Comparing sexual self-concept in women with obesity pre- and post-bariatric surgery.

BACKGROUND: Obesity leads to increased disease burden, decreased life expectancy, and disrupted sexual life. One of the most effective ways of obesity treatment is bariatric surgery. This study was conducted aiming to determine and compare sexual self-concept in women with obesity pre- and post-bariatric surgery. METHOD: A longitudinal study comparing sexual self-concept pre and post- surgery was conducted on women with obesity referring to obesity clinics in the city of Tehran in 2020-2021. Data collection was performed using Snell's Multidimensional Sexual Self-Concept Questionnaire (MSSCQ), which was completed online. Data were analyzed using SPSS version 16 statistical software and Fisher's exact test, chi-square, Mann-Whitney, independent t, and logistic and linear regression tests. A p-value of less than 0.05 was considered significant. RESULTS: According to the findings, the mean (standard deviation) score of sexual self-concept was 240.26 (26.82) in the post-surgery group and 200.26 (32.24) in the pre-surgery group (P = 0.001), and the highest mean (standard deviation) score of sexual self-concept both in the pre-surgery group (13.06 [4.00]) and in the post-surgery group (15.46 [2.16]) was related to the area of sexual depression (P = 0.05). Also, with increasing educational level, the odds of bariatric surgery increased by 33%, and those who had no private bedroom had lower odds of bariatric surgery by 65%. In those who did not have other individuals living in their house and their spouse was not a smoker, the self-concept score was 52.35 and 23.11 units higher. CONCLUSION: In general, bariatric surgery can improve sexual self-care. Considering the issue of sexual self-concept in bariatric surgery, it is recommended to design appropriate counseling and planning before surgery according to the culture of each country.

Technology Usability for People Living With Dementia: Concept Analysis.

BACKGROUND: Usability is a key indicator of the quality of technology products. In tandem with technological advancements, potential use by individuals with dementia is increasing. However, defining the usability of technology for individuals with dementia remains an ongoing challenge. The diverse and progressive nature of dementia adds complexity to the creation of universal usability criteria, highlighting the need for focused deliberations. Technological interventions offer potential benefits for people living with dementia and caregivers. Amid COVID-19, technology's role in health care access is growing, especially among older adults. Enabling the diverse population of people living with dementia to enjoy the benefits of technologies requires particular attention to their needs, desires, capabilities, and vulnerabilities to potential harm from technologies. Successful technological interventions for dementia require meticulous consideration of technology usability. OBJECTIVE: This concept analysis aims to examine the usability of technology in the context of individuals living with dementia to establish a clear definition for usability within this specific demographic. METHODS: The framework by Walker and Avant was used to guide this concept analysis. We conducted a literature review spanning 1984 to 2024, exploring technology usability for people with dementia through the PubMed, Web of Science, and Google Scholar databases using the keywords "technology usability" and "dementia." We also incorporated clinical definitions and integrated interview data from 29 dyads comprising individuals with mild Alzheimer dementia and their respective care partners, resulting in a total of 58 older adults. This approach aimed to offer a more comprehensive portrayal of the usability needs of individuals living with dementia, emphasizing practical application. RESULTS: The evidence from the literature review unveiled that usability encompasses attributes such as acceptable learnability, efficiency, and satisfaction. The clinical perspective on dementia stages, subtypes, and symptoms underscores the importance of tailored technology usability assessment. Feedback from 29 dyads also emphasized the value of simplicity, clear navigation, age-sensitive design, personalized features, and audio support. Thus, design should prioritize personalized assistance for individuals living with dementia, moving away from standardized technological approaches. Synthesized from various sources, the defined usability attributes for individuals living with dementia not only encompass the general usability properties of effectiveness, efficiency, and satisfaction but also include other key factors: adaptability, personalization, intuitiveness, and simplicity, to ensure that technology is supportive and yields tangible benefits for this demographic. CONCLUSIONS: Usability is crucial for people living with dementia when designing technological interventions. It necessitates an understanding of user characteristics, dementia stages, symptoms, needs, and tasks, as well as consideration of varied physical requirements, potential sensory loss, and age-related changes. Disease progression requires adapting to evolving symptoms. Recommendations include versatile, multifunctional technology designs; accommodating diverse needs; and adjusting software functionalities for personalization. Product feature classification can be flexible based on user conditions.

Concordance in the healthcare context: A concept analysis.

Background: The concept of concordance and its usage are indicative of patient-centered healthcare, which encourages an equitable collaboration between patients and clinicians. However, there is a lack of clarity in understanding concordance, and an analysis of this concept is warranted. Objective: This paper seeks to explore the essence of the concordance concept in the healthcare context. Methods: Walker and Avant's eight-step method of concept analysis was applied. A literature search was conducted using concordance AND concord as keywords on CINAHL, MEDLINE, PubMed, ProQuest, Cochrane database, and ScienceDirect databases, published between 2006 and 2022. Results: The attributes of concordance include communication process, therapeutic partnership, and agreement on treatment regimens. Antecedents of concordance comprise provider-patient relationship, patients' beliefs, healthcare providers' characteristics, and complexity of treatment plans. Consequences are improved adherence and compliance, improved clinical outcomes, and better quality of life. Conclusion: This paper offers clarification of concordance by presenting its antecedents, attributes, and consequences. The findings serve as a basis for developing assessments and nursing interventions to promote patient concordance. Nurses can use the findings to encourage concordance by establishing a trusty relationship during health encounters that respects patients' beliefs and effectively communicating to improve patients' understanding in dealing with complex treatment plans.

A taxonomic backbone for the Plumbaginaceae (Caryophyllales).

A taxonomic backbone of the Plumbaginaceae is presented and the current state of knowledge on phylogenetic relationships and taxon limits is reviewed as a basis for the accepted taxon concepts. In total, 4,476 scientific names and designations are treated of which 30 are not in the family Plumbaginaceae. The Plumbaginaceae are subdivided in three tribes with 26 genera and 1,179 accepted species. Two subgenera, 17 sections, two subsections and 187 infraspecific taxa are accepted. At the species and infraspecific level 2,782 synonyms were assigned to accepted taxa, whereas 194 names were excluded from the core checklist (i.e., unplaced taxa, infrageneric subdivisions with still uncertain application, names of verified uncertain application, invalid horticultural names, excluded names from other families, other excluded designations, and unresolved names). The EDIT Platform for Cybertaxonomy was utilized as the tool to compile and manage the names and further taxonomic data under explicit taxon concepts. Secundum references are given in case taxon concepts were taken from the literature, whereas this study serves as reference for newly circumscribed taxa. The family's division into the tribes Aegialitideae, Limonieae, and Plumbagineae departs from earlier two-subfamily classifications, prompted by recent phylogenetic findings that challenge the subfamilial affinity of Aegialitis. The genus Acantholimon was extended to include Gladiolimon, as currently available phylogenetic and morphological data support this merger. In Limonium, all accepted species could be assigned to sections and subsections or the "Mediterranean lineage", respectively, making use of the phylogenetic distribution of their morphological characters and states. A new combination and/or status is proposed for Dyerophytumsocotranum, Limoniumthymoides, Limonium×fraternum, Limonium×rossmaessleri, and Limoniumsect.Jovibarba. Special attention is given to nomenclatural issues, particularly for Staticenomenambiguum to resolve the names under accepted names. The use of artificial groupings like "aggregates", "complexes" and "species groups" in alpha-taxonomic treatments is discussed. The taxonomic backbone will receive continued updates and through the Caryophyllales Taxonomic Expert Network, it contributes the treatment of the Plumbaginaceae for the World Flora Online.

In the I of the beholder: an attempt to capture the implicit self-concept regarding psychopathy.

This article explores the implicit self-concept pertaining to psychopathy. Two online studies showed inconsistent results, with Study 1 (n = 243) suggesting that psychopathy is linked to an implicit self-concept marked by low empathy and Study 2 (n = 230) implying no such relationship. In a sample of offenders and community controls (Study 3a, n = 166), higher scores on the Psychopathy Checklist-Revised (PCL-R) were related to an implicit self-concept of being less rather than more antisocial, and the implicit self-concept showed incremental validity compared to the explicit self-concept. The retesting of an offender subsample (Study 3b, n = 47) yielded no evidence for temporal stability or convergent validity. The implicit self-concept of highly psychopathic individuals thus appears to vary, depending on the social context. Future studies should replicate these results in different samples, using additional external correlates.

Effects of plyometric-based structured game active breaks on fundamental movement skills, muscular fitness, self-perception, and actual behaviour in primary school students.

This study examined the effects of plyometric-based structured game active breaks on fundamental movement skills (FMS), muscular fitness, student self-perception, and teacher's rating of actual behaviour in Grade 3 and 4 students. Primary school children aged 8-10 years old, from four classes, were cluster-randomly assigned to an intervention group (IG) (n = 54) or a control group (CG) (n = 48). The IG participated in structured plyometric-based game active breaks for 7-10 minutes daily, for six consecutive weeks. The CG resumed their regular daily school routine. FMS were assessed with the Canadian Agility Movement Skills Assessment test, and muscular fitness with the standing long jump (SLJ), countermovement jump (CMJ), and seated medicine ball chest throw tests. The Self-Perception Profile for Children and the Teacher's Rating Scale of Child's Actual Behaviour assessed student self-perception and teacher's perception of student actual behaviour, respectively. A significant (p < 0.01) interaction group by time was observed, with greater improvements in the IG compared to the CG in FMS (%diff = 13.11, ƞp2 = 0.12), SLJ (%diff = 6.67, ƞp2 = 0.02), seated medicine ball chest throw (%diff = 4.69, ƞp2 = 0.08), student social self-perception (%diff = 9.31, ƞp2 = 0.10), student scholastic self-perception (%diff = 7.27, ƞp2 = 0.10), and teacher perception of student social competence (%diff = 8.31, ƞp2 = 0.05). No difference (p > 0.05) was found in other variables. Integrating plyometric-based structured game active breaks into primary school settings evidenced improvement in FMS, muscular fitness, student self-perception, and teacher's rating of student actual behaviour.

Speaking the Same Language - The Development of a Glossary of Terms for Social Prescribing in Wales.

Introduction: Social prescribing can facilitate the integration of health, social care and community support but has a diverse and confusing terminology that impairs cross-sectoral communication and creates barriers to engagement. Methods: To address this issue a mixed-methods approach that incorporated a scoping review, a group concept mapping study and consultation was employed to identify and classify the terminology associated with social prescribing. The findings were then used to inform the development of a glossary of terms for social prescribing. Results: Many terms are used interchangeably to describe the same specific aspects of social prescribing. Much of the terminology originates from the health and social care literature of England. Discussion: The terminology used in the academic literature may not accurately reflect the terminology used by the social prescribing workforce. The innovative and interactive glossary of terms identifies the terminology associated with social prescribing and provides additional contextual information. The process of developing the dual language glossary presented several considerations and challenges. Conclusion: The glossary of terms will facilitate cross-sector communication and reduce barriers to engagement with social prescribing. It takes an important first step to help clarify and standardise the language associated with social prescribing, for professionals and members of the public alike.

To be a midwife in Latvia - Midwives talking - Pilot study.

Introduction: For almost 20 years Latvia has been a member state of European Union. Accessible and constantly evolving information has led to a paradigm change in the woman - midwife relationship; nowadays, it should be horizontal - women's and her family orientated. The question is: how do the midwives perceive their professional identity, its core values, norms and beliefs in this new paradigm? Method and findings: Three interview rounds with 20 midwives were performed. Highlighted themes were asked to be explained in the next round of interview in order to compare them with authors' thematic analysis and formulated pre - understandings.The method of thematic analysis was used in frame of a pilot study to understand how practising midwives describe their professional identity.Eleven themes emerged and were categorised in three larger themes: integral part of midwife's professional identity - courage, patience, ability to provide intimacy, flexibility and creativity, the most beautiful profession; desirable part - the ability to evaluate yourself, the ability to draw boundaries, tolerance and acceptance of diversity, "go with the flow" - ability to allow physiological processes to take place, hindrances - struggle with bureaucratic norms and paperwork, struggle with the finances/salary. Conclusion: Within the present study midwives' voices have been conceptualised for the first time in Latvia. With the repeated reflection on their professional identity, midwives not only conceptualised it, but also let light shine on the shadowy side of its components.

In emotion and reading motivation, children with a diagnosis of dyslexia are not just the end of a continuum.

Children with dyslexia (CwD) often report poor psychological well-being. We examined (i) whether anxiety, self-concept and reading motivation in CwD differed from those of typically developing children (TDC; case-control design, Study 1a) and (ii) whether these differences mirrored the linear relationships that these variables present with reading ability in the TDC group (dimensional approach, Study 1b). In Study 1a, 34 CwD were compared with 191 TDC in grades 4-8 on anxiety, self-concept, reading motivation and reading strategy using self-reports (controlling for sex, intelligence and math ability scores). In Study 1b, the differences that emerged in Study 1a were compared with the results obtained from a simulation procedure that generated dyslexia observations under the assumptions of a dimensional hypothesis. The CwD group presented small-to-moderate difficulties, which partially mirrored the predictions in the TDC group. However, violations of predictions based on the population without dyslexia were found for reading self-concept, social anxiety and reading competitiveness. In sum, children's diagnoses affect their self-perception as readers and social anxiety in a way that cannot be inferred from linear relationships. CwD need support to preserve an adequate image of themselves as readers and cope with social anxiety.

[Complex optical systems for individualized correction of presbyopia]. / Komplexe Optiksysteme für eine individualisierte Presbyopiekorrektur.

A multitude of available intraocular lens (IOL) models enable a personalized approach to presbyopia correction in order to meet each patient's needs. This review article discusses more complex approaches which can be useful in selected cases. The concept of reversible trifocality enables correction of presbyopia using a supplementary intraocular lens (IOL), which can be removed if necessary (e.g., intolerance to multifocal optics). The use of capsulotomy-fixated IOLs enables high precision for positioning of the lens and better stability compared to conventional capsular bag-fixated IOLs, which can be particularly advantageous in multifocal optics. The mix and match concept enables a combination of different IOLs with various optical principles to achieve the desired binocular effect. Binocular IOL systems, which consist of two complementary IOLs, can be seen as a further development of the mix and match concept. Knowledge of the available options and their application can further improve correction of presbyopia.

Resilience of individuals with chronic illness who reside in low resource communities: a concept analysis.

Background: Chronic illness diagnosis while living in low resourced communities creates ongoing adversity in the process of adaptation. Resilience is an important phenomenon of study to improve health outcomes. The subject in this particular population has been poorly studied. Objective: To conceptualize resilience of individuals with chronic illness who reside in low resource communities. Design: Concept analysis. Data sources: Seminal works and current studies were searched in PubMed (including Medline), Science Direct, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Google Scholar, OVID, Ebsco, and the Cochrane Database. Qualitative and quantitative studies that investigated individual resilience of adults in the setting of chronic illness who reside in low resource communities were included. Exclusions included children with chronic illness and resilience of communities and populations. Methods: Walker and Avant's method of concept analysis was utilized. The key elements for conceptualizing resilience in the setting of chronic illness who reside in low resource communities included defining attributes, antecedents and consequences of resilience identified from the literature search. Results: Analysis revealed three defining attributes: (1) reflection, contemplation, and the will to live despite adversity through hope; (2) personal transcendence through action; and (3) continuous personal transcendence and maintenance. Antecedents and consequences of resilience in the setting of chronic illness who reside in low resource communities were described and outlined. Conclusions: The conceptualization of resilience in the setting of chronic illness who reside in low resource communities is based on the defining attributes, antecedents, and consequences that resulted in a preliminary conceptual model. The model can be further tested in diverse populations to add to the existing knowledge on the subject, and develop interventions to foster resilience aimed to improve health outcomes and quality of life.

NewAbstractConcepts: A Database of 42 Normed Abstract Concepts and Exemplars.

Recently, researchers have expressed challenges in conducting word-learning experiments in adult populations due to limited availability of normed stimulus materials. This constraint often prompts the use of low-frequency or low-prevalence words, introducing the potential influence of prior knowledge or direct translation to familiar words. In response, we developed novel abstract concepts devoid of word referents, providing better control over prior knowledge. These new concepts describe situations encountered in various settings for which there is no existing word in English. The resulting database comprises 42 normed New Abstract Concepts, offering unique materials structured through scenarios, each containing similar and dissimilar exemplars. These materials underwent meticulous norming for relatability and similarity levels across a series of studies. The success of our approach was demonstrated in a word-learning experiment examining the effects of similarity and diversity. The database serves as a valuable resource for selecting stimuli in experiments exploring the learning of abstract semantic concepts, particularly investigating the role of similarity versus diversity in concept learning. The database is available on OSF (https://osf.io/svm2p/).

Comprehension of English for-adverbials: The Nature of Lexical Meanings and the Neurocognitive Architecture of Language.

What is the nature of lexical meanings such that they can both compose with others and also appear boundless? We investigate this question by examining the compositional properties of for-time adverbial as in "Ana jumped for an hour." At issue is the source of the associated iterative reading which lacks overt morphophonological support, yet, the iteration is not disconnected from the lexical meanings in the sentence. This suggests an analysis whereby the iterative reading is the result of the interaction between lexical meanings under a specific compositional configuration. We test the predictions of two competing accounts: Mismatch-and-Repair and Partition-Measure. They differ in their assumptions about lexical meanings: assumptions that have implications for the possible compositional mechanisms that each can invoke. Mismatch-and-Repair assumes that lexical meaning representations are discrete, separate from the conceptual system from which they originally emerged and brought into sentence meaning through syntactic composition. Partition-Measure assumes that lexical meanings are contextually salient conceptual structures substantially indistinguishable from the conceptual system that they inhabit. During comprehension, lexical meanings construe a conceptual representation, in parallel, morphosyntactic and morphophonological composition as determined by the lexical items involved in the sentence. Whereas both hypotheses capture the observed cost in the punctual predicate plus for-time adverbial composition (e.g., jump (vs. swim) for an hour), their predictions differ regarding iteration with durative predicates; for example, swim for a year (vs. for an hour). Mismatch-and-Repair predicts contrasting processing profiles and nonoverlapping activation patterns along punctuality differences. Partition-Measure predicts overlapping processing and cortical distribution profiles, along the presence of iterativity. Results from a self-paced reading and an functional Magnetic Resonance Imaging (fMRI) studies bear out the predictions of the Partition-Measure account, supporting a view of linguistic meaning composition in line with an architecture of language whereby combinatoriality and generativity are distributed, carried out in parallel across linguistic and nonlinguistic subsystems.

A Computational Framework for Memory Engrams.

Memory engrams in mice brains are potentially related to groups of concept cells in human brains. A single concept cell in human hippocampus responds, for example, not only to different images of the same object or person but also to its name written down in characters. Importantly, a single mental concept (object or person) is represented by several concept cells and each concept cell can respond to more than one concept. Computational work shows how mental concepts can be embedded in recurrent artificial neural networks as memory engrams and how neurons that are shared between different engrams can lead to associations between concepts. Therefore, observations at the level of neurons can be linked to cognitive notions of memory recall and association chains between memory items.

Exploring the conceptualisation, measurement, clinical utility and treatment of formal thought disorder in psychosis: A Delphi study.

BACKGROUND: Formal Thought Disorder (FTD) is a recognised psychiatric symptom, yet its characterisation remains debated. This is problematic because it contributes to poor efficiency and heterogeneity in psychiatric research, with salient clinical impact. OBJECTIVE: This study aimed to investigate expert opinion on the concept, measurement and clinical utility of FTD using the Delphi technique. METHOD: Across three rounds, experts were queried on their definitions of FTD, methods for the assessment and measurement of FTD, associated clinical outcomes and treatment options. RESULTS: Responses were obtained from 56 experts, demonstrating varying levels of consensus across different aspects of FTD. While consensus (>80 %) was reached for some aspects on the concept of FTD, including its definition and associated symptomology and mechanisms, others remained less clear. Overall, the universal importance attributed to the clinical understanding, measurement and treatment of FTD was clear, although consensus was infrequent as to the reasons behind and methods for doing so. CONCLUSIONS: Our results contribute to the still elusive formal definition of FTD. The multitude of interpretations regarding these topics highlights the need for further clarity with this phenomenon. Our findings emphasised that the measurement and clinical utility of FTD are closely tied to the concept; hence, until there is agreement on the concept of FTD, difficulties with measuring and understanding its clinical usefulness to inform treatment interventions will persist. Future FTD research should focus on clarifying the factor structure and dimensionality to determine the latent structure and elucidate the core clinical phenotype.

Veterinary teaching in COVID-19 times: perspectives of university teaching staff.

The digitalization of university teaching has been taking place for many years and, in addition to traditional teaching formats such as practicals and face-to-face lectures, more and more e-learning courses have been used in veterinary education for several years. In the context of the COVID-19 pandemic, universities across Germany had to switch to an ad-hoc, purely digital summer semester. This study evaluated the experiences and implementation of the digital summer semester 2020 at the University of Veterinary Medicine Hannover (TiHo) Foundation from the perspective of the teaching staff. In addition to the technical equipment used by lecturers, this survey also focused on the effects of the digital semester on teaching and the future practicality of digital teaching formats and strategies in veterinary education. Therefore, a questionnaire was designed and distributed among lecturers involved in the digital summer semester 2020. One hundred and three completed questionnaires were evaluated. The results of the evaluation show that teachers see huge potential in blended learning as a teaching method in veterinary education. In addition, teachers were able to digitize teaching well with the available hardware and software. The teaching staff saw difficulties above all in the loss of practical training and in the digitalization of practical exercises. Teachers also needed significantly more time to plan and implement digital teaching compared to pure face-to-face teaching. In summary blended learning offers many advantages, such as increased flexibility for students and teaching staff. In order to be able to use digital teaching methods and strategies profitably in veterinary education in the future, well thought-out didactic concepts and further technical expansion of the universities are required. In addition, the digital skills of teaching staff should be further trained and promoted.

The Bobath concept (NDT) in adult neurorehabilitation: a scoping review of conceptual literature.

PURPOSE: This scoping review aims to describe how Bobath concept is conceptualized, operationalized, and studied in adult neurorehabilitation. METHODS: The Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) guidelines were adopted. Non-scientific and research articles were searched in electronic databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, ScienceDirect, and Physiotherapy Evidence Database (PEDro), with the keywords "Bobath" or "Neurodevelopmental Treatment", published in English, Spanish, and Portuguese, between 2013 and 2023. RESULTS: Of the 78 publications identified, 31 articles addressed the conceptual underpinnings of Bobath concept (seven theoretical papers, seven Delphi/surveys/mixed methods studies, four qualitative studies, one scoping review, 10 letters to the editor, and two editorials), comprising five themes: (a) theoretical principles; (b) clinical principles; (c) clinical reasoning; (d) conceptualizing movement; and, current (e) evidence debate. The revised definition and the Model of Bobath Clinical Practice provide a clarification of the unique aspects of Bobath concept. A new clinical skill was identified beyond facilitation - visuospatial kinesthetic perception - as well as how Bobath experts conceptualize movement, which are all integral to clinical reasoning. CONCLUSIONS: This review provides an updated Bobath clinical framework that gathers the theoretical foundations and clinical practice principles that require careful consideration in the design of future intervention studies.Implications for rehabilitationThis scoping review consolidates the clinical and theoretical principles of contemporary Bobath practice, providing a clear framework for clinicians.The Model of Bobath Clinical Practice (MBCP) framework enables detailed documentation of movement analysis and movement diagnosis, guiding clinical reasoning and interventions.This review identifies fundamental principles and practices to inform future Bobath intervention studies, ensuring their clinical relevance.A framework with specific recommendations has been developed to guide Bobath intervention studies, enhancing the integration of clinical practice, education, and research.

Doctoral students' academic performance: The mediating role of academic motivation, academic buoyancy, and academic self-efficacy.

Understanding influential factors for the academic performance of doctoral students is crucial for supporting their exploration of academic research opportunities and aiding their pursuit of careers in academic research. This study surveyed 659 doctoral students in China, utilizing scales to assess academic motivation, buoyancy, self-efficacy, self-concept, and performance. Based on a partial least squares structural equation modeling (PLS-SEM) analysis, a direct correlation between self-concept and performance was identified. Moreover, motivation, buoyancy, and self-efficacy were significant mediators in the relationship between self-concept and performance. To significantly enhance self-concept's impact on doctoral students' academic performance, educators should endeavor to enhance students' motivation, buoyancy, and self-efficacy. This endeavor will contribute to the discourse on academic performance and its underlying psychological mechanisms.

Off-label use of clomiphene citrate to treat anabolic androgenic steroid induced hypogonadism upon cessation among men (CloTASH) - A pilot study protocol.

Background: Non-prescribed anabolic androgenic steroid (AAS) use is associated with AAS-induced hypogonadism (ASIH), and metabolic, cardiovascular, and mental health risks. Symptoms of ASIH (fatigue, depression, anxiety, sexual dysfunction) are hard to endure following cessation, but there is no consensus on whether endocrine treatment should be used to treat ASIH. This proof-of-concept study aims to explore safety of off-label clomiphene citrate therapy, whether the treatment will reduce the symptoms of androgen deficiency, and to study changes in health risks after cessation. Methods: In this open-labeled non-randomized off-label hormone intervention pilot study, we shall include males with AAS dependence intending to cease use. The 16-week intervention included clomiphene citrate, transdermal testosterone gel for the first four weeks and optional human chorionic gonadotropin (hCG) from week 4 if low treatment response. Measures of physical and mental health will be examined from ongoing AAS use, during the intervention, and at 6- and 12 months post cessation. Change in self-reported symptoms of hypogonadism and other withdrawal symptoms will be compared with data from a group of men who ended AAS use temporarily without the medical intervention. The study may provide valuable clinical insights and may be used to inform the design of future intervention studies.

One or two things we know about concept drift-a survey on monitoring in evolving environments. Part A: detecting concept drift.

The world surrounding us is subject to constant change. These changes, frequently described as concept drift, influence many industrial and technical processes. As they can lead to malfunctions and other anomalous behavior, which may be safety-critical in many scenarios, detecting and analyzing concept drift is crucial. In this study, we provide a literature review focusing on concept drift in unsupervised data streams. While many surveys focus on supervised data streams, so far, there is no work reviewing the unsupervised setting. However, this setting is of particular relevance for monitoring and anomaly detection which are directly applicable to many tasks and challenges in engineering. This survey provides a taxonomy of existing work on unsupervised drift detection. In addition to providing a comprehensive literature review, it offers precise mathematical definitions of the considered problems and contains standardized experiments on parametric artificial datasets allowing for a direct comparison of different detection strategies. Thus, the suitability of different schemes can be analyzed systematically, and guidelines for their usage in real-world scenarios can be provided.