Importance Lifestyle interventions for obesity produce reductions in body weight that can decrease risk for diabetes and cardiovascular disease but are limited by suboptimal maintenance of lost ...weight and inadequate dissemination in low-resource communities. Objective To evaluate the effectiveness of extended care programs for obesity management delivered remotely in rural communities through the US Cooperative Extension System. Design, Setting, and Participants This randomized clinical trial was conducted from October 21, 2013, to December 21, 2018, in Cooperative Extension Service offices of 14 counties in Florida. A total of 851 individuals were screened for participation; 220 individuals did not meet eligibility criteria, and 103 individuals declined to participate. Of 528 individuals who initiated a 4-month lifestyle intervention, 445 qualified for randomization. Data were analyzed from August 22 to October 21, 2019. Interventions Participants were randomly assigned to extended care delivered via individual or group telephone counseling or an education control program delivered via email. All participants received 18 modules with posttreatment recommendations for maintaining lost weight. In the telephone-based interventions, health coaches provided participants with 18 individual or group sessions focused on problem solving for obstacles to the maintenance of weight loss. Main Outcomes and Measures The primary outcome was change in body weight from the conclusion of initial intervention (month 4) to final follow-up (month 22). An additional outcome was the proportion of participants achieving at least 10% body weight reduction at follow-up. Results Among 445 participants (mean SD age, 55.4 10.2 years; 368 82.7% women; 329 73.9% white), 149 participants (33.5%) were randomized to individual telephone counseling, 143 participants (32.1%) were randomized to group telephone counseling, and 153 participants (34.4%) were randomized to the email education control. Mean (SD) baseline weight was 99.9 (14.6) kg, and mean (SD) weight loss after the initial intervention was 8.3 (4.9) kg. Mean weight regains at follow-up were 2.3 (95% credible interval CrI, 1.2-3.4) kg in the individual telephone counseling group, 2.8 (95% CrI, 1.4-4.2) kg for the group telephone counseling group, and 4.1 (95% CrI, 3.1-5.0) kg for the education control group, with a significantly smaller weight regain observed in the individual telephone counseling group vs control group (posterior probability >.99). A larger proportion of participants in the individual telephone counseling group achieved at least 10% weight reductions (31.5% 95% CrI, 24.1%-40.0%) than in the control group (19.1% 95% CrI, 14.1%-24.9%) (posterior probability >.99). Conclusions and Relevance This randomized clinical trial found that providing extended care for obesity management in rural communities via individual telephone counseling decreased weight regain and increased the proportion of participants who sustained clinically meaningful weight losses. Trial Registration ClinicalTrials.gov Identifier:NCT02054624
Glucose levels 2 h after an oral glucose challenge are a clinical measure of glucose tolerance used in the diagnosis of type 2 diabetes. We report a meta-analysis of nine genome-wide association ...studies (n = 15,234 nondiabetic individuals) and a follow-up of 29 independent loci (n = 6,958-30,620). We identify variants at the GIPR locus associated with 2-h glucose level (rs10423928, β (s.e.m.) = 0.09 (0.01) mmol/l per A allele, P = 2.0 × 10−15). The GIPR A-allele carriers also showed decreased insulin secretion (n = 22,492; insulinogenic index, P = 1.0 × 10−17; ratio of insulin to glucose area under the curve, P = 1.3 × 10−16) and diminished incretin effect (n = 804; P = 4.3 × 10−4). We also identified variants at ADCY5 (rs2877716, P = 4.2 × 10−16), VPS13C (rs17271305, P = 4.1 × 10−8), GCKR (rs1260326, P = 7.1 × 10−11) and TCF7L2 (rs7903146, P = 4.2 × 10−10) associated with 2-h glucose. Of the three newly implicated loci (GIPR, ADCY5 and VPS13C), only ADCY5 was found to be associated with type 2 diabetes in collaborating studies (n = 35,869 cases, 89,798 controls, OR = 1.12, 95% CI 1.09-1.15, P = 4.8 × 10−18).
Cross-sectional evidence suggests associations between sleep duration and levels of the inflammatory markers, C-reactive protein and interleukin-6. This longitudinal study uses data from the ...London-based Whitehall II study to examine whether changes in sleep duration are associated with average levels of inflammation from 2 measures 5 years apart. Sleep duration (≤5, 6, 7, 8, ≥9 hours on an average week night) was assessed in 5,003 middle-aged women and men in 1991/1994 and 1997/1999. Fasting levels of C-reactive protein and interleukin-6 were measured in 1997/1999 and 2002/2004. Cross-sectional analyses indicated that shorter sleep is associated with higher levels of inflammatory markers. Longitudinal analyses showed that each hour per night decrease in sleep duration between 1991/1994 and 1997/1999 was associated with higher levels of C-reactive protein (8.1%) and interleukin-6 (4.5%) averaged across measures in 1997/1999 and 2002/2004. Adjustment for longstanding illness and major cardiometabolic risk factors indicated that disease processes may partially underlie these associations. An increase in sleep duration was not associated with average levels of inflammatory markers. These results suggest that both short sleep and reductions in sleep are associated with average levels of inflammation over a 5-year period.
Aim: To study the amelioration of zinc deficiency in blackgram (Vigna mungo L.) through soil applied zinc in Typic Haplustepts soil of Rajasthan. Methodology: A two year field experiment was ...undertaken during Kharif 2016 and 2017 at Instructional Farm (Agronomy), Rajasthan College of Agriculture, Udaipur, Rajasthan. The treatments comprised application of Zn to soil @ 3 kg Zn ha-1, 4 kg Zn ha-1, 5 kg Zn ha-1 and 6 kg Zn ha-1. The experiment was laid out in a randomized block design with four replications. Results: Application of zinc significantly (P=0.05) increased the number of nodules per plant, number of pods per plant, number of seeds per pod, seed yield, haulm yield, biological yield, nutrient (N, P, K & Zn) content and uptake, protein content, net return and B:C ratio in blackgram. Soil application of Zn@5 kg ha-1 significantly increased seed yield, haulm yield and biological yield by 72.53, 50.08 and 57.68 per cent over the control in pooled analysis, respectively. However, the effect of application of Zn@5 kg ha-1 on yield attributes, yield, nutrient content, uptake, quality and economics of blackgram was found statistically at par with the application of 6 kg Zn ha-1. Interpretation: The application of Zn@ 5 kg ha-1 along with the recommended dose of fertilizer (NPK) resulted in significantly (P=0.05) higher productivity, nutrient uptake, quality and profitability of blackgram under Typic Haplustepts soil of Rajasthan.
The present investigation pertaining to growth of fertilizer consumption and food grains production in Rajasthan was conducted during 2017-18. This study was based on time series data, which was ...collected from 1967-68 to 2014-15. The results of the present investigation revealed an increasing trend in fertilizer consumption and food grains production from 1967-68 to 2014-15 in Rajasthan. Total fertilizer consumption in Rajasthan significantly increased at the rate of 13.82 per cent per annum during the post-green revolution phase-I. The consumption of N significantly grew by 14.26 per cent per annum, that of P and K increased by 12.24 per cent and 12.71 per cent, respectively. Food grains production also increased by 2.41 per cent per annum. In the post-green revolution phase-II, growth rate of total fertilizer consumption increased at the rate of 9.96 per cent, N significantly grew by 7.88 per cent, P increased by 17.09 per cent; whereas, K decreased by 0.94 per cent per annum. However, food grains production was increased by 1.57 per cent per annum.The analysis of post reform period pointed out that the total consumption of composite fertilizers, N, P and K significantly increased at the rate of 4.49 per cent, 4.32 per cent, 4.79 per cent and 7.21 per cent, respectively. Food grains production also registered significant growth rate of 3.71 per cent per annum. In entire period of study (1967-68 to 2014-15), total consumption of fertilizers had increased at the rate of 8.35 per cent per annum. While the consumption of N grew by 8.08 per cent per annum, that of P and K increased by 9.60 per cent and 4.95 per cent, respectively. Food grains production was increased by 2.78 per cent per annum.
Nonalcoholic fatty liver disease (NAFLD) clusters in families, but the only known common genetic variants influencing risk are near PNPLA3. We sought to identify additional genetic variants ...influencing NAFLD using genome-wide association (GWA) analysis of computed tomography (CT) measured hepatic steatosis, a non-invasive measure of NAFLD, in large population based samples. Using variance components methods, we show that CT hepatic steatosis is heritable (∼26%-27%) in family-based Amish, Family Heart, and Framingham Heart Studies (n = 880 to 3,070). By carrying out a fixed-effects meta-analysis of genome-wide association (GWA) results between CT hepatic steatosis and ∼2.4 million imputed or genotyped SNPs in 7,176 individuals from the Old Order Amish, Age, Gene/Environment Susceptibility-Reykjavik study (AGES), Family Heart, and Framingham Heart Studies, we identify variants associated at genome-wide significant levels (p<5×10(-8)) in or near PNPLA3, NCAN, and PPP1R3B. We genotype these and 42 other top CT hepatic steatosis-associated SNPs in 592 subjects with biopsy-proven NAFLD from the NASH Clinical Research Network (NASH CRN). In comparisons with 1,405 healthy controls from the Myocardial Genetics Consortium (MIGen), we observe significant associations with histologic NAFLD at variants in or near NCAN, GCKR, LYPLAL1, and PNPLA3, but not PPP1R3B. Variants at these five loci exhibit distinct patterns of association with serum lipids, as well as glycemic and anthropometric traits. We identify common genetic variants influencing CT-assessed steatosis and risk of NAFLD. Hepatic steatosis associated variants are not uniformly associated with NASH/fibrosis or result in abnormalities in serum lipids or glycemic and anthropometric traits, suggesting genetic heterogeneity in the pathways influencing these traits.
Little is known of the molecular mechanisms whereby spermatogonia, mitotic germ cells of the testis, self-renew and differentiate into sperm. Here we show that Zfp145, encoding the transcriptional ...repressor Plzf, has a crucial role in spermatogenesis. Zfp145 expression was restricted to gonocytes and undifferentiated spermatogonia and was absent in tubules of W/Wv mutants that lack these cells. Mice lacking Zfp145 underwent a progressive loss of spermatogonia with age, associated with increases in apoptosis and subsequent loss of tubule structure but without overt differentiation defects or loss of the supporting Sertoli cells. Spermatogonial transplantation experiments revealed a depletion of spermatogonial stem cells in the adult. Microarray analysis of isolated spermatogonia from Zfp145-null mice before testis degeneration showed alterations in the expression profile of genes associated with spermatogenesis. These results identify Plzf as a spermatogonia-specific transcription factor in the testis that is required to regulate self-renewal and maintenance of the stem cell pool.
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