bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in childhood cancer: Incidence and survival analysis over 45 years of SEER data
Authors: Sultan Iyad , Alfaar Ahmad S. , Sultan Yaseen , Salman Zeena , Qaddoumi Ibrahim 
Published: January 2025

Background
The SEER Registry contains U.S. cancer statistics. To assess trends in incidence and survival and the impact of demographic factors among pediatric patients with cancer, we assessed nearly 5 decades (1975–2019) of data.

Methods
All patients below the age of 20 with histology-confirmed malignancy were studied. Kaplan-Meier survival curves were generated to evaluate survival trends across treatment periods and ICCC classes. JoinPoint analysis was conducted to identify changes in incidence and survival.

Results
The incidence of childhood cancer increased from 14.23 cases per 100,000 children in 1975–1979 to 18.89 in 2010–2019, with an average annual percent change of 0.73. This rise was more pronounced in several cancers, including leukemias, lymphomas, brain tumors, hepatic tumors, and gonadal germ cell tumors. Age-adjusted cancer mortality decreased from 4.9 to 2.3 per 100,000. Cancer-related mortality was consistently higher in boys than in girls, and in Black children than in White children. Survival significantly improved, with 5- and 10-year survival rates rising from 63.1% to 85.2% and from 58.8% to 82.7%, respectively. Leukemias showed a substantial increase in 5-year survival from 48.2% ± 1.7% to 85.1% ± 0.4% in 2010–2019. Lymphomas also showed significant improvement, with survival increasing from 72.9% ± 1.7% to 94.2% ± 0.3%. Despite these improvements, the survival of CNS tumors, bone tumors, and sarcomas remained suboptimal, with 5-year survival estimates of approximately 60%. Our joinpoint analysis confirmed our findings but revealed an interesting increase in the incidence of lymphomas limited to the years between 2005 and 2014.

Conclusion
This research elucidates advancements in survival among pediatric patients with cancer. The results offer critical perspectives on pediatric oncology, highlighting the imperative for ongoing innovation in therapeutics. Although the increase in incidence may partially stem from enhanced diagnostic capabilities and more comprehensive registration processes, the underlying causes remain unclear.
Networks of care for optimizing Primary Health Care Service Delivery in Ethiopia: Enhancing relational linkages and care coordination
Authors: Tiruneh Gizachew Tadele , Fesseha Nebreed , Ayehu Temesgen , Chitashvili Tamar , Argaw Mesele Damte , Shiferaw Biruhtesfa Bekele , Teferi Mikias , Semahegn Agumasie , Bogale Biruk , Kifle Yibeltal , Tadesse Hillina , Tesfaye Chala , Emaway Dessalew 
Published: January 2025

Introduction
Ethiopia has made notable progress in reducing maternal and perinatal mortality, yet challenges remain in meeting the 2030 Sustainable Development Goals. Persistent issues such as low service utilization, coupled with poor quality, fragmented care, and ineffective referral systems hinder progress. The "Improve Primary Health Care Service Delivery (IPHCSD)" project, implemented by JSI and Amref Health Africa since April 2022, seeks to address these gaps through a Networks of Care (NoCs) approach. This paper describes the lessons learned from implementing the NoCs approach to optimize primary health care in Ethiopia.

Methods
The project incorporates embedded implementation science, guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Key implementation strategies co-designed included strengthening community engagement, establishing NoCs, and introducing quality improvement initiatives using the Model for Improvement. Routine program monitoring data, NoCs process evaluation, and facility service statistics were utilized for this study. Service statistics were analyzed using Student’s t-test and interrupted time-series analysis to compare maternal and child care outcomes before and after the NoCs intervention, with counterfactual estimates generated to assess the intervention’s impact. Qualitative data from key informant interviews were transcribed, coded, and analyzed to identify themes and patterns using Atlas.ti.

Results
The NoCs approach has significantly enhanced relational linkages between primary health care facilities and health care providers, fostering stronger collaboration and communication. This has fostered trust, improved care coordination, optimized primary health care performance, and increased health service utilization within woreda health systems. The interrupted time series analysis indicated that the rate of ANC 8+ visits was 29.8% per month higher than expected without the NoCs strategy (Coef: 2.39; p-value < 0.01) and an 18.4% increase in obstetric complications managed (Coef: 1.71; p-value = 0.050), with a 43% overall increase. Perinatal mortality decreased by 34%, from 31.3 to 20.1 per 1,000 births [t-test: 2.12; p-value: 0.040)].

Conclusion
The NoCs approach in Ethiopia has proven effective in enhancing the relational elements, care coordination, and quality of primary health care services, leading to better maternal and child health outcomes. The findings expand the existing body of research on NoCs implementation best practices and further confirm that it provides a scalable model for strengthening health services in low-resource settings.
Relationship between oxidative balance indicators and Chronic Kidney Disease
Authors: Chen Xinyun , Shi Fangyu , Yu Wenhui , Gao Chang , Gou Shenju , Fu Ping 
Published: January 2025

Introduction
Chronic Kidney Disease (CKD) is a growing global health issue, affecting approximately 9.1% of the world’s population. Oxidative stress is believed to play a key role in CKD development, with indicators such as the Oxidative Balance Score (OBS), Pro-Oxidant-Antioxidant Balance (PAB), and Total Antioxidant Capacity (TAC) being of particular interest. However, their association with CKD remains unclear.

Methods
This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2018. A total of 18,951 participants were included after applying specific inclusion criteria. Logistic regression models and restricted cubic spline regression were employed to examine the associations between these oxidative balance indicators and CKD. Subgroup and interaction analyses were also conducted for further data analyses. Finally, ROC curve analysis was used to assess the predictive performance of these indicators for CKD risk.

Results
After adjusting for various confounding factors, higher levels of OBS and PAB were significantly associated with a reduced risk of CKD (OR = 0.97, 95% CI: 0.96–0.99, P < 0.001; OR = 0.94, 95% CI: 0.92–0.97, P < 0.001, respectively). The ORs for the highest quartiles of OBS and PAB were 0.60 (95% CI: 0.49–0.75, P < 0.001) and 0.77 (95% CI: 0.63–0.94, P = 0.013), respectively. In contrast, TAC showed no significant association with CKD. ROC curve analysis further indicated that OBS had a superior predictive ability for CKD risk (AUC = 0.579) compared to PAB (AUC = 0.519) and TAC (AUC = 0.492).

Conclusion
The study suggests that oxidative balance indicators, particularly OBS and PAB, are inversely associated with CKD risk, while TAC showed no significant link. OBS demonstrated the strongest predictive ability among the indicators. These findings highlight the potential role of oxidative balance in CKD prevention. Further research is needed to confirm these associations in diverse populations and to explore the underlying mechanisms.
Age-related disparities in national maternal mortality trends: A population-based study
Authors: Huang Ryan S. , Spence Andrea R. , Abenhaim Haim A. 
Published: January 2025

Objective
An upward trend in maternal age has been observed in the United States (US) over the last twenty years. The study objective was to examine the association of maternal age with maternal mortality in the US and examine temporal trends in mortality by maternal age.

Methods
A retrospective population-based analysis in the US between 2000–2019 was conducted using records from the Centers for Disease Control and Prevention’s “Mortality Multiple Cause” and “Birth Data” files. Annual incidence and period trends in maternal deaths were calculated using the annual maternal deaths over annual live births across age groups. Multivariate logistic regression models were used to estimate the association between maternal age and risk of maternal mortality and calculate temporal changes in risk of mortality over the study period.

Results
Between 2000–2019, 21,241 deaths were observed in women during pregnancy and childbirth for an average incidence of 26.3 maternal deaths/100,000 births (95% CI 21.8–31.2). Of all deaths, 6,870 (32.3%) were in women ≥35 years, while only 15.1% of live births were attributed to women ≥35 years. Compared with women 25–29 years of age, there was a significantly greater risk of maternal mortality among women 35–39 (OR 1.60, 1.53–1.67), 40–44 (3.78, 3.60–3.99), 45–49 (28.49, 26.49–30.65) and 50–54 (343.50, 319.44–369.37). Risk of mortality increased over time, with the greatest rise in women ≥35 years.

Conclusion
In the US, maternal mortality increased during the past two decades, especially in women ≥35 years. Given these findings, targeted strategies to reduce the increasing maternal mortality should become a priority.
How the nursing work environment moderates the relationship between clinical judgment and person-centered care among intensive care unit nurses
Authors: Seo Mi Hwa , Kim Eun A. , Kim Hae Ran 
Published: January 2025

Background
Person-centered care focuses on individualized care that respects patients’ values, preferences, and autonomy. To enhance the quality of critical care nursing, institutions need to identify the factors influencing ICU nurses’ ability to provide person-centered care. This study explored the relationship between clinical judgment ability and person-centered care among intensive care unit (ICU) nurses, emphasizing how the ICU nursing work environment moderates this relation.

Methods
A cross-sectional survey was conducted between September 4 and September 18, 2023, with 192 ICU nurses recruited from four general hospitals with a convenience sample (valid response rate = 97.4%). Participants completed online self-report structured questionnaires. The collected data were analyzed using hierarchical multiple regression and PROCESS macro Model 1, with a 95% bias-corrected bootstrap confidence interval to verify moderating effects.

Results
Clinical judgment ability (β = .24, p < .001) and ICU nursing work environment (β = .50 p < .001) were found to be significant predictors of person-centered care. These two predictors explained the 47.0% of person-centered care in the final hierarchical regression model. Additionally, Clinical judgment (B = 0.28, p < .001, Boot. 95%CI = 0.13~0.42) and the ICU nursing work environment (B = 0.41, p < .001, Boot. 95%CI = 0.30~0.52) positively affected person-centered care, and the interaction term of clinical judgment and ICU nursing work environment (B = 0.16, p = .026, Boot. 95%CI = 0.02~0.30) also positively affected person-centered care. The moderating effect was particularly significant when the ICU nursing work environment score was 2.90 points (below 14.6%, above 85.4%) or higher on a scale of 1–5 and As the ICU nursing work environment score increased, the positive moderating effect also increased.

Conclusions
The ICU nurses’ clinical judgment ability positively affected person-centered care, and the nursing work environment moderated the relationship between clinical judgment ability and person-centered care. Therefore, strategies for enhancing person-centered care among ICU nurses should focus on developing educational programs to improve clinical judgment ability and implementing comprehensive efforts to effectively improve and manage the nursing work environment.
Gender disparities in application and admission to the medical residency program in Peru: A cross sectional study from 2016 to 2023
Authors: Medina-Neira Daniel , Caira-Chuquineyra Brenda , Fernandez-Guzman Daniel 
Published: January 2025

Objective
To investigate gender disparities in applications and admissions to the medical residency programs in Peru, focusing on differences in application and admission proportions between male and female.

Methods
We conducted a cross-sectional study to assess the proportions of female applicants and admissions to medical residency programs in Peru from 2016 to 2023. Bayesian multilevel linear models were employed, incorporating random intercepts and slopes by specialty to account for variability across specialties. This approach provided initial proportions of female in 2016 (intercepts) and annual percentage changes (beta coefficients) for each specialty. A multilevel Poisson regression model with robust variance was used to determine if being female was associated with higher admission frequency.

Results
Of the 48,013 applicants, 48% were considered female applicants. Most specialties exhibited an increasing trend in female applicants (+0.2% to +2% annually), except for Family Medicine, Hematology, Pediatric Neurology, and Pathological Anatomy (-0.6%, -0.6%, -0.7%, and -0.9% annually, respectively). The specialties with the highest proportions of female admissions were in Physical Medicine and Rehabilitation (71.9%), Dermatology (71.2%), and Pathological Anatomy (71.2%). In contrast, the lowest proportions were observed in Neurosurgery (18.9%), Thoracic and Cardiovascular Surgery (17.7%), and Urology (15.6%). Declining trends in female admissions were noted in Family Medicine, Hematology, and Pathological Anatomy (-0.6%, -0.6%, and -0.8% annually, respectively). In addition, being female was associated with an 18% lower probability of admission to the medical residency program (prevalence ratio: 0.82; 95% CI: 0.78–0.85; p-value: <0.001).

Conclusion
This study identified persistent gender disparities in medical residency programs in Peru, with female applicants facing reduced probabilities of admission and exhibiting specialty-specific trends from 2016 to 2023.
Virtual learning due to covid-19 pandemic and body weight changes in children aged 6-12 years
Authors: Aulia Nadhira Haliza , Santoso Andintia Aisyah , Ramadhanty Mutiara , Wirawan Bintang , Soesanti Frida 
Published: January 2025

Background The COVID-19 pandemic has led to school closures and virtual learning implementation. The situation has affected children's lifestyles and created an obesogenic environment.
Objective To evaluate the impact of virtual learning during the pandemic on body weight changes in children.
Methods This cross-sectional study was conducted on 6-12 years age children who experienced virtual school learning in Jakarta, Indonesia. Parents or guardians were asked to complete an online questionnaire about lifestyle changes and children's anthropometric data both before and during the virtual learning period. Changes in the weight-for-age Z-score (WAZ) and BMI Z-score (BMIZ) were analyzed using the Wilcoxon signed-rank test.
Results A total of 206 children were assessed. There was a significant relation between virtual learning due to the COVID-19 pandemic and WAZ and BMIZ changes among children aged 6-12 years. Approximately 64% of the children experienced WAZ decrement (P value = 0.000), and 77.1% experienced BMIZ decrement (P value = 0.000).
Conclusion This study do not align with existing studies' indicating that the pandemic lead to weight gain in children. Instead, the results shows that virtual learning period causes both WAZ and BMIZ to decrease.
Hearing exotic smooth structures
Authors: Cavenaghi Leonardo F. , do Ó João Marcos , Sperança Llohann D. 
Published: January 2025

Abstract
This paper explores the existence and properties of basic eigenvalues and eigenfunctions associated with the Riemannian Laplacian on closed, connected Riemannian manifolds featuring an effective isometric action by a compact Lie group. Our primary focus is on investigating the potential existence of homeomorphic yet not diffeomorphic smooth manifolds that can accommodate invariant metrics sharing common basic spectra. We establish the occurrence of such scenarios for specific homotopy spheres and connected sums. Moreover, the developed theory demonstrates that the ring of invariant admissible scalar curvature functions fails to recover the smooth structure in many examples. We show the existence of homotopy spheres with identical rings of invariant scalar curvature functions, irrespective of the underlying smooth structure.
Supplier selection models using fuzzy hybrid methods in the clothing textile industry
Authors: Lahdhiri Mourad , Jmali Mohamed , Babay Amel , Ahlaqqach Mustapha , Hlyal Mustapha 
Published: January 2025

Abstract
Application of models for supplier assessment and selection in the clothing industry remains relatively underexplored. To fill this gap, this research study introduces the following fuzzy hybrid models for evaluating and selecting suppliers for clothing manufacturing firms: fuzzy set theory, Analytic Hierarchy Process method–fuzzy-Technique for Order of Preference by Similarity to Ideal Solution (AHP–fuzzy-TOPSIS), AHP–fuzzy-Weighted Sum Model (WSM), and AHP–fuzzy-Weighted Product Mean (WPM). Criteria weights were established utilizing these models, which were applied to identify the optimal supplier. A practical study was conducted within a clothing firm to evaluate the effectiveness of these fuzzy hybrid models. The main results reveal that the AHP–fuzzy-TOPSIS model outperforms the AHP–fuzzy-WSM and AHP–fuzzy-WPM models in selecting the optimal alternative. Indeed, this approach has the potential to be adapted to different industrial sectors, considering the specific criteria and conditions that govern their supplying processes.
Behind the scenes of EQA – characteristics, capabilities, benefits and assets of external quality assessment (EQA)
Authors: Buchta Christoph , De la Salle Barbara , Marrington Rachel , Aburto Almonacid Andrés , Albarède Stéphanie , Badrick Tony , Bullock David , Cobbaert Christa M. , Coucke Wim , Delatour Vincent , Faria Ana Paula , Geilenkeuser Wolf-Jochen , Griesmacher Andrea , Huggett Jim F. , Ianovska Viktoriia , Kammel Martin , Kessler Anja , Körmöczi Günther F. , Meijer Piet , Miranda Armandina , Patel Dina , Pezzati Paola , Sandberg Sverre , Schennach Harald , Schweiger Christian R. , Schwenoha Karin , Spannagl Michael , Sung Heungsup , Thelen Marc , Weykamp Cas , Zeichhardt Heinz , Restelli Veronica , Perrone Lucy A. 
Published: January 2025

Abstract
External quality assessment (EQA) enhances patient safety through the evaluation of the quality of laboratory-based and point of care testing. Regulatory agencies and accreditation organizations utilize the results and the laboratory’s response to them as part of assessing the laboratory’s fitness to practice. In addition, where EQA samples are commutable and the assigned value has been determined using reference measurement procedures (RMPs), EQA data contributes to the verification of metrological traceability of assays as part of the post-market surveillance of in vitro diagnostic (IVD) medical devices (IVD-MDs). More broadly, the scientific and medical communities use EQA data to demonstrate that medical laboratory examination procedures are fit for clinical purposes, to evaluate common reference intervals, and inclusion of data in clinical databases. Scientific groups, the IVD industry, reference laboratories and National Metrology Institutes can work with EQA providers to identify measurands, which should urgently be supported by the development of reference materials or methods. The ability of health systems to respond effectively to fast-evolving medical challenges, such as the Coronavirus Disease-19 (COVID-19) pandemic, is reliant on EQA to demonstrate confidence in the performance of new laboratory methods and testing services. EQA providers are uniquely positioned to assess the performance of IVD-MDs in addition to individual laboratories and testing sites. Although the primary focus of EQA providers remains the improvement of the performance of individual laboratories, there are many stakeholders who benefit from EQA performance data.
Efficient ecological function optimization for endoreversible Carnot heat pumps
Authors: Su Yiwen , Chen Lingen , Ge Yanlin , Feng Huijun 
Published: January 2025

Abstract
According to the definition of exergy-based efficient ecological-function (EBEEF) which is proposed as product of exergy-based ecological-function (EF) and coefficient of performance (COP) in previous literature, this paper applies the EBEEF to analyze and optimize performance of endoreversible Carnot heat-pumps (ECHPs). Via the ECHP cycle model established in previous literature, EBEEF expression for ECHP cycle model is deduced, relationships among the EBEEF and heating load (HTL) and COP are researched, and performance comparison for ECHP cycle working at the maximum EBEEF and the maximum EF conditions are performed. Results show that relationships among the EBEEF and the HTL and COP are parabolic like ones and the design points of the larger COP and HTL should be selected for designing heat pumps. When the maximum EBEEF is taken as primary objective, the optimized ECHP cycle can improve its COP and reduce its entropy-generation-rate by sacrificing a small amount of its HTL. The EBEEF not only considers the trade-off between the HTL and entropy-generation-rate, but also considers the trade-off between HTL and COP.
Metacavities by harnessing the linear-crossing metamaterials
Authors: Wu Jiaju , Guo Zhiwei , Qi Xin , Wei Qian , He Li , Fang Kai , Sun Yong , Li Yunhui , Chen Yuguang , Jiang Haitao , Chen Hong 
Published: January 2025

Abstract
The formed optical cavity mode intensively relies on the size and geometry of optical cavity. When the defect or impurity exists inside the cavity, the formed cavity mode will be destroyed. Here, we propose a metacavity consisting of arrays of linear-crossing metamaterials (LCMMs) with abnormal dispersion, where each LCMM offers both the directional propagation channel for all incident angles and the negative refraction across its neighboring LCMMs. Such metacavity can be efficiently excited by a point source, where the excited wave vector components propagate along the same optical path in the cavity. More importantly, the proposed metacavity possesses the remarkable feature of partial defect immunity and geometry robustness. Assisted by two-dimensional transmission lines with loaded-circuit elements, a metacavity with partial defect immunity has been experimentally realized. Our work offers a new avenue for designing optical resonators excited by the point source in integrated photonics, which is very useful for high-efficiency filters, ultrasensitive sensors, and enhancement of light–matter interactions.