Sexual dimorphism and topological variability in fingerprint ridge density in a north-west Indian population.

The science of fingerprints is very crucial in criminal investigation as it helps identify perpetrators or victims of a crime. Fingerprint ridge density (FPRD), which refers to the number of ridges within a specific area on the epidermal skin layer of the distal phalanges in humans, has been found to differ between males and females. This study attempts to estimate the sex from FPRD and evaluates the diversity in FPRD across several topological areas. The study involves 208 participants (120 males, 88 females) between the ages 18 to 25 years from a North-west Indian population. Fingerprints were collected, and FPRD was accessed in radial, ulnar, and proximal areas as recommended by Gutierrez-Redomero et al. (Forensic Sci Int 180(1):17-22, 2008). FPRD has been quantified using the techniques described by Acree (Forensic Sci Int 102(1):35-44, 1999). When evaluating FPRD in the lateral pocket loops and twin loops, the proximal-side core was considered. The study reveals that males have a mean fingerprint ridge density of 12.82 ridges/25 mm2 while females have 13.01 ridges/25 mm2. Females have higher fingerprint ridge density solely in the proximal area; males have higher fingerprint ridge density in both radial and ulnar areas. In conclusion, this research underscores the potential of fingerprint ridge density as a parameter for investigating population variations and individual identification. Future studies on fingerprint ridge density in India's diverse population will help establish reference ranges, allowing for sex and likely population group estimation, making it a valuable tool for preliminary examinations and exclusion criteria for sex estimation in crime scene investigations.

Video Call-based Fitness Assessment shows Poor Fitness in People with Type II Diabetes: Findings from Diabefly Digital Therapeutics Program.

OBJECTIVE: Exercise and physical activity are integral aspects for the effective management of diabetes. Unsupervised home exercise although very accessible is limited by poor adherence, risk of injury, and a higher dropout rate of participants. A fitness assessment by a qualified physiotherapist can help in understanding the baseline fitness of individuals and thus generating appropriate exercise prescriptions. The current study assesses the feasibility of video call-based fitness assessment for people with diabetes. The study also assesses the effect of current physical activity status and pain on performance in physical fitness tests. METHODS: One hundred participants with type II diabetes (T2D) underwent 6-minute walk test (6MWT), 1-minute push-up test, wall sit test, 1-minute sit-up test, and V-sit and reach test for measuring different components of physical fitness such as aerobic capacity, upper body strength, lower body strength, core strength, and flexibility, respectively. The performance in physical fitness of participants was analyzed after the video consult along with pain complaints and current exercise status. RESULTS: All the participants underwent the physical fitness test safely based on video call. Out of all the participants, a good range score was achieved by 52% in 6MWT, 17% in push-up test, 1% in wall sit test, 6% in sit-up test, and 9% in V-sit and reach test. Current physical activity status (aerobic exercise for minimum 20 minutes) did not show any association with performance in fitness tests (p = 0.89 for push-up test, p = 0.50 for wall sit test, p = 0.23 for sit-up test, and p = 0.10 for V-sit and reach test). Presence of upper body and lower body pain affected the performance in push-up test and wall sit test with 71.4% and 95.6% of participants achieving scores in poor to below-average range (p-value < 0.001). CONCLUSION: The study showed the safety and feasibility of conducting video call-based assessment of physical fitness by physiotherapists. The study also highlighted the poor glycemic control, high cardiovascular risk, and poor level of physical fitness in people with diabetes in India. Insights based on physical fitness, current physical activity status, and pain can help in developing personalized exercise plans for people with diabetes.

Evaluating Glycemic Control in Patients of South Asian Origin With Type 2 Diabetes Using a Digital Therapeutic Platform: Analysis of Real-World Data.

BACKGROUND: Digital therapeutics are evidence-based therapeutic interventions driven by high-quality software programs for the treatment, prevention, or management of a medical disorder or disease. Many studies in the western population have shown the effectiveness of mobile app-based digital therapeutics for improving glycemic control in patients with type 2 diabetes (T2D). However, few studies have assessed similar outcomes in the South Asian population. OBJECTIVE: This study aims to investigate the real-world effectiveness of the Wellthy CARE digital therapeutic for improving glycemic control among the South Asian population of Indian origin. METHODS: We analyzed deidentified data from 102 patients with T2D from India enrolled in a 16-week structured self-management program delivered using the Wellthy CARE mobile app. Patients recorded their meals, weight, physical activity, and blood sugar in the app, and they received lessons on self-care behaviors (healthy eating, being active, monitoring, medication adherence, problem solving, healthy coping, and reducing risks); feedback provided by an artificial intelligence-powered chatbot; and periodic interactions with certified diabetes educators via voice calls and chats. The primary outcome of the program was a change in glycated hemoglobin A1c (HbA1c). Secondary outcomes included the difference between preintervention and postintervention fasting blood glucose (FBG) and postprandial blood glucose (PPBG) levels; changes in BMI and weight at the completion of 16 weeks; and the association between program engagement and the changes in HbA1c, FBG, and PPBG levels. RESULTS: At the end of 16 weeks, the average change in HbA1c was -0.49% (n=102; 95% CI -0.73 to 0.25; P<.001). Of all the patients, 63.7% (65/102) had improved HbA1c levels, with a mean change of -1.16% (n=65; 95% CI -1.40 to -0.92; P<.001). The mean preintervention and postintervention FBG levels were 145 mg/dL (n=51; 95% CI 135-155) and 134 mg/dL (n=51; 95% CI 122-146; P=.02) and PPBG levels were 188 mg/dL (n=51; 95% CI 172-203) and 166 mg/dL (n=51; 95% CI 153-180; P=.03), respectively. The mean changes in BMI and weight were -0.47 kg/m2 (n=59; 95% CI -0.22 to -0.71; P<.001) and -1.32 kg (n=59; 95% CI -0.63 to -2.01; P<.001), respectively. There was a stepwise decrease in HbA1c, FBG, and PPBG levels as the program engagement increased. Patients in the highest tertile of program engagement had a significantly higher reduction in HbA1c (-0.84% vs -0.06%; P=.02), FBG (-21.4 mg/dL vs -0.18 mg/dL; P=.02), and PPBG levels (-22.03 mg/dL vs 2.35 mg/dL; P=.002) than those in the lowest tertile. CONCLUSIONS: The use of the Wellthy CARE digital therapeutic for patients with T2D showed a significant reduction in the levels of HbA1c, FBG, and PPBG after 16 weeks. A higher level of participation showed improved glycemic control, suggesting the potential of the Wellthy CARE platform for better management of the disease.

Personalized glycemic response led digital therapeutics program improves time in range in a period of 14 days.

Background: Lifestyle modification is an integral aspect for the management of type 2 diabetes (T2D). However, it is difficult to ensure the accuracy of personalized lifestyle advice. The study aims to analyse the real-world effectiveness of personalized glycemic response based Diabefly-Pro digital therapeutics for better glycemic control. Methods: Data from continuous glucose monitoring (CGM) of 64 participants with T2D was analysed. All participants were provided with modified lifestyle plan based on their personalized glycemic response. The CGM data was analysed for a period of 7 days, before and after the introduction of modified lifestyle plan. Primary outcome of the study was change in time in range (TIR). Secondary outcomes of the study were change in mean blood glucose, time above range (TAR), time below range (TBR) and glucose management indicator (GMI). Results: Significant improvement in glycemic control was observed after the introduction of personalized lifestyle plan. Median reduction in mean blood glucose was from 139.5 (118.3 to 169.3) mg/dL to 122.0 (101.5 to 148.8) mg/dL (p < 0.0001). TIR and GMI improved from 70.50 (50.75 to 83.50) % to 75.00 (58.25 to 89.00) % (p = 0.0001) and 6.64 (6.13 to 7.35) % to 6.23 (5.74 to 6.86) % (p < 0.0001) respectively. TAR reduced significantly from 17.00 (4.25 to 38.0) % to 6.00 (1.25 to 26.0) % (p < 0.0001). No significant increase in TBR was observed (p = 0.198). Conclusion: Personalized glycemic response-based Diabefly-Pro digital therapeutics program was effective in achieving better glycemic control in people with T2D.

Fitterfly Diabetes CGM Digital Therapeutics Program for Glycemic Control and Weight Management in People With Type 2 Diabetes Mellitus: Real-world Effectiveness Evaluation.

BACKGROUND: Digital therapeutic platforms facilitate health care through patient-centered strategies based on multidisciplinary teams and shared decision-making. Such platforms can be used for developing a dynamic model of diabetes care delivery, which can help in improving glycemic control by promoting long-term behavior changes in people with diabetes. OBJECTIVE: This study aims to evaluate the real-world effectiveness of the Fitterfly Diabetes CGM digital therapeutics program for improving glycemic control in people with type 2 diabetes mellitus (T2DM) after the completion of 90 days in the program. METHODS: We analyzed deidentified data of 109 participants in the Fitterfly Diabetes CGM program. This program was delivered through the Fitterfly mobile app coupled with continuous glucose monitoring (CGM) technology. This program consists of 3 phases: the first phase is observation, wherein the patient's CGM readings are observed for 7 days (week 1); the second phase is the intervention; and the third phase aims at sustaining the lifestyle modification introduced during the second phase. The primary outcome of our study was the change in the participants' hemoglobin A1c (HbA1c) levels after program completion. We also evaluated the changes in participant weight and BMI after the program, changes in the CGM metrics in the initial 2 weeks of the program, and the effects of participant engagement in the program on improving their clinical outcomes. RESULTS: At the end of the 90 days of the program, the mean HbA1c levels, weight, and BMI of the participants were significantly reduced by 1.2% (SD 1.6%), 2.05 (SD 2.84) kg, and 0.74 (SD 1.02) kg/m2 from baseline values of 8.4% (SD 1.7%), 74.45 (SD 14.96) kg, and 27.44 (SD 4.69) kg/m2 in week 1, respectively (P<.001). The average blood glucose levels and time above range values showed a significant mean reduction by 16.44 (SD 32.05) mg/dL and 8.7% (SD 17.1%) in week 2 from week 1 baseline values of 152.90 (SD 51.63) mg/dL and 36.7% (SD 28.4%), respectively (P<.001 for both). Time in range values significantly improved by 7.1% (SD 16.7%) from a baseline value of 57.5% (SD 25%) in week 1 (P<.001). Of all the participants, 46.9% (50/109) showed HbA1c reduction ≥1% and 38.5% (42/109) showed weight loss ≥4%. The average number of times the mobile app was opened by each participant during the program was 108.80 (SD 127.91) times. CONCLUSIONS: Our study shows that participants in the Fitterfly Diabetes CGM program showed a significant improvement in their glycemic control and reduction in weight and BMI. They also showed a high level of engagement with the program. Weight reduction was significantly associated with higher participant engagement with the program. Thus, this digital therapeutic program can be considered as an effective tool for improving glycemic control in people with T2DM.

Imaging and Diagnostic Challenges in a Patient With Refractory Hypoglycemia Caused by Insulinomas Related to Multiple Endocrine Neoplasia Type 1.

Insulinoma is a rare neuroendocrine tumor. It may occur sporadically or as part of the genetic tumor syndrome multiple endocrine neoplasia type 1 (MEN1). Diagnosis is challenging because of the small size of insulin producing tumors that lead to hyperinsulinemia. Advances in imaging modalities may provide more accurate diagnosis of primary tumors, metastasis, and tumor functional status. Advances allow for improved medical and surgical management with new tools for research of neuroendocrine tumors. Surgical excision of the primary tumor is often curative; however, insulinomas in MEN1 syndrome are often multifocal with a high rate of recurrence presenting unique challenges in management. Here, we present the case of a 34-year-old male with recurrent hypoglycemic episodes and hyperparathyroidism diagnosed with multiple pancreatic insulinomas secondary to MEN1. Furthermore, we provide a brief review of the literature and discuss the approach to diagnosis and management in patients with MEN1 syndrome and future areas of investigation.

Understanding the decay of proteins: A method to study time dependent response of pM concentration of insulin at microwave frequencies.

Bio-molecule when isolated from its natural ecological condition is subjected to rapid decay. This decay leads to change in polarization and permittivity of molecule. This study presents an experimental analysis of the decay pattern of pM concentration of insulin using whispering gallery mode (WGM) dielectric resonator (DR) method. Analysis is carried out by comparing the permittivity, relaxation time and time delay for three days. It is observed that different pM concentrations of insulin solutions start to decay after 24 h at 5°C. Salient features of the present method are:•This method presents time dependent analysis to determine the activity of protein solution by measurement of permittivity, relaxation time and time delay.•In the present paper activity of pM concentration of Insulin in buffer solution is tested for three days.•This method is a general method and can be a fundamental basis to test the activity of bio-molecules in solution.

Smart material platforms for miniaturized devices: implications in disease models and diagnostics.

Smart materials are responsive to multiple stimuli like light, temperature, pH and redox reactions with specific changes in state. Various functionalities in miniaturised devices can be achieved through the application of "smart materials" that respond to changes in their surroundings. The change in state of the materials in the presence of a stimulus may be used for on demand alteration of flow patterns in devices, acting as microvalves, as scaffolds for cellular aggregation or as modalities for signal amplification. In this review, we discuss the concepts of smart trigger responsive materials and their applications in miniaturized devices both for organ-on-a-chip disease models and for point-of-care diagnostics. The emphasis is on leveraging the smartness of these materials for example, to allow on demand sample actuation, ion dependent spheroid models for cancer or light dependent contractility of muscle films for organ-on-a-chip applications. The review throws light on the current status, scope for technological enhancements, challenges for translation and future prospects of increased incorporation of smart materials as integral parts of miniaturized devices.

Identification and quantification of indoor air pollutant sources within a residential academic campus.

There is a growing concern regarding the adverse health effects due to indoor air pollution in developing countries including India. Hence, it becomes important to study the causes and sources of indoor air pollutants. This study presents the indoor concentrations of PM0.6 (particles with aerodynamic diameter less than 0.6µm) and identifies sources leading to indoor air pollution. Indoor air samples were collected at IIT Kanpur campus. Ninety-eight PM0.6 samples were collected during November 2013 to September 2014. PM0.6 concentration was measured using a single stage impactor type PM0.6 sampler. The average PM0.6 concentration indoor was about 94.44µg/m(3). Samples collected were then analysed for metal concentrations using ICP-OES (Inductively Coupled Plasma - Optical Emission Spectrometer). Eight metals Ba, Ca, Cr, Cu, Fe, Mg, Ni and Pb were quantified from PM samples using ICP-OES. Positive Matrix Factorization (PMF) was used for source apportionment of indoor air pollution. PMF is a factor analysis tool which helps in resolving the profile and contribution of the sources from an unknown mixture. Five possible sources of indoor pollutants were identified by factor analysis - (1) Coal combustion (21.8%) (2) Tobacco smoking (9.8%) (3) Wall dust (25.7%) (4) Soil particles (17.5%) (5) Wooden furniture/paper products (25.2%).

Relationship of serum uric acid, serum creatinine and serum cystatin C with maternal and fetal outcomes in rural Indian pregnant women.

BACKGROUND: Hypertensive disorders are the most common in pregnancy. Several studies showed a positive correlation between elevated maternal serum uric acid (UA), serum creatinine and adverse maternal and fetal outcomes, but only a few studies are available on serum cystatin C and maternal and fetal outcomes. The present study was undertaken to study the association of serum UA, creatinine and cystatin C with maternal and fetal outcomes. METHODS: Out of 116 pregnant women 69 women had no hypertension and 47 had hypertension with or without proteinuria. Serum UA, creatinine and cystatin C was measured by modified Uricase method, modified kinetic Jaffe's reaction and particle-enhanced immunonephelometric assay respectively. Multivariate logistic regression was performed to determine the independent effects of serum UA, creatinine and cystatin C on maternal and fetal outcomes using stata 13.1. RESULTS: The adjusted odds ratio (OR) was 3.73 (95% CI: 1.18-11.75; P=0.024) for UA; 15.79 (95% CI: 3.04-81.94; P=0.001) for creatinine and 2.03 (95% CI: 0.70-5.87; P=0.192) for cystatin C in hypertensive disorders of pregnancy. All the three renal parameters were not significantly associated with birth weight, gestational age of delivery and mode of delivery after adjusting for the confounding factors. CONCLUSIONS: Serum creatinine and uric acid are independent risk factors for hypertensive disorders of pregnancy. High serum uric acid is associated with low birth weight and delivery by caesarian section whereas high serum creatinine with preterm delivery only before adjustment for confounding factors and not after adjustment. Serum cystatin C was not significantly associated with the maternal and fetal outcomes.