Search Results (82)

Background: Anabolic–androgenic steroids (AASs) are commonly used for performance enhancement but have been linked to significant neurobiological consequences. This review explores the impact of AASs on neurochemical pathways, cognitive function, and psychiatric disorders, highlighting their potential neurotoxicity. Methods: A narrative review of current literature was conducted to examine AASs-induced alterations in neurotransmitter systems, structural and functional brain changes, and associated psychiatric conditions. The interplay between AASs use and other substances was also considered. Results: Chronic AASs exposure affects serotonin and dopamine systems, contributing to mood disorders, aggression, and cognitive deficits. Structural and functional changes in the prefrontal cortex and limbic regions suggest long-term neurotoxicity. AASs use is associated with increased risks of depression, anxiety, and psychosis, potentially driven by hormonal dysregulation and neuroinflammation. Co-occurring substance use exacerbates neurocognitive impairments and behavioral disturbances. Discussion: While evidence supports the link between AASs use and neurotoxicity, gaps remain in understanding the precise mechanisms and long-term effects. Identifying biomarkers of brain damage and developing targeted interventions are crucial for mitigating risks. Increased awareness among medical professionals and policymakers is essential to address AASs-related neuropsychiatric consequences. Conclusions: AASs abuse poses significant risks to brain health, necessitating further research and prevention efforts. Evidence-based strategies are needed to educate the public, enhance early detection, and develop effective interventions to reduce the neuropsychiatric burden of AASs use. Full article

Background/Objectives: Muscle dysmorphia (MD), a subtype of body dysmorphic disorder, is prevalent among males who engage in the non-medical use of anabolic–androgenic steroids (AASs) and performance-enhancing drugs (PEDs). These individuals often experience severe psychopathology, including mood instability, compulsivity, and a distorted body image. Despite its clinical severity, no randomized controlled trials (RCTs) have evaluated structured psychological treatments in this subgroup. This study aimed to assess the efficacy of a manualized cognitive behavioral therapy (CBT) protocol in reducing MD symptoms and associated psychological distress among male steroid users. Results: Participants in the CBT group showed significant reductions in MD symptoms from the baseline to post-treatment (MDDI: p < 0.001, d = 1.12), with gains sustained at follow-up. Large effect sizes were also observed in secondary outcomes including depressive symptoms (PHQ-9: d = 0.98), psychological distress (K10: d = 0.93), disordered eating (EDE-Q: d = 0.74), and exercise addiction (EAI: d = 1.07). No significant changes were observed in the control group. Significant group × time interactions were found for all outcomes (all p < 0.01), indicating CBT’s specific efficacy. Discussion: This study provides the first RCT evidence that CBT significantly reduces both core MD symptoms and steroid-related psychopathology in men engaged in AAS/PED misuse. Improvements extended to mood, body image perception, and compulsive exercise behaviors. These findings support CBT’s transdiagnostic applicability in addressing both the cognitive–behavioral and affective dimensions of MD. Materials and Methods: In this parallel-group, open-label RCT, 59 male gym-goers with DSM-5-TR diagnoses of MD and a history of AAS/PED use were randomized to either a 12-week CBT intervention (n = 30) or a waitlist control group (n = 29). CBT sessions were delivered weekly online and targeted distorted muscularity beliefs, compulsive behaviors, and emotional dysregulation. Primary and secondary outcomes—Muscle Dysmorphic Disorder Inventory (MDDI), PHQ-9, K10, EDE-Q, EAI, and BIG—were assessed at the baseline, post-treatment, and 3-month follow-up. A repeated-measures ANOVA and paired t-tests were used to analyze time × group interactions. Conclusions: CBT offers an effective, scalable intervention for individuals with muscle dysmorphia complicated by anabolic steroid use. It promotes broad psychological improvement and may serve as a first-line treatment option in high-risk male fitness populations. Future studies should examine long-term outcomes and investigate implementation in diverse clinical and cultural contexts. Full article

This study investigates the potential of ¹H and ¹³C NMR for the characterization and classification of anabolic androgenic steroids (AASs) in various formulations. First, twenty AAS formulations, including tablets, capsules, and injectable solutions, were analyzed using ¹H NMR for the qualitative identification and quantification of active compounds. The results revealed discrepancies between the labeled and detected substances in several samples, highlighting issues related to product mislabeling and potential health risks. Then, twelve oil-based injectable formulations were examined using ¹³C NMR, demonstrating its effectiveness in differentiating and quantifying closely related steroid structures that cannot be discriminated with ¹H NMR. A chemometric approach from ¹³C NMR data, based on a principal component analysis (PCA) and hierarchical cluster analysis (HCA), enabled the classification of samples and the identification of key active ingredients. Full article

Introduction: Radiotherapy (RT) is a frequently offered treatment option for brain metastases (BMs) in patients with non-small-cell lung cancer (NSCLC). This study presents patient-reported outcomes (PROs) in a cohort of NSCLC with BMs treated with RT. This study researched how PRO scores at the start of RT may be useful in survival estimates and how PROs change over time after RT. Methods: NSCLC patients with first-time BMs treated with RT were identified in a prospective observational study. PROs were collected at the start of RT and monthly for up to 1 year. Differences in PRO mean scores at the start of RT (M0) and at month 2 (M2) after treatment are reported. Prognostic values of PROs were analyzed in a stepwise adjusted Cox model. Results: Of 294 patients identified, 239 (81%) responded at M0; 105/239 (44%) responded at both M0 and M2. High scores for weakness of legs at M0 were associated with short survival when adjusting for performance status and status of extracranial metastases. Those responding at M0 only had worse mean scores for overall QoL and PF but similar scores for fatigue and dyspnea compared to patients responding over time. At M2, patients with <6 months survival after RT reported worse scores for overall QoL, PF, fatigue, and dyspnea; long-term survivors reported stable scores. Conclusions: NSCLC patients diagnosed with BMs and expected survival < 6 months should be offered optimal palliative care rather than RT. Full article

Background: Within recent years, there has been a notable lack of research examining the factors associated with adolescent use of anabolic–androgenic steroids (AASs) in Australia, meaning information regarding risk factors of Australian adolescent AAS use is outdated and potentially inaccurate. Methods: To address this omission, the present study examined the prevalence and correlates of adolescent (aged 11 to 19 years) AAS use within the EveryBODY study, a large-scale representative survey of adolescents’ disordered eating behaviours and body image concerns, involving 5071 adolescents across thirteen schools within the Sydney and Newcastle/Hunter region of New South Wales, Australia. Results: A total of 1.1% of adolescents reported lifetime use of AAS to increase muscularity. In univariate analyses, increased prevalence of AAS use was associated with male sex (OR = 5.67), identifying as Aboriginal or Torres Strait Islander (OR = 3.80), identifying as same-sex or questioning sexual attraction (OR = 3.17), higher drive for muscularity (OR = 2.19) and weight/shape concerns in the past month (OR = 1.28), and higher frequency of purging (OR = 1.11) and binge eating (OR = 1.09) in the past month. In multivariate analysis, only drive for muscularity (OR = 2.44) and purging behaviours (OR = 1.10) remained as significant correlates. Finally, adolescents who reported lifetime AAS use also reported feeling significantly higher levels of distress and physical and psychosocial impairment compared to adolescents who reported never having used AAS to increase muscularity. Conclusions: Positive correlations between disordered eating and weight and shape concerns with AAS use suggests that adolescent AAS use may be conceptualised within the spectra of disordered eating among youth. These findings provide clinicians, carers, and educators with prototypical factors that should assist in the screening of adolescent AAS use to facilitate early intervention. Full article

Background and Objectives: The use of anabolic–androgenic steroids (AASs) by competitive and recreational athletes has been studied and well documented. There are numerous studies showing its effects on personality traits and risky behaviors like aggression. The relationship between AAS use, aggression, and narcissism is complex and intricate. We examined this relationship in male bodybuilders who use AASs. Materials and Methods: A total of 319 healthy subjects aged 18–44 years (33.4 ± 9.4) who have been regularly training at bodybuilding for at least 3 years participated voluntarily in the study and completed a demographic data inventory, the Five-Factor Narcissism Inventory Short Form (FFNI-SF), and the Buss–Perry Aggression Scale anonymously. Demographic data were given as percentages, comparisons of aggression and narcissism scores according to AAS use were performed by using an independent sample t test, and effects of narcissism and aggression levels on AAS use was assessed by using logistic regression analysis. All analyses were performed by using SPSS Statistics 22.0. Results: Results showed that AAS users had significantly higher scores on the overall FFNI-SF Scale (p < 0.001) and all sub-dimensions of narcissism (p < 0.001) and on the overall Buss–Perry Aggression Scale (p < 0.001) and all sub-dimensions of aggression (p < 0.001). It was also shown that there were significant and positive correlations between the FFNI-SF overall score (p < 0.001) and both the vulnerable narcissism and grandiose narcissism sub-dimensions (p < 0.001) and the scores of the Buss–Perry Aggression Scale (p < 0.001), physical aggression (p < 0.001), anger (p < 0.001), hostility (p < 0.001), and verbal aggression (p < 0.001) sub-dimensions. Conclusions: These results show a strong relation between AAS use, narcissism, and aggression in bodybuilders. However, it is not clear whether AAS use leads to aggression and narcissism or whether narcissistic and/or aggressive people tend to use AASs. Furthermore, including a lot of potential third variables shows that it does not have to be either one or the other way around. There is a need to conduct future studies to determine this causality. Full article

Background/Objectives: The primary objective of this study was to investigate clinical manifestations, time to diagnosis, and number of biopsies in patients with extranodal natural killer T-cell lymphoma (ENKTL). The secondary objectives were to determine response rates, survival outcomes, prognostic factor for overall survival (OS), and validation of the Prognostic Index of Natural Killer Lymphoma (PINK), Ann Arbor staging system (AASS), and the CA system. Methods: This retrospective study included data pertaining to patients with newly diagnosed ENKTL in Chiang-Mai University Hospital from 2004 to 2020. Comparisons between the areas under the receiver operating characteristic curve (AUC) of prognostic models (PINK, AASS, and CA system) were made. Results: Sixty patients were enrolled (n = 60) with a mean age of 49.1 ± 13.4 years. The most frequent symptom of ENKTL was nasal obstruction (66%). The median time to diagnosis was 22 days (ranging from 3 to 84 days), with 36.7% requiring more than one biopsy for diagnosis. Most patients presented with limited stage disease (75%). The median OS was 49 months. Factors associated with increased mortality were advanced stage, bone marrow involvement, gastrointestinal tract involvement, and receiving chemotherapy. Following prognostic model validation, the CA system model scored the highest level of accuracy (AUC 0.61), followed by AASS (AUC 0.58) and PINK (AUC 0.54). Conclusions: Patients with ENKTL commonly presented with nasal obstruction, with 36.7% requiring more than one biopsy for diagnosis. An advanced stage, bone marrow involvement, or gastrointestinal tract involvement were associated with poor OS. The CA system model has the highest level of accuracy for prognostic determination. Full article

Background: Dry eye disease is a common disorder of the ocular surface, leading patients to seek eye care. Clinical signs and symptoms are currently used to diagnose dry eye disease. Metabolomics, a method for analyzing biological systems, has been found helpful in identifying distinct metabolites in patients and in detecting metabolic profiles that may indicate dry eye disease at early stages. In this study, we explored the use of machine learning and metabolomics data to identify cataract patients who suffer from dry eye disease, a topic that, to our knowledge, has not been previously explored. As there is no one-size-fits-all machine learning model for metabolomics data, choosing the most suitable model can significantly affect the quality of predictions and subsequent metabolomics analyses. Methods: To address this challenge, we conducted a comparative analysis of eight machine learning models on two metabolomics data sets from cataract patients with and without dry eye disease. The models were evaluated and optimized using nested k-fold cross-validation. To assess the performance of these models, we selected a set of suitable evaluation metrics tailored to the data set’s challenges. Results: The logistic regression model overall performed the best, achieving the highest area under the curve score of $0.8378$, balanced accuracy of $0.735$, Matthew’s correlation coefficient of $0.5147$, an F1-score of $0.8513$, and a specificity of $0.5667$. Additionally, following the logistic regression, the XGBoost and Random Forest models also demonstrated good performance. Conclusions: The results show that the logistic regression model with L2 regularization can outperform more complex models on an imbalanced data set with a small sample size and a high number of features, while also avoiding overfitting and delivering consistent performance across cross-validation folds. Additionally, the results demonstrate that it is possible to identify dry eye in cataract patients from tear film metabolomics data using machine learning models. Full article

Patients with advanced gastrointestinal cancers often receive chemotherapy near the end of life (EoL), raising concerns about overtreatment. The PALLiON trial, a cluster-randomized trial, assessed the impact of a complex intervention on frequency of EoL treatment; the intervention involved palliative care referrals and the use of PROMs. The present secondary analysis evaluated the prognostic value of baseline performance status (PS), albumin (alb), C-reactive protein (CRP), and body mass index (BMI) for overall survival, comparing pancreatic (PAN, n = 189) vs. other gastrointestinal cancer patients (GI, n = 286). Baseline PS, alb, CRP, mGPS (modified Glasgow prognostic score), and BMI were analyzed using Cox regression. Adjusted for age, sex, and hospital size, PS ≥ 2 and alb < 35 g/L predicted shorter survival in both PAN and GI cancers, while CRP > 10 predicted shorter survival only in GI cancers. In PAN, PS ≥ 2 predicted a 78.4% higher probability of shorter survival, and mGPS 2 predicted a 68.7% higher probability. In GI, mGPS 2 predicted a 70.8% higher probability, whereas PS was not significant. BMI did not improve predictive models. PS ≥ 2 and low albumin are strong predictors of short survival in PAN, whereas increased CRP and low albumin (mGPS 2) are predictors in GI. Full article

The emerging digitalization in today’s industrial environments allows manufacturers to store online knowledge about production and use it to make better informed management decisions. This paper proposes a multi-agent framework enhanced with digital twin (DT) for production scheduling and optimization. Decentralized scheduling agents interact to efficiently manage the work allocation in different segments of production. A DT is used to evaluate the performance of different scheduling decisions and to avoid potential risks and bottlenecks. Production managers can supervise the system’s decision-making processes and manually regulate them online. The multi-agent system (MAS) uses asset administration shells (AASs) for data modelling and communication, enabling interoperability and scalability. The framework was deployed and tested in an industrial pilot coming from the bicycle production industry, optimizing and controlling the short-term production schedule of the different departments. The evaluation resulted in a higher production rate, thus achieving higher production volume in a shorter time span. Managers were also able to coordinate schedules from different departments in a dynamic way and achieve early bottleneck detection. Full article

Interactions between mobile robots and human operators in common areas require a high level of safety, especially in terms of trajectory planning, obstacle avoidance and mutual cooperation. In this connection, the crossings of planned trajectories and their uncertainty based on model fluctuations, system noise and sensor noise play an outstanding role. This paper discusses the calculation of the expected areas of interactions during human–robot navigation with respect to fuzzy and noisy information. The expected crossing points of the possible trajectories are nonlinearly associated with the positions and orientations of the robots and humans. The nonlinear transformation of a noisy system input, such as the directions of the motion of humans and robots, to a system output, the expected area of intersection of their trajectories, is performed by two methods: statistical linearization and the sigma-point transformation. For both approaches, fuzzy approximations are presented and the inverse problem is discussed where the input distribution parameters are computed from the given output distribution parameters. Full article

Bodybuilding, as a high-performance sport, requires regular strength and resistance exercises with the principal objective of increasing muscle hypertrophy. However, many bodybuilders resort to the use of anabolic-androgenic steroids (AASs) to improve their performance in a short period of time. This study employs a survey-type, cross-sectional, descriptive–analytical method to evaluate the profile of bodybuilding athletes in the State of Sergipe, Brazil, and verify the level of knowledge/awareness about the health risks and impacts resulting from the use of such substances. Finite- and convenience-type populations are assessed, including individuals of both sexes, aged older than 18 years, self-declared bodybuilding athletes residing in the State of Sergipe, Brazil, and participating in regional and/or state competitions. As a result, no significant relationships were determined between sex (p = 0.492), age (p = 0.460), family income (p = 0.141), and medical follow-up sessions. For the variables level of education and medical follow-up vs. no follow-up sessions, a significant result was achieved (p = 0.01), with 74.3% of individuals reporting having follow-up treatment and 25.7% responding that they had no follow-up treatment, a percentage representing the group that completed their higher education. The substances most used by the athletes were Sustanon 250 or Durateston, Nandrolone Decanoate (Deca or Deca-Durabolin), and Testosterone. The most-reported acute side effects were acne at 33.8% (n = 20), irritability at 32.1% (n = 19), alopecia (hair loss), and nervousness at 23.7% (n = 14). The most-reported chronic side effects were arterial hypertension at 36.0% (n = 9), liver disease at 28.0% (n = 7), and cancer (non-specific) at 8.0% (n = 2). We concluded that, regardless of the athletes’ socioeconomic profiles, the use of AASs was high, with two or more substances being used in combination and for a prolonged period. Thus, it is necessary to promote awareness campaigns regarding the use of AASs and their effects on high-performance and recreational athletes. Full article

Up to 40% of non-smallcell lung cancer (NSCLC) patients develop brain metastases (BMs). The potential benefits of radiotherapy (RT) in patients with poor performance status (PS) are questionable, with considerable risk for futile treatment. We analyzed overall survival after initial radiotherapy in NSCLC patients with BMs, focusing on the relationship between PS and survival after RT. This study reports a prospective observational study including consecutive 294 NSCLC patients with first-time BMs. Overall survival (OS) was calculated from the start of RT to death or last follow-up (1 June 2023). Overall, in the 294 included patients (median age 69 years), the median OS was 4.6 months; 2.5 months after WBRT (n = 141), and 7.5 months after SRT (n = 153). After WBRT, mOS was equally poor for patients with ECOG 2 (1.9 months) and ECOG 3–4 (1.2 months). After SRT, mOS for patients with ECOG 2 was 4.1 months; for ECOG 3 patients, mOS was 4 1.6 months. For NSCLC patients with ECOG 2 diagnosed with BMs who are not candidates for surgery or SRT, WBRT should be questioned due to short survival. Full article

Multifunctional nanocomposites from an equimolar As₄S₄/Fe₃O₄ cut section have been successfully fabricated from coarse-grained bulky counterparts, employing two-step mechanochemical processing in a high-energy mill operational in dry- and wet-milling modes (in an aqueous solution of Poloxamer 407 acting as a surfactant). As was inferred from the X-ray diffraction analysis, these surfactant-free and surfactant-capped nanocomposites are β-As₄S₄-bearing nanocrystalline–amorphous substances supplemented by an iso-compositional amorphous phase (a-AsS), both principal constituents (monoclinic β-As₄S₄ and cubic Fe₃O₄) being core–shell structured and enriched after wet milling by contamination products (such as nanocrystalline–amorphous zirconia), suppressing their nanocrystalline behavior. The fluorescence and magnetic properties of these nanocomposites are intricate, being tuned by the sizes of the nanoparticles and their interfaces, dependent on storage after nanocomposite fabrication. A specific core–shell arrangement consisted of inner and outer shell interfaces around quantum-confined nm-sized β-As₄S₄ crystallites hosting a-AsS, and the capping agent is responsible for the blue-cyan fluorescence in as-fabricated Poloxamer capped nanocomposites peaking at ~417 nm and ~442 nm, while fluorescence quenching in one-year-aged nanocomposites is explained in terms of their destroyed core–shell architectures. The magnetic co-functionalization of these nanocomposites is defined by size-extended heterogeneous shells around homogeneous nanocrystalline Fe₃O₄ cores, composed by an admixture of amorphous phase (a-AsS), nanocrystalline–amorphous zirconia as products of contamination in the wet-milling mode, and surfactant. Full article

Boldenone (Bdn) and nandrolone (Ndn) are anabolic androgenic steroids (AASs) that, as our previous studies have shown, may increase the risk of neoplastic transformation of porcine ovarian putative stem cells (poPSCs). The NF-κB pathway may be important in the processes of carcinogenesis and tumour progression. Therefore, in this work, we decided to test the hypothesis of whether Bdn and Ndn can activate the NF-κB pathway by acting through the membrane androgen receptor ZIP-9. For this purpose, the expression profiles of both genes involved in the NF-κB pathway and the gene coding for the ZIP-9 receptor were checked. The expression and localization of proteins of this pathway in poPSCs were also examined. Additionally, the expression of the ZIP-9 receptor and the concentration of the NF-κB1 and 2 protein complex were determined. Activation of the NF-κB pathway was primarily confirmed by an increase in the relative abundances of phosphorylated forms of RelA protein and IκBα inhibitor. Reduced quantitative profiles pinpointed not only for genes representing this pathway but also for unphosphorylated proteins, and, simultaneously, decreased concentration of the NF-κB1 and 2 complex may indicate post-activation silencing by negative feedback. However, the remarkably and sustainably diminished expression levels noticed for the SLC39A9 gene and ZIP-9 protein suggest that this receptor does not play an important role in the regulation of the NF-κB pathway. Full article