Dr. Nitin Shivappa, MBBS, MPH, PhD has collaborated with Dr. James Hébert and other members of the research group at the CPCP to modify and improve the DII®. He has translated his intimate working knowledge of the DII® into established cooperative agreements with over 120 research institutions from all around the world. Their interests in utilizing the DII in research studies with a variety of outcomes range from inflammatory markers to disease end points such as cancer, cardiovascular diseases, and arthritis. These include Harvard University, Columbia University, University of Minnesota, Karolinska Institute, University of Central London, Ghent University, University of Sao Paolo, and University of Queensland, to mention a few. He has worked extensively along with Mr. Thomas Hurley and other members of the CPCP research group in creating the codes that are required to calculate DII®. Dr. Shivappa has a sound knowledge and experience in using statistical software such as SPSS® and SAS®, which was used to develop the scoring algorithm for DII®..