Niyantrita Madhumeha Bharata 2017, Methodology for a Nationwide Diabetes Prevalence Estimate: Part 1.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) poses an ever-increasing threat to people's health worldwide. India has reported high rates of incidence of T2DM. The dangers make accurate assessment of its burden and intervention of lifestyle change, an urgent necessity. AIMS AND OBJECTIVES: The aim of the study was to estimate the nationwide prevalence of prediabetes and diabetes, followed by a translational lifestyle trial. METHODOLOGY: The Indian Yoga Association was commissioned in 2016-2017 by the Government of India to conduct this study which was undertaken in two phases: Phase 1 was to estimate the prevalence of prediabetes and diabetes across the country, and Phase 2 was to conduct a randomized controlled trial using a validated yoga lifestyle protocol. This paper highlights the unique methodology of Phase 1 of the study. The first stage was screening (February to April 2017) for adults (>20 years) with high risk for diabetes on Indian diabetes risk score (IDRS) on mobile app, using a random cluster sampling survey method. All households in the rural (4 villages with about 500 adult population/village) and urban (2 census enumeration blocks [CEBs] of about 1000 adult population/block) sectors of 65 districts (one per ten districts in the entire country) from 29 out of 35 states of India were approached. In the second stage, detailed assessments (sociodemographic, clinical details, A1c, lipid profile, body mass index, stress, and tobacco) were carried out on those with high risk on IDRS and on all self-reported diabetes individuals. RESULTS: In the first stage of door-to-door visit, 240,968 adults in all households of the selected clusters of villages and CEBs were approached. Of these, 162,330 responded. The respondents in the second stage for detailed assessments in the selected cohort were 50,199 (48% rural and 52% urban) adults. Of these, 7472 were self-reported known diabetes adults and the remaining were 42,737. Prevalence estimates for the country will follow in the future publications. CONCLUSION: This rapid survey completed within 3 months in the entire country using trained volunteers offers the methodology to obtain a quick estimate of diabetes and high-risk population to implement any lifestyle program.

Are There Benefits from Teaching Yoga at Schools? A Systematic Review of Randomized Control Trials of Yoga-Based Interventions.

Introduction. Yoga is a holistic system of varied mind-body practices that can be used to improve mental and physical health and it has been utilized in a variety of contexts and situations. Educators and schools are looking to include yoga as a cost-effective, evidence-based component of urgently needed wellness programs for their students. Objectives. The primary goal of this study was to systematically examine the available literature for yoga interventions exclusively in school settings, exploring the evidence of yoga-based interventions on academic, cognitive, and psychosocial benefits. Methods. An extensive search was conducted for studies published between 1980 and October 31, 2014 (PubMed, PsycInfo, Embase, ISI, and the Cochrane Library). Effect size analysis, through standardized mean difference and Hedges'g, allowed for the comparison between experimental conditions. Results and Conclusions. Nine randomized control trials met criteria for inclusion in this review. Effect size was found for mood indicators, tension and anxiety in the POMS scale, self-esteem, and memory when the yoga groups were compared to control. Future research requires greater standardization and suitability of yoga interventions for children.

Influence of Intensity and Duration of Yoga on Anxiety and Depression Scores Associated with Chronic Illness.

BACKGROUND: Chronic illness is commonly associated with anxiety and depression. Both anxiety and depression respond to yoga. However, there is no report on the association between the intensity and duration of yoga practice with the benefits seen. AIM: The present study was intended to determine whether the daily duration of yoga practice and the duration of experience in months would predict anxiety and depression, associated with chronic illness. SUBJECTS AND METHODS: Seven hundred and sixty-three volunteers with ages between 14 and 86 years (group mean age standard deviation, 50.2 [14.2]) who attended a 7 day residential yoga camp in the north of India were included in this cross-sectional study. All participants had chronic illnesses, which were under control with treatment, and which were categorized and are detailed. Participants were assessed for state anxiety scores using State-Trait Anxiety Inventory and for anxiety with hospital anxiety and depression scale (HADS-A), and depression was assessed using HADS-D scores of the HADS. Linear multiple regression analyses were performed using PASW SPSS version 18.0 (Armonk, New York, U.S.) to determine how the daily and monthly duration of yoga practice could influence state anxiety, hospital anxiety and depression of the participants. RESULTS: Yoga practice in months and the time spent practicing yoga each day significantly predict the level of state anxiety (P < 0.001, P = 0.03) and HAD-A (P < 0.01, P < 0.01). The duration of yoga practice in months alone was a significant predictor of the HAD-D (P < 0.01). CONCLUSIONS: The results suggest that the duration of yoga practice in months and daily practice in minutes predict anxiety associated with chronic illness. In contrast the duration of yoga practice in months alone, predicted depression scores.

Voluntary heart rate reduction following yoga using different strategies.

BACKGROUND/AIMS: One month of yoga training has been shown to reduce the pulse rate voluntarily without using external cues. Hence, the present study was designed to understand the strategies used by yoga practitioners and autonomic changes associated with voluntary heart rate reduction. MATERIALS AND METHODS: Fifty volunteers (group mean age ± S.D., 25.4 ± 4.8 years; 25 males) were assessed in two trials on separate days. Each trial was for 12 minutes, with a 'pre' state and 'during' state of 6 minutes each. For both trials the 'pre' state was relaxation with eyes closed. In the 'during' state of Trial I, subjects were asked to voluntarily reduce their heart rate using a strategy of their choice. From their responses to specific questions it was determined that 22 out of 50 persons used breath regulation as a strategy. Hence, in the 'during' state of Trial II, subjects were asked to voluntarily reduce their heart rate by breath regulation. RESULTS: In the first trial, the heart rate was reduced by an average of 19.6 beats per minute and in the second trial (with breath regulation exclusively) an average decrease of 22.2 beats per minute was achieved. CONCLUSIONS: Hence, the strategy used did not markedly alter the outcome.

Phenotypic plasticity to light of two congeneric trees from contrasting habitats: Brazilian Atlantic Forest versus cerrado (savanna).

The Brazilian Atlantic Forest is a typically multi-layer tropical forest, while cerrado (savanna) is a patchy habitat with different physiognomy. Despite these differences, both habitats have high light heterogeneity. Functional traits of Dalbergia nigra and D. miscolobium from the Atlantic Forest and cerrado, respectively, were evaluated under shade (25% of full sunlight) and full sunlight in a nursery experiment. We hypothesised that both species should benefit from high phenotypic plasticity in relation to light. Plasticity was estimated using the relative distance phenotypic index (RDPI). D. miscolobium had lower shoot growth under both light conditions, suggesting it has low competitive capacity in the forest environment, which could explain its limited ability to expand over areas of Atlantic Forest. The studied species exhibited photoprotection strategies under high light and improved light capture under low light. Stomatal conductance, ETR(max) (maximum electron transport rate), PPFD(sat) (saturating photosynthetically active photon flux density), chlorophyll and carotenoid content had higher RDPI than stem morphological traits. Although both species showed considerable phenotypic plasticity, D. miscolobium had higher RDPI for eight of 11 evaluated traits. This high plasticity could be one of the factors that explain the occurrence of this species in a wide range of environmental conditions, from open grassland to dense woodlands, and it could also reflect its adaptation to high light. D. nigra also had considerable plasticity and good growth performance in both shade and full sunlight, but its absence in areas of cerrado suggests that factors other than light limit its occurrence in these habitats.

Right uninostril yoga breathing influences ipsilateral components of middle latency auditory evoked potentials.

A previous report described selective electrical activity of the cerebral hemispheres with uninostril breathing. In the present study, middle latency auditory evoked potentials (MLAEPs) were recorded from symmetrical scalp sites during the practice of uninostril yoga breathing. There were two sessions (40 min each) of right nostril yoga breathing (RNB) and of breath awareness (BAW), with (i) 'before', (ii) test (either RNB or BAW) and (iii) 'after' periods. The participants were 14 male volunteers aged between 18 and 33 years, and the setting was a yoga centre. MLAEPs were recorded from symmetrical scalp sites (C4 and C3). During RNB, the peak amplitudes of two negative components (viz. Na wave and Nb wave) were significantly increased on the right side. Increased peak amplitudes of Na and Nb waves suggested that RNB increased the number of neurons recruited on the right side, suggesting a possible application of RNB in certain psychiatric disorders with cerebral hemispheric imbalance.

Improved performance in the Tower of London test following yoga.

Twenty girls between 10 and 13 years of age, studying at a residential school were randomly assigned to two groups. One group practiced yoga for one hour fifteen minutes per day, 7 days a week, while the other group was given physical training for the same time. Time for planning and for execution and the number of moves required to complete the Tower of London task were assessed for both groups at the beginning and end of a month. These three assessments were separately tested in increasingly complex tasks requiring 2-moves, 4-moves and 5-moves. The pre-post data were compared using the Wilcoxon paired signed ranks test. The yoga group showed a significant reduction in planning time for both 2-moves and 4-moves tasks (53.9 and 59.1 percent respectively), execution time in both 4-moves and 5-moves tasks (63.7 and 60.3 percent respectively), and in the number of moves in the 4-moves tasks (20.9 percent). The physical training group showed no change. Hence yoga training for a month reduced the planning and execution time in simple (2-moves) as well as complex tasks (4, 5-moves) and facilitated reaching the target with a smaller number of moves in a complex task (4-moves).

Improvement in hand grip strength in normal volunteers and rheumatoid arthritis patients following yoga training.

The present study aimed at assessing the effects of a set of yoga practices on normal adults (n = 37), children (n = 86), and patients with rheumatoid arthritis (n = 20). An equal number of normal adults, children, and patients with rheumatoid arthritis who did not practice yoga were studied under each category, forming respective control groups. Yoga and control group subjects were assessed at baseline and after varying intervals, as follows, adults after 30 days, children after 10 days and patients after 15 days, based on the duration of the yoga program, which they attended, which was already fixed. Hand grip strength of both hands, measured with a grip dynamometer, increased in normal adults and children, and in rheumatoid arthritis patients, following yoga, but not in the corresponding control groups, showing no re-test effect. Adult female volunteers and patients showed a greater percentage improvement than corresponding adult males. This gender-based difference was not observed in children. Hence yoga practice improves hand grip strength in normal persons and in patients with rheumatoid arthritis, though the magnitude of improvement varies with factors such as gender and age.

Effect of yoga training on maze learning.

The performance in a maze learning task was assessed in adults of either sex (n = 31) before and after 30 days of yoga training and in an age and gender matched control group of subjects who did not receive training in yoga. Subjects were blind folded and used the dominant hand to trace the path in a wooden pencil maze. At each assessment, subjects were given 5 trials, without a gap between them. Performance was based on the time taken to complete the maze and the number of blind alleys taken. The time and error scores of Trial 1 were significantly less after yoga (two-factor ANOVA, Tukey test). Repeating trials significantly decreased time scores at Trial 5 versus Trial 1, for both groups on Day 1 and for the control group on Day 30. Hence the yoga group showed improved performance in maze tracing at retest 30 days later, which may be related to this group being faster learners and also the effect of yoga itself. Yoga training did not influence maze learning, based on the performance in 5 repeat trials.

A review of mind/body therapies in the treatment of musculoskeletal disorders with implications for the elderly.

BACKGROUND: A comprehensive, but not systematic, review of the research on complementary and alternative treatments, specifically mind/body techniques, on musculoskeletal disease was conducted at Stanford University. The goals of the review were to establish a comprehensive literature review and provide a rationale for future research carrying the theme of "successful aging." METHODS: Computerized searches were conducted using MEDLINE, PsychInfo, Stanford Library, Dissertation Abstracts, Lexus-Nexus, the Internet as well as interviews conducted with practitioners and the elderly. Mind/body practices evaluated were: social support, cognitive-behavioral therapy, meditation, the placebo effect, imagery, visualization, spiritual/energy healing, music therapy, hypnosis, yoga, tai chi, and qigong. Studies published after 1990 were the priority, but when more recent literature was scarce, other controlled studies were included. RESULTS: Mind/body techniques were found to be efficacious primarily as complementary treatments for musculoskeletal disease and related disorders. Studies provided evidence for treatment efficacy but most apparent was the need for further controlled research. CONCLUSIONS: Reviewers found a dearth of randomized controlled research conducted in the US. There is a lack of studies with which to determine appropriate dosage and understand the mechanisms by which many of the practices work. Anecdotal evidence, some controlled research, clinical observation, as well as the cost effectiveness and lack of side effects of the mind/body treatments make further investigation a high priority.

Oxygen consumption and respiration following two yoga relaxation techniques.

The present study was conducted to evaluate a statement in ancient yoga texts that suggests that a combination of both "calming" and "stimulating" measures may be especially helpful in reaching a state of mental equilibrium. Two yoga practices, one combining "calming and stimulating" measures (cyclic meditation) and the other, a "calming" technique (shavasan), were compared. The oxygen consumption, breath rate, and breath volume of 40 male volunteers (group mean +/- SD, 27.0 +/- 5.7 years) were assessed before and after sessions of cyclic meditation (CM) and before and after sessions of shavasan (SH). The 2 sessions (CM, SH) were 1 day apart. Cyclic meditation includes the practice of yoga postures interspersed with periods of supine relaxation. During SH the subject lies in a supine position throughout the practice. There was a significant decrease in the amount of oxygen consumed and in breath rate and an increase in breath volume after both types of sessions (2-factor ANOVA, paired t test). However, the magnitude of change on all 3 measures was greater after CM: (1) Oxygen consumption decreased 32.1% after CM compared with 10.1% after SH; (2) breath rate decreased 18.0% after CM and 15.2% after SH; and (3) breath volume increased 28.8% after CM and 15.9% after SH. These results support the idea that a combination of yoga postures interspersed with relaxation reduces arousal more than relaxation alone does.

Trypanosoma cruzi and human ubiquitin are immunologically distinct proteins despite only three amino acid difference in their primary sequence.

The high similarity between Trypanosoma cruzi and human ubiquitin prompted us to characterize the human humoral immunity to host and parasite ubiquitin in Chagas disease and its possible role in Chagas autoimmunity. We have used a simplified one step purification procedure to partially purify T. cruzi ubiquitin. Using this preparation we have performed ELISA and Western blots, to show that chagasic sera recognise T. cruzi but not human or Leishmania ubiquitin indicating a species-specific response. Our results show that despite the high degree of similarity in the primary structure of human and T. cruzi ubiquitins, the three amino acid difference is sufficient to distinguish parasite versus host proteins.

Factors influencing changes in tweezer dexterity scores following yoga training.

Yoga has already been shown to improve perceptual-motor skills, but the factors which influence its effects are not well defined. This study correlates age, gender, and motivation to learn yoga with the performance in a dexterity task following yoga. Tweezer dexterity was recorded in eighty subjects belonging to four groups. Two groups were given a month of yoga training. One group consisted of subjects who had volunteered to join for the training and the other group were deputed for the training as part of their job. The two remaining groups did not receive yoga training and were selected to match the respective groups receiving yoga, for age and sex, but not for their motivation to learn yoga. The test involved using a tweezer to place metal pins in evenly spaced holes in a metal plate within four minutes. Following yoga the scores of the volunteers who learnt yoga increased significantly, whereas there was no change in scores of deputed subjects and non-yoga groups. For reasons described in detail, factors such as age and gender did not appear to contribute to the difference in performance. Hence motivation to learn yoga appeared to influence the magnitude of increase.

Yoga training and motor speed based on a finger tapping task.

A finger tapping task was used to assess motor speed (MS) of both hands in 53 adults and 152 children before and after yoga training and in 38 adults of a non-yoga (control) group. All subjects were right hand dominant. The 30-second tapping speed (TS) test was considered as three time intervals, i.e. 0-10 second (TS1), 10-20 seconds (TS2) and 20-30 seconds (TS3). There was a significant (Student's t-test) increase in all three TS values following 10 days of yoga in children and 30 days of yoga in adults. However for both groups at baseline and final assessments, TS2 and TS3 were significantly lower than TS1. Hence the TS was increased after yoga training during the first 10-seconds of the test but not during the next 20 seconds. These results suggest an increase in motor speed for repetitive finger movements following yoga training, but not in strength or endurance, as the increase was not sustained over 30 sec.

Sudomotor sympathetic hypofunction in Down's syndrome.

General sympathetic dysfunction has been proposed as an explanation for the inability to reach normal heightened attention in Down's syndrome (DS). The present study on 15 DS subjects (group average age +/- SD, 14.3 +/- 3.6 years; 11 males) and in an equal number of age- and gender-matched normal subjects (NS), evaluated activity in different subdivisions of the sympathetic nervous system. DS subjects had (i) lower skin conductance levels (i.e., lower sudomotor sympathetic activity) and (ii) higher heart rates than NS. In response to auditory stimuli, DS subjects showed abnormal SSR responses (also indicating sudomotor sympathetic activity) but normal cutaneous vasoconstriction. Hence the results suggest that sympathetic dysfunction in DS is restricted to the sudomotor subdivision, activity of which has been associated with attention and recognition.

Shorter latencies of components of middle latency auditory evoked potentials in congenitally blind compared to normal sighted subjects.

A previous study which reported shorter latencies of the Nb component of AEP-MLRs in congenitally blind compared to normal sighted subjects, formed the basis for the present study. The blind subjects had received a rehabilitation program from the age of 4 years onwards, which may have influenced auditory function. Hence the present study was designed to compare the AEP MLRs of normal sighted subjects with age-matched blind subjects who had not undergone early rehabilitation. Auditory evoked potentials (0 to 100 ms. range) were recorded in 10 congenitally blind subjects (average age = 22.4 +/- 4.9 yrs.) and an equal number of age-matched subjects with normal vision. There were two repetitions per subject. The peak latencies of both the Pa (maximum positive peak between Na and 35 ms.) and Nb (maximum negative peak between 38 and 52 ms.) waves was significantly shorter in congenitally blind compared to normal sighted subjects. Since the Pa and Nb waves are believed to be generated by the superior temporal cortex (Heschl's gyrus), it appears that processing at this neural level occurs more efficiently in the blind. Also, in spite of the absence of an early rehabilitation program the present subjects showed the same auditory changes as those reported earlier.

Differences between congenitally blind and normally sighted subjects in the P1 component of middle latency auditory evoked potentials.

Auditory evoked potentials (0 to 100 msec. range) were recorded two times for 9 congenitally blind children (age = 14.1 yr. +/- 1.4 yr) and 9 age-matched children with normal vision. The groups' peak latency and amplitude of the P1 wave were compared. The peak latency was significantly lower for the congenitally blind than for the normally sighted on a two-factor analysis of variance. Since the P1 wave is thought to correspond to either the ascending reticular activating system or the primary auditory cortex, these results suggest that information processing at these neural levels may occur more efficiently in the blind.

A review of mind-body therapies in the treatment of cardiovascular disease. Part 1: Implications for the elderly.

BACKGROUND: A review of research on complementary and alternative treatments, specifically mind-body techniques, was conducted at Stanford University. The goals of the review were to establish a comprehensive literature review and to provide a rationale for future research concerning successful aging. METHODS: Computerized searches were conducted using MEDLINE, PsychInfo, Stanford Library, Dissertation Abstracts, Lexus-Nexus, the Internet, and interviews conducted with practitioners. All studies since 1990 that examined mind-body treatments of cardiovascular disorders in the elderly were included. Mind-body practices evaluated were social support, cognitive-behavioral treatment, meditation, the placebo effect, hope, faith, imagery, spiritual healing, music therapy, hypnosis, yoga, t'ai chi, qigong and aikido. Studies conducted after 1990 were a priority, but when more recent literature was scarce, other studies using randomized, controlled trials were included. RESULTS: Mind-body techniques were found to be efficacious primarily as complementary and sometimes as stand-alone alternative treatments for cardiovascular disease-related conditions. Studies provided evidence for treatment efficacy, but the need for further controlled research was evident. CONCLUSIONS: Reviewers found only a handful of randomized, controlled research studies conducted in the United States. As a result, there is a lack of replicated studies with which to determine appropriate treatment dosage and the mechanisms by which many of the practices work. Compelling anecdotal evidence, the presence of some controlled research, overall cost effectiveness, and the lack of side effects resulting from mind-body treatments make further investigation a high priority.

Zinc diffusion through lipid bilayers.

Zinc diffusion across liposome bilayers was measured for a set of phosphatidylcholines. These lipids were sonicated to form small unilamellar vesicles in the presence of the metallochromic indicator antipyrylazo III. This chelator sequentially forms two complexes with zinc ion. The rate constant for the first complex formation is shown to increase linearly with zinc concentration. The slope of this line, a [Zn2+]-independent, second-order rate constant, varies with changes in phosphatidylcholine properties. The rate constant is little affected by changes in fluidity as estimated from the reduced temperature [Tr = (Texperimental-Tc)/Tc]. In contrast, the rate constant is directly dependent on lipid oxidation as measured by either a thiobarbituric acid test or a spectrophotometric determination of conjugate dienes. We estimate that zinc diffusion stimulated by lipid oxidation can approach rates observed in hepatocyte zinc transport.