Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis

BACKGROUND: Overweight and obesity pose a big challenge to pregnancy as they are associated with adverse maternal and perinatal outcome. Evidence of lifestyle intervention resulting in improved pregnancy outcome is conflicting. Hence the objective of this study is to determine the efficacy of antenatal dietary, activity, behaviour or lifestyle interventions in overweight and obese pregnant women to improve maternal and perinatal outcomes. METHODS: A systematic review and meta-analyses of randomised and non-randomised clinical trials following prior registration (CRD420111122 http://www.crd.york.ac.uk/PROSPERO) and PRISMA guidelines was employed. A search of the Cochrane Library, EMBASE, MEDLINE, CINAHL, Maternity and Infant care and eight other databases for studies published prior to January 2012 was undertaken. Electronic literature searches, study selection, methodology and quality appraisal were performed independently by two authors. Methodological quality of the studies was assessed according to Cochrane risk of bias tool. All appropriate randomised and non-randomised clinical trials were included while exclusions consisted of interventions in pregnant women who were not overweight or obese, had pre-existing diabetes or polycystic ovarian syndrome, and systematic reviews. Maternal outcome measures, including maternal gestational weight gain, gestational diabetes and Caesarean section, were documented. Fetal outcomes, including large for gestational age and macrosomia (birth weight > 4 kg), were also documented. RESULTS: Thirteen randomised and six non-randomised clinical trials were identified and included in the meta-analysis. The evidence suggests antenatal dietary and lifestyle intervention in obese pregnant women reduces maternal pregnancy weight gain (10 randomised clinical trials; n = 1228; -2.21 kg (95% confidence interval -2.86 kg to -1.59 kg)) and a trend towards a reduction in the prevalence of gestational diabetes (six randomised clinical trials; n = 1,011; odds ratio 0.80 (95% confidence interval 0.58 to 1.10)). There were no clear differences reported for other outcomes such as Caesarean delivery, large for gestational age, birth weight or macrosomia. All available studies were assessed to be of low to medium quality. CONCLUSION: Antenatal lifestyle intervention is associated with restricted gestational weight gain and a trend towards a reduced prevalence of gestational diabetes in the overweight and obese population. These findings need to be interpreted with caution as the available studies were of poor to medium quality

Region-based Convolutional Neural Network Driven Alzheimer’s Severity Prediction

It's important to note that Alzheimer's disease can also affect individuals over the age of 60, and in fact, the risk of developing Alzheimer's increases with age. Additionally, while deep learning approaches have shown promising results in detecting Alzheimer's disease, they are not the only techniques available for diagnosis and treatment. That being said, using Region-based Convolutional Neural Network (RCNN) for efficient feature extraction and classification can be a valuable tool in detecting Alzheimer's disease. This new approach to identifying Alzheimer's disease could lead to a more accurate and personalized diagnosis. It can also help in early treatment and intervention. However, it's still important to continue developing new methods and techniques for this disorder. Considering this our work proposes an innovative Region-based Convolutional Neural Network Driven Alzheimer’s Severity Prediction approach in this paper. The exhaustive experimental result carried out, which proves the efficacy of our Alzheimer prediction system

Autoimmune Parkinsonism: A Newer Manifestation of Contactin-Associated Protein-Like 2 Autoimmunity: A Case Report

Contactin-associated protein-like 2 (CASPR2) antibodies are part of an expanding spectrum of disorders. Although they were initially associated with Morvan’s syndrome and peripheral nerve hyperexcitability, their clinical manifestations are more varied than previously recognized. In this report, we present a rare case of a middle-aged woman who experienced gait disturbances, sleep disturbances, behavioral changes, and postural abnormalities over a period of five months. A thorough examination revealed a Parkinsonian phenotype. Considering the timeline and symptomatology, an autoimmune work-up was conducted, which detected CASPR2 antibodies in the patient’s serum. Treatment with high-dose intravenous Methylprednisolone followed by rituximab effectively reversed her clinical manifestations without residual neurological deficits

Self-regulation and expatriate adjustment:The role of regulatory fit

In this paper, we draw on the construct of regulatory fit in explaining how expatriates manage interactional and work-related discrepancies in diverse cultural contexts. When expatriates go overseas, they are often faced with a set of expectations that are at variance with their home country norms and these differences in expectations generate discrepancies. The emergence of discrepancies in an alien cultural context exacerbates the uncertainties facing the expatriate, though the response to uncertainty varies between expatriates. We posit that expatriates with a promotion-focused self-regulatory system are focused on maximizing gains leading them to manage uncertainty through experimentation whereas expatriates with a prevention-focused self-regulatory system are oriented to minimizing losses leading them to manage uncertainty by persisting with the status-quo. Utilizing insights from motivational science and by linking the self-regulatory processes to the cultural context, we develop a framework and propositions for expatriate adaptation in loose and tight cultures. We present managerial implications of our model and offer guidance for testing the framework

Co-cultivation of Curcuma longa with Piriformospora indica Enhances the Yield and Active Ingredients

The rhizome of Curcuma longa is used in the traditional medicinal system. Its secondary metabolites curcumin and the volatile oil possess wound-healing properties and inhibitory activities against certain pathogenic fungi and bacteria. Piriformospora indica is a root endophytic fungus that colonizes many plant roots and promotes the growth. P. indica was cultivated in the 5 litre capacity fermentor under standard conditions. The filtered biomass was then mixed with raw talcum powder. The propagative buds were treated with this formulation containing both sterile and inoculated fungus. We demonstrated that co- cultivation of C. longa and P. indica resulted in pronounced productivity and enhanced secondary metabolites- curcumin and volatile oil in farmers’ field. To the authors best of knowledge this is the first report where symbiotic fungus has added value to this medicinal plant in the agricultural field

TEC Response and Subsequent GPS Error Caused by the Most severe Geomagnetic Storm of Solar Cycle 24 at India

This paper presents the response of low-latitude and mid-latitude ionosphere to a severe geomagnetic storm that occurred on 17 March 2015 at 0445 UT, and the subsequent effect of this storm on GPS error in the East-West (E-W) and North-South (N-S) directions. The Vertical Total Electron Content (VTEC) data has been analysed from three dual frequency GPS receivers, which were installed under the framework of the International GNSS Service (IGS). For each day of the year, the data is downloadable as a single file in the Receiver Independent Exchange Format (RINEX) from the IGS data portal. The VTEC values from the IGS are obtained at one minute intervals. Results   show the variations in GPS derived VTEC during the severe geomagnetic storm. Negative ionospheric storms caused by composition changes are observed at mid-latitude region of Lucknow, while positive ionospheric storms caused by magnetospheric convection and Equatorial Ionospheric Anomaly (EIA) are prominent at low-latitude regions of Bangalore and Hyderabad. The maximum depletion in VTEC peak at mid-latitude region of Lucknow when compared to the quiet day mean VTEC was 61 percent during a negative ionospheric storm that occurred on 18 March 2015, and maximum enhancement in VTEC peak at low-latitude region of Bangalore and Hyderabad when compared to the quiet day mean VTEC was 26 percent and 21 percent respectively during an early positive ionospheric storm on 18 March 2015. Positive ionospheric storms caused by enhanced EIA and Prompt Penetration Electric Fields (PPEF) are prominent at low-latitudes. The highest GPS error during storm time was +7.2 m and +11.3 m in E-W and N-S directions respectively at Lucknow. The average GPS error in E-W and N-S directions during storm time was higher at the mid-latitude station of Lucknow

Visual Acuity and Associated Factors. The Central India Eye and Medical Study

Visual acuity is a major parameter for quality of vision and quality of life. Information on visual acuity and its associated factors in rural societies almost untouched by any industrialization is mostly non-available. It was, therefore, the purpose of our study to determine the distribution of visual acuity and its associated factors in a rural population not marked influenced by modern lifestyle. The population-based Central India Eye and Medical Study included 4711 subjects (aged 30+ years), who underwent a detailed ophthalmologic examination including visual acuity measurement. Visual acuity measurements were available for 4706 subjects with a mean age of 49.5±13.4 years (range: 30–100 years). BCVA decreased significantly (P<0.001) from the moderately hyperopic group (0.08±0.15 logMAR) to the emmetropic group (0.16±0.52 logMAR), the moderately myopic group (0.28±0.33 logMAR), the highly hyperopic group (0.66±0.62 logMAR) and finally the highly myopic group (1.32±0.92 logMAR). In multivariate analysis, BCVA was significantly associated with the systemic parameters of lower age (P<0.001), higher level of education (P<0.001), higher body stature (P<0.001) and higher body mass index (P<0.001), and with the ophthalmic parameters of more hyperopic refractive error (spherical equivalent) (P<0.001), shorter axial length (P<0.001), lower degree of nuclear cataract (P<0.001), and lower intraocular pressure (P = 0.006). The results suggest that in the rural population of Central India, major determinants of visual acuity were socioeconomic background, body stature and body mass index, age, refractive error, cataract and intraocular pressure

Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis

Background: Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. Methods: We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12). Findings: Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9–65·4) were blind (crude prevalence 0·48%; 80% UI 0·17–0·87; 56% female), 216·6 million (80% UI 98·5–359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34–4·89; 55% female), and 188·5 million (80% UI 64·5–350·2) had mild visual impairment (2·57%, 80% UI 0·88–4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1–1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9–997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9–57·3) in 1990 to 36·0 million (80% UI 12·9–65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (–36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68·3–270·0) in 1990 to 216·6 million (80% UI 98·5–359·1) in 2015. Interpretation: There is an ongoing reduction in the age-standardised prevalence of blindness and visual impairment, yet the growth and ageing of the world’s population is causing a substantial increase in number of people affected. These observations, plus a very large contribution from uncorrected presbyopia, highlight the need to scale up vision impairment alleviation efforts at all levels