bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Dynamical Erasure of Initial Conditions in Multi-planetary Systems
Authors: Marimbu Kevin , Lee Eve J.
Published: August 2024

Do sub-Neptunes assemble close to where we see them or do they form full-fledged farther away from their host star then migrate inwards? We explore this question using the distribution of measured orbital periods, one of the most fundamental observable parameters. Under disk-induced migration, planet occurrence rate is expected to decrease toward shorter orbital periods. Presently, the observed sub-Neptune period distribution is flat in log period, between 10 and 300 days. We show, using N-body integration, how post-disk dynamical instabilities and mergers in multi-planetary systems erase the initial conditions of migration emplaced in period distributions over 10 s to 100 Myr timescale, in rough agreement with an observational hint of the abundance of resonant pairs for systems younger than 100 Myr which drops dramatically for more evolved systems. We comment on caveats and future work.
Multi-color Photometry of Near-Earth Asteroid (415029) 2011 UL21
Authors: Novaković Bojan
Published: August 2024

BVR photometric series of observations of potentially hazardous asteroid (415029) 2011 UL21 were obtained at the Astronomical Station of Vidojevica around its close approach to the Earth on 2018 July 1. From these observations, the color indices V − R = 0.48 ± 0.07 and B − V = 0.89 ± 0.06 were determined, suggesting R- or S-type taxonomic classification of the object. The observed small lightcurve amplitude suggests a nearly spherical shape of the asteroid.
Successes and Shortcomings of COVID-19 Vaccine Access for Older Americans
Authors: Travers Jasmine L. , Sadarangani Tina , David Daniel
Published: August 2024

Purpose:

To understand perceived facilitators and barriers older adults experienced in accessing coronavirus disease 2019 (COVID-19) vaccines.

Method:

An electronic survey was distributed to older adults and those familiar with experiences of older adults accessing COVID-19 vaccines. Analysis included descriptive statistics and directed content analysis of open-ended responses, guided by the National Institute on Aging Health Disparities Research Framework.

Results:

Most participants (
n
= 294) identified as White (79.5%), 33.8% identified as Hispanic, 8.1% identified as Black, and 12.4% identified as Other. Two thirds of respondents were male (68.6%), and the median age was 67 years. Five key themes emerged:
Availability and Accessibility
,
Information
,
Cost
,
Safety and Side Effects
, and
Sense of Security
.

Conclusion:

Barriers and facilitators to accessing COVID-19 vaccines for older populations paralleled those seen in other demographics. Similar needs likely exist for access to other vaccines and health care in general. Vaccine rollouts, particularly in public health emergencies, must be carried out with care and an awareness of the barriers faced by vulnerable groups. [
Journal of Gerontological Nursing, 50
(9), 12–17.]
Appropriateness of Nursing Home to Emergency Department Transitional Care for Older Adults With Dementia: A Scoping Review
Authors: Wang Huiting , Takiue Keigo , Liu Xiaoji , Koujiya Eriko , Takeya Yasushi , Yamakawa Miyae
Published: August 2024

Purpose:

To systematically identify knowledge patterns and gaps in the appropriateness of nursing home (NH) to emergency department (ED) transitional care for older adults with dementia.

Method:

A systematic search of multiple information sources was performed from July to August 2023 using predesigned search strategies.

Results:

From 13 articles, 54 identified pieces of specific care evidence were grouped into six major care domains: (1)
Resource Support for Assessing Transfer Needs and Patient Status
; (2)
Resource Support, Shared Decision Making, and Early Advance Care Planning
; (3)
Standardized Multimodal Information Transfer
; (4)
Designated ED and NH Transition Coordinators
; (5)
Enhanced Interfacility Collaboration
; and (6)
Appropriate Transitional Care Education, Research, and Policy Beyond the Transfer Interface
.

Conclusion:

A comprehensive, consensus-based body of evidence is lacking. Despite person-centered, standardized, and professional resources supporting transitional care, reorienting NH cultural models remains unclear. Gaps include evidence tailored to diverse participants and contexts. Thus, a focus on policies, education, and research is required. [
Journal of Gerontological Nursing, 50
(9), 37–45.]
Geometric topology of CR-warped products in six-dimensional sphere
Authors: Alhouiti Noura , Mofarreh Fatemah , Alghamdi Fatemah Abdullah , Ali Akram , Laurian Piscoran-Ioan
Published: August 2024

In this paper, we prove that a three-dimensional CR-warped product submanifold of a nearly Kaehler six-dimensional sphere, under some restrictions, contains finite fundamental groups. Using another approach from the theory of eigenvalues and also the gradient of Ricci curvature, we obtain similar results.
Properties and applications of generalized 1-parameter 3-variable Hermite-based Appell polynomials
Authors: Zayed Mohra , Wani Shahid Ahmad
Published: August 2024

We present a novel framework for introducing generalized 3-variable 1-parameter Hermite-based Appell polynomials. These polynomials are characterized by generating function, series definition, and determinant definition, elucidating their fundamental properties. Moreover, utilizing a factorization method, we established recurrence relations, shift operators, and various differential equations, including differential, integrodifferential, and partial differential equations. Special attention is given to exploring the specific cases of 3-variable 1-parameter generalized Hermite-based Bernoulli, Euler, and Genocchi polynomials, offering insights into their unique features and applications.
Unraveling the urban climate crisis: Exploring the nexus of urbanization, climate change, and their impacts on the environment and human well-being – A global perspective
Authors: Das Sumanta , Choudhury Malini Roy , Chatterjee Bhagyasree , Das Pinanki , Bagri Sandeep , Paul Debashis , Bera Mahadev , Dutta Suman
Published: August 2024

The accelerating pace of urbanization, coupled with the intensifying impacts of climate change, poses unprecedented challenges to both the environment and human well-being. In this review, we delved into the intricate interaction between climate change and urbanization and the various effects they have on the environment and human well-being, shedding light on the emergent urban climate crisis. Urban areas serve as epicenters for diverse socio-economic activities, yet they also contribute significantly to global greenhouse gas emissions and environmental degradation. Through an interdisciplinary lens, we explored the root causes of the urban climate crisis, examining how rapid urbanization exacerbates climate change and vice versa. By synthesizing current research and case studies, we elucidate the various environmental and social ramifications of this nexus, ranging from urban heat island effects to heightened vulnerability to extreme weather events. Furthermore, we delve into the unequal distribution of climate risks within urban populations, highlighting the disproportionate burden borne by marginalized communities. Finally, the chapter presents strategies and interventions for mitigating and adapting to the urban climate crisis, emphasizing the imperative of holistic and equitable approaches that prioritize both environmental sustainability and human well-being. Overall, this review calls for concerted efforts to unravel the complexities of the urban climate crisis and forge a path toward resilient, sustainable, and equitable urban futures.
Green Finance Trends
Authors: Bist Shrey , Tiwari Rajesh , Taneja Sanjay , Nakitende Marie G.
Published: August 2024

Green finance plays a crucial role in promoting sustainable development by funding environmentally friendly projects and supporting the transition to a low-carbon economy. This study conducted a bibliometric analysis of 2,138 articles published from 1998 to 2021 to identify key themes and trends in green finance literature. The analysis included co-authorship network analysis, citation analysis, and topic modeling. Results show a significant increase in green finance research since 2015, with major contributions from China and the United States. Future research directions identified include examining green finance's impact on sustainable development and addressing social and environmental inequalities. This study offers valuable insights for stakeholders promoting sustainable development through green finance and guides scholars interested in this research area.
Management at Strategic Level and Sustainability
Authors: Das Saumendra , Patro Udaya Sankar , Panda Tapaswini , Sahoo Sadananda , Badawy Hassan Refaat Hassan
Published: August 2024

This chapter presents a paradigm grounded on data that demonstrates how external factors compel a business to adopt a strategy-oriented approach to sustainably. It also explores how a firm may effectively react to these external factors by integrating durability into its operations. Furthermore, ensuring that the content of a firm's strategic leadership pieces is aligned helps to provide uniformity in the firm's representation of viability to different customers. Authority may perceive the dynamic nature of various external renewable energy drivers with apprehension. However, the system offers them an adaptable and context-specific approach to beneficial managing sustainable development that can be customized to meet the demands of constantly evolving external environmental responsibility drivers.
Design and Development of AI-Powered Healthcare System
Authors: Kovendan A. K. P. , Balaji G. N. , Khatua Srijita , Singh Harmanpreet , Chatterjee Dibyani
Published: August 2024

Cancer patient survival is an integral part of the healthcare sector, with researchers offering clinicians snipping information as they consider treatment options that have a big impact on patients' lifestyle decisions. Evidently, no study of predicting survival or death from breast cancer using XGBoost method has been attempted. The goal of this project is to design a prediction system that can forecast both the survival rate and the death rate from breast cancer at an early stage by examining the most limited collection of clinical dataset variables. The potential of the XGBoost method is determined using mainly age at the time of diagnosis along with other clinical characteristics, assessed for its relative significance. The project findings show that the XGBoost model fits the testing dataset more effectively, with outcome of accuracy 82.72% approximately.
The Use of Artificial Intelligence in Health Communication
Authors: Tanyildizi Nural Imik , Yıldız Ilkay
Published: August 2024

Communication is of great importance in health services. Nowadays, new media, especially the internet, are frequently used in health communication. Artificial intelligence has also begun to be used in healthcare. Artificial intelligence studies generally aim to develop artificial methods that imitate human ways of thinking. In addition, it is predicted that some programs produced based on artificial intelligence will affect health communication processes in daily use. The most important of these programs is the ChatGPT (Chatbot Generative Pre-trained Transformer) program. The purpose of this study is to reveal the benefits and drawbacks of using the ChatGPT program in health communication by providing a qualitative framework. For this purpose, a semi-structured interview was conducted with 30 people over the age of 18, determined by a purposeful sampling method. In line with the data obtained, the use of Chat GPT in health communication was tried to be explained.
Insights Into Waste Management in Semi-Urban Areas
Authors: Venugopal Koppala
Published: August 2024

This research investigates the multifaceted factors influencing waste management practices of the people in suburban areas of the north coastal Andhra Pradesh, India. Adopting a descriptive research design, mixed approaches are employed to gather comprehensive insights. A convenience sampling method is utilized to select participants, and data is collected through self-administered questionnaires, supplemented by primary and secondary data sources. The study employs EFA and multiple regression, along with machine learning techniques for data analysis. Findings reveal the significance of infrastructure availability, population density, socio-economic status, education, cultural norms, government policies, community engagement, technological innovations, and access to recycling facilities, public health concerns, urban planning, and social norms in shaping waste management behaviors. The study provides valuable insights for policymakers, urban planners, and community stakeholders to enhance waste management strategies.
Nursing Students Mental Well-Being During COVID-19 Pandemic
Authors: Tomas Nestor , Munangatire Takaedza , Niikondo Hileni Nangulohi
Published: August 2024

Student well-being is a top priority in higher education policy. However, recent research has shown that at least three out of five adolescents have psychiatric disorders by the age of 21. Nursing students are experiencing high levels of stress as they try to meet their academic demands. Most rapid reviews on mental well-being during COVID-19 have focused on the healthcare workforce, with little attention given to specific groups like nursing students. This review aims to consolidate knowledge and provide actionable evidence on the mental well-being of nursing students during the COVID-19 pandemic. A scoping review was conducted on English articles from various databases, following the PRISMA checklist. The synthesis includes different well-being strategies implemented by nursing students between 2019 and March 2024. This review provides swift evidence and guidance from Cochrane and the World Health Organization on conducting rapid reviews to address the urgent need for policy planning related to nursing student well-being.
Scrutinizing Consumer Sentiment on Social Media and Data-Driven Decisions for Business Insights
Authors: Singh Bhupinder , Kaunert Christian , Malviya Rishabha , Lal Sahil , Arora Manmeet Kaur
Published: August 2024

AI tools have the capability to analyze emotions conveyed in substantial text inputs such as customer reviews or feedback. These algorithms categorize sentiment as positive, neutral or negative which offering valuable insights into customers' sentiments. The manual analysis of extensive text data is both impractical and time-consuming. Business Intelligence, a fundamental aspect of data analytics, encompasses the gathering, analysis and presentation of business information to facilitate strategic decision-making. Traditionally, Business Intelligence tools have played a crucial role in organizing and visualizing historical data, offering insights into past performances. Artificial Intelligence driven by advanced algorithms and machine learning, surpasses the constraints of traditional Business Intelligence by unlocking the ability to predict future trends, behaviors and outcomes. This chapter comprehensively explores the diverse arena of AI and BI for fostering sustainable business growth via analyzing the consumer sentiments on social websites.
A Study on the Interaction Between the Legal Order of Western States and Chinese Sovereignty Before World War I
Authors: Li Yuhong
Published: August 2024

This chapter uses comparative law, based on the primary archives and research articles, to test the reasons for China's national weakness before World War I. Since the 19th century, Western states have extended their international legal order to various parts of the world, forcing non-Western states to join this order. As a field of interaction among Western states, China's sovereignty has been weakened in the process of communication with the West. State sovereignty is supported by state capabilities This chapter attempts to use the global strategy of the UK and Germany (interacting with China) as a case study to analyze the impact of their struggle for international order norms between “hegemonic powers” and “rising powers” on non-Western states. The UK divided China's state capabilities over Shanghai; Germany divided China's sovereignty and governance over Qingdao. The game between Britain and Germany in the international order resulted in China's basic inability to achieve national capabilities before World War I, leading to the degradation of national sovereignty.
A Relational Analysis of Artificial Intelligence, Entrepreneurship, and Some Demographic Variables
Authors: Gürkan Senem , Duran Volkan
Published: August 2024

The aim of this research is to examine the effect of university students' entrepreneurial tendencies on their attitudes towards digital technology according to some variables. In this quantitative research, relational analysis model was conducted to the data obtained from the students of Ondokuz Mayıs University. Individual entrepreneurship orientation scale and attitude scale for digital technology were used as data collection tools. Results indicate no significant gender differences in entrepreneurial tendencies or digital technology attitudes. Two student clusters were identified, highlighting interest in technology as a key differentiator. These findings suggest that both entrepreneurial skills and technological competence should be integrated into higher education curricula to cater to distinct student profiles effectively. Future research should explore the causal mechanisms and variations across different cultural and academic contexts.
The Relationship Between Emotional Intelligence and Artificial Intelligence in Entrepreneurs
Authors: Dinc Ertan
Published: August 2024

Entrepreneurship requires mastery of emotional intelligence and artificial intelligence to build trust, increase customer loyalty, and motivate team management. AI allows entrepreneurs to analyze large data sets, make strategic decisions, and automate routine tasks. The integration of these two can provide a competitive advantage and ensure long-term success. Entrepreneurs often lead in developing breakthrough technologies like Tesla and SpaceX, leveraging AI and emotional intelligence to create flexible, adaptable, and human-centered businesses. However, entrepreneurs must be cautious about ethical and sustainability issues to gain a competitive advantage. This study aims to provide a conceptual perspective on the impact of AI and emotional intelligence on entrepreneurship.
AI-Infused Business Strategies
Authors: Ahmad Munir , Hasan Md Rokibul , Olushola Yuusuf Jamiu , Maqsood Maida
Published: August 2024

The merger of artificial intelligence (AI) and spatial analysis is revolutionizing strategic development. Businesses are wielding the power of geographic information to streamline operations, optimize product placement, and cater directly to customer needs. By analyzing real-world examples like Walmart's and UPS's supply chains, and Kaiser Permanente's healthcare delivery, we've witnessed the profound impact of these technologies. As businesses integrate AI-powered insights from spatial data into their strategies, exciting possibilities for innovation and efficiency emerge. However, unlocking the full potential of these technologies requires navigating challenges related to data accuracy, reliability, and ethical considerations.
An Entrepreneurial Perspective on Industry 4.0 and Industry 5.0
Authors: Taş Ahmet
Published: August 2024

By the late 20th century, information and communication technologies had entered a period of rapid development worldwide. As the use of computers and the internet became widespread on an individual level, businesses also began to leverage computer and internet technologies to increase and enhance their sales and marketing activities. With the emergence of the digital economy concept in the 2000s, and as almost everything began to transition to virtual environments, Industry 4.0 and digital transformation processes came into play. When these technological advancements intersected with entrepreneurial behaviors, a new entrepreneurial activity emerged. It's evident that Industry 4.0 and Industry 5.0 will impact not only businesses and enterprises but also entrepreneurship and marketing, given their influence across nearly every technological aspect. Industry 4.0 already involved the integration of advanced technologies into production efficiency.
Green Cloud Computing and Energy Efficiency
Authors: Singh Priyank Kumar , Misra Sasmita , Mittal Shashank , Kumar Shubham
Published: August 2024

Cloud computing has penetrated the lives of many through the way we process data, manage, and store it. But there are also serious energy usage and environmental issues as a result of this quick expansion. A key paradigm for reducing the negative environmental effects of cloud services is green cloud computing, which emphasizes sustainable practices and increased energy efficiency. Since technology is always developing, new gadgets that potentially have a variety of negative environmental repercussions are being created. The purpose of this study is to evaluate several aspects of green computing. Bibliometric reports of published studies were analysed and the countries in which they were conducted were compared. Analysis was done in the many theme areas where it was stated what the future and present research tendencies in those areas are. The study yielded insightful data that was used to project future research in this field.
Graphene Oxide in Water Treatment From Adsorption to Photocatalysis
Authors: Das Himadri Sekhar , Mishra Santanu , Roymahapatra Gourisankar
Published: August 2024

Graphene group of chemical elements (GO) arose as a promising material for miscellaneous requests in water treatment on account of exceptional physicochemical features. This chapter determines a comprehensive survey of the exercise of graphene oxide in water situation processes, meeting on its uses in adsorption and photocatalysis. It debates the combining methods of graphene group of chemical elements, allure structural traits, and the determinants doing its adsorption and photocatalytic efficiency. Furthermore, differing strategies to embellish the adeptness of graphene oxide-located adsorbents and photocatalysts are inspected. It also focuses on current advancements, challenges, and future outlooks engaged of graphene oxide-located water situation electronics.
Graphene-Based Nanocomposites, Fabrication, and Application in Pesticide Electrochemical Sensors
Authors: Okoth Kevin Otieno
Published: August 2024

Development of sensors for analysis of pesticides in environmental samples is essential. Pesticides are essential for growth of crops and flowers; however, due to their adverse effects and those of their metabolites, there is need to monitor their release and toxicological effects in the environment. Electrochemical (bio)sensors have emerged as simple, fast, cheap, portable, and selective devices. To this end, extensive research has been carried out on several nanomaterials that have then been used to modify electrodes, amongst them being graphene (GR). The excellent electrical conductivity, electrocatalytic activity, and large surface area have been the driving force behind the extensive use of GR in construction of electrochemical sensors. These properties can be further enhanced by doping with heteroatoms or functionalizing with polymers and semi-conductor nanomaterials. This chapter outlines the preparations of graphene nanocomposite and their application in sensitive detection of pesticides.
Biochar Amendment With Bio Compost for Improving Plant Growth
Authors: Das Shewantika , Mitra Arup Kumar
Published: August 2024

Significant obstacles to agricultural sustainability have resulted from overuse of fossil fuels, soils, nitrogen, and phosphorus. Based on the pyrolysis of organic waste, biochar can improve soil fertility and trap carbon, comparable to the Amazon's nutrient-rich Terra preta soils. That makes it a promising answer. Determining the appropriate quantities and proportions of compost and biochar is necessary to get the optimal plant development conditions. Applying biochar increases the availability of nutrients in the soil, which benefits plant growth characteristics for a variety of crops. Significant increases in foliar nitrogen, above-ground biomass, and root biomass have been seen in long-term field research, which has improved production. When combined with compost and plant growth-promoting rhizobacteria (PGPR), biochar has a synergistic impact that improves plant development and increases resistance to diseases like Alternaria solani. Particularly effective in promoting tomato growth and delaying the onset of early blight is this blend. Additionally, the use of biochar additions has shown benefits in terms of enhancing nutrient availability and soil moisture retention, which promotes improved growth for radish, cucumber, lettuce, wheat, and sorghum. In general, current research highlights the significance of customised strategies and in-depth analyses into biochar interactions to maximise its advantages for various crops and soil conditions while encouraging nutrient cycling.
Enhancing Crop Productivity Through Land Dataset Analysis on Selecting the Right Crops for the Right Land
Authors: Kamatchi C. Bala , Muthukumaravel A.
Published: August 2024

This chapter examines the enhancement of agricultural production utilizing sophisticated data analysis methods, specifically analyzing land datasets and mapping crop suitability. Using geospatial data integration and spatial analytic approaches facilitates the assessment of land suitability for different crops. This enables agricultural stakeholders to make educated decisions. The suitability map findings specify regions with different degrees of appropriateness, guiding crop choices and land use planning. Furthermore, comparing crop production data across numerous years uncovers trends and patterns in agricultural performance. The presented data illustrates variances in crop production, financial gain, and ecological consequences, providing valuable observations on changes throughout time and pinpointing opportunities for improvement. The significance of data-driven methodologies in advancing sustainable agriculture is emphasized in our research, emphasizing the need for well-informed decision-making and focused interventions to improve agricultural output while mitigating environmental consequences.
Next-Gen Phishing Defense Enhancing Detection With Machine Learning and Expert Whitelisting/Blacklisting
Authors: Ishtaiwi Abdelraouf , Ali Ali Mohd , Al-Qerem Ahmad , Sabahean Mohammad , Alzubi Bilal , Almomani Ammar , Alauthman Mohammad , Aldweesh Amjad , Al Khaldy Mohammad A.
Published: August 2024

Machine learning has become ubiquitous across industries for its ability to uncover in- sights from data. This research explores the application of machine learning for identifying phishing websites. The efficiency of different algorithms at classifying malicious sites is evaluated and contrasted. By exposing the risks of phishing, the study aims to develop reliable systems for fake website detection. The results showcase machine learning's capabilities for augmented cybersecurity through automated threat intelligence. Phishing employs social engineering techniques to disguise malicious links as trusted entities, tricking victims into revealing sensitive information. This work investigates phishing detection leveraging curated lists and machine learning for adaptive defense.
The Impact of National Culture on Technological Service Innovation
Authors: Smith David , Shaughnessy Timothy
Published: August 2024

The increasing use of blockchain technology in various industries has generated a significant amount of interest among researchers and practitioners. This study aims to determine a predictive classification model of technological service innovation adoption for blockchain implementation across cultures. Questions of the research are: 1) does national culture impact the prediction of blockchain adoption across countries? and 2) if so, what cultural dimensions have the highest impact on service innovation adoption rates, across and between countries? and finally, 3) are penetration rates of blockchain adoption significantly different across countries? Industry, country, and managerial level variables along with adoption rates are examined. Model formulation and analysis is supported using a neural network to predictively classify firm and country innovation adoption. This study helps organizations understand the factors that impact the adoption of blockchain technology and will also inform policymakers about the potential benefits and cultural challenges of blockchain implementation.
Abstract 15: Glycemic and body weight responses to oral semaglutide in the PIONEER trial program
Authors: Kumar K B Sharan , Dungan Kathleen M , Hertz Christin L , Mellibin Linda , Nielsen Morten Abildlund , Sorrig Rasmus , Woo Vincent C , Vilsboll Tina
Published: August 2024

Case: The PIONEER phase 3 program investigated glycemic response and other efficacy endpoints in patients (pts) with type 2 diabetes randomized to the glucagon-like peptide-1 analog oral semaglutide (sema; 3, 7 or 14 mg once daily), placebo (pbo) or an active comparator (empagliflozin [empa] 25 mg, sitagliptin [sita] 100 mg or liraglutide [lira] 1.8 mg once daily). This post-hoc analysis of the PIONEER 1-5 and 8 trials evaluated the response of any reduction in HbA (%) and/or body weight (%), and a clinically relevant composite endpoint of HbA1c reduction ≥1% and body weight loss ≥5%, with oral sema 14 mg vs. comparators at the end of treatment (26-78 weeks). Across trials, any reduction in HbA1c was observed in higher proportions of pts with oral sema (89- 95%) than with pbo (51-64%) or active comparators (82-88%). A simultaneous reduction in both HbA1c and body weight was seen in 72-86% of pts treated with oral sema. The composite of HbA1c reduction ≥1% and body weight loss ≥5% was achieved by 27-41% of pts with oral sema, 1-8% of pts with pbo, 11% with sita 100 mg, 18% with lira 1.8 mg, and 20% with empa 25 mg. Within each trial, the odds of achieving HbA1c reduction of ≥1% and body weight loss of ≥5% with oral sema 14 mg were significantly greater vs. all comparators.
Abstract 22: Giant parathyroid adenoma presenting with pseudoclubbing – A case report
Authors: Alekya V , Nalla Smitha , Deb Prasun
Published: August 2024

Giant parathyroid adenoma is a rare type of parathyroid adenoma defined as that weighing >3.5 grams. Although it presents with primary hyperparathyroidism, the clinical and laboratory findings are more profound. Bone changes are common in long standing hyperparathyroidism but presentation with clubbing is rare. Here, we report a case of 60-year male with history of finger deformities and swelling in neck. On evaluation he had hypercalcemia with high PTH levels. He underwent parathyroidectomy for the giant parathyroid adenoma but had eventful postoperative period with prolonged hypocalcemia. This emphasizes the importance of timely management of hyperparathyroidism to prevent untoward consequences.
Abstract 23: Primary hyperparathyroidism masking hypercalcemia of malignancy: A case report
Authors: Alekya V , Nalla Smitha , Deb Prasun
Published: August 2024

Primary hyperparathyroidism is the third most common endocrine disease, while association with Non-Hodgkin's Lymphoma is extremely rare. Both conditions can initially present with hypercalcemia. Here we present a case of 62-year-old female with recurrent syncope as initial complaint which was found to be secondary to hypercalcemia. There was elevated PTH, and she underwent parathyroidectomy with good intraop reduction of PTH but still had hypercalcemia. She was lost to follow-up and presented after 2 months with paraplegia. On evaluation she had abnormal cytology that was suggestive of leukemia. Further evaluation with bone marrow biopsy and flow cytometry revealed NHL. Association of nonendocrine cancers with parathyroid tumors is well established though pathogenesis is not yet clear. This emphasizes the importance of postoperative follow-up of primary hyperparathyroidism patients for early detection of associated cancers.
Abstract 27: Neuropathy in primary hypothyroidism and response to thyroxine replacement
Authors: Muthukrishnan J , Mishra Shyam Kumar , Asturkar Vikram
Published: August 2024

Background: Entrapment neuropathy and sensorimotor polyneuropathy has been described as a manifestation of hypothyroidism in many studies. Only few studies are available in Indian population to know the extent of neuropathies in hypothyroid patient and effect of thyroxine replacement on these abnormalities.

Aims and Objectives: To study the extent and pattern of peripheral nerve involvement in hypothyroid (subclinical and overt) patients and the response to optimal thyroid hormone replacement in them.

Methods: Consecutive patients with primary hypothyroidism were clinically and electrophysiologically evaluated for peripheral nerve dysfunction at baseline and after achieving euthyroid status.

Results: A total of 61 patients, were studied (Mean age 39.2 yrs, Range 19 - 55 yrs, Mean TSH 22.32 ±15.6 IU/ml). Baseline clinical examination was abnormal in 13 (21.3%) and electrophysiology was abnormal in 21 (34.4%). Among these, 6 (29%) had demyelination, 8 (38%) axonal neuropathy and 07 (33%) entrapment neuropathy. After optimal thyroxine replacement, 14 (67%) showed complete recovery. While 8 (72.7%) out of 11 with sensory axonal neuropathy showed significant improvement, all 04 patients with motor neuropathy showed significant improvement. One patient with demyelinating neuropathy did not show any improvement. Out of 7 patients with CTS, 5 (71.4%) showed improvement after thyroxine replacement

Conclusion: Subclinical peripheral nerve involvement is frequent in primary hypothyroidism and most cases responds well to optimum thyroxine replacement.
Abstract 28: Change in glycaemic parameters in adults with type 2 diabetes initiated with or switched to insulin degludec/insulin aspart (IDegAsp) in a real-world setting – An analysis of Indian cohort of ARISE study
Authors: Baruah Manash P , Aneja Pankaj , Pitale Shailesh , Bhograj Abhijit , Agrawala Ritesh K , Aggarwal Ajay , Mahadev Prasad Gurumallappa , Madhavdas Deepaklal Chhabrai , Shah Sanjay , Pathan Muzammil Khan A , Praveen A N , Manjunatha R , Singh Kiran Pal
Published: August 2024

Aim: To investigate the effect of insulin degludec/insulin aspart (IDegAsp) on glycaemic control in people with T2DM treated with IDegAsp in real-world setting.

Methods: This was a ~26 weeks open-label, non-interventional study (NCT04042441) including 1102 T2DM adults on any anti-hyperglycaemic treatment initiating or switching to IDegAsp as per local practice in 6 countries. Participants were included based on physician's decision to start treatment with IDegAsp. Primary endpoint was change in glycosylated haemoglobin (HbA1c) from baseline to end of study (EOS).

Results: Amongst 185 participants from India, 57.3% (n=106) were men. The mean age was 58.1±10.3 years, with the mean duration of T2DM being 14.4±8.1 years. IDegAsp was given once daily (n = 81 [43.8%]) or twice daily (n=104 [56.2%]) ± OADs. Of these, initiation was done in 90 (48.6%) participants uncontrolled on OADs. Mean HbA1c (SD) decreased significantly from 9.8 (1.8)% at baseline to 8.2 (0.1)% at the EOS; change in HbA1c from baseline [95% CI]: -1.6% [-1.83; -1.42], p<0.0001. There was significant reduction in mean fasting plasma glucose, FPG (SD) from 190.0 (65.8) mg/dl at baseline to 141.9 (4.3) mg/dl at EOS; change in FPG from baseline [95% CI]: -52.2 mg/dl [-60.65; -43.66], p<0.0001. Mean body weight (SD) changed from 70.8 (11.5) kg at baseline to 70.5 (0.4) kg at EOS; change in body weight from baseline [95% CI]: 0.3 kg [-0.59; 1.1], p=0.54. There was numerical reduction in number of patients reporting resource utilisation associated with diabetes & its complications (outpatient visits: 72 to 32 and workdays missed: 2 to 0). Patient-reported non-severe (47 to 8) and severe hypoglycaemic episodes (4 to 1) reduced as well.

Conclusion: In real-world population of Indian adults with T2DM, initiation with or switch to IDegAsp improved glycaemic control, with numerically lower resource utilisations (outpatient visits and workdays missed) and patient-reported hypoglycaemia.
Abstract 38: Sellar mass – An unusual presentation of metastatic thyroid carcinoma
Authors: Sriramaneni Nikitha , Kalra1 Pramila
Published: August 2024

Background: Sellar metastases are rare. They may precede the diagnosis of primary malignancy in 20-30% of the cases.

Case Report: A 47year female presented with ptosis and diminished vision of right eye. She had a mass in the sellar region extending into the suprasellar area. Her serum prolactin level was 215 ng/ml. She had galactorrhea, secondary hypothyroidism, secondary hypocortisolemia. A trial of cabergoline was given for 6 weeks. She had progressive diminution in vision and a repeat MRI brain showed an increase in the size of the mass. She underwent tumour decompression. The histopathology was suggestive of metastatic tumor of the sella. Immunohistochemistry of pituitary biopsy was positive for CK and TTF-1 (nuclear). On evaluation, FDG-PET CT scan showed metabolically active nodule in the left lobe of thyroid. Ultrasound scan of thyroid showed multinodular goiter (TIRADS 5). FNAC of the left thyroid nodule was suggestive of Hashimoto's thyroiditis. With a suspicion of primary thyroid malignancy, total thyroidectomy was performed. Surgical biopsy report of thyroid showed well-differentiated follicular carcinoma. Radioablation with I-131 was performed for residual thyroid tissue in the neck and metastases.

Conclusion: Metastasis to the pituitary can be a rare presentation of thyroid cancer. It may mimic a pituitary adenoma.
Abstract 40: Adrenal insufficiency in patients with HbE/Beta thalassemia
Authors: Singh Arijit , Mukhopadhyay Pradip , Ghosh Sujoy
Published: August 2024

Background: Adrenal insufficiency (AI) in HbE/Beta thalassemia is not well documented.

Aims and Objectives: Prevalence of AI in HbE/Beta thalassemia. Difference in prevalence of AI according to severity of HbE/Beta thalassemia and dependence on transfusion.

Results: In this observational, cross sectional study, one hundred four patients with HbE/Beta thalassemia were evaluated. Amongst them 57 and 47 were transfusion dependent (TD) and non-transfusion dependent (NTD) thalassemia. According to Mahidol criteria, patients were classified into mild (n=39), moderate (n=39) and severe (n=26) disease. Early morning (8 AM) serum cortisol, plasma ACTH, DHEAS, androstenidione and plasma aldosterone, renin were measured. Patients with baseline cortisol of 5-18 μg/dl underwent both 1 μg and 250 μg SST (Short Synacthen Test). Overt adrenal insufficiency was found in 41% (n= 43). Amongst them 72% (n= 31) had primary AI and 27% (n= 12) had secondary AI. Thirty three patients (31%) with normal or elevated ACTH, with low or normal aldostreone with high renin were diagnosed as subclinical adrenal insufficiency. There was no significant difference in prevalence of AI between TD and NTD (p = 0.56) nor was there was any difference in prevalence of AI according to disease severity (p=0.52).

Conclusion: Adrenal insufficiency is common in HbE/Beta thalassemia and is independent of transfusion dependency and disease severity.
Abstract 41: Effect of zoledronic acid on bone mineral density in Indian postmenopausal osteoporotic women with and without diabetes – A prospective cohort study
Authors: Merugu Chandhana , Sahoo Jayaprakash , Kamalanathan Sadishkumar , Ramkumar1 Govindarajalou , Reddy2 Sagili Vijaya Bhaskar , Kar3 Sitanshu Sekhar , Naik Dukhabandhu , Roy4 Ayan , Narayanan Niya , Patel Deepika , Suryadevara Varun
Published: August 2024

Background and Aims: A significant number of postmenopausal women have both diabetes and osteoporosis in our country. The objectives of the study were to study the effect of intravenous (IV) zolendronic acid (ZA) on change in bone mineral density (BMD) at lumbar spine (LS), total hip (TH), femoral neck (FN) and distal forearm (FA) and the changes in bone turnover markers (BTMs) in postmenopausal osteoporotic women with and without diabetes after 12 months of treatment.

Results: A total of 80 patients with postmenopausal osteoporosis were included-diabetes (n=40) and non-diabetes (n=40). Patients with diabetes were older and had lower BTMs levels compared to non-diabetic patients. At baseline, BMD at all four areas were similar in both the groups. Mean increase in LS-BMD at 12-months in diabetes and non-diabetes group was 3.6 ± 4.7% and 6.2 ± 4.7 % respectively (P=0.02). There was no difference in the percent change in the TH, FN and FA BMD between the groups at 12 months. There was a significant reduction in BTMs from the baseline in both the groups after 12 months of follow-up. Acute phase reactions were seen in 75% of patients with pyrexia being more common in non-diabetes group.

Conclusion: The gain in the LS-BMD was significantly lower in the diabetes group as compared to the non-diabetes group at 12 months following a single IV infusion of 4 mg ZA.
Abstract 42: B-Lymphocyte subset distribution in patients with hyperprolactinemia
Authors: Shah Moxit
Published: August 2024

Background: The PRL-R is a member of the GH/cytokine receptor super family which is also expressed on immune cells and activation modulates several cell functions such as differentiation, proliferation, survival, and secretion. Peripheral B-cell subset distribution and the serum autoantibody profile in women with HPRL are largely unknown.

Aims and Objectives: The current study aimed to investigate B-lymphocyte subset distribution and the autoantibody prevalence in women with HPRL.

Methods: Peripheral blood was collected from 30 women who had PRL>50ng/ml and from 24 healthy women who had normal PRL aged between 18-45. All were examined for prolactin, B-cell subsets were measured by flow cytometry, Anti-nuclear antibody (ANA), Rheumatoid factor, Anticardiolipin IgG, Immunoglobulin G, M&A, Anti-TPO, Anti-Tg.

Results: The percentages of Plasmablast (p-0.015) among the total B cells from and Immunoglobulin IgA (p-0.012) in HPRL women were significantly higher than those from healthy women, while percentages of B-regulatory (p-0.003) and Mature cell (p<0.001) and Immunoglobulin M (p-0.012) were higher in healthy women.

Conclusions: Women with HPRL had a higher prevalence of more Plasmablast cells and lower prevalence of B-regulatory cells than healthy women.
D1 MTE1 Case 3: A hypogonad with weak bones
Authors: Vishwanath S
Published: August 2024

A 22 years old male, one of the identical twin brothers, born out of 3rd degree consanguinity, presented with delayed dentition, ASD closure in childhood, multiple surgeries for recurrent fractures of long bones of lower limbs, correctional surgery for genu valgum, renal stones, delayed puberty and with similar history in his twin brother. On examination he was pale, had synophrys, hypotelorism, micrognathia, gynecomastia Tanner B3, A+, P2, SPL of 5cm and bilateral TV < 2 ml. Investigations revealed anemia, hypokalemia (K 3.1 mEq/L), hypophosphatemia and elevated alkaline phosphatase (PO4 1.26 mg/dl, calcium 8.7 mg/dl, ALP 450 U/L, Vit D 37 ng/ml, iPTH 32 pg/ml), normal urea and creatinine and hypergonadotrophic hypogonadism with 46 XY karyotype (FSH >150 mIU/ml, LH 106 mIU/ml, Total testosterone 0.15 ng/ml).
D1 MTE2 Case 4: A case of men - 1
Authors: Dass Ashwitha Shruti , Delampady Kishan , Bhattacharyya Arpandev
Published: August 2024

Mr. GR, 40 year man presented to us in 2019 with frequent loose stools and generalised tiredness. He has T2DM (7 years, HbA1c-6.7%), CAD (AWMI-PTCA-2013), well-controlled hypertension and his father had primary hyperparathyroidism (all four removed), nephrolithiasis, T2DM, received renal transplant. Five years back, Mr. GR was diagnosed to have Neuroendocrine tumour following distal pancreatectomy and splenectomy on histopathology. Later in 2019, when his scans were repeated for recurrent abdominal symptoms, the new diagnosis of primary hyperparathyroidism was made (PTH-135 [14-65 pg/mL], Corrected Calcium-11.1 [8.5-10.2 mg/dL], Vitamin D-40 [30-40 ng/mL], 24-hour urinary calcium-328 [100-300 mg/day]). Sestamibi scan showed right inferior parathyroid adenoma. He had abdominal issues with elevated Chromogranin A- 6880 (<93 ng/mL) and Gastrin-730 (0-180 pg/mL), Ga 68-DOTATATE scan revealed overexpressing-somatostatin receptor peripancreatic node and pulmonary metastasis. He was started on Octreotide (2 weeks S/C TID following which monthly LAR injection was given for duration of 12 months. His latest reports showed Chromogranin A-325.7, Gastrin-346, Corrected Calcium-11, PTH-136. Presently, he is asymptomatic, improved with no abdominal issues with moderate glycaemic control (HbA1c-6.7%, FBS-121 mg/dl). How would we move forward with the management of this patient?
Abstract 45: The clinical and etiological profile of primary amenorrhea: A single centre experience from South Tamil Nadu
Authors: Nazirudeen Roshan , Natarajan Vasanthiy , Raja Rameez , Subbiah Sridhar
Published: August 2024

Introduction: Primary amenorrhea, the absence of menstrual cycles by 16years of age, or by 13 years with associated short stature or lack of secondary sexual characters, is most commonly due to gonadal dysgenesis and Mullerian agenesis worldwide and in previous Indian studies.

Aims and Objectives: To study the clinal and etiological profile of primary amenorrhea patients presenting to our center.

Methods: All cases of primary amenorrhea attending Endocrinology OP from October 2019 to October 2021 were included. Detailed history and physical examination, routine investigations, LH, FSH, TSH, testosterone and estradiol by Roche Cobase e411 and ultrasound abdomen and pelvis were done in all cases, followed by MRI pelvis or MRI brain. Serum cortisol, 11-deoxycorticosterone, 21deoxycortisol, DHEAS, dihydrotestosterone, androstenedione and 17αhydroxyprogesterone, karyotyping, laparoscopy, and gonadal biopsy were done in appropriate cases.

Results: 30 patients with primary amenorrhea were included, of which nine were Turner syndrome, seven Mullerian abnormalities, six hypogonadotropic hypogonadism, three CDGP, two CAH-17 alfa hydroxylase deficiency, one case each of 17 beta hydroxysteroid deficiency CAH and Swyer syndrome. Mean age was 20.2years, oldest 33years. All Turner syndrome and 3 hypogonadotropic hypogonadism cases were short in stature. Secondary sexual characters were normal in Mullerian agenesis. Bony deformities were present in two Turner cases and one Mullerian agenesis, renal anomalies in five Mullerian agenesis and two Turner syndrome, and cardiac anomalies in three Turner cases. Hormonal profile, imaging/ karyotype confirmed the diagnosis. Mosaicism was present in 2 cases of Turner syndrome.

Conclusion: Primary amenorrhea is quite common in South Indian population and clinical features correlate well with etiology, Turner syndrome being the most common etiology, followed by Mullerian agenesis and hypogonadotropic hypogonadism. Delayed age of diagnosis reflects need for increasing awareness and removing social stigma.