***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: There is good evidence for cognitive and physiological arousal in chronic insomnia . Accordingly , clinical trial studies of insomnia treatments aim ed at reducing arousal , including relaxation and meditation , have reported positive results . Yoga is a multicomponent practice that is also known to be effective in reducing arousal , although it has not been well evaluated as a treatment for insomnia . In this preliminary study , a simple daily yoga treatment was evaluated in a chronic insomnia population consisting of sleep-onset and /or sleep-maintenance insomnia and primary or secondary insomnia . Participants maintained sleep – wake diaries  during a pretreatment 2-week baseline and a subsequent 8-week intervention , in which they practice d the treatment on their own following a single in-person training session with subsequent brief in-person and telephone follow-ups . Sleep efficiency ( SE ) , total sleep time ( TST ) , total wake time ( TWT ) , sleep onset latency ( SOL ) , wake time after sleep onset ( WASO ) , number of awakenings , and sleep quality measures were derived from sleep – wake diary entries and were averaged in 2-week intervals . For 20 participants completing the protocol , statistically significant improvements were observed in SE , TST , TWT , SOL , and WASO at end-treatment as compared with pretreatment values An open label intervention study was undertaken on 26 mild hypertensives and 26 apparently healthy adults ( 30 - 60 y ) , for the effect of Sudarshan Kriya Yoga practice for two months as complementary therapy . In the hypertensives , there was a significant decrease in diastolic blood pressure ( P < 0.01 ) , serum urea ( P < 0.01 ) and plasma MDA ( malondialdehyde adducts ) as oxidative stress marker ( P < 0.05 ) . Other parameters ; viz . ; plasma levels of cholesterol , triglycerides , glucose , did not change significantly ( P > 0.1 ) . The pattern of change in most of the study parameters was such that values above normal range were lowered but values within normal range were unaltered . The action of Yoga on diastolic blood pressure , malondialdehyde adducts and kidney function in hypertensives was of counteractive nature and felt to be distinctly different than the effect of drugs OBJECTIVES Chronic back pain affects a large proportion of both the general population and of military veterans . Although numerous therapies exist for treating chronic back pain , they can be costly and tend to have limited effectiveness . Thus , demonstrating the efficacy and cost-effectiveness of additional treatment alternatives is important . The purpose of our study was to examine the benefits of a yoga intervention for Veterans Administration ( VA ) patients . SUBJECTS/INTERVENTION : VA patients with chronic back pain were referred by their primary care providers to a yoga program as part of clinical care . Before starting yoga , a VA physician trained in yoga evaluated each patient to ensure that they could participate safely . DESIGN The research study consisted of completing a short battery of question naires at baseline and again 10 weeks later . OUTCOME MEASURES Question naires included measures of pain , depression , energy/fatigue , health-related quality of life , and program satisfaction . Paired t-tests were used to compare baseline scores to those at the 10-week follow-up for the single group , pre-post design . Correlations were used to examine whether yoga attendance and home practice were associated with better outcomes . RESULTS Baseline and follow-up data were available for 33 participants . Participants were VA patients with a mean age of 55 years . They were 21 % female , 70 % white , 52 % married , 68 % college graduates , and 44 % were retired . Significant improvements were found for pain , depression , energy/fatigue , and the Short Form-12 Mental Health Scale . The number of yoga sessions attended and the frequency of home practice were associated with improved outcomes . Participants appeared highly satisfied with the yoga instructor and moderately satisfied with the ease of participation and health benefits of the yoga program . CONCLUSIONS Preliminary data suggest that a yoga intervention for VA patients with chronic back pain may improve the health of veterans .  However , the limitations of a pre-post study design make conclusions tentative . A larger r and omized , controlled trial of the yoga program is planned Highly stressed employees are subject to greater health risks , increased cost , and productivity losses than those with normal stress levels . To address this issue in an evidence -based manner , worksite stress management programs must be able to engage individuals as well as capture data on stress , health indices , work productivity , and health care costs . In this r and omized controlled pilot , our primary objective was to evaluate the viability and proof of concept for two mind-body workplace stress reduction programs ( one therapeutic yoga-based and the other mindfulness-based ) , in order to set the stage for larger cost-effectiveness trials . A second objective was to evaluate 2 delivery venues of the mindfulness-based intervention ( online vs. in-person ) . Intention-to-treat principles and 2 ( pre and post ) × 3 ( group ) repeated- measures analysis of covariance procedures examined group differences over time on perceived stress and secondary measures to clarify which variables to include in future studies : sleep quality , mood , pain levels , work productivity , mindfulness , blood pressure , breathing rate , and heart rate variability ( a measure of autonomic balance ) . Two hundred and thirty-nine employee volunteers were r and omized into a therapeutic yoga worksite stress reduction program , 1 of 2 mindfulness-based programs , or a control group that participated only in assessment . Compared with the control group , the mind-body interventions showed significantly greater improvements on perceived stress , sleep quality , and the heart rhythm coherence ratio of heart rate variability . The two delivery venues for the mindfulness program produced basically equivalent results . Both the mindfulness-based and therapeutic yoga programs may provide viable and effective interventions to target high stress levels , sleep quality , and autonomic balance in employees Background Tobacco smoking remains the leading preventable cause of death among American women .  Exercise has shown promise as an aid to smoking cessation because it reduces weight gain and weight concerns , improves affect , and reduces nicotine withdrawal symptoms and cigarette craving . Studies have shown that the practice of yoga improves weight control , and reduces perceived stress and negative affect . Yoga practice also includes regulation of breathing and focused attention , both of which may enhance stress reduction and improve mood and well-being and may improve cessation outcomes . Methods / Design This pilot efficacy study is design ed to examine the  rates of cessation among women r and omized to either a novel , 8-week Yoga plus Cognitive Behavioral Therapy ( CBT ) smoking cessation intervention versus a Wellness program plus the same CBT smoking cessation intervention . Outcome measures include 7-day point prevalence abstinence at end of treatment , 3 and 6 months follow up and potential mediating variables ( e.g. , confidence in quitting smoking , self-efficacy ) . Other assessment s include measures of mindfulness , spirituality , depressive symptoms , anxiety and perceived health ( SF-36 ) . Discussion Innovative treatments are needed that address barriers to successful  smoking cessation among men and women . The design chosen for this study will allow us to explore potential mediators of intervention efficacy so that we may better underst and the mechanism(s ) by which yoga may act as an effective complementary treatment for smoking cessation . If shown to be effective , yoga can offer an alternative to traditional exercise for reducing negative symptoms that often accompany smoking cessation and predict relapse to smoking among recent quitters . Trial Registration Clinical Trials Background Little is known about the metabolic and heart rate responses to a typical hatha yoga session . The purpose s of this study were 1 ) to determine whether a typical yoga practice using various postures meets the current recommendations for levels of physical activity required to improve and maintain health and cardiovascular fitness ; 2 ) to determine the reliability of metabolic costs of yoga across sessions ; 3 ) to compare the metabolic costs of yoga practice to those of treadmill walking . Methods In this observational study , 20 intermediate-to-advanced level yoga practitioners , age 31.4 ± 8.3 years , performed an exercise routine inside a human respiratory chamber ( indirect calorimeter ) while wearing heart rate monitors . The exercise routine consisted of 30 minutes of sitting , 56 minutes of beginner-level hatha yoga administered by video , and 10 minutes of treadmill walking at 3.2 and 4.8 kph each . Measures were mean oxygen consumption ( VO2 ) , heart rate ( HR ) , percentage predicted maximal heart rate ( % MHR ) , metabolic equivalents ( METs ) , and energy expenditure ( kcal ) . Seven subjects repeated the protocol so that measurement reliability could be established . Results Mean values across the entire yoga session for VO2 , HR , % MHR , METs , and energy/min were 0.6 L/kg/min ; 93.2 beats/min ; 49.4 % ; 2.5 ; and 3.2 kcal/min ; respectively . Results of the ICCs ( 2,1 ) for mean values across the entire yoga session for kcal , METs , and % MHR were 0.979 and 0.973 , and 0.865 , respectively . Conclusion Metabolic costs of yoga averaged across the entire session represent low levels of physical activity , are similar to walking on a treadmill at 3.2 kph , and do not meet recommendations for levels of physical activity for improving or maintaining health or cardiovascular fitness . Yoga practice incorporating sun salutation postures exceeding the minimum bout of 10 minutes may contribute some portion of sufficiently intense physical activity to improve cardio-respiratory fitness in unfit or sedentary individuals . The measurement of energy expenditure across yoga sessions is highly reliable Background Lactic acid-producing bacteria ( LAB ) probiotics demonstrate immunomodulating and anti-inflammatory effects and the ability to lessen the symptoms of  arthritis in both animals and humans . This r and omized , double-blind , placebo-controlled , parallel- design , clinical pilot trial was conducted to evaluate the effects of the LAB probiotic preparation , Bacillus coagulans GBI-30 , 6086 , on symptoms and measures of functional capacity in patients with rheumatoid arthritis ( RA ) in combination with pharmacological anti-arthritic medications . Methods Forty-five adult men and women with symptoms of RA were r and omly assigned to receive Bacillus coagulans GBI-30 , 6086 or placebo once a day in a double-blind fashion for 60 days in addition to their st and ard anti-arthritic medications .  Arthritis activity was evaluated by clinical examination , the American College of Rheumatology ( ACR ) criteria , the Stanford Health Assessment Question naire Disability Index ( HAQ-DI ) , and laboratory tests for erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP ) . Results Subjects who received Bacillus coagulans GBI-30 , 6086 experienced borderline statistically significant improvement in the Patient Pain Assessment score ( P = .052 ) and statistically significant improvement in Pain Scale ( P = .046 ) vs placebo . Compared with placebo , Bacillus coagulans GBI-30 , 6086 treatment result ed in greater improvement in patient global assessment and self-assessed disability ; reduction in CRP ; as well as the ability to walk 2 miles , reach , and participate in daily activities . There were no treatment-related adverse events reported throughout this study . Conclusions Results of this pilot study suggest that adjunctive treatment with Bacillus coagulans GBI-30 , 6086 LAB probiotic appeared to be a safe and effective for patients suffering from RA . Because of the low study population size , larger trials are needed to verify these results .Trial registration There is growing evidence that yoga may offer a safe and cost-effective intervention for Type 2 Diabetes mellitus ( DM 2 ) . However , systematic review s are lacking . This article critically review s the published literature regarding the effects of yoga-based programs on physiologic and anthropometric risk profiles and related clinical outcomes in adults with DM 2 . We performed a comprehensive literature search using four computerized English and Indian scientific data bases . The search was restricted to original studies ( 1970–2006 ) that evaluated the metabolic and clinical effects of  yoga in adults with DM 2 . Studies targeting clinical population s with cardiovascular disorders that included adults with comorbid DM were also evaluated . Data were extracted regarding study design , setting , target population , intervention , comparison group or condition , outcome assessment , data analysis and presentation , follow-up , and key results , and the quality of each study was evaluated according to specific predetermined criteria . We identified 25 eligible studies , including 15 uncontrolled trials , 6 non-r and omized controlled trials and 4 r and omized controlled trials ( RCTs ) . Overall , these studies suggest beneficial changes in several risk indices , including glucose tolerance and insulin sensitivity , lipid profiles , anthropometric characteristics , blood pressure , oxidative stress , coagulation profiles , sympathetic activation and pulmonary function , as well as improvement in specific clinical outcomes .  Yoga may improve risk profiles in adults with DM 2 , and may have promise for the prevention and management of cardiovascular complications in this population . However , the limitations characterizing most studies preclude drawing firm conclusions . Additional high- quality RCTs are needed to confirm and further eluci date the effects of st and ardized yoga programs in population s with DM 2 In this study , a stress management program based on cognitive behavioural therapy principles was compared with a Kundaliniyoga program .  A study sample of 26 women and 7 men from a large Swedish company were divided r and omly into 2 groups for each of the different forms of intervention ; a total of 4 groups . The groups were instruct 
    Output:
    
Outcomes of interest were clinical CVD events and major CVD risk factors .
There is some evidence that yoga has favourable effects on diastolic blood pressure , HDL cholesterol and triglycerides , and uncertain effects on LDL cholesterol .