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Effects of Low-Energy Diet or Exercise on Cardiovascular Function in Working-Age Adults With Type 2 Diabetes: A Prospective, Randomized, Open-Label, Blinded End Point Trial

OBJECTIVE

To confirm the presence of subclinical cardiovascular dysfunction in working-age adults with type 2 diabetes (T2D) and determine whether this is improved by a low-energy meal replacement diet (MRP) or exercise training.

RESEARCH DESIGN AND METHODS

This article reports on a prospective, randomized, open-label, blinded end point trial with nested case-control study. Asymptomatic younger adults with T2D were randomized 1:1:1 to a 12-week intervention of 1) routine care, 2) supervised aerobic exercise training, or 3) a low-energy (~810 kcal/day) MRP. Participants underwent echocardiography, cardiopulmonary exercise testing, and cardiac magnetic resonance (CMR) at baseline and 12 weeks. The primary outcome was change in left ventricular (LV) peak early diastolic strain rate (PEDSR) as measured by CMR. Healthy volunteers were enrolled for baseline case-control comparison.

RESULTS

Eighty-seven participants with T2D (age 51 ± 7 years, HbA1c 7.3 ± 1.1%) and 36 matched control participants were included. At baseline, those with T2D had evidence of diastolic dysfunction (PEDSR 1.01 ± 0.19 vs. 1.10 ± 0.16 s–1, P = 0.02) compared with control participants. Seventy-six participants with T2D completed the trial (30 routine care, 22 exercise, and 24 MRP). The MRP arm lost 13 kg in weight and had improved blood pressure, glycemia, LV mass/volume, and aortic stiffness. The exercise arm had negligible weight loss but increased exercise capacity. PEDSR increased in the exercise arm versus routine care (β = 0.132, P = 0.002) but did not improve with the MRP (β = 0.016, P = 0.731).

CONCLUSIONS

In asymptomatic working-age adults with T2D, exercise training improved diastolic function. Despite beneficial effects of weight loss on glycemic control, concentric LV remodeling, and aortic stiffness, a low-energy MRP did not improve diastolic function.





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Can High-Intensity Exercise Improve Your Memory?

Exercise like walking, swimming, and even dancing have been shown to be good for your memory, but the optimal intensity of that exercise has been unclear... until now

-- Read more on ScientificAmerican.com




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Clinton, Obama and the Narcissist's Tale

Put yourself in the shoes of Sen. Barack Obama or Sen. Hillary Rodham Clinton. You are widely seen by Democratic voters as a transformational presidential candidate. Democrats are nearly evenly divided between you and your competitor, and you think you are the best candidate for your party -- and...




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All Eyes Turn to Congress, Following Trump Decision to Terminate DACA Program

By winding down DACA over six months, President Trump may have addressed a short-term political dilemma. But this action ensures debate will rage on in search of a lasting solution, as many in Congress and beyond recognize the loss of work authorization and deportation relief will affect not only DACA recipients and their families, but also employers, universities, and communities alike, as this commentary explores.




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Elementary Guide to Literary Criticism, by Franklin Newton Painter

“As a rule,” urges Franklin Newton Painter in his critically acclaimed classic, Elementary Guide to Literary Criticism,  “we should read only books of recognized excellence, and read them with sympathetic intelligence. Trashy books, whatever pleasure they may give, add but little to knowledge or culture; and immoral books often leave an ineradicable stain upon the soul.”

The ideas of “recognized excellence,” “sympathetic intelligence” and “ineradicable stain upon the soul” make one wonder about the criteria by which Painter determines and advocates such notions. Although the criteria for evaluating literature are as old as Homer, they have undergone massive expansion in the 20th century. Besides, in view of new trends in literary theory and criticism, it is also worth pausing for a moment to reconsider the meaning of "theory" itself. According to the Norton Anthology of Theory and Criticism, today the term "theory" entails a mode of questioning and analysis that goes beyond the earlier criteria of "literariness" of literature.  To an earlier generation, it seems that theory is more of an advocacy rather than a disinterested, objective inquiry into poetics of literature. Because of the effects new social movements, especially the women's and civil rights movements, theory now entails skepticism towards previously taken for granted systems, institutions, and norms. Now theory shows a readiness to take critical stands and to engage in resistance, an interest in blind spots, contradictions, and distortions,  and a habit of linking local and personal practices to the larger economic, political, historical, and ethical forces of culture. How and why did that happen in the world of literature?

Please join us at Brooklyn Book Talk, as we compare Painter’s classical criteria from the beginnings of the 20th century to newer perspectives such as formalism, Marxism,  psychoanalysis, structuralism, post-structuralism, reader-response , feminism, deconstruction, queer theory, cultural studies, new historicism, post-colonial, race, and ethnicity studies, etcetera.

The electronic version of Painter's Elementary Guide to Literary Criticism is in the public domain and can be accessed from Project Gutenberg online at:

 




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Association of BMI, Fitness, and Mortality in Patients With Diabetes: Evaluating the Obesity Paradox in the Henry Ford Exercise Testing Project (FIT Project) Cohort

OBJECTIVE

To determine the effect of fitness on the association between BMI and mortality among patients with diabetes.

RESEARCH DESIGN AND METHODS

We identified 8,528 patients with diabetes (self-report, medication use, or electronic medical record diagnosis) from the Henry Ford Exercise Testing Project (FIT Project). Patients with a BMI <18.5 kg/m2 or cancer were excluded. Fitness was measured as the METs achieved during a physician-referred treadmill stress test and categorized as low (<6), moderate (6–9.9), or high (≥10). Adjusted hazard ratios for mortality were calculated using standard BMI (kilograms per meter squared) cutoffs of normal (18.5–24.9), overweight (25–29.9), and obese (≥30). Adjusted splines centered at 22.5 kg/m2 were used to examine BMI as a continuous variable.

RESULTS

Patients had a mean age of 58 ± 11 years (49% women) with 1,319 deaths over a mean follow-up of 10.0 ± 4.1 years. Overall, obese patients had a 30% lower mortality hazard (P < 0.001) compared with normal-weight patients. In adjusted spline modeling, higher BMI as a continuous variable was predominantly associated with a lower mortality risk in the lowest fitness group and among patients with moderate fitness and BMI ≥30 kg/m2. Compared with the lowest fitness group, patients with higher fitness had an ~50% (6–9.9 METs) and 70% (≥10 METs) lower mortality hazard regardless of BMI (P < 0.001).

CONCLUSIONS

Among patients with diabetes, the obesity paradox was less pronounced for patients with the highest fitness level, and these patients also had the lowest risk of mortality.




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Interdisciplinary Team Care for Diabetic Patients by Primary Care Physicians, Advanced Practice Nurses, and Clinical Pharmacists

David Willens
Apr 1, 2011; 29:60-68
Feature Articles




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Six Simple Signs Of A Narcissist (M)

One of the most commonly believed signs of a narcissist is a myth.

Support PsyBlog for just $5 per month. Enables access to articles marked (M) and removes ads.

→ Explore PsyBlog's ebooks, all written by Dr Jeremy Dean:




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I’m a Cisgender Woman and My Husband Watches Trans Porn: Does That Mean He’s Not Into Me?

A reader submitted the following question: “I recently discovered that my husband is attracted to transsexuals (MTF - non op). This is the only type of porn that he looks at. He also role plays online with men for sexual play and chat. I discovered this after I started snooping because I had some red flags. He is very embarrassed and uncomfortable discussing it. He has apologized for the online chatting (as we had agreed this was out of bounds for our relationship). He says he likes them because they are feminine but his primary attraction is to women (with female parts). However, I just am not sure I believe him. I am terrified that when we are intimate (which I have to pretty much beg for), he can only do it when its dark and I am fearful he is fantasizing that I have a penis. This bothers me deeply on a number of different levels. Are there men who are only interested in transsexuals? Is it possible he is no longer turned on by my female genitalia?” There’s a lot to unpack in this question, but let’s start here: over the years, I’ve received several emails from women describing similar stories and concerns, so you’re not alone in feeling the way that you do.



  • Sex Question Friday
  • Sexual Problems and Solutions

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Racism has a cost for everyone | Heather C. McGhee

Racism makes our economy worse -- and not just in ways that harm people of color, says public policy expert Heather C. McGhee. From her research and travels across the US, McGhee shares startling insights into how racism fuels bad policymaking and drains our economic potential -- and offers a crucial rethink on what we can do to create a more prosperous nation for all. "Our fates are linked," she says. "It costs us so much to remain divided."




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Behavioral Decision Research and Management (BDRM), Barcelona, June 16-18, 2020

SAVE THE DATE ESADE Business School will host the 2020 Behavioral Decision Research and Management (BDRM) conference, in Barcelona, Spain. Dates: Tuesday June 16th – Thursday June 18th, 2020. More information coming, September of 2019. Faculty Organizers Uri Simonsohn (ESADE) Isabelle Engeler (IESE) Jordi Quoidbach (ESADE) Bart de Langhe (ESADE) Johannes Müller-Trede (IESE) Ioannis Evangelidis […]

The post Behavioral Decision Research and Management (BDRM), Barcelona, June 16-18, 2020 appeared first on Decision Science News.




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Professorship in decision making at Wharton, Operations, Information and Decisions (OID), University of Pennsylvania

APPLICATION DEADLINE OCTOBER 15, 2019 The Operations, Information and Decisions Department at the Wharton School is seeking applicants for a full-time, tenure track, Assistant Professor faculty position in the area of decision-making. Our decision-making faculty is comprised of scholars with a diverse set of backgrounds and interests, and we encourage applicants with degrees in economics, […]

The post Professorship in decision making at Wharton, Operations, Information and Decisions (OID), University of Pennsylvania appeared first on Decision Science News.




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Annual Interdisciplinary Symposium on Decision Neuroscience (ISDN), Philadelphia, June 5-6, 2020

DEADLINE FOR ORAL PRESENTATIONS: FEB 15, 2020 On June 5-6 2020, Temple University will host the 10th Annual Interdisciplinary Symposium on Decision Neuroscience (ISDN) in Philadelphia, PA. This symposium is unique in that it brings together a range of constituencies involved in the use of neuroscience techniques to understand consumer decision making – world renowned […]

The post Annual Interdisciplinary Symposium on Decision Neuroscience (ISDN), Philadelphia, June 5-6, 2020 appeared first on Decision Science News.




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Teenagers Who Believe They Are Particularly Intelligent Tend To Be More Narcissistic And Happier With Life

By Emily Reynolds. But self-assessed intelligence was not actually related to objective measures of intelligence




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Intruders post racist language in Oklahoma education meeting




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San Francisco schools adopt new grading policy amid pandemic




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San Francisco schools adopt new grading policy amid pandemic




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Decision on NJ schools likely on Thursday, Murphy says




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2 Georgia high schoolers expelled after posting racist video




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President of Delaware Teachers' Union Resigns Due to Sexist, Racist Posts

Mike Matthews wrote several sexist and racist blog posts a decade ago that were recently unearthed.




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Patchwork decisions throw wrinkle in college football plans

There are 130 major college football teams, spread across 41 states and competing in 10 conferences, save for a handful of independents. The goal is to have all those teams start the upcoming season at the same time - whether that's around Labor Day as scheduled or later - and play the same number of games. Despite the best intentions of conference leaders, the possibility exists of college football being played in SEC country before it begins in Pac-12 territory - or something else entirely.




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South Australian Civil and Administrative Tribunal significant decisions / presented by the Hon. Justice Greg Parker PSM.




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Confiscation of assets : forfeiture, foreclosure and forlorn : a review of recent decisions under the Criminal Assets Confiscation Act 2005 (SA) / presented by His Honour Judge Tilmouth, District Court of South Australia.




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Recent Disciplinary Decisions and Trends.




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Recent Disciplinary Decisions and Trends.




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Forum 2019 : 8C Are regular casual employees entitled to paid annual leave? : the implications of the Federal Court's decision in WorkPac Pty Ltd v Skene / slides presented by John Love, EMA Legal.




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Fake : a startling true story of love in a world of liars, cheats, narcissists, fantasists and phonies / Stephanie Wood.

Wood, Stephanie -- Relations with men.




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White fragility : why it's so hard for white people to talk about racism / Robin DiAngelo.

Racism.




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Fascists among us : online hate and the Christchurch massacre / Jeff Sparrow.

Fascism -- History -- 21st century.




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The gospel of climate skepticism : why evangelical Christians oppose action on climate change / Robin Globus Veldman.

Climatic changes -- Effect of human beings on -- Religious aspects -- Christianity.




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The craft of dying : the modern face of death / Lyn H. Lofland ; introduction by John Troyer ; epilogue by Ara A. Francis.

Death -- Psychological aspects.




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Des rétrécissements du canal de l'urèthre / par Édouard de Smet.

Bruxelles : H. Manceux, 1880.




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A description of the diseased conditions of the knee-joint which require amputation of the limb, and those conditions which are favourable to excision of the joint : with an explanation of the relative advantages of both operations as far as can be ascert

London : J. Churchill, 1865.




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Digest of researches and criticisms bearing on the revision of the British pharmacopoeia, 1898 : 1899 to 1902 inclusive / prepared for the Pharmacopoeia Committee of the General Council of Medical Education and Registration of the United Kingdom by W. Cha

London : printed for the Council by Spottiswoode, 1903.




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Discourse on the enlarged and pendulous abdomen : showing it to be a visceral affection, attended with important consequences in the human economy : with cursory observations on diet, exercise, and the general management of health : for the use of the dys

London : Longman, Brown, Green, and Longmans, 1842.




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Diseases and remedies : a concise survey of the most modern methods of medicine / written expressly for the drug trade by physicians and pharmacists.

London : Chemist and Druggist, 1898.




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Du retrécissement cicatriciel du col de l'utérus au point de vue de l'accouchement / par Victor-Albert Taurin.

Paris : G. Steinheil, 1895.




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Du traitement de l'accouchement dans les bassins rétrécis / par C. C. Th. Litzmann, à Kiel... traduit par A. Charpentier,...

Paris : Delahaye, 1877.




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The Dublin dissector; : or, Manual of anatomy, comprising a concise description of ... the human body, for the use of students in the dissecting room / by a member of the Royal College of Surgeons in Ireland.

Dublin : printed for Hodges and Smith, 1831.




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Earth to earth : a plea for a change of system in our burial of the dead / by Francis Seymour Haden.

London : Macmillan, 1875.




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Eléments de pathologie médicale; ou, Précis de médecine theórique et pratique, écrit dans l'esprit du vitalisme hippocratique / par A. L. J. Bayle.

Paris : Germer-Bailliere, 1856-1857.




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The elements of embryology / by M. Foster and Francis M. Balfour.

London : Macmillan, 1883.




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Enteric fever : its prevalence and modifications, aetiology, pathology and treatment as illustrated by Army data at home and abroad / by Francis H. Welch.

London : H.K. Lewis, 1883.




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Essai sur le rétrécissement tricuspidien / Robert Leudet.

Paris : Steinheil, 1888.




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The Catholic powers gather around the infant James Francis Edward Stuart. Etching by R. de Hooghe, 1688, with letterpress.

[The Netherlands] : [publisher not identified], [1688]




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Penguins may face ‘tough decisions’ with goalies thanks to salary cap crunch

Could they lose one or more of Murray, Jarry, and DeSmith?




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Scissors and Glue Zine collage/vegan/art




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Natalie Chou on why she took a stand against anti-Asian racism in wake of coronavirus

During Wednesday's "Pac-12 Perspective" podcast, Natalie Chou shared why she is using her platform to speak out against racism she sees in her community related to the novel coronavirus.




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The weight function in the subtree kernel is decisive

Tree data are ubiquitous because they model a large variety of situations, e.g., the architecture of plants, the secondary structure of RNA, or the hierarchy of XML files. Nevertheless, the analysis of these non-Euclidean data is difficult per se. In this paper, we focus on the subtree kernel that is a convolution kernel for tree data introduced by Vishwanathan and Smola in the early 2000's. More precisely, we investigate the influence of the weight function from a theoretical perspective and in real data applications. We establish on a 2-classes stochastic model that the performance of the subtree kernel is improved when the weight of leaves vanishes, which motivates the definition of a new weight function, learned from the data and not fixed by the user as usually done. To this end, we define a unified framework for computing the subtree kernel from ordered or unordered trees, that is particularly suitable for tuning parameters. We show through eight real data classification problems the great efficiency of our approach, in particular for small data sets, which also states the high importance of the weight function. Finally, a visualization tool of the significant features is derived.