bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge of cervical cancer risk factors and symptoms among women in a refugee settlement: a cross-sectional study in northern Uganda
Authors: Adoch Winnie , Garimoi Christopher Orach , Scott Suzanne E. , Okeny Geoffrey Goddie , Moodley Jennifer , Komakech Henry , Walter Fiona M. , Mwaka Amos Deogratius 
Published: December 2020

Abstract
Background
There are limited data on awareness of cervical cancer risk factors and symptoms among refugee populations living in Uganda. In this study, we sought to determine the awareness and knowledge of cervical cancer risk factors and symptoms among women in Palabek refugee settlement, northern Uganda.

Methods
We conducted a cross-sectional study. 815 women (aged 18–60 years) were randomly selected using multistage sampling in Palabek refugee settlement. Data were collected using pre-tested, structured questionnaires. Logistic regression models were used to determine magnitudes of association between socio-demographic and health system factors, and knowledge on cervical cancer risk factors and symptoms.

Results
The majority of participants (53%, n = 433) were young (18–29 years), married (68%, n = 553), and did not have formal employment (93%, n = 759). Less than half (40%, n = 325) had heard of cervical cancer. Of those who had heard, most recognized multiple male sexual partners, early onset of sexual intercourse and HPV infections as risk factors for cervical cancer (93%, n = 295; 89%, n = 283; and 86%, n = 271 respectively). Median knowledge score for risk factor recognition = 7 (IQR: 3–9). Median knowledge score for symptoms recognition = 7 (IQR: 1–10). Half of women (50%, n = 409) correctly recognized 7 to 11 symptoms of cervical cancer, with vaginal bleeding between menstrual periods, pelvic pain, and vaginal bleeding during/after sexual intercourse recognized by 58, 52 and 54% respectively. Single women (OR = 0.59 (95%CI: 0.38–0.94), and women that lived farther than 1 kilo meter from nearest health facility in South Sudan (OR = 0.36–0.49 (95%CI: 0.26–0.84) were less likely to be knowledgeable of symptoms of cervical cancer.

Conclusion
A significant proportion of women in Palabek refugee settlement had not heard about cervical cancer. Refugee health services providers could increase awareness of cervical cancer risk factors and symptoms through health education in order to promote risk reduction behaviours and guide women during symptoms appraisal. Single women and those who lived more than one kilo metre from nearest health facility in home country could be a priority group for awareness intervention in the settlement.
The effectiveness of battlefield acupuncture in addition to standard physical therapy treatment after shoulder surgery: a protocol for a randomized clinical trial
Authors: Crowell Michael S. , Brindle Richard A. , Mason John S. , Pitt Will , Miller Erin M. , Posner Matthew A. , Cameron Kenneth L. , Goss Donald L. 
Published: December 2020

Abstract
Introduction
There is a large incidence of shoulder instability among active young athletes and military personnel. Shoulder stabilization surgery is the commonly employed intervention for treating individuals with instability. Following surgery, a substantial proportion of individuals experience acute post-operative pain, which is usually managed with opioid pain medications. Unfortunately, the extended use of opioid medications can have adverse effects that impair function and reduce military operational readiness, but there are currently few alternatives. However, battlefield acupuncture (BFA) is a minimally invasive therapy demonstrating promise as a non-pharmaceutical intervention for managing acute post-operative pain.

Methods
This is a parallel, two-arm, single-blind randomized clinical trial. The two independent variables are intervention (2 levels, standard physical therapy and standard physical therapy plus battlefield acupuncture) and time (5 levels, 24 h, 48 h, 72 h, 1 week, and 4 weeks post shoulder stabilization surgery). The primary dependent variables are worst and average pain as measured on the visual analog scale. Secondary outcomes include medication usage, Profile of Mood States, and Global Rating of Change.

Discussion
The magnitude of the effect of BFA is uncertain; current studies report confidence intervals of between-group differences that include minimal clinically important differences between intervention and control groups. The results of this study may help determine if BFA is an effective adjunct to physical therapy in reducing pain and opioid usage in acute pain conditions.

Trial registration
ClinicalTrials.gov NCT04094246. Registered on 16 September 2019.
Discriminative validity of the lower and upper quarter Y balance test performance: a comparison between healthy trained and untrained youth
Authors: Schwiertz Gerrit , Beurskens Rainer , Muehlbauer Thomas 
Published: December 2020

Abstract
Background
The Lower (YBT-LQ) and Upper (YBT-UQ) Quarter Y Balance Test have been widely used for the assessment of dynamic balance and shoulder mobility/stability, respectively. However, investigations on the validity of the two tests in youth are lacking. Therefore, we performed two studies to determine discriminative validity of the YBT-LQ (study 1) and the YBT-UQ (study 2) in healthy youth.

Methods
Sixty-nine male soccer players (age: 14.4 ± 1.9 yrs) and 69 age-matched untrained male subjects (14.3 ± 1.6 yrs) participated in study 1 and 37 young swimmers (age: 12.3 ± 2.1 yrs) as well as 37 age−/sex-matched individuals (age: 12.5 ± 2.0 yrs) took part in study 2. Absolute (cm) and relative (% leg/arm length) maximal reach distances per reach direction and the composite score of the YBT-LQ/UQ were used as outcome measures. One-way analysis of variance and the receiver operator characteristic curve analysis (i.e., calculating the area under the curve [AUC]) were conducted to assess discriminative validity.

Results
Concerning the relative values, youth athletes showed significantly better YBT-LQ (study 1: p < 0.001, d = 0.86–1.21) and YBT-UQ (study 2: p < 0.001, d = 0.88–1.48) test performances compared to age- and sex-matched untrained subjects. Further, AUC-values indicated a chance of ≥74% (YBT-LQ) and ≥ 71% (YBT-UQ) to discriminate between youth athletes and controls. These findings were confirmed when using the absolute data for analysis.

Conclusions
According to our results, the YBT-LQ and the YBT-UQ seem to be useful test instruments to discriminate trained and untrained healthy youth performance for dynamic balance and shoulder mobility/stability, respectively.
Priority domains, aims, and testable hypotheses for implementation research: Protocol for a scoping review and evidence map
Authors: Garner Bryan R. , Patel Sheila V. , Kirk M. Alexis 
Published: December 2020

Abstract
Background
The challenge of implementing evidence-based innovations within practice settings is a significant public health issue that the field of implementation research (IR) is focused on addressing. Significant amounts of funding, time, and effort have been invested in IR to date, yet there remains significant room for advancement, especially regarding IR’s development of scientific theories as defined by the National Academy of Sciences (i.e., a comprehensive explanation of the relationship between variables that is supported by a vast body of evidence). Research priority setting (i.e., promoting consensus about areas where research effort will have wide benefits to society) is a key approach to helping accelerate research advancements. Thus, building upon existing IR, general principles of data reduction, and a general framework for moderated mediation, this article identifies four priority domains, three priority aims, and four testable hypotheses for IR, which we organize in the priority aims and testable hypotheses (PATH) diagram.

Methods
The objective of this scoping review is to map the extent to which IR has examined the identified PATH priorities to date. Our sample will include IR published in leading implementation-focused journals (i.e., Implementation Science, Implementation Science Communications, and Implementation Research and Practice) between their inception and December 2020. The protocol for the current scoping review and evidence map has been developed in accordance with the approach developed by Arksey and O’Malley and advanced by Levac, Colquhoun, and O’Brien. Because scoping reviews seek to provide an overview of the identified evidence base rather than synthesize findings from across studies, we plan to use our data-charting form to provide a descriptive overview of implementation research to date and summarize the research via one or more summary tables. We will use the PATH diagram to organize a map of the evidence to date.

Discussion
This scoping review and evidence map is intended to help accelerate IR focused on suggested priority aims and testable hypotheses, which in turn will accelerate IR’s development of National Academy of Sciences-defined scientific theories and, subsequently, improvements in public health.

Systematic review registration
Open Science Framework https://osf.io/3vhuj/
Lipopolysaccharide exposure induces oxidative damage in Caenorhabditis elegans: protective effects of carnosine
Authors: Ma Jing , Xu Xiaoyuan , Wang Ranran , Yan Haijing , Yao Huijuan , Zhang Hongmei , Jiang Shaowei , Xu Ajing 
Published: December 2020

Abstract
Background
The present study was designed to investigate the protective effects and mechanisms of carnosine on lipopolysaccharide (LPS)-induced injury in Caenorhabditis elegans.

Methods
C. elegans individuals were stimulated for 24 h with LPS (100 μg/mL), with or without carnosine (0.1, 1, 10 mM). The survival rates and behaviors were determined. The activities of superoxide dismutase (SOD), glutathione reductase (GR), and catalase (CAT) and levels of malondialdehyde (MDA) and glutathione (GSH) were determined using the respective kits. Reverse transcription polymerase chain reaction (RT-PCR) was performed to validate the differential expression of sod-1, sod-2, sod-3, daf-16, ced-3, ced-9, sek-1, and pmk-1. Western blotting was used to determine the levels of SEK1, p38 mitogen-activated protein kinase (MAPK), cleaved caspase3, and Bcl-2. C. elegans sek-1 (km2) mutants and pmk-1 (km25) mutants were used to elucidate the role of the p38 MAPK signaling pathway.

Results
Carnosine improved the survival of LPS-treated C. elegans and rescued behavioral phenotypes. It also restrained oxidative stress by decreasing MDA levels and increasing SOD, GR, CAT, and GSH levels. RT-PCR results showed that carnosine treatment of wild-type C. elegans up-regulated the mRNA expression of the antioxidant-related genes sod-1, sod-2, sod-3, and daf-16. The expression of the anti-apoptosis-related gene ced-9 and apoptosis-related gene ced-3 was reversed by carnosine. In addition, carnosine treatment significantly decreased cleaved caspase3 levels and increased Bcl-2 levels in LPS-treated C. elegans. Apoptosis in the loss-of-function strains of the p38 MAPK signaling pathway was suppressed under LPS stress; however, the apoptotic effects of LPS were blocked in the sek-1 and pmk-1 mutants. The expression levels of sek-1 and pmk-1 mRNAs were up-regulated by LPS and reversed by carnosine. Finally, the expression of p-p38MAPK and SEK1 was significantly increased by LPS, which was reversed by carnosine.

Conclusion
Carnosine treatment protected against LPS injury by decreasing oxidative stress and inhibiting apoptosis through the p38 MAPK pathway.
Neuroinflammation and protein pathology in Parkinson’s disease dementia
Authors: Kouli Antonina , Camacho Marta , Allinson Kieren , Williams-Gray Caroline H. 
Published: December 2020

AbstractParkinson’s disease dementia is neuropathologically characterized by aggregates of α-synuclein (Lewy bodies) in limbic and neocortical areas of the brain with additional involvement of Alzheimer’s disease-type pathology. Whilst immune activation is well-described in Parkinson’s disease (PD), how it links to protein aggregation and its role in PD dementia has not been explored. We hypothesized that neuroinflammatory processes are a critical contributor to the pathology of PDD. To address this hypothesis, we examined 7 brain regions at postmortem from 17 PD patients with no dementia (PDND), 11 patients with PD dementia (PDD), and 14 age and sex-matched neurologically healthy controls. Digital quantification after immunohistochemical staining showed a significant increase in the severity of α-synuclein pathology in the hippocampus, entorhinal and occipitotemporal cortex of PDD compared to PDND cases. In contrast, there was no difference in either tau or amyloid-β pathology between the groups in any of the examined regions. Importantly, we found an increase in activated microglia in the amygdala of demented PD brains compared to controls which correlated significantly with the extent of α-synuclein pathology in this region. Significant infiltration of CD4+ T lymphocytes into the brain parenchyma was commonly observed in PDND and PDD cases compared to controls, in both the substantia nigra and the amygdala. Amongst PDND/PDD cases, CD4+ T cell counts in the amygdala correlated with activated microglia, α-synuclein and tau pathology. Upregulation of the pro-inflammatory cytokine interleukin 1β was also evident in the substantia nigra as well as the frontal cortex in PDND/PDD versus controls with a concomitant upregulation in Toll-like receptor 4 (TLR4) in these regions, as well as the amygdala. The evidence presented in this study show an increased immune response in limbic and cortical brain regions, including increased microglial activation, infiltration of T lymphocytes, upregulation of pro-inflammatory cytokines and TLR gene expression, which has not been previously reported in the postmortem PDD brain.
Cellphone laws and teens’ calling while driving: analysis of repeated cross-sectional surveys in 2013, 2015, 2017, and 2019
Authors: Li Li , Pope Caitlin N. , Andridge Rebecca R. , Bower Julie K. , Hu Guoqing , Zhu Motao 
Published: December 2020

Abstract
Background
Distracted driving among teens is a public health and safety concern. Most states in the U.S. have sought to restrict cellphone use while driving by enacting laws. This study examines the difference in prevalence of self-reported calling while driving (CWD) between states with different cellphone bans.

Methods
Demographics and CWD data were extracted from state Youth Risk Behavior Surveys (YRBS) from 14 states in 2013, 2015, 2017, and 2019. The state YRBS is conducted every 2 years with a representative sample of 9th through 12th grade students attending public school. States were grouped by type of cellphone law(s): no ban (the absence of both handheld calling ban and young driver ban), young driver ban (a ban on all forms of cellphone use while driving, for young drivers only), or concurrent ban (a young driver ban plus a ban on handheld calling for all drivers irrespective of age). Poisson regression models with robust variance were used to estimate prevalence ratios comparing CWD prevalence across ban types.

Results
In total, 157,423 high school students participated in the surveys, and 65,044 (45%) participants reached the minimum age to obtain an intermediate license and drove during the 30 days prior the survey. Approximately 53% of participants reported CWD at least once during the previous 30 days, and the percentages varied widely by states (range: 51–55%). Compared to students from states with no ban, those from states with concurrent bans were 19%(95% CI: 14–24%) less likely to engage in CWD. Students in states with concurrent bans were 23% less likely to engage in CWD compared to students in states with young driver bans (95% CI:17–27%).

Conclusions
Engaging in CWD is common among teen drivers. The concurrent implementation of a handheld calling ban and a young driver ban was associated with a lower prevalence of CWD.
Interfacial assessment of degraded amorphous silicon module using scanning probe microscopy
Authors: Meyer E. L. , Osayemwenre G. O. 
Published: December 2020

AbstractThis is a study of the degradation of amorphous silicon solar cells. The study accessed structural defects and the mechanical stress of solar cells at nanoscale level. Interface morphology, deformation, and internal delamination of the cells were analyzed. Adequate analysis of roughness parameters was performed to investigate the state of degradation of the amorphous silicon solar modules (a-Si:H) used in this study. Roughness parametric test is necessary in thin film solar cells production process because it is used to quantify the relationship that exists between roughness parameters and electrical efficiencies of solar cells. However, in this study, a roughness analysis was not only performed to quantify the performance of the a-Si:H module but to also compliment their mechanical degradation analysis. Roughness indicators such as root means square (RMS) roughness and average roughness were acquired from line profiles. Measurements were taken with scanning probe microscope (SPM) and PeakForce Quantitative Nanomechanical (QNM) technique was used through the cross sectional area of the analyzed samples. The method was validated with adhesive force and deformation analyses; it was established that high roughness values result from mechanical degradation. Results from the roughness parameters and the mechanical degradation analysis were further observed from in situ measurements and these showed good compatibility. The benefit of this technique is that it provides a good procedure for the evaluation of mechanical degradation without destroying any part of the intrinsic layers in a-Si:H modules.
Extraluminal recanalization for postoperative biliary obstruction using transseptal needle
Authors: Horinouchi Hiroki , Ueshima Eisuke , Sofue Keitaro , Komatsu Shohei , Okada Takuya , Yamaguchi Masato , Fukumoto Takumi , Sugimoto Koji , Murakami Takamichi 
Published: December 2020

Abstract
Background
Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle.

Case presentation
A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma.

Conclusions
Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.
Recurrent and Subsequent Injuries in Professional and Elite Sport: a Systematic Review
Authors: Bitchell Charlotte Leah , Varley-Campbell Jo , Robinson Gemma , Stiles Victoria , Mathema Prabhat , Moore Isabel Sarah 
Published: December 2020

Abstract
Background
Injury surveillance in professional sport categorises injuries as either “new” or “recurrent”. In an attempt to make categorisation more specific, subsequent injury categorisation models have been developed, but it is not known how often these models are used. The aim was to assess how recurrent and subsequent injuries are reported within professional and elite sport.

Methods
Online databases were searched using a search strategy. Studies needed to prospectively report injury rates within professional or elite sports that have published consensus statements for injury surveillance.

Results
A total of 1322 titles and abstract were identified and screened. One hundred and ninety-nine studies were screened at full text resulting in 81 eligible studies. Thirty studies did not report recurrent injuries and were excluded from data extraction. Within the studies that reported recurrent injuries, 21 reported the number and percentage; 13 reported only the proportion within all injuries; three reported only the number; five reported the number, percentage and incidence; and two only reported the incidence. Seven studies used subsequent injury terminology, with three reporting subsequent injury following concussion, one using an amended subsequent injury model and three using specific subsequent injury categorisation models. The majority of subsequent injuries (ranging from 51 to 80%) were categorised as different and unrelated to the index injury. The proportion of recurrent injuries (exact same body area and nature related to index injury) ranged from 5 to 21%.

Conclusions
Reporting recurrent or subsequent injuries remains inconsistent, and few studies have utilised subsequent injury models. There is limited understanding of subsequent injury risk, which may affect the development of injury prevention strategies.

Trial Registration
CRD42019119264
Applying multivariate-fractionally integrated volatility analysis on emerging market bond portfolios
Authors: Demirel Mustafa , Unal Gazanfer 
Published: December 2020

AbstractThis study examines emerging market (EM) local bonds from a portfolio risk perspective and suggests methodologies for risk evaluation, on which the literature is limited. Despite the growth of EM bond funds in recent years, comprehensive studies regarding this industry have been scarce. In light of this, 203 different local bonds of EM countries—Indonesia, Brazil, India, South Africa, Mexico, and Turkey—are elaborated in terms of return, volatility, and cross-correlation features. This study focuses on an untouched field—long memory properties—and the application of fractional models to EM bond portfolios. Based on the outcomes of a dynamic conditional correlation and fractionally integrated generalized autoregressive conditional heteroscedasticity approach and related value at risk analysis, the study finds that fractional models are useful tools for risk management, as they deliver satisfactory empirical results for several static and dynamic versions of EM bond portfolios.