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The information on altitude distribution of aerosols in the atmosphere is essential in assessing the impact of aerosol warming on thermal structure and stability of the atmosphere. In addition, aerosol altitude distribution is needed to address complex problems such as the radiative interaction of aerosols in the presence of clouds. With this objective, an extensive, multi-institutional and multi-platform field experiment (ICARB-Integrated Campaign for Aerosols, gases and Radiation Budget) was carried out under the Geosphere Biosphere Programme of the Indian Space Research Organization (ISRO-GBP) over continental India and adjoining oceans during March to May 2006. Here, we present airborne LIDAR measurements carried out over the east Coast of the India during the ICARB field campaign. An increase in aerosol extinction (scattering + absorption) was observed from the surface upwards with a maximum around 2 to 4 km. Aerosol extinction at higher atmospheric layers (>2 km) was two to three times larger compared to that of the surface. A large fraction (75–85%) of aerosol column optical depth was contributed by aerosols located above 1 km. The aerosol layer heights (defined in this paper as the height at which the gradient in extinction coefficient changes sign) showed a gradual decrease with an increase in the offshore distance. A large fraction (60–75%) of aerosol was found located above clouds indicating enhanced aerosol absorption above clouds. Our study implies that a detailed statistical evaluation of the temporal frequency and spatial extent of elevated aerosol layers is necessary to assess their significance to the climate. This is feasible using data from space-borne lidars such as CALIPSO, which fly in formation with other satellites like MODIS AQUA and MISR, as part of the A-Train constellation.

Mineral dust constitutes the single largest contributor to continental aerosols. To accurately assess the impact of dust aerosols on climate, the spatial and temporal distribution of dust radiative properties is essential. Regional characteristics of dust radiative properties, however, are poorly understood. The magnitude and even sign of dust radiative forcing is uncertain, as it depends on a number of parameters, such as vertical distribution of dust, cloud cover and albedo of the underlying surface. In this paper, infrared radiance (10.5-12.5 µm), acquired from the METEOSAT-5 satellite ( resolution), was used to retrieve regional characteristics of dust aerosols for all of 1999. The infrared radiance depression, due to the presence of dust in the atmosphere, has been used as an index of dust load, known as the Infrared Difference Dust Index (IDDI). There have been several studies in the past carried out over the Sahara using IDDI as a measure of dust load. Over the Indian region, however, studies on dust aerosols are sparse. Spatial and temporal variability in dust loading and its regional distribution over various arid and semiarid regions of India and adjacent continents (0-35° N; 30° E-100° E) (excluding Sahara) have been studied and the results are examined along with surface soil conditions (such as vegetation cover and soil moisture). The advantage of the IDDI method is that information on aerosol properties, such as chemical composition or microphysical properties, is not needed. A large day-to-day variation in IDDI was observed over the entire study region, with values ranging from 4 to 22 K. It was observed that dust activity starts by March over the Indian deserts, as well as over deserts of the Africa and Arabian regions. The IDDI reaches maximum during the period of May to August. Regional maps of IDDI, in conjunction with biomass burning episodes (using TERRA satellite fire pixel counts), suggest that large IDDI values observed during the winter months over Northern India could be due to a possible deposition of black carbon on larger dust aerosols. The IDDI values have been compared with another year (i.e. 2003), with a large number of dust storms reported by meteorological departments based on visibility data. During the dry season, the magnitude of the monthly average IDDI during 2003 was slightly higher than that of 1999. The monthly mean IDDI was in the range from 4 to 9 K over the Indian deserts, as well as over the deserts of Africa and Arabia. The maximum IDDI during a month was in the range from 6 to 18 K. Large IDDI values were observed even over vegetated regions (such as the vegetated part of Africa and central India), attributed to the presence of transported dust from nearby deserts.

Aerosol spectral optical depth (AOD) measurements were made covering three years (2001, 2002 and 2003) at an urban continental location, Bangalore (13°N, 77.6°E) in India. These ground-based observations have shown that AODs reach a maximum during April (~0.5 at 500nm) and minimum during the November to January period (~0.2). The Angstrom wavelength exponent (α) was ~1.1 during the dry season (December to April), which, in conjunction with the high optical depth indicates significant anthropogenic influence. Seasonal variations in AODs appear to have an association with monsoon rainfall. Large AODs (α~1.4) were observed during the rain-deficit summer monsoon season (SMS) of 2002, which persisted for more than six months. Enhancement in AODs during SMS 2002 was ~0.15 (at 500nm), compared to 2001 and 2003.

The impact of anthropogenic absorbing aerosols (such as soot) on the climate over the Indian region has been studied using the NCMRWF general circulation model. The absorbing aerosols increase shortwave radiative heating of the lower troposphere and reduce the heating at the surface. These effects have been incorporated as heating of the lower troposphere (up to 700hPa) and cooling over the continental surface based on INDOEX measurements. The heating effect is constant in the pre-monsoon season and reduces to zero during the monsoon season. It is shown that even in the monsoon season when the aerosol forcing is zero, there is an overall increase in rainfall and a reduction in surface temperature over the Indian region. The rainfall averaged over the Tropics shows a small reduction in most of the months during the January to September period. The impact of aerosol forcing, the model's sensitivity to this forcing and its interaction with model-physics has been studied by changing the cumulus parameterization from the Simplified Arakawa-Schubert (SAS) scheme to the Kuo scheme. During the pre-monsoon season the major changes in precipitation occur in the oceanic Inter Tropical Convergence Zone (ITCZ), where both the schemes show an increase in precipitation. This result is similar to that reported in Chung2002. On the other hand, during the monsoon season the changes in precipitation in the continental region are different in the SAS and Kuo schemes. It is shown that the heating due to absorbing aerosols changes the vertical moist-static stability of the atmosphere. The difference in the precipitation changes in the two cumulus schemes is on account of the different responses in the two parameterization schemes to changes in vertical stability. Key words. Atmospheric composition and structure (aerosols and particles) – Meteorology and atmospheric dynamics (tropical meteorology; precipitation)

• New method for wind speed extrapolation to higher altitude using shorter met masts. • Data-driven improved modeling in lieu of empirical equations. • Only 1-day data at 10-min intervals is enough to generate the best fitting symbolic function. • Maximum of 61.04% reduction achieved in daily Root Mean Square Error with respect to power law. • Superiority in performance observed always up to 34 km from the reference mast. Prolonged wind speed assessment at higher altitudes is essential for wind energy estimation and planning. However, the erection and maintenance of tall wind measuring masts for this purpose cause many practical inconveniences from the engineering perspective. A rather simplified method often used for this task is to measure the wind profile at relatively lower altitudes and extrapolate the same to the required higher heights by empirical equations framed using hypothetical and experiential research. Such models often show errors due to the uncertainties caused by the complex nature of turbulent flows and the terrain. In this paper, we propose a new method of applying symbolic regression to the wind speed data over a short duration measured at a reference location to obtain a symbolic function capable of estimating wind speeds at higher altitudes using wind speed data at lower altitudes at different locations. Compared to the traditional power law method, the new method performs more accurately in different seasons at the reference as well as far away locations, achieving a maximum of 61.04% reduction in daily RMSE when analyzed with wind speeds averaged over 10-min intervals in this study. The new method opens up the possibility of wind resource assessment at higher altitudes at different locations by employing engineering-friendly shorter wind measuring masts. [ABSTRACT FROM AUTHOR]

Primary prevention of diabetes still remains as an unmet challenge in a real world setting. While, translational programmes have been successful in the developed nations, the prevailing social and economic inequities in the low and middle income countries, fail to integrate diabetes prevention into their public health systems. The resulting exponential increase in the prevalence of diabetes and the cost of treatment has put primary prevention in the back seat. As a call to action, an expert group was formed to lay down practical guidelines for clinicians in the South East Asian regions to implement primary prevention programmes at an individual or at a community level. The guideline was developed based on the outcomes of the evidence based prevention programmes conducted in India. This decentralised self-guided approach for primary prevention of diabetes follows a three step implementation process of screening, diagnosis of intermediate hyperglycaemia and design and delivery of personalized interventions. Recommendations provided on dietary intake and physical activity can be tailored by the clinician to suit individual needs. Initiation of pharmacological treatment to achieve desired targets has also been addressed. A personalised approach by the clinician may be effective and offer a sustainable solution to curb the rising epidemic., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

We present a method for predicting hyperchaotic time series using a complex network-based forecasting model. We first construct a network from a given time series, which serves as a coarse-grained representation of the underlying attractor. This network facilitates multistep forecasting by capturing the local nonlinearity of the dynamics and offers superior accuracy over more extended periods than traditional methods. The network is formed by converting the patterns of local oscillations into sequences of numerical symbols, which are then used to create nodes and edges in a network, capturing the system's dynamical behavior at a reduced resolution. The network allows predictions up to several steps ahead without the exponential error increase usually associated with linear first-order methods. The improved predictions result from the unique ability of the network to collect identical pattern transitions in the orbit dynamics into a system of neighborhoods in the network. The effectiveness of this approach is demonstrated through its application to several high-dimensional hyperchaotic systems, where it outperforms both the linear first-order and other network-based methods in terms of prediction accuracy and horizon. Besides enhancing the predictability of chaotic systems, this methodology also outlines a procedure to develop a discrete model flow within an attractor.

Background: We studied the prevalence and incidence of type 2 diabetes (T2DM) and its associated risk factors in younger (20 and 39 years) and older individuals (≥40 years) over a 10-year period., Methods: Epidemiological surveys in 2006 (n = 7066) and 2016 (n = 9848) were conducted in similar urban and rural locations of southern India among people aged ≥20 years. Diagnosis of T2DM was made using World Health Organization criteria. Self-reported diabetes was verified from medical records. Age and gender standardized prevalence and incidence rates, percentage change in obesity, hypertension, and dyslipidemia were calculated. Prevalence ratios (PR) were calculated using Poisson regression analyses. Primary study was registered on www., Clinicaltrials: gov. Identifier: NCT03490136., Results: In 10 years, the prevalence of T2DM increased in younger (7.8% vs. 4.5%, p < 0.0001) and older individuals (34% vs. 28.4%, p < 0.0001). After adjusting for age, family history of diabetes, and waist circumference, younger individuals showed a higher percentage increase in prevalence than the older group (PR = 1.36 [95% confidence interval [CI], 1.14-1.62], p = 0.001) versus (PR = 1.11 [95% CI, 1.02-1.20], p = 0.02). Increase in rates of obesity and dyslipidemia was also higher in the younger than in the older individuals. In 10 years, incidence of T2DM increased by 120% (1.1% vs. 0.5%, p < 0.0001) and 150% (5% vs. 2%, p < 0.0001) in the younger and older individuals, respectively., Conclusions: Higher percentage increase in prevalence of T2DM was seen among younger individuals over a 10-year period. Obesity and family history of diabetes were shown to be the primary contributing factors for the rise in prevalence., (© 2024 The Author(s). Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)

Aims: We aimed to compare the effectiveness of Glargine plus Glulisine to premixed insulin analogue, as measured by HbA1c ≤ 7.0% in insulin naive Type 2 Diabetes (T2D) patients with elevated fasting and/or postprandial plasma glucose., Methods: Insulin-naive T2D patients (116 men, 84 women) on ≥ 2 oral hypoglycemic agents with inadequate glycemic control were randomized either to group 1 (insulin Glargine plus Glulisine, n = 101) or group 2 (Premixed Insulin analogue, n = 99)., Results: In the intention to treat analysis, at week 24, percentage of patients with good glycaemic control (HbA1c ≤ 7.0%) was similar between the two groups (16.8% in Group 1 vs. 13.1% in Group 2, χ2 - 0.535, p = 0.47). Significant reductions in fasting and postprandial levels were observed in groups 1 and 2 at both post-baseline time points (Week 12 and 24). In group 1, reduction in HbA1c from baseline to week 12 was 0.6 ± 0.1 and 0.7 ± 0.2 at week 24, p < 0.0001 for all. In group 2, no significant change in HbA1c was observed. In group 1, 83.2% required an additional dose of glulisine and in group 2, 88.9% required an additional dose of premixed insulin. Hypoglycemic events were similar in both groups (0.12 events per person-year in group 1 and 0.13 events per person-year in group 2). Weight gain was non-significant in both groups., Conclusions: Glargine plus Glulisine, though in higher dose was effective as premixed insulin in lowering HbA1c. Hypoglycemic events per person-year were similar in both groups., Competing Interests: Declaration of Competing Interest On behalf of all authors I, Professor Ambady Ramachandran declare that there is no conflict on interest in the preparation of the manuscript., (Copyright © 2024 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

The sorting of deforming capsules of varying stiffnesses is a challenging problem that finds applications in areas such as the pharmaceutical and food industries. Recent studies have shown that various flow configurations can be used to segregate the capsules. A lack of inertia in the microchannels makes the design of such devices extremely challenging. In this context, we propose a sorting device, which consists of capsules going through a tapered slit section. Using numerical simulations, we show that the proposed device is able to achieve significant levels of sorting with a compact setup. The design parameters can be conveniently adjusted, thus making it easier to extend the use of the device to a large range of stiffnesses.

COVID-19 pandemic is the main outbreak in the world, which has shown a bad impact on people's lives in more than 150 countries. The major steps in fighting COVID-19 are identifying the affected patients as early as possible and locating them with special care. Images from radiology and radiography are among the most effective tools for determining a patient's ailment. Recent studies have shown detailed abnormalities of affected patients with COVID-19 in the chest radiograms. The purpose of this work is to present a COVID-19 detection system with three key steps: "(i) preprocessing, (ii) Feature extraction, (iii) Classification." Originally, the input image is given to the preprocessing step as its input, extracting the deep features and texture features from the preprocessed image. Particularly, it extracts the deep features by inceptionv3. Then, the features like proposed Local Vector Patterns (LVP) and Local Binary Pattern (LBP) are extracted from the preprocessed image. Moreover, the extracted features are subjected to the proposed ensemble model based classification phase, including Support Vector Machine (SVM), Convolutional Neural Network (CNN), Optimized Neural Network (NN), and Random Forest (RF). A novel Self Adaptive Kill Herd Optimization (SAKHO) approach is used to properly tune the weight of NN to improve classification accuracy and precision. The performance of the proposed method is then compared to the performance of the conventional approaches using a variety of metrics, including recall, FNR, MCC, FDR, Thread score, FPR, precision, FOR, accuracy, specificity, NPV, FMS, and sensitivity, accordingly., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Elsevier Ltd. All rights reserved.)

Heart disease causes major death across the entire globe. Hence, heart disease prediction is a vital part of medical data analysis. Recently, various data mining and machine learning practices have been utilized to detect heart disease. However, these techniques are inadequate for effectual heart disease prediction due to the deficient test data. In order to progress the efficacy of detection performance, this research introduces the hybrid feature selection method for selecting the best features. Moreover, the missed value from the input data is filled with the quantile normalization and missing data imputation method. In addition, the best features relevant to disease detection are selected through the proposed hybrid Congruence coefficient Kumar-Hassebrook similarity. In addition, heart disease is predicted using SqueezeNet, which is tuned by the dwarf mongoose optimization algorithm (DMOA) that adapts the feeding aspects of dwarf mongoose. Moreover, the experimental result reveals that the DMOA-SqueezeNet method attained a maximum accuracy of 0.925, sensitivity of 0.926, and specificity of 0.918., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 S. Balasubramaniam et al.)

Aims: We studied the outcome of glycaemic management using Diahome, a smart-phone application compared to conventional treatment. Overall acceptability of the application among users was also assessed., Methods: This is a retrospective, case-control study of patients on virtual diabetes care using the Diahome app (n = 441) and those visited the hospital out-patient services (n = 446) between April and June 2021. Men and women aged 45-60 years with type 2 diabetes (T2DM) were selected., Results: A total of 173 records with initial and follow-up visits were analyzed (app users n = 91, non-app users n = 82). Participants were aged 59 ± 12 years and were obese. The two groups were similar by age, gender distribution and duration of T2DM. Fasting blood glucose significantly reduced only among the app-users from a baseline level of 156 ± 70 mg/dl to 129 ± 40 mg/dl at follow-up (p < 0.02). Reduction in HbA1c levels was observed in both groups (p < 0.0001); percentage improvement was better among app (15.8%) than in non-app users (10.4%), p = 0.004. Triglycerides level were higher at both time points among app-users (p < 0.05) as compared to the other group. More than 56% of the users rated the performance of Diahome app as excellent; virtual consultation was rated the highest (71.5%) among the Diahome services., Discussion: Glycaemic management of diabetes using a dedicated mobile application was superior to in-person hospital visits. Its long-term effectiveness and cost savings need to be ascertained., Competing Interests: Competing interests None to declare., (Copyright © 2022. Published by Elsevier Ltd.)

Background and Aims: Association of serum and salivary adiponectin, apelin, visfatin and vaspin were studied in type 2 diabetes (T2DM) among Asian Indians. Their concentrations in periodontitis were also studied., Methods: In this cross-sectional analysis, men and women aged ≥35 years, with no history of diabetes, were screened for ≥3 risk factors for T2DM (n = 615). Eligible persons underwent a 75 gm oral glucose tolerance test and were categorized as Group A (Normal and Impaired Glucose Tolerant, n = 65) and Group B (Incident T2DM, n = 25). Screening for periodontitis was done. Saliva samples were collected in the morning. Participants refrained from food intake for about 2 hours prior to collection . Serum and saliva were stored for analysis., Results: Serum adiponectin was low (p = 0.006) in T2DM and correlated with its salivary levels (r = 0.46, p < 0.001). Serum apelin levels were similar, but salivary concentrations were higher (p = 0.014) in T2DM. Higher serum (p = 0.016) and salivary (p = 0.03) visfatin levels were seen in T2DM. Vaspin levels showed no significant difference in the two groups, either in blood or saliva. Serum adipokines did not differ in the presence of periodontitis. In saliva, higher vaspin (p = 0.034) and lower visfatin (p = 0.018) concentrations were observed., Conclusions: The selected adipokines were measurable in saliva, in lower concentrations. Salivary adiponectin and visfatin measurements may be useful in studies on T2DM., Competing Interests: Declaration of competing interest No potential conflicts of interest relevant to this article were reported., (Copyright © 2022 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Aims: To study the concordance in the incidence of type 2 diabetes (T2DM) between cohorts with prediabetes, selected either by oral glucose tolerance test (OGTT) or glycosylated haemoglobin (HbA1c) at two years in a real world situation., Methods: Two cohorts with impaired glucose tolerance (IGT) were selected from the non-interventional arm of the Indian diabetes prevention programmes; a group selected by using OGTT (Cohort 1, n = 498), another selected based on the HbA1c criterion (Cohort 2, n = 504). Clinical and biochemical data collected for 24 months at 6 monthly intervals were used in assessing the cumulative incidence of T2DM using the respective diagnostic criteria. Intra and inter group comparisons were analysed using appropriate statistical tests. A multiple logistic regression analysis was used to identify the variables significantly associated with the incidence of diabetes., Results: Incidence of diabetes in both cohorts were similar at 12 and 24 months with either of the two criteria (25.3% with glucose and 27.5% with HbA1c, p = 0.41 at 24 months). The multivariate analysis confirmed the results. Only baseline waist circumference was positively associated with the incidence., Conclusion: Both OGTT and HbA1c have similar utility and validity in identifying persons with IGT. Persons identified with either of the criterion had similar incidence of T2DM among Asian Indians., (Copyright © 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

The classical surrogate data tests, which are used to differentiate linear noise processes from nonlinear processes, are not suitable for nonstationary time series. In this paper, we propose a surrogate data test that can be applied on both stationary time series as well as nonstationary time series with short-term fluctuations. The method is based on the idea of constructing a network from the time series, employing a generalized symbolic dynamics method introduced in this work, and using any one of the several easily computable network parameters as discriminating statistics. The construction of the network is designed to remove the long-term trends in the data automatically. The network-based test statistics pick up only the short-term variations, unlike the discriminating statistics of the traditional methods, which are influenced by nonstationary trends in the data. The method is tested on several systems generated by linear or nonlinear processes and with deterministic or stochastic trends, and in all cases it is found to be able to differentiate between linear stochastic processes and nonlinear processes quite accurately, especially in cases where the common methods would lead to false rejections of the null hypothesis due to nonstationarity being interpreted as nonlinearity. The method is also found to be robust to the presence of experimental or dynamical noise of a moderate level in an otherwise nonlinear system.

To study the association and possible predictive role of visfatin, resistin, fetuin-A and chemerin with incident type 2 diabetes (T2DM) among Asian Indians with prediabetes. Their association with insulin resistance, β-cell function, glycaemia and anthropometry were also studied. This is a nested case-control study of a large 2-year prospective prevention trial in persons at high risk of developing T2DM. Baseline HbA1c values between 6.0% (42 mmol/mol) and 6.2% (44 mmol/mol) were chosen for this analysis (n = 144). At follow-up, persons with incident T2DM (HbA1c ≥ 6.5%, 48 mmol/mol) were grouped as cases (n = 72) and those reverted to normoglycaemia, (HbA1c < 5.7% (39 mmol/mol) as controls (n = 72). Insulin resistance showed the strongest association with incident T2DM ((Odds Ratio (OR): 23.22 [95%CI 6.36-84.77]; p < 0.0001). Baseline visfatin (OR: 6.56 [95%CI 2.21-19.5]; p < 0.001) and fetuin-A (OR: 1.01 [95%CI (1.01-1.04)]; p < 0.0001) independently contributed to the conversion of prediabetes to T2DM. The contribution was significantly higher when their elevated levels coexisted (OR: 12.63 [95%CI 3.57-44.63]; p < 0.0001). The area under the curve was 0.77 ± SE 0.4 (95%CI 0.69-0.85) and 0.80 ± SE 0.04 (95%CI 0.73-0.88) for visfatin (median 17.7 ng/ml, sensitivity and specificity: 75%, p < 0.0001) and fetuin-A (mean 236.2 µg/ml, sensitivity: 71%, specificity: 75%, p < 0.0001) respectively. Higher baseline visfatin and fetuin-A concentrations are strongly associated with incident T2DM and are predictive of future diabetes., (© 2021. The Author(s).)

Aims: To study changes in cardiovascular (CV) risk factors; hypertension (HTN), dysglycaemia (DG) and dyslipidaemia (DL) and their interrelationship, in urban and rural Southern India, in a decade., Methods: Epidemiological data of a city (Chennai, n = 2192(2006), n = 3850(2016)) and peri-urban villages (Panruti, n = 2584 (2006), n = 2468 (2016)) among persons aged ≥ 20 years in 2006 and in 2016 were analysed. Age-standardized prevalence, prevalence ratios and interrelationships of HTN, DG and DL and effect of time in years, age, gender and obesity were calculated using Poisson regression analyses., Results: Response rates in urban and rural areas were 86.5% and 87.6% respectively. Mean age, general obesity (GO), abdominal obesity (AO), total calories and carbohydrate intake increased in both populations (p < 0.0001). Rural population had lower BMI than the urban but had higher AO, particularly among women. Physical activity decreased only in the urban population. HTN increased in urban population; in both, proportion of known HTN decreased, DG and DL increased., Conclusions: In both populations, GO, AO, DG and DL increased; AO and DL were more common among rural women. HTN did not increase in the rural population. The risk factors increased rapidly even in rural areas projecting the impact of urbanisation on the CV burden., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background and Aims: We studied the profile and outcome of patients hospitalized for coronavirus disease-19 (COVID-19) infection with and without type 2 diabetes (T2DM)., Methods: In this observational study, clinical details of patients with COVID-19, identified by Reverse Transcription - Polymerase Chain Reaction admitted to 4 hospitals in Chennai, Tamil Nadu, India were collected from May to November 2020. A total of 845 (n = 423 with diabetes, n = 422 without diabetes) were selected for the analysis. Clinical details, biochemical and radiological investigations, diabetes treatment, intensive care, mortality and other adverse outcomes were recorded. Patients with clinical history of T2DM, glycosylated haemoglobin (HbA1c) of ≥6.5% (48 mmol/mol) and/or random blood glucose ≥200 mg/dl (11.1 mmol/l) were included. Statistical analyses were done using chi-square or 't' test and multiple logistic regression analysis., Results: At admission, patients with T2DM were older (p < 0.0001), had higher co-morbidities such as coronary artery disease (p = 0.02), hypertension (p < 0.0001), hypothyroidism (p = 0.03) and renal disorders (p = 0.01) than non-diabetes persons. Requirement for intensive care was higher among them. Acute renal injury or failure, pneumonia and myocardial infarction developed in higher percentage of T2DM. Mortality was significantly higher in T2DM (10.2% vs 5.9%, p = 0.02). However, in the multiple logistic regression analysis, only age (p < 0.0001) and renal disorders (p = 0.002) were significantly associated with mortality., Conclusion: Our study showed that mortality was associated with higher age and renal disorders but did not show an association with diabetes, among patients hospitalized for COVID-19 infection., Competing Interests: Declaration of competing interest On behalf of all authors I, Professor Ambady Ramachandran declare that there is no conflict on interest for the authors in the preparation of the manuscript., (Copyright © 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Graphene has proved to be superior material for its exceptional physicochemical properties. However engineering graphene macroscopic structures by manipulating microscopic structures has faced a great challenge. Towards this here we report a fabrication method of graphene nanofiber by using simple electrospinning method. Fourier transform infrared and Raman spectroscopic characterizations confirmed the transformation from GO to reduced graphene for the nanofiber material. Estimated surface area of this material is as high as 526 m²g -1 with pores having size around 20 nm. Specific-capacitance of these nanofibers for current-density of 1 Ag -1 is 144.2 Fg -1 , which will be useful for the advancement of devices for storing energy.

Background and Aim: Study the changing clinical and therapeutic profiles of type 2 diabetes (T2D) patients during a 10-year period in a diabetes care centre in Southern India., Methods: Retrospective, cross-sectional data of newly registered and review patients at four periods between 2009 and 2018 were analysed (n = 50,322). Clinical findings, anthropometry, blood pressure (BP), glycaemia, lipids, treatment, and co-morbid conditions were analysed. We studied the trends in age and gender distributions, body mass index (BMI), glycaemia, (Glycosylated haemoglobin A1c (HbA1c) levels), BP, cholesterol, triglycerides and therapeutic regimen during this period. Trend analyses were done., Results: Approximately 60% of patients were men. Percentages in 30-40 years increased, ∼60% were aged 50-69 years and proportion of older patients decreased (p < 0.0001). In 10 years, 85.9% was overweight, obesity increased from 22.1% to 25.0% (p < 0.0001) and <13% maintained normal BMI. HbA1c <7.0% remained approximately at 22%, percentage with moderate glycaemic control (HbA1c 7.0-7.9%) increased significantly, HbA1c of ≥9.0% decreased from 35.1% to 29.1% (p < 0.0001). Use of monotherapy decreased. Prevalence of hypertension increased from 16.2% to 21.6% (p < 0.0001); use of Angiotensin Receptor Blockers (ARB) and calcium channel blockers increased, Angiotensin Converting Enzyme Inhibitors and thiazides decreased (p < 0.0001). Increased use of statins paralleled with reduction in total cholesterol and LDLc., Conclusion: Increasing percentages of younger patients and obesity, use of multiple drugs and reduction in HbA1c were the important observations. Rising prevalence of hypertension, increased use of ARB and statins with better control of dyslipidaemia was observed. Achievement of ideal HbA1c and BP were suboptimal., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Purpose: Detection and accurate localization of renal masses (RM) are important steps toward future potential classification of benign vs malignant RM. A fully automated algorithm for detection and localization of RM may eliminate the observer variability in the clinical workflow., Method: In this paper, we describe a fully automated methodology for accurate detection and segmentation of RM from contrast-enhanced computed tomography (CECT) images. We first determine the boundaries of the kidneys on the CECT images utilizing a convolutional neural network-based method to be used as a region of interest to search for RM. We then employ a homogenous U-Net-based ensemble learning model to identify and delineate RM. We used an institutional dataset comprised of CECT images in 315 patients to train and evaluate the proposed method. We compared results of our method to those of three-dimensional (3D) U-Net for RM localization and further evaluated our algorithm using the kidney tumor segmentation (KiTS19) challenge dataset., Results: The developed algorithm reported a Dice similarity coefficient (DSC) of 95.79% ± 5.16% and 96.25 ± 3.37 (mean ± standard deviation) for segmentation accuracy of kidney boundary from 125 and 60 test images from institutional and KiTS19 datasets, respectively. Using our method, RM were detected in 125 and 52 test cases, which corresponds to 100% and 86.67% sensitivity at patient level in institutional and KiTS19 test images. Our ensemble method for RM localization yielded a mean DSC of 88.65% ± 7.31% and 87.91% ± 6.82% on the institutional and KiTS19 test datasets, respectively. The mean DSC for RM delineation from CECT institutional test images using 3D U-Net was 85.95% ± 1.46%., Conclusion: We describe a method for automated localization of RM using CECT images. Our results are important in terms of clinical perspective as fully automated detection of RM is a fundamental step for further diagnosis of cystic vs solid RM and eventually benign vs malignant solid RM, that has not been reported previously., (© 2020 American Association of Physicists in Medicine.)

The work reported in this paper is the first attempt to delineate the molecular or particle dynamics from the thermal lens signal of carbon allotropic nanofluids (CANs), employing time series and fractal analyses. The nanofluids of multi-walled carbon nanotubes and graphene are prepared in base fluid, coconut oil, at low volume fraction and are subjected to thermal lens study. We have studied the thermal diffusivity and refractive index variations of the medium by analyzing the thermal lens (TL) signal. By segmenting the TL signal, the complex dynamics involved during its evolution is investigated through the phase portrait, fractal dimension, Hurst exponent, and sample entropy using time series and fractal analyses. The study also explains how the increase of the photothermal energy turns a system into stochastic and anti-persistent. The sample entropy (S) and refractive index analyses of the TL signal by segmenting into five regions reveal the evolution of S with the increase of enthalpy. The lowering of S in CAN along with its thermal diffusivity (50%-57% below) as a result of heat-trapping suggests the technique of downscaling sample entropy of the base fluid using carbon allotropes and thereby opening a novel method of improving the efficiency of thermal systems.

The photothermal phenomenon resulting in thermal lens formation in liquid media involves complex molecular dynamics responsible for temperature and refractive index variation. As a thermodynamic system, the entropy of the medium also changes. In this paper, the time series and phase portrait analysis of the thermal lens signal is carried out to understand the molecular dynamics. The study reveals the increase in complexity, disorder, and antipersistance nature through fractal dimension, sample entropy, and Hurst exponent, respectively. The analysis of the signal on segmentation reveals the evolution of sample entropy and the stochastic nature of the system with time. The phase portrait analysis also is in support of these observations. Thus, the study suggests that the temporal evolution of sample entropy is similar to the temperature-dependent refractive index.

Aims/hypothesis: This randomised controlled trial was performed in India and the UK in people with prediabetes to study whether mobile phone short message service (SMS) text messages can be used to motivate and educate people to follow lifestyle modifications, to prevent type 2 diabetes., Methods: The study was performed in people with prediabetes (n = 2062; control: n = 1031; intervention: n = 1031) defined by HbA 1c ≥42 and ≤47 mmol/mol (≥6.0% and ≤6.4%). Participants were recruited from public and private sector organisations in India (men and women aged 35-55 years) and by the National Health Service (NHS) Health Checks programme in the UK (aged 40-74 years without pre-existing diabetes, cardiovascular disease or kidney disease). Allocation to the study groups was performed using a computer-generated sequence (1:1) in India and by stratified randomisation in permuted blocks in the UK. Investigators in both countries remained blinded throughout the study period. All participants received advice on a healthy lifestyle at baseline. The intervention group in addition received supportive text messages using mobile phone SMS messages 2-3 times per week. Participants were assessed at baseline and at 6, 12 and 24 months. The primary outcome was conversion to type 2 diabetes and secondary outcomes included anthropometry, biochemistry, dietary and physical activity changes, blood pressure and quality of life., Results: At the 2 year follow-up (n = 2062; control: n = 1031; intervention: n = 1031), in the intention-to-treat population the HR for development of type 2 diabetes calculated using a discrete-time proportional hazards model was 0.89 (95% CI 0.74, 1.07; p = 0.22). There were no significant differences in the secondary outcomes., Conclusions/interpretation: This trial in two countries with varied ethnic and cultural backgrounds showed no significant reduction in the progression to diabetes in 2 years by lifestyle modification using SMS messaging., Trial Registration: The primary study was registered on www.ClinicalTrials.gov (India, NCT01570946; UK, NCT01795833)., Funding: The study was funded jointly by the Indian Council for Medical Research and the UK Medical Research Council.

Aims: The aim of the study was to evaluate the effect of text messaging as a tool to improve glycaemic control among newly diagnosed T2D patients in a 2 year period., Methods: This is a multicentric, randomised controlled trial conducted in 2 states of India. The primary outcome was improvement in glycaemia measured by an HbA1c value of ≤7% (53 mmol/mol) with intervention. The secondary outcomes were changes in biochemical, dietary parameters and physical activity. Acceptability of text messages was assessed. Persons having HbA1c value of ≥6.5% (48 mmol/mol) at diagnosis were enrolled. A total of 248 participants with a mean age of 43.3 ± 8.7 years were recruited. Participants in the control group (n = 122) received standard care, the intervention group (n = 126) received customized text messages thrice a week. Both groups received personal advice at the beginning of the study., Results: Baseline characteristics were similar in both groups. At 24 months, both groups showed significant reduction in blood pressure and glycaemic variables in comparison to the baseline values. The intervention group showed significant lowering of LDLc also. Multivariate analysis showed that reduction in HbA1c was associated with intervention., Conclusion: Text messaging can lead to improvement in glycaemic control through personal empowerment and sustained behavioural changes., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: The objective of the current study was to assess the secular trends in the prevalence of diabetes, prediabetes, and risk factors from two epidemiological surveys done 10 years apart in three adult populations of different geographic and socioeconomic backgrounds in Tamil Nadu, India., Research Design and Methods: This survey was conducted in 2016 using methodology similar to that used in 2006. Persons aged ≥20 years ( n = 9,848) were screened for diabetes, prediabetes, and the risk variables. Fasting and 2-h plasma glucose, lipid profile, blood pressure, anthropometry, and socioeconomic and behavioral details were recorded. Comparative analyses of age-standardized prevalence were done. Prevalence ratios (PRs) between 2016 and 2006 of diabetes and also prediabetes were assessed using Poisson regression analyses., Results: Prevalence of diabetes increased from 18.6% (95% CI 16.6-20.5) to 21.9 (20.5-23.3) in the city, 16.4 (14.1-18.6) to 20.3 (18.9-21.6) in the town, and 9.2 (8.0-10.5) to 13.4 (11.9-14.8) in the periurban villages (PUVs) ( P < 0.0001 in all). The PR showed a nonsignificant 8% rise in diabetes in the city, while significant increases had occurred in the town (39%) and PUVs (34%). Prevalence of prediabetes also increased. Age, family history of diabetes, and waist circumference were common risk determinants among the populations. Though general obesity and abdominal obesity increased, the latter was associated with the increased prevalence., Conclusions: Prevalence of diabetes and prediabetes increased in all locations; the rise was significant only in the town and PUVs. Abdominal obesity is significantly associated with increased trend even among the villagers. Rural populations may be targeted for future public health measures to combat diabetes., (© 2019 by the American Diabetes Association.)

Aim: The increased morbidity and mortality due to type 2 diabetes can be partly due to its delayed diagnosis. In developing countries, the cost and unavailability of conventional screening methods can be a setback. Use of random blood glucose (RBG) may be beneficial in testing large numbers at a low cost and in a short time in identifying persons at risk of developing diabetes. In this analysis, we aim to derive the values of RBG corresponding to the cut-off values of glycosylated hemoglobin (HbA1c) used to define prediabetes and diabetes., Methods: Based on their risk profile of developing diabetes, a total of 2835 individuals were screened for a large diabetes prevention study. They were subjected to HbA1c testing to diagnose prediabetes and diabetes. Random capillary blood glucose was also performed. Correlation of RBG with HbA1c was computed using multiple linear regression equation. The optimal cut-off value for RBG corresponding to HbA1c value of 5.7% (39 mmol/mol), and ≥ 6.5% (48 mmol/mol) were computed using the receiver operating curve (ROC). Diagnostic accuracy was assessed from the area under the curve (AUC) and by using the Youden's index., Results: RBG showed significant correlation with HbA1c (r=0.40, p<0.0001). Using the ROC analysis, a RBG cut-off value of 140.5 mg/dl (7.8 mmol/L) corresponding to an HbA1c value of 6.5% (48mmol/mol) was derived. A cut-off value could not be derived for HbA1c of 5.7% (39 mmol/mol) since the specificity and sensitivity for identifying prediabetes were low., Conclusion: Use of a capillary RBG value was found to be a simple procedure. The derived RBG cut-off value will aid in identifying people with undiagnosed diabetes. This preliminary screening will reduce the number to undergo more cumbersome and invasive diagnostic testing., Competing Interests: Conflicts of Interest All authors have no conflict of interest to declare.

Objective: This was a 5 year comparative analysis of the incidence of type 2 diabetes in men who had persistent impaired glucose tolerance (P-IGT) versus transient impaired glucose tolerance (T-IGT). P-IGT (positive IGT on two oral glucose tolerance tests (OGTT), T-IGT (IGT in first OGTT and normal glucose tolerance (NGT) in the 2nd OGTT)., Methods: The samples were collected from a randomized controlled diabetes prevention study. The prevention study was done using lifestyle modification (LSM) promoted by use of mobile short message services (SMS) for 2 years. The control group of the randomized study who received advice on LSM at only the baseline formed the P-IGT group for the 3 years follow up study (n=236). T-IGT (n=569) were available from those who had NGT on the 2nd OGTT while screening for the prevention study. The total diabetes incidence at 5 years in the study groups were compared using standard OGTT (WHO criteria)., Results: The conversion rate to diabetes in 5 years was significantly lower among T-IGT than among P-IGT, OR=0.202 (95% CI, 0.145-0.296,p< 0.0001). P-IGT had higher rate of risk factors for diabetes than T-IGT., Conclusion: The risk of conversion to diabetes was 80 percent lower in T-IGT than in P-IGT. Identification of P-IGT will help in selecting persons who require early intervention for diabetes., (© Journal of the Association of Physicians of India 2011.)

Background: Type 2 diabetes is a serious clinical problem in both India and the UK. Adoption of a healthy lifestyle through dietary and physical activity modification can help prevent type 2 diabetes. However, implementing lifestyle modification programmes to high risk groups is expensive and alternative cheaper methods are needed. We are using a short messaging service (SMS) programme in our study as a tool to provide healthy lifestyle advice and an aid to motivation. The aim of the study is to assess the efficacy and user acceptability of text messaging employed in this way for people with pre-diabetes (HbA1c 6.0% to ≤6.4%; 42-47 mmol/mol) in the UK and India., Methods/design: This is a randomised, controlled trial with participants followed up for 2 years. After being screened and receiving a structured education programme for prediabetes, participants are randomised to a control or intervention group. In the intervention group, text messages are delivered 2-3 times weekly and contain educational, motivational and supportive content on diet, physical activity, lifestyle and smoking. The control group undergoes monitoring only. In India, the trial involves 5 visits after screening (0, 6, 12, 18 and 24 months). In the UK there are 4 visits after screening (0, 6, 12 and 24 months). Questionnaires (EQ-5D, RPAQ, Transtheoretical Model of Behavioural Change, and food frequency (UK)/24 h dietary recall (India)) and physical activity monitors (Actigraph GT3X+ accelerometers) are assessed at baseline and all follow-up visits. The SMS acceptability questionnaires are evaluated in all follow-up visits. The primary outcome is progression to type 2 diabetes as defined by an HbA1c of 6.5% or over(India) and by any WHO criterion(UK). Secondary outcomes are the changes in body weight, body mass index, waist circumference, blood pressure, fasting plasma glucose; lipids; proportion of participants achieving HbA1c ≤6.0%; HOMA-IR; HOMA-β; acceptability of SMS; dietary parameters; physical activity and quality of life., Discussion: The study is designed to assess the efficacy of tailored text messaging in addition to standard lifestyle advice to reduce the progression from prediabetes to type 2 diabetes in the two different countries., Trial Registration: ClinicalTrials.gov ; NCT01570946 , 4 th April 2012 (India); NCT01795833 , 21 st February 2013 (UK).

Aims: We had shown that mobile phone based text messaging was an effective tool to deliver lifestyle changes among Asian Indian men with a 36% relative risk reduction in incident diabetes over two years. The present analysis investigated whether beneficial effects of intervention on diabetes prevention persisted for an additional three years after withdrawal of active intervention., Methods: The primary two year randomized controlled trial (2010-2012) compared lifestyle changes with use of automated text messaging reminders in the intervention (n = 271) versus standard care advice (n = 266) at baseline. At the end of the study, both groups received additional advice on lifestyle changes by a trained dietician. Participants free of diabetes (n = 394) were invited three years later to ascertain the sustained effect of intervention. The primary outcome was incidence of type 2 diabetes. This trial is registered with ClinicalTrials.gov,number NCT02848547., Results: During the mean follow-up of 5 years, 346 out of 394 (87.8%) men were reviewed. Incidence of diabetes was reduced by 30% in the intervention group, with declining gap between-group differences over time (Kaplan-Meier analysis). Significant improvement in dietary adherence occurred in the intervention group at 2nd and 5th year follow up (trend χ 2  = 21.35, p < 0.0001). Cox regression analysis showed that the 5th year incidence of diabetes was significantly reduced in the intervention group. Higher body mass index and 2 h plasma glucose at 24 months increased the incidence of diabetes., Conclusions: Sustained reduction in incident diabetes was apparent after cessation of active lifestyle intervention. This was possibly associated with continuing practice of improved lifestyle., (Copyright © 2018 Elsevier B.V. All rights reserved.)

In this article, cerium oxide nanoparticles (CeO2 NPs) and reduced graphene oxide nanocomposite have been fabricated through simple, easy and cost effective co-precipitation method. The structural, optical and morphological characterization provides the evidence of successful synthesis of CeO2 NPs and nanocomposite. X-ray photoelectron spectroscopic characterization provides useful information about the concentrations and proportions of Ce3+ and Ce4+ ions in nanoparticles as well as in nanocomposite. These studies provide an insight to understand enhanced photocatalytic activity of nanocomposite. The nanocomposite produces 81% photocatalytic degradation of methyl orange compared to only 45% degradation by CeO2 NPs alone.

Identification and treatment of individuals with prediabetes is crucial. Effective interventional strategies are key to reducing the diabetes risk at the population level. Lifestyle intervention is found to be more effective but more expensive. Evidence of potential benefits from pharmacotherapy is accumulating. The choice of a pharmacologic intervention to reduce the progression of type 2 diabetes (T2DM) in high risk individuals must consider the balance between the benefit to risk ratio. A meta-analysis of the results of the three important studies has shown that metformin used for up to three years decrease the likelihood of progression to diabetes. Metformin showed greater beneficial effect in people with higher baseline Body Mass Index (BMI) and higher Fasting Plasma Glucose (FPG) than in leaner prediabetic counterparts with low FPG concentrations. Besides diabetes risk reduction, the drug has also proved to be cancer and cardio-protective. The National Institute for Clinical Excellence, UK has recommended the use of metformin in prevention of T2DM in adults at high risk on failure to adhere to lifestyle changes. In view of the long standing safety and tolerability, metformin could be prescribed to people who are unable to comply with lifestyle advice., (© Journal of the Association of Physicians of India 2011.)

Aims: We describe a two-step screening approach using non-invasive risk assessment and glycated hemoglobin (HbA1c) to identify participants for a diabetes prevention trial., Methods: A total of 6030 non-diabetic persons of 35-55 years were screened using risk assessment for diabetes. Those with three or more risk factors were screened using point of care HbA1c test. For this study, participants in HbA1c categories of 6.0% (42.1 mmol/mol)-6.4% (46.4 mmol/mol) were selected and their characteristics were analyzed., Results: Among 6030 persons, 2835 (47%) had three or more risk factors for diabetes. Among those screened with HbA1c, 43.2% (1225) had HbA1c values of <6.0% (42.1 mmol/mol), 46.8% (1327) had HbA1c values between 6.0% (42.1 mmol/mol) and ≤ 6.4% (46.4 mmol/mol) and 10% (283) had undiagnosed diabetes with ≥6.5% (47.5 mmol/mol). Positive family history was present in 53.2%, 81.7% were obese and 14.8% were overweight., Conclusions: Opportunistic screening using a two-step approach: diabetes risk profile and HbA1c measurement detected a large percentage of individuals with prediabetes. Prediabetic persons recruited to the trial had higher percentage of obesity and presence of positive family history than those who had lower HbA1c values. Outcomes from this trial will enable comparisons with the previous prevention studies that used blood glucose levels as the screening criteria., (Copyright © 2015. Published by Elsevier Ireland Ltd.)

Unlabelled: The big data storage is a challenge in a post genome era. Hence, there is a need for high performance computing solutions for managing large genomic data. Therefore, it is of interest to describe a parallel-computing approach using message-passing library for distributing the different compression stages in clusters. The genomic compression helps to reduce the on disk"foot print" of large data volumes of sequences. This supports the computational infrastructure for a more efficient archiving. The approach was shown to find utility in 21 Eukaryotic genomes using stratified sampling in this report. The method achieves an average of 6-fold disk space reduction with three times better compression time than COMRAD., Availability: The source codes are written in C using message passing libraries and are available at https:// sourceforge.net/ projects/ comradmpi/files / COMRADMPI/.

Conducting polymer/inorganic hybrid composites have large surface areas, which makes the adsorbent properties of the polymer composites as good the constituents. Polyaniline/montmorilonite (PANi-MMT) and polypyrrole/montmorillonite (PPy-MMT) composites were prepared, characterized (Fourier transform infrared, scanning electron microscopy, energy dispersive spectroscopy and X-ray diffraction patterns) and were employed as adsorbents for the removal of fluoride ions from aqueous solution by the batch sorption method. The spectral studies of the adsorbents before and after the adsorption are recorded to get better insight into the mechanism of the adsorption process. The results indicated that the removal of fluoride ions from water by these composites occurs via the combined effect of both the constituents, that is, through a physico-chemical mechanism. The amount of fluoride ion adsorbed by PANi-MMT and PPy-MMT at 30 degrees C is observed to be 2.3 and 5.1 mg g(-1), respectively, when compared to 0.77 and 2.66 mg g(-1), respectively, for the polymers alone. The Langmuir, Freundlich and Dubinin-Radushkevich isotherms were used to describe the adsorption equilibrium.

There is a direct correlation between increasing periodontal probing depth and increasing presence of residual biofilms and calculus. One of the more common areas to find postscaling and root-planing residual biofilm and calculus is the cemento-enamel junction (CEJ)--an area that in most cases is easily accessible. Yet few studies have addressed the question of why the CEJ is a potential biofilm and calculus trap. This article discusses the various anatomical relationships of enamel, dentin, and cementum at the CEJ, the role of CEJ anatomy in the retention of biofilm (with SEM photographs as supporting evidence), and the biological and clinical implications of subgingival residual biofilm and calculus.

Evidence-based practice involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognizes that care is individualized and ever-changing and involves uncertainties and probabilities. The specialty of periodontics has abundant high-level evidence upon which treatment decisions can be determined. This paper offers a brief commentary and overview of the available evidence commonly used in the private practice of periodontics.

Background: The purpose of this study was to compare the tensile strengths of commonly used sutures over a 2-week period under simulated oral conditions., Methods: Three suture materials (chromic gut [CG], polyglactin [PG], and polyglactin-fast absorbing [PG-FA]) were used in 4-0 and 5-0 gauges. After pretensioning, 252 suture samples (42 of each material and gauge) were used. A biologic simulation was created in vitro by mixing 9 ml sterile human saliva and human serum in a 1:1 ratio in a petri dish maintained at a pH of 7.4 to 8.1 at 37 degrees C. All samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength was assessed using a microtensile tester, and the maximum load required to cause suture breakage was determined. The point of breakage in the samples and the samples themselves were also assessed., Results: During the first 24 hours of immersion, all 4-0 and 5-0 samples of CG and PG maintained their initial level of tensile strength; PG-FA 5-0 decreased in strength, which was statistically significant (P = 0.001). Between days 1 and 3, the tensile strength of PG and PG-FA decreased significantly, with PG-FA 5-0 showing a greater and more precipitous decrease than PG-FA 4-0; the tensile strength of CG changed little during this time. After 7 days of immersion, PG 4-0 had significantly greater tensile strength than CG, and both were significantly greater than that of PG-FA. By day 10, CG and PG had statistically greater strength (P = 0.01) than PG-FA, and values were similar for the 4-0 and 5-0 gauge materials. All samples of PG-FA 5-0 and most samples of the PG-FA 4-0 exhibited 0.00 N strength (i.e., they had disintegrated) at the 10- and 14-day periods of evaluation., Conclusions: 4-0 sutures are stronger and have greater tensile strength than 5-0 sutures. CG seems to sustain its strength better than PG and PG-FA after 2 weeks. PG-FA may not be a desirable suture if tensile strength is required after 10 days. Appropriately designed clinical studies are necessary to confirm this finding in an in vivo environment.

Background: Maxillary tuberosities have been widely used as a source of autogenous bone for a variety of oral surgical procedures. However, no previous studies have actually demonstrated the histologic and histomorphometric characteristics of this anatomical region in detail. The aim of this study was to evaluate maxillary tuberosities in cadavers histologically and histomorphometrically., Methods: A block section, including the overlying alveolar mucosa, was obtained from a randomly assigned maxillary tuberosity of 20 cadavers (nine females and 11 males). All cadavers were edentulous distal to the second bicuspid teeth, and 14 out of 20 were edentulous distal to the cuspids. A minimum of 35 serial sections were obtained from each cadaver. Description analysis was performed for the presence of either a fibrotic or fatty infiltration of the marrow spaces and thickness and continuity of alveolar bone. Computer-based histomorphometric image analysis of the percentage surface area of bone was also carried out in three sections of each cadaver. Statistical analysis was performed to establish possible differences between genders. The analysis did not control for nutritional status and/or possible systemic or skeletal diseases., Results: Little variation existed between specimens, regardless of gender, with respect to thickness of oral mucosa overlying the tuberosity. Descriptive bone analysis revealed thin cortical bone and sparse cancellous bone patterns. In addition, the block specimens exhibited no evidence of osteoid or active bone formation, but large marrow spaces infiltrated with loosely organized fibrous connective tissue and/or lipid cells. Histomorphometric analysis demonstrated a mean percentage of vital bone of 24.23% +/- 5.2%. Stratification of the data revealed statistically significant differences in mean percentage of vital bone between genders (27.15% +/- 4.7% for males versus 20.66% +/- 3.4% for females; P = 0.003)., Conclusions: Within the limitations of this study, maxillary tuberosities seem to mainly consist of marrow spaces, adipose tissue, and a low vital bone profile. Females demonstrated a statistically significant lower amount of vital bone than males. The results suggest that this specific area may not be an ideal source of autogenous bone for grafting purposes in older individuals. However, it is imperative to note that this investigation did not control for nutritional imbalances and skeletal disorders. Further studies are necessary to control all confounding factors.

Background: The potential of calcium channel blockers (CCBs) to induce gingival enlargement (GE) as well as the influence of diabetes mellitus on periodontal tissues has been well documented. This case report documents a conservative clinical approach to the management of felodipine-influenced gingival enlargement and displays a clinical and histologic case of felodipine-influenced GE in an undiagnosed type 2 diabetic patient., Methods: At the initial examination, a medical consultation was requested and two incisional biopsies were taken for pathological evaluation. The patient was diagnosed with uncontrolled type 2 diabetes. Felodipine was withdrawn and the diabetes was controlled before dental treatment was initiated. The patient then underwent selective extractions and full-mouth scaling and root planing as well as oral hygiene instructions. No surgical therapy was indicated., Results: The histological results demonstrated the presence of elongated rete pegs; fibrous hyperplasia; a low-grade chronic inflammatory infiltrate, predominantly consisting of lymphocytes; and collagen bundle groups randomly distributed. These features were similar to those present in other drug-influenced GE. Clinical results have demonstrated almost complete resolution of GE after the withdrawal of felodipine and the control of diabetes. Further improvements were seen after scaling and root planing and oral hygiene instructions. No recurrences were noted 12 months after initial therapy., Conclusions: This report demonstrated that the control of systemic factors seemed to have the most influence on success for this particular case. Since the control of diabetes was managed at the same time as the felodipine withdrawal, it remains difficult to speculate how these two factors impacted both the severity of the GE and the therapeutic results. More importantly, the conservative treatment rendered demonstrated the stability of periodontal status during maintenance phase and the avoidance of surgical interventions.