bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Information and Communication Technology in the Digitalization of Violence and Sexual Politics in the Indian Scenario
Authors: Verma Rabindra Kumar , Gupta Ashish Kumar
Published: October 2023

The latter half of the 20th century witnessed rapid growth in the domain of science and technology especially information and communication technology (ICT). The impact of ICT can easily be seen in the different domains of humans like science, education, professional career, culture, and politics, explicitly and implicitly or negatively. There are different types of digital violence exercised against women. Some of the forms range from hacking, controlling, or manipulating information, doxing, dissemination of intimate photos or private information, use of spyware, surveillance, faking identity, cyberbullying like posting or sharing embarrassing or threatening pictures, defamation, harassment, stalking in the form of sending online unsolicited or unwanted sex-based materials, and rape threats. The chapter attempts to explore role of the digital technology and online platforms as intermediaries in rendering gender-based violence, digitalization of gender-based violence, verbal or nonverbal sexual assaults, and online sexual politics to prolong women's subjection in India.
Unveiling the Portrayal of Intimate Partner Violence Against Women in the Media
Authors: Akbaş Gülçin , Ceylan-Batur Suzan
Published: October 2023

Intimate partner violence (IPV) against women is a pervasive global issue. The media plays a significant role in shaping society's perceptions and understanding of IPV. This study focuses on the representation of femicide in Turkish newspapers, with a specific focus on the context of Turkey as an honor culture characterized by a distinct emphasis on female sexual purity and male dominance. Honor cultures often justify violence against women in the name of preserving honor. This research aims to investigate how newspapers depict honor-based IPV through quantitative analysis, content analysis, discourse analysis, and frame analysis of femicide cases. The findings reveal that newspapers frame IPV within an honor culture by victim-blaming and justifying men's violent behavior. Additionally, news coverage often portrays honor-based IPV as isolated incidents, failing to recognize its reflection of the broader honor culture. These portrayals inadvertently perpetuate and legitimize IPV, discouraging women from seeking assistance and support.
Marginalization at Cyberspace
Authors: Ajit Geeta
Published: October 2023

Cyberspace has been acknowledged as a free space, opening opportunities regardless of caste or gender. But this notion that this technology liberates users into a more democratic genderless world with equality still remains a fallacy. Neither has gender been erased nor has everyone been welcomed into this cyberspace. Not only are girls and women targeted more in this space; they also suffer serious consequences resulting in permanent psychological suffering. Male perpetrators not only dominate the mixed-sex electronic conversation; they have also been identified as frequent instigators of on-line sexual harassment-observations difficult to reconcile with the notion of a gender-neutral utopia. While women enter into this space in hope of a common genderless language, they soon end up unsubscribing from this digital space and also withdraw themselves into silence and isolation thereon.
Semiotic Violence and Gender in Digital Spaces
Authors: Ghosh Soumya Sankar
Published: October 2023

Various definitions of violence exist, ranging from those that only consider physical assaults to those that also take into account sexual assault, psychological abuse, and economic exploitation. Both genders are discursively represented in their heterogeneity. (The feminine is frequently portrayed as a commodity, while the masculine is frequently portrayed as weak and pathological.) What is more important, though, is the understanding that there are specific types of gender violence that target women and utilize sexist language and images to harm and oppress them. This incident is categorized in the study as semiotic violence. Women are not the only ones who may experience this type of assault; anybody can. Even though it is the most pervasive, covert, and despised kind of violence committed against a person, it is generally ignored. The main goal of this study on semiotic violence is to improve understanding of this kind of violence.
Cyber Crime in India
Authors: Pareek Ritu
Published: October 2023

The increasing use of digital technologies and the internet has provided immense opportunities for communication, information sharing, and social interaction. However, alongside these benefits, the cyber world has also become a platform for the perpetration of offences against women. This chapter investigates the problem of violations and crimes targeting women in the cyber world, with particular emphasis on India. It explores the various forms of cyber offence women face, the underlying factors contributing to such crime, and the legal and policy framework in India. The chapter also highlights the challenges in addressing cyber offences against women and proposes strategies for prevention and support.
A Study of Cyber Threats on Physical and Mental Health With Special Reference to Pandemic Times
Authors: Choudhary Sanju , Chaudhary Vishva , Meel Vijendra Singh
Published: October 2023

Cyber security has always been critical for safeguarding sensitive information, but in recent years, its impact on physical health has become increasingly apparent. The need for cyber security has become more critical in the digital age, as cyber threats have become more sophisticated and pervasive. As healthcare becomes increasingly digitized, the need for robust cyber security measures has become more important than ever. Cyber-attacks on healthcare systems can have devastating consequences on patient care, as the loss of crucial patient information can lead to delays or errors in medical treatment. Moreover, the pandemic has accelerated the shift to remote healthcare and telemedicine, leading to an increase in cyber-attacks on personal devices used for medical purposes, such as laptops and smartphones. These attacks can compromise personal health data, leading to delayed or ineffective medical treatment.
Messaging App Using Flutter
Authors: Talluri Sreelalitha , Vaishnavi G. , Naidu G. , Shiva D.
Published: October 2023

The aim of this project is to build a real-time messaging app using modern technologies. Unlike most chat apps available in the market, the present system will focus on developers and will try to increase their productivity are coding and archive view. The main features of the project are completely open source. The users will be able to dig into the code to learn what happens after the scenes or contribute to the source code. It was therefore within this intent to write pure codes, which could be measured by following the most popular patterns and principles of each language and relevant libraries. The main objective of this project is going to build an application through which Instant mobile app and web applications are used for communication between the users. The applications initiate message sending via internet, making it free of cost for the users. Sending messages can be in the form of a text message or it can be a voice call.
Comprehensive Analysis of the Artificial Intelligence Approaches for Detecting Misogynistic Mixed-Code Online Content in South Asian Countries
Authors: Yadav Sargam , Kaushik Abhishek , Sharma Surbhi
Published: October 2023

The rise of social media has drastically altered several aspects of daily life and businesses. With all its advantages, the anonymity and lack of accountability social media provides encourages unsavoury individuals to spread hate. Hate targeted towards a particular group, such as women, can have a silencing effect and discourage them from participating in online discourse. In this chapter, the authors review recent studies and toolkits that attempt to tackle the issue of hate speech on online platforms using natural language processing (NLP) techniques. Challenges and shared tasks that are regularly conducted to advance the current state-of-the-art in hate speech detection in English and other under-resourced languages are also reviewed. The comprehensive survey suggests that despite the recent increase in interest in the problem of filtering online hate speech, the field is still in its infancy, specifically the problem of misogyny identification in under-resourced languages.
Balancing Resilience and Digital Distractions
Authors: O'Byrne W. Ian , Ward Spencer
Published: October 2023

The digital age has presented both advantages and issues in learning, communication, and overall well-being. Digital technology can provide entertainment, information, and connection but can also increase stress levels, and confusion, and weaken resilience. How can youth build the skills needed to stay focused and avoid digital distractions? What support do educators and parents offer in this endeavor? The chapter will conclude by highlighting the importance of balancing resilience and digital engagement in the digital landscape. While digital distractions can pose challenges to youth's focus and concentration, they can also offer opportunities for learning and creativity. The chapter will argue that youth need to develop a critical and reflective attitude toward digital technology and its role in their lives. The chapter concludes by highlighting the importance of balancing resilience and digital engagement and developing a critical and reflective attitude toward digital technology.
Open Innovation and Crowdsourcing in the Public Sector in Portugal
Authors: Bernardino Susana , Rocha Vera
Published: October 2023

Participatory budgeting is a recent mechanism that is related to open innovation and crowdsourcing in public entities and allows the participation of society in governmental interests. This chapter aims to analyse the use of open innovation and crowdsourcing tools in the public sector in Portugal, in the form of participatory budgets, and also to understand the characteristics of the participatory budget processes used, as well as the motivations for their implementation and the difficulties faced. For these purposes, the investigation uses a quantitative methodology, by means of a questionnaire sent to Portuguese municipalities. The research carried out reveals influences between the size of municipalities and the use of participatory budget and its characteristics. The investigation also highlights the main motivations for its implementation, the greatest difficulties experienced, and the perceived barriers to non-implementation.
The Role of New Media Literacy and Critical Thinking on Predicting Digital Citizenship
Authors: Orhan Ali
Published: October 2023

This chapter aimed to investigate the predictive role of new media literacy levels and critical thinking dispositions of university students on their digital citizenship levels. The study was carried out with 124 university students studying in different departments of a state university in Türkiye, and the data were gathered using New Media Literacy Scale, Sosu Critical Thinking Dispositions Scale, and Digital Citizenship Scale. It was concluded that university students had high new media literacy levels and critical thinking dispositions while they presented moderate digital citizenship levels. Also, university students' new media literacy levels and critical thinking dispositions had a moderate and positive relationship with their digital citizenship levels. It was also concluded that university students' new media literacy levels and critical thinking dispositions significantly predicted their digital citizenship levels, and they together explained 17% of the total variance on their digital citizenship levels.
Beyond the Stars
Authors: Adetayo Adebowale Jeremy , Ufomba Eleazar Enyioma
Published: October 2023

This study analyzed data from 1009 participants to examine the relationship between information sources on the James Webb Space Telescope (JWST) and beliefs in a supreme being. Results revealed a significant correlation between JWST information sources and changes in belief. Facebook, church/mosque, and religious leaders were identified as influential factors if intelligent alien life were discovered by JWST. Libraries ranked as crucial unbiased sources of JWST information. The study underscores the importance of accessing reliable information, utilizing libraries, and engaging in informed discussions within religious organizations. It highlights the potential impact of discovering extraterrestrial life on religious beliefs and suggests the need for open dialogue. Overall, the study provides valuable insights into how information sources can shape beliefs and advocates for an informed approach to JWST information dissemination.
The Spiritual Paradox of AI
Authors: Ali Syed Adnan , Khan Rehan
Published: October 2023

This book chapter explores the relationship between AI and spirituality, considering how AI's increasing presence and influence may challenge traditional spiritual beliefs and practices, and how it may shape our understanding of spirituality and the divine. The chapter also considers how AI may impact our sense of self, including its ability to collect and analyze vast amounts of personal data and the ethical implications of this. The potential spiritual benefits and drawbacks of AI's increasing presence in society are reflected upon, including its ability to help us connect with the divine in new and unexpected ways while challenging us to think more deeply about our own sense of self and our relationship with the world around us.
The Soulful Machine
Authors: Chakraborty Swati
Published: October 2023

“The Soulful Machine: Reflections on Humanism, Spiritualism, and Artificial Intelligence” is a thought-provoking title that explores the intersection of humanism, spiritualism, and artificial intelligence. This chapter delves into the profound questions surrounding the nature of consciousness, the soul, and the impact of AI on our understanding of these concepts. It delves into how humanistic and spiritual perspectives can inform our approach to AI development, ethics, and the overall integration of technology into our lives. Through deep reflections and insightful discussions, this chapter invites readers to contemplate the spiritual dimensions of AI and its implications for our personal and collective journeys.
Semantic Web Service Architecture for Improving Supply Chain Operation
Authors: Pal Kamalendu
Published: October 2023

Data-driven decision-making is the lifeblood of supply chain business processes' smooth execution. Technological development is ushering in the possible improvement of supply chain data-processing architecture. The centralized server-based data-processing system has been dominating industrial supply chain management for a long time with the challenge of scalability, data integrity, and information security. In recent years, the internet of things (IoT) with service-oriented architecture (SOA) and semantic technology has eliminated the drawbacks of server-based centralized working practices. This approach enhances the information processing performance for resource-constrained supply chain operations through semantic data integration and system security enhancement. This chapter presents an IoT with semantic web service-based information system architecture to allow safe data flow along the supply chain networks. Finally, the chapter describes a semantic similarity assessment algorithm to realize the advantage of this architecture.
Marketing Big Data Analytics and Customer Relationship Management
Authors: Bouhtati Naoual , Alla Lhoussaine , Bentalha Badr
Published: October 2023

Customer knowledge is a strategic element, and its importance is growing all the time. The role of the vast quantities of information available in customer relationship management (CRM) systems, when processed using emerging big data techniques, is still in its infancy. Customer relationship management needs big data to improve customer experience and the right targeting of marketing actions. The study aims at designing a hierarchical model via the fuzzy approach of the indicators of the big data marketing approaches and the possible effects on the CRM. The results suggest that CRM initiatives based on big data could be envisaged as a supportive trend in relation to various managerial and structural dimensions. The study also identified major difficulties of big data analysis in CRM, such as storage, quality, process, and cost issues.
Introducing On-Demand Internet Business Model in the Informal Public Transportation System in Developing Countries
Authors: Hiran Kamal Kant , Doshi Ruchi , Mijwil Maad M.
Published: October 2023

Paratransit transport drives the transport system in most emerging nations. It is essential to urban and rural movement. The informal transport system carries most people and is often more accessible, faster, ubiquitous, cheaper, and reliable, but it has also become environmentally unclean, rickety, unsafe, and oversupplied, causing traffic congestion, especially in cities. Due to their informal nature, informal public transport system improvements have failed. The research studied the possibility of bringing the on-demand internet business model to informal public transportation using Accra's paratransit as a case study. The report evaluated the unique nature, characteristics, potential and problems of the informal public transport eco-system and advocated activities that will meet the socio-economic and travel demands of all parties of the two-sided platform. Thus, adopting the on-demand internet business model in the informal public transport sector will not only address the paratransit service's supply-demand mismatch but also significantly reduce traffic congestion.
Transforming Supply Chains (SCs) to Meet Sustainability Challenges
Authors: Iqbal Tahir
Published: October 2023

The key aspect of the current chapter is related to the sustainability challenges of the supply chain and its associated consideration towards the transformation of operations. The primary motivation for evaluation has been related to the influence of sustainability considerations for supply chain development, aligned issues, and their respective solutions. To highlight the reader's approach for supply chain sustainability, the importance and influences have been discussed regarding waste management and its related influences on the cost and productivity efficiency within the supply chain. The crucial aspects of supply chain sustainability have also enlightened some challenges. The challenges include human resources, management, structure development, and user perception as well. Technological and intelligence based facilities such as IoT, block-chain, and artificial intelligence have an influence on the management of challenges and the developing effective strategies for green supply chain management. The recommendation for production to transportation management has been provided.
Using videos to mitigate risk factors for cardiovascular disease and diabetes mellitus in risk communication; sharing experiences from Singapore
Authors: Illangasinghe Dhananja K.
Published: October 2023

No abstract available
Translation, adaptation and validation of the Sinhala Version of Weight Efficacy Lifestyle Questionnaire Short Form (WEL-SF) for women
Authors: Herath Deshani , Kasturiratne Anuradhani
Published: October 2023

Introduction: The global obesity burden is rising alarmingly due to unhealthy lifestyle behaviours and environmental factors. To date, prevention and treatment efforts to combat obesity mainly focus on lifestyle modifications through diet and physical activity. Eating self-efficacy has been related to weight loss and is considered a significant predictor of weight loss in an individual. The Weight Efficacy Lifestyle Questionnaire Short Form (WEL-SF) is an American instrument used for research and clinical purposes to measure self-efficacy for controlling eating in specific situations.Objectives: Translation, cultural adaptation and validation of the WEL-SFMethods: A sample of 100 women aged ≥ 18 years who were attempting to reduce their weight through self-monitored non-therapeutic diet control in Panadura Medical Officer of Health (MOH) Area, Sri Lanka was recruited using a purposive sampling method. Data were collected using a self-administered questionnaire with socio-demographic information and Sinhala version of the WEL-SF. The construct validity was evaluated by Exploratory Factor Analysis (EFA) using Principal Component Analysis (PCA), while the reliability of the scale was determined by Cronbach's alpha.Results: The eight-item WEL-SF showed a one-factor solution by EFA. All the items on the scale were retained. The model explained a total variance of 59.35%. The internal consistency of WEL-SF was 0.905 using Cronbach’s alpha. The test-retest reliability of the instrument had a high Spearman's correlation of more than 0.7.Conclusions & Recommendations: The Sinhala version of WEL-SF for women to assess self-efficacy levels in overeating appears to be psychometrically valid with high reliability. This instrument can be recommended as a screening tool to assess self-efficacy levels in women striving for a healthy weight.
Emphysematous Pyelonephritis and Diabetes Mellitus
Authors: Bale Charan , Mhaske Sunil , Purandare Vedavati B , Kulkarni Akshay , Chavan Abhijit , Vyas Nishant , Purandare Bharat
Published: October 2023

Emphysematous urinary tract infections (UTIs) are lower or upper UTIs associated with gas formation. Emphysematous pyelonephritis (EPN) is a rare disease but is highly prevalent in patients with diabetes and even higher among female patients with diabetes. Earlier, the mortality rate of EPN was 60%–80%, but now, it has been reduced to 20% to 25% due to the availability of good antimicrobial agents and timely treatment. Our objective of this article is to elucidate the pathogenesis of EPN including gas-forming mechanism; discuss clinical features, radiological classification, and prognostic factors; in addition, compare the modalities of management of EPN and outcome among the various radiological classes.
Pragmatic and Early Usage of Statin in Patients with Diabetes for Prevention of Atherosclerotic Cardiovascular Disease
Authors: Kalra Sanjay , Kumar Surender , Pandit Kaushik , Anantharaman R. , Dhingra Atul , Periyandavar I , Chawla Manoj , Magdum Mohan , Desai Piyush , Deb Prasun , Rajasekaran Senthil Kumar , Nair Ramesh N. , Shaikh Shehla , Banzal Subodh , Kota Sunil , Shah Tejas , Revankar Santosh Y. , Gupta Amit
Published: October 2023

Background:

An early initiation of statins in the diabetes population helps in prevention of atherosclerotic cardiovascular disease (ASCVD). However, there is a paucity of data on its use in young Indian patients with diabetes. This survey report aimed to provide opinion-based recommendations for pragmatic usage of statin in diabetes population of India.

Material and Methods:

Discussion and virtual survey (a questionnaire of 18 questions) was conducted at 16 round table meetings (RTMs) which included participation of health-care practitioners (HCPs) from India. On the basis of their opinions and discussion, general recommendations about early usage of statins in diabetes for prevention of ASCVD were derived.

Results:

Out of 261 HCPs participated, 56.1% recommended initiating statins in patients aged 41–50 years irrespective of their total/low-density lipoprotein cholesterol (LDL-C) levels. Among people with diabetes aged between 20 and 39 years, 38.9% of HCPs considered LDL-C >100 mg/dL and 77% of HCPs considered history of ASCVD as a risk factor for early statin initiation. Overall, 98.9% of HCPs agreed that early initiation of statin in people with diabetes and ASCVD risk factors will help reduce ASCVD. The majority of HCPs recommended initiating moderate-intensity (51.2%) and low-intensity (43.8%) statins and assess every 3 months for tolerance and compliance in people with diabetes (aged 20–39 years) and additional ASCVD risk factors. The use of rosuvastatin (78.5% of HCPs) was preferred for early initiation in people with diabetes. Majority of HCPs agreed (57.3%) or strongly agreed (36.2%) that rosuvastatin has more clinical utility compared to other statins due to better LDL-C-lowering effect and other pleiotropic effects. Physician's inertia limits the effective use of statins among young adults with diabetes (55.8%), and 65.8% of HCPs recommended screening of people with diabetes for additional ASCVD risk factors.

Conclusion:

The participating HCPs opined that early initiation of statin therapy in people with diabetes and ASCVD risk factors will help reduce ASCVD. Rosuvastatin is mostly recommended for early initiation of statin therapy among the diabetes population for prevention of ASCVD. There is a necessity of using a proactive approach to screen for additional ASCVD risk factors in young individuals with diabetes and further increase the awareness about benefits of initiating statin therapy from an early stage.
Paricalcitol Improved Cardiac Hypertrophy and Fibrosis through Upregulation of Fibroblast Growth Factor-23 and Downregulation of Transforming Growth Factor-beta in a Rat Model of Isoproterenol-Induced Cardiomyopathy
Authors: Wu Chieh-Jen , Li Yu-He , Chen Hsin-Hung
Published: October 2023

Acute cardiomyopathy is a significant global health concern and one of the leading causes of death in developed countries. Prior studies have shown an association between acute cardiomyopathy and low vitamin D levels. Although paricalcitol, a vitamin D receptor (VDR) activator, has demonstrated clinical benefits in patients with advanced kidney disease, its effect on cardiac remodeling in cardiomyopathy is unknown. This study aimed to investigate the relative effects of paricalcitol on cardiomyopathy in rats. Wistar–Kyoto rats were administered vehicle (sham control group) or isoproterenol to induce cardiomyopathy. Rats administered isoproterenol were subsequently treated with paricalcitol (experimental group) or vehicle (isoproterenol group). Picrosirius red and immunofluorescence staining were used to analyze cardiac fibrosis and hypertrophy. Immunohistochemistry staining was used to confirm the molecular mechanisms involved in isoproterenol-induced cardiomyopathy in rats. Injection of paricalcitol could reduce collagen and transforming growth factor-beta 1 (TGF-β1) levels while activating fibroblast growth factor receptor 1 (FGFR1) and fibroblast growth factor-23 (FGF23) without the help of Klotho, thereby reducing myocardial hypertrophy and fibrosis. As a VDR activator, paricalcitol reduces isoproterenol-induced cardiac fibrosis and hypertrophy by reducing the expression of TGF-β1 and enhancing the expression of VDR, FGFR1, and FGF23.
Exploring the self-control efficacy of risk factors using self-management program in patients with acute coronary
Authors: Yang Yi-Chun , Wang Hsiang-Ping , Wu Bao-Tzung , Chiang Tsay-I , Chang Kuang-Hsi
Published: October 2023

Background:

Cardiovascular diseases are a major cause of death and disability. Research shows that self-management is better than routine care for improving patients’ awareness of diseases, self-care, and self-efficacy, thereby reducing the recurrence and mortality rates of cardiovascular diseases.

Objectives:

This study examined the self-control efficacy of risk factors in patients with acute coronary syndrome (ACS) before and after a self-management program.

Methods:

Purposive sampling was used in this quasi-experimental study. Thirty-eight participants were enrolled from January 1, 2020, to June 30, 2020. The case manager utilized a self-management program as the intervention and developed the “Questionnaire on Self-management of ACS.” Measurements were conducted for each sample before, during, and after the intervention.

Results:

Each participant in the sample had at least three risk factors for ACS, with an average of 5.3 risk factors. The overall self-management scores before and after the intervention were notably different (F = 135.842, P < 0.001), with significant differences in two dimensions: disease awareness (F = 159.752, P < 0.001) and behavior compliance (F = 111.63, P < 0.001).

Conclusion:

Controlling the risk factors for ACS requires continuous adjustment and maintenance of lifestyle. Exercise-related behaviors before and after the self-management program showed the worst compliance. Thus, appropriate interventions should be combined with intelligent devices to assist patients in integrating health management into their lifestyles, thereby reducing risk factors and preventing disease recurrence.
Situational analysis of medical care for heart failure patients in a regional hospital in central Taiwan
Authors: Yang Yi-Chun , Lin Pin-Chun , Chiao Chun-Hui , Lin Cheng-Sheng
Published: October 2023

Background:

Heart failure (HF) is a complex clinical syndrome and a leading cause of morbidity and mortality worldwide. Its symptoms are the ultimate severe results of all heart diseases.

Objectives:

To assess the situation of medical care for patients with HF in a regional hospital in central Taiwan.

Methods:

This retrospective study was conducted from June 1, 2019, to September 30, 2021, collecting basic information of patients, hospitalization and medication after discharge, emergency room visit, readmission, and mortality.

Results:

This study included 101 patients with HF with reduced ejection fraction, of which 71.3% were males. Their mean age was 64.9 ± 15.4 years, and the mean body mass index was 26.4 ± 5.6 kg/m2. Moreover, 89.1% of them had chronic diseases, such as hypertension, diabetes, and heart disease; the mean left ventricular ejection fraction was 27.4% ± 7.7%. During hospitalization and at 1, 6, and 12 months after discharge, the administration rates were 61.4%, 39.6%, 26.7%, and 22.8% for angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker/angiotensin-neprilysin inhibitor; 64.4%, 41.6%, 27.7%, and 35.6% for beta-blocker; 47.5%, 26.7%, 14.9%, and 17.8% for mineralocorticoid receptor antagonist; and 4.9%, 2.0%, 1.0%, and 3.0% for sodium-glucose cotransporter-2 inhibitor, respectively. The rates of emergency room visit, readmission, and mortality due to cardiac reasons within 12 months after discharge were 18.8%, 20.8%, and 8.9%, respectively.

Conclusion:

Given that HF is a complex disease, the underlying causes must be treated, and the guideline-directed medical therapy must be applied to prevent the recurrence of an acute attack. Given the complexity of this high-functioning disease, it is essential to have a dedicated case manager who can ensure comprehensive integration of care.
Chronic pain syndrome—Fibromyalgia
Authors: Liao Da-Ming , Chen Chieh
Published: October 2023

Fibromyalgia is a systemic disease with multiple muscle and fascia tender points, combined with chronic inflammation or neuropathies. Apart from feeling many tender points all over the body, patients also have many atypical symptoms, such as anxiety and migraine. Pain can be caused by even light activities. Additionally, the incidence rate of women aged 20–50 years is much higher than that of men, and the main clinical symptoms are chronic and extensive pain and tenderness. Patients with fibromyalgia have many common clinical comorbidities, such as depression, anxiety, sleep disorders, chronic fatigue, chronic headaches, temporomandibular joint disorders, general numbness and tingling, irritable bowel syndrome, difficulty concentrating, and so on. The symptoms reduce the patient’s quality of life. Patients with fibromyalgia often have symptoms other than muscle pain. Thus, it is clinically referred to as fibromyalgia syndrome. Moreover, fibromyalgia is similar to the symptoms of many autoimmune diseases, such as rheumatoid arthritis, lupus erythematosus, polymyositis, and so on. Physicians should exclude these diseases to ensure accurate diagnosis.
Evaluating Time in Range as an Outcome Measure for Vildagliptin 100 mg SR OD
Authors: Bhograj Abhijit , Sahay Rakesh , Sawn Pramod , Warrier Sona , Prasad Ashish , Birla Ashish
Published: October 2023

Background:

Vildagliptin, a dipeptidyl peptidase-4 inhibitor, has shown promising effects in improving glycemic control in patients with diabetes. Glycemic variability, characterized by fluctuations in blood glucose levels, is a common challenge in diabetes management. It has been associated with an increased risk of both acute and chronic complications. Clinical studies evaluating the effects of vildagliptin 50 mg bid have demonstrated its ability to reduce glycemic variability and improve the TIR. Vildagliptin has been shown to decrease postprandial glucose excursions and nocturnal glycemic fluctuations, leading to a smoother glycemic profile.

Aims and Objectives:

This pilot study highlights the relationship between vildagliptin 100 mg sustained release once daily (SR OD) therapy and its potential impact on reducing glycemic variability and promoting a better time in range (TIR) for patients with diabetes.

Materials and Methods:

In this study, patients were enrolled in a prospective, multicentric, and observational study to assess the real-world experience of vildagliptin 100 mg SR OD in terms of glycemic variability.

Results and Conclusions:

At the end of the pilot study period of 14 days, the results demonstrated that in real-life experience, vildagliptin 100 mg SR OD was associated with a clinically meaningful reduction in hemoglobin A1c, and a higher proportion of patients maintained their average blood glucose levels between 70 and 180 mg/dL for almost three-fourth of a day.
Vitamin D status & bone health in patients with liver cirrhosis
Authors: Grover Indu , Singh Namrata , Gunjan Deepak , Benjamin Jaya , Ramakrishnan Lakshmy , Pandey R.M. , Sati Hem Chandra , Saraya Anoop
Published: October 2023

Background & objectives:

Vitamin D plays an important role in bone metabolism, and liver is the intermediary site of vitamin D metabolism. The purpose of this study was to study the prevalence of vitamin D deficiency and bone health in patients with cirrhosis.

Methods:

Prospectively, serum 25-hydroxy vitamin D [25(OH)D] level were assessed in cirrhotics by chemiluminescence method. Endocrine Society Clinical practice guideline was used to define deficiency and insufficiency of vitamin D. Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry and the World Health Organization criteria was used to define osteoporosis and osteopenia. The lowest T score at the left hip neck or lumbar spine was taken as osteoporosis or osteopenia. The Child-Turcotte-Pugh score was used to assess the severity of cirrhosis.

Results:

Cirrhotics (n=350, male: 278, compensated: 210) were included. Mean serum 25(OH)D level was 8.75 ng/ml. The prevalence of vitamin D deficiency (VDD) and low-BMD (osteopenia and osteoporosis) was 89.4 and 86 per cent, respectively. VDD, insufficiency and osteoporosis was found in 86.7, 11.9 and 33.8 per cent, respectively, in patients with compensated cirrhosis; and 93.6, 3.6 and 40 per cent, respectively, in patients with decompensated cirrhosis. Body mass index of >25 kg/m2 was protective for bone health.

Interpretation & conclusions:

VDD and low-BMD is prevalent in Indian patients with cirrhosis and should be looked for in patients with cirrhosis for its prevention.
Overview of immunological & virological factors driving the evolution & global spread of SARS-CoV-2 variants
Authors: Ramasamy Ranjan
Published: October 2023

The SARS-CoV-2, a highly infectious positive strand RNA virus first identified in December 2019, has produced multiple genetic variants that have rapidly and sequentially spread worldwide during the coronavirus disease 2019 (COVID-19) pandemic. Genetic changes in SARS-CoV-2 for greater infectivity, replication and transmission were selected during the early stages of the pandemic. More recently, after widespread infection and vaccination, SARS-CoV-2 variants that evade antigen-specific adaptive immunity, have begun to be selected. This article provides an overview of the molecular immunological and virological factors underlying the origin and global spread of important SARS-CoV-2 variant lineages.
Lipid profile abnormalities & 10 yr risk of CVD assessment among adult in North East India: A cross-sectional study
Authors: Majumder Nilratan , Das Rituparna , Debbarma Ripan , Majumder Nilanjan , De Suranjana
Published: October 2023

Background & objectives:

In India, lifestyle changes have contributed to increase in the number of people suffering from lipid profile abnormalities, which is a major risk factor for coronary artery diseases. The present study was aimed to estimate the prevalence of lipid profile abnormalities and 10 yr risk of cardiovascular disease (CVD) among the adult population in west Tripura district and to study the association of lipid profile abnormalities and increased CVD risk with sociodemography, body mass index (BMI), hypertension, random blood sugar (RBS) and haemoglobin level.

Methods:

This cross-sectional study was conducted amongst 445 adults of 20 to 60 yr of age from a randomly selected block in west Tripura district. The 10 yr risk of CVD was estimated using the Framingham Risk Assessment Tool.

Results:

The study revealed that overall 83.4 per cent adult population had lipid profile abnormalities, with 22.2, 42 and 70.3 per cent of participants having hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein level, respectively. Gender (P=0.02) and BMI (P<0.001) were the significant determinants of dyslipidaemia. Only 3.8 per cent of participants had intermediate or high risk of CVD, with all of them being males. Gender, age, occupation and RBS were significantly associated with increased CVD risk.

Interpretation & conclusions:

The study revealed a high burden of lipid profile abnormalities in the study population, with males having more risk of CVD. Hence, periodic screening of lipid profile abnormalities and risk of CVD should be incorporated at the primary care level to combat the CVD epidemic in India.
Transfusion trigger in the critically ill with sepsis or septic shock: A prospective study
Authors: Mustahsin Mohd. , Maitra Souvik , Anand Rahul Kumar , Soneja Manish , Madan Karan , Darlong Vanlal , Baidya Dalim Kumar
Published: October 2023

Background & objectives:

Current practice around transfusion trigger in critically ill sepsis patients is not clear. Moreover, any association of haemoglobin trigger and other transfusion parameters such as age of red blood cells (RBCs) at transfusion and number of units of RBCs transfused with mortality and other adverse outcomes need further assessment.

Methods:

In this prospective study, patients aged 18-70 yr and admitted to intensive care with a diagnosis of sepsis were included (n=108). Baseline demographic, clinical and laboratory parameters were noted and various transfusion data, i.e., haemoglobin trigger, number of units of RBCs and the age of RBCs were recorded. Following outcome data were collected: 28 and 90 day mortality, duration of mechanical ventilation, vasopressor therapy, intensive care unit (ICU) and hospital stay and requirement of renal replacement therapy.

Results:

Of the total 108 participants, 78 (72.2%) survived till 28 days and 66 (61.1%) survived till 90 days. Transfusion trigger was 6.9 (6.7-7.1) g/dl [median (interquartile range)]. On multivariable logistic regression analysis, acute physiology and chronic health evaluation (APACHE) II [adjusted odds ratio (aOR) (95% confidence interval {CI}): 0.86 (0.78, 0.96); P=0.005], cumulative fluid balance (CFB) [aOR (95% CI): 0.99 (0.99, 0.99); P=0.005] and admission platelet count [aOR (95% CI): 1.69 (1.01, 2.84); P=0.043] were the predictors of 28 day mortality [model area under the receiver operating characteristics (AUROC) 0.81]. APACHE II [aOR (95% CI): 0.88 (0.81, 0.97); P=0.013], CFB [a OR (95% CI): 0.99977 (0.99962, 0.99993); P=0.044] and transfusion trigger [aOR (95% CI): 3 (1.07, 8.34); P=0.035] were the predictors of 90 day mortality (model AUROC: 0.82).

Interpretation & conclusions:

In sepsis, patients admitted to the ICU, current practice suggests transfusion trigger is below 7 g/dl and it does not affect any adverse outcome including 28 day mortality.
Differential invasiveness & expression of antimicrobial peptides in Shigella serotypes
Authors: Narayan Chandradeo , Kant Vishal , Mahajan Jai Kumar , Mohan Balvinder , Taneja Neelam
Published: October 2023

Background & objectives:

The study of Shigella pathogenesis at present is severely hampered by the lack of a relevant animal model that replicates human bacillary dysentery. Different Shigella serogroups cause varying severity of clinical illness. Ex vivo colonization of Shigella flexneri, S. dysenteriae and S. sonnei were characterized in human paediatric colonic pinch biopsies in the in vitro organ culture (IVOC) model to study the invasiveness of Shigella by gentamicin protection assay (GPA). Furthermore, the expression of antimicrobial peptides (AMPs) in response to different serotypes of Shigella was also studied in IVOC model.

Methods:

IVOC explants were inoculated with 109 colony forming units of different serotypes of Shigella and recovery of bacteria studied. Histopathological analysis was carried out to study inflammatory immune responses. GPA was done to elucidate the invasiveness of different serotypes of Shigella. Secretions of AMPs were measured by enzyme-linked immunosorbent assay (ELISA). Western blotting was performed to check the expression of AMPs and nuclear factor kappa B in IVOC explants.

Results:

After 24 h post-infection, the colon biopsies showed intense inflammatory reaction. In both IVOC and GPA, S. dysenteriae 1 was the most invasive as compared to S. flexneri and S. sonnei. S. sonnei was the least invasive. ELISA demonstrated that S. sonnei dampened the HBD (human β-defensin)-2 responses whereas there was augmentation by S. dysenteriae and there was a modest but non-significant increase by S. flexneri. A modest increase in HBD-3 by S. sonnei and S. flexneri was observed but was not found to be significant. However, western blotting data showed upregulation of all AMPs by all serotypes. Western blotting is more sensitive than ELISA.

Interpretation & conclusions:

In the present study, differences in invasiveness and AMP production induced by different serotypes of Shigella were found. Human intestinal IVOC represents a model system to investigate early interaction between pathogenic bacteria and the human gut.
Total ablative stereotactic body radiotherapy to primary and oligometastatic renal cell carcinoma in medically inoperable cases: An institutional analysis
Authors: Bisht Shyam Singh , Kataria Tejinder , Shishak Sorun , Gupta Deepak , Kaliyaperumal Venkatesan , Wadhwa Jyoti , Suryavanshi Manav , Banerjee Susovan , Narang Kushal , Goyal Shina , Rathi Deepak , Mayank Mayur , Selvaraj Rajesh , Khandelwal Anubhav
Published: October 2023

Introduction:

Stereotactic body radiotherapy (SBRT) has been found to be an effective and safe modality with excellent oncological outcome in medically inoperable primary renal cell carcinoma (RCC) and oligometastases. There is scarcity of data on the synchronous delivery of SBRT to primary and oligometastatic RCC in patients unfit for nephrectomy. Here, we report the findings of a retrospective study of prospectively collected data on “total ablative SBRT.”

Methods:

Oligometastatic RCC patients with intact primary tumors were enrolled between May 2021 and June 2022. SBRT was synchronously delivered to the primary tumor and metastases. Demographics, treatment, oncologic outcomes, and toxicity were assessed. Kaplan–Meier estimates were generated for oncologic outcomes. The primary endpoint of this study was feasibility and tolerability.

Results:

Eleven patients were enrolled between May 2021 and June 2022. One patient died at 2 months after SBRT due to viral pneumonitis (possibly COVID pneumonia). Nine patients (82%) had metastatic disease, while 2 (18%) were stage II. The average maximal diameter of primary was 68.7 mm (range, 23–128 mm). The SBRT doses for primary and metastasis ranged from 40 to 55 Gray (Gy) in 5 to 7 fractions and 22 to 40Gy in 2 to 5 fractions, respectively. The median follow-up period was 10.5 months (Range: 4–15 months). Response assessment was available for ten patients. Local control, marginal control, regional control and initial oligometastatic control (OMC) rates were 100%. OMC declined to 87.5% as one patient had recurrence in irradiated subcarinal lymphnode at 7 months. The metastatic control rate was 80% and loco-regional progression-free survival was 8 months (range, 4–15 months). Toxicities were minimal and manageable. At the last follow–up, 7 of 11 patients were alive with an overall survival of 63.5%. Six patients received systemic therapy after SBRT.

Conclusions:

Synchronous delivery of SBRT to primary and oligometastatic sites in patients unfit for nephrectomy was feasible and tolerable with good locoregional control. The total ablative SBRT strategy needs to be explored in similar cohorts.
Serum prostate-specific antigen trends and prostate cancer detection on follow-up in men with a prior negative biopsy: A cohort study
Authors: Modi Ankush , Singh Prabhjot , Seth Amlesh , Kumar Rajeev
Published: October 2023

Introduction:

Elevated serum prostate-specific antigen (PSA) is the most common trigger for a prostate biopsy. However, the range of normal PSA is poorly defined in many populations. Men with “elevated” PSA may not harbor cancer, and it is unclear if such men with a prior negative prostate biopsy should be biopsied again. We conducted a cohort study to assess the PSA trends and cancer detection rates in such men.

Methods:

In an Institutional Review Board-approved ambispective study, men who underwent prostate biopsy between January 2016 and December 2021 for PSA > 4 ng/mL were identified. Among them, those whose biopsy was negative for malignancy were contacted either telephonically or reviewed in person, and the most recent PSA and histopathology of any repeat prostate biopsy were determined. These were evaluated to assess the PSA trend, re-biopsy rate, and cancer detection rate.

Results:

During the study period, prostate biopsies were performed in a total of 1260 men; out of which 444 were negative for malignancy and 241 patients fulfilled the inclusion criteria. Their median prebiopsy PSA was 9.81 ng/mL (interquartile range [IQR]: 7.14–15.6), and the median follow-up PSA was 5.08 (IQR: 3.18–8.4). At a median follow-up of 53 months (range: 6–77 months), PSA had decreased in 177 (73.4%) patients, was static in 48 (19.9%) patients, and increased in only 16 (6.6%) patients. Repeat biopsy was performed on 20 patients; of whom seven had cancer (35%) with an overall positivity rate of 2.9% among the 241 patients. Although the positivity rate was higher in men with increased PSA, it was not statistically different from those with lower or similar PSA. No factors could be identified to predict a positive repeat biopsy.

Conclusions:

PSA, the sole trigger for a prostate biopsy, declined in nearly three-quarters of men with a negative first biopsy, and <3% of men were detected to have cancer on a repeat biopsy. This information could help appropriately counsel patients and allay anxiety after a negative biopsy.
Primary amelanotic malignant melanoma masquerading as adenocarcinoma prostate – A pathological dilemma
Authors: Kudunthail Jeena Raju , Sandhu Arjun Singh , Nalwa Aasma , Bhirud Deepak Prakash
Published: October 2023

A rare disease at an aberrant location can mimic a usual presentation of another disease. We report a case of primary amelanotic malignant melanoma of the prostate with clinical and histological characteristics that closely mimic poorly differentiated adenocarcinoma prostate.