MODULATION OF AUTONOMIC NERVOUS SYSTEM ASSESSED THROUGH HEART RATE VARIABILITY BY INTEGRATED AMRITA MEDITATION TECHNIQUE IN TYPE 2 DIABETIC SUBJECTS – A PILOT STUDY

Objective: This study aims in understanding the effects of Integrated Amrita Meditation (IAM), a type of mindfulness meditation, on the autonomic balance of type 2 diabetic patients through assessment of heart rate variability (HRV). Methods: After the initial screening of 30 type 2 diabetic subjects, 10 type 2 diabetic subjects between the age group of 30 and 65 years were randomized into two groups, diabetic test (n=5) and diabetic control group (n=5). Diabetic test group practiced IAM technique under the guidance of a trained practitioner. Both the groups continued the same dietary pattern and medications during the 6-month study period. HRV was taken for all subjects at baseline and after 6 months. In our study, we have focused on the power spectral analysis of HRV which include normalized units of high frequency (nHF), low frequency (nLF), and low frequency-high frequency ratio (LF/HF ratio). Results: Mean percentage change in nHF, nLF, and LFHF ratio showed significant changes in between-group comparison (p<0.05). Normalized units of HF increased (p=0.049) while LF (p=0.036) and LFHF ratio (p=0.024) decreased significantly within test group after 6 months of IAM practice suggesting the potential of IAM in improving the parasympathetic tone, thereby tuning the mind and body to calm down during stress. Conclusion: Our study has shown demonstrable improvement in autonomic function which reflects reduced stress after the practice of IAM in diabetic patients

Impact of Integrated Amrita Meditation Technique on Adrenaline and Cortisol Levels in Healthy Volunteers

The objective was to find out the effect of Integrated Amrita Meditation Technique (IAM) on the stress hormones: adrenaline and cortisol. One hundred and fifty healthy subjects were randomized into three groups. Blood was collected at 0 hour, 48 hours, 2 months, and 8 months after the first visit. Adrenaline was analyzed by ELISA and cortisol by Chemiluminescent method. In the IAM, PMR and control groups 44, 44, and 36 came, respectively, for the baseline visit. Within group, cortisol and adrenaline levels reduced in the IAM 48 hours onwards and the fall sustained until 8 months (P < .05). ANCOVA (Repeated measures) on adrenaline taking the four levels of observation showed a highly significant (P = .001) drop in the IAM group. The mean cortisol values between groups were not statistically significant (P = .138). IAM Technique was effective in reducing adrenaline and cortisol levels within group comparisons

Isolated Disease of the Proximal Left Anterior Descending Artery Comparing the Effectiveness of Percutaneous Coronary Interventions and Coronary Artery Bypass Surgery

ObjectivesThis study sought to systematically compare the effectiveness of percutaneous coronary intervention and coronary artery bypass surgery in patients with single-vessel disease of the proximal left anterior descending (LAD) coronary artery.BackgroundIt is uncertain whether percutaneous coronary interventions (PCI) or coronary artery bypass grafting (CABG) surgery provides better clinical outcomes among patients with single-vessel disease of the proximal LAD.MethodsWe searched relevant databases (MEDLINE, EMBASE, and Cochrane from 1966 to 2006) to identify randomized controlled trials that compared outcomes for patients with single-vessel proximal LAD assigned to either PCI or CABG.ResultsWe identified 9 randomized controlled trials that enrolled a total of 1,210 patients (633 received PCI and 577 received CABG). There were no differences in survival at 30 days, 1 year, or 5 years, nor were there differences in the rates of procedural strokes or myocardial infarctions, whereas the rate of repeat revascularization was significantly less after CABG than after PCI (at 1 year: 7.3% vs. 19.5%; at 5 years: 7.3% vs. 33.5%). Angina relief was significantly greater after CABG than after PCI (at 1 year: 95.5% vs. 84.6%; at 5 years: 84.2% vs. 75.6%). Patients undergoing CABG spent 3.2 more days in the hospital than those receiving PCI (95% confidence interval: 2.3 to 4.1 days, p &lt; 0.0001), required more transfusions, and were more likely to have arrhythmias immediately post-procedure.ConclusionsIn patients with single-vessel, proximal LAD disease, survival was similar in CABG-assigned and PCI-assigned patients; CABG was significantly more effective in relieving angina and led to fewer repeat revascularizations

Evaluating Detection and Diagnostic Decision Support Systems for Bioterrorism Response

We evaluated the usefulness of detection systems and diagnostic decision support systems for bioterrorism response. We performed a systematic review by searching relevant databases (e.g., MEDLINE) and Web sites for reports of detection systems and diagnostic decision support systems that could be used during bioterrorism responses. We reviewed over 24,000 citations and identified 55 detection systems and 23 diagnostic decision support systems. Only 35 systems have been evaluated: 4 reported both sensitivity and specificity, 13 were compared to a reference standard, and 31 were evaluated for their timeliness. Most evaluations of detection systems and some evaluations of diagnostic systems for bioterrorism responses are critically deficient. Because false-positive and false-negative rates are unknown for most systems, decision making on the basis of these systems is seriously compromised. We describe a framework for the design of future evaluations of such systems

HIV Testing of At Risk Patients in a Large Integrated Health Care System

OBJECTIVE: Early identification of HIV infection is critical for patients to receive life-prolonging treatment and risk-reduction counseling. Understanding HIV screening practices and barriers to HIV testing is an important prelude to designing successful HIV screening programs. Our objective was to evaluate current practice patterns for identification of HIV. METHODS: We used a retrospective cohort analysis of 13,991 at-risk patients seen at 4 large Department of Veterans Affairs (VA) health-care systems. We also reviewed 1,100 medical records of tested patients. We assessed HIV testing rates among at-risk patients, the rationale for HIV testing, and predictors of HIV testing and of HIV infection. RESULTS: Of the 13,991 patients at risk for HIV, only 36% had been HIV-tested. The prevalence of HIV ranged from 1% to 20% among tested patients at the 4 sites. Approximately 90% of patients who were tested had a documented reason for testing. CONCLUSION: One-half to two-thirds of patients at risk for HIV had not been tested within our selected VA sites. Among tested patients, the rationale for HIV testing was well documented. Further testing of at-risk patients could clearly benefit patients who have unidentified HIV infection by providing earlier access to life-prolonging therapy

The burden of prostate cancer in Trinidad and Tobago: one of the highest mortality rates in the world

Purpose In Trinidad and Tobago (TT), prostate cancer (CaP) is the most commonly diagnosed malignancy and the leading cause of cancer deaths among men. TT currently has one of the highest CaP mortality rates in the world. Methods: 6,064 incident and 3,704 mortality cases of CaP occurring in TT from January 1995 to 31 December 2009 reported to the Dr. Elizabeth Quamina Cancer population-based cancer registry for TT, were analyzed to examine CaP survival, incidence, and mortality rates and trends by ancestry and geography. Results: The age-standardized CaP incidence and mortality rates (per 100,000) based on the 1960 world-standardized in 2009 were 64.2 and 47.1 per 100,000. The mortality rate in TT increased between 1995 (37.9 per 100,000) and 2009 (79.4 per 100,000), while the rate in the US decreased from 37.3 per 100,000 to 22.1 per 100,000 over the same period. Fewer African ancestry patients received treatment relative to those of Indian and mixed ancestry (45.7%, 60.3%, and 60.9%, respectively). Conclusions: Notwithstanding the limitations surrounding data quality, our findings highlight the increasing burden of CaP in TT and the need for improved surveillance and standard of care. Our findings highlight the need for optimized models to project cancer rates in developing countries like TT. This study also provides the rationale for targeted screening and optimized treatment for CaP to ameliorate the rates we report. Electronic supplementary material The online version of this article (10.1007/s10552-018-1038-8) contains supplementary material, which is available to authorized users

Interaction of a Sliding Wedge with a Metallic Substrate Containing a Single Inhomogeneity

Surface folding is a recently discovered unsteady plastic flow mode in metal sliding, caused by microstructure-related spatial heterogeneity. In this work, we simulate a wedge sliding against a metallic specimen with a single, near-surface inhomogeneity or pseudograin, representative of unit asperity-grain interactions. The inhomogeneity is either plastically softer or harder than the surrounding substrate and is perfectly bonded to it. Remarkably, this simple model is able to reproduce numerous experimentally observed aspects of unsteady sliding, including the development of bumps and depressions on the prow, surface self-contact (fold) formation and the development of crack-like damage features on the residual surface. It is found that a hard inhomogeneity causes surface depressions, while a soft inhomogeneity causes surface bumps. Both features develop into folds, and subsequently, crack-like damage features. The model also reproduces the effects of sliding incidence angle, friction and size of inhomogeneity on the sliding response. The propensity to bump and fold formation decreases on increasing the depth at which the inhomogeneity is embedded. Analysis reveals that plastic buckling is a plausible mechanism for the development of perturbations on the surface of the prow. The present model differs from the classical triboplastic models of Oxley and Torrance mainly by way of the added inhomogeneity and is a minimal model to produce folding and associated damage in a single sliding pass. Implications for wear and deformation processing are discussed

THE MICROSTRUCTURAL ORIGIN OF SINUOUS FLOW IN METAL CUTTING

In situ, high-speed imaging experiments have revealed the existence of sinuous flow, a recently discovered mode of chip formation in machining. The origin and consequences of sinuous flow are still being investigated, but it is now known that sinuous flow involves extensive redundant plastic deformation, poor surface finish and paradoxically high cutting forces. Here, we use full-scale simulations to show that microstructure related inhomogeneity is a major cause of sinuous flow. The simulations are conducted in a Lagrangian FE framework, and use a simple pseudograin model to represent the metal workpiece as a polycrystalline aggregate. The model successfully captures all essential features of sinuous flow in metals like OFHC copper and CP aluminum, and points to the importance of including material microstructure in cutting simulations