The South Pacific Islands Resist Diabetes With Intense Training (SPIRIT) Study : impact of progressive resistance training and aerobic training on glycaemic control in Māori and Pacific Islands people with type 2 diabetes and grade III obesity : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Exercise and Sport Science, Institute of Food, Nutrition, and Human Health, College of Sciences, Massey University at Wellington, New Zealand

The purpose of the South Pacific Islands Resist diabetes with Intense Training (SPIRIT) study was to evaluate and compare the effectiveness of two conventional training modalities for improving glycosylated haemoglobin (HbA1c) and related physiological and psychological outcomes in Polynesian adults diagnosed with type 2 diabetes and visceral obesity. Twenty-six adults of self-identified Māori or Pacific Islands descent (20 women, 6 men; 47 ± 8 years; 116.3 ± 27.5 kg; waist circumference 124.0 ± 17.8 cm) were randomised to progressive resistance training (PRT) or aerobic training (AER), 3x/week, for 16 weeks. Nine subjects per exercise group (n = 18) completed the study and were included in per protocol analyses. Within-group ANOVAs revealed that HbA1c remained elevated in PRT and AER after 16 weeks of training (10.7 ± 2.1 to 10.6 ± 2.4%, P > 0.05; 8.9 ± 1.9 to 8.8 ± 2.1%, P > 0.05, respectively). AER resulted in significant reductions in systolic (P = 0.006) and diastolic blood pressure (P = 0.02), an increase in skeletal muscle GLUT4 (P = 0.02), capillary density (P = 0.05), and power output (watts) (P < 0.001), while PRT resulted in a significant increase in upper (P = 0.001) and lower body strength (P < 0.001) and a reduction in hip circumference (P = 0.05). Eight (5 AER, 3 PRT) of 18 subjects completed ≥ 75% of available training sessions. Post-hoc analysis on these eight patients revealed a significant reduction in waist circumference (P < 0.001). Despite low attendance, many SF-36 QOL domains scores and the Physical Component Summary scores significantly improved in both groups (P ≤ 0.002). The findings of this doctoral research project suggest that improvement of metabolic outcomes may be delayed or overwhelmed by a combination of low attendance and class III morbid obesity (BMI ≥ 40 kg/m2). The improvements observed in QOL and muscle outcomes suggest that psychological and myocellular changes may precede changes in systemic metabolic outcomes. Additional research is required to investigate these hypotheses and overcome barriers to exercise adoption in Māori and Pacific Islands people with morbid obesity and type 2 diabetes

Immunoglobulin A nephropathy in children: a review of the literature and own data

Background. Immunoglobulin A (IgA) nephropathy is the most common primary chronic glomerulopathy in adults and children. It is believed that in childhood it has a benign course, but in adults it ranks first among all glomerulopathies as a cause of end-stage renal disease at a young age. The purpose of the study was analysis of literature data, clinical, immunopathological and morphological changes in IgA nephropathy to identify children at high risk of disease progression. Materials and methods. The study included 53 patients with IgA nephropathy (36 boys, 17 girls) aged from 6 to 17 years, who were under observation at the Republican Center for Pediatric Nephrology and Renal Replacement Therapy in Minsk. Inclusion criteria: predominance of dominant/co-dominant mesangial IgA deposits in kidney specimen according to MEST-C 2016 classification. The duration of follow-up ranged from 13 months to 6 years. Results. In children with IgA nephropathy, the concentration of aberrant deGal-IgA1 was significantly higher as compared to the patients with Henoch-Schonlein nephritis and healthy individuals (p < 0.001). The risk of rapid progression and onset of end-stage renal disease is inc reased in patients with hypertension, proteinuria over 0.5 g/day, a decrease in estimated glomerular filtration rate less than 60 ml/min, the presence of segmental sclerosis, tubular atrophy, interstitial fibrosis, fibrous and fibrocellular crescents, a large number of IgA deposits in combination with C3 in the biopsy specimen. Conclusions. In childhood in most cases, IgA nephropathy has a low rate of progression and does not lead to a complete loss of kidney function

A State of Impermanence: Buddhism, Liberalism, and the Problem of Politics

This dissertation explores the relationship of Buddhist political thought and liberal political thought at the level of first principles. I will examine the tension created by the Buddhist view of political life as instrumental and secondary to man\u27s being as a function of the transition of the Buddhist world into the sphere of Western political life, which views the role of politics as primary to man\u27s nature. In Part I, this will be accomplished through a consideration of the origins of political life and the foundation of the political state in each tradition as viewed through the themes of human nature, the individual, and wisdom. In Part II of this dissertation, I will view the tensions of this transition as a function of contemporary political practice. Here I will address the political history and political thought of Myanmar and consider how these features have contributed to the current humanitarian crisis in the country. I will then examine the contemporary Western political movement of socially-engaged Buddhism. I conclude with a brief consideration of the ways that Buddhist political thought\u27s deflationary understanding of politics can help address the problem of ideology in modern Western political life

Evaluation of the contribution of herpes virus infection to the development and progression of chronic glomerular diseases in children

Background. Etiology of chronic glomerular diseases is not completely known to the present day. A number of factors, including viral infections, are described. Aim of the study: determination of antibodies to Epstein-Barr virus (EBV) (immunoglobulin (Ig) G to the nuclear and early antigen (AG), IgG and IgM to viral capsid AG), cytomegalovirus (CMV) (IgG, IgM), herpes simplex virus (HSV) (IgM, IgG), specific DNA fragments of herpes and polyomaviruses (BK and JC) in the blood serum and kidney tissue to clarify the role of viral infection in the development of glomerulopathies (GP) in children. Materials and methods. One hundred thirty children with primary and secondary GP were examined for the presence of antibodies and DNA fragments of herpes and polyomaviruses, including 42 recipients of the kidney transplant (Tx); 36 appa­rently healthy individuals were included in the control group. Ultrastructural analysis of kidney tissue for herpes viruses was performed. Results. IgM to HSV and IgM to CMV were detected in the sera of patients with secondary and primary GP more often than in controls (17.1 and 12.8 % vs. 0, 20 and 17 % vs. 5.5 %, respectively), and also children with Tx (vs. 0 % for HSV, 5 % for CMV, and 7 % for EBV, respectively). In 5 cases of secondary GP, IgM to 2 or more herpes viruses simultaneously were detected. In the blood serum of 24.4 % of children with secondary GP, both antibodies to EBV (IgG to early AG and IgM to viral capsid AG) and nucleic acids of HSV, CMV and EBV were detected. The ultrastructural analysis of 10 biopsy specimens showed the presence of type 1 and 2 HSV DNA in one case and CMV DNA in 2 cases. The features of the course of GP associated with herpetic infection are presented. Conclusions. Herpes viruses influence the development and course of the pathological process in chronic GP. The presented algorithm of virological examination of children with GP can be used in the practice of a nephrologist

Targeting the type 2 diabetes epidemic in Polynesia : historical perspective and rationale for exercise intervention trials

The Polynesian people of New Zealand are particularly vulnerable to type 2 diabetes mellitus (T2DM) and related comorbidities, including obesity and cardiovascular disease. T2DM could potentially be managed and abated with appropriate and targeted exercise prescriptions; however, the uptake of such interventions by this cohort remains low. The purpose of this article is to present a rationale for the investigation of targeted exercise prescriptions for the management and potential remission of T2DM in Polynesian people. The diabetes epidemic will be contextualized by contrasting historical observations of health and physical fitness with current trends and statistics related to significant T2DM risk factors (ie, obesity and inactivity). Longitudinal trials that have prescribed lifestyle-related and exercise interventions in this cohort will be critically reviewed, and novel research avenues will be proposed. Studies are currently required to investigate many critically important hypotheses in this cohort. The outcomes of such studies may facilitate the investigation of exercise prescriptions in other indigenous populations, including indigenous Australians, Americans and Africans, who also suffer a severe burden of T2DM

Genome-wide transcriptional profiling and enrichment mapping reveal divergent and conserved roles of Sko1 in the Candida albicans osmotic stress response

Candida albicans maintains both commensal and pathogenic states in humans. Here, we have defined the genomic response to osmotic stress mediated by transcription factor Sko1. We performed microarray analysis of a sko1\u3b4/\u3b4 mutant strain subjected to osmotic stress, and we utilized gene sequence enrichment analysis and enrichment mapping to identify Sko1-dependent osmotic stress-response genes. We found that Sko1 regulates distinct gene classes with functions in ribosomal synthesis, mitochondrial function, and vacuolar transport. Our in silico analysis suggests that Sko1 may recognize two unique DNA binding motifs. Our C. albicans genomic analyses and complementation studies in Saccharomyces cerevisiae showed that Sko1 is conserved as a regulator of carbohydrate metabolism, redox metabolism, and glycerol synthesis. Further, our real time-qPCR results showed that osmotic stress-response genes that are dependent on the kinase Hog1 also require Sko1 for full expression. Our findings reveal divergent and conserved aspects of Sko1-dependent osmotic stress signaling. \ua9 2013 Elsevier Inc.Peer reviewed: YesNRC publication: Ye

Exercise training in high-risk ethnic populations with type 2 diabetes : a systematic review of clinical trials

In order to review clinical trials that have prescribed exercise training in high-risk, ethnic populations with type 2 diabetes mellitus (T2DM) and delineate areas for future research, a systematic review using computerized databases was performed. The systematic review located nine trials, including four uncontrolled trials, and five randomized controlled trials (RCTs) that included 521 participants. Cohorts studied included African, Indian, Polynesian, Hispanic, Arabian, and Chinese peoples and interventions included aerobic training, resistance training or a combination thereof. Several trials documented improvements in HbA1c, insulin action, body composition, blood lipids and systolic and diastolic blood pressure. In general, a longer duration and greater frequency of training resulted in greater adaptation. Studies demonstrating no effect were generally limited by an inadequate intervention. There was evidence of differential training responses between Caucasians and non-Caucasians in two studies drawing such comparisons. Robust RCTs prescribing appropriate, targeted interventions and investigating relevant outcomes may be required to stimulate greater advocacy for exercise as a therapeutic adjunct for diabetes management in these populations. Investigations should be extended to other high-risk populations, particularly indigenous peoples who suffer an extreme burden of T2DM. Translation of research into clinical application should remain the overall objective

More standing and just as productive: Effects of a sit-stand desk intervention on call center workers\u27 sitting, standing, and productivity at work in the Opt to Stand pilot study

This study evaluated the effects of sit-stand desks on workers\u27 objectively and subjectively assessed sitting, physical activity, and productivity. This quasi-experimental study involved one intervention group (n = 16) and one comparison group (n = 15). Participants were call center employees from two job-matched teams at a large telecommunications company in Sydney, Australia (45% female, 33 ± 11 years old). Intervention participants received a sit-stand desk, brief training, and daily e-mail reminders to stand up more frequently for the first 2 weeks post-installation. Control participants carried out their usual work duties at seated desks. Primary outcomes were workday sitting and physical activity assessed using ActivPAL or ActiGraph devices and self-report questionnaires. Productivity outcomes were company-specific objective metrics (e.g., hold time, talking time, absenteeism) and subjective measures. Measurements were taken at baseline, 1, 4, and 19 weeks post-installation. Intervention participants increased standing time after 1 week (+ 73 min/workday (95% CI: 22, 123)) and 4 weeks (+ 96 min/workday (95% CI: 41, 150)) post-intervention, while control group showed no changes. Between-group differences in standing time at one and 4 weeks were + 78 (95% CI: 9, 147) and + 95 min/workday (95% CI: 15, 174), respectively. Sitting time in the intervention group changed by − 64 (95% CI: − 125, − 2), − 76 (95% CI: − 142, − 11), and − 100 min/workday (95% CI: − 172, − 29) at 1, 4, and 19 weeks post-installation, respectively, while the control group showed no changes. No changes were observed in productivity outcomes from baseline to follow-up in either group. Sit-stand desks can increase standing time at work in call center workers without reducing productivity

South Pacific Islanders resist type 2 Diabetes: comparison of aerobic and resistance training

The purpose of this study was to evaluate the effectiveness of two exercise modalities for improving glycosylated hemoglobin (HbA1c) and associated clinical outcomes in Polynesian adults diagnosed with type 2 diabetes and visceral obesity. Twenty-six adults were randomized to receive resistance training or aerobic training, 3x/week, for 16 weeks. Dependent variables collected before and after intervention included: diabetes markers including HbA1c, blood lipids, relevant cytokines (C-reactive protein, adiponectin), and anthropometric and hemodynamic indices. Eighteen participants (72% female; age: 49.3 ± 5.3 years; waist circumference: 128.7 ± 18.7 cm) completed the intervention and follow-up assessments. Body mass index in the whole cohort at baseline indicated Class III (morbid) obesity (43.8 ± 9.5 kg/m2). Compliance to training was 73 ± 19 and 67 ± 18% in the aerobic and resistance training groups, respectively. HbA1c remained elevated in both groups after training. Aerobic training reduced systolic and diastolic blood pressure and increased serum triglycerides (all P < 0.05). No other exercise-induced adaptations were noted within or between groups. Post hoc analysis using pooled data indicated that higher adherence to training (≥75% attendance, n = 8) significantly reduced waist circumference (P < 0.001) and tended to reduce body weight and fasting insulin (all P ≤ 0.11) versus lower adherence (<75% attendance, n = 10). In conclusion, this study did not demonstrate an improvement in HbA1c with exercise in morbidly obese Polynesian people. Future investigations involving exercise regimens that are more practicable and which involve greater frequency and duration of training may be required to induce significant and clinically meaningful adaptations in this unique diabetes population