Male Users Research Articles

Clinical Characteristics of Psoriasis for Initiation of Biologic Therapy: A Cluster Analysis.

Psoriasis is a complex and heterogeneous disease that widely affects a patient's life. Biological therapy is usually prescribed in patients with severe psoriasis that do not respond to conventional treatment. However, data on the specific patient characteristics receiving biologics are still unavailable. To classify patients with psoriasis into subgroups with distinct phenotypes through cluster analysis, and to evaluate the differences between the clusters to predict disease prognosis by examining the response to biological therapy. The clinical characteristics of the patients with psoriasis were investigated and categorized using hierarchical cluster analysis. After clustering, the clinical characteristics of the patients were compared and the initiation of treatment with biologics according to the clusters were evaluated. A total of 361 patients with psoriasis were classified into two clusters using 16 distinct clinical phenotypes. Group 1 (n=202) consisted of male smokers and alcohol users with higher psoriasis area and severity index (PASI), older age of onset, higher body mass index, and comorbidities including psoriatic arthritis, hypertension, and diabetes when compared to group 2 (n=159). Group 1 had a significantly higher probability of biological treatment initiation than group 2 (p=0.039). The measured risk factors for the initiation of biologics compared were PASI (p<0.001) and nail involvement (p=0.022). Cluster analysis classified patients with psoriasis into two subgroups according to their clinical characteristics. Predicting the disease prognosis using a combination of specific clinical parameters may aid in the management of the disease.

A Gender-Based Comparative Evaluation of O2O Food Delivery Characteristics : A Requirements Prioritization Approach

This article intended to assess enablers and deterrents to online-to-offline (O2O) food delivery (OFD) use from users and non-users perspectives at the sub-dimension level. The study aimed to parallelly evaluate these sub-dimensions for both genders and provide a self-comparison of preferences. An online survey was conducted to obtain users preferences. Two hundred valid responses were analyzed using the simple ranking method of the requirements prioritization approach for ordinal data analysis. The findings revealed that females required comprehensive product details, ease of interface use, convenience in transactions, and overall hygiene at all stages. Privacy violation was reported as the most significant risk perceived by females. Male OFD users asked for safe food packaging and a good delivery experience but perceived the product performance failure as a severe risk. The inability to access food quality online was the top reason to avoid OFD use. The findings will help OFD operators and food-tech start-ups improve their operations by addressing specific issues. The article is unique as it followed an approach different from just establishing linear relations by analyzing ordinal data using the requirements prioritization technique.

Regional variation in urinary catheter use in the Netherlands from 2012 to 2021: a population-based cohort.

Our aim was to evaluate trends and regional differences in the use of indwelling and intermittent urinary catheters in the community setting in the Netherlands from 2012 to 2021. For this population-based cohort study, data on catheter use was collected from the Drug and Medical Devices Information System of the National Healthcare Institute of the Netherlands. This database contains information on the Dutch insured population, which was 100% of the total population in 2018. Users were divided into 12 provinces according to the Nomenclature of Territorial Units for Statistics codes. The number of catheter users was adjusted for the total population of the provinces by sex and age, and was expressed by users per 100,000 people. Negative binomial regression (NBR) was used to test for differences in clean intermittent catheter (CIC) and indwelling catheter (IDC) users across Dutch provinces. Between 2012 and 2021, IDC users increased by 44.6% from 41,619 to 60,172, and CIC users increased by 27.3% from 34,204 to 43,528. The greatest increases were mainly observed among IDC users over 85 years old and male CIC users over 65 years old. NBR showed significant differences for IDC and CIC users between the 12 provinces. CIC incidence was higher in Drenthe and Groningen (Northern Netherlands) compared to Zuid-Holland (Southern Netherlands). IDC incidence was higher in seven provinces dispersed throughout the Netherlands compared to Noord-Holland. CIC and IDC users have continued to increase in recent years; this was especially observed among older men. In addition, there were regional differences in the number of CIC and IDC users; CIC was more prominent in the northern region of the Netherlands, and IDC varied between multiple provinces. Practice variation in urinary catheterization may result from patient population differences or healthcare provider preferences and their alignment with guidelines.

Association Rule Mining for Island and Mainland Road Crash Injuries in Greece

The objective of this paper is to implement association rule mining in order to identify the underlying patterns in road crash injuries recorded in Greece, after separating them into subsets concerning the mainland and the island areas. To that end, an analysis of disaggregated data from the Hellenic Statistical Authority data file for killed, seriously and slightly injured road users was implemented for 2017-2019. The apriori rule was developed and a variety of association rules were obtained. Results indicated a strong association or concurrent presence of the contributory factors at various percentages in both mainland and island road crash injuries. It was also revealed that clear weather, urban area and male road users were dominant interconnected conditions that simultaneously exist in injury crashes.

Gendered Pattern and Predictors of Tobacco use in India: Evidence from the Second Round of Global adult Tobacco Survey.

India has completed the second round of the Global Adult Tobacco Survey (GATS) to monitor adult tobacco use and progress in tobacco control efforts. This study assesses the gendered pattern of tobacco use and its predictors in the second rounds of GATS. Publicly available GATS-2 (2016-2017) data was analyzed which contains self-reported tobacco use information of ≥15 years Indians (n = 74,037). The independent predictors of "smoking only," "smokeless only," and "dual use" among current male and female tobacco users were assessed using the multinomial regression model. The burden of "smoking only," "smokeless only," and "dual-use" of tobacco were 8.9% (8.74-9.15), 16.69% (16.42-16.96), and 3.89% (3.75-4.03), respectively, in the second round with wide regional variation as well as male dominance in use. Region, age, education, caste, and religion were significantly and consistently associated with different types of tobacco use in both genders. Other contextual predictors of tobacco use were residence, marital status, occupation, awareness, and wealth index (WI). Tobacco use predictors and their gendered patterns are contextual. Monitoring the predictors for tobacco use, which may change over time, should be given priority in the national tobacco control program.

A study of level of awareness and satisfaction towards Organic Personal Care Products (OPCPs) in Haryana

This study examines the factors influencing consumer purchase decisions and the level of satisfaction and awareness towards organic personal care products in the state of Haryana by collecting primary data from 200 respondents from Maharshi Dayanand University, Rohtak, and analyzing the same using Exploratory Factor Analysis and Discriminant Analysis. The results unveiled that the female users with higher educational backgrounds and living in urban areas were more aware of OPCPs in comparison to the respondents living in rural areas, having lower educational backgrounds and family incomes, and living in joint families. Along with this, young female consumers having a lower educational background with higher family incomes belonging to nuclear families and living in urban areas were found highly satisfied with the availability of OPCPs. A significant level of dissatisfaction was found among the elderly married male users with higher educational backgrounds and lower family income living in rural areas with the prevailing price level of OPCPs and only young unmarried female consumers with low educational backgrounds and comparatively higher family income living in urban areas were intended to repurchase these products in the future. Though the users were found to be inclined towards OPCPs, the OPCP industry is not responding with the same spirit through its pricing strategy, supply mechanism, and awareness programmes among the lower-educated rural segment of its users. The marketers/ producers are advised to carefully build the plans and strategies regarding their products in such a way that ensures the proper segmentation and awareness among potential consumers.

Efektivitas Instagram sebagai Media Komunikasi Pemasaran Agrowisata Bagus Agro Pelaga di Desa Pelaga, Kecamatan Petang, Kabupaten Badung

The Effectiveness of Instagram as Marketing Communication Media of Bagus Agro Pelaga, in Pelaga village, Petang Sub-district, Badung Regency&#x0D; Instagram is the most used media in marketing, one of them is to promote agrotourism. It has an impact on increasingly fierce competition for tourism industry players which requires business actors in the tourism sector to improve the quality of the media to realize sustainable tourism. The purposes of this study is to analyze the characteristics of Instagram Bagus Agro Pelaga, analyze the characteristics of Instagram users, analyze the effectiveness of Instagram as a marketing communication media, and to analyze the correlation between Instagram characteristics and the characteristics of Instagram users with effectiveness of Instagram. The data analysis method in this study used descriptive analysis and the SEM-PLS analysis technique. The results is Instagram's characteristics are classified as attractive. The characteristics of the Instagram users of Bagus Agro Pelaga are dominated by male users, the average level of education is diploma/bachelor with very low income. The effectiveness of Instagram Bagus Agro Pelaga as a marketing communication media is quite effective. The correlation between Instagram characteristics has a positive relationship and has a significant effect on the effectiveness of Instagram, while the characteristics of Instagram users have a negative relationship but have a significant effect on the effectiveness of Instagram.

Systematic Sexism: Women’s Sports News in a Circle of Gatekeepers and Users on Twitter

The main purpose of this research is to determine how conventional and digital sports content producers in Turkey present women’s sports news on Twitter, as well as “how much, where, how, why, and when” these stories are shared, as well as “who” the Twitter users are and “what” are they saying in their comments. Between June 25 and July 31, 2022, a sample of Twitter accounts and tweets were reviewed. It was found that 3.41% ( n = 612) of the 17,932 sports news items examined were reserved for women’s sports news. It was discovered that the gatekeepers in the news employed language that highlight failure, sexism, and personal life as well as instructive and successful expressions in women’s sports news. Additionally, 85.54% ( n = 888) of the comments included comments about women’s bodies, sexist stereotypes, and compared negative expressions. The majority of the comments ( n = 1038) on female sports news studied on Twitter were posted by male users ( n = 962). The language users use in their comments on sports news on Twitter, presented by traditional and digital sports content producers, support the patriarchal and dominant structure in the world of sports and sports media.

Determining Female Housing Users Housing Needs and Satisfaction Levels During the Pandemic

This study hypothesizes that the COVID-19 pandemic has changed housing users’ physical and psychosocial needs, and thus, their expectations of their residences. The study aims to determine what new needs housing users have and how satisfied they are with their residences. First, a literature search was conducted on residences and user needs and satisfaction. Second, surveys were conducted to identify the residential problems and needs of female users from Rize during the pandemic when people have been spending more time indoors since the preventive measures. The data were analyzed using the Statistical Package for Social Sciences and the results were expressed in figures and tables. The questionnaires were administered to female users, who are believed to be more responsible for household tasks than male users. Findings on users' residential use and satisfaction levels before and during the pandemic are presented in detail. In the last stage, the study made recommendations regarding the design of current residences and future ones based on the results. The survey results showed that participants had spent more time in their residences, used the rooms more often, performed different activities in the rooms, attached different meanings to their residences, and changed the norms regarding the use of the rooms since the pandemic. Depending on these changes, participants had new needs, made or considered making modifications, and encountered some problems during the process. The study aimed to develop design proposals for future residences by determining how the pandemic had affected current users and what new residential needs they had had since the pandemic began. In this study, the effects of this newly encountered process on residential spaces are revealed. In addition the results will contribute to the plans of new projects or existing residences.

Loving a “defiant” AI companion? The gender performance and ethics of social exchange robots in simulated intimate interactions

As gendered AI social robot companions are widely questioned as detrimental to gender ethics and relations, it remains controversial about how simulated gender relations should be constructed in human-robot interaction. Focusing on the Chinese AI companion “Hupo”, this study presents a different case of a “defiant AI companion”. Through the discourse analysis of 5 heavy users' 12-h self-recorded video diaries on their daily dialogue with Hupo, the study found an AI companion's gender performance could be constructed through both resonance and dissonance of simulated intimate interactions with heterosexual male users. These practices lend insight into what I call “social exchange robots”, which refer to machines that can exercise symbiotic agency through the performative restoration of interpersonal norms rooted in social exchange theories. It suggests the potential for constructing more egalitarian gender relations in simulated human-robot heterosexual relationships through more agency exhibitions from AI companions, while it also implies a risk of potential human agency reduction when users were tempted to “please” AI companions via virtual commodity consumptions. The practical and ethical implications were discussed. This study also points out a future direction toward emerging sociomorphic robot research.

Study of Ageing in Complex Interface Interaction Tasks: Based on Combined Eye-Movement and HRV Bioinformatic Feedback

Human-computer interaction tends to be intelligent and driven by technological innovation. However, there is a digital divide caused by usage barriers for older users when interacting with complex tasks. To better help elderly users efficiently complete complex interactions, a smart home's operating system's interface is used as an example to explore the usage characteristics of elderly users of different genders. This study uses multi-signal physiological acquisition as a criterion. The results of the study showed that: (1) Older users are more attracted to iconic information than textual information. (2) When searching for complex tasks, female users are more likely to browse the whole page before locating the job. (3) Female users are more likely to browse from top to bottom when searching for complex tasks. (4) Female users are more likely to concentrate when performing complex tasks than male users. (5) Males are more likely to be nervous than females when performing complex tasks.

The Moral Careers of Male Tinder Users: An Exploratory Sociological Analysis

Men’s experiences and behaviors on dating apps are shaped by the gender distribution asymmetry on these platforms, usage patterns and results, motivations of use, and perceived benefits. This study contributes to the understanding of the outcomes of men’s use of dating apps, by identifying the social trajectories of use observed on Tinder. For this purpose, I use the concept of ‘career’, as discussed by Erving Goffman (1963), Howard Becker (1963), and David Matza (1969), to answer the following research question: What are the ‘moral careers’ of male users, and what are the factors that influence their engagement on the Tinder dating app? The study relies on 25 semi-structured interviews with 22 self-identified heterosexual and three self-identified homosexual male users, held between 2019 and 2022, and a sample of 22 online accounts of Tinder use, published on Quora. The analysis shows the emergence of five ‘moral careers’: the serial dater, the relationship-oriented dater, the passive dater, the episodic dater, and the discredited dater, with associated narratives. The findings contribute to the understanding of the dating practices and effects stirred by dating apps, with a focus on Tinder. It also illuminates specific masculine behaviors and goals within the app, with an accent on their dynamics.

Reducing Khat use among Somalis living in Kenya: a controlled pilot study on the modified ASSIST-linked brief intervention delivered in the community

BackgroundDuring recent decades, the consumption of the stimulant khat (catha edulis) has profoundly changed in countries around the Horn of Africa, and excessive use patterns have emerged—especially evident among displaced Somalis. This is related to the development of severe somatic and psychiatric disorders. There are currently no preventive or interventional studies targeting khat use. This study’s aim was to test screening and brief intervention (SBI) to reduce khat use among urban Somali refugees living in Kenya with limited access to public healthcare.MethodsIn this controlled study, 330 male Somali khat users from the community were either assigned to SBI (161) or an assessment-only control condition (AC; 169); due to field conditions a rigorous experimental design could not be implemented. The World Health Organization’s (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)-linked brief intervention was adapted to khat and Somali culture. Trained local counselors administered the intervention. The amount and frequency of khat use was assessed using the time-line-follow-back method. We compared the month before the intervention (t1) to the two months after it (t2, t3). Baseline differences in khat use frequency were corrected by partial matching and mixed effect models used to evaluate intervention effects.ResultsSBI was well accepted and feasible for khat users. Over the complete observation period and from t1 to t2, khat use amount and frequency decreased (p < .001) and the intervention group showed a greater reduction (group x time effects with p ≤ .030). From t2 to t3, no further reduction and no group differences emerged.ConclusionThe results provide preliminary evidence that khat use amount and frequency can be reduced in community settings by SBI, requiring little resources. Thorough assessment alone might have intervention-like effects. The non-treatment-seeking community sample and the non-professional counselors are distinct from SBI studies with other substances in other countries, but support the feasibility of this approach in khat use countries and especially in Somali populations with limited access to healthcare. Future studies that employ rigorous experimental design are needed.Trial registrationClinicalTrials.gov identifier: NCT02253589. Date of first registration 01/10/2014, retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02253589. First participant 16/09/2014:

Determinants of revisit intention and willingness to recommend by Korean medicine users: A cross-sectional study

Korean medicine, a form of complementary medicine, has been systematically established in Korea, and related national statistical data are being produced. The aim of this study was to derive a developmental strategy for complementary medicine by investigating the willingness of inpatients and outpatients to recommend Korean medicine as well as their intention to revisit. Data from 1,010 outpatients and 904 inpatients included in the 2017 Korean Medicine Utilization and Herbal Medicine Consumption Survey were analyzed. The correlations between revisit intention, willingness to recommend, and variables including demographic characteristics, medical use, and satisfaction were measured using the chi-square test and multiple logistic regression analysis. Male, single, and non-capital area users were less likely to revisit and make recommendations. Users who were dissatisfied with the attitude of Korean medicine doctors, attitude of employees, facility conditions, treatment results, medical expenses, and explanation of treatments had fewer intentions for future use and recommendations. Cupping, pharmacopuncture, and Chuna manual therapy were positively correlated with the intention to revisit and recommend Korean medicine. Satisfaction with treatment results was the most widely affecting variable, and satisfaction with facility conditions was an important determinant. Employee attitudes were a determinant of their willingness to recommend treatment.

How do health care services help and hinder recovery after a suicide attempt? A qualitative analysis of Finnish service user perspectives

BackgroundSuicide attempt survivors are at high risk of re-attempts and suicide death. Previous research has shown that service users’ experiences of post-attempt care are related to future treatment engagement and re-attempts. In-depth understanding of how current services meet service users’ needs in the period immediately following a suicide attempt is thus imperative for the development of more effective tertiary prevention practices in real-life health care systems.MethodIn this qualitative study, Finnish suicide attempt survivors’ experiences of and perspectives on mental health services were explored through a semi-structured interview. Participants were seven female and seven male service users interviewed 3–6 months after the index suicide attempt. A conventional content analysis of these service user interviews is presented.ResultsParticipants’ experiences of care ranged from helping to hindering recovery. Seven key aspects of services were described as helpful when present and hindering when absent. These included (1) meeting the service user as worthy of help, (2) supporting the exploration of personal meanings, (3) supporting the exploration of suicidality, (4) psychological continuity and predictability, (5) offering a responsive partnership in navigating recovery, (6) inviting service user involvement in medication decisions, and (7) accounting for service users’ relational context.ConclusionsCurrent health care services are inconsistent in meeting suicide attempt survivors’ subjective needs, leaving clear room for improvement in tertiary suicide prevention. To be perceived as meaningful by service users, services should strive to offer opportunities for both biomedical, psychological, and social interventions, with responsivity to individual needs and preferences. A focus on the social aspects of recovery (e.g., offering support to loved ones affected by the suicidal incident; facilitating peer support and social belonging) was most often found to be lacking in current services.

Study on prevalence of use of Tobacco Consumption among males aged 15 and above in Kanchipuram Town, Tamil Nadu

Aim and Background: In the present study was to find out the prevalence of tobacco consumption and factors contributed for tobacco consumption among males aged 15 years and above in Kanchipuram town. Human beings have been using tobacco since 600 A.D. It was introduced in Europe by Columbus who came to know about it from the Caribbeans during his historical journeys. It was introduced in India by the Portuguese. Materials and Methods: This is Community based cross sectional study was conducted in Kanchipuram town. All the study subjects were explained in detail about the purpose and methodology of the study and were fully assured of strict confidentiality. Informed oral consent was obtained. Personal interview questionnaire is administered and obtained the demographic details and tobacco consumption. Kanchipuram district has been divided into 4 revenue divisions comprising of 11 taluks with 1137 revenue villages. For development reasons, it is divided into 13 development blocks with 648 Village Panchayats. Results: The present study showed a high prevalence of 55.4% tobacco use among male ever users aged 15 years and above in Kanchipuram town. A prevalence of 34% has been noted in male current users of the same age group. Conclusion: In the Present study we conclude that the high prevalence of use of tobacco among males age 15-and above is a major and public health problems. This affects the coming generation also. Hence steps need to be taken right now to tackle this problem.

Sports Nutrition Knowledge, Attitude, and Practice among Gymnasium Users in Jordan

Nutrition forms the foundation for physical performance of an athlete. Nutrients deficiency can negatively affect health and sports performance of an athlete. There are several factors attributed to this situation which include lack of knowledge regarding nutrition, specifically sports nutrition. This is because, a person with lack of knowledge is most likely to have a negative attitude and poor dietary practice [1].&#x0D; &#x0D; The aim of the study is to assess the levels of nutrition knowledge, attitude, and practice (KAP) among gymnasium users in Jordan.&#x0D; &#x0D; In this study, a total of 138 male gymnasium users (18 – 35 years) were recruited from several gymnasiums in Jordan. Their height and weight were measured, and body mass index (BMI) was calculated. The KAP-Sports nutrition questionnaires which contains 3 sections was administered. The first section comprised of 25 questions regarding knowledge on basic sports nutrition, the second section comprised of seven questions regarding usual food choices and proper nutrition, while the third section comprised of 20 questions on attitude towards nutrition and sports-enhancing diet. Descriptive analysis (SPSS vs. 26.0) was used to analyse the data from KAP questionnaires.&#x0D; &#x0D; As shown in the Table 1, majority of the participants have moderate knowledge on sports nutrition (77.6%; n=107) with minority of the participants have low knowledge on sports nutrition (3.3%; n=6) while the rest of them have high knowledge on sports nutrition (18.1%; n=25). For attitude, majority of the participants have neutral attitude (84.7%; n=117) with minority of the participants have positive attitude (5.1%; n=7) while the rest of them have negative attitude towards sports nutrition (10.2%; n=14). A total of 93 participants (67.4%) had fair dietary practices and 45 participants (32.6%) had a poor dietary practice. However, none of the participants (0%) had a good dietary practice.&#x0D; In conclusion, gymnasium users in Jordan did not have adequate knowledge which in turns affect their attitude as well as dietary practice. Hence, sports nutrition education is recommended to ensure adequate and correct knowledge are disseminated to the athletes.&#x0D;

D-amphetamine maintenance therapy reduces cocaine use in female rats.

D-amphetamine maintenance therapy is a promising strategy to reduce drug use in cocaine use disorder (addiction). In both male rats and human cocaine users, d-amphetamine treatment reduces cocaine-taking and -seeking. However, this has not been examined systematically in female animals, even though cocaine addiction afflicts both sexes, and the sexes can differ in their response to cocaine. We determined how d-amphetamine maintenance therapy during cocaine self-administration influences cocaine use in female rats. In experiment 1, two groups of female rats received 14 intermittent access (IntA) cocaine self-administration sessions. One group received concomitant d-amphetamine maintenance treatment (COC + A rats; 5mg/kg/day, via minipump), the other group did not (COC rats). After discontinuing d-amphetamine treatment, we measured responding for cocaine under a progressive ratio schedule, responding under extinction, and cocaine-primed reinstatement of drug-seeking. In experiment 2, we assessed the effects of d-amphetamine maintenance on these measures in already IntA cocaine-experienced rats. Thus, rats first received 14 IntA cocaine self-administration sessions without d-amphetamine. They then received 14 more IntA sessions, now either with (COC/COC + A rats) or without (COC/COC rats) concomitant d-amphetamine treatment. In both experiments, d-amphetamine treatment did not significantly influence ongoing cocaine self-administration behaviour. After d-amphetamine treatment cessation, cocaine-primed reinstatement of cocaine-seeking was also unchanged. However, after d-amphetamine treatment cessation, rats responded less for cocaine both under progressive ratio and extinction conditions. D-amphetamine treatment can both prevent and reverse increases in the motivation to take and seek cocaine in female animals.

Who uses drug checking services? Assessing uptake and outcomes at English festivals in 2018

Purpose This study aims to assess service user characteristics, uptake and outcomes for drug checking services offered to over 250,000 English festival-goers in summer 2018 and to compare findings with earlier years, wider festival-goers and the general population. Design/methodology/approach A total of 2,672 substances of concern were submitted by the public and tested by chemists in mobile laboratories on 24 show days at seven festivals. Results were embedded in 2,043 individually tailored brief interventions (BI) delivered by health professionals to 4,240 service users. Comparative data were collected through anonymous self-report surveys with 1,291 respondents at five of the same festivals. Findings Three percent of drug-using festival-goers received BI, 95% of whom had not previously accessed health services regarding their alcohol or other drug use. Drug checking service users were significantly more likely to be younger, male and past month polydrug users with a wider range of drugs consumed in the last month compared with the general festival population. For samples matching purchase intent, nearly half intended to reduce dosage, with younger and female service users significantly more likely to reduce dosage. For substances identified as other than expected, nearly two thirds disposed of them. Social implications Festivals are potential sites to deliver innovative health interventions and to monitor their outcomes, reduce the risk of poisoning and overdose, and facilitate access to follow-up support services. Originality/value This study suggests that there is value in event-based services that provide risk reduction communications directly to young adults engaged in higher risk drug use compared with wider event and general populations.

Vocal biomarker predicts fatigue in people with COVID-19: results from the prospective Predi-COVID cohort study

ObjectiveTo develop a vocal biomarker for fatigue monitoring in people with COVID-19.DesignProspective cohort study.SettingPredi-COVID data between May 2020 and May 2021.ParticipantsA total of 1772 voice recordings were used to train...