bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of premature adult mortality associated with lack of access to electricity in India
Authors: Hejjaji Vittal , Barbhaya Dweep , Rahimian Amirarsalan , Yamparala Aishwarya , Yakkali Shreyas , Khetan Aditya K. 
Published: March 2024

Background
The impact of electricity access on all-cause premature mortality is unknown.

Methods
We use a national dataset from India to compare districts with high access to electricity (>90% of households) to districts with middle (50–90%) and low (<50%) access to electricity and estimate the effect of lack of electricity access on all-cause premature mortality.

Results
In 2014, out of 597 districts in India, 174 districts had high access, 228 had middle access, and 195 had low access to electricity. When compared to districts with high access, districts with low access had higher rates of age-standardized premature mortality in both women (2.09, 95% CI: 1.43–2.74) and men (0.99, 0.10–1.87). Similarly, these districts had higher rates of conditional probability of premature death in both women (9.16, 6.19–12.13) and men (4.04, 0.77–7.30). Middle access districts had higher rates of age-standardized premature mortality and premature death in women, but not men. The total excess deaths attributable to reduced electricity access were 444,225 (45,195 in middle access districts and 399,030 in low access districts). In low access districts, the proportion of premature adult deaths attributable to low electricity access was 21.3% (14.4%– 28.1%) in women and 7.9% (1.5%– 14.3%) in men.

Conclusion
Poor access to electricity is associated with nearly half a million premature adult deaths. One out of five premature deaths in adult women were linked to low electricity access making it a major social determinant of health.
Impact of obesity on outcomes of rotator cuff repair: A systematic review and meta-analysis
Authors: Ma Xiaojun , Shen Jia , Wan Jun 
Published: March 2024

Background
To synthesize the existing evidence on the association between obesity and rotator cuff repair outcomes such as pain, shoulder function, range of motion, and complications.

Methods
We searched PubMed, EMBASE, and Scopus databases for relevant observational studies (cohort and case-control) and randomized controlled trials (RCTs). The target population in the included studies comprised adults who had undergone rotator cuff repair procedures. The outcomes of interest were functional outcomes (such as range of motion), pain scores, patient-reported outcome measures, and complication rates (such as re-repair and readmission rates). We applied random-effects models and calculated pooled effect sizes reported as standardized mean differences (SMDs) or relative risks (RRs) with 95% confidence intervals.

Results
We analysed data from 11 studies. In most, the follow-up periods ranged from 12 to 60 months. Obese individuals experienced greater pain (SMD 0.30; 95% CI, 0.10, 0.50) and lower shoulder function (SMD -0.33; 95% CI, -0.54, -0.12) than other individuals in the long-term post-operative follow-up. Obese individuals also had higher risks of complications (RR 1.48; 95% CI, 1.11, 1.98) and readmission (RR 1.35; 95% CI, 1.27, 1.43), but a similar likelihood of re-repair (RR, 1.27; 95% CI, 0.82, 1.95) than non-obese/normal BMI individuals. While the forward flexion and external rotation functions were comparable, obese individuals displayed less internal rotation function than other individuals (SMD -0.59; 95% CI, -0.87, -0.30).

Conclusion
Obesity was associated with unfavourable outcomes after rotator cuff surgery, including increased pain, reduced shoulder function, high risks of complications, and readmission. These findings emphasize the importance of addressing obesity-related factors to improve post-operative outcomes.
The trajectories of CD4 T lymphocytes over time in patients who have defaulted on treatment for tuberculosis in a cohort of people living with HIV, Recife/PE
Authors: Cunha Rossana , Filho Demócrito de B. M. , M. Albuquerque Maria de Fátima P. , Lacerda Heloísa R. , Diniz George T. N. , Montarroyos Ulisses R. , Rodrigues Laura C. , Vilela Moura Líbia Cristina R. , Ximenes Ricardo A. A. 
Published: March 2024

Background
The CD4 T lymphocyte count in people living with HIV (PLHIV) is a predictor for the progression of the disease (AIDS), survival and response to antiretroviral treatment (ART). A CD4 T lymphocyte count of less than 200 cells/mm3 is indicative of a greater risk for the onset of opportunistic diseases and death. Defaulting on treatment for tuberculosis (TB) may impact immune recovery in PLHIV who are taking ART. The aim of this study was to investigate an association of the CD4 lymphocyte with TB treatment Trajectory and with death.

Methods
A cohort of PLHIV over eighteen years of age and who were taking ART and who had defaulted on pulmonary TB treatment. Latent Class analysis was used to identify different trajectories of CD4 T lymphocyte counts over time.

Results
Latent class 1 (High CD4 trajectory) grouped individuals together who were characterized as maintaining a low probability (0 to 29%) of a CD4 count ≤ 200 cells/mm3over time, while latent class 2 (Low CD4 trajectory) grouped individuals together with a high probability (93% to 60%), and latent class 3 (Fluctuating CD4 trajectory), grouped individuals with a fluctuating probability (66% to 0%). The chance of defaulting on treatment earlier (≤ 90 days) was four times higher in latent class 2 (Low CD4 trajectory). Although there was no statistical significance, there was a higher frequency of deaths in this same latent class.

Conclusion
Individuals with a high probability of a CD4 count ≤ 200 cells/ mm3 should be monitored in order to avoid treatment default and thereby prevent death. New studies should be conducted with a larger sample size and a longer follow-up time in PLHIV who initiated ART treatment early so as to support clinical decisions for a better understanding of immune behavior.
Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay
Authors: Danu Nugroho , Handryastuti Setyo , Mangunatmadja Irawan , Pusponegoro Hardiono D. 
Published: March 2024

Background Early detection of autism spectrum disorders (ASD) in children with speech delay is important to improve outcomes. Behavioral responses to calling, teasing, poking, and blocking can be used to screen for ASD in daily practice.
Objective To evaluate the accuracy of behavioral responses to stimuli in detecting ASD in children aged 18 months to 4 years with speech delay.
Methods This cross-sectional study was conducted in children with speech delay aged 18 months to 4 years who visited the Outpatient Clinic of Cipto Mangunkusumo Hospital, Jakarta. Subjects were stimulated while playing by poking, teasing, calling, and blocking (stopping the child’s play using the examiner’s hand) and were assessed for their responses. Lack of seeking eye contact with the examiner following the stimulus was considered as a response suggestive of ASD. Independent diagnosis based on DSM-V criteria was considered the gold standard to diagnose ASD or non-ASD.
Results A total of 109 children were included in this study, with an average age of 32 (SD 7.4) months. There were 52 subjects (47.7%) with ASD and 57 subjects (52.2%) with non-ASD. Behavioral response analysis revealed that calling, blocking and teasing had high sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for identifying ASD. The poking response had the highest specificity to rule out ASD compared to other stimuli, with 75% sensitivity (95%CI 63.2% to 86.7%), 93% specificity (95%CI 86.3% to 99.6%), 90% PPV (95%CI 82% to 99.3%), and 80% NPV (95%CI 70.7% to 89.9%). When all behavioral responses were combined, with lack of a response to all four stimuli considered suggestive of ASD, we obtained 100% specificity, 42% sensitivity, 100% PPV and 65% NPV.
Conclusion The combination of behavioral responses had high specificity, sensitivity, PPV, and NPV for early detection of ASD in children with speech delay.
Clinical spectrum and outcomes of the 2019-2020 pediatric diphtheria outbreak in Yemen
Authors: Bawazir Omar Abdul-Rahman Bawazir , Binkroom Noor Abdulaziz , Binghouth Abdulla Salem 
Published: March 2024

Background Diphtheria is an acute bacterial infectious disease characterized by serious morbidity and mortality. Outbreaks continue to occur in developing countries despite national vaccination programs. Vaccination, early recognition the disease, and adequate intervention are needed to avoid devastating outcomes.
Objective To describe the clinical spectrum of childhood diphtheria and its association to outcomes during the 2019-2020 diphtheria outberak in Yemen.
Methods This was a retrospective study to assess the demographic, clinical features, and outcomes of paediatric respiratory diphtheria in patients with diphtheria during the outbreak from September 2019 until May 2020 admitted at Mukalla Maternity and Children Hospital. We used SPSS 22 version for data analysis.
Results There were 34 culture-confirmed diphtheria cases included in this study, their age ranged from 13 months to 15 years old. Most of the cases (76.5%) happened to children at more than 5 years old. There was no gender difference. Of these 34-positive diphtheria, 79.4% from Hadramout and 17.6% from Shabwa governorate. Most of the cases (35.3%) were admitted in December. More than half of the patients (52.9%) were unimmunized. Fever, sore throat, and enlarged tonsils were presented in all patients, dysphagia (82.4 %), pseudomembrane (91.7%), bull neck (52.9%), and stridor (8.8%) were also found in some patients. Complications included acute renal failure (20.6%), disseminated intravascular coagulation (DIC), shock (17.6%), and myocarditis (8.8%). Significant poor outcome (P< 0.05) was associated with bull neck, myocarditis, acute renal failure, DIC, and shock. The case fatality rate (CFR) was 20.6%.
Conclusion Fever, sore throat, tonsillitis, pseudomembrane, and bull neck are high index suspicion of diphtheria and anticipation of ominous outcome. The shifting of occurrence of diphtheria to older age group indicates the need for booster(s) diphtheria toxoid vaccine in addition to improving and strengthening the current immunization program.
Effects of non-pharmacological methods on post-operative procedural pain management in neonates admitted in the neonatal intensive care unit: A systematic review
Authors: Sharma Abhishek , Sharma Nidhi , Chahal Aksh 
Published: March 2024

Background In the post-operative period during the NICU stay, neonates must undergo various painful procedures. Non-pharmacological methods may be beneficial in managing the harmful effects of procedural pain on the development of neonates in their early life.
Objectives To investigate the effect of non-pharmacological methods on post-operative procedural pain in neonates admitted to neonatal intensive care units.
Methods A search in electronic databases was done to identify randomized clinical trials published from 2010 to 2020 that encompassed neonates undergoing painful procedures in the NICU and followed PRISMA guidelines. Studies with non-human subjects, neonates with unstable vital signs, non-clinical studies, and incomplete methodology were excluded. PubMed, Cochrane, and Physiotherapy Evidence Database (PEDro) were evaluated respectively using Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS).
Results Two reviewers examined articles independently and found 11 articles that met the study's inclusion criteria, with a total of 955 neonates with non-pharmacological methods of pain management in neonates. Non-pharmacological methods, such as massage therapy, oral sucrose, kangaroo mother care, and facilitated tucking showed significant reduction in pain scores among neonates who underwent painful procedures in NICU. Outcomes showed variability in effectiveness, emphasizing the need for tailored approaches.
Conclusions The findings indicated that non-pharmacological methods can effectively manage pain in neonates admitted to the NICU. Pain management improves the clinical condition of neonates and promotes parents-neonate bonding, with consequent reduction in length of stay in the hospital.
Complete atrioventricular block in an adolescent with acute rheumatic fever: a case report
Authors: Sunbanu Samlek Elisawyn 
Published: March 2024

Acute rheumatic fever (ARF) is an autoimmune, multiorgan inflammatory disease that occurs in genetically susceptible individuals after group A-hemolytic streptococcal infection. Carditis and polyarthritis are the most common symptoms of ARF. Repeated streptococcal infections can cause recurrent valvulitis and valvular heart disease.
Prolonged atrioventricular conduction (first-degree heart block) is a well-known symptom of ARF, occurring in one-fifth to three-fifths of patients. This condition is a minor criterion for diagnosing ARF based on Jones's criteria. Advanced conduction delay, such as a second-degree or a complete atrioventricular (AV) block, is a rare condition of ARF that can occur before symptoms like carditis, polyarthritis, and Sydenham chorea appear. We present a case of ARF in an adolescent with complete AV block.
Container Security in Cloud Environments
Authors: Oluyede Michael Sanya , Mart Joseph , Olusola Akinbusola , Olatuja Gabriel 
Published: March 2024

A

bstract:

The widespread adoption of containers in modern software applications has introduced new challenges to security and integrity. Containers, known for their lightweight and portable nature, facilitate agile deployment across diverse environments. However, this popularity has led to security risks such as vulnerabilities in container images, misconfigurations, and insecure runtime environments. This paper addresses these challenges by proposing automated and robust security techniques integrated into continuous integration and continuous development pipelines. The work emphasizes the importance of a solid security policy, container image scanning, orchestration security, and runtime monitoring. The study also identifies specific issues faced by the DevSecOps community and proposes initial fixes to fortify container security.

In the cloud environment, containers play a pivotal role in application deployment by sharing the same OS kernel, reducing resource requirements, and minimizing start-up times. Despite their advantages, weak container isolation poses security challenges, including privilege escalation and information leaks. To mitigate these concerns, the paper conducts an in-depth analysis of existing access control mechanisms for container security. It discusses challenges in architecture modeling and presents use cases for fulfilling security requirements, encompassing container, inter-container, and
host protection. The work emphasizes the need for both software and hardware solutions to enhance container security.
Containers have emerged as a lightweight alternative to virtual machines, supporting microservices architecture. The container market is growing rapidly, but security concerns remain a significant barrier to adoption. This paper surveys existing literature on container security, categorizing it into four use cases: protecting containers from internal applications, inter-container protection, safeguarding the host from containers, and defending containers froma malicious or semi-honest host. The analysis reveals that software-based solutions, leveraging Linux kernel features and security modules, address the first three use cases, while the last use case relies on hardware-based solutions. The paper concludes with highlighting open research problems and future directions to guide further exploration in container security.
Impact of HIV Infection on Liver and Cardiovascular Outcomes in Veterans With Metabolic Dysfunction-Associated Steatotic Liver Disease
Authors: Wong Robert J. , Yang Zeyuan , Yeoh Aaron , Do Albert , Ahmed Aijaz , Cheung Ramsey 
Published: March 2024

INTRODUCTION:Hepatic steatosis is highly prevalent in people living with HIV. It remains unclear whether HIV in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with greater risks of liver disease progression and cardiovascular disease (CVD). We aim to evaluate the impact of HIV infection on risks of liver and CVD outcomes among US Veterans with MASLD.METHODS:Using national Veterans Administration data from 2010 to 2022, we created a propensity score-matched cohort of MASLD patients with vs without HIV. Primary outcomes were incidence of cirrhosis and hepatocellular carcinoma (HCC) among patients with vs without HIV and patients with MASLD-HIV on antiretroviral therapy (ART) vs not on ART. Secondary outcomes included incidence of major adverse cardiovascular events and overall survival.RESULTS:The propensity-matched cohort included 920 MASLD patients with HIV and 920 MASLD patients without HIV and was similar in demographics and comorbidities. Compared with MASLD patients without HIV, incidences of cirrhosis and HCC were similar among MASLD with HIV. Compared with MASLD patients without HIV, incidence of major adverse cardiovascular event was higher among MASLD patients with HIV (5.18 vs 4.48 per 100 person-years,P= 0.03). Overall 5-year survival was significantly lower among MASLD patients with HIV and even lower among those not on ART.DISCUSSION:Among US Veterans with MASLD, concurrent HIV infection, and particularly not being on ART, is associated with greater risks of CVD and decreased overall survival. No differences in risks of cirrhosis or HCC were observed.
Improved deep learning segmentation of outdoor point clouds with different sampling strategies and using intensities
Authors: Harintaka Harintaka , Wijaya Calvin 
Published: March 2024

AbstractThe rapid growth of outdoor digital twin data sets and advancements in 3D data acquisition technology have sparked interest in improving segmentation performance using deep learning. This research aims to analyze and evaluate different sampling strategies and optimization techniques while exploring the intensity information of outdoor point cloud data. Two sampling strategies, random and stratified sampling, are employed to divide a limited data set. Additionally, the data set is divided into point cloud data with and without intensity. The PointNet++ model is used to segment the point cloud data into two classes, vegetation and structure. The results indicate that stratified sampling outperforms random sampling, yielding a considerable improvement in mean intersection over union scores of up to 10%. Interestingly, the inclusion of intensity information in the data set does not universally enhance performance. Although the use of intensity improves the performance of random sampling, it does not benefit stratified sampling. This research provides insights into the effectiveness of different sampling strategies for outdoor point cloud data segmentation. The findings can contribute to the development of optimized approaches to improving segmentation accuracy in outdoor digital twin applications using deep learning techniques.
Study on three-dimensional model of ventilation drying and heat and mass transfer of bulk grain pile based on discrete-continuous media
Authors: Chen Pengxiao , Liu Ye , Fan Mengke , Zhu Wenxue , Jiang Meng meng , Wu Jianzhang , Wang Xiaowan , Lv Ruobing 
Published: March 2024

Abstract
In order to ensure the safety of grain storage and explore the mechanisms of water and heat transfer during the drying process of grain piles, this paper takes wheat as the research object, uses a thermal conductivity analyzer to measure the thermal conductivity and specific heat capacity of wheat, and obtains a linear relationship between the heat constant and water content of wheat. COMSOL software was used to establish a three-dimensional model of ventilation drying and heat and mass transfer of bulk grain piles based on discrete continuum media, which simulated the temperature and humidity changes during the drying process of the grain pile. The model was verified by a thin layer drying experiment. The results show that the simulated values of temperature and water content obtained by the wet heat transfer model are in good agreement with the experimental values, and the maximum errors are 2.14 % and 5.68 % respectively. During the drying process, the grain temperature of wheat at the bottom of the grain pile increased rapidly, compared with that at the top of the grain pile, and the temperature of the wheat at the center was higher than that at the edge. At the end of drying, the moisture content from highest to lowest was top edge > top center > bottom edge > bottom center. Therefore, the model can be used to further study the changes of grain pile temperature gradient and water gradient.
Effectiveness of ginkgo diterpene lactone meglumine on cognitive function in patients with acute ischemic stroke
Authors: Zhang Meini , Hu Xiao , Wang Tao , Liu Xianghong 
Published: March 2024

Abstract

Objective
To explore the efficacy of ginkgo diterpene lactone (GDLM) on cognitive function in patients with acute ischemic stroke (AIS).

Methods
A total of 126 patients with AIS in Shaanxi Provincial People’s Hospital from July 2019 to December 2020 were collected and randomly divided into the control group and treatment group (n = 63). All patients received conventional treatment, on which 25 mg/day GDLM was administered in the treatment group. Coagulation and inflammation indexes, National Institutes of Health Stroke Scale (NIHSS) and activities of daily living scale (ADL) scores were measured before and 14 days after treatment. NIHSS and ADL scores were performed again after 3 months. Cognitive function was assessed by Montréal Cognitive Assessment (MoCA) score, Mini-Mental State Examination (MMSE) score, and potential P300.

Results
After 14 days of treatment, all biochemical indices were lower than before treatment (P < 0.05). The NIHSS and ADL scores of the treatment group were significantly better than those of the control group after treatment (P < 0.05). The MoCA and MMSE scores of the treatment group improved more significantly compared with the control group (P < 0.05). After treatment, the P300 indexes of both groups were significantly better than before treatment (P < 0.05).

Conclusion
Conventional treatment of AIS combined with GDLM can effectively improve the cognitive function of patients, which is worthy of clinical recommendation.
Microstructure and properties of Co based laser cladded composite coatings
Authors: Anghel Iasmina-Mădălina , Uțu Ion-Dragoș , Pascu Alexandru , Hulka Iosif , Woelk Dino Horst , Mărginean Gabriela 
Published: March 2024

Abstract
Coatings deposition using different materials and various techniques are a viable method to improve the surface properties of alloys, especially the surface strength with improved tribological properties. In this study, a series of Co-based reinforced composite coatings containing different ratios of WC–CoCr–Ni particles were fabricated by laser cladding onto the surface of an AISI 904L stainless steel substrate. The main goal of this experimental work was to determine the influence of the WC particle addition on the structure and properties of the obtained Co composite coating in terms of improving the sliding wear resistance without negative influence the corrosion resistance in chloride media. The effect of the WC particles onto the microstructure, phase composition, microhardness, wear and corrosion properties, was investigated by means of scanning electron microscopy (SEM), X-ray diffraction (XRD) in association with the evolution of the friction coefficient and that of the polarization curves, respectively. The achieved results have shown that the new phase composition, especially developed due to the remelting of the WC phase, led to an improvement of the wear resistance. No significant changes were recorded after the electrochemical tests evaluation.