According to the World Health Organization, between 2000 and 2050, the proportion of the world's population over 60 will double, from 11% to 22%. In absolute numbers, this age group will increase from 605 million to 2 billion in the course of half a century. It is a reality that most of them prefer to live alone, so it is necessary to look for mechanisms and tools that will help them to improve their autonomy. Although in recent years, we have been living in a veritable explosion of domotic systems that facilitate people's daily lives, it is also true that there are not many tools specifically aimed at this sector of the population. The aim of this paper is to present a potential solution to the monitoring of activity of daily living in the least intrusive way for people. In this case, anomalous patterns of daily activities will be detected by analysing the daily consumption of household appliances. People who live alone usually have a pattern of daily behaviour in the use of household appliances (coffee machine, microwave, television, etc.). A neuronal model is proposed for the detection of abnormal behaviour based on an autoencoder architecture. This solution will be compared with a variational autoencoder to analyse the improvements that can be obtained. The well‐known dataset called UK‐DALE will be used to validate the proposal.
Background
Testosterone deficiency (TD) is a prevalent condition, especially in men ≥45 years old, and testosterone therapy (TTh) can improve the quality of life in these patients.
Aim
To evaluate the safety profile of compounded subcutaneous testosterone pellets and to compare the efficacy between compounded and market brand testosterone pellets for TTh: E100 (Empower Pharmacy) and Testopel (Food and Drug Administration approved), respectively.
Methods
This was a prospective, phase 3, randomized, noninferiority clinical trial. We enrolled 75 men diagnosed with TD and randomized them 1:1 to a market brand group and a compounded pellet group. The patients were implanted with their respective testosterone pellets: Testopel (10 pellets of 75 mg) and E100 (8 pellets of 100 mg).
Outcomes
We evaluated adverse events after implantation and followed men at 2, 4, and 6 months for morning laboratory levels (prior to 10 am): serum testosterone, estradiol, hematocrit, and prostate-specific antigen.
Results
After randomization, 33 participants were enrolled in the Testopel arm and 42 in the E100 arm. Serum testosterone levels were similar between the groups at 2, 4, and 6 months, with most men (82%) dropping to <300 ng/dL by the end of the trial. Adverse events were also similar, such as elevations in prostate-specific antigen, estradiol, and hematocrit. Most dropouts were related to persistent TD symptoms and serum testosterone <300 ng/dL, with similar rates between the groups in the study.
Clinical Implications
Men treated with Testopel and E100 pellets had comparable serum testosterone levels and similar adverse event rates, providing an effective choice of long-term TTh among men with TD.
Strengths and Limitations
Strengths include the prospective, randomized, single-blinded study design and adequate follow-up. Limitations include the lack of external validity and the single-institution cohort.
Conclusion
E100 compounded testosterone pellets are a noninferior option of TTh as compared with Testopel for men presenting with TD.
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