Total Assets The existence of Merger and Acquisition (M&A) activity waves, where takeovers are clustered in wave-like profiles, have been proposed as indicators of changing levels of M&A activity over time. It has been argued that the identification of M&A waves, with the corresponding improved likelihood of acquisition when the wave is surging, captures the effect of the rate of takeover activity at specific points in time, and serves as valuable input into takeover prediction models. Consistent with M&A activity waves and their explanation as a motivation for takeovers is the industry disturbance hypothesis: 8 H7: Industry merger and acquisition activity will lead to an increased likelihood of acquisition. An industry relative ratio of takeover activity is suggested by this hypothesis: 21. The numerator is the total bids launched in a given year, while the denominator is the average number of bids launched across all the industries in the ASX. Size will have an impact on the likelihood of acquisition. It seems plausible that smaller firms will have a greater likelihood of acquisition due to larger firms generally having fewer bidding firms with the resources to acquire them. This gives rise to the following hypothesis: H8: The size of a firm will be negatively related to the likelihood of acquisition. Explanatory variables that can be employed to control for size include: 21. Log (Total Assets) 22. Net Assets 4. Data and Method The data requirements for the variables defined above are derived from the financial statements and balance sheet date price information for Australian listed companies. The financial statement information was sourced from the AspectHuntley data base which includes annual financial statement data for all ASX listed companies between 1995 and 2006. The database includes industry classifications for all firms included in the construction of industry relative ratios. Lists of takeover bids and their respective success were obtained from the Connect4 database. This information enabled the construction of variables for relative merger activity between industries. Additionally, stock prices from the relevant balance dates of all companies were sourced from the AspectHuntley online database, the SIRCA Core Price Data Set and Yahoo! Finance. 4.1 The Discrete Choice Modelling Framework The modelling procedure used is the nominal logit model, made popular in the bankruptcy prediction literature by Ohlson (1980) and, subsequently, in the takeover prediction literature by Palepu (1986). Logit models are commonly utilised for dichotomous state problems. The model is given by equations [1] to [3] below. 9 [3] The logit model was developed to overcome the rigidities of the Linear Probability Model in the presence of a binary dependent variable. Equations [1] and [2] show the existence of a linear relationship between the log-odds ratio (otherwise known as the logit Li) and the explanatory variables. However, the relationship between the probability of the event and acquisition likelihood is non-linear. This non-linear relationship has a major advantage that is demonstrated in equation [3]. Equation [3] measures the change in the probability of the event as a result of a small increment in the explanatory variables, . When the probability of the event is high or low, the incremental impact of a change in an explanatory variable on the likelihood of the event will be compressed, requiring a large change in the explanatory variables to change the classification of the observation. If a firm is clearly classified as a target or non-target, a large change in the explanatory variables is required to change its classification. 4.2 Sampling Schema Two samples were used in the model building and evaluation procedure. They were selected to mimic the problem faced by a practitioner attempting to predict takeover targets into the future. The first sample was used to estimate the model and to conduct in-sample classification. It was referred to as the Estimation Sample. This sample was based on financial data for the 2001 and 2002 financial years for firms that became takeover targets, as well as selected non-targets, between January, 2003 and December, 2004. The lag in the dates allows for the release of financial information as well as allowing for the release of financial statements for firms whose balance dates fall after the 30th June. Following model estimation, the probability of a takeover offer was estimated for each firm in the entire sample of firms between January, 2003 and December, 2004 using the estimated model and each firm’s 2001 and 2002 financial data. Expost predictive ability for each firm was then assessed. 10 A second sample was then used to assess the predictive accuracy of the model estimated with the estimation sample data. It is referred to as the Prediction Sample. This sample includes the financial data for the 2003 and 2004 financial years, which will be used in conjunction with target and non-target firms for the period January, 2005 to December, 2006. Using the model estimated from the 2001 and 2002 financial data, the sample of firms from 2005 and 2006 were fitted to the model using their 2003 and 2004 financial data. They were then classified as targets or non-targets using the 2005 and 2006 data. This sampling methodology allows for the eva

英語

saya pergi ke kediri

最終更新: 2014-02-23
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インドネシア語

The left side in Eq. (10) is the quantity of particles that move onto the top side of the weighing bar. The first term on the right side represents the mass of particles larger than particle size xi among the particles that move, while the second term on the right side is the mass of particles smaller than particle size xi among the particles that move. From Eqs. (2), (5), (8), and (10),

英語

I am ashamed

最終更新: 2013-10-24
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インドネシア語

qS1 ¼ qL; ð7Þ W1 ¼ VBqL; ð8Þ G1 ¼ VBqB W1 ¼ VBðqB  qLÞ: ð9Þ Eq. (10) shows the mass balance of floating particles in a suspension. C0  CðtÞ ¼ C0 Z xmax xi f ðxÞdx þ C0 Z xi xmin vðxÞt h f ðxÞdx: ð10Þ The left side in Eq. (10) is the quantity of particles that move onto the top side of the weighing bar. The first term on the right side represents the mass of particles larger than particle size xi among the particles that move, while the second term on the right side is the mass of particles smaller than particle size xi among the particles that move. From Eqs. (2), (5), (8), and (10),

英語

Indonesian translation google english

最終更新: 2013-10-24
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インドネシア語

Timun Mas Long time ago, living a couple of farmers. They live in a village near the forest. They live happy, unfortunately they have not only was a child also. Every day they pray to the God. They pray to be soon be a child. One day a giant passes where they reside. Giant prayer is heard that wife’s husband. Giant then provide them with seeds cucumber. “Plant seeds of this, Later you will soon get a female child,” said the giant. “Thank you, giant,” said the couple. “But there is condition, at the age of 17 years the child must be submitted with you to me,” the giant reply. Without thinking long they agree, because it wanted a child. Husband and wife farmers to plant the seeds cucumber. Every day they start caring for the plants that grow with it as best as possible. Many months and then bear a cucumber with golden color. Fruit cucumber that the longer become larger and heavier. When the fruit is ripe, they take it, carefully slit the fruit. Sudenlly, in the fruit is found in infants of women who are very beautiful. Couple was very happy, they gave the name of the baby Timun Mas. Year after year passed, Timun Mas grown into a beautiful girl. Both parents are very proud of her. But they became very afraid, because in the anniversary Timun Mas at 17, the giant will back. The giant take back that promises to take Timun Mas. Farmers are trying to calm. “Wait a moment. Timun Mas playing. My wife would called her,” he said. Farmers find it immediately to her doughter. “My girl, take this,” she said while giving a cloth bag. “This will help fight the giant. Now flee as soon as possible,” she said. So even Timun Mas immediately fled. Couple on the sad departure Timun Mas. But they are not willing if their child become food giant. Giant waiting long time. He was not a patient. He knew, was that lied by couple of farmers. And he also destroyed the huts of the farmers. Then it was to pursue Timun Mas to forest. Giant run chase immediately Timun Mas. Near the gian,Timun Mas immediately take the handful of salt from the cloth pouch. Then salt spread it to the giant. Suddenly a wide sea also unfold. Giant forced to swim with great difficulty. Timun Mas ran again. But then most successful giant come closer. Timun Mas again taking bizarre objects from a cloth bag. He took the handful chili. Chili throwed to the giant. At once the tree branches and sharp thorns of the giant trap. Giant cried in pain. Timun Mas while running to save herself. But the giant is really strong. He was again nearly captured Timun Mas. So Timun Mas is also a third issue of miraculous. She sow seeds Cucumber magic. At once grow the cucumber garden very knowledgeable. Giant very tired and hungry. He also eat the fresh cucumber with oneself. Because of too much eating, giant was slept. Timun Mas again fled. She ran for dear life. But long run power out. More unlucky again because a giant awakened from sleep. Giant again almost catch her. Timun Mas very terrified. He also threw the last tool handful shrimp paste. Again, miracles happen. A lake of mud spread wide. Giant fall into it. Hands almost reach Timun Mas. But the lake mud is basic to withdraw it. Giant panic, he can not breathe, then submerged. Timun Mas relieved. She has survived, Timun Mas is also return to home to their parents. Father and mother’s Timun Mas happy to see Timun Mas be save. They held, “Thank you, God. You have to save my girl,” said their delighted. Since that time Timun Mas can live quietly with her parents. They can be happy without living in fear again.

英語

Indonesian translation google english

最終更新: 2013-06-13
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インドネシア語

gAssessment of menopausal status, including premature ovarian failure Assessing ovarian status, including follicle development, ovarian reserve, and ovarian responsiveness, as part of an evaluation for infertility and assisted reproduction protocols such as in vitro fertilization Assessing ovarian function in patients with polycystic ovarian syndrome Evaluation of infants with ambiguous genitalia and other intersex conditions Evaluating testicular function in infants and children Diagnosing and monitoring patients with antimullerian hormone-secreting ovarian granulosa cell tumors Method Name Immunometric Assay Reporting Name Antimullerian Hormone, S Aliases Mullerian inhibiting factor (MIF) Mullerian-inhibiting hormone (MIH) Mullerian-inhibiting substance (MIS) Specimen Type Serum Specimen Required Container/Tube: Preferred: Red top Acceptable: Serum gel Specimen Volume: 0.2 mL Specimen Minimum Volume 0.1 mL Reject Due To Hemolysis Mild OK; Gross reject acceptable to 1,000 mg/dL Lipemia Mild OK, Gross needs to be spun Icterus Mild OK, interpret with caution; Gross reject Other NA Specimen Stability Information Specimen Type Temperature Time Serum Refrigerated (preferred) 7 days Frozen 90 days Clinical Information Antimullerian hormone (AMH), also known as mullerian-inhibiting substance, is a dimeric glycoprotein hormone belonging to the transforming growth factor-beta family. It is produced by Sertoli cells of the testis in males and by ovarian granulosa cells in females. Expression during male fetal development prevents the mullerian ducts from developing into the uterus and other mullerian structures, resulting in normal development of the male reproductive tract. In the absence of AMH, the mullerian ducts and structures develop into the female reproductive tract. AMH is also expressed in the follicles of females of reproductive age and inhibits the transition of follicles from primordial to primary stages. Follicular AMH production begins during the primary stage, peaks in the preantral and small antral stages, and then decreases to undetectable concentrations as follicles grow larger. AMH serum concentrations are elevated in males under 2 years old and then progressively decrease until puberty, when there is a sharp decline. By contrast, AMH concentrations are low in female children until puberty. Concentrations then decline slowly over the reproductive lifespan as the size of the pool of remaining microscopic follicles decreases. AMH concentrations are frequently below the detection limit of current assays after natural or premature menopause. Because of the gender differences in AMH concentrations, its changes in circulating concentrations with sexual development, and its specificity for Sertoli and granulosa cells, measurement of AMH has utility in the assessment of gender, gonadal function, fertility, and as a gonadal tumor marker. Since AMH is produced continuously in the granulosa cells of small follicles during the menstrual cycle, it is superior to the episodically released gonadotropins and ovarian steroids as a marker of ovarian reserve. Furthermore, AMH concentrations are unaffected by pregnancy or use of oral or vaginal estrogen- or progestin-based contraceptives. Studies in fertility clinics have shown that females with higher concentrations of AMH have a better response to ovarian stimulation and tend to produce more retrievable oocytes than females with low or undetectable AMH. Females at risk of ovarian hyperstimulation syndrome after gonadotropin administration can have significantly elevated AMH concentrations. Polycystic ovarian syndrome can elevate serum AMH concentrations because it is associated with the presence of large numbers of small follicles. AMH measurements are commonly used to evaluate testicular presence and function in infants with intersex conditions or ambiguous genitalia, and to distinguish between cryptorchidism (testicles present but not palpable) and anorchia (testicles absent) in males. In minimally virilized phenotypic females, AMH helps differentiate between gonadal and nongonadal causes of virilization. Serum AMH concentrations are increased in some patients with ovarian granulosa cell tumors, which comprise approximately 10%[ERROR] of ovarian tumors. AMH, along with related tests including inhibin A and B (#81049 Inhibin A, Tumor Marker, Serum; #88722 Inhibin B, Serum, #86336 Inhibin A and B, Tumor Marker, Serum), estradiol (#81816 Estradiol, Serum), and CA-125 (#9289 Cancer Antigen 125 (CA 125), Serum), can be useful for diagnosing and monitoring these patients. Reference Values Males 12 years: 0.7-19 ng/mL Females 45 years: <1.0 ng/mL Interpretation Menopausal women or women with premature ovarian failure of any cause, including after cancer chemotherapy, have very low antimullerian hormone (AMH) levels, often below the current assay detection limit of 0.25 ng/mL. While the optimal AMH concentrations for predicting response to in vitro fertilization are still being established, it is accepted that AMH concentrations in the perimenopausal to menopausal range (0-0.6 ng/mL) indicate minimal to absent ovarian reserve. Depending on patient age, ovarian stimulation is likely to fail in such patients and most fertility specialists would recommend going the donor oocyte route. By contrast, if serum AMH concentrations exceed 3 ng/mL, hyper-response to ovarian stimulation may result. For these patients, a minimal stimulation would be recommended. In patients with polycystic ovarian syndrome, AMH concentrations may be 2 to 5 fold higher than age-appropriate reference range values. Such high levels predict anovulatory and irregular cycles. In children with intersex conditions, an AMH result above the normal female range is predictive of the presence of testicular tissue, while an undetectable value suggests its absence. In boys with cryptorchidism, a measurable AMH concentration is predictive of undescended testes, while an undetectable value is highly suggestive of anorchia or functional failure of the abnormally sited gonad. Granulosa cell tumors of the ovary may secrete AMH, inhibin A, and inhibin B. Elevated levels of any of these markers can indicate the presence of such a neoplasm in a woman with an ovarian mass. Levels should fall with successful treatment. Rising levels indicate tumor recurrence/progression. Cautions Like all laboratory tests, antimullerian hormone (AMH) measurement alone is seldom sufficient for diagnosis and results should be interpreted in the light of clinical findings and other relevant test results, such as ovarian ultrasonography (in fertility applications, this would include an antral follicle count), abdominal or testicular ultrasound (intersex/testicular function applications) and measurements of sex steroids (estradiol, testosterone, progesterone), follicle-stimulating hormone (FSH), inhibin B (for fertility), and inhibin A and B (for tumor workup). Elevated AMH is not specific for malignancy, and the assay should not be used exclusively to diagnose or exclude an AMH-secreting ovarian tumor. This assay demonstrates no cross reactivity with transforming growth factor beta-1, activin A, inhibin A or B, luteinizing hormone alpha or beta, FSH, thyroid-stimulating hormone, or insulin-like growth factor-1. However, although unlikely, there might be cytokines that have not been evaluated for cross reactivity that do cross react, resulting in false-elevations. As with other immunoassays, the AMH assay can be susceptible to false-low results at extremely high analyte concentrations (hooking effect) or in the hypothetical scenario of the presence of anti-AMH autoantibodies in a patient serum specimen. Heterophilic antibody interferences that are not blocked by the assay’s blocking regents may also rarely occur, causing typically false-high results. If test results are incongruent with the clinical picture, the laboratory should be contacted.

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