bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser Powder Bed Fusion of Multifunctional Bio-inspired Vertical Honeycomb Sandwich Structures: For the Application of Lightweight Bipolar Plates of Proton Exchange Membrane Fuel Cells
Authors: Lin Kaijie , Xu Yong , Gu Dongdong , Shan Junhao , Shi Keyu , Zhang Wanli 
Published: September 2024

AbstractThe bipolar plate (BPP) is a crucial component of proton exchange membrane fuel cells (PEMFC). However, the weight of BPPs can account for around 80% of a PEMFC stack, posing a hindrance to the commercialization of PEMFCs. Therefore, the lightweight design of BPPs should be considered as a priority. Honeycomb sandwich structures meet some requirements for bipolar plates, such as high mechanical strength and lightweight. Animals and plants in nature provide many excellent structures with characteristics such as low density and high energy absorption capacity. In this work, inspired by the microstructures of the Cybister elytra, a novel bio-inspired vertical honeycomb sandwich (BVHS) structure was designed and manufactured by laser powder bed fusion (LPBF) for the application of lightweight BPPs. Compared with the conventional vertical honeycomb sandwich (CVHS) structure formed by LPBF under the same process parameters setting, the introduction of fractal thin walls enabled self-supporting and thus improved LPBF formability. In addition, the BVHS structure exhibited superior energy absorption (EA) capability and bending properties. It is worth noting that, compared with the CVHS structure, the specific energy absorption (SEA) and specific bending strength of the BVHS structure increased by 56.99% and 46.91%, respectively. Finite element analysis (FEA) was employed to study stress distributions in structures during bending and analyze the influence mechanism of the fractal feature on the mechanical properties of BVHS structures. The electrical conductivity of structures were also studied in this work, the BVHS structures were slightly lower than the CVHS structure. FEA was also conducted to analyze the current flow direction and current density distribution of BVHS structures under a constant voltage, illustrating the influence mechanism of fractal angles on electrical conductivity properties. Finally, in order to solve the problem of trapped powder inside the enclosed unit cells, a droplet-shaped powder outlet was designed for LPBF-processed components. The number of powder outlets was optimized based on bending properties. Results of this work could provide guidelines for the design of lightweight BPPs with high mechanical strength and high electrical conductivity.
Conventional versus high-voltage, long-term pulse Radiofrequency of ganglion impar in perineal pain with advanced rectal cancer: a Randomized, double-blind controlled trial
Authors: Li Qin , Wang Huaiming , Zhong Bo , Zhang Taomei , Wang Zhiqiang , Tao Ping , Zou Jiang , Zhang Aimin 
Published: September 2024

Abstract
Study objective
Advanced rectal cancer is a common cause of perineal pain and research on the use of radiofrequency therapy for the treatment of this pain is limited. In the present study, we aimed to compare the effectiveness and safety of conventional radiofrequency (CRF) and high-voltage long-term pulsed radiofrequency (H-PRF) of radiofrequency therapy in the management of perineal pain in advanced rectal cancer.

Design
Randomized, Double-Blind Controlled Trial.

Setting
Sichuan Cancer Hospital & Institute and Yanjiang District People’s Hospital in Sichuan, China.

Participants
A total of 72 patients with advanced rectal cancer experiencing perineal pain who were accepted for radiofrequency treatment.

Interventions
Patients were assigned randomly (1:1) assigned to either the group CRF or H-PRF in a double-blind trial.

Measurements and main results
The primary focus was on assessing perineal pain using numeric rating scales (NRS) scores at various time points. Secondary outcomes included the duration of maintaining a sitting position, depression scores, sleep quality, consumption of Oral Morphine Equivalent and Pregabalin, and the incidence of perineal numbness. A total of 57 patients (28 patients in the group CRF and 29 patients in the group H-PRF) were investigated. At all observation time points postoperatively, both groups of patients exhibited significant reductions in pain, enhancements in depression, improvements in sleep quality, and increased duration of sitting compared to their baseline measurements (P<0.05). During the 3 months and 6 months follow-up period, the group CRF exhibited significant reduction in pain, improvement in depression, sleep quality, and increased the time of keeping a sitting position compared with the group H-PRF (P<0.05). The consumption of oral morphine equivalent and Pregabalin as well as the incidence of perineal numbness were not significantly different between groups (P > 0.05).

Conclusion
Our results demonstrate that application of CRF and H-PRF in ganglion impar to reduce perineal pain and improve the quality of life of patients with advanced rectal cancer is safe and effective. However, the long-term effect of CRF is better compared with that of H-PRF.

Trial registration
https://www.chictr.org.cn/ (ChiCTR2200061800) on 02/07/2022. This study adheres to CONSORT guidelines.
Primary healthcare practitioners’ perspectives on trauma-informed primary care: a systematic review
Authors: Bulford Eleanor , Baloch Surriya , Neil Jennifer , Hegarty Kelsey 
Published: September 2024

Abstract
Background
Exposure to domestic and family violence is a pervasive form of complex trauma and a major global public health problem. At the frontline of the health system, primary healthcare practitioners are uniquely placed to support individuals with experiences of trauma, yet their views on trauma-informed primary care are not well understood. This systematic review of qualitative literature sought to explore primary healthcare practitioners’ perspectives on trauma-informed primary care.

Methods
Eight databases were searched up to July 2023. Studies were included if they consisted of empirical qualitative data, were conducted in general practice or equivalent generalist primary healthcare settings, and included the perspectives of primary healthcare practitioners where they could be distinguished from other participants in the analysis. Thematic synthesis was used for analysis.

Results
13 papers met inclusion criteria, representing primary care settings from the United States, Canada, Australia, and Norway. Three key themes were developed: Changing the paradigm, Building trust, and Navigating the emotional load. Findings shed light on how primary healthcare practitioners perceive and strive to practise trauma-informed primary healthcare and the challenges of navigating complex, trauma-related work in the primary care environment.

Conclusions
This review supports the need for recognition of the value of primary care in supporting patients with histories of trauma and violence, the development of interventions to mitigate the emotional load worn by primary healthcare practitioners, and further work to develop a deep and consistent understanding of what trauma-informed primary care encompasses.
Learning for life, friendships and relationships from the perspective of children and young people with intellectual disabilities: findings from a UK wide qualitative study
Authors: Brown Michael , Linden Mark , Marsh Lynne , Truesdale Maria , Sheerin Fintan , McCormick Freda 
Published: September 2024

Abstract
Background
Relationships and sexuality education (RSE) programmes are widely taught in schools, however for children and young people with intellectual disabilities, these programmes appear to be limited regarding information on relationships, informed choices and decision making. The purpose of this study was to seek the views and understanding of children and young people with intellectual disabilities, and those involved in their care and education, to identify best practice and approaches to the delivery on relationships and sexuality education.

Methods
This study used a qualitative design with 37 pupils from five special schools from across the United Kingdom (UK) participating. In-depth semi-structured interviews were held online, or in person. All interviews were recorded and transcribed verbatim. Transcripts were anonymised, assigned a pseudonym and subjected to inductive thematic analysis.

Findings
Four themes emerged from the data: (i) enthusiasm and inquisitiveness to acquire knowledge; (ii) dynamics of positive friendships; (iii) experiences and understanding of supportive relationships and sexuality; and (iv) valuing the exchange of knowledge and information. The findings highlight that children and young people with intellectual disabilities want education, support and information on matters relating to their relationships and sexuality.

Conclusions
This is the largest study to date providing a voice to children and young people with intellectual disabilities regarding their relationships and sexuality. While special schools provide relationships and sexuality education, there is a requirement for a programme and resources specific to the needs of pupils with intellectual disabilities to be developed and evaluated. Such education should continue beyond school and be embedded in adult services.
Trends in Norwegian adolescents’ substance use between 2014 and 2022: socioeconomic and gender differences
Authors: Myhr Arnhild , Vesterbekkmo Renate K. , Samarawickrema Indira , Sund Erik R. 
Published: September 2024

Abstract
Background
Substance use is a global health concern and early onset among adolescents increases health risks. We explore national overall trends in prevalence and trends in socioeconomic inequalities in past year alcohol intoxication, cannabis use, and use of other illicit drugs among Norwegian adolescents (ages ∼ 15–19 years of age) between 2014 and 2022.

Method
The present study builds on data from a nationwide repeated cross-sectional survey collected in 2014–2016 (T1), 2017–2019 (T2), 2021 (T3) and 2022 (T4). In total 415,560 adolescents (50.3% girls) completed the questionnaire during the study period. Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII).

Results
While the prevalence of alcohol intoxication remained fairly stable, the prevalence of cannabis and other illicit drug use increased between 2014 and 2022 among upper secondary school boys (13.3–17.6%, and 2.0–5.2%, respectively) and girls (8.8–12.8%, and 1.1–2.7%, respectively). Similar trends were observed among 10th-grade adolescents. Boys were more likely than girls to use cannabis or other illicit drugs, but the gender gap in cannabis use narrowed during the study period. Among upper secondary girls, use of cannabis and other illicit drugs was higher among those from less affluent backgrounds, with absolute and relative inequalities in cannabis use increasing between 2014 and 2022. Small inequalities in cannabis use and decreasing relative inequalities in the use of other illicit drug were observed among upper secondary boys.

Conclusions
The increasing use of cannabis and other illicit drugs among Norwegian adolescents is concerning. Future studies should explore the underlying causes of this rise and explore the complex factors influencing adolescent substance use behaviours. A comprehensive understanding of these factors is essential for developing targeted and effective interventions.
Work hours and the risk of hypertension: the case of Indonesia
Authors: Andini Friska Aulia Dewi , Siregar Adiatma Y. M. 
Published: September 2024

Abstract
Background
Individuals working excessive hours is a worldwide phenomenon. In Indonesia, over 32 million people work more than 40 h per week, contributing to around 26% of the workforce. Excessive working may affect health, increasing the risk of cardiovascular diseases such as hypertension. Hypertension affected around 34% of Indonesian adults, approximately 63.3 million people and led to about 427,000 deaths in 2018, and the prevalence remains high at 29.2% in 2023. This study aims to analyze the relationship between work hours and the risk of hypertension among working individuals in Indonesia.

Methods
This study used a pooled cross-sectional data from the Indonesian Family Life Survey (IFLS) wave 4 (2007) and wave 5 (2014) and performed a logit regression analysis to examine the likelihood of a working individual having hypertension based on the individual’s work hours. A dummy variable of hypertension is created based on the result of blood pressure measurement. The sample consists of 22,500 working individuals in Indonesia. This study controlled for job characteristics, sociodemographic status and health-behavioral risk factors such as BMI and smoking behavior, and performed additional regression analyses for alternative models to check for robustness.

Results
Our findings showed that there is a higher probability of having hypertension for workers who work longer hours by 0.06% points for each additional hour of work (p < 0.01). Other factors such as physical activity and smoking behavior have also been demonstrated to be significantly correlated to the risk of hypertension.

Conclusions
This study revealed a positive relationship between work hours and hypertension. Although this study cannot suggest causality, the strongly significant correlation may provide an idea and an overview regarding the risk of hypertension among working individuals in Indonesia. The Indonesian government could consider conducting further studies to implement and promote flexible working arrangements initiatives and incentive programs to improve workers’ health outcomes.
Evaluating the impact of extended dosing intervals on mRNA COVID-19 vaccine effectiveness in adolescents
Authors: Tsang Tim K. , Sullivan Sheena G. , Meng Yu , Lai Francisco Tsz Tsun , Fan Min , Huang Xiaotong , Lin Yun , Peng Liping , Zhang Chengyao , Yang Bingyi , Ainslie Kylie E. C. , Cowling Benjamin J. 
Published: September 2024

Abstract

Background

Extending the dosing interval of a primary series of mRNA COVID-19 vaccination has been employed to reduce myocarditis risk in adolescents, but previous evaluation of impact on vaccine effectiveness (VE) is limited to risk after second dose.

Methods
We quantified the impact of the dosing interval based on case notifications and vaccination uptake in Hong Kong from January to April 2022, based on calendar-time proportional hazards models and matching approaches.

Results
We estimated that the hazard ratio (HR) and odds ratio (OR) of infections after the second dose for extended (28 days or more) versus regular (21–27 days) dosing intervals ranged from 0.86 to 0.99 from calendar-time proportional hazards models, and from 0.85 to 0.87 from matching approaches, respectively. Adolescents in the extended dosing groups (including those who did not receive a second dose in the study period) had a higher hazard of infection than those with a regular dosing interval during the intra-dose period (HR 1.66; 95% CI 1.07, 2.59; p = 0.02) after the first dose.

Conclusions
Implementing an extended dosing interval should consider multiple factors including the degree of myocarditis risk, the degree of protection afforded by each dose, and the extra protection achievable using an extended dosing interval.
A systems serology approach to identifying key antibody correlates of protection from cerebral malaria in Malawian children
Authors: Walker Isobel S. , Dini Saber , Aitken Elizabeth H. , Damelang Timon , Hasang Wina , Alemu Agersew , Jensen Anja T. R. , Rambhatla Janavi S. , Opi D. Herbert , Duffy Michael F. , Takashima Eizo , Harawa Visopo , Tsuboi Takafumi , Simpson Julie A. , Mandala Wilson , Taylor Terrie E. , Seydel Karl B. , Chung Amy W. , Rogerson Stephen J. 
Published: September 2024

Abstract
Background
Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) proteins are expressed on the surface of infected erythrocytes, mediating parasite sequestration in the vasculature. PfEMP1 is a major target of protective antibodies, but the features of the antibody response are poorly defined.

Methods
In Malawian children with cerebral or uncomplicated malaria, we characterized the antibody response to 39 recombinant PfEMP1 Duffy binding like (DBL) domains or cysteine-rich interdomain regions (CIDRs) in detail, including measures of antibody classes, subclasses, and engagement with Fcγ receptors and complement. Using elastic net regularized logistic regression, we identified a combination of seven antibody targets and Fc features that best distinguished between children with cerebral and uncomplicated malaria. To confirm the role of the selected targets and Fc features, we measured antibody-dependent neutrophil and THP-1 cell phagocytosis of intercellular adhesion molecule-1 (ICAM-1) and endothelial protein C (EPCR) co-binding infected erythrocytes.

Results
The selected features distinguished between children with cerebral and uncomplicated malaria with 87% accuracy (median, 80–96% interquartile range) and included antibody to well-characterized DBLβ3 domains and a less well-characterized CIDRγ12 domain. The abilities of antibodies to engage C1q and FcγRIIIb, rather than levels of IgG, correlated with protection. In line with a role of FcγRIIIb binding antibodies to DBLβ3 domains, antibody-dependent neutrophil phagocytosis of ICAM-1 and EPCR co-binding IE was higher in uncomplicated malaria (15% median, 8–38% interquartile range) compared to cerebral malaria (7%, 30–15%, p < 0.001).

Conclusions
Antibodies associated with protection from cerebral malaria target a subset of PfEMP1 domains. The Fc features of protective antibody response include engagement of FcγRIIIb and C1q, and ability to induce antibody-dependent neutrophil phagocytosis of infected erythrocytes. Identifying the targets and Fc features of protective immunity could facilitate the development of PfEMP1-based therapeutics for cerebral malaria.
Investigation of hydrochemical characteristic, water quality and associated health risks of metals and metalloids in water resources in the vicinity of Akamkpa quarry district, southeastern, Nigeria
Authors: Ikpi George E. , Nganje Therese N. , Edet Aniekan , Adamu Christopher I. , Eyong Godswill A. 
Published: September 2024

AbstractQuarrying of rock aggregates generates produced water that, if not handled properly will be a source of pollution for nearby water bodies, thus affecting the chemistry of the water. This study examined the chemistry, impact of quarrying activities on water resources and the health consequences/risks posed by ingestion of the water by humans in the Akamkpa quarry region in southeastern Nigeria. Thirty (30) water samples consisting of pond water, stream water, hand dug wells, and borehole samples were collected and analyzed for their physicochemical parameters using standard methods. The results obtained from the analyses indicated that the water was moderately acidic, fresh, and not salty, with many parameters below the recommended standards with Ca2+, and HCO3−being the dominant ions present in the water resources. Rock weathering processes including silicate weathering as illustrated by hydrochemical facies, cross plots, and Gibbs diagrams are the dominant mechanisms influencing the quality and major ions chemistry of the water resources with minor contributions from dissolution, anthropogenic activities, and ion exchange. Ca-Mg-SO4-Cl and Na–K-HCO3−are the most important water types. Although the water quality index shows that the water is suitable for human use and irrigation, the mean values of As, Cd, Pb, and Se are above the acceptable limits. Additionally, the calculated contamination factor revealed the water resources are moderate to highly contaminated by As, Cd, Cr, Mo, Pb, Sb, and Se, and are therefore unsuitable for consumption with regards to these parameters. However, the residual sodium carbonate and water hazard index (WHI) values showed that 38% to 90% of sites in the quarry area were unsuitable for cultivation, 10–30% were in the low to medium impact category, and 60% were classified as risky and are from high to very high impact category. A non-cancer study of inhabitants living in the vicinity of the quarry area indicated that 6.7% of the sites have values greater than one, indicating that it may endanger the health of the people. Therefore, constant monitoring of the water quality is recommended as long-term use of contaminated water can harm humans, plants, and soils.
Association of nonalcoholic fatty liver disease with new-onset atrial fibrillation stratified by age groups
Authors: Cho Eun Ju , Chung Goh Eun , Yoo Jeong-Ju , Cho Yuri , Lee Kyu Na , Shin Dong Wook , Kim Yoon Jun , Yoon Jung-Hwan , Han Kyungdo , Yu Su Jong 
Published: September 2024

Abstract
Background
The association between nonalcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) has been inconsistent, and the impact of hepatic fibrosis on this relationship remains uncertain. We investigated the association between NAFLD and the risk of new-onset AF across different age groups.

Methods
A total of 3,179,582 participants from the 2009 Korean National Health Screening Program were divided into five groups based on NAFLD status: no NAFLD (fatty liver index [FLI] < 30); grade 1 NAFLD without advanced fibrosis (FLI 30–59 & BARD < 2); grade 1 NAFLD with advanced fibrosis (FLI 30–59 & BARD ≥ 2); grade 2 NAFLD without advanced fibrosis (FLI ≥ 60 & BARD < 2); and grade 2 NAFLD with advanced fibrosis (FLI ≥ 60 & BARD ≥ 2). The primary outcome was incident AF.

Results
During the median follow-up of 9.3 years, 62,542 patients were diagnosed with new-onset AF. In the age- and sex-adjusted model, the risk of new-onset AF increased across NAFLD grades and fibrosis categories: grade 1 NAFLD without advanced fibrosis (hazard ratio [HR] 1.120, 95% confidence interval [CI]: 1.081–1.161); grade 1 NAFLD with advanced fibrosis (HR 1.275, 95% CI 1.251–1.300); grade 2 NAFLD without advanced fibrosis (HR 1.305, 95% CI: 1.252–1.360); and grade 2 NAFLD with advanced fibrosis (HR 1.627, 95% CI: 1.586–1.670). In the multivariate model, the excess risk of AF in patients with NAFLD and advanced fibrosis remained significant, even in participants aged 20–39 years.

Conclusion
Patients with NAFLD had a higher risk of new-onset AF, which increased progressively with NAFLD severity, particularly in those aged 20–29 years.