USV (India)

This research work is all about the examination of the reasons why the Tamil language is less confidently transmitted to the younger generations in India, especially in urban and migrant contexts. Instead of blaming the situation of forcibly moved, displaced, or directly suppressed people for the decline of the language, the paper proposes that language loss today is mainly due to decision-making in families, schools, and institutions. The paper brings together the sociolinguistics, education, and language policy disciplines' concepts to describe the daily changes that result in language transmission from one generation to another becoming less successful. These changes are less use of Tamil at home, the early stage where reading and writing skills get weakened, and schooling practices favoring dominant regional languages and English. Besides that, the research exposes a blatant inconsistency in language policy. On paper, multilingualism is accepted and supported, but it is implemented through systems that result in language substitution rather than language accumulation. The paper claims that phenomena associated with urbanisation, social mobility, and migration, among other things, influence this pattern by altering the ways in which languages are valued and used in daily life, mainly in the multilingual metropolitan environments. Based on a few European experiences, the paper proposes that multilingualism should be considered as a continuation, which comes from regular use and literacy that is sustained over generations. The research work finally points out the possible practical implications of this for families, the education sector, and state institutions. Besides, it also suggests the preservation of languages like Tamil should not be considered individuals' burden but as the social responsibility that is shared by everyone.

Introduction: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide and dyslipidemia is the major risk factor for CVD. Aim: The aim of the study was to assess the real-world treatment patterns associated with the use of rosuvastatin + ezetimibe combination therapy for lipid management. Methods: This retrospective multicentric, noncomparative, nonrandomized, observational real-world study was conducted at multiple healthcare centers in India. Patients aged ≥18 years (either sex), with uncontrolled dyslipidemia, familial hypercholesteremia, and mixed dyslipidemias, with persistently elevated levels of low-density lipoprotein cholesterol (LDL-C) despite receiving statin therapy were included. Fasting blood LDL-C was monitored in high, very high, and extreme-risk patients. Results: A total of 1465 patients were enrolled with a mean age of 60.87 years and men predominance (67.49%). Median (range) duration of hypercholesteremia of patients was 4.00 (0.40–19.50) years. The majority of patients were on moderate-intensity statin therapy (54.68%), followed by high-intensity statin (27.37%) and low-intensity statin (17.95%). The majority of patients taking moderate-intensity statins (47.38%) had LDL-C levels between 151 and 200 mg/dL, compared to those taking low (36.50%). Combination rosuvastatin + ezetimibe therapy showed a significant reduction in mean LDL-C levels of patients using low, moderate, and high-intensity statins with a mean difference of 100.63 mg/dL, 94.24 mg/dL, and 92.00 mg/dL ( P < 0.001 each) as well as a significant reduction in LDL-C levels, total cholesterol levels, and triglycerides levels ( P < 0.001 each). Conclusion: Rosuvastatin and ezetimibe therapy was an effective and well-tolerated lipid-lowering agent, offering higher efficacy, especially in the reduction of LDL-C levels.

Background: Hypertension (HTN) is the primary modifiable risk factor for chronic coronary syndrome (CCS), which significantly contributes to morbidity and mortality. This study aimed to gather expert consensus from Indian cardiologists on managing HTN in patients with CCS, to optimize therapy and improve patient care. Methods: A consensus is based on Indian cardiologists’ inputs collected via an online survey. The questionnaire covered diagnostic practices, clinical patterns, and real-world treatment regimens for managing hypertensive CCS patients. Survey responses were analyzed and discussed during round table meetings. Further expert opinions were graded from Level A (strong consensus) to Level D (no consensus). Recommendations were formulated based on collective expert opinions. Results: The consensus highlights the clinical strategies for managing patients with CCS and associated comorbid conditions. The key diagnostic tools, such as ambulatory blood pressure monitoring and Holter electrocardiogram, are strongly recommended for comprehensive evaluation. Pharmacological management should prioritize the use of angiotensin II receptor blockers and beta-blockers combinations, particularly telmisartan–metoprolol fixed-dose combination (FDC) in the management of hypertensive CCS patients with type 2 diabetes mellitus or dyslipidemia. Conclusions: Indian cardiologists emphasized the importance of using, telmisartan–metoprolol FDC as a preferred drug regimen owing to their cost-effectiveness, improved efficacy, and enhanced adherence. These consensus recommendations aim to enhance therapeutic outcomes and guide future clinical practice in Indian context.

Mobile learning is shifting from static content delivery to intelligent, human-centered ecosystems aligned with Industry 5.0. Yet many platforms remain fragmented, offering only limited personalization, weak ethical safeguards, and low adaptability. This study introduces the Learning eXperience with Agency (LXA v1.0) framework, developed to guide mobile learning toward 2030 through agentic AI. LXA v1.0 was created using a mixed-method approach. The process combined a scoping review of research published between 2015 and 2025, conceptual modeling, and a two-round Delphi study with 14 international experts. The review examined how learning management systems (LMS) have developed into AI-enabled platforms while also pointing out persistent gaps in autonomy, transparency, and resilience. Feedback from experts stressed the need to design systems that are inclusive and firmly rooted in ethical values. The framework is built around four connected pillars. The agency focuses on learner control supported by AI. Ambient learning relates to context-aware experiences. Inclusion & ethics point to fair and transparent design. Resilience refers to the ability to adapt during periods of disruption. The Delphi validation produced strong agreement on clarity, feasibility, measurability, and relevance. Taken together, LXA v1.0 provides a tested roadmap for building mobile-first learning ecosystems that are advanced in technology, grounded in ethics, and prepared for the future.

Objectives: The color and physical appearance of pills influence people’s expectations of their effectiveness, alongside their actual medicinal purpose. Therefore, the present study aimed to evaluate how pill color influences medication adherence. Materials and Methods: This questionnaire-based survey was conducted among Indian patients visiting cardiologists with cardiovascular diseases. Patients were asked to fill out a form that included 9 questions designed to assess the impact of pill color on drug adherence. In addition, demographic characteristics of the patients were collected. Results: A total of 901 patients were included in the study. Approximately 91% of the 876 patients reported that they were taking medications that needed to be taken daily. When taking multiple pills, 29.4% of patients remember the medication by the pill color, 28.4% remember by the strip color, and 28.0% remember by the brand name. The proportion of patients aged >50 years who reported that similar-looking medications confused identifying their medication was significantly higher compared to those aged ≤50 years (63.2% vs. 50.5%; P < 0.001). When managing multiple medications, female patients primarily relied on pill color (33.1% vs. 26.6%) and strip color (30.7% vs. 26.4%) for identification compared to male patients. The proportion of patients with a high school education who believed that unique pill colors could help in easy identification, reduce forgetfulness, and enhance medication adherence was significantly higher compared to those with a college education and above ( P < 0.001). Conclusion: This study emphasizes that pill color significantly aids in medication identification and adherence, particularly among older adults, women, and individuals with lower educational levels.

Cancer remains a significant global health challenge, with varying incidence and mortality rates across the globe. According to the Surveillance, Epidemiology, and End Results (SEER) registry [1] and the American Cancer Society (ACS) [2], more than 2 million new cancer cases are expected in the US by 2025. Understanding the burden of disease and advancements in tailored treatments, also known as precision or personalized medicine, is crucial for improving patient outcomes. Pharmacogenomics is the study of how an individual’s genetic makeup influences their response to treatment [3]. This field aims to identify genetic variations among individuals (pharmacogenomic variants) to predict drug efficacy and the risk of adverse drug reactions, thereby optimizing and personalizing treatment while minimizing side effects for patients [4]. In the last decade, attention has increasingly shifted beyond the traditional coding genome to noncoding RNAs (ncRNAs), which serve as key regulators of gene expression and biomarkers in cancer, adding complexity to tumor signaling networks.

Abstract Introduction: Chronic kidney disease (CKD) is a progressive condition characterized by reduced kidney function, leading to increased morbidity and mortality. The risk of cardiovascular disease is notably high among individuals with CKD and type 2 diabetes mellitus (T2D). Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have emerged as a promising treatment for CKD, offering renoprotective and cardioprotective benefits beyond glucose-lowering effects. Materials and Methods: A panel of 210 nephrologists from different regions of India participated in a consensus-building process. Using a Delphi methodology, the panelists were surveyed on various aspects of CKD care, with a focus on the use of SGLT-2 inhibitors individuals with or without diabetes. The consensus process involved multiple rounds of surveys and group discussions moderated by experts to arrive at practical recommendations for integrating SGLT-2 inhibitors into CKD management at the primary care level. Results: The majority (48.57%) of clinicians strongly agreed that primary care physicians play a vital role in early CKD management. There was a consensus on the need for early CKD screening, especially among high-risk groups, such as those with diabetes, hypertension, or a family history of kidney disease. Serum creatinine, proteinuria measurement, and estimated glomerular filtration rate were identified as the most critical diagnostic tests. The consensus supported the incorporation of SGLT-2 inhibitors into early CKD management to delay disease progression, especially in patients with T2D, with evidence suggesting significant cardiovascular and renal benefits. Conclusion: SGLT-2 inhibitors have shown substantial efficacy in improving renal and cardiovascular outcomes in CKD patients. Early integration of SGLT-2 inhibitors in CKD management, particularly in high-risk groups, can slow disease progression, reduce complications, and improve patient outcomes.

The substantial increase in the consumption of certain products known to have repercussions on the health of consumers has led to the establishment of measures to help discourage consumption, but also to increase health awareness. The aim of our work is to highlight the correlation between excise duties and consumption at EU level, with the application of excise duties having the expected effects in relation to the worrying consumption of alcohol and tobacco products. For this research we have used SPSS statistical software, the correlation being determined on the basis of an econometric model with the level of excise duty as the dependent variable and alcohol and cigarette consumption as the independent variables The research results reveal that if the per capita recorded alcohol consumption decreases by one unit and the per capita recorded cigarette consumption remains constant, then the excise tax level increases on average by 0.782 units, and if the per capita recorded cigarette consumption decreases by one unit and the per capita recorded alcohol consumption remains constant, then the excise tax level increases on average by 1.638 units. Therefore, this correlation highlights consumption as a factor generating health problems at national and international level.