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We present a patient with chronic insomnia resistant to traditional pharmacologic (eg, sedative-hypnotics) and nonpharmacologic (eg, cognitive behavioral therapy for insomnia) therapy. A finding of elevated serum homocysteine triggered a whole-genome sequencing analysis which revealed a homozygous methylenetetrahydrofolate reductase (MTHFR) gene polymorphism (C677T/C677T; dbSNP rs1801133). Interventions targeting her polymorphism-dependent loss of function successfully resolved her insomnia. This case demonstrates a genomic approach for insomnia whereby successful treatment was focused on optimizing the patient’s metabolome, which was altered as a result of a missense single-nucleotide polymorphism. CITATION: Kapoor V, Watson NF, Ball L. Chronic insomnia in the setting of MTHFR polymorphism. J Clin Sleep Med. 2022;18(4):1215–1218.

We present a patient with chronic insomnia resistant to traditional pharmacologic (e.g., sedative-hypnotics) and nonpharmacologic (e.g. cognitive behavioral therapy for insomnia; CBT-I) therapy. A finding of elevated serum homocysteine triggered a whole genome sequencing analysis which revealed a homozygous methylenetetrahydrofolate reductase (MTHFR) gene polymorphism (C677T/C677T; dbSNP rs1801133). Interventions targeting her polymorphism-dependent loss of function successfully resolved her insomnia. This case demonstrates a genomic approach for insomnia whereby successful treatment was focused on optimizing the patient's metabolome which was altered as a result of a missense single nucleotide polymorphism.

Iron supplementation is the most commonly considered treatment option for children with restless legs syndrome (RLS) or periodic limb movement disorder (PLMD); however, there is a scarcity of evidence on the effectiveness of intravenous preparations. In this study, we evaluated the effectiveness and tolerability of intravenous ferric carboxymaltose (IV FCM) on clinical symptoms and iron indices in children with RLS or PLMD.This was a single-center retrospective data analysis. Children with a diagnosis of RLS or PLMD, who underwent a single infusion of IV FCM, were included. Clinical Global Impression (CGI) Scale scores, serum ferritin, and serum iron profile at baseline and after eight weeks post infusion were obtained. Adverse effects were assessed.Thirty-nine children received IV FCM, 29 with RLS and 10 with PLMD. Pre-infusion CGI-Severity revealed moderate illness, with post-infusion CGI-Improvement between "very much improved" and "much improved". Ferritin increased from 14.6 μg/L±7.01 to 112.4 μg/L±65.86 (p 0.00001), together with improvements in iron, total iron binding capacity, and transferrin levels from baseline to post-treatment. When compared to children with RLS, those with PLMD had a similar improvement in clinical symptoms and laboratory parameters. Seven subjects (14.3%) experienced one or two adverse events; all were mild.Children with RLS and PLMD responded to IV iron supplementation with improvement in both clinical severity and laboratory parameters. Treatment was well tolerated. Although larger, randomized-controlled trials are needed, IV FCM appears to be a promising alternative to oral iron supplementation for the treatment of pediatric RLS or PLMD.

American Journal of Business and Operations research (AJBOR) Vol. 3, No. 1, PP. 39-47, 2021

Study Objectives To evaluate leg movements during sleep (LMS) in children taking serotonergic antidepressants, compared to those of children with restless legs syndrome (RLS) and controls, and to assess the time structure of intermovement intervals (IMI). Methods Twenty-three children (12 girls, mean age 14.1 years) on antidepressants and with a total LMS index ≥ 15/h, 21 drug-naïve RLS children (11 girls, mean age 13.6 years) also with total LMS index ≥ 15/h, and 35 control children (17 girls, mean age 14.3 years) were recruited. LMS were scored and a series of parameters was calculated, along with the analysis of their time structure. Results Children taking antidepressants showed higher total and periodic LMS (PLMS) indexes than both controls and RLS children, as well as higher short-interval and isolated LMS indexes than controls. LMS periodicity was highest in children on antidepressants. In children taking antidepressants, a well-defined PLMS IMI peak corresponding to approximately 10–60 s, with a maximum at approximately 20 s was present, which was much less evident in RLS patients and absent in controls. A progressive decrease of PLMS during the night and more frequent arousals were found in children on antidepressants and with RLS. Conclusions Children taking serotonergic antidepressants show higher periodicity LMS than children with RLS or controls and have a higher number of PLMS through the night. Antidepressant-associated PLMS in children seem to have features similar to PLMS of adults with RLS. Whether this is a marker of an increased risk to develop RLS later in life needs to be determined.

Changes in medical student learning preferences help drive innovation in teaching and require schools and commercial resources to quickly adapt. However, few studies have detailed the relationship of learner preferences to the environment and teaching modalities used in the pre-clerkship years, nor do they incorporate third-party resources. Our study attempts to analyze learner preferences by comparing the use of traditional and third-party resources. In 2017–18, a survey was distributed to medical students and residents at two accredited medical schools. Participants noted preferred styles of learning regarding lecture duration, timing, location, format, third-party resources, learner types and USMLE Step 1 scores. The ‘Learning Environment, Learning Processes, and Learning Outcomes’ (LEPO) framework [5] was used to examine learner preferences, with responses compared using the Mann-Whitney U and two proportion z-tests. A total of 329 respondents completed the survey: 62.7% medical students and 37.3% residents. The majority of participants identified their learning style by Kolb [6] as converging (33.0%) or accommodating (39.2%). Students preferred lectures 30–40 minutes long (43.3%), during morning hours (54.2%), in their own homes (52.0%), via online lectures with simultaneous drawings (56.0%), and classroom/podcast lectures with PowerPoint® presentations (54.3%). Overall, students rated third-party resource characteristics higher than traditional curricula, including effectiveness of teachers, length, quality, time of day, and venue (p

“It is not technology but people’s mindset that makes the world a scary place to live in.” India is one of the top 3 countries to report cyberbullying cases. One in 10 Indian adolescents faces cyberbullying, half of them don’t even report it. Cyberbullying is one of the issues that are so common in India. There are so many social issues that are not openly discussed. With such increasing issues, it is very essential to address them. Technology affects us in all possible ways today. It is technological solutions that can help us fight such issues. This paper discusses - Social Conclave, a national social conference that discusses these pressing issues and comes up with solutions that are then implemented. Social Conclave is the social conference of NMIMS’ School of Technology Management and Engineering. Social Conclave aims at discussing the pressing issues that are prevalent in India to come up with a solution that is the betterment of society. Delegates from all over the country meet up to discuss these different social issues. They are taken to various field visits to experience and see what India is dealing with. The debate among themselves to come up with the most sustainable solution for a particular issue. The solution given by the delegates is then implemented on the ground level by the students. This paper shares the idea and the experience of the conference.

STUDY OBJECTIVES: Restless sleep is a very common parental complaint in children with attention-deficit/hyperactivity disorder (ADHD), but restless sleep has been seen in association with other comorbidities such as restless legs syndrome and obstructive sleep apnea. Restless sleep disorder (RSD) needs to be identified from other disorders when evaluating children with ADHD. In this study we aim to identify the prevalence of RSD in children with ADHD referred to our sleep center. METHODS: This is a retrospective study of children with ADHD who underwent polysomnography. The following diagnostic and descriptive data were obtained for each patient: age, sex, presence/absence of RSD, other sleep disorders, psychiatric comorbidities, and medications. RSD was diagnosed per diagnostic criteria. RESULTS: There were 66 children with ADHD. All of them underwent polysomnography, 17 were females, and 49 were males. Mean age was 11.6 years (± 3.6 standard deviation). The complaint of restless sleep was reported by the parents of 54 (81.1%) of the children; however, only 6 of them (9.1%) were diagnosed with RSD. Seventy-one percent had obstructive sleep apnea and 19.7% had restless legs syndrome. A significant number of patients had psychiatric comorbidities and were on various medications. CONCLUSIONS: Although restless sleep is a common complaint reported in 81.1% of children with ADHD, only 9.1% had RSD. Most causes of restless sleep are secondary and associated with other sleep disorders, psychiatric comorbidities, or medication use. CITATION: Kapoor V, Ferri R, Stein MA, Ruth C, Reed J, DelRosso LM. Restless sleep disorder in children with attention-deficit/hyperactivity disorder. J Clin Sleep Med. 2021;17(4):639–643.

Mobile learning has been increased in past years and has attracted the interests of academicians and educators in the past many years especially in higher education. The mobile-based online test is the buzzing in the current pandemic time. Institutions need to use online learning as a powerful tool for conducting exams and assess the students effectively. Integrating technology in education can be advantageous for universities and help engage better results for students. Therefore, it is important to understand each student their capacities and create a different test based on the required difficulty. Students should be graded based on their capabilities. The purpose of the research study is to develop the progressive model with the calibration of difficulty level according to the student capacity. To achieve the goal, a test of 20 python questions was conducted on 120 students with each question having difficulty given by 8 field experts. To verify the model, 5 categories were formed with different difficulty levels which in turn gave satisfactory results. To find a relation between the initial difficulty and the calculative difficulty based on the student response, a correlation test was conducted. After careful analysis of the question difficulty and student responses, it was observed that both are highly dependent on each other wherein the difficulty level of any question can be calculated using incorrect answers. The correlation coefficient obtained between them was 0.9833. Upon collecting the difficulty of the questions and student responses, respective grading could be done using the stated formula. Later on, the progressive model was simulated with five different cases (Best case, above-average case, below average case, the average case, worst case). The model outperformed in all the cases with appropriate difficulty levels. Online Tests have ushered a revolution in the assessment of students but yet they tend to be unpopular in India as the evaluation based on pen-paper approach is preferred. The main reasons for this are difficult to grade everyone at the same level, susceptible to cheating, and transition to open books. Using our study, universities can identify obstacles, and prepare an appropriate result-driven plan of action for implementing the mobile-based online test and make easy migration from paper-based test to online test.

Violence against women is seen as sexual or physical activity committed against women. In India, general forms of violence against women in India includes cruelty by relatives, dowry, rape, sexual assault, kidnapping, immoral trafficking, molestation etc. The security of the women is the utmost priority of any government in this world. In India, many policies and laws have been enforced to ensure the safety against women. Technology is being the biggest supporter to the government in this context. Data mining allows various techniques such as clustering classification, regression provides analysis in any form of data and helps intelligent predictions on the given dataset. In this paper, we use k-means clustering analysis on women crime dataset. As a part of pre-processing, we collated the data entries which had crime cases against women and made women crime sub-dataset from the real dataset. We then applied K means clustering for further analysis. We used a rapid miner tool for clustering analysis as it is widely used for clustering purposes. After completion of clustering analysis, we proposed our views and discussions on the clustering results. At the end, we ended up giving the futuristic work to be further done on the derived dataset we made and made available on public repositories.

According to the one of the renowned and Oscar award-winning American actor and film director Marlon Brando who once said - “Privacy is not something that I’m merely entitled to, it’s an absolute prerequisite.” Technology always has continued improvements and innovations in this world and yes! Credit goes to researchers and innovators. Internet of Things (IoT) is one of such gift given by the technology which connects and communicates between devices to exchange information and fulfills the task through means of internet. Wearable technology is the most recent technology of IoT deals with generating lots of human health data (Blood-Oxygen level, step counters, GPS tracking etc.) on cloud. When such health information is stored, there is always inherent rise of risk of getting sensitive data in wrong human hands. The research study carried in this paper sums up the work done by existing researchers on various privacy issues. Through the careful literature survey, it lists some important privacy issues in wearable devices and gives future directions to address them.

Introduction The etiology of restless sleep has recently been identified as secondary to various medical and sleep conditions. Parents of children with ADHD complain of restless sleep and sleep disturbances in their children. We aimed to assess restless sleep causes in our patient population with ADHD and establish the prevalence of restless sleep disorder (RSD), as recently defined. Methods A retrospective study of children with ADHD who underwent polysomnography was carried out. Diagnostic and descriptive information collected for each patient included age, sex, polysomnographic parameters, sleep disorders, psychiatric comorbidities, and medications. Results Sixty-six PSGs were reviewed. The mean age of children was 11.6 (±3.6 SD) years; 17 were female and 49 were male. Parents of 54 (81.1%) children had concerns of restlessness during sleep; 47 (71.2%) children had obstructive sleep apnea, 17 (25.8%) had PLMS ≥5/hour, 13 (19.7%) had RLS, 6 (9.1%) had RSD, 27 (41%) had depression or anxiety, 5 (7.6%) had insomnia. Conclusion In a pediatric sleep medicine referred group of patients with ADHD, who are known to have significant sleep and psychiatric comorbidities, obstructive sleep apnea, RLS, and RSD were found to be the most prevalent sleep disorders, whereas depression and anxiety were the most common psychiatric disorders. Complaint of secondary restless sleep seems to be common, while primary restless sleep disorder was seen in approximately 9% of children. The results of this study aid pediatricians and child psychiatrists in screening children with ADHD for associated sleep disorders. Support (if any)

The currency of today’s social media is influence. The influence is any action or reaction by which you can drive your thoughts on people’s mind through social platforms. Internet memes are getting very popular in today’s generation. With the rise of technology and technological devices, the ability of concentration of young minds has drastically reduced. In a typical case, the classroom-based teaching tools like blackboard, PPT, videos are no more appreciated by the newer generation. This is because today's generation is practical oriented and wants skills to acquire and do not want traditional teaching which enforce memory rather than knowledge. They want class-room-based teaching methods to be innovative. Looking at the popularity of the memes, the paper shares and experiences of use of internet memes from existing papers available on the internet. Based on the available literature survey, the two research questions were formed in order to examine the perception on memes in student’s mind. The survey of 201 student population is statistically analysed and hypothesis testing was also conducted. It is over-served that students are more positively agree to use of memes in classroom teaching. Another viewpoint in this paper is the use of memes are incorporated in test papers. The acceptance of inclusion of memes in mid-term test papers proves that learning through memes is now new normal in today’s generation.