Yoga Meets Intelligent Internet of Things: Recent Challenges and Future Directions.

The physical and mental health of people can be enhanced through yoga, an excellent form of exercise. As part of the breathing procedure, yoga involves stretching the body organs. The guidance and monitoring of yoga are crucial to ripe the full benefits of it, as wrong postures possess multiple antagonistic effects, including physical hazards and stroke. The detection and monitoring of the yoga postures are possible with the Intelligent Internet of Things (IIoT), which is the integration of intelligent approaches (machine learning) and the Internet of Things (IoT). Considering the increment in yoga practitioners in recent years, the integration of IIoT and yoga has led to the successful implementation of IIoT-based yoga training systems. This paper provides a comprehensive survey on integrating yoga with IIoT. The paper also discusses the multiple types of yoga and the procedure for the detection of yoga using IIoT. Additionally, this paper highlights various applications of yoga, safety measures, various challenges, and future directions. This survey provides the latest developments and findings on yoga and its integration with IIoT.

A Novel Smart Belt for Anxiety Detection, Classification, and Reduction Using IIoMT on Students' Cardiac Signal and MSY.

The prevalence of anxiety among university students is increasing, resulting in the negative impact on their academic and social (behavioral and emotional) development. In order for students to have competitive academic performance, the cognitive function should be strengthened by detecting and handling anxiety. Over a period of 6 weeks, this study examined how to detect anxiety and how Mano Shakti Yoga (MSY) helps reduce anxiety. Relying on cardiac signals, this study follows an integrated detection-estimation-reduction framework for anxiety using the Intelligent Internet of Medical Things (IIoMT) and MSY. IIoMT is the integration of Internet of Medical Things (wearable smart belt) and machine learning algorithms (Decision Tree (DT), Random Forest (RF), and AdaBoost (AB)). Sixty-six eligible students were selected as experiencing anxiety detected based on the results of self-rating anxiety scale (SAS) questionnaire and a smart belt. Then, the students were divided randomly into two groups: experimental and control. The experimental group followed an MSY intervention for one hour twice a week, while the control group followed their own daily routine. Machine learning algorithms are used to analyze the data obtained from the smart belt. MSY is an alternative improvement for the immune system that helps reduce anxiety. All the results illustrate that the experimental group reduced anxiety with a significant (p < 0.05) difference in group × time interaction compared to the control group. The intelligent techniques achieved maximum accuracy of 80% on using RF algorithm. Thus, students can practice MSY and concentrate on their objectives by improving their intelligence, attention, and memory.

Vasorelaxant Effect of Boesenbergia rotunda and Its Active Ingredients on an Isolated Coronary Artery.

Cardiovascular diseases are a major cause of death in developed countries. The regulation of vascular tone is a major approach to prevent and ameliorate vascular diseases. As part of our ongoing screening for cardioprotective natural compounds, we investigated the vasorelaxant effect of rhizomes from Boesenbergia rotunda (L.) Mansf. [Boesenbergia pandurata (Roxb.) Schltr.] used as a spice and herbal medicine in Asian countries. The methanol extract of B. rotunda rhizomes (BRE) exhibited significant vasorelaxation effects ex vivo at EC50 values of 13.4 ± 6.1 µg/mL and 40.9 ± 7.9 µg/mL, respectively, with and without endothelium in the porcine coronary artery ring. The intrinsic mechanism was evaluated by treating with specific inhibitors or activators that typically affect vascular reactivity. The results suggested that BRE induced relaxation in the coronary artery rings via an endothelium-dependent pathway involving NO-cGMP, and also via an endothelium-independent pathway involving the blockade of Ca2+ channels. Vasorelaxant principles in BRE were identified by subsequent chromatographic methods, which revealed that flavonoids regulate vasorelaxant activity in BRE. One of the flavonoids was a Diels-Alder type adduct, 4-hydroxypanduratin A, which showed the most potent vasorelaxant effect on porcine coronary artery with an EC50 of 17.8 ± 2.5 µM. Our results suggest that rhizomes of B. rotunda might be of interest as herbal medicine against cardiovascular diseases.

The Antioxidant and Tyrosinase-Inhibiting Activities of 4-Hydroxycinnamoyl-Malate from a Citrus junos Callus Extract.

We evaluated the antioxidant and skin-lightening activities of 4-hydroxycinnamoyl-malate (4-HCM) in vitro; the material is a water-soluble component of Citrus junos callus. 4-HCM was waterextracted from callus grown on MS medium containing picloram to enhance growth. The antioxidant activity of 4-HCM was determined using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2'-azinobis-(3-ethylbenzoline-6-sulfonate) (ABTS) free-radical-scavenging assays. 4-HCM-mediated inhibition of extracellular matrix protein glycation was assessed using the elastin and collagen glycation assays. Inhibition of skin pigmentation was evaluated by measuring anti-tyrosinase activity and melanogenesis in melanoma cells. 4-HCM was then incorporated into elastic nanoliposomes (ENLs) and delivered topically to enhance percutaneous absorption. At 5 mM, the free-radical-scavenging activity of 4-HCM was 54.2±0.631% in the ABTS assay, comparable to that of 1 mM ascorbic acid (46.5± 0.17%). The IC50 value for inhibition of advanced glycation end-product formation from elastin was 1.25±0.23 mM; collagen glycation was completely inhibited when the 4-HCM level was >5 mM. At 0.5 mM, the material afforded 49.2±3.09% inhibition of tyrosinase activity and, at 10 mM, reduced the melanocyte melanin content by 78% without significant cellular toxicity. Moreover, 4-HCM-loaded ENLs exhibited 569% enhanced permeation of 4-HCM across the human epidermis, which may afford skin-lightening if included in cosmetic formulations.

Citrus junos Fruit Extract Facilitates Anti-Adipogenic Activity of Garcinia cambogia Extract in 3T3-L1 Adipocytes by Reducing Oxidative Stress.

Obesity is a metabolic disorder associated with chronic oxidative stress and inflammation. Recruitment of inflammatory cells to adipose tissue and subsequent production of a large amount of reactive oxygen species (ROS) facilitates adipocyte differentiation and promotes lipid accumulation. The removal of ROS with anti-oxidants appeared an effective strategy against lipid accumulation. Here, we chose Citrus junos, a good dietary source of anti-oxidants and tested the anti-adipogenic potential of Citrus junos extract (CE). CE effectively suppressed the ROS production and lipid accumulation in H2O2-stimulated 3T3-L1 cells. CE also inhibited the expression of CEBP-α and PPAR-γ, the transcription regulators of adipocyte differentiation. These data suggest that CE might suppress the adipocyte differentiation through ROS scavenging action. Also, CE and Garcinia cambogia extract (GE) appeared act additively in reducing ROS and in inhibiting lipid accumulation. It implied a potential usefulness of this combination in the management of obesity related disorders.

Preparation, Characterization, and Biological Activities of Topical Anti-Aging Ingredients in a Citrus junos Callus Extract.

In this study, we prepared and characterized a callus extract from Citrus junos and assessed its utility as a source of topical anti-aging ingredients. Callus extract was produced by aqueous extraction from Citrus junos grown on Murashige and Skoog medium with picloram as a growth regulator. After measuring the total phenolic and flavonoid contents, the major phenolic compound in calli was identified as p-hydroxycinnamoylmalic acid (1) by spectroscopic analysis. The total phenol content in the extract was determined to be 24.50 ± 0.43 mg/g of gallic acid equivalents; however, the total flavonoid content of the extract was not determined. The biological activities of the callus extract, in terms of skin anti-aging, were assessed by measuring the anti-tyrosinase activity in, and melanogenesis by, melanoma cells; and proliferation of, and procollagen synthesis by, human fibroblasts. The callus extract was incorporated into nanoliposomes (NLs) to improve its percutaneous absorption. Addition of the callus extract resulted in a 1.85-fold decrease in the melanin content of melanocytes compared with that with arbutin. The extract (500 µg/mL) significantly promoted the proliferation of, and procollagen synthesis by, fibroblasts (by 154% and 176%, respectively). In addition, the flux through the human epidermis of Citrus junos callus extract incorporated into NLs was 17.67-fold higher than that of the callus extract alone. These findings suggest that Citrus junos callus extract-loaded NLs have promise as an anti-aging cosmetic, as well as having a skin-lightening effect.

Current Risk Adjustment and Comorbidity Index Underperformance in Predicting Post-Acute Utilization and Hospital Readmissions After Joint Replacements: Implications for Comprehensive Care for Joint Replacement Model.

OBJECTIVE: To compare the performances of 3 comorbidity indices, the Charlson Comorbidity Index, the Elixhauser Comorbidity Index, and the Centers for Medicare & Medicaid Services (CMS) risk adjustment model, Hierarchical Condition Category (HCC), in predicting post-acute discharge settings and hospital readmission for patients after joint replacement. METHODS: A retrospective study of Medicare beneficiaries with total knee replacement (TKR) or total hip replacement (THR) discharged from hospitals in 2009-2011 (n = 607,349) was performed. Study outcomes were post-acute discharge setting and unplanned 30-, 60-, and 90-day hospital readmissions. Logistic regression models were built to compare the performance of the 3 comorbidity indices using C statistics. The base model included patient demographics and hospital use. Subsequent models included 1 of the 3 comorbidity indices. Additional multivariable logistic regression models were built to identify individual comorbid conditions associated with high risk of hospital readmissions. RESULTS: The 30-, 60-, and 90-day unplanned hospital readmission rates were 5.3%, 7.2%, and 8.5%, respectively. Patients were most frequently discharged to home health (46.3%), followed by skilled nursing facility (40.9%) and inpatient rehabilitation facility (12.7%). The C statistics for the base model in predicting post-acute discharge setting and 30-, 60-, and 90-day readmission in TKR and THR were between 0.63 and 0.67. Adding the Charlson Comorbidity Index, the Elixhauser Comorbidity Index, or HCC increased the C statistic minimally from the base model for predicting both discharge settings and hospital readmission. The health conditions most frequently associated with hospital readmission were diabetes mellitus, pulmonary disease, arrhythmias, and heart disease. CONCLUSION: The comorbidity indices and CMS-HCC demonstrated weak discriminatory ability to predict post-acute discharge settings and hospital readmission following joint replacement.

A Comprehensive Review on Chemical Profiling of Nelumbo Nucifera: Potential for Drug Development.

Nelumbo nucifera, also known as sacred lotus, has primarily been used as food throughout the Asian continent, and its medicinal values have been described in Ayurvedic and Traditional Chinese Medicine. The purpose of this study is to systematically characterize the chemical profiling and pharmacological activities of N. nucifera. Herein, we critically reviewed and analysed the phytochemical and pharmacological reports of N. nucifera. Our search for the keyword 'Nelumbo nucifera pharmacology' in all databases reported in Web of Science yielded 373 results excluding reviews and abstracts in document types. Two hundred and forty-three spectrum natural compounds from different parts of N. nucifera belonging to diverse chemical groups, including alkaloids, flavonoids, glycosides, terpenoids, steroids, fatty acids, proteins, minerals, and vitamins have been reported. In addition, distinct pharmacological activities, mainly against cancer, microbial infection, diabetes, inflammation, atherosclerosis, and obesity, have been associated with crude extracts, fractions, and isolated compounds. This review highlights potential use of neferine, liensinine, isoliensinine, and nuciferine in clinical trials. In depth, mechanism of the potential chemical entities from N. nucifera via structure activity relationship needs to be explored to guarantee the stability and safety for the clinical use. Copyright © 2016 John Wiley & Sons, Ltd.

Alkaloid rich fraction from Nelumbo nucifera targets VSMC proliferation and migration to suppress restenosis in balloon-injured rat carotid artery.

AIMS: Restenosis- an adverse consequence following angioplasty, and atherosclerosis are characterized by abnormal vascular smooth muscle cell (VSMC) proliferation and migration leading to neo-intima formation. In the present study, we investigated the inhibitory effects of alkaloid rich fraction (ARF) from Nelumbo nucifera and isolated compound neferine on platelet-derived growth factor (PDGF-BB) induced VSMC proliferation and migration in vitro and neo-intima formation in a rat carotid artery injury model. METHODS: PDGF-BB induced VSMC proliferation and migration was assessed using colorimetric assay and modified Boyden chamber method respectively. Gene expression of cell cycle associated molecules was determined by reverse transcription-polymerase chain reaction (RT-PCR). The signaling molecules such as PDGF-Rß, extracellular regulated kinase (ERK)1/2, c-Jun N-terminal kinase (JNK), P38, metalloproteinase (MMP)-9 and nuclear factor-kappa B (NF-κB) were determined by western blot analysis. Stress fiber formation was evaluated using immunofluorescence microscopy. The rat carotid artery balloon injury model was performed to assess the effect of ARF on neo-intima formation. RESULTS: ARF possessed the strongest anti-oxidant activities. The anti-proliferative activity of both ARF and neferine was due to suppression of cyclin D1, cyclin E and cyclin-dependent kinase (Cdk) gene expression. Moreover, ARF and neferine inhibited PDGF-Rß, ERK1/2, JNK and P38 activations and NF-κB translocation. Also, ARF and neferine inhibited VSMC migration by inhibiting MMP-9 activity without affecting cytoskeleton remodeling. In a rat carotid artery injury model, ARF inhibited neo-intima formation. CONCLUSION: Our results indicate that ARF targets VSMC proliferation and migration to attenuate neo-intima formation by inhibition of PDGF-Rß mediated signaling.