Total Size Research Articles

Normal saline versus lactated Ringer’s solution for acute pancreatitis resuscitation, an open-label multicenter randomized controlled trial: the WATERLAND trial study protocol

BackgroundSome evidence suggests that fluid resuscitation with lactated Ringer’s solution (LR) may have an anti-inflammatory effect on acute pancreatitis (AP) when compared to normal saline (NS) and may be associated with a decrease in severity, but existing single-center randomized controlled trials showed conflicting results. The WATERLAND trial aims to investigate the efficacy and safety of fluid resuscitation using LR compared to NS in patients with AP.MethodsThe WATERLAND trial is an international multicenter, open-label, parallel-group, randomized, controlled, superiority trial. Patients will be randomly assigned in a 1:1 ratio to receive LR versus NS-based fluid resuscitation for at least 48 h. The primary outcome will be moderately severe or severe AP, according to the revision of the Atlanta classification. The secondary objectives of the WATERLAND trial are to determine the effect of LR versus NS fluid resuscitation on several efficacy and safety outcomes in patients with AP.A total sample of 720 patients, 360 in the LR group and 360 in the NS group, will achieve 90% power to detect a difference between the group proportions of 10%, assuming that the frequency of moderately severe or severe AP in the LR group will be 17%. A loss to follow-up of 10% of patients is expected, so the total sample size will be 396 patients in each treatment arm (792 patients overall). The test statistic used is the two-sided Z test with pooled variance set at a 0.05 significance level.DiscussionThe WATERLAND study aims to improve the early management of AP. Fluid resuscitation is an inexpensive treatment available in any hospital center worldwide. If a better evolution of pancreatitis is demonstrated in one of the treatment arms, it would have important repercussions in the management of this frequent disease.Trial registrationClinicalTrials.gov, NCT05781243. Registration date on January 4, 2023. EudraCT number 2023–000010-18, first posted March 23, 2023.

Protocol for a prospective randomized trial of surgical versus conservative management for unstable fractures of the distal radius in patients aged 65 years and older.

The primary aim of this study is to quantify and compare outcomes following a dorsally displaced fracture of the distal radius in elderly patients (aged ≥ 65 years) who are managed conservatively versus with surgical fixation (open reduction and internal fixation). Secondary aims are to assess and compare upper limb-specific function, health-related quality of life, wrist pain, complications, grip strength, range of motion, radiological parameters, healthcare resource use, and cost-effectiveness between the groups. A prospectively registered (ISRCTN95922938) randomized parallel group trial will be conducted. Elderly patients meeting the inclusion criteria with a dorsally displaced distal radius facture will be randomized (1:1 ratio) to either conservative management (cast without further manipulation) or surgery. Patients will be assessed at six, 12, 26 weeks, and 52 weeks post intervention. The primary outcome measure and endpoint will be the Patient-Rated Wrist Evaluation (PRWE) at 52 weeks. In addition, the abbreviated version of the Disabilities of Arm, Shoulder and Hand questionnaire (QuickDASH), EuroQol five-dimension questionnaire, pain score (visual analogue scale 1 to 10), complications, grip strength (dynamometer), range of motion (goniometer), and radiological assessments will be undertaken. A cost-utility analysis will be performed to assess the cost-effectiveness of surgery. We aim to recruit 89 subjects per arm (total sample size 178). The results of this study will help guide treatment of dorsally displaced distal radial fractures in the elderly and assess whether surgery offers functional benefit to patients. This is an important finding, as the number of elderly distal radial fractures is estimated to increase in the future due to the ageing population. Evidence-based management strategies are therefore required to ensure the best outcome for the patient and to optimize the use of increasingly scarce healthcare resources.

A novel miniaturized microstrip filtering power divider with high selectivity based on composite right/left-handed (CRLH) concept

Abstract This paper proposes a compact microstrip filtering power divider (FPD) with high selectivity and equal power division ratios based on the composite right/left-handed (CRLH) concept. The proposed equal microstrip FPD is designed by cascading two CRLH unit cells and a grounded via hole. The proposed CRLH unit cell is realized by an interdigital capacitor loaded between two transmission lines (TL) on the upper metal layer and the fractal/meander complementary split-ring resonator (FMCSRR) on the ground plane. The grounded via hole has been used to improve frequency selectivity and out-of-band rejection of the proposed microstrip FPD. The equivalent circuit model compared with full-wave simulation results of the proposed microstrip FPD has been provided. The proposed microstrip FPD has been fabricated and measured, and a good agreement has been found between the simulation and measurement results. The proposed microstrip FPD has a passband covering 2.38–2.45 GHz, and its measured 3 dB fractional bandwidth is about 2.9 %. The total size of the proposed microstrip FPD is 0.17 λ g × 0.07 λ g. Compared with other reported FPDs, the presented microstrip FPD has many advantages like compact size, low loss, easy fabrication, extremely sharp rejection skirts around the desired passband and high selectivity.

Investigating the Relationship Between Social Networks and the Academic Performance of University Students (Case Study: Faryab University Students)

In recent decades, with the increasing expansion of communication technology, the use of social networks has become one of the most important online activities. However, technology has not only had positive effects on human relationships and personal communication, but its negative effects on academic performance are also well-known. This research focuses on evaluating the negative effects of social networks on academic performance, with a focus on students of Faryab University. This research is applied in terms of classification based on the objective, and can be considered a descriptive-correlational research in terms of methodological classification. The total sample size includes all day students, which is 3000, and a sample of 268 individuals has been selected based on Morgan's table. The questionnaire is used as a data collection tool, and the SPSS software is used for descriptive and inferential statistics (relationship and correlation) for data analysis. The findings of the research indicate a pervasive negative relationship between the use of social networks and academic performance among Faryab University students. While positive interactions such as parental support and strategic personal and peer interactions can increase academic results, potential drawbacks such as distraction, stress, and addiction require a comprehensive approach to deal with the challenges arising from social media.

Optimization the design of fixed and group sequential three-arm non-inferiority trials with dichotomous endpoints of risk difference and odds ratio

Although the risk difference (RD) is the most common and well explored functional form for testing efficacy with dichotomous endpoint, odds ratio (OR) is also suggested and well applied measure for non-inferiority (NI) trials. Since the construction and interpretation of these function forms are quite different, this study aims to provide detailed discussions and comprehensive comparisons on the design and testing approach for RD and OR scales for the fixed and group sequential three-arm NI trials under various of situations. The sample size determinations and testing approaches for assessing NI of a new treatment in three-arm clinical trials for RD and OR scales were reviewed comprehensively. Simulation studies are conducted for hundreds of scenarios with parameter configurations of the response rates, randomized allocations, NI margins and interim analysis. The operating characteristic (OC) of RD and OR scales based on the MLE and RMLE methods were thoroughly investigated. A trial example was designed and analyzed to demonstrate the methodologies. It is found that sample size determination on OR scale gives smaller sample size and robust procedure compared to RD scale in the majority of situations. When evaluating the behaviors of the attained power, the RMLE methods based on OR scale outperforms the MLE method and tend to have more power to reject the null hypothesis especially under the small sample size situations. Compared to the fixed design, the group sequential design has better OC, which provides a comparable power while needing smaller total average sample sizes for all cases. In addition, we suggest a lower significance level with a higher power for the sample size determination in the superiority test stage in the group sequential design, which can significantly reduce the total sample sizes while the number of subjects in the placebo group does not increase much. It can offer some recommendations for the investigators to choose the optimal endpoints and parameter configurations to design a three-arm NI trial under certain situations.

The relationship between leadership and adaptive performance: A systematic review and meta-analysis.

This research presents a comprehensive review and meta-analysis of literature to examine the impact of various leadership styles on organizational adaptive performance (AP). AP is essential for job performance, especially in environments undergoing rapid changes. Previous reviews on AP found that transformational and self-leadership had had a positive influence on job adaptivity, while the relationship between other leadership styles and AP had not been clear. First, authors outlined the theoretical framework of AP and leadership, clarifying how job adaptivity and the different leadership styles are defined and discussed in the scientific literature. Subsequently four scientific databases were explored to identify studies that investigate the Leadership and AP' relationship. 32 scientific articles and 2 conference papers were investigated for review, of which 31 were used to conduct a meta-analysis; 52 different effect sizes from 32 samples were identified for a total sample size of 11.640 people. Qualitative synthesis revealed that the influence of different leadership styles on AP depended on contextual variables and on aspects related to the nature of the work. Moreover, it was found that leadership supported AP through motivational and relational aspects. Through this meta-analysis, it was found that a significant positive relationship between leadership and AP existed (Zr = .39, SE = .04, p < .001. 95%CI [.32, .47], r = .37). However, no differences emerged from the different leadership styles examined in the studies. This review deepens the importance of leadership as organizational factor that affect the employees' likelihood of dealing with continuously emergent changes at work, extended the search to emerging leadership approaches to highlight the value of collective contributions, ethics, and moral and sustainable elements that could positively affect AP.

A Study On Effects Of Work-Life Balance And Women Employees Job Productivity In It Organizations

This study examined just at work-life balance and women productivity in only few IT sectors in Chennai. The study was stimulated by the IT sectoring industry's high rate of work-life unequal distribution. The study specifically examined the impact of workload pressure, role conflict, family stress, and work flexibility on female productivity. The relevant conceptual, theoretical, and empirical literatures were investigated. This work examined the work life balance and ladies productivity in selected IT sectors in Chennai city. The study was necessitated by high rate of work-life unbalance in the IT sectoring industry. Specifically the study determined the effect of workload pressure, role conflict, family stress and Work flexibility on ladies productivity. Relevant conceptual, theoretical and empirical literatures were examined. A total of fifteen IT sectors were studied, and the population of study was 2021, with the sample size of total sample size evaluated using the statistical formula SPSS. The research also revealed that family stress has a significant impact on female productivity. The study concluded that work load pressure, role conflict, and family-related stress all have a negative impact on female productivity. According to the study, people should relax in ways that do not interfere with their work; it can be an efficient way to recover from identified work-life balance issues. Management must take note of the volume of work assigned to women in order to deal with work-life balance issues in the workplace. Management must act immediately to rectify the issue; work should be delegated accordingly to ensure that no one is overloaded. Ladies should be given appropriate breaks and vacation time.

Corneal Endothelial Changes in Chinese Patients with Fuchs’ Uveitis Syndrome

ABSTRACT Purpose To analyze the changes of corneal endothelial cells in Chinese patients with unilateral Fuchs’ uveitis syndrome (FUS) and investigate the factors relevant to these changes. Methods Bilateral specular microscopic examination was performed in 459 Chinese patients with unilateral FUS from April 2008 to April 2023. The affected eyes constituted the study group, while the contralateral eyes served as controls. Results The median values of endothelial cell density (ECD), cell count, total cell size, and hexagonality were significantly lower in the FUS eyes compared to the control eyes (p < 0.001). The median values of average cell size, maximum cell size, SD of cell size, and CV were significantly higher in the FUS eyes compared to the control eyes (p < 0.001). Central ECD showed a negative correlation with age (r = −0.339; p < 0.001), maximum IOP (r = −0.127; p = 0.006), and the interval since symptom onset (r = −0.172; p < 0.001). The ECD was lower in eyes with ocular hypertension compared to those without ocular hypertension (p < 0.001). Eyes with KPs distributed on the central corneal endothelium had a significantly lower ECD than those with KPs distributed diffusely or KPs distributed triangularly on the inferior corneal endothelium (p = 0.006). Conclusion Our findings suggest decreased ECD, increased cell size, and morphological alterations in the affected eyes of Chinese patients with FUS. The reduction in ECD is correlated with age, elevated IOP, the interval since symptom onset, and the distribution of KPs.

Effects of Mantram Repetition on Spiritual Well-Being: A Systematic Review and Meta-Analysis.

Background: Spiritual well-being is an essential component of whole-person care and is increasingly recognized in various clinical disciplines as positively affecting mental health. Mantram repetition (MR) is an intervention rooted in Eastern spiritual traditions that has been shown to have clinical benefits, including reduction of psychological distress, among individuals with chronic psychological conditions. The central aim of this meta-analysis was to examine the effects of MR on spiritual well-being. Methods: Fifteen databases were searched from their inception year to July 19, 2023. Two independent reviewers extracted and coded data from randomized or quasi-experimental studies with comparison groups, conducted to test MR, measured spiritual well-being, and reported their study in English. Coded data included study quality indicators which were used in moderator analyses. Results: After the initial and updated searches and removal of duplicates, we reviewed 2,072 articles; seven studies met inclusion criteria with a total sample size of 556 (MR = 272, comparison = 284). Overall, MR had a positive effect on spiritual well-being with a pooled effect size of 0.535 with Hartung-Knapp-Sidik-Jonkman adjusted 95% confidence intervals of 0.18 and 0.89 (p = 011). Using moderator analyses, we examined the effect of the quality indicators and intervention characteristics on effect size; only session length was significant. Longer MR intervention sessions (i.e., 90 min) had greater effects than shorter sessions (i.e., 50-60 min). Conclusions: Across these seven studies, MR showed moderate to strong effects on spiritual well-being. Additional studies are needed to determine the reliability of these findings.

The Role of Leverage in Moderating ESG Disclosure and Financial Slack on the Company's Financial Performance

The purpose of this study is to determine the effect of ESG Disclosure and financial slack on the Company's financial performance by using leverage as a moderating variable. The emergence of issues related to the environment, social, and governance of company operations in Indonesia raises concern and responsibility to the community in the form of sustainability reporting. ESG disclosure provides a more complete picture of the sustainability aspects of company performance that supports regulatory reporting in Indonesia which provides an overview of how the company performs financially in a certain period. This research uses a quantitative approach with an explanatory method. The sample of this study is a mining company listed on the IDX for the period 2020-2022. The sampling method used was purposive sampling, with a total sample size of 50 companies and a total observation data of 150. Data analysis using moderated regression analysis (MRA). The results showed that the financial slack variable had a significant effect on the company's financial performance and leverage was able to negatively moderate the influence of the financial slack variable on the company's financial performance. In contrast, ESG disclosure had no significant effect on the company's financial performance and leverage was unable to moderate the influence of the ESG disclosure variable on the company's financial performance.

Characterization and genomic analysis of the lytic bacteriophage vB_EclM_HK6 as a potential approach to biocontrol the spread of Enterobacter cloacae contaminating food

BackgroundIncreased prevalence of Enterobacter cloacae within food products underscores food as an underexplored reservoir for antibiotic resistance, thus requiring particular intervention. Bacteriophages have been explored as a promising approach for controlling bacterial growth in different matrices. Moreover, their specific interaction and self-replication, put them apart from traditional methods for controlling bacteria in different matrices.MethodsSixteen Enterobacter cloacae strains were recovered from raw chicken. These strains were used to isolate bacteriophages using enrichment protocol. The broad-spectrum bacteriophage was evaluated in terms of thermal, pH, shearing stress and storge. Moreover, its infection kinetics, in vitro antibacterial activity, cytotoxicity were also assessed. Genomic sequencing was performed to exclude any potential virulence or resistance genes. Finally, the capability of the isolated phages to control bacterial growth in different chicken samples was assessed alone and in combination with sodium nitrite.ResultsThe lytic bacteriophage vB_EclM_HK6 was isolated and showed the broadest spectrum being able to infect 8/16 E. cloacae strains with a lytic activity against its host strain, E. cloacae EC21, as low as MOI of 10–6. The phage displays a latent period of 10 min and burst size of 115 ± 44 and resistance frequency of 5.7 × 10–4 ± 3.0 × 10–4. Stability assessment revealed a thermal tolerance up to 60 ˚C, wide range pH stability (3–10) and the ability to withstand shearing stress up to 250 rpm. HK6 shows no cytotoxicity against oral epithelial cells up to 1012 PFU/ml. Genomic analysis revealed a Strabovirus with total size of 177,845 bp that is free from known resistance and virulence genes. Finally, HK6 pretreatment of raw chicken, chicken nuggets and ready-made cheese salad shows a reduced bacterial count up to 4.6, 2.96 and 2.81 log-units, respectively. Moreover, combing HK6 with sodium nitrite further improved the antibacterial activity in both raw chicken and chicken nuggets without significant enhancement in case of cheese salad.ConclusionEnterobacter bacteriophage vB_EclM_HK6 presents a safe and effective approach for controlling E. cloacae contaminating stored chicken food samples. Moreover, they could be combined with a reduced concentrations of sodium nitrite to improve the killing capacity.

The Effect Of Advertising Attractiveness, Influencer Marketing, And Online Customer Review On Smartphone Purchasing Decisions For Generation Z In Surabaya

The usage of smartphones in Indonesia has continuously increased. In 2018, 56.2% of the Indonesian population used smartphones. One of the prominent market leaders is Samsung smartphones, which rank second with the largest market share in Indonesia at 20.99%. Indonesia is predominantly comprised of generation Z, accounting for approximately 27.94% of the total population. The role of digital marketing is highly significant in the decision-making process for smartphone purchases among generation Z. This study aims to determine the influence of Advertising Attractiveness, Influencer Marketing, and Online Customer Review on the purchasing decisions of smartphones by generation Z in Surabaya. This research uses a quantitative research approach. The study population consists of generation Z in Surabaya. The sampling technique employed is purposive sampling. The sample criteria include generation Z aged 15-29 years in Surabaya who have purchased a Samsung smartphone at least once, with a total sample size of 315 respondents. Data collection was conducted by distributing questionnaires to respondents through Google Forms. The research method involves multiple linear regression analysis using the SPSS program. The research results indicate that the significance value for all variables is 0.000 (&lt; 0.05), leading to the conclusion that Advertising Attractiveness, Influencer Marketing, and Online Customer Review have a positive and significant influence on the smartphones purchasing decisions by generation Z in Surabaya.

Gradient distribution of cations in rhabdophane La0.27Y0.73PO4·nH2O nanoparticles

The structure of gradient rhabdophane nanoparticles of variable composition (La,Y)PO4·nH2O obtained by precipitation is considered. According to the data of HAADF TEM and EDX mapping using the Abel inversion procedure, it was shown that there is an inhomogeneous distribution of yttrium and lanthanum atoms in the particles from the central part to the periphery. At the same time, the nominal composition of both individual nanoparticles and the entire sample meets the value specified during synthesis within the error of the method – La0.27Y0.73PO4·nH2O. According to SAXS data, it was determined that in the particles of (La,Y)PO4·nH2O, there is a redistribution of scattering densities, which is caused by an increase in the fraction of YPO4 in the peripheral region of the particles. The observed effect of the distribution of cations over the particle made it possible to determine the size of the gradient layer, which reaches 50 % of the total particle size.

Adoption Level of Farmers Regarding Cultivation Practices of Areca Nut in Chikmagalur District, Karnataka, India

The study examined the adoption of cultivation practices of areca nut in Chikmagalur district of Karnataka state during the year 2018-19. Chikmagalur is one of the largest and traditional areca nut-producing districts of Karnataka. Two taluks were selected in chikmagalur district based on the highest area under cultivation and the total sample size was 100. Seventeen items were considered to form a table to know the adoption of individual recommended practices by farmers concerning areca nut cultivation. Further to classify the overall adoption of areca nut growers recommended cultivation practices were grouped in to three major categories low, medium and high. The findings of the study revealed that, regarding the overall adoption of farmers about the cultivation of areca nut, less than half (43.00%) of the respondents were found in the medium adoption category, followed by 31.00 per-cent of respondents were found in high adoption category and more than one fourth (26.00%) of respondents were found in low adoption category regarding the adoption of individual recommended cultivation practices by areca nut growers.

A stochastic optimization procedure to design the fair aggregation of energy users in a Renewable Energy Community

Optimizing unit sizes and operation within a Renewable Energy Community (REC) can match intermittent renewable energy generation with variable user energy demands. These uncertain variables are often represented by pre-defined stochastic scenarios, without searching for the “best” scenarios and testing the optimization models with these scenarios. Moreover, little work both optimized RECs under uncertainty and distributed optimal life-cycle costs (investment and operation) among members. Thus, the objectives are: i) identifying the “best” set of stochastic scenarios of solar irradiance and user electricity demands and ii) assessing the accuracy of the “stochastic forecasts” of the total system costs and unit sizes, obtained by solving a stochastic programming model based on the “best” scenarios. The proposed novel procedure shifts the “present moment” back in time to split historical data into “past” and “future” periods used to identify the “best” scenarios and compare the “stochastic forecasts” with the utopic “perfect forecasts” based on the perfect knowledge of real data, respectively. The small errors between these forecasts in the optimal life-cycle costs (less than 2 %) and sizes (3–13 %) indicate good effectiveness of the suggested procedure. Also, the optimal life-cycle costs of “stochastic forecasts” are fairly distributed among users by applying the Shapley value mechanism.

Draft genome sequence of non-pathogenic Escherichia coli 5C LMG S-33222, isolated from healthy donor feces.

We present the genome sequence of Escherichia coli 5C LMG S-33222, a non-pathogenic microorganism with potential probiotic features. The strain was isolated in 2021 from a fecal sample of a healthy Italian infant. The total genome size is 4,712,575 bp with a G + C content of 51%.

On the aquatic phenology of sympatric crested and marbled newts (genus Triturus)

Abstract The large-bodied newts Triturus cristatus and T. marmoratus possess ranges that overlap in western France where they frequently share breeding ponds. I test the hypothesis that the aquatic phenology differs between them, as associated with a more aquatic and terrestrial life style respectively. Total adult population sizes were determined in spring in 13 experiments by the capture-mark-recapture methodology, followed by equivalent experiments in summer. Population sizes dropped by an order of magnitude on average whereas species frequencies changed in favour of T. cristatus, suggesting that T. marmoratus leaves the breeding site earlier than T. cristatus. Interspecies hybrids behaved like T. marmoratus. Descriptions are provided of other features (in ecology, morphology, demography, and colouration pattern) that support the different, aquatic versus terrestrial life styles of T. cristatus and T. marmoratus.

Comparison of space vector and switching frequency optimal pulse width modulation for diode free F‐type multi level inverter

AbstractThis study presents a comprehensive examination of space vector pulse width modulation (SVPWM) and switching frequency optimal PWM (SFOPWM) for an F‐type multilevel inverter (FTMLI). SVPWM offers a simple, digital implementation for three‐phase, three‐level inverter structures, and carrier‐based SFOPWM allows for maximum use of switching frequency with a simple construction. This approach reveals the underlying relationship between the above two PWM techniques with various amplitude and frequency modulation indices to ensure the performance of FTMLI. A suitable comparative study was carried out to verify the PWM techniques based on the inverter output voltage, total harmonic distortion, switching stress, and filter size. The analytical conclusions are supported by the simulation results and their experimental validation.

Chromosome-Scale Genome and Transcriptomic Analyses Reveal Differential Regulation of Terpenoid Secondary Metabolites in Hericium coralloides.

Construction of the genome of Hericium coralloides, a species of edible mushroom, and identification of the genes involved in terpenoid biosynthesis can determine the biology and genetics of terpenoids. The present study describes the assembly of a high-quality chromosome-scale genome of H. coralloides using Pacbio HiFi sequencing and Hi-C technology. This genome consisted of 13 chromosomes, a total size of 43.6 Mb, contigs of N50 3.6 Mb, GC content at 54%, and BUSCOs integrity of 96.9%. Genes associated with terpenoid biosynthesis were predicted by KEGG enrichment analysis and homologous alignment. The Her011461 and Her008335 genes, encoding proteins in the terpenoid backbone synthesis pathway, were found to encode geranylgeranyl pyrophosphate and farnesyl diphosphate synthases, key enzymes in the biosynthesis of geranylgeranyl diphosphate, a precursor of several diterpenoids. Her011463 was found to be involved in regulating diterpene cyclase. The Her005433, Her006724, Her010605, and Her010608 genes were found to encode sesquiterpene synthesis. Most of these genes were more highly expressed in dikaryotic mycelia than in the primordium and fruiting bodies, indicating that terpenoids may be more abundant in dikaryotic mycelia. To our knowledge, this study is the first to assemble the H. coralloides genome at the chromosome scale and to identify the genes involved in terpenoid biosynthesis.

Climatic Oscillations and Dynastic Trends: A Multiproxy analysis of the past two millennia in the Indian Subcontinent

The study examines centennial-scale climatic oscillations over the past two millennia in the monsoon-dominated Indian subcontinent by multiproxy analysis of pollen along with stable carbon isotope, total organic carbon, magnetic susceptibility, and grain size from a 274 cm deep sediment profile in Sarsapukhra Lake, Varanasi, in the Central Ganga Plain (CGP) to portray vegetation changes and their impact on rise and fall of dominant dynasties. Between ∼1800 to 1600 cal yr BP, the coarser silty sand with few Poaceae and Asteraceae pollen with other proxy data, indicate that the region experienced a strong Indian Summer Monsoon (ISM). Subsequently, from ∼1600 to 1350 cal yr BP, presence of mixed moist deciduous taxa such as Shorea robusta, Madhuca indica, Rubiaceae, Morus alba, Syzygium, and Moraceae indicate a moderate ISM while between 1350 to 1200 cal yr BP, the dominance of dry deciduous taxa viz. Acacia sp., Bombax ceiba, Holoptelea, Rutaceae, Madhuca indica, Mangifera indica etc. suggested weak ISM conditions. A pulsative ameliorating trend from ∼1200 to 1030 cal yr BP showed the dominance of deciduous taxa such as Holoptelea, Rutaceae, Ziziphus, Rubiaceae, Maytenus and Acanthaceae etc. indicating warm and moist climatic conditions, followed by a weak ISM until ∼900 cal yr BP and improved ISM until 620 cal yr BP. Subsequently, an improving trend in the ISM from ∼620 to 450 cal yr BP was observed, with increased dominance of wetland taxa, followed by acute dry climate beyond ∼450 cal yr BP indicating poor ISM conditions.Additionally, the alternating warm and cold episodes had a direct impact on vegetation, forcing human civilizations to migrate from their original locations and contributing to the downfall of prominent dynasties. Furthermore, this study lays the foundation for future research into issues related to vegetation change, the amount of ISM shift, and human culture−climate relationship.