The Impact of the COVID-19 Pandemic on Female Domestic Workers in an Urban Setting

This paper focuses on the increasing marginalisation and vulnerability of female domestic workers in urban India in the wake of the COVID-19 pandemic. It analyses the impact of the pandemic on the livelihood and the physical, mental and emotional well-being of women domestic workers through a primary survey conducted in Lucknow city in 2020 and 2021. The paper highlights the effect of lockdown on their livelihoods, savings, food security, family life and mental health. It also analyses the effectiveness of the outreach of government support to this vulnerable segment of the urban informal sector. Given the vulnerability of this group to various forms of exploitation, the authors suggest that policy interventions aimed at providing welfare and social protections will need to be coupled with strong political will and increased social consciousness to have an enduring impact. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Home-based care programme (HBCP) for patients with COVID-19: Boon or burden during pandemic management?

Introduction and Aim: India experienced the peak of the second wave of COVID-19 during April to June 2021. Massive surge of cases resulting in shortage of beds and oxygen, home care was recommended as a strategy for management of asymptomatic/mild COVID-19 cases. The present study was undertaken to perform home visits and monitor COVID 19 patients who are a part of home-based care programme (HBCP) in Puttur taluk of Dakshina Kannada district, identification and immediate referral of patients with red flag signs/ symptoms and to identify barriers/challenges faced by health care staff in implementing the programme. Methodology: The present study was a cross-sectional study with universal sampling. It was carried out as part of a district programme for management of home isolation COVID-19 patients. The team visited the houses of COVID-19 patients and evaluated them. Result(s): A total of 112 COVID-19 patients were in home isolation during the study period in Puttur Taluk. Hypertension (29.5%) was the most common co-morbidity and nearly two-fifths (41.1%) of the study participants had one or more comorbidities. Almost two-third (63%) of the patients with comorbidities were symptomatic compared to only 29.4% of patients without any comorbidities. Of the six patients who had saturation of less than 95% five were more than 60 years of age, only one had received vaccination against COVID-19 and all had comorbidities. The HBCP had to face several challenges as the team members could not be in full PPE because of long distances between the houses and hard to reach areas. Conclusion(s): Overall, it is a helpful initiative for patients as the health services were provided at the doorstep during the time of restriction of movement. This can be an important tool in managing not only COVID pandemic but also future outbreaks that may follow.Copyright © 2023, Indian Association of Biomedical Scientists. All rights reserved.

Hospitality & Tourism Research during (COVID-19) Pandemic: A Bibliometric Analysis

COVID-19 has changed the world forever in every imaginable aspect. Hospitality and Tourism has been one of the world's largest employers and key economic contributors. Hospitality and Tourism has been one of the worst-hit sectors due to the pandemic (COVID-19) worldwide. This has called upon the attention of many researchers worldwide. The main purpose of this study is to analyse the literature during 2019-2022, identify the most productive authors, most influential countries, most productive institution and journals also top-performing research articles and keyword analysis to know the research themes and trends focussing coronavirus in the fields of Hospitality and Tourism. The study also suggests the areas of future research to the researchers and policymakers and proposes solutions to contemporary issues. The study uses "biblioshiny” – an interface of R-package and VOSviewer for conducting bibliometric analysis that ameliorates the quality of review bereft of any subjective biasness. ©Copyright IJHTS.

Towards Intermediated Workflows for Hybrid Telemedicine

The growing platformization of health has spurred new avenues for healthcare access and reinvigorated telemedicine as a viable pathway to care. Telemedicine adoption during the COVID-19 pandemic has surfaced barriers to patient-centered care that call for attention. Our work extends current Human-Computer Interaction (HCI) research on telemedicine and the challenges to remote care, and investigates the scope for enhancing remote care seeking and provision through telemedicine workflows involving intermediation. Our study, focused on the urban Indian context, involved providing doctors with videos of remote clinical examinations to aid in telemedicine. We present a qualitative evaluation of this modified telemedicine experience, highlighting how workflows involving intermediation could bridge existing gaps in telemedicine, and how their acceptance among doctors could shift interaction dynamics between doctors and patients. We conclude by discussing the implications of such telemedicine workflows on patient-centered care and the future of care work. © 2023 Owner/Author.

Systems genetics identifies miRNA-mediated regulation of host response in COVID-19.

BACKGROUND: Individuals infected with SARS-CoV-2 vary greatly in their disease severity, ranging from asymptomatic infection to severe disease. The regulation of gene expression is an important mechanism in the host immune response and can modulate the outcome of the disease. miRNAs play important roles in post-transcriptional regulation with consequences on downstream molecular and cellular host immune response processes. The nature and magnitude of miRNA perturbations associated with blood phenotypes and intensive care unit (ICU) admission in COVID-19 are poorly understood. RESULTS: We combined multi-omics profiling-genotyping, miRNA and RNA expression, measured at the time of hospital admission soon after the onset of COVID-19 symptoms-with phenotypes from electronic health records to understand how miRNA expression contributes to variation in disease severity in a diverse cohort of 259 unvaccinated patients in Abu Dhabi, United Arab Emirates. We analyzed 62 clinical variables and expression levels of 632 miRNAs measured at admission and identified 97 miRNAs associated with 8 blood phenotypes significantly associated with later ICU admission. Integrative miRNA-mRNA cross-correlation analysis identified multiple miRNA-mRNA-blood endophenotype associations and revealed the effect of miR-143-3p on neutrophil count mediated by the expression of its target gene BCL2. We report 168 significant cis-miRNA expression quantitative trait loci, 57 of which implicate miRNAs associated with either ICU admission or a blood endophenotype. CONCLUSIONS: This systems genetics study has given rise to a genomic picture of the architecture of whole blood miRNAs in unvaccinated COVID-19 patients and pinpoints post-transcriptional regulation as a potential mechanism that impacts blood traits underlying COVID-19 severity. The results also highlight the impact of host genetic regulatory control of miRNA expression in early stages of COVID-19 disease.

Laser: A boon during the COVID pandemic in aerosol mitigation - A systematic review

The scientific community was always intrigued by the indoor air quality in dental offices. The unexpected emergence of the COVID pandemic has put greater challenges on dental professionals. Shortly after the declaration of coronavirus as a pandemic by the World Health Organization in March 2020, the American Dental Association abstained the dental society from providing routine dental procedures. An evidence-based review of the literature was conducted electronically using three databases, PubMed, Science Direct, and Google Scholar between January 2005 to December 2021. Three articles were selected for the qualitative analysis out of 41 screened articles from the databases. The evidence suggests that there is a significant reduction in aerosol generation with laser when compared to conventional treatment modalities. Laser-assisted treatment procedures bring the dentist and patients a step closer to providing safe dental treatments and reducing the risk of transmission of disease.

Neoteric Trends of Unmanned Aerial Vehicle (UAV) Research: A Scientometric Analysis

Artificial intelligence is becoming more prevalent across diverse disciplines, and aerial vehicles are increasingly becoming "Unmanned”. It is beneficial when residents might otherwise be in danger, such as during COVID-19 medicine delivery, gathering information about the enemy, or using it in agriculture. This study aims to provide a scientometric assessment of the latest research centres, patterns, and global reach of UAVs from 2007 to 2022. The study uses bibliographic information downloaded in CSV format from Scopus to examine the in-depth visualization of the index item's properties. In addition to examining article expansion, field classifications, global dispersion, citation analysis, and the impact of the institutions and writers, the study examines UAV applications distributed throughout the world. To analyse term co-occurrence, we use a Java-based program called VOSviewer, which lists hubs and the latest innovations in UAV research. © Author (s) 2023.

Executive summary of the XXIV State Annual conference of Medicolegal Association of Maharashtra (MLAM): Forensicon 2021

The XXIV annual state conference of the Medicolegal Association of Maharashtra: Forensicon 2021 organized by the department of Forensic and Toxicology, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai. Previous conference "Forensicon 2020” was held at TNMC & BYL Nair Ch. Hospital, Mumbai in the month of April 2021 as COVID pandemic prevented the continuity of the conference in the year 2020. Responsibility of organizing XXIV annual State conference was allotted to Department of Forensic Medicine and Toxicology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai on 22nd November 2021. The organizing committee have magnificently conducted the annual state conference in the very short duration of 24 days on 17th and 18th December 2021 at main auditorium, Lokmanya Tilak Municipal Medical College and hospital, Mumbai. Dr Rajesh Dere, professor and head, Forensic Medicine Dept, LTMMC & hospital and Dean BKC Jumbo COVID 19 facility, Mumbai through his valiant efforts as team leader overcoming all the obstacles brought this conference to epitome of success. © 2022, Medicolegal Association of Maharashtra. All rights reserved.

Hypertension clinical care in the era of coronavirus disease 2019: Practical insights from India

Objective: The objective of this study was to seek the opinion of Indian health-care professionals (HCPs) about hypertension (HTN) care during coronavirus disease 2019 (COVID-19) era. Methods: HCPs' opinions (n = 2832) were recorded based on survey and round table meetings. Standard questionnaire consisting of nine questions pertaining to HTN care in COVID-19 was prepared, discussed, and evaluated by experts who treat patients with HTN during COVID-19 era. Results: Smoking/tobacco use, obesity, and comorbidities (diabetes/dyslipidemia) were ranked as the top three modifiable risk factors. A total of 37% and 33% of HCPs reported an increase in blood pressure (BP) during the lockdown period in 10%–20% and 20%–40% of hypertensive patients, respectively, who were on monotherapy. Around 35% of HCPs reported that 20%–30% of their patients with HTN showed uncontrolled BP (>150/100 mmHg). Dual-drug therapy in patients with uncontrolled BP was preferred by 56% of HCPs. Nearly 71% preferred dual combination for HTN management. In dual combination, 27% preferred angiotensin receptor blockers (ARBs) + diuretic, 26% preferred ARB + calcium channel blockers, and 18% preferred ARB + beta-blockers. The majority of HCPs (44%) consider that <30% of their patients with HTN check BP at home. A total of 47% of HCPs reported acute coronary syndrome as the most common HTN-related complication. The majority of HCPs (57%) considered that avoiding contamination during BP measurement is the challenging parameter. Around 32% considered self-BP monitoring (SBPM) as the best method to improve medication adherence. Conclusion: SBPM, combination therapies, and digital connect with patients are critical aspects of HTN management during COVID-19 pandemic. © 2023 The Author(s).

Systemic lupus erythematosus nephritis and COVID-19 disease.

Of the more than 20 studies published on SLE patients with COVID-19, none of the studies focused on lupus nephritis. We report the outcomes of renal biopsy-proven systemic lupus erythematosus (SLE) nephritis patients after COVID-19 disease. Our institute has been declared as a state COVID-19 hospital in the last week of March 2020. From then till now, we have admitted and managed COVID-19 patients from several districts of Andhra Pradesh and neighbouring states. We collected the data of patients with SLE nephritis contemporaneously from admission to the outcomes on a computerised proforma. We had identified sixteen patients with SLE nephritis who were admitted with COVID-19 disease. Of them, fourteen were females and two were males. The mean age was 29.3 years. Out of sixteen patients, seven required a mechanical ventilator and dialysis and eventually succumbed. One more patient died due to disseminated tuberculosis. Our results suggested that with an approximately 50% mortality rate, the COVID-19 disease had a calamitous effect on SLE nephritis patients. Key Points • We identified the significant risk factors for mortality: younger age, higher serum creatinine at presentation, higher CT severity score and lower serum albumin. • After the analysis done for this article, we decided to reduce the medications for SLE nephritis to prednisolone 10 mg/day when COVID-19 disease is contracted.

Impact of Covid-19 among Small Scale Industry Fishermen - A Mixed Methods Study from Coastal Area of Karnataka

Background: The ongoing COVID-19 pandemic has grave implications worldwide. Workers in small scale industries like fisheries forms a vulnerable group without social security/recognised labour rights Objectives: To assess the physical, mental and socio- economic impact of COVID-19 among fishermen community from coastal area of Karnataka 2. To understand the challenges faced and coping mechanism adopted to mitigate the impact Methodology: This community based mixed methods study was conducted among 138 participants from a fishermen community in coastal Karnataka. Quantitative data included sociodemographics, COVID-19 diagnosis, treatment, related expenses and DASS -21 questionnaire. Qualitative data was collected through 3 Focus Group Discussions and 7 Key informant Interviews till data saturation. Result(s): A total of 138 participants (quantitative 107 and qualitative 31) were included. Majority of the participants were males (70.1%), belonged to age category of 46-60 years (37.4%), nuclear family (71%) and were from low socioeconomic status (79.4%). COVID-19 appropriate behaviour was found to be poor among participants with only 36% using masks, 24.3% washing hands and 10.3% maintaining social distancing. Among 107, 51 (47.7%) participants had probable COVID-19 symptoms. However only 7 (10.9%) had tested for COVID-19 with test positivity rate of 57.1%. Two participants were admitted in hospital with mean hospital stay of 7 days. According to DASS-21, 20.6%, 15.9% and 9.3% screened positive for depression, anxiety and stress respectively. Nealy 90% lost jobs and more than 75% reported to have financial difficulties. Major challenges included loss of livelihood, inaccessibility to health care, repayment of loans, stigma related to Covid-19 and meeting educational expenses of children with one drop out from college. Strategies to cope up with financial difficulty included borrowings, pawning and selling assets at individual level. Activities of local self-help groups in the community and grass root level marketing strategies were highly successful in mitigating the impact as a community. Conclusion(s): COVID-19 has affected fishermen community to a large extent. This understanding will enable to implement need-based intervention strategies and help in disaster preparedness among this population.

COVID-19 SOP Compliance and Monitoring Electronic System for Business and Public Places Using Arduino Uno

COVID-19 Corona virus disease is a rapidly spreading contagious disease that is causing a global public health crisis. In December 2019, the coronavirus was identified in Wuhan, China. COVID-19 is causing severe disease issues and many people are losing their lives daily. SARS-CoV-2 (Severe Acute Respiratory Syndrome coronavirus 2) is a severe infectious disease that is spreading very fast and is currently inflicting a healthcare crisis across the globe. The lethal coronavirus was founded in Wuhan, China in December 2019. The symptoms of this disease are fever, cough, fatigue, no taste or smell, stinging throat, headache, and difficulty in breathing. This deadly disease, COVID-19, is difficult to identify and spread. The vaccination process is still going on around the world. There are some existing strategies to minimize the spread of the COVID-19 virus by monitoring the temperature rise using sensors, wearing masks, and sanitizing their hands frequently. The proposed system comprises of an RFID reader, an IR sensor, a temperature sensor, a buzzer, a laptop or a personal computer with a web cam. A person on entry gets detected for their body temperature, wearing a face mask and then sanitizing their hands. If the temperature of the person is below 37.6 degrees, i.e., below the acceptance limit, then mask detection takes place by using MATLAB followed by spraying the sanitizer. Now the door will open automatically. Otherwise, the door will not open and the buzzer will sound. With these precautionary steps, people can survive this pandemic situation. © 2023 IEEE.

The Coronavirus Pandemic and the Transformation of Telehealth in the Context of Artificial Intelligence

The pandemic is seriously affecting individuals' wellbeing, occupations, economies, and practices. This pandemic has shaken the world dramatically and framed a moment to think about the future, incorporating our relationship with nature. Since the COVID-19 pandemic started, it's been relied upon to drive remarkable development in telehealth, especially for demonstrative patients, to stay at home and talk with specialists through virtual stations, helping with diminishing the spread of the disease to mass and the clinical staff on the ground zero. The novel coronavirus epidemic has changed our way of living, society, and human services framework. This study proposed the application of artificial intelligence to make its classification. The outcomes of the proposed systems are equated with pre-existing algorithms to highlight the benefits of test time minimization and classification error. Furthermore, this study tries to analyse corona time series data on the level of classification and found that the decision tree algorithm gives the best accuracy of approx. 100% with zero error and zero standard deviation with 7098 milliseconds. © 2022 IEEE.

A novel computational approach for rapid screening of antibody therapeutics for efficacy against SARS-CoV-2 variants of concern including Omicron variant

Multiple severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) variants continue to evolve carrying flexible amino acid substitutions in the spike protein's receptor binding domain (RBD). These substitutions modify the binding of the SARS-CoV-2 to human angiotensin-converting enzyme 2 (hACE2) receptor and have been implicated in altered host fitness, transmissibility and efficacy against antibody therapeutics and vaccines. Reliably predicting the binding strength of SARS-CoV-2 variants RBD to hACE2 receptor and neutralizing antibodies (NAbs) can help assessing their fitness, and rapid deployment of effective antibody therapeutics, respectively. Here, we introduced a two-step computational framework with threefold validation that first identified dissociation constant as a reliable predictor of binding affinity in hetero-dimeric and -trimeric protein complexes. The second step implements dissociation constant as descriptor of the binding strengths of SARS-CoV-2 variants RBD to hACE2 and NAbs. Then, we examined several variants of concern (VOCs) such as Alpha, Beta, Gamma, Delta, and Omicron and demonstrated that these VOCs RBD bind to the hACE2 with enhanced affinity. Furthermore, the binding affinity of Omicron variant's RBD was reduced with majority of the RBD-directed NAbs, which is highly consistent with the experimental neutralization data. By studying the atomic contacts between RBD and NAbs, we revealed the molecular footprints of four NAbs (GH-12, P2B-1A1, Asarnow-3D11, and C118)-that may likely neutralize the recently emerged omicron variant-facilitating enhanced binding affinity. Finally, our findings suggest a computational pathway that could aid researchers identify a range of current NAbs that may be effective against emerging SARS-CoV-2 variants.

Comparison of the efficacy of tocilizumab and itolizumab for the treatment of severe COVID-19: a retrospective cohort study

Introduction: Itolizumab, a CD6 inhibitor has been found to be effective in COVID-19 in some studies [1] but there is no randomised controlled trial at present to prove its effectiveness. Method(s): The study population was adults (> 18 years) with severe COVID-19 pneumonia admitted in the ICU who received either tocilizumab or itolizumab in their course of stay in ICU. The primary outcome of the study was a clinical improvement (CI). The secondary outcomes were time for clinical improvement, improvement in PO2/ FiO2 ratio, best PO2/ FiO2 ratio, need for mechanical ventilation (MV) after administration of study drugs, time to discharge and survival days. Result(s): 126 patients were included in the study;92 received tocilizumab, and 34 received itolizumab. CI was seen in 46.7% and 61.7% of the patients in the tocilizumab and itolizumab groups, respectively and was statistically non-significant. The time to CI was also non-significant between the tocilizumab and itolizumab groups (median 12 vs 11 days). The number of days required to achieve the improvement of 100 in the PO2/ FiO2 ratio was significantly less with itolizumab as compared to tocilizumab. (6 vs 8 days, p value = 0.028). The best PO2/ FiO2 ratio achieved was also significantly better with itolizumab as compared to tocilizumab (315 vs 250, p value = 0.043). The incidence of serious adverse events due to the study drugs was significantly higher with itolizumab as compared to tocilizumab (14.7 vs 3.26%). The estimated median time for CI was 12 days and 11 days in the tocilizumab and itolizumab groups, respectively and was non-significant (log-rank p value = 0.262) (Fig. 1). Conclusion(s): The clinical improvement and survival rates with itolizumab are similar to tocilizumab. Better oxygenation can be achieved with itolizumab and can be a substitute for tocilizumab in managing severe COVID-19 infection.

Biomarkers of renal injury as early predictors of COVID-19 associated AKI: a prospective observational trial (BRICOAKI-trial)

Introduction: Early prediction by the use of serum and urinary biomarkers for the detection of acute kidney injury (AKI) may be very valuable to optimize the management and helps in improving the outcomes. This study aims to investigate whether daily measurement of urinary and plasma renal biomarkers have a role in earlier predicting COVID-19 associated AKI. Method(s): The study was conducted as a single-center, prospective, observational cohort study between August 2020 and December 2020 in hospitalized COVID-19 patients. A total of 65 moderate and severe COVID-19 positive adult (>= 18 years) patients were enrolled for this study. We measured serum creatinine, cystatin C, NGAL, KIM-1, Urine-Klotho, TIMP-2, IL-6 level, and urinary microalbumin/urinary creatinine on various days. The receiver operating characteristic curve (ROC) analysis was used to find the sensitivity and specificity of various markers to predict the incidence of AKI. Result(s): A total of 24 moderate and 41 severe COVID-19 patients were included. Out of which 47 patients developed (72.3%) acute kidney injury (AKI) over the course of COVID-19. Among these subjects, 18/47 (38.2%) developed severe AKI (KDIGO 2 + 3), and 5/47 (10.6%) required RRT. NGAL was found to be the best marker to predict the probability of AKI (Area under curve AUC of 0.713-0.786) with a sensitivity of 76-90% and specificity of 56-79% on different days of assessment from Day 1 to Day 7. IL-6 had moderate accuracy of prediction and cystatin C, KIM-1, Urine-Klotho, TIMP-2, IL-6 had poor accuracy for predicting the incidence of AKI. Conclusion(s): Urinary biomarkers like NGAL have good predictability for AKI.

Checklists: To Get Things Done Right-All the Time

Anaesthesia machine, medication and crisis checklists have developed over the decades from the development of anaesthesia practice and the experience of unfortunate lapses, errors and patient harm. The ever increasing need to improve patient safety and reduce morbidity and mortality as well as improve workflow, teamwork and communication within the operating room has led to the development of a variety of checklists. These cover aspects of machine and equipment functionality but also basic standards such as essential monitoring, oxygen supply and emergency equipment. Crisis checklists have lowered the mortality associated with such perioperative emergencies. Overall, checklist use, mandatory practice in many hospitals, is highly recommended for patient safety in the operating room. © Springer Nature Switzerland AG 2022.

IMPACT OF SARS-CoV-2-MEDIATED CD4 T CELL ACTIVATION AND HIV DNA PERSISTANCE IN VIVO

Background: Antigen-driven CD4+ T cell proliferation is a proposed mechanism of HIV-1 reservoir persistence. We previously reported that SARSCoV- 2 infection leads to increased detectable low-level HIV-1 plasm RNA blips months after COVID-19, but the impact of SARS-CoV-2-mediated T cell activation on expansion of HIV-1 reservoirs is not known. We sought to identify if SARSCoV- 2 infection leads to expansion of preferentially HIV-infected CD4+ T cells in people with HIV (PWH) on ART. Method(s): Five PWH with samples collected prior to and approximately two months after SARS-CoV-2 infection were identified. We performed a surface activation induced marker (AIM) assay using a CD4-optimized overlapping SARS-CoV-2 peptide pool to measure OX40/CD137 expression following peptide stimulation and sorted CD4+ T cells based on surface marker expression. ddPCR quantification of genomic HIV-1 DNA was performed on sorted subsets. Result(s): We observed an increase in the frequency of SARS-CoV-2 AIM+ non-naive CD4+ T cells following COVID-19 in samples from 4 of 5 participants (mean AIM+ % 0.13 pre- vs 0.31 post). A large percentage of non-naive AIM+ CD4+ T cells expressed PD1 compared with total non-naive cells before (76% vs 36%) and after (65% vs 19%) COVID-19;PD1 expression was lower following SARS-CoV-2 in both AIM+ and AIM- CD4+ T cell subsets (although very few cells were AIM+ prior to COVID-19). HIV-1 DNA levels in non-naive AIM- CD4+ T cells prior to COVID-19 unexpectedly decreased following infection (mean 3,522 to 766 copies/106 cells). The numbers of AIM+ cells obtained by cell sorting were overall low ( 3,863 mean) and only one participant had detectable DNA in post-COVID AIM+ CD4+ T cells. However, a large majority of this participant's post-COVID AIM+ cells harbored HIV-1 DNA (0.89 copies per cell) whereas HIV DNA in their AIM- cells decreased from 8,387 to not detected following SARSCoV- 2 infection. No HIV-1 DNA was detected in the small number of AIM+ cells obtained prior to COVID-19 in this participant. Conclusion(s): COVID-19 in PWH led to a modest SARS-CoV-2-specific CD4+ cell response approximately two months following acute presentation. One participant may have preferentially expanded HIV-1-infected, SARS-CoV-2- specific CD4+ T cells following COVID-19 but studies involving larger numbers of participants and larger numbers of cells will be needed to fully understand the impact of SARS-CoV-2 on clonal expansion and HIV persistence.

The interplay of skills, digital financial literacy, capability, and autonomy in financial decision making and well-being

Covid-19 and the unprecedented surge in financial technology contributed to unexpected financial challenges, affecting the relevance of financial decision making and perceived financial well-being. This paper examines the mediating effects of digital financial literacy, financial autonomy, financial capability, and impulsivity on financial decision making and perceived financial well-being. The data come from 512 re-spondents in Delhi/NCR (National Capital Region), India, using a snowball-sampling technique and partial least squares structural equation modeling to test 13 structural hypotheses with SmartPLS3.3. Partial least squares (PLS) prediction is employed to estimate the out-of-sample predictive power of the proposed model. Our findings reveal that skills directly affect financial decision making and perceived financial well-being, and digital financial literacy emerges as a direct and mediating predictor of financial decision making. The dominance of financial capability and financial autonomy as mediators in financial decision making and financial well-being become more evident, and impulsivity fails to have mediating effects on financial decision making. The results have academic, regulatory, and managerial implications, all of which calls for more concerted efforts at recognizing the unique interaction among skills-financial decision making-perceived financial well-being, the cu-mulative effect of which enhances the critical ability to deal with environmental challenges, manage socioeconomic pressures in a sustainable manner, and translate the benefits into prudent gender-specific policy decisions and practices.Copyright (c) 2022 Borsa Istanbul Anonim S , irketi. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).