bluuebunny/crossref_metadata_2025_split huggingface dataset:
Employability Factors Contributing to Youth Unemployment in the EAC Countries Data and Policy Analysis
Authors: Hatibu Semboja Haji , Hafidh Hafidh Ali 
Published: May 2021

This policy research paper analyses employability factors and challenges contributing to youth unemployment and also provides working recommendations for further dialogue and engagement on youth employability in the East African community EAC Countries. The policy analysis is based on the theory of 4-Es as propounded by International Labour Organization ILO and Youth Employment Network literature. The field research survey, focus group discussion, combined observational and consultations with key informants were major research methods used in collecting secondary and primary data and information. Data analysis uses non-parametric methods, mainly frequency and cross tabulations.
The paper found that costs of doing business among the youth in the formal and informal economies are significantly high. There are weak limited skills matching systems and provision of relevant curriculum that produce an updated knowledge base. The problem of rural-urban migration is related to inadequate rural infrastructures; lack of establishment of sustainable agro-processing industries, limited provision of rural vocation and training programmes to equip youth with skills for employability. The education and training systems do not comply with regional, international standards and technological changes in the world. There are weak career counselling and guidance centres for youth. There is a limited access to good quality education and thus decent jobs for youth with disability.
The policy solution is to enhance employability conditions. Relevant policy strategies include reducing cost of doing business, enhance business skills development and matching; minimizing rural-urban migration; creating conducive environment for business for youth with disability; increasing agricultural mechanization to enhance productivity, increasing rural connectivity and accessibility; improving VET and higher education learning systems; increasing access to schools, technical and vocational training for youth with disability; improving conditions and quality of employment systems and enhancing provision of information regarding employment opportunities in these EAC countries.
Assessment of Sub-endometrial Blood Flow Parameters Following Oral Dydrogesterone versus Micronized Vaginal Progesterone in Women with Idiopathic Recurrent Miscarriage
Authors: Nasr Magda I. , Omar Mona K. , Ataallah Walid M. , Mahfouz Amal E. 
Published: May 2021

Background: Recurrent pregnancy loss is an important reproductive health issue, affecting 2%–5% of couples. An unsupportive endometrium, leading to abnormal implantation, is considered to be one of the key factors contributing to idiopathic recurrent spontaneous miscarriage (IRSM). The aim of this work was to evaluate differences in uteroplacental blood ﬂow and pregnancy outcome in women with idiopathic recurrent spontaneous miscarriage (IRSM) following administration of micronized vaginal progesterone versus oral dydrogesteron.
Materials and Methods: This prospective, randomized-controlled study comprised 90 pregnant women who came to outpatient clinic of obstetrics .All women had a singleton pregnancy with active cardiac pulsations at gestational age between 5-8 weeks Pregnant women in the study group were randomly distributed into: Group {A}: 30 pregnant women received 10 mg of oral dydrogesterone (Duphaston; Abbott Company) twice daily.Group {B}: 30 pregnant women received 200 mg micronized vaginal progesterone (Prontogest) twice-daily. Control group:30 pregnant women without history of recurrent miscarriage served as controls and they received folic acid as placebo.
Results: comparing the Doppler indices before progesterone supplementation, the mean resistance index (RI) was statistically significant less in the control group compared with both study groups (A&B) (P=0.012, P=0.005 respectively) .Moreover, pulsatility index (PI) was statistically significant less in the control group compared with both study groups (A&B) (P=0.026, P=0.05 respectively) .Paralleled to that, the S/D ratio was statistically significant less in control group compared with both group A &B (P=0.43, & P=0.019respectively) .In addition, the mean PSV was significantly higher in control group compared to group B (P=0.047) and was higher in control group than group A with nearly significant P value.
Conclusion: Considerable improvement in uteroplacental blood flow parameters of pregnant women with IRSM is evident with progesterone supplementation.
Diabetic Ketoacidosis in Children with Type-1 Diabetes in a Tertiary Hospital in Sokoto, North-Western Nigeria: Clinical Profile and Outcome
Authors: Ugege M. O. , Yusuf T. 
Published: May 2021

Introduction: Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D). Few reports are available on DKA among children in North-west Nigeria.
Objective: To describe the clinical profile and outcome of children managed for DKA in the Paediatric Endocrinology Unit of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, North-western Nigeria over a ten-year period (January 2011- December 2020).
Methods: This was a retrospective review of the case records of all children managed for T1D between 2011 and 2020. Socio-demographic and clinical data of those with DKA were extracted and analysed using SPSS version 23.
Results: Ten (62.5%) out of 16 children with T1D had DKA, comprising 8 males and 2 females; M: F ratio 4:1. Majority (90%) were adolescents aged 10-15years. The mean age ± standard deviation (SD) at diagnoses of T1D was 11.1 ± 3.14 years; DKA was the presenting manifestation of diabetes in 4 (40%) children, while 6(60%) were known diabetics with an average of 2-episodes per patient. The median duration of symptoms was 5 days (range 1-42 days). Abdominal pain (90%), polyuria (80%), fast breathing (70%), vomiting (70%), altered consciousness (70%), dehydration (100%) and Kussmaul respiration (70%) were the common presenting features. The mean blood glucose, bicarbonate and venous PH at admission were 23.28± 7.14 (range; 12.3-33.3) mmol/L, 14.1± 3.41 (10-21) mmol/L and 6.96± 0.06 (6.92-7.00) respectively. Co-morbid conditions included infections (80%), predominantly malaria (70%). There was no mortality.
Conclusion: DKA is common in male adolescents, with good management outcome in our facility. Abdominal pain, dehydration, polyuria and Kussmaul respiration were the commonest presenting features. A high index of suspicion of DKA is recommended in any child, particularly, male adolescents with the aforementioned features. Effort should be made to confirm diagnosis and prompt treatment instituted.
Ferroelectric α‐In2Se3 Wrapped‐Gate β‐Ga2O3 Field‐Effect Transistors for Dynamic Threshold Voltage Control
Authors: Yang Jeong Yong , Yeom Min Jae , Park Youngseo , Heo Junseok , Yoo Geonwook 
Published: May 2021

AbstractIndium selenide (α‐In2Se3), which is a recently emerging ferroelectric semiconductor, can solve a major hindrance to applications of an ultra‐wide bandgap beta‐gallium oxide (β‐Ga2O3) semiconductor. Here, ferroelectric α‐In2Se3 wrapped‐gate β‐Ga2O3 field‐effect transistors (FETs) for dynamic threshold voltage (VTH) control is demonstrated. The dry‐transferred α‐In2Se3 layer is wrapped around β‐Ga2O3 channel, which allows efficient electrostatic gate modulation. Thus, the ferroelectricity of α‐In2Se3 and a thin native oxide interlayer formed at the interface between β‐Ga2O3 and α‐In2Se3 can provide effective VTH control. Applying a positive voltage pulse to the gate electrode induces positive VTH shift; hence, the device can be even changed from depletion to enhancement (E‐) mode. The E‐mode β‐Ga2O3 FET exhibits steep‐subthreshold slope with a negligible hysteresis. The VTH of E‐mode can be further modulated by applying back‐gate bias, and electrical performance can be enhanced via dual‐gate operation. The approach demonstrates an energy efficient β‐Ga2O3‐based switching device architecture integrated with ferroelectric van der Waals 2D materials.
Incident Rheumatoid Arthritis in HIV Infection: Epidemiology and Treatment
Authors: Hanberg Jennifer S. , Hsieh Evelyn , Akgün Kathleen M. , Weinstein Erica , Fraenkel Liana , Justice Amy C. ,   the VACS Project Team
Published: May 2021

ObjectiveTo assess the incidence, presentation, and management of rheumatoid arthritis (RA) in patients with HIV, including the use of disease‐modifying antirheumatic drugs (DMARDs) in this immunosuppressed population.MethodsPatients included in this study were from the Veterans Aging Cohort Study, a longitudinal cohort of veterans with HIV and age‐, race‐, and site‐matched uninfected veterans. We identified all patients who had ≥1 rheumatologist‐generated International Classification of Diseases, Ninth Revision (ICD‐9) or Tenth Revision (ICD‐10) code for RA and whose serum samples were tested for rheumatoid factor (RF) and anti–cyclic citrullinated peptide (anti‐CCP) antibodies. To further confirm the diagnosis of RA, medical charts were reviewed to verify whether patients met the American College of Rheumatology/European Alliance of Associations for Rheumatology 2010 criteria for RA. We recorded DMARD use and adverse effects during the first contiguous course of treatment (i.e., >6 months of no interruption in DMARD treatment).ResultsThis study included 56,250 patients with HIV and 116,944 uninfected individuals over 2,384,541 person‐years. Of the 2,748 individuals in this cohort who were reviewed for a diagnosis of RA based on ICD‐9 or ICD‐10 codes, incident RA was identified in 215 individuals, including 21 patients with HIV. The incidence rate ratio of RA for patients with HIV compared to uninfected individuals was 0.29 (95% confidence interval 0.19–0.48). Most of the patients diagnosed as having RA (88%) were seropositive for RA‐associated autoantibodies (RF and/or anti‐CCP). However, high autoantibody titers were less frequent in RA patients with HIV compared to RA patients without HIV. In total, 5% of RA patients with HIV (1 of 21) had both high titers of anti‐CCP and high titers of RF, compared to 41% of uninfected individuals (81 of 194). DMARDs were prescribed in 71% of RA patients with HIV (15 of 21) compared to 94% of RA patients without HIV (183 of 194). There was no indication that the DMARD safety profile was worse among RA patients with HIV who were prescribed DMARDs (n = 10 assessed) compared to RA patients without HIV who were prescribed DMARDs (n = 158 assessed).ConclusionIn this cohort, incident RA was less common in patients with HIV compared to uninfected individuals. Moreover, compared to RA patients without HIV, the seropositivity rate and titers of RA‐specific autoantibodies were lower among RA patients with HIV, and those with HIV were prescribed DMARDs less frequently than those without HIV.
Constructions of LGBTQI+ rights and claims in lay discourse in Greece: Liberal dilemmas and sexual citizenship boundaries
Authors: Michos Ioannis , Figgou Lia , Bozatzis Nikos 
Published: May 2021

AbstractThis study explores ways in which diverse LGBTQI+ claim frames are sedimented in Greek everyday discourse. Specifically, it is interested in the identification of the argumentative resources that inform lay constructions of LGBTQI+ claims and rights, as well as of their potential social implications. The research data are drawn from seven focus groups, conducted in Thessaloniki, Greece and analysed by the conceptual tools of Critical Discursive Social Psychology. According to the analysis, liberal dilemmas over difference, visibility, and equality are mobilized. In particular, when accounting for violence and discriminations against LGBTQI+ community members, participants construct a normative hierarchy of exclusion, based on alleged differences between sexual and gender‐related categories. Notably, in the context of arguing over different claim‐making practices, participants prioritize the projection of uniformity – instead of difference – through non‐provocative, consensual claiming actions. While liberal concepts and subsequent dilemmas inform these constructions, “liberalism” is also represented as the rhetorical other, when participants prioritize intersectional claims over (sexual and gender‐related) identity politics. Finally, participants' discourse is informed by tensions between oriental and occidental ideological patterns. A juxtaposition between Western/European liberalism and Eastern backwardness is used to challenge homonormative perceptions, which are constructed as a means of de‐radicalization.
Decision fatigue in low‐value prostate cancer screening
Authors: Hunt Trevor C. , Ambrose Jacob P. , Haaland Benjamin , Kawamoto Kensaku , Dechet Christopher B. , Lowrance William T. , Hanson Heidi A. , O'Neil Brock B. 
Published: May 2021

BackgroundLow‐value prostate‐specific antigen (PSA) testing is common yet contributes substantial waste and downstream patient harm. Decision fatigue may represent an actionable target to reduce low‐value urologic care. The objective of this study was to determine whether low‐value PSA testing patterns by outpatient clinicians are consistent with decision fatigue.MethodsOutpatient appointments for adult men without prostate cancer were identified at a large academic health system from 2011 through 2018. The authors assessed the association of appointment time with the likelihood of PSA testing, stratified by patient age and appropriateness of testing based on clinical guidelines. Appointments included those scheduled between 8:00 am and 4:59 pm, with noon omitted. Urologists were examined separately from other clinicians.ResultsIn 1,581,826 outpatient appointments identified, the median patient age was 54 years (interquartile range, 37‐66 years), 1,256,152 participants (79.4%) were White, and 133,693 (8.5%) had family history of prostate cancer. PSA testing would have been appropriate in 36.8% of appointments. Clinicians ordered testing in 3.6% of appropriate appointments and in 1.8% of low‐value appointments. Appropriate testing was most likely at 8:00 am (reference group). PSA testing declined through 11:00 am (odds ratio [OR], 0.57; 95% CI, 0.50‐0.64) and remained depressed through 4:00 pm (P < .001). Low‐value testing was overall less likely (P < .001) and followed a similar trend, declining steadily from 8:00 am (OR, 0.48; 95% CI, 0.42‐0.56) through 4:00 pm (P < .001; OR, 0.23; 95% CI, 0.18‐0.30). Testing patterns in urologists were noticeably different.ConclusionsAmong most clinicians, outpatient PSA testing behaviors appear to be consistent with decision fatigue. These findings establish decision fatigue as a promising, actionable target for reducing wasteful and low‐value practices in routine urologic care.Lay Summary

Decision fatigue causes poorer choices to be made with repetitive decision making.

This study used medical records to investigate whether decision fatigue influenced clinicians' likelihood of ordering a low‐value screening test (prostate‐specific antigen [PSA]) for prostate cancer.

In more than 1.5 million outpatient appointments by adult men without prostate cancer, the chances of both appropriate and low‐value PSA testing declined as the clinic day progressed, with a larger decline for appropriate testing.

Testing patterns in urologists were different from those reported by other clinicians.

The authors conclude that outpatient PSA testing behaviors appear to be consistent with decision fatigue among most clinicians, and interventions may reduce wasteful testing and downstream patient harms.
The impact of natural disasters and epidemics on sexual and reproductive health in low‐ and middle‐income countries: A narrative synthesis
Authors: Loewen Samantha , Pinchoff Jessie , Ngo Thoai D. , Hindin Michelle J. 
Published: May 2021

AbstractBackgroundNatural disasters and epidemics can strain already‐fragile health systems, diverting resources away from essential sexual and reproductive health (SRH) services, threatening supply chains, and adversely impacting access to health facilities.ObjectiveTo describe how natural disasters and epidemics affect multiple dimensions of SRH service delivery and outcomes, and identify potential approaches to facilitate resumption of services.Search strategyKey words searched in Google Scholar, PubMed, and Scopus.Selection criteriaStudies published in English between 2005 and 2020 covering events in low‐ and middle‐income countries.Data collection and analysisThis review was developed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) 2009 checklist. The initial electronic database searching yielded 64 345 studies, but after screening 13 studies were included in the final review.Main resultsAcross contexts, disruptive events worsened the availability of and women's access to SRH services, contributed to decreased utilization of SRH services, and often resulted in lower use of family planning, particularly methods requiring facility‐based interaction.ConclusionSRH in disaster response plans must be prioritized, as women often lose access to these essential services at a time when they are at their most vulnerable. Evidence regarding effective interventions and policies is lacking.
Comparison of the MSMS and NanoShaper molecular surface triangulation codes in the TABI Poisson–Boltzmann solver
Authors: Wilson Leighton , Krasny Robert 
Published: May 2021

AbstractThe Poisson–Boltzmann (PB) implicit solvent model is a popular framework for studying the electrostatics of solvated biomolecules. In this model the dielectric interface between the biomolecule and solvent is often taken to be the molecular surface or solvent‐excluded surface (SES), and the quality of the SES triangulation is critical in boundary element simulations of the model. This work compares the performance of the MSMS and NanoShaper surface triangulation codes for a set of 38 biomolecules. While MSMS produces triangles of exceedingly small area and large aspect ratio, the two codes yield comparable values for the SES surface area and electrostatic solvation energy, where the latter calculations were performed using the treecode‐accelerated boundary integral (TABI) PB solver. However we found that NanoShaper is computationally more efficient and reliable than MSMS, especially when parameters are set to produce highly resolved triangulations.
Moments of Insight in Problem‐Solving Relate to Bodily Arousal
Authors: Nam Beth , Paromita Projna , Chu Sharon Lynn , Chaspari Theodora , Woltering Steven 
Published: May 2021

AbstractProblem‐solving involves both cognitive and physiological changes. Since most prior work has focused on examining the cognitive side of problem‐solving, there is more to explore on the physiological side, including skin conductance. The present study examined skin conductance reactivity (SCR) to the moment participants solved three different types of problems: (a) straightforward (basic), (b) analytic processing (analytic questions), and (c) a sudden insight (riddles). The authors predict different responses in SCR between basic, analytic, and riddle conditions, and the level of difficulty in riddles. Moreover, the authors predict that a faster and correct response is related to larger physiological arousal. Thirty‐one participants were confronted with problems that were best solved using either sudden insight (riddles) or analytic thinking, as well as a control condition with basic questions. Participants showed the largest SCR amplitudes to the insight condition versus the basic control condition. Furthermore, hard insight problems had greater SCR amplitudes than easy insight problems. These findings suggest that physiological response to problem‐solving is dependent on the type of problem and the amount of challenge it poses to an individual.
Tumor suppressor miR‐192‐5p targets TRPM7 and inhibits proliferation and invasion in cervical cancer
Authors: Dong Ruo‐Fan , Zhuang Yong‐Ju , Wang Yuan , Zhang Zhen‐Yu , Xu Xi‐Zhong , Mao Yu‐Rong , Yu Jin‐Jin 
Published: May 2021

AbstractCervical cancer is the fourth highest mortality cancer among women worldwide. Many researchers have discovered the major anticancer role of miR‐192‐5p. However, no study has revealed the effect of miR‐192‐5p on cervical cancer and its molecular mechanism. Therefore, in this study, we aimed to explore the role of miR‐192‐5p in proliferation, invasion of cervical cancer, and its regulatory mechanism. Firstly, the expression level of miR‐192‐5p was examined by real‐time quantitative polymerase chain reaction. Cell counting kit‐8 analysis was applied to detect the proliferation of transfected Caski and SiHa cells. Flow cytometry assay was applied to detect the apoptosis of transfected Caski and SiHa cells. Our result showed that miR‐192‐5p restrained cervical cancer cell proliferation and induced apoptosis. Then we employed wound healing and transwell assays to analyze the migration and invasion abilities of Caski and SiHa cells in vitro. The results showed that miR‐192‐5p had an inhibitory effect on cervical cancer migration and invasion. The results of in vivo experiment demonstrated that miR‐192‐5p also inhibited tumor development in nude mice. We further detected that the binding of transient receptor potential melastatin‐subfamily member 7 (TRPM7) to miR‐192‐5p using bioinformatic methods and dual‐luciferase reporter assay. Finally, we found that TRPM7 overexpression reversed the inhibitory effects of miR‐192‐5p on proliferation, migration, and invasion on cervical cancer cells. In conclusion, the findings of the present study revealed that miR‐192‐5p performs an inhibitory role in cervical cancer proliferation and invasion by targeting TRPM7.
Speech Recognition as a Function of Age and Listening Experience in Adult Cochlear Implant Users
Authors: Murr Alexander T. , Canfarotta Michael W. , O'Connell Brendan P. , Buss Emily , King English R. , Bucker Andrea L. , Dillon Sarah A. , Rooth Meredith A. , Dedmon Matthew M. , Brown Kevin D. , Dillon Margaret T. 
Published: May 2021

Objectives/HypothesisSpeech recognition with a cochlear implant (CI) tends to be better for younger adults than older adults. However, older adults may take longer to reach asymptotic performance than younger adults. The present study aimed to characterize speech recognition as a function of age at implantation and listening experience for adult CI users.Study DesignRetrospective review.MethodsA retrospective review identified 352 adult CI recipients (387 ears) with at least 5 years of device listening experience. Speech recognition, as measured with consonant‐nucleus‐consonant (CNC) words in quiet and AzBio sentences in a 10‐talker noise masker (10 dB signal‐to‐noise ratio), was reviewed at 1, 5, and 10 years postactivation.ResultsSpeech recognition was better in younger listeners, and performance was stable or continued to improve through 10 years of CI listening experience. There was no indication of differences in acclimatization as a function of age at implantation. For the better performing CI recipients, an effect of age at implantation was more apparent for sentence recognition in noise than for word recognition in quiet.ConclusionsAdult CI recipients across the age range examined here experience speech recognition benefit with a CI. However, older adults perform more poorly than young adults for speech recognition in quiet and noise, with similar age effects through 5 to 10 years of listening experience.Level of Evidence3 Laryngoscope, 131:2106–2111, 2021