Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of Low-Calorie Sweetener Restriction on Glycemic Variability and Cardiometabolic Health in Children with Type 1 Diabetes: Findings of a Pilot and Feasibility Study

Low-calorie sweeteners (LCS) are commonly consumed by children with type 1 diabetes (T1D), yet their role in cardiometabolic health is unclear. This study examined the feasibility, acceptability, and preliminary effects of 12 weeks of LCS restriction among children with T1D. Children (n = 31) with T1D completed a two-week run-in (n = 28) and were randomly assigned to avoid LCS (LCS restriction, n = 15) or continue their usual LCS intake (n = 13). Feasibility was assessed using recruitment, retention, and adherence rates percentages. Acceptability was assessed through parents completing a qualitative interview (subset, n = 15) and a satisfaction survey at follow-up. Preliminary outcomes were between-group differences in change in average daily time-in-range (TIR) over 12 weeks (primary), and other measures of glycemic variability, lipids, inflammatory biomarkers, visceral adiposity, and dietary intake (secondary). Linear regression, unadjusted and adjusted for age, sex, race, and change in BMI, was used to compare mean changes in all outcomes between groups. LCS restriction was feasible and acceptable. No between-group differences in change in TIR or other measures of glycemic variability were observed. However, significant decreases in TNF-alpha (−0.23 ± 0.08 pg/mL) and improvements in cholesterol (−0.31 ± 0.18 mmol/L) and LDL (−0.60 ± 0.39 mmol/L) were observed with usual LCS intake, compared with LCS restriction. Those randomized to LCS restriction did not report increases in total or added sugar intake, and lower energy intake was reported in both groups (−190.8 ± 106.40 kcal LCS restriction, −245.3 ± 112.90 kcal usual LCS intake group). Decreases in percent energy from carbohydrates (−8.5 ± 2.61) and increases in percent energy from protein (3.2 ± 1.16) and fat (5.2 ± 2.02) were reported with usual LCS intake compared with LCS restriction. Twelve weeks of LCS restriction did not compromise glycemic variability or cardiometabolic outcomes in this small sample of youth with T1D. Further examination of LCS restriction among children with T1D is warranted.
Atrial Fibrillation and Ischemic Stroke despite Oral Anticoagulation

Patients with atrial fibrillation (AF) experiencing ischemic stroke despite oral anticoagulation (OAC), i.e., breakthrough strokes, are not uncommon, and represent an important clinical subgroup in view of the consistently high risk of stroke recurrence and mortality. The understanding of the heterogenous potential mechanism underlying OAC failure is essential in order to implement specific therapeutic measures aimed at reducing the risk of recurrent ischemic stroke. However, due to the incomplete comprehension of this phenomenon and the limited available data, secondary stroke prevention in such high-risk patients represents a clinical dilemma. There are several available strategies to prevent ischemic stroke recurrence in AF patients with breakthrough stroke in the absence of competing causes unrelated to AF, and these include continuation or change in the type of OAC, addition of antiplatelet therapy, left atrial appendage closure, or any combination of the above options. However, due to the limited available data, the latest guidelines do not provide any specific recommendations about which of the above strategies may be preferred. This review describes the incidence, the clinical impact and the potential mechanisms underlying OAC failure in AF patients. Furthermore, the evidence supporting each of the above therapeutic options for secondary stroke prevention and the potential future directions will be discussed.
The Effects of Different Re-Warm-Up Strategies on Power, Changing of Direction and Ball Shooting Velocity in Well-Trained Soccer Players

The purpose of the study was to investigate whether a re-warm-up training session either with tuck jumps and linear sprints or with changing of directions may enhance power, agility or ball shooting velocity in well-trained soccer players. Ten soccer players (age: 18.2 ± 1.7 years; body mass: 64.4 ± 8.0 kg; body height: 1.71 ± 0.04 m) participated in the study. Players performed three different re-warm-up interventions including no re-warm-up (C), change of direction (COD) and jump-sprint condition (JS). Before each re-warm-up intervention, players performed the same warm-up condition followed by 8 min of passive rest. Following the re-warm-up interventions, countermovement jump (CMJ), T-Test agility time-trial and ball shooting velocity were measured. Performance in CMJ height, power and power per body mass remained unchanged following all three conditions (p > 0.05). However, the agility time-trial was significantly reduced following COD re-warm-up compared to C (−1.7 ± 1.6%, p = 0.03). Ball shooting velocity was increased following COD compared to C (4.7 ± 3.8%, p = 0.014), while a statistical trend was found between JS and C interventions (4.8 ± 5.4%, p = 0.060). These results suggest that a re-warm-up intervention including changing of directions may significantly enhance T-Test agility time-trial and ball shooting velocity in well-trained soccer players.
Access to mechanical thrombectomy and ischemic stroke mortality in Japan: a spatial ecological study

Background Advances in stroke treatment have greatly improved outcomes; however, disparities in access to treatment might increase. Achieving equitable access to stroke treatment is a health policy challenge, as rapid treatment is essential for positive outcomes. This ecological cross-sectional study aimed to determine the relationship between the disparities in spatial accessibility to mechanical thrombectomy (SAMT) and stroke mortality rates in Japan, hypothesizing that disparities in SAMT may increase the differences in stroke mortality between regions. Methods We used the average number of ischemic stroke (IS) deaths between 2020 and 2021 as the response variable; and SAMT, medical resources, and socioeconomic characteristics of each municipality as explanatory variables. A conditional autoregressive model was used to examine the association between the risk of stroke mortality and SAMT. The standardized mortality ratio (SMR) was mapped to understand the nationwide disparities in stroke mortality risk. Results The median number of IS deaths was 17.5 persons per year in the municipalities (2020 to 2021). The study also found that municipalities with low SAMT were located in the northern part of Japan. The non-spatial regression model results indicated that poor accessibility, a small proportion of bachelor’s degrees or higher, and a high proportion of workers in secondary industries were related to high IS mortality. Three models were evaluated using spatial analysis; Model 1 with accessibility indicators alone, Model 2 with medical resources added to Model 1, and Model 3 with socioeconomic characteristics added to Model 2. In Models 1 and 2, the population-weighted spatial accessibility index (PWSAI) showed a significant negative relationship with stroke mortality. However, this was not evident in Model 3. Mapping using Model 3 showed that the high-risk areas were predominantly located in northern Japan, excluding Hokkaido. Conclusion Access to mechanical thrombectomy was estimated, and regional differences were observed. The relationship between accessibility and IS mortality is unknown; however, regardless of accessibility, municipalities with a high proportion of workers in secondary industries and a small proportion with bachelor’s degrees or above are at risk of death from stroke.
Influence of the propagation method of three semidwarf rootstocks on the growth and activity of the physiological processes of maiden sweet cherry trees in a nursery

Rootstocks that reduce the vigor of sweet cherry trees are currently in high demand in orchard production. However, their suitability for nursery production is not fully verified. There are also difficulties in the method of their obtaining, mainly through in vitro cultures, which is associated with high prices. The experiment compared the growth of maiden trees of four sweet cherry varieties on rootstocks that reduce their vigor, ‘Gisela 5’, ‘Krymsk 5;, and ‘Pi-ku 1’. In addition, rootstocks produced by cheaper means using shoot cuttings were evaluated compared with those from in vitro. The lower efficiency of maiden trees was obtained on the ‘Krymsk 5’ rootstock than on the other two rootstocks. In contrast, the vigor of maiden trees on this rootstock was significantly more potent. Generally, rootstocks derived from in vitro yielded a higher percentage of maiden trees. Additionally, for most of the varieties and years tested, the rootstocks obtained in this way improved the growth of the trees as determined by their diameter and length of the lateral shoots. The activity of the physiological processes of the maiden trees varied with the rootstock used. Maiden trees on the ‘Krymsk 5’ rootstock were most often characterized by the lowest levels of the three tested parameters (E, C, and I CO2). Meanwhile, the net photosynthetic intensity was lowest on the ‘Pi-ku 1’ rootstock.
A critical evaluation of market segmentation at national arts festivals in South Africa

A CRITICAL EVALUATION OF MARKET SEGMENTATION AT NATIONAL ARTS FESTIVALS IN SOUTH AFRICA The Klein Karoo National Arts Festival (KKNK) and the Aardklop National Arts Festival (Aardklop) are two of the largest and most popular arts festivals in South Africa. From a sustainability point of view, the primary aim of these festivals is to increase show ticket sales. However, show ticket sales have declined in recent years which, if this trend continues, will result in the discontinuation of these festivals. Market segmentation can assist the festivals' marketers/organisers to address this problem by identifying markets that buy show tickets, thereby supporting the festivals' shows/productions. With the latter in mind, the main purpose of this study was to critically evaluate different segmentation variables and approaches available to segment visitors who buy show tickets. Market segmentation is the process of dividing the festival market into smaller, more clearly defined groups that share similar needs, wants and characteristics. The more detailed the knowledge of the needs and motives of potential visitors, the closer the festivals can get to a customised festival programme creating greater satisfaction, long-term relationships, repeat visits and an,increase in tickets supporting the shows/productions. Various variables/bases are used to segment a market to understand visitors' needs, motives and expectations. These variables/bases of segmentation include demographics;--expenditure, psychographies, decision behaviour, geographic, product specific, interests, travel motivations and communication channels. These variables give a complete visitors profile and are used to identify and compare different segments. Although these variables have been recommended as viable segmentation bases, there seems to be no single ideal base or variable that is the most effective segmentation criterion, since each variable serves a specific purpose. Therefore, the most appropriate variable or variables can only be selected if the objectives of the segmentation strategy are clearly defined. With the aim of the festivals in mind, it is therefore imperative to evaluate these segmentation variables and approaches critically to determine the most suitable variables to segment the festival market. To achieve the latter as well as the goal of this study, the study is divided into five articles. Research for all the articles was undertaken at the festivals and data obtained from 2008 were used for Aardklop, while data gathered in 2009 were used for the KKNK. Questionnaires were interview-administered and distributed randomly during the course of the
Grazing Intensity Effects on Vegetation, Livestock and Non-Game Birds in North Dakota Mixed-Grass Prairie

We conducted studies in native prairie mixed-grass pastures in south-central North Dakota (U.S.A.) during 1989 – 2003 to determine how different grazing intensities affected structural characteristics of vegetation, livestock production and the occurrence and density of grassland birds. Generally, as grazing treatment intensity increased from light to extreme, mean vegetation structural values decreased for visual obstruction readings, tallest plants of grasses, forbs, and shrubs, and litter depth. Nineteen species of non-game birds were detected during 2001 and 2002. Overall breeding bird densities were negatively affected by increasing levels of grazing intensity in mixed-grass prairie. Claycolored sparrows (Spizella pallida), grasshopper sparrows (Ammodramus savannarum), and savannah sparrows (Passrculus sandwichensis) reached their highest densities in the light and moderate grazing intensity treatments whereas they occurred at very low densities or were absent from extreme grazing intensity treatments. In contrast, densities of chestnut-collared longspurs (Calcarius ornatus), horned larks (Eremophila alpestris), upland sandpipers (Bartramia longicauda), marbled godwits (Limosa fedoa), and willets (Catoptrophorus semipalmatus) were highest in the heavy and extreme grazing treatment plots. Livestock average daily weight gains and body condition scores decreased directly with increasing grazing intensity. In contrast, average red meat production gains per unit of pasture had a quadratic relationship to stocking rates, increasing with increased grazing intensity (more animals per unit of pasture) until it reached a peak and then declined. Results from this study suggest that management of grassland habitats can be manipulated under specific grazing intensities to provide predictable conditions of nesting habitat for grassland bird species of management concern. Collectively, our results support that stocking rates equal to or nearly equal to our light to moderate grazing intensity treatments would provide habitat for most species of non-game birds nesting in mixed-grass prairies and still enable ranchers to obtain a profit from livestock production.
A Comparison of the Effects of Empagliflozin and Sitagliptin, When Combined With Metformin, on Lipid Levels in Patients with Type 2 Diabetes: A Clinical Investigation

Introduction Type 2 diabetes (T2D) is emerging as a major global health concern. An associated condition, dyslipidemia, which acts as a significant modifiable risk factor for T2D, exhibits variations across different ethnicities and socioeconomic backgrounds. While many patients rely on metformin as their primary treatment, it does not always effectively control hyperglycemia. As a result, there is a growing need for adjunctive treatments, including sodium-glucose cotransporter-2 (SGLT2) and dipeptidyl peptidase-4 (DPP-4) inhibitors. This study evaluated the comparative effects of empagliflozin (an SGLT2 inhibitor) and sitagliptin (a DPP-4 inhibitor), both combined with metformin, on the lipid profiles of individuals with T2D. Methods Over six months at the Federal Government Polyclinic Hospital in Islamabad, we enrolled 126 participants diagnosed with T2D. Using a nonprobability consecutive sampling technique, we divided them into two groups. Group A received metformin and empagliflozin, while Group B was administered metformin and sitagliptin. We assessed their fasting lipid profiles three months into the treatment. Results Both groups consisted of 63 patients each. We observed that those in Group B, treated with sitagliptin and metformin, demonstrated a more significant reduction in total cholesterol and low-density lipoprotein-C levels than those in Group A, treated with empagliflozin and metformin. This difference proved to be statistically meaningful. Conclusion The combination of sitagliptin and metformin showed enhanced benefits in lipid profile management compared to the combination of empagliflozin and metformin in patients with T2D. This discovery underscores the need for holistic treatment modalities that factor in blood glucose levels and cardiovascular health.
Introspective Deep Metric Learning

This paper proposes an introspective deep metric learning (IDML) framework for uncertainty-aware comparisons of images. Conventional deep metric learning methods focus on learning a discriminative embedding to describe the semantic features of images, which ignore the existence of uncertainty in each image resulting from noise or semantic ambiguity. Training without awareness of these uncertainties causes the model to overfit the annotated labels during training and produce overconfident judgments during inference. Motivated by this, we argue that a good similarity model should consider the semantic discrepancies with awareness of the uncertainty to better deal with ambiguous images for more robust training. To achieve this, we propose to represent an image using not only a semantic embedding but also an accompanying uncertainty embedding, which describes the semantic characteristics and ambiguity of an image, respectively. We further propose an introspective similarity metric to make similarity judgments between images considering both their semantic differences and ambiguities. The gradient analysis of the proposed metric shows that it enables the model to learn at an adaptive and slower pace to deal with the uncertainty during training. Our framework attains state-of-the-art performance on the widely used CUB-200-2011, Cars196, and Stanford Online Products datasets for image retrieval. We further evaluate our framework for image classification on the ImageNet-1 K, CIFAR-10, and CIFAR-100 datasets, which shows that equipping existing data mixing methods with the proposed introspective metric consistently achieves better results (e.g., +0.44% for CutMix on ImageNet-1 K).
Altered Functional Connectivity of Large-Scale Brain Networks in Psychogenic Erectile Dysfunction Associated with Cognitive Impairments

Purpose Several studies have demonstrated that psychogenic erectile dysfunction (pED) patients potentially suffer from cognitive dysfunction. Despite that previous neuroimaging studies have reported abnormal functional connections of brain areas associated with cognitive function in pED, the underlying mechanisms of cognitive dysfunction in pED remain elusive. This study aims to investigate the underlying mechanisms of cognitive dysfunction by analyzing large-scale brain networks. Patients and Methods A total of 30 patients with pED and 30 matched healthy controls (HCs) were recruited in this study and scanned by resting-state functional magnetic resonance imaging. The Dosenbach Atlas was used to define large-scale networks across the brain. The resting-state functional connectivity (FC) within and between large-scale brain networks was calculated to compare pED patients with HCs. The relationship among cognitive performances and altered FC of large-scale brain networks was further explored in pED patients. Results Our results showed that the decreased FC within visual network, and between visual network and default mode network, visual network and frontoparietal network, and ventral attention and default mode network were found in pED patients. Furthermore, there was a positive correlation between immediate memory score and FC within visual network. The visuospatial score was negatively correlated with decreased FC between ventral attention network and default mode network. Conclusion Taken together, our findings revealed the relationship between cognitive impairments and altered FC between large-scale brain networks in pED patients, providing the new evidence about the neural mechanisms of cognitive dysfunction in pED patients.
The Brainstem Cavernoma Case Series: A Formula for Surgery and Surgical Technique

Background and Objectives: Cavernous malformations (CM) are vascular malformations with low blood flow. The removal of brainstem CMs (BS) is associated with high surgical morbidity, and there is no general consensus on when to treat deep-seated BS CMs. The aim of this study is to compare the surgical outcomes of a series of deep-seated BS CMs with the surgical outcomes of a series of superficially located BS CMs operated on at the Department of Neurosurgery, College of Tuebingen, Germany. Materials and Methods: A retrospective evaluation was performed using patient charts, surgical video recordings, and outpatient examinations. Factors were identified in which surgical intervention was performed in cases of BS CMs. Preoperative radiological examinations included MRI and diffusion tensor imaging (DTI). For deep-seated BS CMs, a voxel-based 3D neuronavigation system and electrophysiological mapping of the brainstem surface were used. Results: A total of 34 consecutive patients with primary superficial (n = 20/58.8%) and deep-seated (n = 14/41.2%) brainstem cavernomas (BS CM) were enrolled in this comparative study. Complete removal was achieved in 31 patients (91.2%). Deep-seated BS CMs: The mean diameter was 14.7 mm (range: 8.3 to 27.7 mm). All but one of these lesions were completely removed. The median follow-up time was 5.8 years. Two patients (5.9%) developed new neurologic deficits after surgery. Superficial BS CMs: The median diameter was 14.9 mm (range: 7.2 to 27.3 mm). All but two of the superficial BS CMs could be completely removed. New permanent neurologic deficits were observed in two patients (5.9%) after surgery. The median follow-up time in this group was 3.6 years. Conclusions: The treatment of BS CMs remains complex. However, the results of this study demonstrate that with less invasive posterior fossa approaches, brainstem mapping, and neuronavigation combined with the use of a blunt “spinal cord” dissection technique, deep-seated BS CMs can be completely removed in selected cases, with good functional outcomes comparable to those of superficial BS CM.