bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of laughter yoga on health-related quality of life in cancer patients undergoing chemotherapy: a randomized clinical trial
Authors: Namazinia Mohammad , Mazlum Seyyed Reza , Mohajer Samira , Lopez Violeta 
Published: June 2023

Abstract
Background
Chemotherapy is associated with a wide range of physical and psychological side effects, so complementary and alternative therapies may be practiced as an independent treatment or combined with the standard ones to improve health-related quality of life of cancer patients. Laughter yoga has predominantly been used as a complementary therapy to enhance health and wellbeing of ordinary people and patients with chronic diseases. However, to date, few studies have evaluated the effects of this modern exercise on cancer patients undergoing chemotherapy in clinical settings, to the best of the authors’ knowledge. the present study aimed to investigate the effects of Laughter Yoga on the health-related quality of life of cancer patients undergoing chemotherapy.

Methods
This study was a two-group randomized clinical trial on 69 cancer patients undergoing chemotherapy at Reza Radiotherapy and Oncology Center, Iran in 2018. Patients were randomly divided into intervention and control groups. The intervention group received laughter yoga for four sessions at one-week intervals. Each session consists of one part and lasts for 20–30 min. Patients’ health-related quality of life was assessed before and after the laughter yoga sessions using Quality of Life Questionnaire European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) version 3.0. SPSS Statistics (v.20 software was used to conduct Chi-square, independent t-test, Mann-Whitney, Wilcoxon and paired t-tests analyses of the data.

Results
The number of participants in intervention and control groups were 34 and 35, there was no significant difference of demographic and disease related characteristics and pre-intervention HRQOL between two groups. In the intervention group, there is significant difference between pre- and post-intervention scores (Mean ± Standard Deviation) of emotional functioning (12.99 ± 10.49), physical functioning (0.78 ± 6.08), role functioning (3.43 ± 7.97), fatigue (-8.82 ± 22.01), pain (-8.33 ± 11.78), sleep disturbance (-15.68 ± 18.77), and global health and quality of life (6.37 ± 5.04) (p < 0.05). There was no significant change in the control group. Participants reported no adverse events.

Conclusions
A structured laughter yoga intervention in a hospital setting effectively improved health-related quality of life for cancer patients undergoing chemotherapy. Benefits to many patients could be expected if this would become a part of routine care.

Trial Registration
This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20180429039463N1) on 21/08/2018.
Global competency impact of sustained remote international engagement for students
Authors: Kelly Tracy , Bekele Abebe , Kapadia Sonja G. , Jassal Simrat K. , Ineza Darlene , Uwizeyimana Theogene , Clarke Olivia , Flickinger Tabor E. , Dillingham Rebecca , Durieux Marcel E. 
Published: June 2023

Abstract
Background
To provide just equity in academic exchange, as well as to reduce prohibitive travel cost and address environmental concerns, the past paradigm of international student exchange has fundamentally shifted from one directional travel to mutually beneficial bidirectional remote communication between students all over the globe. Current analysis aims to quantify cultural competency and evaluate academic outcomes.

Methods
Sixty students half from the US and half from Rwanda grouped in teams of 4 engaged in a nine-month project-focused relationship. Cultural competency was evaluated prior to project initiation and six months after completion of the project. Student perspective of project development was analyzed weekly and final academic outcome was evaluated.

Results
Change in cultural competency was not significant; however, students did identify satisfaction in team interaction and academic outcomes were achieved.

Conclusion
A single remote exchange between students in two countries may not be transformative but it can provide cultural enrichment and successful academic project outcome and may serve to enhance cultural curiosity.
Increased peripartum mortality associated with maternal subclinical malaria in Mozambique
Authors: Jaén-Sánchez Nieves , González-Azpeitia Gloria , Carranza-Rodriguez Cristina , Manwere Nicholas , Garay-Sánchez Paloma , Vallejo-Torres Laura , Pérez-Arellano José-Luis 
Published: June 2023

Abstract
Background
Plasmodium falciparum infection in pregnant women in sub-Saharan Africa is often asymptomatic. As these forms of malaria are often submicroscopic and difficult to diagnose by conventional methods (microscopy and/or rapid diagnostic test), diagnosis requires the use of molecular techniques such as polymerase chain reaction (PCR). This study analyses the prevalence of subclinical malaria and its association with adverse maternal and neonatal outcomes, a topic that has been scarcely evaluated in the literature.

Methods
A cross-sectional study was conducted using semi-nested multiplex PCR to assess the presence of P. falciparum in placental and peripheral blood of 232 parturient pregnant women at the Hospital Provincial de Tete, Mozambique between March 2017 and May 2019. Multivariate regressions were performed to assess the associations of maternal subclinical malaria with several maternal and neonatal outcomes after controlling for the presence of preeclampsia/eclampsia (PE/E) and HIV infection, as well as for other maternal and pregnancy characteristics.

Results
In total, 17.2% (n = 40) of the women studied had positive PCR for P. falciparum (7 in placental blood only, 3 in peripheral blood only). We found a significant association between subclinical malaria and a higher peripartum mortality risk, which persisted after controlling for maternal comorbidity and maternal and pregnancy characteristics (adjusted odds ratio: 3.50 [1.11–10.97]). In addition, PE/E and HIV infections were also significantly associated with several adverse maternal and neonatal outcomes.

Conclusion
This study demonstrated the association of subclinical malaria, as well as of PE/E and HIV, in pregnant women with adverse maternal and neonatal outcomes. Therefore, molecular methods may be sensitive tools to identify asymptomatic infections that can reduce the impact on peripartum mortality and their contribution to sustained transmission of the parasite in endemic countries.
The predictive value of perioperative circulating markers on surgical complications in patients undergoing robotic-assisted radical prostatectomy
Authors: Lu Haohua , Yu Chenhao , Maimaiti Muzhapaer , Li Gonghui 
Published: June 2023

Abstract
Background
The occurrence of postoperative complications was associated with poor outcomes for patients undergoing robotic-assisted radical prostatectomy. A prediction model with easily accessible indices could provide valuable information for surgeons. This study aims to identify novel predictive circulating biomarkers significantly associated with surgical complications.

Methods
We consecutively assessed all multiport robotic-assisted radical prostatectomies performed between 2021 and 2022. The clinicopathological factors and perioperative levels of multiple circulating markers were retrospectively obtained from the included patients. The associations of these indices with Clavien-Dindo grade II or greater complications, and surgical site infection were assessed using univariable and multivariable logistic regression models. Further, the models were validated for the overall performance, discrimination, and calibration.

Results
In total, 229 patients with prostate cancer were enrolled in this study. Prolonged operative time could independently predict surgical site infection (OR, 3.39; 95% CI, 1.09–10.54). Higher RBC (day 1-pre) implied lower risks of grade II or greater complications (OR, 0.24; 95% CI, 0.07–0.76) and surgical site infection (OR, 0.23; 95% CI, 0.07–0.78). Additionally, RBC (day 1-pre) independently predicted grade II or greater complications of obese patients (P value = 0.005) as well as those in higher NCCN risk groups (P value = 0.012). Regarding the inflammatory markers, NLR (day 1-pre) (OR, 3.56; 95% CI, 1.37–9.21) and CRP (day 1-pre) (OR, 4.16; 95% CI, 1.69–10.23) were significantly associated with the risk of grade II or greater complications, and both the indices were independent predictors in those with higher Gleason score, or in higher NCCN risk groups (P value < 0.05). The NLR (day 0-pre) could also predict the occurrence of surgical site infection (OR, 5.04; 95% CI, 1.07–23.74).

Conclusions
The study successfully identified novel circulating markers to assess the risk of surgical complications. Postoperative increase of NLR and CRP were independent predictors for grade II or greater complications, especially in those with higher Gleason score, or in higher NCCN risk groups. Additionally, a marked decrease of RBC after the surgery also indicated a higher possibility of surgical complications, especially for the relatively difficult procedures.
Lenvatinib with or without stereotactic body radiotherapy for hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective study
Authors: Ji Xiaoquan , Xu Zhe , Sun Jing , Li Wengang , Duan Xuezhang , Wang Quan 
Published: June 2023

Abstract
Background and objectives
Patients with hepatocellular carcinoma (HCC) involving portal vein tumor thrombosis (PVTT) are presently lacking effective treatment options. We aimed to compare the efficacy and safety of lenvatinib with or without SBRT for HCC with PVTT.

Materials and methods
This retrospective analysis included 37 patients treated with lenvatinib in combination with SBRT and 77 patients treated with lenvatinib alone from August 2018 to August 2021. Overall survival (OS), progression-free survival (PFS), intrahepatic PFS (IHPFS) and objective remission rate (ORR) were compared between the two groups, while adverse events (AEs) was analyzed between the two groups to assess safety profiles.

Results
Median OS, PFS and IHPFS were significantly prolonged in the combination treatment group compared with the single treatment group (median OS, 19.3 vs. 11.2 months, p < 0.001; median PFS: 10.3 vs. 5.3 months, p < 0.001; median IHPFS, 10.7 vs. 5.3 months, p < 0.001). Moreover, a higher ORR (56.8% vs. 20.8%, P < 0.001) were observed in the lenvatinib combined with SBRT group. In subgroup analyses of Vp1-2 and Vp3-4 group, median OS, PFS and IHPFS were also significantly longer in the lenvatinib combined with SBRT group than those in the lenvatinib alone group. AEs in the combined therapy group were mostly manageable and the incidence was not statistically significant compared to the monotherapy group.

Conclusion
Lenvatinib plus SBRT had a significantly better survival benefit than lenvatinib monotherapy in the treatment of HCC patients with PVTT and was well tolerated.
The crisis of maternal and child health in Afghanistan
Authors: Glass Nancy , Jalalzai Rabia , Spiegel Paul , Rubenstein Leonard 
Published: June 2023

Abstract
Background
The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of movement, work, political participation, and education. This study examined Afghan health workers’ experiences and perceptions of availability and quality of maternal and child health care since then.

Methods
We conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover.

Results
131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were “worse” or “much worse” than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings.

Conclusion
The combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population.
Hypokalemic periodic paralysis as the first sign of thyrotoxicosis- a rare case report from Somalia
Authors: Mohamed Hawa Nuradin , Ghedi Abdi Karim Ahmed , Ozturk Sevgi , Jeele Mohamed Osman Omar , Bashir Ahmed Muhammad 
Published: June 2023

Abstract
Background
Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare complication of hyperthyroidism characterized by thyrotoxicosis, hypokalemia, and paralysis. It is the most common form of acquired periodic paralysis. THPP is precipitated by strenuous exercise, a high carbohydrate diet, stress, infection, alcohol, albuterol, and corticosteroid therapy. It is most common in Asian men with hyperthyroidism and exceptionally rare in black people.

Case Presentation
A 29-year-old man was admitted to the emergency department in Somalia with a sudden onset of paralysis after a high carbohydrate meal. Laboratory investigations showed low serum potassium 1.8 mEq/l (3.5–4.5), and biochemical thyrotoxicosis with TSH 0.006 miu/l (0.35–5.1), total T3 3.2 ng/ml (0.9–2.8) and total T4 13.5 ng/ml (0.6–1.2). He was successfully treated with potassium chloride infusion and an antithyroid drug, methimazole.

Conclusion
To prevent life-threatening cardiac and respiratory complications, it is critical to consider and diagnose THPP early, even in populations where the condition is rare.
Systematic approaches to C-lignin engineering in Medicago truncatula
Authors: Ha Chan Man , Escamilla-Trevino Luis , Zhuo Chunliu , Pu Yunqiao , Bryant Nathan , Ragauskas Arthur J. , Xiao Xirong , Li Ying , Chen Fang , Dixon Richard A. 
Published: June 2023

Abstract
Background
C-lignin is a homopolymer of caffeyl alcohol present in the seed coats of a variety of plant species including vanilla orchid, various cacti, and the ornamental plant Cleome hassleriana. Because of its unique chemical and physical properties, there is considerable interest in engineering C-lignin into the cell walls of bioenergy crops as a high-value co-product of bioprocessing. We have used information from a transcriptomic analysis of developing C. hassleriana seed coats to suggest strategies for engineering C-lignin in a heterologous system, using hairy roots of the model legume Medicago truncatula.

Results
We systematically tested strategies for C-lignin engineering using a combination of gene overexpression and RNAi-mediated knockdown in the caffeic acid/5-hydroxy coniferaldehyde 3/5-O-methyltransferase (comt) mutant background, monitoring the outcomes by analysis of lignin composition and profiling of monolignol pathway metabolites. In all cases, C-lignin accumulation required strong down-regulation of caffeoyl CoA 3-O-methyltransferase (CCoAOMT) paired with loss of function of COMT. Overexpression of the Selaginella moellendorffii ferulate 5-hydroxylase (SmF5H) gene in comt mutant hairy roots resulted in lines that unexpectedly accumulated high levels of S-lignin.

Conclusion
C-Lignin accumulation of up to 15% of total lignin in lines with the greatest reduction in CCoAOMT expression required the strong down-regulation of both COMT and CCoAOMT, but did not require expression of a heterologous laccase, cinnamyl alcohol dehydrogenase (CAD) or cinnamoyl CoA reductase (CCR) with preference for 3,4-dihydroxy-substituted substrates in M. truncatula hairy roots. Cell wall fractionation studies suggested that the engineered C-units are not present in a heteropolymer with the bulk of the G-lignin.
Valorization of Boehmeria nivea stalk towards multipurpose fractionation: furfural, pulp, and phenolic monomers
Authors: Zhang Zhen , Tao Furong , Ji Hairui 
Published: June 2023

Abstract
Background
As one of the most abundant bioresource in nature, the value-added utilization of lignocellulosic biomass is limited due to its inherent stubbornness. Pretreatment is a necessary step to break down the recalcitrance of cell walls and achieve an efficient separation of three main components (cellulose, hemicelluloses, and lignin).

Results
In this study, hemicelluloses and lignin in Boehmeria nivea stalks were selectively extracted with a recyclable acid hydrotrope, an aqueous solution of P-toluenesulfonic acid (p-TsOH). 79.86% of hemicelluloses and 90.24% of lignin were removed under a mild pretreatment condition, C80T80t20, (acid concentration of 80 wt%, pretreatment temperature and time of 80 °C and 20 min, respectively). After ultrasonic treatment for 10 s, the residual cellulose-rich solid was directly converted into pulp. Subsequently, the latter was utilized to produce paper via mixing with softwood pulp. The prepared handsheets with a pulp addition of 15 wt% displayed higher tear strength (8.31 mN m2/g) and tensile strength (8.03 Nm/g) than that of pure softwood pulp. What’s more, the hydrolysates of hemicelluloses and the extracted lignin were transformed to furfural and phenolic monomers with yields of 54.67% and 65.3%, respectively.

Conclusions
The lignocellulosic biomass, Boehmeria nivea stalks, were valorized to pulp, furfural, and phenolic monomers, successfully. And a potential solution of comprehensive utilization of Boehmeria nivea stalks was provided in this paper.

Graphical Abstract
HepaClear, a blood-based panel combining novel methylated CpG sites and protein markers, for the detection of early-stage hepatocellular carcinoma
Authors: Bai Yi , Xu Juan , Li Deqiang , Zhang Xiaoyu , Chen Dapeng , Xie Fucun , Huang Longmei , Yu Xiaotian , Zhao Haitao , Zhang Yamin 
Published: June 2023

Abstract
Background
Early screening and detection of hepatocellular carcinoma (HCC) can efficiently improve patient prognosis. We aimed to identify a series of hypermethylated DNA markers and develop a blood-based HCC diagnosis panel containing DNA methylation sites and protein markers with improved sensitivity for early-stage HCC detection.

Results
Overall, 850K methylation arrays were performed using paired tissue DNA samples from 60 HCC patients. Ten candidate hypermethylated CpG sites were selected for further evaluation by quantitative methylation-specific PCR with 60 pairs of tissue samples. Six methylated CpG sites, along with α-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP), were assayed in 150 plasma samples. Finally, an HCC diagnosis panel, named HepaClear, was developed in a cohort consisting of 296 plasma samples and validated in an independent cohort consisting of 198 plasma samples. The HepaClear panel, containing 3 hypermethylated CpG sites (cg14263942, cg12701184, and cg14570307) and 2 protein markers (AFP and DCP), yielded a sensitivity of 82.6% and a specificity of 96.2% in the training set and a sensitivity of 84.7% and a specificity of 92.0% in the validation set. The HepaClear panel had higher sensitivity (72.0%) for early-stage HCC than AFP (≥ 20 ng/mL, 48.0%) and DCP (≥ 40 mAU/mL, 62.0%) and detected 67.5% of AFP-negative HCC patients (AFP ≤ 20 ng/mL).

Conclusions
We developed a multimarker HCC detection panel (HepaClear) that shows high sensitivity for early-stage HCC. The HepaClear panel exhibits high potential for HCC screening and diagnosis from an at-risk population.
Fixed-point results for fuzzy generalized β-F-contraction mappings in fuzzy metric spaces and their applications
Authors: Wong Koon S. , Salleh Zabidin , Che Taib Che M. I. 
Published: June 2023

AbstractIn this paper, we introduce fuzzy generalized β-F-contractions as a generalization of fuzzy F-contractions with admissible mappings. We deduce sufficient conditions for the existence and uniqueness of fixed points for fuzzy generalized β-F-contractions in complete strong fuzzy metric spaces. Our results generalize several fixed-point results from the literature. We present an application of our main result.
Linkages between different types of globalization and socio-economic variables: panel data analysis for 129 countries
Authors: Naz Ayesha 
Published: June 2023

AbstractPresent study explores the linkages between three categories of globalization to socio-economic indicators, which include poverty, inequality, unemployment and Human Development Index (HDI) using the sample of 129 countries over the period 1990 to 2019. The results show presence of co-integration among socio-economic variables and three categories of globalization. The findings indicate that economic, political and social globalization is positively related to each other. It is worth mentioning that all the three types of globalization decreases poverty but the role of economic dimension is appeared to be insignificant. Some negative effect of globalization on inequality and unemployment is also reported by this study. The traditional link between inequality, poverty and unemployment in the presence of globalization show that these three variables are closely related to one another, deterioration in any one variable has adverse effect on other two variables. Furthermore, results of Vector Error Correction Mechanism (VECM) show that socio-economic variables not only cause each other but they also improve human welfare that is measured by HDI. Long run causality indicates that all variables cause each other as error correction term is significant.