bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advanced Mechanical Analysis Workflow for Chiplets Integration Predictive Design
Authors: Cao Lihong , Kou Chinli , Wang Chen-Chao , Lo Chieh 
Published: January 2025

Chiplet-based designs offer a compelling value proposition compared to traditional monolithic System on Chip (SoC) architectures with advantages in IP reuse, performance, cost, and time to market. Mechanical modeling and analysis (M&A) play a critical role in enabling the integration of chiplets, spanning the chip-package-board-system domains to support product development. The integration of chiplets from various suppliers and deverse technologies introduces differences in material properties, thermal coefficients, and mechanical behaviors that presents a significant challenge in ensuring a good mechanical reliability across the chiplet-based integration system. Consequently, chiplet-based designs encounter more challenges to address the elevated mechanical stress and reliability concerns. Traditional mechanical analysis and simulation workflows are primarily tailored for monolithic SoC-based designs and are not readily applicable to chiplet-based designs. The latter can no longer afford to overlook issues related to mechanical and thermal stress induced by multiple chiplets, especially with the use of advanced 2.5D and high-density fanout packages. In this paper, an advanced mechanical analysis workflow for chiplet-based designs is proposed. The representative examples that demonstrate the efficacy of this workflow are also presented. The advanced mechanical analysis workflow involves modeling of chiplets interactions at the early design stage spanning from the Si level to package level and encompassing scales from micrometers to millimeters that includes the components such as Through-Silicon Vias (TSVs), HIgh Density Fanout Cu RDL (Redistribution Layer) and microbumps. Furthermore, the predictive mechanical analysis workflow extends to analyses at the millimeter to meter scale, considering entire systems and incorporating elements like heat sinks and printed circuit boards (PCBs). It represents a multifaceted process spanning chip-to-package co-design, stress analysis, thermal analysis, failure analysis, and chiplet-based design optimization.
Process Considerations for Defluxing Ultra-Fine Pitch Die on CoWs
Authors: Parthasarathy Ravi 
Published: January 2025

Heterogeneous integration stands as a pivotal strategy in the semiconductor technology realm. As process nodes relentlessly scale down from 16nm to 5nm and beyond, CMOS component speeds soar. This dynamic corresponds to incorporating twice the component count within the same space every 18-24 months. The evolution from CoS (Chip on Substrate) to CoW (Chip on Wafer) marks a significant advancement. CoW integrates chips onto an interposer, applies wafer-level molding, and culminates with a flip chip (FC) substrate connection. This technology offers a superior physical structure to accommodate extensive die and larger interposer dimensions. The technical paper titled ‘Defluxing of Copper Pillar Bumped Flip Chips,’ initially presented at IPC Apex 2022 and subsequently at IMAPS Device Packaging Conference 2023, discussed a comparative study. The study confirmed that the De-ionized water inline cleaning system faces consistent and effective cleaning challenges beneath low standoff components under copper pillar packages featuring 150μm pitch and a 30μm Cu pillar height when compared to low concentration alkaline cleaning agents. This follow-up study is a continuation of the initial effort, focusing on cleaning under next tier of ultra-fine pitch CoW devices with bump pitches under 25μm and bump counts surpassing 150K. The author adhered to the same low-concentration alkaline cleaning agent for testing, exploring the impact of wash temperatures and conveyor belt speed. The assessment employed analytical/functional tests, including Visual Inspection, FTIR with color mapping, and SEM/EDX analysis.
Changes of retinal ganglion cell–inner plexiform layer thickness and visual acuity in patients with diabetic macular edema treated with Aflibercept
Authors: Alsaad Mouna M. , Shehadeh Amin B. , Alsaad Iyman M. , Alubous Khalid A. , Meqbil Jehad S. , Qablawi Mohammed Z. , AIRyalat Saif Aldeen S. , Elubous Rawan A. 
Published: January 2025

Background
Anti-vascular endothelial growth factor agents have now become the first line of treatment for diabetic macular edema (DME). Changes in the thickness of the individual retinal layers including the ganglion cell–inner plexiform layer (GC–IPL) might serve as a biomarker for the response to treatment.

Aim
The aim of this study was to evaluate the effect of intravitreal injections of Aflibercept on the average thicknesses of the GC–IPL in naïve eyes and on the visual acuity in patients with DME.

Patients and methods
This is a retrospective observational study that included 224 naïve eyes of 224 patients having DME. It compared the changes in the GC–IPL thickness at baseline and after receiving three loading doses of Aflibercept followed by as needed protocol for 12 months. All patients had optical coherence tomography imaging at baseline (with GC–IPL thickness measurement) and at the 12-month visit. The change in GC–IPL thickness was measured and was correlated with best-corrected visual acuity.

Results
During the study duration, a median of five injections of Aflibercept were given. There was a statistically significant decrease in the posttreatment values of the GC–IPL thickness from 89±13 to 84±14.7 µm (P=0.029). Moreover, a statistically significant association was found between the thickness reduction of the GC–IPL in the central macular area and the best-corrected visual acuity (r=0.9, P=0.005, Pearson coefficient=0.26).

Conclusion
The results of this study suggest that the reduction in the GC–IPL thickness can be used as a prognostic tool for the response to Aflibercept as it was associated with improved visual acuity.
Combined preoperative and intraoperative aflibercept injection versus preoperative intravitreal aflibercept injection only in optimizing the anatomical and functional outcomes in diabetic vitrectomy
Authors: Al-Naimy Mohammed A. , Khedr Marwa A.M. , Deiaeldin Yasmine A. 
Published: January 2025

Purpose
The aim of this study was to evaluate the effect of adding intraoperative aflibercept injection to preoperative injection in optimizing the anatomical and functional outcomes of diabetic vitrectomy compared to preoperative injection only.

Patients and methods
This retrospective interventional comparative study included 30 eyes of 30 patients scheduled for pars plana vitrectomy for complications of proliferative diabetic retinopathy. The patients were allocated into two groups: group I that received combined preoperative and intraoperative aflibercept (Eylea) injection and group II that received preoperative injection only. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were compared preoperatively and 3 months postoperatively in both groups. The patients were also followed up to detect any postoperative persistent vitreous hemorrhage (VH) or sub-silicone hemorrhage. The patients who developed persistent nonclearing VH for more than 1 month or persistent nonclearing sub-silicone premacular hemorrhage were scheduled for surgical reintervention.

Results
The mean preoperative BCVA was 1.53±0.28 LogMAR in group I and 1.50±0.26 LogMAR in group II. At the end of the third postoperative month, there was a continuous significant improvement in BCVA in both groups with a mean of 0.31±0.10 in group I and 0.62±0.26 in group II, with a statistically significant difference between the two groups (P<0.0001). The baseline CMT was measured within 1–3 weeks postoperatively with a mean of 393±31.54 μm in group I and 379.3±40.42 μm in group II. Three months postoperatively, the CMT significantly decreased to 206±12.94 μm in group I and 301.67±48.6 μm in group II with a statistically significant difference between the two groups (P<0.0001). Postoperative persistent VH occurred in three eyes out of the six (50%) air-filled eyes in each group, while three eyes out of the eight (37.5%) silicone-filled eyes in group I and six (60%) eyes out of the 10 silicone-filled eyes in group II developed postoperative sub-silicone hemorrhage. Only one (12.5%) case in group I and five cases in group II required surgical reintervention due to persistent sub-silicone hemorrhage.

Conclusion
Combined preoperative and intraoperative aflibercept injection compared to preoperative injection alone was more effective in optimizing the anatomical and functional outcomes and in reducing the possible postoperative complications after pars plana vitrectomy.
Countries with Fewer Procedures for Cardiovascular Disease Management Face Greater Premature Mortality from Noncommunicable Diseases
Authors: Prasad Manya , Gupta Sunanda 
Published: January 2025

Abstract

Background:
The rate at which low- and middle-income countries (LMICs) are transitioning into high-burden states for noncommunicable diseases (NCDs) is currently posing a global health security threat. Not only cardiovascular disease (CVD) occurs earlier in these countries but also it is likely that individuals do not have access to adequate management procedures. The present study was undertaken to find the effect of availability of procedures for CVD management on premature mortality in NCDs and to juxtapose this with the prevalence of two main risk factors, hypertension and diabetes.

Methods:
The World Health Organization’s Global Health Observatory data were used, which include health-related data on its 194 member states. The correlation matrix was constructed for risk factors, income classification, availability of CVD management procedures, and premature NCD mortality. Multiple linear regression was done to find the association between availability of management procedures, income classification, and premature NCD mortality.

Results:
A negative correlation was observed between premature NCD mortality and income group and between premature NCD mortality and availability of CVD management procedures. Countries possessing fewer procedures for CVD management suffered a greater burden of premature NCD mortality, and this was in the form of a strong linear association. Income class and availability of CVD management procedures both independently affected premature NCD mortality. Each unit increase in income class and number of CVD management procedures reduced the premature NCD mortality by 7.9 and 2.8 units, respectively. The impact of both these factors on premature NCD mortality was statistically significant. Countries with higher prevalence of hypertension were seen to be possessing fewer CVD management procedures. Income groups also demonstrated disparities, with high-income countries bearing less burden of hypertension and having more ubiquitous CVD management resources.

Conclusion:
The present study found that availability of CVD management procedures, such as thrombolysis, coronary bypass/stenting, and acute stroke care and rehabilitation, significantly reduce premature NCD mortality across the world. Countries that face higher burden of premature NCD mortality are not only the ones that are least prepared to manage them but also the ones that bear the greatest prevalence of risk factors like hypertension and diabetes. Making procedures for NCD management available in LMICs must be put on high priority on the global health agenda.
Prevalence and Associated Factors with Sugar-sweetened Beverages Consumption among Kurdish High-school Children
Authors: Abdulah Deldar Morad , Sulaiman Saad Jbraeil , Abdulmajeed Ayoub Abid 
Published: January 2025

Abstract
Adolescents’ excessive consumption of sugar-sweetened beverages (SSBs) has become a global concern due to its detrimental effects on health. We explored the prevalence and associated factors of the consumption of SSB in high-school children in the Kurdistan Region. In this study, we included 560 students randomly from the 152 available high schools in Duhok City in the Kurdistan Region. Both genders of high school children who registered for the academic years 2021–2022 in 32 high schools were eligible. The study found that a considerable number of students did not eat breakfast (32.68%). Mostly, the students had lunch (83.21%) and dinner (53.57%), with 53.57% having extra eating portions. A significant percentage of the students consumed junk food (fast food) more than three times per week (39.82%) and consumed SSB 1–3 times/day (61.07%) at varying frequencies. The study found that 14.64% and 12.86% were overweight and obese, respectively. The prevalence of SSB consumption 4–5 times/week was 47.68% (soda), 21.61% (tea), 34.64% (coffee), 22.50% (energy drink), and 36.25% (juice). A similar prevalence of SSB consumption was found among parents (23.39%) and friends/classmates (20.36%). The male students were more likely to consume tea (P = 0.0104). However, female students were more likely to consume juice and energy drinks (P = 0.004 and P < 0.0001, respectively). Students with lower levels of education were also more likely to consume SSB. The intake of SSB was high among high school children in the Kurdistan Region and was related to gender and parents’ consumption.
Establishing a baseline titer for reporting immunoglobulin M seropositivity of diagnosis of scrub typhus in our region
Authors: Rout Diptimayee , Praharaj Ira , Rath Sonalika , Otta Sarita 
Published: January 2025

Abstract

Background:
Clinical diagnosis of scrub typhus an agent of undifferentiated fever caused by Orientia tsutsugamushi often rests on serological (immunoglobulin [Ig] M enzyme-linked immunosorbent assay [ELISA]) test. This assay needs a baseline titer in the region to serve to be used as a reference value. Owing to the lack of studies in our area, the present study aims to bridge the gap of data of a baseline titer value for reporting IgM ELISA for O. tsutsugamushi.

Materials and Methods:
The study was conducted in a prospective manner in Bhubaneswar, Odisha, wherein a period of 1 year, 150 serum samples of patients who were hospitalized with a suspicion of scrub typhus and 200 serum samples from healthy blood donors were included. The IgM ELISA was performed by Scrub Typhus Detect™ IgM ELISA system, InBios International Inc. kit. IgG ELISA was performed on 100 healthy blood donor samples by Scrub Typhus Detect™ IgM ELISA system, InBios International Inc. kit.

Statistical Analysis:
The optical density (OD) obtained as the result of ELISA study was entered into MS Excel and cutoff was determined by SPSS software.

Results:
The cutoff value for IgM was 0.6 by receiver operating characteristic curve analysis with a sensitivity and specificity of 92.16% and 98.01%, respectively. Similarly, cutoff OD of 2.1 for IgG ELISA was determined in our area.

Conclusion:
Considering the need for a cost-effective serological method and unavailability of paired sera, these cutoffs can be used in our area and surrounding nearby areas of Eastern part of India as a reference value for reporting of scrub typhus.
Divine visions and vermillion blood: Cultural sanctioning of adolescent distress
Authors: Mishra Ashish , Kumar Suparna , Pattnaik Jigyansa Ipsita , Panda Udit Kumar , Das Sudipta Kumar 
Published: January 2025

Abstract
This case report describes a 16-year-old Indian male who presented with factitious disorder manifesting through culturally influenced symptoms, including simulated hematemesis using vermillion powder and religious experiences. The presentation coincided with his transition to higher secondary education and first-time hostel admission. The patient reported divine visions featuring Hindu deities and supernatural encounters, which were reinforced by family beliefs and cultural interpretations. Initial diagnostic challenges arose from the complex interplay between cultural beliefs and psychopathology. A multimodal treatment approach, including supportive psychotherapy, family interventions, and environmental modifications, led to the successful resolution of symptoms over 6 months. This case highlights the importance of cultural competency in psychiatric assessment, the role of developmental stressors in symptom formation, and the need for culturally sensitive therapeutic approaches. It contributes to the limited literature on factitious disorder in Indian adolescents and emphasizes the significance of understanding cultural contexts in psychiatric practice, particularly in educational settings where academic stress intersects with developmental challenges.
Systemic lupus erythematosus in an adolescent male: A rare case presentation
Authors: Singh Anupama , Saha Ishani , Siva Sadhvik Karri , Rup Amit Ranjan , Das Swarnalata , Mohakud Nirmal Kumar 
Published: January 2025

Abstract
Pediatric systemic lupus erythematosus (pSLE) is a rare but severe autoimmune condition with multisystem involvement, disproportionately affecting females. Here, we report the case of a 15-year-old male presenting with polyarthralgia, fatigue, and intermittent fever, accompanied by photosensitive skin rash, oral ulcers, and nonproductive cough. Examination revealed a malar rash sparing the nasolabial fold, hard palate ulcers, and a palpable purpuric rash. Initial investigations demonstrated bicytopenia, elevated inflammatory markers, and liver enzyme derangements. Autoimmune workup confirmed pSLE per Systemic Lupus International Collaborating Clinics criteria, with positive anti-double-stranded DNA, anti-Smith antibodies, low complement levels, and direct Coombs test positivity. Radiological findings included minimal pleural effusion and mild ileitis. The patient was managed with pulse methylprednisolone, oral prednisolone, hydroxychloroquine, and cyclophosphamide, resulting in clinical improvement. This case underscores the diagnostic challenges of pSLE in male adolescents and highlights atypical manifestations such as scalp lesions mimicking tinea capitis. Early recognition and timely intervention are crucial for the favorable outcomes.
Optimizing Quality Assurance in Naval Hospitals: A Qualitative Study by Comprehensive Strength, Weakness, Opportunity, and Threat Analysis
Authors: Roy Kaushik , Maramraj Kiran K. , Kumar Sanjeev , Sarin Arti , Honwad Manish S. 
Published: January 2025

Abstract

Introduction:
Quality assurance (QA) in healthcare is the degree to which healthcare services increase the likelihood of desired outcomes and are consistent with the current professional knowledge. It is a panacea to achieve higher levels of patient safety and satisfaction. This study aims to do a situational analysis of the current QA mechanism in naval hospitals through a Strength, Weakness, Opportunity, and Threat (SWOT) analysis.

Methods:
The study is a qualitative study where data were collected by in-depth interviews and focused group discussions as well as by review of reports. The data were processed using transcription and anonymized to maintain the data security and integrity. Further, it was iterated and triangulated to establish credibility and reliability. Number and relevant events were analyzed to arrive at inferences. Based on these themes and inferences, a situational analysis of QA mechanisms in naval hospitals by SWOT method was done by the authors. Ethical consent was obtained from the institutional ethical committee.

Results:
National QA Standards (NQAS) developed by the National Health Systems Resource Centre, and the Ministry of Health and Family Welfare is a comprehensive and objective QA tool. QA by modified NQAS tool has also been rolled out systematically in the naval hospitals over the past 1 year. The strengths identified with respect to the adoption of NQAS are improved patient safety and satisfaction, objective assessment to ensure accuracy, consistency, and compliance, ensure benchmarking against international standards, aid in comparison of hospitals, build accountability, and ensure trust among stakeholders. The weakness in the implementation of NQAS is the lengthy assessment process, implementation cost for training and infrastructure upgradation, biased internal audits, lack of felt need among users, and resistance to change. The strengths far outweigh the weaknesses.

Conclusion:
By leveraging the strengths, addressing existing weaknesses, capitalizing on opportunities, and mitigating threats, naval hospitals can significantly enhance their QA mechanisms. Thus, the adoption of a continuous improvement process by NQAS implementation is crucial in advancing healthcare quality. Spreading awareness to generate the felt need, emphasizing proactive training, focusing on patient satisfaction surveys, and incentivizing the process will ensure robust implementation. Through these measures, naval hospitals can maintain excellence in healthcare delivery and readiness to meet future challenges.
Tamil Insights: Enhancing Oral Health Education (OHE) Through Questionnaire Validation
Authors: Anita M , Bhuminathan S , Priya V , Kumar R Pradeep , Suganya P , Dhanushkodi Charumathi 
Published: January 2025

ABSTRACT

Aim:
This study aims to validate an OHE questionnaire in Tamil to ensure linguistic and cultural accuracy for Tamil-speaking populations.

Methodology:
The study involved English-Tamil fluent adults, using a 15-item OHE questionnaire translated through expert forward and backward translations. An expert panel ensured conceptual equivalence, and a pilot study with 30 participants refined the translation. The final Tamil version was tested for internal consistency with 1500 participants and test-retest reliability with 500 persons.

Results:
The Tamil OHE questionnaire demonstrated excellent internal consistency, with Cronbach’s alpha values >0.99, and high test-retest reliability, with Pearson correlation coefficients >0.90 for most items.

Conclusion:
The validated Tamil OHE questionnaire is a reliable tool for evaluating oral health-related quality of life, supporting effective, and culturally appropriate oral health interventions in Tamil-speaking regions.
Correlation of Anthropometric Measurements with Insulin Resistance Assessed by HOMA-IR in Obese Normotensive Individuals: A Cross-Sectional Study in South India
Authors: Sudha Meriam S Swarupa Gnana , Susethira Karunya Varsha Ragavendran , Saravanan B.S. , Rajendran Susethira Aruppukottai , Periasamy Panneerselvam , Gunasekaran Sasikala 
Published: January 2025

ABSTRACT

Background:
The study aims to evaluate insulin resistance in obese individuals with normotensive diabetes using Homeostasis Model Assessment and correlate it with anthropometric measurements, highlighting the link between poor lifestyles and metabolic syndrome.

Methods:
The research assessed the anthropometric, lipid, fasting blood glucose, hemoglobin A1C, serum insulin, and lipidosis profiles of 100 people using both traditional procedures and the Homeostatic model assessment (HOMA)-IR.

Results:
A study of 100 participants, including 43 males and 57 females, found a significant waist–hip ratio (HOMA-IR >2.5) among the group, indicating a high level of health.

Conclusions:
The research discovered notable connections between anthropometric measurements and clinical and biochemical factors associated with insulin resistance, with subscapular skinfold thickness demonstrating more robust linkages.