Clinical Utility of a Digital Therapeutic Intervention in Indian Patients With Type 2 Diabetes Mellitus: 12-Week Prospective Single-Arm Intervention Study.

BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) having elevated levels of blood glucose and glycated hemoglobin (HbA1c) are at higher risk of macro- and microvascular complications. Nonetheless, the goal of achieving glycemic control cannot be met with the use of pharmacotherapy alone. The recent emergence of digital therapeutic tools has shown the possibility of improving the modifiable risk factors and self-management of diabetes. OBJECTIVE: The aim of this study was to examine the clinical utility of a digital therapeutic intervention as an add-on therapy to achieve glycemic control in patients with T2DM. METHODS: This was a 12-week prospective, single-arm digital intervention study in patients with T2DM receiving regular antidiabetic treatment. The eligibility criteria included male and female patients with HbA1c≥6.5%, functional English literacy, and a mobile phone capable of running the intervention app. Outcome measures of the study were mean changes in HbA1c, fasting blood glucose (FBG), postprandial blood glucose (PPBG), BMI, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index at the end of 12 weeks. RESULTS: A total of 128 participants completed the study period of 12 weeks. There were 54.7% (70/128) men and 45.3% (58/128) women with a mean age of 48.48 years (SD 10.27). At the end of 12 weeks, the mean change in HbA1c, FBG, PPBG, and BMI for the overall study population was -0.84% (P<.001), -8.39 mg/dl (P=.02), -14.97 mg/dl (P<.001), and -0.24 kg/m2 (P=.06), respectively. Among the participants showing improvement in the HbA1c value at the end of 12 weeks (responders), the mean change in HbA1c, FBG, PPBG, and BMI was -1.24% (P<.001), -12.42 mg/dl (P=.003), -21.45 mg/dl (P<.001), and -0.34 kg/m2 (P=.007), respectively. There was an increase in HOMA-IR values for the overall study population (0.54, P=.29). HbA1c response showed a significant association with a baseline HbA1c level ≥7.5%, no prior history of smoking, and no prior COVID-19 infection, as well as with higher levels of program engagement. CONCLUSIONS: A digital therapeutic intervention when used alongside standard medications significantly reduces HbA1c, FBG, and PPBG levels in patients with T2DM.

Mg3N2-assisted one-pot synthesis of 1,3-disubstituted imidazo[1,5-a]pyridine.

A novel Mg3N2-assisted one-pot annulation strategy has been developed via cyclo-condensation reaction of 2-pyridyl ketones with alkyl glyoxylates or aldehydes, allowing the formation of imidazo[1,5-a]pyridines exclusively with an exellent yield.

Utilizing the iron tolerance potential of Bacillus species for biogenic synthesis of magnetite with visible light active catalytic activity.

Recently, nanomaterial mediated degradation of water polluting industrial pollutant and dyes has become a topic of great interest. This study demonstrates enrichment, isolation, screening and molecular identification of iron tolerant Bacillus species for biosynthesis of iron oxide magnetic nanoparticles (IOMNPs). Synthesis parameters such as 5 mM FeCl3, 7 days of static incubation at 37 °C and slightly alkaline pH range of 7-7.5 were the most optimum conditions. The spectroscopic and imaging studies demonstrated inverse spinel face-centered cubic structure of magnetite with average size of 81.3 nm, polydispersity of 0.343 and zeta potential of -42.49 mV. The specific saturation magnetization value and coercivity Hc of hysteresis loop of 28.1 emu/g and 5.8 Oe respectively confirmed the super-paramagnetic nature of IOMNPs. The comparison of phtotocatalytic activities under UV and visible light irradiation for degrdation of methyl violet, methylene blue, and rhodamine-B indicated that IOMNPs were visible light active photocatalysts. The study of effects of various reaction parameters indicated that catalyst loadings of 500-600 µg/mL, pH 7 and 20 µg/mL initial dye concetration were optimum conditions and reactions at these parameters were also observed to follow pseudo first order kinetics. This study successfully demonstrated the use of iron tolerant bacterium for visible light active, photocatalyst synthesis.

Cerebral and spinal air embolism following percutaneous nephrolithotomy.

We present a case report of cerebral and spinal air embolism following percutaneous nephrolithotomy in a patient without evidence of intra-cardiac defects or prepulmonary A-V shunts. The position of the patient during the incidence determined the site of eventual lodgement of air emboli in the arterial circulation. We suspect that the time of onset of symptoms following the procedure may be the clue to the path followed by air emboli.

Gelation of covalently edge-modified laponites in aqueous media. 1. rheology and nuclear magnetic resonance.

We describe the covalent modification of the edges of laponite with organic groups and the influence of this modification on gelation behavior. We compare three materials: an unmodified laponite, a laponite edge modified with a trimethyl moiety (MLap), and an octyldimethyl moiety (OLap). Gelation is investigated using rheology and NMR T1 relaxation measurements and nuclear Overhauser enhancement spectroscopy (NOESY). MLap and OLap show qualitatively different gelation. Gelation of MLap is very similar to laponite: MLap gels over the same time scale as laponite and has about the same solid modulus, and the MLap gel is almost as transparent as laponite. In contrast, OLap gels rapidly relative to laponite and forms a weak, turbid gel. We believe that gelation in laponite and MLap results from the formation of a network of well-dispersed platelets (or a few platelets), while in OLap, gelation results from a network of stacks of several platelets. NMR relaxation measurements indicate that gelation does not affect the average relaxation of water protons. However, T1 increases marginally for the protons in the organic moieties in MLap and decreases for protons in the organic moieties in OLap. Relaxation measurements, analyses of line width, and NOESY taken together suggest that, in OLap, gelation is a consequence of association of the organic moieties on the laponite edges, and that this association strengthens with time. Thus, the time-dependent changes in NMR suggest a structural origin for the time-dependent changes in the rheological behavior.