Development of sensor system and data analytic framework for non-invasive blood glucose prediction

Periodic quantification of blood glucose levels is performed using painful, invasive methods. The proposed work presents the development of a noninvasive glucose-monitoring device with two sensors, i.e., finger and wrist bands. The sensor system was designed with a near-infrared (NIR) wavelength of 940 nm emitter and a 900-1700 nm detector. This study included 101 diabetic and non-diabetic volunteers. The obtained dataset was subjected to pre-processing, exploratory data analysis (EDA), data visualization, and integration methods. Ambiguities such as the effects of skin color, ambient light, and finger pressure on the sensor were overcome in the proposed 'niGLUC-2.0v'. niGLUC-2.0v was validated with performance metrics where accuracy of 99.02%, mean absolute error (MAE) of 0.15, mean square error (MSE) of 0.22 for finger, and accuracy of 99.96%, MAE of 0.06, MSE of 0.006 for wrist prototype with ridge regression (RR) were achieved. Bland-Altman analysis was performed, where 98% of the data points were within ± 1.96 standard deviation (SD), 100% were under zone A of the Clarke Error Grid (CEG), and statistical analysis showed p < 0.05 on evaluated accuracy. Thus, niGLUC-2.0v is suitable in the medical and personal care fields for continuous real-time blood glucose monitoring.

Profile of 10,935 elderly patients attending the geriatrics department of a medical college: A retrospective study from South India

Introduction

Globally, the elderly population is growing at a rate of 2.6% per year. Understanding the health profile and healthcare needs of the elderly is important. The elderly is the most vulnerable and high-risk groups in terms of health status. Their healthcare-seeking behaviour is crucial in any society. There is a need to generate awareness among the public, politicians, and policymakers regarding multiple issues related to the ageing population in the country.

Objective

To know the health profile and health-related problems of geriatric patients visiting the department of geriatrics at a medical college.

Methodology

A five-year retrospective analysis of medical records of patients visiting the department of geriatrics from 4 September 2016 to 4 September 2021 was done using Microsoft Excel software and IBM SPSS Statistics. All records in that duration were reviewed and included.

Results

Descriptive statistics of medical and dental problems of geriatric patients were recorded. The association of medical and dental problems with gender was assessed.

Conclusion

A majority of geriatricians are unaware of oral health problems. Medical-dental collaboration is inadequate and should be improved in geriatrics.

Cross-cultural Adaptation of Oral and Maxillofacial Frailty Assessment Tools for Geriatric Population of Kerala

AIM

The aim of this study is to translate the oral and maxillofacial frailty index (OMFI) into Malayalam, culturally adapt it, and test its reliability and validity in the Kerala geriatric population.

MATERIALS AND METHODS

OMFI was translated, culturally adapted, and validated in Malayalam using a methodological and cross-sectional study design. The Malayalam version of OMFI underwent full linguistic validation and was tested on 200 patients at Amritakripa Hospital in Kalpetta. Principal component analysis with varimax rotation was used for exploratory factor analysis, and Cronbach's alpha was used to assess reliability.

RESULTS

Two-hundred patients were recruited in this study. Participants ranged in age from 60 to 83 years; mean age was 68 years (SD: 15.21). In total 55.5% were male participants, and 30.5% were belonging to upper middle class as per the Kuppuswami scale. Only 12% of the participants were living alone. Kaiser-Meyer-Olkin was found to be 0.583, and Bartlett's test of sphericity was significant with a Chi-square test value of 1003.469. A principal axis factor analysis conducted on 20 items with orthogonal rotation (varimax). OMFI Malayalam version (5 items) had a good internal consistency (Cronbach's alpha = 0.751). Item-total correlations were reviewed for the items of OMFI.

CONCLUSION

The OMFI Malayalam version demonstrated acceptable validity and reliability and can be used to screen the oral frailty of the geriatric population in Kerala.

CLINICAL SIGNIFICANCE

As Kerala is having highest geriatric population in India, we need to assess the oral frailty burden of Kerala. This study provided the first measure to assess the oral frailty in elderly in Kerala.

Analysis of neuropathological comorbid conditions in elderly patients with mild cognitive impairment in a tertiary care center in South India

Introduction:

Mild cognitive impairment (MCI) is a transitional stage in the continuum of cognitive decline. Multiple risk factors may be involved apart from neuropathological states such as Alzheimer’s disease, Parkinson’s disease, and vascular dementia. There is scant data in the literature pertaining to our study population in Kerala, South India that provide associations between suggested risk factors and MCI. Most of the elderly present to family and primary care physicians with complaints of some form of memory impairment.

Objectives:

To find out the significant neuropathological comorbid conditions present in elderly patients with MCI. To assess for other risk factors in the same population- including laboratory parameters, comorbidities, and psychosocial parameters.

Methods:

This retrospective record-based study included a sample of 93 patients with MCI as quantified by the Mini-Mental Status Examination (MMSE). These subjects were compared with controls (n = 97) without MCI, with respect to neuropathological diagnoses, laboratory parameters and psychosocial parameters.

Results:

The findings of our study were that female gender, higher depression scores, a greater number of medications taken, benzodiazepine use, higher alkaline phosphatase levels, positive fall history, loss of a spouse, and lower levels of education were associated with MCI. MCI is negatively associated with positive alcohol history. The most commonly seen proven neuropathological diagnosis was Parkinson’s disease.

Conclusion:

The risk factors that were found in our study should be highlighted in the elderly and preventive measures should be taken to prevent the downward progression through the cognitive continuum. Prospective studies looking into mild cognitive impairment with better screening tools and proper assessment of neuropathological comorbid conditions can further elucidate the findings related to this study.

A study of medication compliance in geriatric patients with chronic illness

Introduction

Adherence is a multifactorial phenomenon. Usually geriatric patients will have multiple co morbidities because of which poly pharmacy results. This can adversely affect medication compliance. The purpose of our study is to identify various factors responsible for low medication compliance. Elderly people are usually affected with chronic illnesses like Hypertension, Diabates Mellitus, Dyslipidemia, Coronary artery diseases, Osteoarthritis, etc., All these diseases require long-term treatment. So, medication compliance is a very important factor which increases therapeutic outcome.

Materials and Methods

The study subjects were assessed by using 15 item structured questionnaires as per indigenously modified Morisky Medication Adherence Scale (MMAS).

Results

A total of 100 patients of geriatric age group were assessed for the level of compliance for long term medication. The compliance level was assessed by providing a 15-item structured questionnaire as per indigenously modified MMAS. The level of compliance was high in 82%, medium in 16% and low in 2% in the first visit. The level of compliance was again assessed during next review visit. The level of score during review visit was high in 74%, medium in 25% and low in 1%.

Conclusion

The compliance to medication is adversely affected by complicated regimes, ignorance about the disease and complications, physical and economic problems. Geriatric patients especially have a tendency to stop taking drugs off their own when they consider their symptoms have been ameliorated. This can hinder the expected improvement in adherence in the review visit.

Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India

OBJECTIVES

There is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence of falls and associated risk factors among free living elderly population from Kerala, India.

DESIGN

Prospective cohort study with stratified random cluster sampling.

SETTING

The study location was Ernakulam, Kerala, India, and we collected information via house visits using a questionnaire. During the research, the subjects were followed up prospectively for 1 year by phone at intervals of 3 months and missing subjects were contacted by house visits.

PARTICIPANTS

Community-dwelling elderly above 65 years of age.

RESULTS

We recruited a total of 1000 participants out of which a total of 201 (20.1%) subjects reported a fall during the follow-up. The incidence rate of falls was 31 (95% CI 27.7 to 34.6) per 100 person-years. Female sex (OR 1.48, 95% CI 1.05 to 2.10, p=0.027), movement disorders including Parkinsonism (OR 2.26, 95% CI 1.00 to 5.05, p=0.048), arthritis (OR 1.48, 95% CI 1.05 to 2.09, p=0.026), dependence in basic activities of daily living (OR, 3.49, 95% CI 2.00 to 6.09, p<0.001), not using antihypertensive medications (OR, 1.53, 95% CI 1.10 to 2.13, p=0.012), living alone during daytime (OR 3.27, 95% CI 1.59 to 6.71, p=0.001) and a history of falls in the previous year (OR, 2.25, 95% CI 1.60 to 3.15, p<0.001) predicted a fall in the following year.

CONCLUSIONS

One in five community-dwelling senior citizen fall annually and one in four who fall are prone to fall again in the following year. Interventions targeting falls among the elderly need to focus on modifiable risk factors such as living alone during daytime, movement disorders, arthritis and dependence on basic activities of daily living.

Gastric Antral Vascular Ectasia: An Uncommon Cause of Anemia in the Elderly

Gastric antral vascular ectasia (GAVE), also referred to as “watermelon stomach,” is an uncommon, under-reported, yet significant cause of acute or chronic gastrointestinal blood loss in the elderly. It accounts for about 4% of the nonvariceal upper GI bleeds, and diagnosis is established by the demonstration of characteristic watermelon stripes on upper GI endoscopy. The exact cause is unknown but is often associated with many systemic conditions and characterized by chronic anemia. With this case, we wish to emphasize the need to do upper GI endoscopy in all elderly patients undergoing anemia evaluation and to consider this possibility even in the very elderly individuals.

Characterization of a Novel POU1F1 Mutation Identified on Screening 160 Growth Hormone Deficiency Patients

The objective of the study is the functional characterization of a novel POU1F1 c.605delC mutation in combined pituitary hormone deficiency (CPHD) and to report the clinical and genetic details of 160 growth hormone deficiency patients. Screening of GH1, GHRHR, POU1F1, PROP1, and HESX1 genes by Sanger sequencing was carried out in 160 trios and 100 controls followed by characterization of the POU1F1 c.605delC mutation by expression studies including site directed mutagenesis, co-transfection, protein degradation, and luciferase assays to compare the wild type and mutant POU1F1. In vitro studies showed that the POU1F1 c.605delC mutation codes for a truncated protein with reduced transactivation capacity on its downstream effectors, viz., growth hormone (GH) and prolactin (PRL) causing severe CPHD. Experiments using different protease inhibitors reveal rescue of the protein upon blockage of the lysosomal pathway that might be useful in novel drug designing using targeted approach thereby maintaining the milieu and preventing/delaying the disease. The study provides an insight into the disease causing mechanism of POU1F1 c.605delC mutation identified in a CPHD child with severe short stature and failure to thrive. It also shows mutation effect on the expression, function and turnover of protein and highlights mechanistic details by which these potent regulators may operate.

A Dependable Time Series Analytic Framework for Cyber-Physical Systems of IoT-based Smart Grid

With the emergence of cyber-physical systems (CPS), we are now at the brink of next computing revolution. The Smart Grid (SG) built on top of IoT (Internet of Things) is one of the foundations of this CPS revolution, which involves a large number of smart objects connected by networks. The volume of time series of SG equipment is tremendous and the raw time series are very likely to contain missing values because of undependable network transferring. The problem of storing a tremendous volume of raw time series thereby providing a solid support for precise time series analytics now becomes tricky. In this article, we propose a dependable time series analytics (DTSA) framework for IoT-based SG. Our proposed DTSA framework is capable of providing a dependable data transforming from CPS to the target database with an extraction engine to preliminary refining raw data and further cleansing the data with a correction engine built on top of a sensor-network-regularization-based matrix factorization method. The experimental results reveal that our proposed DTSA framework is capable of effectively increasing the dependability of raw time series transforming between CPS and the target database system through the online lightweight extraction engine and the offline correction engine. Our proposed DTSA framework would be useful for other industrial big data practices.

Spectroscopic investigation and computational studies on the interaction of Acriflavine with various estrogens

The fluorescence quenching of Acriflavine (AFN) by certain estrogens was examined in aqueous media by employing steady state and time-resolved fluorescence measurements. The absorption spectra of AFN change with significant bathochromic shift in presence of quencher molecules. The quenching behavior was examined by correlating the bimolecular quenching rate constant (k_q) with the free energy change (ΔG). The decrease in quenching rate constant depends on the increase in oxidation potential of quencher molecules. The fluorescence quenching experiments were carried out in different solvents of varying polarities and reveals the possibility of charge transfer quenching mechanism. Lifetime measurements indicate static quenching. The quenching behavior is addressed from bond dissociation enthalpy (BDE) calculations. The antioxidant activity of estrogen compounds were evaluated by deoxyribose oxidation assay.

Nth Order Binary Encoding with Split-Protocol

To cope up with the Big Data explosion, the Nth Order Binary Encoding (NOBE) algorithm with the Split-protocol has been proposed. In the earlier papers, the application Split-protocol for security, reliability, availability, HPC have been demonstrated and implemented encoding. This technology will significantly reduce the network traffic, improve the transmission rate and augment the capacity for data storage. In addition to data compression, improving the privacy and security is an inherent benefit of the proposed method. It is possible to encode the data recursively up to N times and use a unique combination of NOBE's parameters to generate encryption keys for additional security and privacy for data on the flight or at a station. This paper describes the design and a preliminary demonstration of (NOBE) algorithm, serving as a foundation for application implementers. It also reports the outcomes of computable studies concerning the performance of the underlying implementation.

Genome-wide gene expression pattern underlying differential host response to high or low pathogenic H5N1 avian influenza virus in ducks

The differences in the influenza viral pathogenesis observed between different pathogenic strains are associated with distinct properties of virus strains and the host immune responses. In order to determine the differences in the duck immune response against two different pathogenic strains, we studied genome-wide host immune gene response of ducks infected with A/duck/India/02CA10/2011 and A/duck/Tripura/103597/2008 H5N1 viruses using custom-designed microarray. A/duck/India/02CA10/2011 is highly pathogenic virus (HP) to ducks, whereas A/duck/Tripura/103597/2008 is a low pathogenic (LP) virus strain. Comparative lung tissue transcriptome analysis of differentially expressed genes revealed that 686 genes were commonly expressed, 880 and 1556 genes are expressed uniquely to infection with HP and LP virus, respectively. The up-regulation of chemokines (CCL4 and CXCR4) and IFN-stimulated genes (IFITM2, STAT3, TGFB1 and TGFB3) was observed in the lung tissues of ducks infected with HP virus. The up-regulation of other immune genes (IL17, OAS, SOCS3, MHC I and MHC II) was observed in both infection conditions. The expression of important antiviral immune genes MX, IFIT5, IFITM5, ISG12, β-defensins, RSAD2, EIF2AK2, TRIM23 and SLC16A3 was observed in LP virus infection, but not in HP virus infection. Several immune-related gene ontology terms and pathways activated by both the viruses were qualitatively similar but quantitatively different. Based on these findings, the differences in the host immune response might explain a part of the difference observed in the viral pathogenesis of high and low pathogenic influenza strains in ducks.

ROOT HAIR DEFECTIVE SIX-LIKE4 (RSL4) promotes root hair elongation by transcriptionally regulating the expression of genes required for cell growth

ROOT HAIR DEFECTIVE SIX-LIKE4 (RSL4) is necessary and sufficient for root hair elongation in Arabidopsis thaliana. Root hair length is determined by the duration for which RSL4 protein is present in the developing root hair. The aim of this research was to identify genes regulated by RSL4 that affect root hair growth. To identify genes regulated by RSL4, we identified genes whose expression was elevated by induction of RSL4 activity in the presence of an inhibitor of translation. Thirty-four genes were identified as putative targets of RSL transcriptional regulation, and the results suggest that the activities of SUPPRESSOR OF ACTIN (SAC1), EXOCSYT SUBUNIT 70A1 (EXO70A1), PEROXIDASE7 (PRX7) and CALCIUM-DEPENDENT PROTEIN KINASE11 (CPK11) are required for root hair elongation. These data indicate that RSL4 controls cell growth by controlling the expression of genes encoding proteins involved in cell signalling, cell wall modification and secretion.

Clinical and laboratory profile of dengue in the elderly

Background:

Dengue is the most rapidly spreading mosquito-borne viral disease in the world with a 30-fold increase in incidence in the last 50 years. Approximately, 50 million dengue infections occur annually.

Aim:

To study the various clinical and laboratory manifestations of dengue in the elderly and observe for any variations in IgM titer elevation with progression of age.

Design:

Retrospective observational study.

Subjects and Methods:

Medical charts of all patients admitted to the Division of Geriatrics of the institute during study period were reviewed for collection of demographic, clinical, and laboratory information. The diagnosis of dengue was made based on positive dengue IgM ELISA. An elderly patient referred to one whose age was ≥60 years.

Results:

Fever and myalgia were noted to be the most common clinical manifestation with only four patients presenting with overt bleeding manifestations. Only one patient presented in delirium and there was no case fatality. Thrombocytopenia was the single most common hematological abnormality noted. Hyponatremia was found to be prevalent in a majority of the patients and were symptomatic in more than half of them. There have been very few studies done worldwide on the varied clinical manifestations of dengue in the elderly.

Functional thoracic hyperkyphosis model for chronic subacromial impingement syndrome: an insight on evidence based "treat the cause" concept--a case study and literature review

Recent evidences suggest functional thoracic hyperkyphosis (FTH) could be a different approach in the management of subacromial impingement syndrome (SIS). This case study aims firstly with the development of evidence informed FTH model for SIS. Secondly this study aimed to develop well defined multimodal physical therapy intervention for FTH and its related mechanical consequences in elderly patient with chronic SIS. As a result, Level IV positive evidence was found in both the short and long-term pain and disability of chronic SIS, using FTH model with 26 months of follow-up.

Multimodal physiotherapeutic management for stage-IV osteitis pubis in a 15-year old soccer athlete: a case report

Osteitis pubis among soccer athletes is a disabling painful condition and it is difficult to manage without integrating a multimodal treatment approach. There is limited scientific evidence on the effectiveness of exercise in treating Osteitis pubis especially when it progress to a chronic painful condition. The purpose of this case report is to discuss the successful multimodal physiotherapeutic management for a 15-year old soccer athlete diagnosed with stage-IV Osteitis pubis. Land and water based active core muscle strengthening exercises, Proprioceptive neuromuscular facilitation techniques (PNF) and Manual Therapy are some of the essential components incorporated in multimodal intervention approach with emphasis to water based strength and endurance training exercises. The athlete was able to make progress to a successful recovery from his chronic painful condition and accomplished the clearly established clinical outcomes during each phase of rehabilitation.

Perinatal immunomodulation

The fetus and the neonate are particularly vulnerable to injury caused directly by immunologic mechanisms or inflicted by infectious agents that take advantage of their relatively immature and inexperienced immune system. With increasing survival of high-risk neonates in the surfactant era, prevention/treatment of sepsis and chronic lung disease (CLD) has emerged as an area of priority in neonatal research. Considering the role of inflammatory mediators in the pathogenesis of sepsis and CLD, the clinical application of immunomodulator therapy to neonatology is perhaps more important at present than ever. Advances in molecular biology and immunology have led to development of newer immune modulator therapies that are directed towards specific cells or cytokines rather than resulting in a general suppression of the immune response. Failure of promising, newer immunomodulator therapies in sepsis trials in adults has, however, clearly documented the difficulties in diagnosing/correcting the imbalance between pro- and anti-inflammatory responses. As in the case of sepsis, development of a single magic bullet for prevention/management of a multi-factorial illness like CLD may be difficult, as prevention of prematurity - the single most important high-risk factor for CLD - is an unachievable goal at present. As new frontiers are being explored, older, well-established therapies like antenatal anti-D immunoglobulin prophylaxis continue to emphasize the tremendous potential of immunomodulator therapy in neonatology/perinatology. The current immunomodulators/immunotherapeutic agents with established/potential clinical applications in the perinatal period are reviewed.

When is meconium-stained cord actually bile-stained cord? Case report and literature review

It is reasonable to assume that an umbilical cord stained green is due to the baby having passed meconium in utero. We describe a newborn baby in whom there was a delay in diagnosing an imperforate anus because the baby's umbilical cord was stained green with bile and it was assumed that the baby had passed meconium in utero.

alpha,alpha-Trehalase of Trichoderma reesei

A simple adsorption and elution of the trehalase of Trichoderma reesei on bentonite increased the specific activity 70-80 times, with a recovery of 90%. This alpha,alpha-trehalase has an optimum pH of 4.4, a pl of 5.7, a Km of 3.1 X 10(-3) M, and a specific activity of 50 mumol/mg. min-1.

beta-Glucosidase: microbial production and effect on enzymatic hydrolysis of cellulose

The enzymatic conversion of cellulose is catalyzed by a multiple enzyme system. The Trichoderma enzyme system has been studied extensively and has insufficient beta-glucosidase (EC 3.2.1.21) activity for the practical saccharification of celluose. The black aspergilli (A. niger and A. phoenicis) were superior producers of beta-glucosidase and a method for production of this enzyme in liquid culture is presented. When Trichoderma cellulase preparations are supplemented with beta-glucosidase from Aspergillus during practical saccharifications, glucose is the predominant product and the rate of saccharification is significantly increased. The stimulatory effect of beta-glucosidase appears to be due to the removal of inhibitory levels of cellobiose.