Role of yoga in stress management and implications in major depression disorder.

Major Depressive Disorder (MDD) is one of the leading causes of disability affecting more than 340 million people and second largest contributor to global burden of disease. Chronic stress is a common risk factor and important contributor for MDD. Stress could be defined as the "perceived inability to cope". Stressful life events are shown to provoke a sequence of psychological and physiological adjustments including nervous, endocrine and immune mechanisms. Stress can lead to elevation of a variety of inflammatory cytokines and stress hormones, can cause autonomic dysfunction and imbalance in neurotransmitters. Yoga can reduce depressive symptoms by alleviating stress. Studies have shown that yoga can reduce inflammation, maintain autonomic balance and also has a role in maintaining the neurotransmitters. It has role on hypothalamic-pituitary-adrenal (HPA) axis, the peripheral nervous system including GABA, limbic system activity, inflammatory and endocrine responses. Yoga along with antidepressants can help in reducing the depressive symptoms in patient with MDD. Yoga is an ideal complementary and alternative therapy for mental health disorders.

Positioning of Low Alcohol or Alcohol-Free Minoxidil Formulation for the Management of Androgenetic Alopecia: Indian Perspective.

Topical minoxidil is used for treating different hair disorders. Even though it is an effective therapy, many patients show poor compliance due to the cost, side effects, and duration of treatment. Topical minoxidil is the mainstay treatment for androgenetic alopecia (AGA). Recently, low alcohol or alcohol-free topical minoxidil formulation has proven to be an alternative for patients suffering from AGA, including those with poor compliance with other therapies. Thus, the current article provides the positioning of low alcohol or alcohol-free topical minoxidil to manage AGA in Indian clinical practice.

Foot reflexology for reduction of blood pressure in hypertensive individual: A systematic review.

IMPORTANCE: Hypertension is the modifiable risk factor associated with cardiovascular diseases and all-cause mortality. Foot reflexology has been proposed to reduce the blood pressure for the patients with hypertension but the available evidences are uncertain. OBJECTIVE: We conducted a systematic review and meta-analysis, know the efficacy of foot reflexology on blood pressure reduction in patients with hypertension. DATA SOURCES AND SELECTION: A systematic search of electronic databases such as PubMed, Scopus, ClinicalTrials.gov, Embase, and Cochrane library since inception till January 2022. Randomized controlled trial with foot reflexology as an intervention for lowering blood pressure (BP) in hypertensive patients was included in the study. DATA EXTRACTION AND OUTCOME MEASURES: Data was independently extracted by four authors. Systolic and diastolic blood pressure was the primary outcome measure. Standardized mean difference (SMD) and 95 % confidence interval (CI) were calculated to determine the effect size. RESULTS: The pooled effect of SBP (SMD: -2.70, 95 % of CI: -6.79, 1.39, I2 - 97 %, P < 0.001) and DBP (SMD: -2.12, 95 % of CI: -5.95, 1.71, I2 - 97 %, P < 0.001) changes are not favorable for foot reflexology in terms of reducing blood pressure. CONCLUSION: Findings from the studies showed that foot reflexology interventions were not much effective in the reduction of blood pressure among patients with hypertension.

Effects of 12 sessions of steam bath intervention on spirometry parameters among healthy adult volunteers.

OBJECTIVES: Steam bath is extensively used around the world. However, its physiological influence is not understood in detail. Objective of the current study is to examine the effects of 12 sessions of steam bath on spirometric parameters among healthy participants. METHODS: Forty healthy adult volunteers of both sex (14 male and 26 female) aged 26.38 ± 8 years participated in the study. A steam bath session (10-15 min) was given once a week for 12 weeks. The spirometric parameters [forced expiratory volume in the 1st second (FEV1, L), forced vital capacity (FVC, L), FEV1/FVC ratio (absolute value), maximal mid-expiratory flow (MMEF, L/s) and peak expiratory flow (PEF, L/s)] were measured by Helios 401 spirometer. RESULTS: Compared to baseline, post-intervention spirometric parameters showed significant (p<0.05) improvement in the FVC (82.40 ± 11.24 to 96.91 ± 18.76), FEV1 (86.13 ± 14.39 to 91.17 ± 12.48), FEV1/FVC ratio (86.96 ± 3.64 to 93.75 ± 4.80), MMEF 25-75% (86.96 ± 3.64 to 94.16 ± 11.57), peak expiratory flow rate (79.82 ± 14.90 to 92.18 ± 18.96). CONCLUSIONS: Taking steam bath improves the spirometric parameters of healthy adult participants. However, future randomized controlled trials with on a large scale have to done to validate our findings.

Effect of Yoga on Oxidative Stress in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis.

BACKGROUND: Diabetes mellitus has a significant impact on public health. Oxidative stress plays a major role in the pathophysiology of Type 2 Diabetes Mellitus (T2DM), leading to various complications of T2DM. Yoga is being widely used in the management of T2DM. The primary objective of this systematic review and meta-analysis is to understand the effects of yoga on oxidative stress parameters among adult patients diagnosed with T2DM. MATERIALS AND METHODS: Electronic databases such as PubMed, Scopus, Cochrane Library and Science Direct from start of the study till March 2020 were searched to obtain eligible studies. Study designs of all nature were included (except case studies and reviews). The primary outcome was Malondialdehyde (MDA) and secondary outcomes included fasting plasma glucose, HbA1C and Superoxide Dismutase (SOD) levels. RESULTS: A total of four trials with a total of 440 patients met the inclusion criteria. The results of meta-analysis indicated that yoga significantly reduced MDA (SMD: -1.4; 95% CI -2.66 to -0.13; P = 0.03; I2 = 97%), fasting plasma glucose levels (SMD: -1.87: 95% CI -3.83 to -0.09; P = 0.06; I2= 99%), and HbA1c (SMD: -1.92; 95% CI - 3.03 to -0.81; P = 0.0007; I2 = 92%) in patients with T2DM. No such effect was found for SOD (SMD: -1.01; 95% CI -4.41 to 2.38; P = 0.56; I2= 99%). CONCLUSION: The available evidence suggests that yoga reduces MDA, fasting plasma glucose and HbA1C, and thus would be beneficial in the management of T2DM as a complementary therapy. However, considering the limited number of studies and its heterogeneity, further robust studies are necessary to strengthen our findings and investigate the long-term benefits of yoga.

Effect of six months pranayama training on stress-induced salivary cortisol response among adolescents-Randomized controlled study.

BACKGROUND: A combination of yoga practices has been documented to reduce stress and stress-induced cortisol levels. The objective of the current study is to examine the effects of six months of a single pranayama practice (Bhramari [Bhr. P]) on reducing salivary cortisol response to the cold pressor test (CPT) among adolescents. METHODS: Twenty-six healthy adolescents between the ages of 11 and 19 were randomly assigned to either yoga group (n-13) or control group (n-13). Yoga group participants were trained to do Bhr. P for 45 min, thrice a week for six months. All participants underwent CPT at baseline and at end of six months. Saliva samples were collected at baseline (t0), at 20 min (t1), 40 min (t2), and 60 min after the CPT (t3). RESULTS: Contradictory to our hypothesis, participants in the yoga group exhibited a higher salivary cortisol response to the CPT at t1 (p = 0.04) when compared to the control group. However, the t3 salivary cortisol levels showed a statistically significant reduction (p = 0.03) in yoga group when compared to the control group. A significant interaction with time (F (1, 88) = 316.5, p = .001, ηp2:0.91) and between the group × time (F (3, 88) = 2.83, p = 0.04, ηp2:0.8) was found after the intervention. CONCLUSIONS: An increase in the cortisol responsiveness observed in the study is an indication of the adaptive capability achieved through regular yoga training, evidenced by an initial rise in cortisol followed by a rapid fall below baseline after 60 min. Further research is required to conclusively determine the changes in cortisol levels over time in response to stress in long-term yoga practitioners.

Population Risk Improvement with Model Compression: An Information-Theoretic Approach.

It has been reported in many recent works on deep model compression that the population risk of a compressed model can be even better than that of the original model. In this paper, an information-theoretic explanation for this population risk improvement phenomenon is provided by jointly studying the decrease in the generalization error and the increase in the empirical risk that results from model compression. It is first shown that model compression reduces an information-theoretic bound on the generalization error, which suggests that model compression can be interpreted as a regularization technique to avoid overfitting. The increase in empirical risk caused by model compression is then characterized using rate distortion theory. These results imply that the overall population risk could be improved by model compression if the decrease in generalization error exceeds the increase in empirical risk. A linear regression example is presented to demonstrate that such a decrease in population risk due to model compression is indeed possible. Our theoretical results further suggest a way to improve a widely used model compression algorithm, i.e., Hessian-weighted K-means clustering, by regularizing the distance between the clustering centers. Experiments with neural networks are provided to validate our theoretical assertions.

Comparative Evaluation of Mechanical Properties of Titanium Dioxide Nanoparticle Incorporated in Composite Resin as a Core Restorative Material.

AIM: To compare and evaluate the mechanical properties of 2.5% titanium dioxide nanoparticle (TiO2 NP) incorporated as filler in an experimental composite resin with everX Flow and MultiCore Flow. MATERIALS AND METHODS: TiO2 was prepared and incorporated into experimental dental composite resin. The experimental and traditional composite resin was grouped as follows: Group I: The experimental composite resin with 2.5% of TiO2 fillers, Group II: everX Flow (GC EUROPE), and Group III: MultiCore Flow (Ivoclar Vivadent). Based on International Standards Organization (ISO) 4049, the samples were prepared for the compressive, diametral tensile, and flexural test. RESULTS: Statistical analysis was done, and the results were tabulated. Compared to the other tested materials, the experimental composite resin had relatively high compressive strength, diametral tensile strength, and flexural strength. Compared to MultiCore Flow, the everX Flow showed strong mechanical properties. CONCLUSION: Based on the result of the study, it can be concluded that the 2.5% TiO2 NP incorporated as filler in an experimental composite resin demonstrated higher mechanical properties compared to the conventional material. CLINICAL SIGNIFICANCE: The unique photoactivities of TiO2 NP and their superior mechanical properties make them one of the ideal additives to enhance the performance of polymeric materials.

Indian monsoon derailed by a North Atlantic wavetrain.

The forecast of Indian monsoon droughts has been predicated on the notion of a season-long rainfall deficit linked to a warm equatorial Pacific. Here we show that nearly half of all droughts over the past century differ from this paradigm in that they (i) occur when Pacific temperatures are near-neutral and (ii) are subseasonal phenomena, characterized by an abrupt decline in late-season rainfall. This severe subseasonal rainfall deficit can be associated with a Rossby wave from mid-latitudes. Specifically, we find that the interaction of upper-level winds with an episodic North Atlantic vorticity anomaly results in a wavetrain that curves toward East Asia, disrupting the monsoon. This atmospheric teleconnection offers an avenue for improved predictability of droughts, especially in the absence of telltale signatures in the Pacific.

Effect of Sheetali pranayama on cardiac autonomic function among patients with primary hypertension - A randomized controlled trial.

BACKGROUND: Sheetali pranayama is a cooling pranayama practiced for hypertension (HTN). The effects of Sheetali pranayama, as a solitary intervention on cardiovascular and autonomic changes in hypertension is unknown. MATERIALS AND METHODS: The current study was conducted on 100 patients with HTN, randomly allocated to HTN with pranayama (Intervention group,n = 50) and HTN without pranayama (control group,n = 50) group. The intervention group practiced Sheetali pranayama for a period of 3 months. Blood pressure and HRV was assessed before and after the intervention. RESULTS: Intervention group showed a significant (P < 0.05) reduction in blood pressure variables when compared to the control group. In short term HRV, time and frequency domain parameters showed parasympathetic dominance (P < 0.05) in the intervention group. CONCLUSION: Sheetali pranayama significantly reduces blood pressure in patients with HTN and improved heart rate variability. Sheetali pranayama could thus be practiced in addition to regular medications for the efficacious management of HTN.

Effects of hot foot and arm bath in bronchial asthma: A single case report.

BACKGROUND: Managing the condition of corticosteroid resistant asthmatic patients is quite difficult and challenging despite the plethora of new and modern medications. Hot Foot and Arm Bath (HFAB) is a widely used treatment modality for the management of bronchial asthma in Naturopathy. However, no scientific documentation or study is available so far assessing its effectiveness. CASE SUMMARY: A 33-year-old male was admitted to our hospital, with major complaints of wheezing and dyspnea for two weeks before admission, with a known case of asthma and occasional use of inhalers. Spirometry tests showed a reversible obstructive pattern (pre-bronchodilator FEV1, 1.64L; post-bronchodilator FEV1, 2.02L; reversibility, 16%). The patient underwent HFAB application for 3 days in the morning, and the pulmonary function test was recorded before and immediately after HFAB. The pulmonary function's parameters such as FVC, FEV1, FEV1/FVC ratio, PEF 25-75 %, and PEFR showed significant improvement immediately after the HFAB on day 2 and day 3 when compared to day 1. CONCLUSIONS: The findings suggest that HFAB application has an immediate action on improving lung function in patients with bronchial asthma and could be used as effective adjuvant therapy for the management of bronchial asthma. This is the first case report on HFAB application for bronchial asthma and future extensive studies with a large population would validate our findings.

Environmental & load data: 1:15 Scale tidal turbine subject to a variety of regular wave conditions.

Experimental data was obtained in order to investigate the effect of waves on the loads and performance of tidal turbines. An instrumented 1:15 scale tidal turbine was installed in the FloWave Ocean Energy Research Facility, and a wide range of regular wave conditions were generated; systematically varying both wave frequency and height. Waves were generated both following and opposing a fixed mean current velocity of 0.81 m/s. Data are made available of the measured turbine loads and environmental conditions obtained for five repeats of 24 wave conditions via https://doi.org/10.7488/ds/2472. A description of the data collection process, data processing, file structure and naming conventions are provided in this article. The analysis and presentation of the described dataset can be found in Ref. [1].

Clinical and equipment-related factors associated with the adequate peripheral blood stem cell collection in autologous transplant at a tertiary cancer center in Kerala - A retrospective cohort study.

BACKGROUND: PBSC collection using apheresis is the preferred source of hematopoietic stem cells transplantation. However, apheresis procedures fail to harvest adequate CD34 yield in 5 to 40% of patients during the first collection. Therefore, this study aimed to study both the clinical- and equipmentrelated factors influencing CD34 yield among the autologous patients and to compare the collection efficiency of two apheresis equipments(Haemonetics MCS+ and Terumo Spectra Optia). METHODS: Retrospective analysis of 69 patients underwent PBSC collection from 2015 to 2018. Frequency, clinical- and equipment-related factors responsible for adequate CD34+ cells (≥2 x106 cells/kg) yield during the first collection was studied. Factors such as collection efficiency, percentage platelet loss and percentage hemoglobin loss were considered to compare the two apheresis system. RESULTS: Two-third (72%) patients of the study population had adequate CD34 stem cells yield during the first collection. Factors such as exposure to lenalidomide-based pretreatment regimen, peripheral blood WBC count and CD34 count are associated with the adequate CD34 yield. Optia had a slightly better collection efficiency than MCS+ (50 and 44; p=0.37). Optia had lower product volume (237 vs 298 ml) and lesser procedure duration (277 vs 360 min), whereas the median Hb loss (3.0% and 2.3%) and mean platelet loss (49% and 34%) were higher with MCS. CONCLUSION: This study infers that the collection efficiency of both the equipments in collecting CD34 stem cells was similar. However, during PBSC collection, procedures using Optia can be preferred to MCS+ on the patients with risk of anemia and thrombocytopenia.

Simultaneous Determination of Impurities of Atazanavir and Ritonavir in Tablet Dosage Form by Using Reversed-Phase Ultra Performance Liquid Chromatographic Method.

A simple, rapid, selective and stability indicating reversed phase-ultra performance liquid chromatography method was developed and validated for the simultaneous quantification of process related and degradation impurities present in Atazanavir and Ritonavir tablets. The two proposed drug components and their respective impurities were separated using Acquity BEH C18 (100 mm × 2.1 mm), 1.7 µ column at a flow rate of 0.4 mL/min. Buffer used as Mobile phase-A which consists of 0.01 M monobasic potassium hydrogen phosphate adjusted the pH to 3.6 and acetonitrile is used as organic modifier (mobile phase-B). The detector wavelength of 240 nm was used for quantifying the impurities. Both the drug components along with their impurities were eluted within a runtime of 18 min. The performance of the developed method was checked by validating the method according to the requirements of International Conference on Harmonization for parameters such as specificity, precision, linearity, ruggedness, accuracy, sensitivity (limit of detection (LOD) and limit of quantitation (LOQ)) and robustness. Linearity and range were established from LOQ level to 150% level. Accuracy of the method was demonstrated from LOQ level to 150% level. The developed stability indicating method is capable for determination of impurities of Atazanavir and Ritonavir in combined tablet dosage form as well as individual dosage forms also. The reported method enables lesser solvent consumption and reduces time and cost of the analysis in quality control laboratory.

Precision medicine for suicidality: from universality to subtypes and personalization.

Suicide remains a clear, present and increasing public health problem, despite being a potentially preventable tragedy. Its incidence is particularly high in people with overt or un(der)diagnosed psychiatric disorders. Objective and precise identification of individuals at risk, ways of monitoring response to treatments and novel preventive therapeutics need to be discovered, employed and widely deployed. We sought to investigate whether blood gene expression biomarkers for suicide (that is, a 'liquid biopsy' approach) can be identified that are more universal in nature, working across psychiatric diagnoses and genders, using larger cohorts than in previous studies. Such markers may reflect and/or be a proxy for the core biology of suicide. We were successful in this endeavor, using a comprehensive stepwise approach, leading to a wealth of findings. Steps 1, 2 and 3 were discovery, prioritization and validation for tracking suicidality, resulting in a Top Dozen list of candidate biomarkers comprising the top biomarkers from each step, as well as a larger list of 148 candidate biomarkers that survived Bonferroni correction in the validation step. Step 4 was testing the Top Dozen list and Bonferroni biomarker list for predictive ability for suicidal ideation (SI) and for future hospitalizations for suicidality in independent cohorts, leading to the identification of completely novel predictive biomarkers (such as CLN5 and AK2), as well as reinforcement of ours and others previous findings in the field (such as SLC4A4 and SKA2). Additionally, we examined whether subtypes of suicidality can be identified based on mental state at the time of high SI and identified four potential subtypes: high anxiety, low mood, combined and non-affective (psychotic). Such subtypes may delineate groups of individuals that are more homogenous in terms of suicidality biology and behavior. We also studied a more personalized approach, by psychiatric diagnosis and gender, with a focus on bipolar males, the highest risk group. Such a personalized approach may be more sensitive to gender differences and to the impact of psychiatric co-morbidities and medications. We compared testing the universal biomarkers in everybody versus testing by subtypes versus personalized by gender and diagnosis, and show that the subtype and personalized approaches permit enhanced precision of predictions for different universal biomarkers. In particular, LHFP appears to be a strong predictor for suicidality in males with depression. We also directly examined whether biomarkers discovered using male bipolars only are better predictors in a male bipolar independent cohort than universal biomarkers and show evidence for a possible advantage of personalization. We identified completely novel biomarkers (such as SPTBN1 and C7orf73), and reinforced previously known biomarkers (such as PTEN and SAT1). For diagnostic ability testing purposes, we also examined as predictors phenotypic measures as apps (for suicide risk (CFI-S, Convergent Functional Information for Suicidality) and for anxiety and mood (SASS, Simplified Affective State Scale)) by themselves, as well as in combination with the top biomarkers (the combination being our a priori primary endpoint), to provide context and enhance precision of predictions. We obtained area under the curves of 90% for SI and 77% for future hospitalizations in independent cohorts. Step 5 was to look for mechanistic understanding, starting with examining evidence for the Top Dozen and Bonferroni biomarkers for involvement in other psychiatric and non-psychiatric disorders, as a mechanism for biological predisposition and vulnerability. The biomarkers we identified also provide a window towards understanding the biology of suicide, implicating biological pathways related to neurogenesis, programmed cell death and insulin signaling from the universal biomarkers, as well as mTOR signaling from the male bipolar biomarkers. In particular, HTR2A increase coupled with ARRB1 and GSK3B decreases in expression in suicidality may provide a synergistic mechanistical corrective target, as do SLC4A4 increase coupled with AHCYL1 and AHCYL2 decrease. Step 6 was to move beyond diagnostics and mechanistical risk assessment, towards providing a foundation for personalized therapeutics. Items scored positive in the CFI-S and subtypes identified by SASS in different individuals provide targets for personalized (psycho)therapy. Some individual biomarkers are targets of existing drugs used to treat mood disorders and suicidality (lithium, clozapine and omega-3 fatty acids), providing a means toward pharmacogenomics stratification of patients and monitoring of response to treatment. Such biomarkers merit evaluation in clinical trials. Bioinformatics drug repurposing analyses with the gene expression biosignatures of the Top Dozen and Bonferroni-validated universal biomarkers identified novel potential therapeutics for suicidality, such as ebselen (a lithium mimetic), piracetam (a nootropic), chlorogenic acid (a polyphenol) and metformin (an antidiabetic and possible longevity promoting drug). Finally, based on the totality of our data and of the evidence in the field to date, a convergent functional evidence score prioritizing biomarkers that have all around evidence (track suicidality, predict it, are reflective of biological predisposition and are potential drug targets) brought to the fore APOE and IL6 from among the universal biomarkers, suggesting an inflammatory/accelerated aging component that may be a targetable common denominator.

Wave directional spreading from point field measurements.

Ocean waves have multidirectional components. Most wave measurements are taken at a single point, and so fail to capture information about the relative directions of the wave components directly. Conventional means of directional estimation require a minimum of three concurrent time series of measurements at different spatial locations in order to derive information on local directional wave spreading. Here, the relationship between wave nonlinearity and directionality is utilized to estimate local spreading without the need for multiple concurrent measurements, following Adcock & Taylor (Adcock & Taylor 2009 Proc. R. Soc. A465, 3361-3381. (doi:10.1098/rspa.2009.0031)), with the assumption that directional spreading is frequency independent. The method is applied to measurements recorded at the North Alwyn platform in the northern North Sea, and the results compared against estimates of wave spreading by conventional measurement methods and hindcast data. Records containing freak waves were excluded. It is found that the method provides accurate estimates of wave spreading over a range of conditions experienced at North Alwyn, despite the noisy chaotic signals that characterize such ocean wave data. The results provide further confirmation that Adcock and Taylor's method is applicable to metocean data and has considerable future promise as a technique to recover estimates of wave spreading from single point wave measurement devices.