bluuebunny/crossref_metadata_2025 huggingface dataset:
A Four-Generation Autoethnography of Caregiving for Older Family Members
Authors: McMillan Sally J.
Published: February 2024

The goal of this chapter is to document the role of caregiving for older family members over the past 130+ years, to explore how changes in communication technologies have impacted caregiving and communicating, to explore how both caregiving and communication are becoming more fractured in contemporary society, and to develop recommendations for optimizing communication tools to manage family caregiving. This chapter examines the lives of four generations of women in my family who reached age 65+. It draws on theoretical work of Innis and McLuhan regarding evolutions in communication technology. Caregiving is examined in the context of four types of supports: economic, service, social, and emotional. Implications are considered for caring for older family members based on two key dimensions: level of family participation in care and access to monetary resources.
Asymmetric Impact of Financial Conditions on Credit Default Swaps (CDS) in Turkey
Authors: Erdas Mehmet Levent
Published: February 2024

Sovereign credit risk is an important consideration for investors, academics, and practitioners in the countries, and CDS spreads play a leading role to handle credit risk. The CDS premium has been mainly used as a market-based reference for sovereign credit risk. The increasing popularity of CDS spreads has brought into question whether there is a relation between CDS spreads and financial factors. To this end, the aim of this research is to explore the effect of financial factors on CDS in Turkey using the ARDL models. The results confirm that Brent and VIX volatility have an asymmetric relationship with CDS spreads in Turkey. The empirical findings suggest that a positive shock in VIX causes an increase in CDS spreads. The asymmetry in the relationships between CDS and financial factors highlights important policy implications for portfolio and risk management and financial stability.
Financial Inclusion in China
Authors: Zreik Mohamad , Marzuki Sharifah Zannierah Syed , Iqbal Badar Alam
Published: February 2024

In this chapter, the authors examine the causes, consequences, and potential development of financial inclusion in China. It explores how factors including financial literacy and regulatory settings, as well as novel financial inclusion strategies, have shaped China's inclusive financial system. It examines the effects of financial inclusion on several economic and social metrics. The chapter finishes with suggestions for improving financial inclusion in China, which might serve as examples for other countries, and identifies emerging areas of study and theoretical discourse.
Generative AI Ethical Considerations and Discriminatory Biases on Diverse Students Within the Classroom
Authors: Salazar Leslie Ramos , Peeples Shanna F. , Brooks Mary E.
Published: February 2024

Generative artificial intelligence (AI) can induce a variety of biases that can impact decision-making processes, and it can produce inaccurate or distorted information that may harm marginalized student groups in higher education classrooms. With the increase in generative AI use among college students and instructors, it is important to examine the ethical risks and discriminatory biases that can negatively influence students' learning experiences. For this purpose, this chapter focuses on the different types of generative AI ethical risks that can occur in U.S. classrooms. The variety of AI discriminatory biases against diverse student populations are also documented. Further, the authors discuss a case application that expands on the potential AI biases in higher education. To prevent and address potential AI ethical risks and biases, recommendations are offered to higher education educators. Lastly, guidance is offered suggesting future research in AI biases and diversity in higher education institutions.
AI Monsters
Authors: Zipf Sarah T. , Petricini Tiffany , Wu Chuhao
Published: February 2024

Research into perceptions of artificial intelligence (AI) by faculty and students outside of specific disciplines has been relatively sparse. With the recent release of ChatGPT in November 2022, there have been numerous inquiries into the role of generative AI (GAI), in particular. While a timely response is important, so is ensuring that the responses that universities and faculty are implementing are evidence based. In the spring 2023 semester, the authors surveyed 380 students and 276 faculty. The quantitative data was analyzed with implications for higher education, including student-faculty trust, academic integrity, and uncertainty. This chapter is an analysis of the open-ended responses, using “Monster Theory” as a framework for understanding the themes that underlie the perceptions evident in the responses. The authors “demonsterize” AI. This is a mix of promoting literacy, ethical and transparent use, and developing language that is mindful about practices that may either empower or disempower individuals.
A Qualitative Journey on Instructors' Perceptions of Artificial Intelligence in EFL Education
Authors: Dincer Nazmi , Bal Samet
Published: February 2024

Artificial intelligence influences education, particularly language instruction. Despite its expanding attention, few studies have examined teachers' views on AI in education. This qualitative study explores EFL teachers' AI-related views and insights. The study uses semi-structured interviews with 21 instructors from diverse universities to uncover complex attitudes toward AI, pedagogical ideologies, perceived benefits and drawbacks of AI, and privacy concerns. The study highlights four main themes: AI's capacity to adapt to individual learning needs, its influence on pedagogical dynamics, the need for technical proficiency to integrate AI, and ethical and security issues related to AI use. These results highlight the perceived benefits and challenges educators face when using AI and emphasize the need for continued research to develop successful AI integration techniques for language instruction.
Designing Language Learning Experiences With Generative AI Tools
Authors: Czerkawski Betül C.
Published: February 2024

Artificial intelligence (AI), particularly generative AI, can present many opportunities for language learners to practice and improve their language skills, receive timely feedback on their performance, and customize their learning based on their needs and language proficiency. AI's benefits are not limited to second language (L2) learners. Instructors can also benefit from the novel generative AI technologies by using them in curriculum and lesson design, developing new teaching and assessment materials, or addressing diverse learner skills and needs. Despite AI's advantages, the main issue is how to design L2 environments effectively so learners can receive the best benefits from AI while reducing some associated drawbacks. This chapter argues that learning experience design (LXD) presents a road map for L2 instructors as they incorporate generative AI into their instruction. If the learning design is random and left to good intentions, achieving meaningful learning outcomes will also be left to chance. Following proven LXD guidelines may help alleviate the confusion around AI.
Equity and Inclusion in Learning Ecosystems
Authors: Tariq Muhammad Usman
Published: February 2024

Globally, educational institutions increasingly recognise the need for equality and inclusion in creating successful and equitable learning environments. This chapter delves deeply into the various issues of fairness and inclusion within learning environments. This chapter outlines these essential ideas and emphasises their importance in education. It investigates the historical underpinnings, legislative structures, and theoretical views supporting the quest for fairness and inclusion. In the current educational environment, equity and inclusion have emerged as critical components in ensuring that every individual has access to excellent learning opportunities regardless of background or characteristics. The notion of “learning ecosystems” embraces the full educational experience, encompassing official and informal settings, digital tools, community resources, and support networks that transcend traditional borders. Equity and inclusion are the pillars upon which a fair, diversified, and accessible education system is formed within these learning environments.
Exploring Groupthink Bias and Polarisation Bias
Authors: Aktukun Leyla Aylin
Published: February 2024

Cognitive biases play a crucial role in shaping human judgement and choices in the complex environment of decision making. This chapter provides a comprehensive examination of two prominent cognitive biases, groupthink bias, and polarisation bias. In this context, the importance of cognitive biases in decision-making processes is emphasised and placed in a rich research context. By meticulously detailing the methods and sources used in the research, the scope and main objectives of these biases are discussed, and a road map is endeavoured to be presented for a solution. This chapter has two aims: first, to elucidate the role and impact of cognitive biases in decision-making; and second, to provide a comprehensive analysis of two specific cognitive biases - groupthink bias and polarisation bias - and to provide a literature review on the subject, presenting a variety of different views and strategies for overcoming these biases. In addition, real-world examples provide vivid snapshots of how cognitive biases shape these areas.
Leveraging Advanced Analytics for Financial Fraud Detection
Authors: Shukla Rishi Prakash , Ranjan Prafulla , Singh Praveen
Published: February 2024

Financial institutions grapple with the escalating challenges posed by diverse and sophisticated forms of financial fraud. In response, this comprehensive chapter unfolds a case study, delving into the transformative role of advanced analytics, specifically leveraging SAS tools, to fortify fraud detection mechanisms. By examining historical cases, elucidating real-world examples, exploring machine learning foundations, showcasing SAS integration in financial analytics, and addressing ethical considerations, the chapter aims to offer a nuanced understanding of financial fraud's multifaceted nature. Practical applications, industry-specific implementations, and insights from successful case studies contribute to a robust exploration of fraud prevention. The chapter concludes by envisioning future trends, emphasizing the importance of staying ahead through continuous learning, and underlining the ethical dimensions of responsible data usage in the evolving landscape of financial security.
Indian Banking System and Blockchain Technology
Authors: Khurana Ajay , Pathak Nitin , Gawshinde Shanul , Preet Anmol
Published: February 2024

Innovations have significantly altered the structure of the banking process, and technology and banking are inextricably linked. Blockchain technology (BCT) is a disruptive development in the global financial sector that has revolutionized the banking sector by replacing traditional barter systems with the introduction of money and digital signatures. The chapter aims to give a general overview of blockchain technology, highlighting its advantages and possibilities in the Indian banking industry. Since receiving constant encouragement and guidelines from the IMF to adopt blockchain technology, 15 Indian banks have banded together to establish the blockchain technology used by the Indian Banks Blockchain Infrastructure Co. Pvt Ltd. (IBBIC) business that handles transactions and digitizes the financial system. The study's results indicate that blockchain will eventually play a pivotal role in revolutionizing the Indian banking sector by improving the speed, safety, transparency, and effectiveness of banking transactions.
Development of Financial Forecasting Tools
Authors: Bhardwaj Monu , Prakash Namrata , Kargeti Himanshu , Tiwari Rajesh
Published: February 2024

Technology has disrupted business processes. The financial sector cannot remain isolated from the technological disruption. Financial forecasting has attracted the attention of researchers attempting to explore technology driven forecasting. This chapter explores the development of financial forecasting tools. Artificial intelligence has gained prominence in financial forecasting and other domains of investment management. Machine learning offers immense potential for enhancing the efficiency of investment management. Fusion of the best models is required to explore new approaches. Instead of relying on a single model, a hybrid model approach needs to be explored to incorporate the benefits of the best models.
Building a Sustainable Tomorrow
Authors: Reepu  , Taneja Sanjay
Published: February 2024

This chapter explores sustainable entrepreneurship, which integrates environmental, social, and economic objectives into business ventures. It discusses the challenges faced by sustainable ventures while highlighting their benefits in addressing global issues such as climate change and inequality. The chapter emphasizes the need for strategic planning and innovation to overcome obstacles and capitalize on opportunities within sustainable entrepreneurship. It also recognizes the changing preferences of consumers and larger corporations towards sustainability. The future prospects of sustained entrepreneurship are projected to continue growing in response to consumer demand for environmentally conscious products and services.
Cognitive AI's Role in the Banking Industry
Authors: Kaur Ranjeet , Jewandah Simran , Singh Satnam
Published: February 2024

Artificial intelligence (AI) has become a transformative force, particularly in the banking sector, aiming to enhance efficiency and customer satisfaction through intelligent automation. This chapter explores the multifaceted impact of AI on the banking industry, emphasizing its prevalence in financial institutions and its role in mitigating challenges such as cyber threats. Global banking institutions can experience a profound shift in their operations, introducing revolutionary products and services, and, notably, guaranteeing the preservation of seamless customer experiences, all thanks to the impact of artificial intelligence (AI). To remain competitive, banking and financial institutions must incorporate artificial intelligence (AI) into their overarching business strategy and day-to-day activities. This chapter will examine the role of AI platforms in the banking sector, underscoring their escalating influence as a significant disruptor and addressing key unresolved issues within this business sphere.
System Dynamics Model to Improve Logistics Cost Efficiency in Fertilizer Distribution outside Java (Gresik - Medan)
Authors: Katon Yoke Candra , Handani Dhimas Widhi , Artana Ketut Buda , Lumirang Mikha Asta , Aprilia Putu Widhi
Published: February 2024

Within the vast development of globalization, companies are encouraged to increase competitiveness level, in order to survive in the market. One certain way to stay competitive and retain customers is to provide such products with reasonable selling prices. Supply chain costs have a great influence upon the cost of the final product; therefore, companies are suggested to continuously improve supply chain processes regarding reducing overall costs. One industry indicated with high supply chain costs is the fertilizer industry, referring to the fact that it has a nationwide distribution system. For countries which regulate fertilizer as a subsidized product, companies must be able to provide fertilizer at an efficient price to maintain prevalence in the market. Currently, the problem faced by one of the fertilizer companies is an indication of expensive logistics costs for fertilizer distribution outside Java. The most expensive logistics costs are owned by the Medan area with variations in bulk transportation. This problem can be solved if there are alternative economic scenario designs in accordance with capabilities. The purpose of this research is to provide alternative scenarios, simulate those scenarios, and choose the most efficient scenario. The method used in this research is system dynamics and 12 scenarios were generated in this paper. Selection of the appropriate ship size and type of heavy equipment for loading and unloading cargo from those scenarios can impact in energy saving/fuel consumption and minimize operational costs. Beside cost, fertilizer deficit is also a consideration in scenario selection. From the result, scenario 3 has the lowest distribution costs with a total cost is Rp. 241,513 and the total fertilizer deficit is 0 tons, so scenario 3 is the selected alternative scenario to minimize operational cost.
Business Model Design for Cathode Material Manufacturer Startup Case Study: PT Polimikro Berdikari Nusantara
Authors: Sudian Dian Ahmad Pratama Bunayah , Sutopo Wahyudi , Hisjam Muhammad
Published: February 2024

Startups often offer innovations in solving problems, but if these innovations have a business model, they will be protected from entering the valley of death. Polimikro Berdikari Nusantara is one of the startups recently facing risk. Polimikro Berdikari Nusantara’s main product, Lithium Nickel Manganese Cobalt Oxide (NMC), had Technological Readiness Level (TRL) 7 Demonstration System. However, the Market Readiness Level (MRL) is level MRL 4 Small Scale Early Adopter Campaign. Therefore, several activities need to be done to increase MRL to save Polimikro from the valley of death. This study aims to provide a design model and business strategy for Polimikro Berdikari Nusantara. This qualitative research uses analytical techniques using an interactive analysismodel by Miles and Huberman. Data collection was done by observation, documentation, andinterviews. The results obtained in this study are business models in the form of Business ModelCanvas (BMC) and Lean Canvas (LC) integration
Design and Implementation of Automatic Aiming and Locking System
Authors: Chen Ping Cheng , Pan Chung Long
Published: February 2024

In this article, the training parameters of cascade classifiers for specific targets (such as human faces and palms) are obtained by using the program training function provided by OpenCV and adjusting parameters such as the number of positive and negative samples and ratios to achieve better recognition results. Finally, the aiming and locking system for specific targets is constructed by combining recognition, algorithm, and robot control capabilities.
Structural and Functional Characterization of a Fish Type I Subgroup d IFN Reveals Its Binding to Receptors
Authors: Guan Yanyun , Chen Jingjie , Guan Hongxin , Chen Tao-Tao , Teng Yan , Wei Zuyun , Li Zekai , Ouyang Songying , Chen Xinhua
Published: February 2024

Teleost fish type I IFNs and the associated receptors from the cytokine receptor family B (CRFB) are characterized by remarkable diversity and complexity. How the fish type I IFNs bind to their receptors is still not fully understood. In this study, we demonstrate that CRFB1 and CRFB5 constitute the receptor pair through which type I subgroup d IFN (IFNd) from large yellow croaker, Larimichthys crocea, activates the conserved JAK-STAT signaling pathway as a part of the antiviral response. Our data suggest that L. crocea IFNd (LcIFNd) has a higher binding affinity with L. crocea CRFB5 (LcCRFB5) than with LcCRFB1. Furthermore, we report the crystal structure of LcIFNd at a 1.49-Å resolution and construct structural models of LcIFNd in binary complexes with predicted structures of extracellular regions of LcCRFB1 and LcCRFB5, respectively. Despite striking similarities in overall architectures of LcIFNd and its ortholog human IFN-ω, the receptor binding patterns between LcIFNd and its receptors show that teleost and mammalian type I IFNs may have differentially selected helices that bind to their homologous receptors. Correspondingly, key residues mediating binding of LcIFNd to LcCRFB1 and LcCRFB5 are largely distinct from the receptor-interacting residues in other fish and mammalian type I IFNs. Our findings reveal a ligand/receptor complex binding mechanism of IFNd in teleost fish, thus providing new insights into the function and evolution of type I IFNs.
Screening of cardiac allograft vasculopathy in heart transplant patients with coronary computed tomography angiography
Authors: Amador Ana Filipa , Amorim Sandra , Proença Tânia , Vasconcelos Mariana , Tavares Da Silva Marta , Rebelo João , Carvalho André , Pinheiro-Torres José , Pinho Paulo , Rodrigues Rui
Published: February 2024

Although coronary angiography (CA) is the gold standard for coronary allograft vasculopathy (CAV) screening, non-invasive modalities have arisen as potential alternatives, such as coronary computed tomography angiography (CCTA). CCTA also quantifies plaque burden, which may influence medical treatment. From January 2021 to April 2022, we prospectively included heart transplant recipients who performed CCTA as a first-line method for CAV detection in a single center. Clinical, CCTA, and CA data were collected. 38 patients were included, 60.5% men, aged 58±14 years. The most frequent cause of transplantation was dilated cardiomyopathy (42.1%), and the median graft duration was 10 years [interquartile range (IQR) 9]. The median left ventricle ejection fraction was 61.5% (IQR 6). The median calcium score was 17 (IQR 231) and 32 patients (84.2%) proceeded to CCTA: 7, 24, and 1 patients had a graded CAV of 0, 1, and 2, respectively. Most patients (37.5%) had both calcified and non-calcified plaques, and the median number of affected segments was 2 (IQR 3). The remaining six patients had extensive coronary calcification, so CA was performed: 4 had CAV1, 1 had CAV2, and 1 had CAV3. During follow-up (12.2±4.2 months), there were neither deaths nor acute coronary syndromes. After CCTA, therapeutic changes occurred in about 10 (26.3%) of patients, mainly related to anti-lipid intensification; such changes were more frequent in patients with diabetes after heart transplant. In this cohort, CCTA led to therapeutic changes in about one-quarter of patients; more studies are needed to assess how CCT may guide therapy according to plaque burden.
Bone Marrow Metastasis in Nonhematological Malignancies: A Study from Tertiary Care Center
Authors: Singh Anurag , Rawat Shalini , Kushwaha Rashmi , Jain Mili , Verma Shailendra Prasad , Verma Nishant , Singh Uma Shankar
Published: February 2024

Introduction:

Metastatic cancer presents a treatment challenge to clinicians, particularly for patients with bone marrow infiltration. For tumor staging, therapy selection, and prognosis risk stratification, the status of the bone marrow should be known for the presence or absence of metastasis. The study aimed to evaluate the hematological findings and comprehensive analysis of bone marrow in cases of nonhematological malignancies with bone marrow metastasis.

Materials and Methods:

This retrospective study comprised a record retrieval of the departmental archives for the past 6 years. A total of 331 patients with nonhematological malignancies were found, of whom 31.42% (104/331) showed bone marrow metastasis. An integrated clinical approach with bone marrow examination findings and immunohistochemistry whenever necessary was used to achieve a definitive diagnosis of bone marrow metastasis.

Results:

Among the study population, 31.42% (104/331) of patients had nonhematological malignancies that metastasized to the bone marrow. Most of the patients with bone marrow metastasis had anemia, which was found in 77.88% (81/104) of the cases. Leukoerythroblastic reaction was noted in 31.73% (33/104) of the cases, and thrombocytopenia was found in 25% (26/104) of the cases. The most common malignancy with bone marrow metastasis in adults was prostatic adenocarcinoma (28.1%) (9/32) and in pediatric cases, neuroblastoma (53.9%) (52/98).

Conclusions:

It is essential to diagnose nonhematological malignancies that have metastasized to the bone marrow since this necessitates tumor staging, therapy selection, and prognosis risk stratification. To conclude, not a single hematological parameter is predictive of bone marrow metastasis; however, unexplained anemia, a leukoerythroblastic blood picture, and thrombocytopenia in peripheral blood should raise suspicion for bone marrow metastasis in cases of nonhematological malignancies.
Positivity of Interferon-Gamma Release Assay among Foreign-Born Individuals, Tokyo, Japan, 2015–2017
Authors: Miyake Satoshi , Endo Masayuki , Ikedo Keiko , Kayebeta Aya , Takahashi Ikumi , Ota Masaki
Published: February 2024

Background:

The aim of this study is to analyze interferon-gamma release assay (IGRA) data of foreign-born individuals in Japan derived from tuberculosis (TB) contact investigations.

Methods:

A contact with a TB patient was considered to have occurred when an individual had contact with a TB patient for more than 8 h indoors. This is a retrospective cohort study, and all the TB contacts tested with IGRA during the contact investigations conducted by the Shinjuku city Health Office from 2015 through 2017 were enrolled.

Results:

A total of 880 foreign-born contacts were investigated. The IGRA positivity of the contacts from China and Viet Nam were both 5.1% (95% confidence intervals [CIs]: 3.2%–7.8% and 2.4%–9.5%, respectively), whereas that from Nepal and Myanmar were 24.4% (95% CI: 16.0%–34.6%) and 23.3% (95% CI: 9.9%–42.3%), respectively. Multiple logistic regression analysis showed that the risk factors were smear status of the index patient (1+: adjusted odds ratio [aOR]: 6.2, 95% CI: 1.2–30.5, smear status 3+: aOR: 14.3, 95% CI: 1.7–118.2), age of the contact (aOR: 1.1, 95% CI: 1.0–1.1 for 1 year increment), and being born in Nepal (aOR: 5.6, 95% CI: 2.8–11.2) and Myanmar (aOR: 4.3, 95% CI: 1.4–13.0), compared with China as reference.

Conclusions:

In contact investigations involving foreign-born individuals, local health offices should carefully consider the composition of the TB contacts and expand the focus of the investigation, if deemed necessary.
Chronotype and Its Relationship with Sleep Quality among Professional Students at Indian University
Authors: Khan Moazzam Hussain , Sharma Saurabh , Saleem Mohammad
Published: February 2024

Context:

Chronotype varies from one individual to others and thus results in individual difference in physical performance and quality of sleep.

Aims:

This study’s goal was to determine the chronotype and its relationship to sleep quality in university-level professional students.

Settings and Design:

This was a cross-sectional survey of professional students at university level.

Subjects and Methods:

A total of 240 students completed the Horne and Ostberg morningness–eveningness questionnaires (MEQs) to determine their chronotype and Pittsburgh Sleep Quality Index (PSQI) to determine the quality of sleep at university students.

Statistical Analysis:

The data were analyzed with Spearman’s correlation test and Chi-square test.

Results:

A total of 240 students, 72 (30%) females and 168 (70%) males, participated in this study (age 18–28 years): 137 (57.1%) intermediate types, 75 (31.3%) morning types, and 28 (11.7%) evening types. Morning typology was more common among Indian males. In terms of MEQ typology, there was no discernible gender difference (P = 0.06 > 0.05). A noteworthy inverse relationship has been observed between the chronotype score (MEQ) and the sleep quality (PSQI) (rho = −0.15). It was noted that 10.4% of individuals had poor sleep quality.

Conclusion:

The majority of Indian university professionals are of the intermediate type, and it appears that Indian students, particularly males, are slightly more likely to be morning type than people from some Western societies. Evening chronotype students have poor quality of sleep.
Online gaming motives, family relationships, and personality among Indian youth
Authors: Ajith SJ , Narayanan Gitanjali , Sharma Manoj Kumar , Anand Nitin , Vishwakarma Akash
Published: February 2024

Background:

Youth involvement in gaming has become an important concern for mental health professionals due to its significant impact on functionality and relationships. However, the gaming motives and associated family relationships and personality traits in the Indian context are poorly understood.

Aim:

The study examined problematic online gaming, including Internet gaming disorder in connection to gaming motives and personality, especially as they impact family relationships among Indian youth.

Materials and Methods:

The study consisted of 179 participants (86 males; 93 females) with the age range of 18–25 years who were involved in Internet gaming in the last 1 year. The subjects were recruited using an online survey. Tools used were brief and included the Gaming Usage Questionnaire, Internet Gaming Disorder Scale-Short-Form, Motivation for Online Gaming Questionnaire UCLA Loneliness Scale, Sheehan Disability Scale, Brief Family Relationships Questionnaire, and MINI International Personality Item Pool.

Results:

The mean age of the participants was 21.99 ± 2.202 years. A stepwise multivariate regression analysis indicated that escape and competition motives, low cohesion in family relationships, low level of conscientiousness, and low level of intellect/imagination contributed to problematic gaming behaviors.

Conclusions:

The study established a relationship between gaming motives and both internal and external factors associated with problematic online gaming. Generalizing the findings across a larger youth population would help in developing informed preventive measures to reduce the risk of developing a gaming disorder.
Amisulpride as the antipsychotic of choice in severe psychotic disorder with comorbid impaired glucose tolerance
Authors: Asif Sumaila , Pattnaik Jigyansa Ipsita , Ahmed Syed Shahruq , Ravan Jayprakash Russell
Published: February 2024

Antipsychotics are the mainstay treatment for the majority of severe mental illnesses. Such patients are also more prone to develop medical comorbidities, which complicate the treatment decisions. It is estimated that up to 40% of individuals with schizophrenia have impaired glucose tolerance (IGT) or diabetes, which can be attributed to a combination of genetic, lifestyle, and medication-related factors. Some widely used antipsychotic medications like olanzapine, risperidone, and clozapine have been associated with an increased risk of weight gain, insulin resistance, and other metabolic abnormalities, which can worsen IGT and increase the risk of developing diabetes. Among second-generation antipsychotics (SGAs), amisulpride, aripirazole, and ziprasidone have a fairly low potency to cause obesity and hyperglycemia. In this context, clinicians must balance the benefits and risks of different antipsychotic medications and consider the individual’s specific needs and preferences. Here, we shall discuss three cases, to ascertain how the use of amisulpride helped in glycemic control, and also reflect on probable etiologies leading to deranged glucose levels.
Prevalence of internet addiction and its relationship with insomnia, depression, anxiety, and stress among medical students of a tertiary care medical institute of Eastern India
Authors: Rani Shreya , Sinha Niska , Kumar Rajesh
Published: February 2024

Background:

Internet has become an integral part of our daily lives but as the use of internet is increasing, it is important to be aware of the prevalence, context, and impact of its addiction on sleep and the presence of anxiety, depression, and stress in our lives.

Aim:

To assess the prevalence of internet addiction and its association with insomnia, depression, anxiety, and stress among medical students in a tertiary care medical institute in Eastern India.

Materials and Methods:

A descriptive cross-sectional questionnaire-based study with a purposive sampling method was conducted among 420 undergraduate medical students of different professional years. Out of 420 medical students, 413 students who gave consent and returned complete performa were taken in the study using a semi-structured performa for sociodemographic details, Young’s Internet Addiction Test, Insomnia Severity Index, and Depression Anxiety Stress Scale.

Results:

We found 31.2% of students had internet addiction, 24.2% had clinical insomnia, 58.1% had stress, 68.8% had anxiety, and 64.6% had depression. Potential internet addiction was significantly related to average screen time, insomnia, stress, anxiety, and depression.

Conclusions:

Internet addiction is prevalent among medical students affecting sleep, anxiety, depression, and stress, which needs urgent preventive strategies.
Navigating the Landscape of Preterm Neonatal Pain: A New Horizon in Sensory Stimulation
Authors: Sharma Abhishek , Sharma Nidhi , Chahal Aksh
Published: February 2024

Preterm infants often undergo painful medical procedures, and mitigating their pain remains a critical challenge in neonatal care. This manuscript explores the innovative approach of sensory stimulation as a promising horizon in alleviating preterm pain. Through a comprehensive review of existing literature, we examine the current understanding of pain perception in preterm infants and the limitations of conventional pain management strategies. The manuscript deals with the neurobiological underpinnings of pain in preterm neonates, shedding light on the unique challenges posed by their immature nervous systems. Drawing on recent advances in sensory science, we propose a paradigm shift toward personalized sensory stimulation interventions tailored to the developmental stage of preterm infants. A critical analysis of studies investigating the efficacy of various sensory modalities, including music therapy, tactile stimulation, and olfactory interventions, is presented. The manuscript also explores the potential integration of technological innovations, such as virtual reality, into neonatal care to enhance the positive impact of sensory stimulation on pain modulation. By fostering a deeper understanding of the neurobiological basis of pain in preterm neonates and exploring innovative interventions, this work aims to contribute to the ongoing efforts to improve the quality of care for this vulnerable population.
Ayurvedic management of Mootrashmari: A case report
Authors: Rana Deeksha , Sharma Meenakshi , Mandal Sisir Kumar , Agarwal Vivek
Published: February 2024

Urolithiasis is a urological disorder affecting about 12% of the world’s population. It results in recurrent urinary tract infections (UTI). The disease Mutrashmari is Kapha Pradhan Tridoshajavyadhi formed in Mutravahastrotasa (the urinary system). It is one among Asta-Mahagadha (eight fatal conditions) showing its severity. In the present case report, a 22-year-old female patient has complaints of acute pain and tenderness in the left and right iliac region, fever, burning micturition, and nausea. In Ayurveda, the condition corresponds to Mutrashmari. Classical holistic approach including Shamana Chikitsa with Varunadikashyam, Hazrulyahud Bhasma, and Cystone syrup for 6 months period was employed in this case. All the symptoms were relieved within 2 months of intervention and ultrasonography of abdomen was done after 6 months, which revealed no evidence of calculus. The case proved the potential of ayurvedic interventions in such renal calculus cases where the patient was advised nephrolithotomy by the allopathic physicians. The uniqueness of the case was that she got relief in not only objective and subjective parameters but no relapse of calculus and UTI was seen even after 1 year without taking the treatment. The findings of the case also suggested that the classical approach has enough potential in the management of large renal stones (> 6.5 mm) without any surgical intervention.
Acute encephalitis syndrome
Authors: Patnaik Sibabratta , Kamath Shrishu R. , Jain Mukesh Kumar
Published: February 2024

Acute encephalitis syndrome (AES) is a serious disorder characterized by the sudden onset of inflammation in the brain, which may lead to life-threatening clinical situations. This syndrome encompasses a range of neurological disorders, including, but not limited to, viral and bacterial infections, toxins, and metabolic causes. It includes a wide array of spectrum of diseases, and diagnosis is based on clinical symptoms and a wide range of investigations. Treatment is usually symptomatic, and in some instances, definitive treatment is available. Long-term sequelae of AES can include cognitive deficits, behavioral changes, motor impairments, and epilepsy. Rehabilitation and supportive care are often necessary.
Hemodynamic assessment and management of septic shock in children
Authors: Ranjit Suchitra , Natraj Rajeswari
Published: February 2024

The three main pathophysiologic contributors to septic shock include varying combinations of hypovolemia (relative > absolute), vasoplegia, and myocardial dysfunction. The three pillars of hemodynamic support include fluid boluses (FBs), vasopressors ± inotropic agents. The three goals of hemodynamic resuscitation include an adequate cardiac output (CO)/clinical perfusion markers, pressure parameters (adequate mean arterial pressure [MAP] and diastolic blood pressure [DBP]) for organ perfusion, and avoiding congestion (worse filling) parameters. Fluid bolus-induced CO improvements are variable (33%–50%) and ill-sustained on account of sepsis-mediated glycocalyx injury. A pragmatic approach is to administer a small bolus (10 mL/kg over 20–30 min) as a test and judge the response based on clinical perfusion markers, pressure parameters, and congestive features. Vasoplegia is characterized by low DBP, which is a major contributor to hypotension in septic shock; furthermore, FBs may exacerbate vasoplegia. A strategy of restricted FB with early low-dose norepinephrine (NE) (0.05–0.1 µg/kg/min) can be helpful. NE has press or effects and also mild inotropy and can be a useful first-line vasoactive even in patients with mild-moderate septic myocardial dysfunction (SMD) to maintain adequate coronary perfusion and DBP while minimizing tachycardia. Severe SMD may benefit from additional inotropy (epinephrine/dobutamine). Except vasopressin, most vasoactive drugs may safely be administered via a peripheral route. The lowest MAP (5th centile for age) may be an acceptable target, provided that end-organ perfusion and organ function (mentation and urine output) are satisfactory. An individualized rather than protocolized approach combining the history, physical examination, laboratory analyses, available monitoring tools, and re-assessments can improve outcomes.
Utility of pediatric early warning score at emergency room in predicting the level of care required for next 48 h: A single-center, prospective, observational study
Authors: Parwaiz Anas , Agrawal Nitika , Gupta Alpa , Simalti Ashish , Kedarnath Manju
Published: February 2024

Background:

Pediatric scores such as the Pediatric Early Warning Score (PEWS) are based on parameters available at the bedside. The aim of this study was to assess the utility of PEWS to determine the need for critical care support within the next 24–48 h. this study aimed to see if PEWS could predict a suitable level of care, namely ward, high-dependency unit (HDU), or pediatric intensive care unit (PICU).

Subjects and Methods:

It was a prospective observational study and a convenient sample method was used with children of age groups from 1 month to 18 years, coming to the pediatrics department being the subject. We correlated the level of care at admission and also after 48 h with PEWS at the time of admission of children already intubated, children on inotropes at the time of admission, children with surgical illness, and children admitted only for procedure/procedural sedation were excluded from this study. The Brighton PEWS was used to calculate PEWS.

Results:

A total of 953 patients were enrolled in this study. In this study, the likelihood of admission to PICU correlated well with PEWS above 6 with a positive predictive value of 56% and a negative predictive value of 99.43%.

Conclusions:

The admission PEWS can be used as an effective tool for deciding the level of care area. Score <3 admission PEWS can be kept at the ward, while >3 score at HDU/PICU where frequent periodic monitoring should be done.
Peri vesical and retroperitoneal vascular injury following pd catheter insertion in a child: An unusual occurrence
Authors: Srinivasan Shreyas , Singh Akhand Pratap , Kiran Chimmani Sai , Peters Nitin James
Published: February 2024

Peritoneal dialysis (PD) is an important modality of renal replacement therapy (RRT) in children in the acute setting. Despite the favorable outcomes of RRT, PD catheter insertions have various complications that may be related either to variations in procedural technique or infections. We report a case of a child with massive retroperitoneal and intra-abdominal bleeding secondary to injury to the inferior epigastric arterial arcade, near the urinary bladder following the insertion of a PD catheter.
Comparison of bedside risk assessment scores to predict the outcome of patients with acute febrile illness admitted to pediatric intensive care unit: A single-center prospective observational study
Authors: Alam Shahzad , Mazahir Rufaida , Agarwal Deepika
Published: February 2024

Background:

Acute febrile illness (AFI) is the most common presentation in the pediatric emergency room, and bedside risk assessment scores are very useful to identify those at risk. This study aimed to evaluate the predictive validity of quick Sequential Organ Failure Assessment (qSOFA), quick Pediatric Logistic Organ Dysfunction-2 (qPELOD-2), Liverpool qSOFA (LqSOFA), and Pediatric Early Warning Score (PEWS) to predict the outcome of patients with AFI admitted to the pediatric intensive care unit (PICU).

Subjects and Methods:

This prospective observational study included children under the age of 18 years admitted to PICU. A thorough history and examination was performed in the ER, and the qSOFA, the qPELOD-2, the LqSOFA, and the PEWS scores were calculated. The primary outcome was inhospital mortality. The capacity of the scores to predict outcome was evaluated for calibration (using Hosmer–Lemeshow adaptation of the Chi-square test) and discrimination (using receiver operating characteristic [ROC] curve). The scores were compared for any significant difference using z-statistics.

Results:

The study included 239 patients with the most common diagnosis of dengue fever. The overall mortality rate in the study was 8.4%. On the calibration of the models, all the scores showed a good fit to predict mortality. On discrimination by ROC curve, the LqSOFA score and PEWS had the best area under the curve for ROC curve (AUC-ROC) (0.913), followed by the qSOFA score (0.859). On comparing the AUC-ROC curve, no statistically significant difference was found between the scoring systems to predict mortality.

Conclusions:

Bedside risk stratification scores are a simple and convenient tool to identify patients at risk for mortality and assess prognosis. No single assessment tool was found superior to others.
Correlation of dental caries severity with physical properties of saliva in connection with nutrition status among a group of adolescent
Authors: Yousif Sarah Hikmat , Qasim Alhan Ahmed
Published: February 2024

Background:

One of the most common oral health problems in the world, dental caries, is a multifactorial sickness. Interactions between saliva, fermentable carbohydrates, acid-producing bacteria, and several host factors cause it.

Objective:

This study was conducted among a group of adolescents to evaluate the correlation of dental caries severity with the physical properties of saliva in connection with nutrition status among a group of adolescents.

Materials and Methods:

In total, 90 teenagers of both genders, aged 15, participated in the current observational (comparison) study. The participants were split into two groups: 60 had previously had caries (the study group) and 30 had not (the control group). Adolescents with diverse caries experiences were separated into two groups in accordance with World Health Organization (WHO) recommendations from 2013: 30 of them had moderately carious (1–3) teeth, and 30 had severely carious experiences (Decay-Missing-Filled Teeth [DMFT] > 10). Caries’ experience was measured using the DMFT Index. Weight, height, and body mass index (BMI) measurements were used to determine nutritional status. Based on their BMI, adolescents were categorized as having a healthy weight, being at risk of becoming overweight, or being overweight.

Results:

The current study’s findings show that both salivation rate and salivary and potential of hydrogen (pH) mostly decrease within nutritional status and caries severity groups but with no significant difference except in the total sample in salivation rate among nutritional status, its result is significant; also, there is a significant result between healthy and overweight in salivary flow rate, whereas other results are not significant.

Conclusion:

This study concluded that obesity is one of the factors responsible for deranged salivary parameters, that is, diminished stimulated salivary flow rate, buffer capacity, and salivary pH, which in turn has an adverse effect on oral health.
The role of methylenetetrahydrofolate reductase gene polymorphisms hypercoagulable status of coronavirus disease
Authors: Taha Ibraheem Kais , Mahmood Ibrahim Abdulla , Al-Mayah Qasim S
Published: February 2024

Background:

Hypercoagulation is a hallmark in coronavirus disease (COVID-19). The activity of the enzyme methylenetetrahydrofolate reductase (MTHFR) determines homocysteine levels, and polymorphisms in the enzyme’s gene can influence the enzyme activity with a consequence of hypercoagulability in patients with COVID-19.

Objectives:

To investigate the association of two single nucleotide polymorphisms (SNPs) in the MTHFR gene with hypercoagulability status in COVID-19.

Materials and Methods:

This is a retrospective cross-sectional study, which included 90 patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with variable severity. Patients were classified according to D-dimer level at admission into two groups: with and without hypercoagulability. Nucleic DNA was extracted from leukocytes and gene fragments corresponding to C677T and A1298C MTHFR gene were amplified and genotyped using allele specific polymerase chain reaction.

Results:

Hypercoagulation was reported in 42.22% of the patients. The mutant homozygous genotype (TT) was more frequent among hyper - than normocoagulable patients (13.6% vs. 1.92%) with a significant difference (odds ratio [OR] = 9.28, 95% confidence interval [CI] = 1.02–84.78, P = 0.048). Furthermore, T allele was more common among hyper- than normocoagulable patients (28.95% vs. 13.46%) with a significant difference (OR = 2.62, 95% CI = 1.24–5.5, P = 0.012). In contrast, the SNP A1298C had no significant impact.

Conclusions:

The TT genotype and T allele of C677T polymorphism but not A1298C in cMTHFE gene could be considered a risk factor for the hypercoagulable status in COVID-19.