bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Holiness of Riẓba: A Study of a Rabbinic Historiography
Authors: Yahalom Shalem 
Published: October 2023

Abstract
This study deals with the public declaration by the Tosaphist R. Yitzhak ben Abraham (Riẓba) about his inability to consummate his marriage during its first few years. Ephraim Urbach, the great mid-twentieth century Jewish historian, considered this confession to be an expression of holiness and purity and to the ability to dissociate sexuality from feelings of guilt and shame. This assessment reflects the pretensions of Judaic studies of the era to understand the characters and predilections of rabbinic figures at a remove of hundreds of years. This paper rejects Urbach’s conclusions, maintaining that the compunctions associated with nudity and sexuality are modern phenomena. In medieval Europe, men and women bathed together, and this practice was considered perfectly acceptable in both Jewish and non-Jewish circles. Likewise, the intimate lives of married couples were not private. Consequently, Riẓba’s disclosure does not attest to his being holy or pure to an unusual degree.
“How Would He Not Protest God’s Putting to Death the Righteous Child?”
Authors: Lawee Eric 
Published: October 2023

Abstract
Medieval Jewish readings of the Akedah, the Binding of Isaac, remain almost entirely oblivious to the antinomy between ethics and the revealed divine command that many modern interpretations find at the heart of the story. This study explores an exception, the teaching of the fourteenth-century rationalist, Eleazar Ashkenazi ben Nathan Ha-Bavli. In his Revealer of Secrets, Eleazar seeks a remedy for what he takes to be the theological and moral scandals that arise when the Akedah is read according to its plain sense. While Eleazar’s treatment of the Akedah builds in many ways on that of Maimonides, it also adds novel layers regarding this most difficult of biblical accounts. For this reason, the study begins with a substantial review of Maimonides’ intentionally elusive treatment of the Akedah and its reception among some representative later medieval interlocutors. Turning to its main focus, the article supplies a case study in medieval Jewish rationalism at its limits, in both matter and manner.
Unbiased image segmentation assessment toolkit for quantitative differentiation of state-of-the-art algorithms and pipelines
Authors: Goyal Vishakha , Schaub Nick J. , Voss Ty C. , Hotaling Nathan A. 
Published: October 2023

Abstract
Background
Image segmentation pipelines are commonly used in microscopy to identify cellular compartments like nucleus and cytoplasm, but there are few standards for comparing segmentation accuracy across pipelines. The process of selecting a segmentation assessment pipeline can seem daunting to researchers due to the number and variety of metrics available for evaluating segmentation quality.

Results
Here we present automated pipelines to obtain a comprehensive set of 69 metrics to evaluate segmented data and propose a selection methodology for models based on quantitative analysis, dimension reduction or unsupervised classification techniques and informed selection criteria.

Conclusion
We show that the metrics used here can often be reduced to a small number of metrics that give a more complete understanding of segmentation accuracy, with different groups of metrics providing sensitivity to different types of segmentation error. These tools are delivered as easy to use python libraries, command line tools, Common Workflow Language Tools, and as Web Image Processing Pipeline interactive plugins to ensure a wide range of users can access and use them. We also present how our evaluation methods can be used to observe the changes in segmentations across modern machine learning/deep learning workflows and use cases.
Genetic factors, adherence to healthy lifestyle behaviors, and risk of bladder cancer
Authors: He Qiangsheng , Wu Siqing , Zhou Ying , Liu Yuchen , Xia Bin , Li Wenjing , Zhao Jinyu , Mi Ningning , Xie Peng , Qin Xiwen , Yuan Jinqiu , Pan Yihang 
Published: October 2023

Abstract
Background
Genetic and lifestyle factors both contribute to the pathogenesis of bladder cancer, but the extent to which the increased genetic risk can be mitigated by adhering to a healthy lifestyle remains unclear. We aimed to investigate the association of combined lifestyle factors with bladder cancer risk within genetic risk groups.

Methods
We conducted a prospective study of 375 998 unrelated participants of European ancestry with genotype and lifestyle data and free of cancer from the UK biobank. We generated a polygenic risk score (PRS) using 16 single nucleotide polymorphisms and a healthy lifestyle score based on body weight, smoking status, physical activity, and diet. Cox models were fitted to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of genetic and lifestyle factors on bladder cancer.

Results
During a median follow-up of 11.8 years, 880 participants developed bladder cancer. Compared with those with low PRS, participants with intermediate and high PRS had a higher risk of bladder cancer (HR 1.29, 95% CI 1.07–1.56; HR 1.63, 95% CI 1.32–2.02, respectively). An optimal lifestyle was associated with an approximately 50% lower risk of bladder cancer than a poor lifestyle across all genetic strata. Participants with a high genetic risk and a poor lifestyle had 3.6-fold elevated risk of bladder cancer compared with those with a low genetic risk and an optimal lifestyle (HR 3.63, 95% CI 2.23 –5.91).

Conclusions
Adhering to a healthy lifestyle could substantially reduce the bladder cancer risk across all genetic strata, even for high-genetic risk individuals. For all populations, adopting an intermediate lifestyle is more beneficial than a poor one, and adhering to an optimal lifestyle is the ideal effective strategy for bladder cancer prevention.
A real-world analysis of trametinib in combination with hydroxychloroquine or CDK4/6 inhibitor as third- or later-line therapy in metastatic pancreatic adenocarcinoma
Authors: Tang Hui , Ge Yuping , You Tingting , Li Xiaoyuan , Wang Yingyi , Cheng Yuejuan , Bai Chunmei 
Published: October 2023

Abstract
Background
There are no standard third-line treatment options for metastatic pancreatic ductal adenocarcinoma (mPDAC). Trametinib in combination with hydroxychloroquine (HCQ) or CDK4/6 inhibitors for pancreatic adenocarcinoma showed promising efficacy in preclinical studies. However, the regimens have not been well examined in patients with mPDAC.

Methods
Patients with mPDAC who received the combination of trametinib and HCQ or CDK4/6 inhibitors as third- or later-line therapy were reviewed. The efficacy and prognosis were further analyzed.

Results
A total of 13 mPDAC patients were enrolled, of whom 8 and 5 patients were treated with trametinib plus HCQ or a CDK4/6 inhibitor (palbociclib or abemaciclib), respectively. All enrolled patients had either KRAS G12D or G12V mutations and had received a median of 3 prior lines of therapy (range, 2–6). The median trametinib treatment duration was 1.4 months. Of the 10 patients with measurable disease, only 1 patient achieved stable disease, and the remaining patients had progressive disease. Moreover, in patients treated with trametinib plus HCQ and a CDK4/6 inhibitor, the median progression-free survival was 2.0 and 2.8 months, respectively, and the median overall survival was 4.2 and 4.7 months, respectively. Moreover, 5 (50%) patients experienced grade 3–4 adverse events in 10 patients with available safety data.

Conclusions
The combination of trametinib and HCQ or CDK4/6 inhibitors may not be an effective later-line treatment for mPDAC, and the current preliminary findings need to be confirmed by other studies with larger sample sizes.
Non-meningeal, non-pulmonary cryptococcosis with limited posterior uveitis in a kidney organ transplant recipient with antibody-mediated rejection: a case report
Authors: Lu Yi-An , Lin Chun-Hsien , Chang Chia-Jen , Shu Kuo-Hsiung , Chung Mu-Chi , Chou Chien-Chih 
Published: October 2023

Abstract
Background
Cryptococcosis is one of the most frequent fungal eye infections in patients with immunosuppression. Currently, treatment approaches for non-meningeal, non-pulmonary cryptococcosis are based on those used for cryptococcal meningitis or pneumonia.

Case presentation
We present a rare case of non-meningeal, non-pulmonary cryptococcosis with clinical manifestations limited to one eye of a cadaveric kidney transplant recipient with chronic-active antibody-mediated rejection. Typical manifestations, diagnosis, and treatments, including antifungal therapies, adjunctive therapies, and immunosuppression reduction, are discussed. After timely diagnosis and treatment, her visual acuity recovered to baseline without recurrence or sequelae of cryptococcosis.

Conclusions
Clinicians should be aware of rare presentations of fungal infections, especially when a kidney transplant recipient with rejection has been treated with intensive immunosuppressants. Early diagnosis with individualized therapies may have a favorable prognosis.
The role of loneliness and learning burnout in the regulation of physical exercise on internet addiction in Chinese college students
Authors: Wang Kun , Li Yan , Yang Yi , Zhang Tingran , Luo Jiong 
Published: October 2023

Abstract
Objective
To explore the mediating effects of physical exercise on internet addiction in Chinese college students and to reveal the mediating effects of loneliness and learning burnout on physical exercise and internet addiction.

Methods
1238 Chinese college students were investigated by physical exercise scale, loneliness scale, learning burnout scale, and internet addiction scale. The SPSS 27.0 was used to conduct a correlation analysis of the data and AMOS21.0 was used to establish a structural equation model to investigate the mediation effect.

Results
Physical exercise could directly negatively predict the internet addiction of college students. Loneliness and learning burnout partially mediate the relationship between physical exercise and internet addiction, and the mediating pathways included “physical exercise-loneliness-internet addiction”, “physical exercise-learning burnout-internet addiction”, and “physical exercise-loneliness-learning burnout-internet addiction”, accounting for 9.38%, 15.63% and 21.88% of the total effect, respectively. In the chain mediation effect, it was mainly the loneliness and sub-dimensions of learning burnout (low mood, misbehavior) that were at play.

Conclusion
Physical exercise not only directly affects internet addiction of college students but also indirectly affects internet addiction through the independent mediating effect of loneliness and learning burnout and the chain mediating effect of “loneliness-learning burnout”.
Mixed-methods cross-sectional study of the prevention of vertical HIV transmission program users unaware of male partner’s HIV status, in six South African districts with a high antenatal HIV burden
Authors: Mmotsa Tshiamo M. , Magasana Vuyolwethu , Nsibande Duduzile F. , Buthelezi Mbongeleni , Dassaye Reshmi , Rodriguez Violeta J. , Jones Deborah L. , Goga Ameena E. , Ngandu Nobubelo K. 
Published: October 2023

Abstract
Background
Elimination of vertical HIV Transmission (VHT) and maternal deaths are global health priorities. Male involvement is one of the most important factors that influences women’s decisions, including the uptake of Prevention of vertical HIV transmission (P-VHT). We sought to understand not knowing a male partner’s HIV status (MPHIVs) amongst women using services to prevent vertical HIV transmission in six South African districts with high antenatal HIV burden.

Methods
A mixed-methods cross-sectional study was conducted in six South African districts, and data collected through face-to-face interviews with women and focus group discussions (FGDs) with women or male partners. The quantitative data were analyzed using STATA SE-17.0 and an inductive approach was used for qualitative data analysis.

Results
Overall, 28.7% of women were unaware of their MPHIVs, while 25.3% and 46.0% knew the MPHIVs was positive or negative, respectively. In multivariable logistic regression, single marital status and unplanned pregnancy increased the odds of not knowing a MPHIVs while a woman’s disclosure of her HIV status to the male partner reduced the odds. FDGs highlighted complexities around MPHIVs disclosure, e.g., reluctance to test for HIV and potential interventions including healthcare worker (HCW) assisted HIV disclosure.

Conclusion
User-informed interventions to address MPHIVs non-disclosure amongst women of child-bearing age, particularly those at risk of unstable sexual partners and unplanned pregnancies, should be strengthened.
Plasma 8-OHdG act as a biomarker for steroid-induced osteonecrosis of the femoral head
Authors: Peng Peng , He Mincong , Fang Weihua , Lai Mengqi , Xiao Fangjun , He Wei , Xiao Huan , Wei Qiushi 
Published: October 2023

Abstract
Background
Oxidative stress was closely related to the occurrence and development of Steroid-induced osteonecrosis of the femoral head (SIONFH). 8-hydroxy-2'-deoxyguanosine (8-OHdG) is a important index of oxidative stress. The aim of this study is to investigate the role of 8-OHdG in the development of SIONFH.

Methods
From May 2021 and November 2021, 33 patients diagnosed with SIONFH and 26 healthy controls were recruited in this study. Assessment included the radiography and pathology evaluation of clinical bone tissue, expression position and level of 8-OHdG, level of plasma 8-OHdG, as well as the receiver operating characteristic (ROC) curve.

Results
We observed that expression levels of 8-OHdG in bone samples decreased with Association Research Circulation Osseous (ARCO) stages. Plasma 8-OHdG levels were significantly increased in the SIONFH group compared to the healthy control group. Plasma 8-OHdG level of pre-collapse patients was higher than that of post-collapse patients, the decreased plasma 8-OHdG level was related to higher ARCO stages.

Conclusion
Plasma 8-OHdG may represent potential biomarkers during SIONFH at different stages. Higher plasma 8-OHdG levels indicated early stage of SIONFH. The current study provided new clues for early diagnosis and treatment for SIONFH.
Comparison of short-term and long-term clinical effects of modified overlap anastomosis and conventional incision-assisted anastomosis in laparoscopic total gastrectomy
Authors: Wu Chu-Ying , Lin Jian-An , Huang Qiao-Zhen , Xu Jian-Hua , Zhong Wen-Jin , Kang Wen-Gui , Wang Jin-Tian , Chen Jun-Xing , Zheng Hui-Da , Ye Kai 
Published: October 2023

Abstract
Background
To compare short-term and long-term clinical effects of modified overlap anastomosis and conventional incision-assisted anastomosis for laparoscopic total gastrectomy.

Methods
This retrospective cohort study included patients with gastric cancer admitted to the Second Affiliated Hospital of Fujian Medical University from January 2016 to March 2020. Quality of life, intraoperative and postoperative conditions were analyzed.

Results
Compared with the conventional assisted group, the modified overlap group showed a shorter auxiliary incision, milder postoperative pain, shorter time to the first postoperative anal exhaust, shorter time to the first postoperative liquid food intake, and shorter postoperative stay. There were no differences between the two groups regarding operation time, esophagus-jejunum anastomosis time, intraoperative blood loss, number of lymph nodes dissected, and length of the upper incision margin. There were no differences between the two groups regarding postoperative early and late complications. There were no differences between the two groups regarding the QLQ-C30 scale three years after the operation. The scores of the QLQ-STO22 scale 3 years after the operation showed significantly lower scores for dysphagia and feeding limit in the modified overlap group than those in the conventional assisted anastomosis group. There was no recurrence in the modified overlap group but one patient in the conventional assisted group.

Conclusions
Patients undergoing totally laparoscopic total gastrectomy with modified overlap anastomosis have better minimal invasiveness and faster post-operative recovery than conventional incision-assisted anastomosis.
Evaluating the effect of mechanical debridement with adjunctive antimicrobial photodynamic therapy in comparison with mechanical debridement alone on the peri-implant parameters in type 2 diabetic mellitus patients with peri-implantitis: a systematic review and meta-analysis
Authors: Afrasiabi Shima , Heidari Mohadeseh , Younespour Shima , Chiniforush Nasim 
Published: October 2023

Abstract
Background
Type 2 diabetes mellitus (T2DM) is a major risk factor for localized diseases such as peri-implantitis that may affect ideal implant treatment. This study was aimed to evaluate the effect of mechanical debridement (MD) + antimicrobial photodynamic therapy (a-PDT) in patients with peri-implantitis who have T2DM in terms of bleeding on probing (BOP) and probing depth (PD) as primary outcomes and plaque index (PI) and crestal bone loss (CBL) as secondary outcomes.

Methods
Publications compared outcomes between MD + aPDT and MD alone in T2DM patients with peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. Literature until July 2023 using MEDLINE (through PubMed), Scopus, Cochrane Library, Embase, Web of Science, and Google Scholar were collected.

Results
Two randomized controlled trials (RCTs, 88 individuals) and one controlled clinical trial (CCT, 67 individuals) with follow-up periods ranged from 3 to 12 months were recruited. All studies used diode laser with wavelengths ranged from 660 to 810 nm. The results demonstrated that the MD + aPDT group showed significant benefits for BOP reduction after 6 months (SMD = -2.15, 95% CI: -3.78 to -0.51, p = 0.01). However, a great amount of heterogeneity was observed (I2 = 91.52%, p < 0.001). Moreover, there was a significant difference between MD + aPDT and MD alone groups in CBL (SMD = -0.69, 95% CI: -1.07 to -0.30, p < 0.001). In addition, homogeneity assumption was satisfied (I2 = 22.49%, p = 0.28). Significant differences in PD and PI reduction were not found except for PI reduction after 3 months (SMD = -0.79, 95% CI: -1.24 to -0.33, p < 0.001. Also, no heterogeneity was observed (I2 = 0.00%, p = 0.47).

Conclusion
Given that high heterogeneity in BOP and PD outcome was found in this systematic review, future long-term CTs with MD + aPDT should be examined to arrive at a firm conclusion.
Prevalence and factors associated with child marriage, a systematic review
Authors: Pourtaheri Asma , Sany Seyedeh Belin Tavakoly , Aghaee Monavvar Afzal , Ahangari Hamideh , Peyman Nooshin 
Published: October 2023

Abstract
Background
Girl child marriage is increasingly recognized as a critical barrier to global public health and gender discrimination. There are still more gaps in the global rate of child marriage and the underlying factors. Thus, the present systematic review aimed to explore the prevalence of child marriage and the underlying factors.

Methods
A comprehensive search was conducted for all English-language studies that measured the prevalence of child marriage and its correlates from 2000 to March 2022, indexed in PubMed, Scopus, Web of Science, Poplin, and Google Scholar databases. Child marriage is defined as marriage under the age of 18. In the present study, Joanna Briggs' quality assessment checklist was used for data collection. Two independent reviewers reviewed all the articles.

Results
In total, 34 eligible prevalence articles and 14 trend articles were included in the study with data from 127,945 participants. The prevalence of child marriage ranged between 1.8% to 90.85%. In most studies, the trend of child marriage was decreasing. The most important individual factors include the respondent's education and occupation, interpersonal factors such as the education and occupation of parents and husband, family size and type. Community factors include socioeconomic status, region, residence, ethnicity, and religion at the social level.

Conclusion
Despite a central focus of research and policies on interventions that decrease child marriage, this phenomenon is still prevalent in many places. Therefore, further specific interventions are required to improve education, reduce poverty and inequality. This may help achieve the 2030 Sustainable Development Goals.
An ex vivo model for education and training of unilateral cleft lip surgery
Authors: Lutz Rainer , Schulz Katja Leonie , Weber Manuel , Olmos Manuel , Möst Tobias , Bürstner Jan , Kesting Marco Rainer 
Published: October 2023

Abstract
Background
Unilateral cleft lip surgery is a complex procedure, and the outcome depends highly on the surgeon’s experience. Digital simulations and low-fidelity models seem inadequate for effective surgical education and training. There are only few realistic models for haptic simulation of cleft surgery, which are all based on synthetic materials that are costly and complex to produce. Hence, they are not fully available to train and educate surgical trainees. This study aims to develop an inexpensive, widely available, high-fidelity, ex vivo model of a unilateral cleft lip using a porcine snout disc.

Methods
A foil template was manufactured combining anatomical landmarks of the porcine snout disc and the anatomical situation of a child with a unilateral cleft. This template was used to create an ex vivo model of a unilateral cleft lip from the snout disc. Millard II technique was applied on the model to proof its suitability. The individual steps of the surgical cleft closure were photo-documented and three-dimensional scans of the model were analysed digitally. Sixteen surgical trainees were instructed to create a unilateral cleft model and perform a unilateral lip plasty. Their self-assessment was evaluated by means of a questionnaire.

Results
The porcine snout disc proved highly suitable to serve as a simulation model for unilateral cleft lip surgery. Millard II technique was successfully performed as we were able to perform all steps of unilateral cleft surgery, including muscle suturing. The developed foil-template is reusable on any porcine snout disc. The creation of the ex vivo model is simple and inexpensive. Self-assessment of the participants showed a strong increase in comprehension and an eagerness to use the model for surgical training.

Conclusions
A porcine snout disc ex vivo model of unilateral cleft lips was developed successfully. It shows many advantages, including a haptic close to human tissue, multiple layers, low cost, and wide and rapid availability. It is therefore very suitable for teaching and training beginners in cleft surgery and subsequently improving surgical skills and knowledge. Further research is needed to finally assess the ex vivo model’s value in different stages of the curriculum of surgical residency.