bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Overview of the State of Electoral Democracy in Africa
Authors: Fombad Charles Manga 
Published: December 2021

Abstract
Most recent accounts paint a bleak and gloomy picture of the state of global democracy. This is particularly so in Africa where the optimism of a democratic revival in the 1990s is rapidly giving way to narratives of doom and gloom. Using survey data compiled by well-established regional and global international organisations, this paper assesses the state of electoral democracy in Africa, reviews the challenges that have been encountered, and considers the prospects for the future. The trend in the evolution of electoral democracy on the continent in the last three decades points to an authoritarian mobilisation and resurgence. Although elections have become the norm, these elections are increasingly being used to disguise all forms of undemocratic governance. The major lesson to be drawn from the study is that there is no African country where democracy and constitutionalism can be thought of as firmly consolidated and secure. The number of countries which are declining due to failed or flawed electoral processes, or which show signs of stagnation, far exceed those that have improved to one degree or another. Current developments are not random ad hoc efforts to undermine the credibility of elections and democracy but rather, rational and well-calculated responses by ruling African elites who seek to perpetuate their rule. What this points to is the need to rethink strategies for promoting genuinely competitive elections, democracy, and constitutionalism.
The Socialization of Human Rights and the African Human Rights Action Plan: Issues, Challenges and Opportunities
Authors: Odumosu-Ayanu Ibironke T. , Okafor Obiora C. , Bawa Sylvia 
Published: December 2021

Abstract
This article critically analyzes human rights socialization in Africa through the lens of the draft African Human Rights Action Plan (AHRAP). It argues that the AHRAP presents a framework for human rights socialization, and it speaks to human rights socialization in distinctive ways. The article demonstrates that the AHRAP relies on African and international influences and seeks to propagate norms inspired by these influences. It analyzes three key issues from the AHRAP and discusses how those issues shape understanding of continental human rights socialization in Africa. These issues are the multiple roles and positions of the African Union, the identity of actors to whom socialization processes apply or ought to apply, and the nature of norms which are the focus of socialization efforts. The article’s analysis of these issues along with the AHRAP’s reliance on African and other influences reveal a path for human rights socialization in Africa that is both challenging and promising.
The Role of Proximity in Developing an Inter-Regional Innovation System
Authors: Lalrindiki Mandy , O’Gorman Bill 
Published: December 2021

Abstract
While most innovation collaboration projects consist of partners who are located at close proximity, recent literature has explored the development of innovation collaboration in the context of non-spatial proximity. Using a longitudinal mixed methods design, this article explores the inter-regional collaboration of triple helix partners from four non-contiguous European regions (Bucharest-Ilfov, Romania; Central Hungary, Hungary; Castilla-La Mancha, Spain; and South East, Ireland) which worked together to develop an inter-regional innovation system. The results from the study identified three non-spatial forms of proximity (social, cognitive and organisational) that were key determinants for developing the successful inter- regional innovation collaboration studied in this research. Based on the findings derived from this research, an inter-regional innovation system framework was developed to facilitate collaboration between stakeholders based in non-contiguous regions without them having to depend on geographical proximity. The major contributions of this research to theory and practice are the development of a novel framework for inter-regional innovation systems (iRIS) which can be applied by stakeholders in regions that want to collaborate from a distance. Furthermore, the research suggests that the substitution mechanism of geographical proximity consists of not just one non-spatial form, but it consists of the three non-spatial forms identified in this research.
Creating Gaps in Understanding: How Gen Z Disrupts Gender Norms on TikTok
Authors: Wynne Ellen , Wright William , Alvermann Donna 
Published: December 2021

Abstract
Since its inception, social media has been an important method of constructing and performing identity, including gender identity. Identity work on social media is perhaps especially relevant to Gen Z (those born after 1996; Parker & Igielnik, 2020), who are the first generation with access to it in early childhood. In this article, we explore how Gen Z constructs and performs gender identity and other facets of intersectional identity on popular video platform TikTok by analyzing selected content from three TikTokers through the lenses of performativity, intersectionality, and automediality.
“Here Comes a Thought”: Steven Universe as Social Emotional Curriculum
Authors: Muñoz Joaquin , Chang Nou-Chee 
Published: December 2021

Abstract
The emphasis on social emotional learning as a focus in schools has led to the development of new materials for curriculum in classrooms for teaching social emotional content and competencies. This paper conceptualizes the use of narrative television and animation, specifically, the cartoons Steven Universe and Steven Universe Future as powerful pedagogical tools for engaging social emotional learning in classrooms. The purpose of this paper is to demonstrate the efficacy of these cartoons as tools for classroom use given their emphasis on inclusivity, diversity, and their popularity with young people today. Utilizing the Collaborative for Academic, Social, and Emotional Learning Competencies as a framework, the paper highlights selected episodes of the shows, and demonstrates ways the shows can be used to teach these competencies. As teachers continue to encounter ever-diversifying student populations, the use of media such as Steven Universe can help support inclusive classroom environments that engage the emotional lives and experiences of young people today.
Regional Differences in the Ratio of Observed and Expected In-hospital Mortality for Acute Coronary Syndrome Patients in China: The Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project Analysis
Authors: Yong Jing Wen , Xing Yue Yan , Zhou Meng Ge , Yang Na , Hao Yong Chen , Liu Jing , Liu Jun , Zhao Dong , Zhou Yu Jie , Wang Zhi Jian ,   CCC-ACS Investigators
Published: December 2021

Previous studies reported regional variations in in-hospital acute coronary syndrome (ACS) mortality, but the reasons for that were not clearly defined. We explored whether differences in patient characteristics could explain regional variation. The Improving Care for Cardiovascular Disease in China (CCC)-ACS project is an ongoing national registry and quality improvement project, involving 150 tertiary hospitals from 30 provinces across China. We applied a prediction model that included patient-specific variables to calculate the expected in-hospital mortality. For each province, we reported the observed, expected in-hospital mortality and the risk-adjusted ratio which is based on the observed divided by the expected mortality. From 2014 to 2018, 79 585 ACS patients were enrolled. The average in-hospital mortality was 1.8%. There was a wide variation in the in-hospital mortality among different provinces (0.2-3.9%). Patient characteristics explained part of this variation because of differences in the expected in-hospital mortality (0.7-2.8%). There was a substantial variation in the risk-adjusted ratio among provinces (0.2-3.5), which suggests that the variations in the mortality cannot be completely explained by the differences in patient characteristics. In conclusion, we observed a wide regional variation in mortality for ACS, part of which could be explained by the difference in patient characteristics.
Predictors of successful outcome of tubularized incised plate for primary distal hypospadias repair
Authors: Abdelhalim Khaled M. , Abdelwahab Hassan A. , Abdelgawad Esam , Kadry Ahmed M. , Sherief Mahmoud H. 
Published: December 2021

AbstractBackgroundSeveral preoperative factors affect the outcome of Tabularized Incised Plate (TIP) repair. Our aim was to collect and analyze all these factors to define what the most important predictive factors are.MethodsHundred patients (1–5 years old) with primary distal hypospadias were included. Exclusion criteria included previous penile operations and hormonal treatment or associated congenital anomalies. Anogenital distance (AGD), stretched penile length (SPL), meatal site, glanular shape, chordee and torsion degree, plate width and glans meatus shaft (GMS) score were assessed. TIP repair was done to all patients and followed up for one year. The outcome was correlated with the above parameters.ResultsMean ± SD of age of patients was 3.5 ± 1.5 years, while weight was 14.1 ± 3.0 kg. Complication rate was 18% including urethrocutaneous fistula (UCF) and meatal stenosis 14%, repair breakdown 1% and urethral stricture 3%. Patients with chordee degree < 30° and distal penile meatal location were associated with increased risk for complications by 11.6 and 8.2 times; 95% CI was (1.46–91.75) and (1.02–66.52), respectively (p < 0.05 for each). Plate width ≥ 9 mm, AGD > 5 cm, GMS score ≤ 7 (p < 0.001 for each), age of patient ≤ 2 years old, and SPL > 3.5 cm (p < 0.01 for each) were associated with successful outcome of repair.ConclusionThe proposed successful criteria of TIP repair were absent chordee, coronal/subcoronal penile meatal location, plate width ≥ 9 mm, AGD > 5 cm, age of patient ≤ 2 years old, GMS score ≤ 7, SPL > 3.5 cm and grooved glanular shape.
Sarcopenia and coronary heart disease synergistically increase the risk of new onset depressive symptoms in older adults
Authors: Chen Xiaoyu , Han Peipei , Yu Xing , Zhang Yuanyuan , Song Peiyu , Liu Yuewen , Liu Jinghuan , Tang Jiawei , Zhang Yisong , Zhao Yong , Zheng Jiejiao , Chu Lixi , Wang Hong Bing , Guo Qi 
Published: December 2021

Abstract
Background
Coronary heart disease (CHD), sarcopenia and depression are common disorders that markedly impair quality of life and impose a huge financial burden on society. They are also frequently comorbid, exacerbating condition and worsening prognosis. This study aimed to investigate the additive effects of CHD and sarcopenia on the risk of new onset depressive symptoms in older adults.

Methods
The prospective cohort study comprised 897 Chinese community-dwelling participants who were aged 60 years and older (386 men; mean age 66.9 ± 5.9 years) without depressive symptoms at baseline, recruited from Chadian of Tianjin, China. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. CHD was identified via medical records or new diagnosed by at least two physicians. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS) ≥11. Longitudinal data on new onset depressive symptoms were collected up to 12 months after baseline.

Results
We found that 103 (11.5%) of the 897 participants without depressive symptoms at baseline had developed depressive symptoms. Participants were classified into mutually exclusive groups based on sarcopenia status and CHD: normal, CHD alone, sarcopenia alone, and co-occurring groups. A logistic regression showed that the CHD alone [odd ratios (OR) = 1.78, 95% confidence interval (CI) = 1.05–3.02], sarcopenia alone (OR = 2.79, 95% CI = 1.26–6.22), and co-occurring (OR = 7.19, 95% CI = 2.75–18.81) had higher risk of depressive symptoms than the normal group after adjusting for the covariates.

Conclusions
CHD and sarcopenia synergistically increase the risk of new onset depressive symptoms in older adults. Thus, older adults may require early detection, and appropriate interventions should be implemented.
Gestational week-specific of uterine artery Doppler indices in predicting preeclampsia: a hospital-based retrospective cohort study
Authors: Wu Jiang-Nan , Li Ming-Qing , Xie Feng , Zhang Bin 
Published: December 2021

Abstract
Background
Plenty of studies explored the relationship between uterine artery (UtA) Doppler indices and the onset of preeclampsia at different trimesters. However, few studies test the gestational week-specific predictive value of the UtA indices for subsequent preeclampsia and compare the difference of right or left UtA indices (e.g., pulsatility or resistance index [PI or RI]).

Methods
Hospital-based retrospective cohort study of singleton pregnant women who received the Doppler test between 2012 and 2016 was conducted in 2018. The predictive performance of the UtA indices for preeclampsia and its variants, including early-onset preeclampsia (< 34 weeks) and preterm preeclampsia (< 37 weeks), was estimated.

Results
The UtA indices, with a cutoff value of 1.11 for the right and left UtA-PI, and 0.66 and 0.63 for the right and left UtA-RI, respectively, were effective predictors for subsequent preeclampsia. The prediction was satisfactory at the 9th week of the Doppler scan: areas under the curve ≥ 0.80, the Youden index ranging from 0.54 to 0.58, the sensitivity of 63.2 ~ 73.7%, and the specificity 84.2 ~ 91.3%, respectively. The UtA indices had comparable performance in screening for early-onset and preterm preeclampsia but showed lower predictive value for late-onset cases. Among these indices, the right UtA-RI had the highest specificity (all P < 0.01), while the left UtA-PI showed good authenticity (higher Youden index) in predicting the disorder.

Conclusions
The second-trimester measured UtA indices had a satisfactory performance at the 9th week in predicting subsequent preeclampsia. The right UtA-RI was the first choice in ruling out preeclampsia, while the left UtA-PI showed the best authenticity of the prediction.
A 3D printing personalized percutaneous puncture guide access plate for percutaneous nephrolithotomy: a pilot study
Authors: Keyu Gao , Shuaishuai Li , Raj Ashok , Shuofeng Li , Shuai Liu , Yuan Zhang , Haitao Zhu , Junqi Wang 
Published: December 2021

Abstract
Objective
CT-Urography combined with 3D printing technology, digital design, construction of individualized PCNL puncture guides, and preliminary analyze their efficacy, safety puncture positioning for PCNL.

Methods
Twenty-two patients with renal calculi were randomly selected at the affiliated Hospital of Xuzhou Medical University during 2017–2018. We randomly divided the patients into two groups: in 10 experimental groups, we used our 3D printing personalized percutaneous puncture guide access plate for PCNL, and in the control group, 12 patients with standard USG guide PCNL. The accuracy of puncture position, puncture time, and intraoperative blood loss was compared.

Results
In the experimental group, 10 patients with 3D printing personalized percutaneous puncture guide access plate. The puncture needle was accessed through the guide plate and verified by the color Doppler. The single puncture, needle position, and depth success rate were 100.00% (10/10). The angles were consistent with the preoperative design. In the control group, 12 patients via USG guided PCNL success rate was 75.00% (9/12). The puncture time and amount of hemorrhage was (7.78 ± 0.94) min and (49.31 ± 6.43) mL, and (9.04 ± 1.09) min and (60.08 ± 12.18) mL, respectively. The above data of the two groups were statistically significant (P < 0.05).

Conclusion
3D printing personalized percutaneous nephrolithotomy guide plate for PCNL can improve PCNL renal puncture channel positioning accuracy, shorten puncture time, reduce intraoperative blood loss, bleeding-related complications and provide a new method for PCNL renal puncture positioning, which is worthy of further clinical exploration.
Associations of hypoglycemia, glycemic variability and risk of cardiac arrhythmias in insulin-treated patients with type 2 diabetes: a prospective, observational study
Authors: Andersen Andreas , Bagger Jonatan I. , Sørensen Samuel K. , Baldassarre Maria P. A. , Pedersen-Bjergaard Ulrik , Forman Julie L. , Gislason Gunnar , Lindhardt Tommi B. , Knop Filip K. , Vilsbøll Tina 
Published: December 2021

Abstract
Background
Insulin-treated patients with type 2 diabetes (T2D) are at risk of hypoglycemia, which is associated with an increased risk of cardiovascular disease and mortality. Using a long-term monitoring approach, we investigated the association between episodes of hypoglycemia, glycemic variability and cardiac arrhythmias in a real-life setting.

Methods
Insulin-treated patients with T2D (N = 21, [mean ± SD] age 66.8 ± 9.6 years, BMI 30.1 ± 4.5 kg/m2, HbA1c 6.8 ± 0.4% [51.0 ± 4.8 mmol/mol]) were included for a one-year observational study. Patients were monitored with continuous glucose monitoring ([mean ± SD] 118 ± 6 days) and an implantable cardiac monitor (ICM) during the study period.

Results
Time spend in hypoglycemia was higher during nighttime than during daytime ([median and interquartile range] 0.7% [0.7–2.7] vs. 0.4% [0.2–0.8]). The ICMs detected 724 episodes of potentially clinically significant arrhythmias in 12 (57%) participants, with atrial fibrillation and pauses accounting for 99% of the episodes. No association between hypoglycemia and cardiac arrhythmia was found during daytime. During nighttime, subject-specific hourly incidence of cardiac arrhythmias tended to increase with the occurrence of hypoglycemia (incident rate ratio [IRR] 1.70 [95% CI 0.36–8.01]) but only slightly with increasing time in hypoglycemia (IRR 1.04 [95% CI 0.89–1.22] per 5 min). Subject-specific incidence of cardiac arrhythmias during nighttime increased with increasing glycemic variability as estimated by coefficient of variation whereas it decreased during daytime (IRR 1.33 [95% CI 1.05–1.67] and IRR 0.77 [95% CI 0.59–0.99] per 5% absolute increase, respectively).

Conclusions
Cardiac arrhythmias were common in insulin-treated patients with T2D and were associated with glycemic variability, whereas arrhythmias were not strongly associated with hypoglycemia.
Trial registration: NCT03150030, ClinicalTrials.gov, registered May 11, 2017. https://clinicaltrials.gov/ct2/show/NCT03150030
Metabolic engineering of Corynebacterium glutamicum for producing branched chain amino acids
Authors: Yu Shengzhu , Zheng Bo , Chen Zhenya , Huo Yi-Xin 
Published: December 2021

AbstractBackgroundBranched chain amino acids (BCAAs) are widely applied in the food, pharmaceutical, and animal feed industries. Traditional chemical synthetic and enzymatic BCAAs production in vitro has been hampered by expensive raw materials, harsh reaction conditions, and environmental pollution. Microbial metabolic engineering has attracted considerable attention as an alternative method for BCAAs biosynthesis because it is environmentally friendly and delivers high yield.Main textCorynebacterium glutamicum(C. glutamicum) possesses clear genetic background and mature gene manipulation toolbox, and has been utilized as industrial host for producing BCAAs. Acetohydroxy acid synthase (AHAS) is a crucial enzyme in the BCAAs biosynthetic pathway ofC. glutamicum, but feedback inhibition is a disadvantage. We therefore reviewed AHAS modifications that relieve feedback inhibition and then investigated the importance of AHAS modifications in regulating production ratios of three BCAAs. We have comprehensively summarized and discussed metabolic engineering strategies to promote BCAAs synthesis inC. glutamicumand offer solutions to the barriers associated with BCAAs biosynthesis. We also considered the future applications of strains that could produce abundant amounts of BCAAs.ConclusionsBranched chain amino acids have been synthesized by engineering the metabolism ofC. glutamicum. Future investigations should focus on the feedback inhibition and/or transcription attenuation mechanisms of crucial enzymes. Enzymes with substrate specificity should be developed and applied to the production of individual BCAAs. The strategies used to construct strains producing BCAAs provide guidance for the biosynthesis of other high value-added compounds.
p53 signaling in cancer progression and therapy
Authors: Marei Hany E. , Althani Asmaa , Afifi Nahla , Hasan Anwarul , Caceci Thomas , Pozzoli Giacomo , Morrione Andrea , Giordano Antonio , Cenciarelli Carlo 
Published: December 2021

AbstractThe p53 protein is a transcription factor known as the "guardian of the genome" because of its critical function in preserving genomic integrity. The TP53 gene is mutated in approximately half of all human malignancies, including those of the breast, colon, lung, liver, prostate, bladder, and skin. When DNA damage occurs, the TP53 gene on human chromosome 17 stops the cell cycle. If p53 protein is mutated, the cell cycle is unrestricted and the damaged DNA is replicated, resulting in uncontrolled cell proliferation and cancer tumours. Tumor-associated p53 mutations are usually associated with phenotypes distinct from those caused by the loss of the tumor-suppressing function exerted by wild-type p53protein. Many of these mutant p53 proteins have oncogenic characteristics, and therefore modulate the ability of cancer cells to proliferate, escape apoptosis, invade and metastasize. Because p53 deficiency is so common in human cancer, this protein is an excellent option for cancer treatment. In this review, we will discuss some of the molecular pathways by which mutant p53 proteins might perform their oncogenic activities, as well as prospective treatment methods based on restoring tumor suppressive p53 functions.