Nocturnal surveys of lined seahorses reveal increased densities and seasonal recruitment patterns.

Although the nighttime ecology of organisms remains understudied, nocturnal surveys play an integral part in assessing fish assemblages and the selective forces shaping them. Eleuthera (Bahamas) contains an unusual population of lined seahorses (Hippocampus erectus) in an anchialine lake, possessing morphological characteristics distinct from those found in the ocean. Population surveys for seahorses and their potential predators were conducted at midnight and midday during wet and dry seasons, with belt transects perpendicular to the shoreline that increased in depth away from shore. Nocturnal surveys uncovered seahorse densities 259% higher than daytime transects on average. Sex ratios were consistently male-biased, and the frequency of animals from different reproductive categories varied significantly by time of day, with gravid males observed around the clock but females and nongravid males observed more often at night. Spatial and seasonal recruitment was detected for the first time in this species, with an increase in juveniles detected in the shallow ends of transects during dry season surveys. Juvenile recruitment is poorly understood across syngnathid fishes, so the detection of early recruits at night has broad implications for this fish family. Seahorses from all reproductive categories were perched significantly higher in the water column during the night regardless of their depth or season. Predator densities followed a similar pattern with higher densities observed at night, indicating that elevated nocturnal perch height may be a response to predator presence. However, the selective agents driving these nocturnal behaviors have yet to be identified. Considering H. erectus is listed on the IUCN Red List as "Vulnerable," the increase in nocturnal population size and the detection of juveniles has crucial implications for understanding their ecology, recruitment, and conservation.

Guidelines on the diagnosis, clinical assessments, treatment and management for CLN2 disease patients.

BACKGROUND: CLN2 disease (Neuronal Ceroid Lipofuscinosis Type 2) is an ultra-rare, neurodegenerative lysosomal storage disease, caused by an enzyme deficiency of tripeptidyl peptidase 1 (TPP1). Lack of disease awareness and the non-specificity of presenting symptoms often leads to delayed diagnosis. These guidelines provide robust evidence-based, expert-agreed recommendations on the risks/benefits of disease-modifying treatments and the medical interventions used to manage this condition. METHODS: An expert mapping tool process was developed ranking multidisciplinary professionals, with knowledge of CLN2 disease, diagnostic or management experience of CLN2 disease, or family support professionals. Individuals were sequentially approached to identify two chairs, ensuring that the process was transparent and unbiased. A systematic literature review of published evidence using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance was independently and simultaneously conducted to develop key statements based upon the strength of the publications. Clinical care statements formed the basis of an international modified Delphi consensus determination process using the virtual meeting (Within3) online platform which requested experts to agree or disagree with any changes. Statements reaching the consensus mark became the guiding statements within this manuscript, which were subsequently assessed against the Appraisal of Guidelines for Research and Evaluation (AGREEII) criteria. RESULTS: Twenty-one international experts from 7 different specialities, including a patient advocate, were identified. Fifty-three guideline statements were developed covering 13 domains: General Description and Statements, Diagnostics, Clinical Recommendations and Management, Assessments, Interventions and Treatment, Additional Care Considerations, Social Care Considerations, Pain Management, Epilepsy / Seizures, Nutritional Care Interventions, Respiratory Health, Sleep and Rest, and End of Life Care. Consensus was reached after a single round of voting, with one exception which was revised, and agreed by 100% of the SC and achieved 80% consensus in the second voting round. The overall AGREE II assessment score obtained for the development of the guidelines was 5.7 (where 1 represents the lowest quality, and 7 represents the highest quality). CONCLUSION: This program provides robust evidence- and consensus-driven guidelines that can be used by all healthcare professionals involved in the management of patients with CLN2 disease and other neurodegenerative disorders. This addresses the clinical need to complement other information available.

Yoga practice in the UK: a cross-sectional survey of motivation, health benefits and behaviours.

OBJECTIVES: Despite the popularity of yoga and evidence of its positive effects on physical and mental health, little is known about yoga practice in the UK. This study investigated the characteristics of people who practise yoga, reasons for initiating and maintaining practice, and perceived impact of yoga on health and well-being. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional online anonymous survey distributed through UK-based yoga organisations, studios and events, through email invites and flyers. 2434 yoga practitioners completed the survey, including 903 yoga teachers: 87% were women, 91% white and 71% degree educated; mean age was 48.7 years. MAIN OUTCOME MEASURES: Perceived impact of yoga on health conditions, health outcomes and injuries. Relationships between yoga practice and measures of health, lifestyle, stress and well-being. RESULTS: In comparison with national population norms, participants reported significantly higher well-being but also higher anxiety; lower perceived stress, body mass index and incidence of obesity, and higher rates of positive health behaviours. 47% reported changing their motivations to practise yoga, with general wellness and fitness key to initial uptake, and stress management and spirituality important to current practice. 16% of participants reported starting yoga to manage a physical or mental health condition. Respondents reported the value of yoga for a wide range of health conditions, most notably for musculoskeletal and mental health conditions. 20.7% reported at least one yoga-related injury over their lifetime. Controlling for demographic factors, frequency of yoga practice accounted for small but significant variance in health-related regression models (p<0.001). CONCLUSION: The findings of this first detailed UK survey were consistent with surveys in other Western countries. Yoga was perceived to have a positive impact on physical and mental health conditions and was linked to positive health behaviours. Further investigation of yoga's role in self-care could inform health-related challenges faced by many countries.

Associations of yoga practice, health status, and health behavior among yoga practitioners in Germany-Results of a national cross-sectional survey.

BACKGROUND: While yoga can improve health-related variables and health behavior, different yoga styles and practice components appear to be associated with specific health outcomes. The aim of this study was to explore the connection between yoga use, health, and health behaviors across different yoga styles. METHODS: A cross-sectional anonymous online survey (n = 1,702; 88.9% female; 93.3% German nationality; mean age 47.2 ± 10.8 years; 58.2% yoga teachers) assessed yoga practice characteristics, health-related variables and health behavior. The survey was distributed in Germany only but not limited to German participants. RESULTS: Ashtanga yoga (15.7%), Hatha yoga (14.2%), and Sivananda yoga (22.4%) were the most commonly practiced yoga styles; participants practiced for a mean of 12.7 ± 10.0 years. Most participants had good to excellent (96.1%) overall health; 87.7% reported improved health since starting yoga. Controlling for sociodemographic and clinical factors, health-related variables were mainly associated with frequency of yoga postures practice (p < 0.05), health behaviors also with yoga philosophy study (p < 0.05). The various yoga styles were associated with specific health-related variables (p < 0.05). CONCLUSION: Yoga practitioners generally have a good overall health and a healthy lifestyle. While health variables are mainly associated with practice of yoga postures, health behaviors are also associated with the study of yoga philosophy. Yoga interventions targeting prevention or health promotion should include yoga philosophy to modify health behaviors. The specific yoga style employed may also influence health outcomes.

Yoga and Healthcare in the United Kingdom.

The emergence of yoga therapy in the United Kingdom began about 45 years ago with the emergence of yoga therapy organizations that offered both treatment and training. The integration of yoga into the National Health Service (NHS) is gradually happening Because: (a) yoga research supports its efficacy as a cost-effective, preventive and complementary treatment for a host of non-communicable diseases; and (b) the escalating economic burden of long-term conditions is overwhelming the NHS. The NHS is actively developing 'sustainability and transformation plans' that include yoga. Chief among these is 'social prescribing,' which empowers patients with complex health needs through activities groups. These activities reduce sedentary habits and social isolation, while helping patients to be more self-reliant. The NHS has allocated £450 million in funding to implement a variety of programs for its own staff, in which staff yoga classes were expressly mentioned. The yoga community is mobilizing forces and applying for funding to pilot relevant NHS staff yoga courses that can support the service in achieving its vision. Research shows that integrating yoga therapy for the treatment of low back pain (LBP) into the NHS would result in significant cost savings as compared with usual care. The National Institute for Health and Care Excellence (NICE) Guidelines on LBP and sciatica include yoga as one of the recommended treatments for these conditions. Three groups of yoga teachers, using different yoga practices, have gained traction with the NHS for the application of yoga therapy to LBP. Many regional hospitals in England have yoga classes. The NHS Choices website, which conveys information to the public regarding treatment options, has a page dedicated to the health benefits of yoga. Several institutions offer comprehensive training programs in yoga therapy and yoga therapy is recognized as an official profession. The Yoga in Healthcare Alliance has been established to help integrate yoga therapy into the NHS. This consists of parliamentarians, leaders in the NHS, yoga researchers, health professionals, and representatives from leading yoga organizations.

Embodied health: the effects of a mind-body course for medical students.

OBJECTIVE: An effective career in medicine requires empathy and compassion, yet the demands of a medical education increase stress and decrease students' ability to connect with patients. However, research suggests mind-body practices improve psychological well-being. This study aimed to evaluate the psychological effects on medical students of an 11-week elective course, Embodied Health or EH, which combines yoga and meditation with neuroscience didactics. METHODS: The effects on 27 first- and second-year medical students were evaluated via surveys in four areas: empathy, perceived stress, self-regulation, and self-compassion. Scales used were 1. Jefferson Scale of Physician Empathy, which measures empathy among health students and professionals and medical students on a scale of 1 (least empathetic) to 7 (most empathetic); 2. Cohen's Perceived Stress Scale, a measure of the perceived uncontrollability of respondents' lives, from 0 (least stressed) to 4 (most stressed); 3. Self-Regulation Questionnaire, which measures the development and maintenance of planned behavior to achieve goals, from 1 (least self-regulated) to 5 (most self-regulated); and 4. Self-Compassion Scale, which measures self-criticism, from 1 (least self-compassionate) to 5 (most self-compassionate). Students also reflected on EH's impact on their well-being in a post-course essay. RESULTS: Self-regulation and self-compassion rose 0.13 (SD 0.20, p=0.003) and 0.28 (SD 0.61, p=0.04), respectively. Favorable changes were also seen in empathy and perceived stress, which went up by 0.11 (SD 0.50, p=0.30) and down by 0.05 (SD 0.62, p=0.70), respectively; these changes did not reach statistical significance. Students' essays were found to discuss the following recurrent themes: 1) Reconnection between mind and body; 2) Community in a competitive environment; 3) Increased mindfulness; 4) Confidence in use of mind-body skills with patients; and 5) Stress management. These themes overlapped with the measures EH affected quantitatively. CONCLUSION: A mind-body course for medical students increased self-regulation and self-compassion. Qualitative themes discussed in students' post-course essays reflected these effects.

Cardiovascular and respiratory effect of yogic slow breathing in the yoga beginner: what is the best approach?

Slow breathing increases cardiac-vagal baroreflex sensitivity (BRS), improves oxygen saturation, lowers blood pressure, and reduces anxiety. Within the yoga tradition slow breathing is often paired with a contraction of the glottis muscles. This resistance breath "ujjayi" is performed at various rates and ratios of inspiration/expiration. To test whether ujjayi had additional positive effects to slow breathing, we compared BRS and ventilatory control under different breathing patterns (equal/unequal inspiration/expiration at 6 breath/min, with/without ujjayi), in 17 yoga-naive young healthy participants. BRS increased with slow breathing techniques with or without expiratory ujjayi (P < 0.05 or higher) except with inspiratory + expiratory ujjayi. The maximal increase in BRS and decrease in blood pressure were found in slow breathing with equal inspiration and expiration. This corresponded with a significant improvement in oxygen saturation without increase in heart rate and ventilation. Ujjayi showed similar increase in oxygen saturation but slightly lesser improvement in baroreflex sensitivity with no change in blood pressure. The slow breathing with equal inspiration and expiration seems the best technique for improving baroreflex sensitivity in yoga-naive subjects. The effects of ujjayi seems dependent on increased intrathoracic pressure that requires greater effort than normal slow breathing.

Differential control of cell death and gene expression during two distinct phases of hormonally-regulated muscle death in the tobacco hawkmoth Manduca sexta.

In larvae of the tobacco hawkmoth Manduca sexta, the intersegmental muscles (ISMs) span eight abdominal segments and represent the major muscle group. Following pupation, the ISMs in the first two and last two segments undergo programmed cell death (PCD), while the remaining four segments persist until the time of adult eclosion, when they too undergo PCD. ISM death at adult eclosion is initiated by a decline in the circulating ecdysteroid titer and requires de novo gene expression. In this study we have investigated the hormonal regulation and the patterns of gene expression that accompany both early and late ISM death. We find that distinct endocrine cues regulate these two periods of muscle death. Even though the middle segments of ISMs are exposed to the same endocrine environment as the adjacent cells that die following pupation, they do not express death-associated transcripts until they are specifically signaled to die following adult eclosion. These data indicate that subsets of homologous muscles appear to make segment-specific decisions to couple their endogenous cell death programs to distinctly different developmental cues. Nevertheless, once cell death is initiated, they utilize many of the same molecular components.

Childhood obesity: a transtheoretical case management approach.

Childhood obesity is an increasing health problem because of its strong associations with chronic health problems in children and adults. Obesity during childhood commonly persists into adulthood and is resistant to interventions that involve only recommendations to decrease caloric intake and to increase caloric expenditure through increased physical activity. The challenge with this approach to childhood obesity is that it is not theoretically based, nor does it consider the child's or the parent's perceptions of the health problem or their transition along the stages of behavioral change. Case management has been proven to be successful in managing various chronic health problems in both adults and children. This article will introduce a new intervention model based on the transtheoretical framework by utilizing case management in a primary care setting to treat childhood obesity.

Loss of notch activity in the developing central nervous system leads to increased cell death.

Many cells in the mammalian brain undergo apoptosis as a normal and critical part of development but the signals that regulate the survival and death of neural progenitor cells and the neurons they produce are not well understood. The Notch signaling pathway is involved in multiple decision points during development and has been proposed to regulate the survival and apoptosis of neural progenitor cells in the developing brain; however, previous experiments have not resolved whether Notch activity is pro- or anti-apoptotic. To elucidate the function of Notch signaling in the survival and death of cells in the nervous system, we have produced single and compound Notch conditional mutants in which Notch1 and Notch3 are removed at different times during brain development and in different populations of cells. We show here that a large number of neural progenitor cells, as well as differentiating neurons, undergo apoptosis in the absence of Notch1 and Notch3, suggesting that Notch activity promotes the survival of both progenitors and newly differentiating cells in the developing nervous system. Finally, we show that postmitotic neurons do not require Notch activity indefinitely to regulate their survival since elevated levels of cell death are observed only during embryogenesis in the Notch mutants and are not detected in neonates.

Notch 1 inhibits photoreceptor production in the developing mammalian retina.

The transmembrane receptor Notch1 plays a role in development and homeostasis in vertebrates and invertebrates. The mammalian retina is an excellent tissue in which to dissect the precise role of Notch signaling in regulating cell fate and proliferation. However, a systematic analysis has been limited by the early embryonic lethality of Notch1-null mice. Here, Notch1 was conditionally removed from the murine retina either early or late in development. Removal of Notch1 early led to a reduction in the size of the retina as well as aberrant morphology. A decrease in the number of progenitor cells and premature neurogenesis accounted for the reduction in size. Unexpectedly, ablation of Notch1 in early progenitor cells led to enhanced cone photoreceptor production, and ablation of Notch1 at later points led to an almost exclusive production of rod photoreceptor cells. These data suggest that Notch1 not only maintains the progenitor state, but is required to inhibit the photoreceptor fate. These cone enriched mutant mice should prove to be a valuable resource for the study of this relatively rare mammalian photoreceptor cell type.

Notch signaling coordinates the patterning of striatal compartments.

Numerous lines of evidence suggest that Notch signaling plays a pivotal role in controlling the production of neurons from progenitor cells. However, most experiments have relied on gain-of-function approaches because perturbation of Notch signaling results in death prior to the onset of neurogenesis. Here, we examine the requirement for Notch signaling in the development of the striatum through the analysis of different single and compound Notch1 conditional and Notch3 null mutants. We find that normal development of the striatum depends on the presence of appropriate Notch signals in progenitors during a critical window of embryonic development. Early removal of Notch1 prior to neurogenesis alters early-born patch neurons but not late-born matrix neurons in the striatum. We further show that the late-born striatal neurons in these mutants are spared as a result of functional compensation by Notch3. Notably, however, the removal of Notch signaling subsequent to cells leaving the germinal zone has no obvious effect on striatal organization and patterning. These results indicate that Notch signaling is required in neural progenitor cells to control cell fate in the striatum, but is dispensable during subsequent phases of neuronal migration and differentiation.

Brain lipid-binding protein is a direct target of Notch signaling in radial glial cells.

Radial glia function during CNS development both as neural progenitors and as a scaffolding supporting neuronal migration. To elucidate pathways involved in these functions, we mapped in vivo the promoter for Blbp, a radial glial gene. We show here that a binding site for the Notch effector CBF1 is essential for all Blbp transcription in radial glia, and that BLBP expression is significantly reduced in the forebrains of mice lacking the Notch1 and Notch3 receptors. These results identify Blbp as the first predominantly CNS-specific Notch target gene and suggest that it mediates some aspects of Notch signaling in radial glia.

Psychological state and quality of life in patients having behavioral treatment (biofeedback) for intractable constipation.

OBJECTIVE: Behavioral techniques, including biofeedback, improve symptoms in a majority of patients with intractable idiopathic constipation. However, it is unknown whether there is also improvement in patients' psychological well-being and quality of life (QOL). It is also unknown whether psychological or QOL factors can be used to predict the response to treatment. We aimed to assess these factors prospectively. METHODS: Thirty-one consecutive patients (median age 36 yr) receiving biofeedback retraining for idiopathic constipation were studied. A bowel symptom record, the General Health Questionnaire-28 (GHQ-28) (n = 31) and Hospital Anxiety and Depression Scale (n = 20), both psychological measures, and the Short Form-36 (SF-36) (n = 22), a generic QOL measure, were recorded before and after treatment. RESULTS: Twenty-two of the patients felt subjectively symptomatically improved. When considering all patients, treatment resulted in decreased depression (p < 0.05), anxiety (p < 0.05), and somatic symptoms (p < 0.01) (psychological measures: GHQ-28), and improved general health (p < 0.05) and vitality (p < 0.05) (QOL measures: SF-36). Patients who improved symptomatically showed significantly higher scores on the GHQ-28 and SF-36, in contrast to the unchanged scores in patients who did not symptomatically improve. Pretreatment GHQ-28 did not predict who would benefit from treatment, but patients in whom pain, emotional problems, or low vitality interfered with daily living (SF-36 pain subscales) were significantly (p < 0.05) less likely to respond to treatment. CONCLUSIONS: The symptomatic improvement produced by biofeedback in constipated patients is associated with improved psychological state and QOL. Some of the psychological morbidity in these patients is reversible. QOL parameters may be useful for predicting a likely response to treatment.