bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient delay and associated factors among tuberculosis patients in Gamo zone public health facilities, Southern Ethiopia: An institution-based cross-sectional study
Authors: Arja Asrat , Godana Wanzahun , Hassen Hadiya , Bogale Biruk 
Published: July 2021

Background
Delayed tuberculosis diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment are essential for effective TB control. Therefore, the main objective of this study was to assess the magnitude and factors associated with patient delay among tuberculosis patients in Gamo Zone, Southern Ethiopia.

Methods
A cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities of the study area were selected randomly and 255 TB patients who were ≥18 years of age were included. Data were collected using a questionnaire through face-to-face interviews and analyzed using SPSS version 20.0. Patient delay was analyzed using the median as the cut-off value. Multivariable logistic regression analysis was fitted to identify factors associated with patient delay. A p-value of ≤ 0.05 with 95% CI was considered to declare a statistically significant association.

Results
The median (inter-quartile range) of the patient delay was 30 (15–60) days. About 56.9% of patients had prolonged patients’ delay. Patient whose first contact were informal provider (adjusted odds ratio [AOR]: 2.24; 95% confidence interval [CI] 1.29, 3.86), presenting with weight loss (AOR: 2.53; 95%CI: 1.35, 4.74) and fatigue (AOR: 2.38; 95%CI: 1.36, 4.17) and body mass index (BMI) categories of underweight (AOR: 1.74; 95%CI: 1.01, 3.00) were independently associated with increased odds of patient delay. However, having good knowledge about TB (AOR: 0.44; 95% CI: 0.26, 0.76) significantly reduce patients’ delay.

Conclusion
In this study, a significant proportion of patients experienced more than the acceptable level for the patient delay. Knowledge about TB, the first action to illness, presenting symptoms, and BMI status were identified factors associated with patient delay. Hence, raising public awareness, regular training, and re-training of private and public healthcare providers, involving informal providers, and maintenance of a high index of suspicion for tuberculosis in the vulnerable population could reduce long delays in the management of TB.
Intergenerational educational mobility in Bangladesh
Authors: Huq Mohammed Nazmul , Hossain Moyazzem , Abdulla Faruq , Yeasmin Sabina 
Published: July 2021

Introduction
Social mobility is considered as an important indicator of the economic development of a country. However, it varies widely across geographical regions and social groups in developing countries like Bangladesh. This paper intends to evaluate the intergenerational mobility in Bangladesh across generations.

Methods and materials
This paper considers a nationally representative sample survey of 8,403 respondents (rural: 5,436 and urban: 2,967). The male and female respondents aged 23 years and above were included in the sample. The education attainment of a son or daughter as compared to their father’s education level was considered as the measure of intergenerational mobility. Transition probability matrix and different social mobility indices were used to find out the intergenerational education mobility in Bangladesh.

Results
The findings reveal that approximately three-fourth (74.5%) of the respondents attained formal education, while more than half (58.3%) of the respondents’ father was illiterate. The educational status of the respondents and their father who lived in urban areas was relatively better than who lived in rural areas. It is also observed that 91.2% and 81.6% of the intergenerational class movement was upward among sons and daughters respectively. The probability of a higher educated father will have a higher educated child is higher in urban areas than in rural areas of Bangladesh. The intergenerational mobility is higher in the primary, secondary, and higher secondary educational levels, though the illiterate and higher education levels are the least mobile classes. In addition, the limiting probabilities reveal that the chance of sending sons to schools by an illiterate father is less as compared to their daughters. Such difference is more obvious in the urban areas, i.e., it is highly likely that sons of the illiterate father are also illiterate.

Conclusion
Bangladesh has been progressing remarkably in recent years. To keep the pace of the ongoing economic development in the country, it is necessary to give more attention to the illiterate people especially the girls who live in rural areas. The authors anticipate that the findings will be helpful for the policymakers as the relationship between inequality and intergenerational mobility is vital for several aspects of the economic development of a country.
Description and analysis of representative COVID-19 cases–A retrospective cohort study
Authors: Herrmann Yannis , Starck Tim , Brindl Niall , Kitchen Philip J. , Rädeker Lukas , Sebastian Jakob , Köppel Lisa , Tobian Frank , Souares Aurélia , Mihaljevic André L. , Merle Uta , Hippchen Theresa , Herth Felix , Knorr Britta , Welker Andreas , Denkinger Claudia M. 
Published: July 2021

Background
Most data on COVID-19 was collected in hospitalized cases. Much less is known about the spectrum of disease in entire populations. In this study, we examine a representative cohort of primarily symptomatic cases in an administrative district in Southern Germany.

Methods
We contacted all confirmed SARS-CoV-2 cases in the administrative district. Consenting participants answered a retrospective survey either via a telephone, electronically or via mail. Clinical and sociodemographic features were compared between hospitalized and non-hospitalized patients. Additionally, we assessed potential risk factors for hospitalization and time to hospitalization in a series of regression models.

Results
We included 897 participants in our study, 69% out of 1,305 total cases in the district with a mean age of 47 years (range 2–97), 51% of which were female and 47% had a pre-existing illness. The percentage of asymptomatic, mild, moderate (leading to hospital admission) and critical illness (requiring mechanical ventilation) was 54 patients (6%), 713 (79%), 97 (11%) and 16 (2%), respectively. Seventeen patients (2%) died. The most prevalent symptoms were fatigue (65%), cough (62%) and dysgeusia (60%). The risk factors for hospitalization included older age (OR 1.05 per year increase; 95% CI 1.04–1.07) preexisting lung conditions (OR 3.09; 95% CI 1.62–5.88). Female sex was a protective factor (OR 0.51; 95% CI 0.33–0.77).

Conclusion
This representative analysis of primarily symptomatic COVID-19 cases confirms age, male sex and preexisting lung conditions but not cardiovascular disease as risk factors for severe illness. Almost 80% of infection take a mild course, whereas 13% of patients suffer moderate to severe illness.

Trial registration
German Clinical Trials Register, DRKS00022926. URL: https://www.drks.de/drks_web/setLocale_EN.do
The Production of Compost from Organic Wastes using Bioactivators and Its Application to Celery (Apium graveolens L.) Plant
Authors: Indrayani Sri , Nuriyanah Nuriyanah , Nurjanah Lisyeu , Wibowo Heru , Priadi Dody 
Published: July 2021

Dilakukan pembuatan pupuk kompos dari limbah Jerami padi sawah percobaan dan seresah daun tanaman buah-buahan kebun plasma nutfah Cibinong Science Center-Botanic Garden (CSC-BG) LIPI menggunakan bioaktivator StarTmik@OK dan Tricho Plus (LIPI) dan Promi (produk komersial). Kompos yang dihasilkan diaplikasikan kepada tanaman seledri (Apium graveolens L.) di rumah kasa (screenhouse) Puslit Bioteknologi-LIPI Cibinong, Kabupaten Bogor, Jawa Barat. Parameter pertumbuhan yang diamati adalah tinggi tanaman, jumlah petiol daun, dan biomassa. Penelitian disusun berdasarkan Rancangan Acak Lengkap (RAL) dengan tiga ulangan. Data hasil penelitian dianalisis secara statistik menggunakan SPSS ver. 24 dilanjutkan dengan uji jarak berganda Duncan (DMRT). Hasil menunjukkan bahwa secara umum kompos yang berasal dari jerami padi dengan menggunakan berbagai bioaktivator menghasilkan nilai rataan pertumbuhan tertinggi yaitu tinggi tanaman (35,7 cm), jumlah petiol (23,7), dan biomassa (42,3 g) dibandingkan dengan kompos yang menggunakan bahan lainnya. Penggunaan pupuk kimia masih diperlukan untuk meningkatkan pertumbuhan tanaman seledri.Abstract The organic waste of rice straw from the experimental paddy field and broadleaf litter from the fruit germplasm garden of Cibinong Science Center-Botanic Garden (CSC-BG) was processed into compost with the addition of bioactivators. The bioactivator of StarTmik@OK and Tricho Plus (LIPI) and Promi (commercial product) was added to the composting raw materials. Produced compost was then applied to celery (Apium graveolens L.) plants in the screenhouse of RD Center for Biotechnology-LIPI. The growth parameters observed were plant height, leaf petiole, and biomass. The experiment was arranged in a Completely Randomized Design (CRD) with three replications. Obtained data were statistically analyzed using SPSS ver.24, followed by Duncan’s multiple range tests (DMRT). The result showed that the highest growth rates, i.e., plant height (35.7 cm), number of petiol (23.7), dan biomass (42.3 g), were obtained by using rice straw compost using various bioactivators. Meanwhile, chemical fertilizer is still needed to increase the growth of celery plants.
Assessment of RCS-specific SNR and Loglikelihood Function in Detecting Low-observable Targets and Drones Illuminated by a Low Probability of Intercept Radar Operating in Littoral Regions
Authors: Neelakanta Perambur , Groff Dolores De 
Published: July 2021

The objective of this study is to deduce signal-to-noise ratio (SNR) based loglikelihood function involved in detecting low-observable targets (LoTs) including drones Illuminated by a low probability of intercept (LPI) radar operating in littoral regions. Detecting obscure targets and drones and tracking them in near-shore ambient require ascertaining signal-related track-scores determined as a function of radar cross section (RCS) of the target. The stochastic aspects of the RCS depend on non-kinetic features of radar echoes due to target-specific (geometry and material) characteristics; as well as, the associated radar signals signify randomly-implied, kinetic signatures inasmuch as, the spatial aspects of the targets fluctuate significantly as a result of random aspect-angle variations caused by self-maneuvering and/or by remote manipulations (as in drones). Hence, the resulting mean RCS value would decide the SNR and loglikelihood ratio (LR) of radar signals gathered from the echoes and relevant track-scores decide the performance capabilities of the radar. A specific study proposed here thereof refers to developing computationally- tractable algorithm(s) towards detecting and tracking hostile LoTs and/or drones flying at low altitudes over the sea (at a given range, R) in littoral regions by an LPI radar. Estimation of relevant detection-theoretic parameters and decide track-scores in terms of maximum likelihood (ML) estimates are presented and discussed.
Oscillatory bifurcation problems for ODEs with logarithmic nonlinearity
Authors: Shibata Tetsutaro 
Published: July 2021

Abstract
We study the global structure of the oscillatory perturbed bifurcation problem which comes from the stationary logarithmic Schrödinger equation

−

u

″

(

t

)

=
λ

(

log

(

1
+
u

(

t

)

)

+
sin
u

(

t

)

)

,

u

(

t

)

>
0
,

t
∈
I
≔

(

−
1
,
1

)

,

u

(

±
1

)

=
0
,

-{u}^{^{\prime\prime} }\left(t)=\lambda (\log \left(1+u\left(t))+\sin u\left(t)),\hspace{1.0em}u\left(t)\gt 0,\hspace{1.0em}t\in I:= \left(-1,1),\hspace{1.0em}u\left(\pm 1)=0,

where

λ
>
0

\lambda \gt 0

is a parameter. It is known that

λ

\lambda

is a continuous function of

α
>
0

\alpha \gt 0

, written as

λ

(

α

)

\lambda \left(\alpha )

, where

α

\alpha

is the maximum norm

α
=
‖

u

λ

‖

∞

\alpha =\Vert {u}_{\lambda }{\Vert }_{\infty }

of the solution

u

λ

{u}_{\lambda }

associated with

λ

\lambda

. In the field of bifurcation theory, the study of global structures of bifurcation curves is one of the main subjects of research, and it is important to investigate the influence of the oscillatory term on the global structure of bifurcation curve. Due to the effect of

sin
u

\sin u

, it is reasonable to expect that an oscillatory term appears in the second term of the asymptotic formula for

λ

(

α

)

\lambda \left(\alpha )

as

α
→
∞

\alpha \to \infty

(cf. [1]). Contrary to expectation, we show that the asymptotic formula for

λ

(

α

)

\sqrt{\lambda \left(\alpha )}

as

α
→
∞

\alpha \to \infty

does not contain oscillatory terms by the third term of

λ

(

α

)

\sqrt{\lambda \left(\alpha )}

. This result implies that the oscillatory term has almost no influence on the global structure of

λ

(

α

)

\lambda \left(\alpha )

. The result is, therefore, unexpected, new and novel, since such phenomenon as this is not known so far. For the proof, the involved time map method and stationary phase method are used.
Zirconium in the Nuclear Industry: 19th International Symposium
Authors: Motta Arthur T. , Yagnik Suresh K. 
Published: July 2021

Description
Featuring 37 peer-reviewed and award-winning papers from industry experts that were presented at this 2019 symposium held in Manchester, United Kingdom.
Topics covered include
Sponsored by ASTM International Committee B10 on Reactive and Refractory Metals and Alloys and its subcommittee Zirconium and Hafnium.
Timing of Supplemental Nutrition Assistance Program Benefits and Families’ Home Food Environments
Authors: You Susan , Ansah Rosemary , Mullins Alexa , Johnson Sara B. , Perin Jamie , Flessa Sarah J. , Thornton Rachel L.J. 
Published: July 2021

BACKGROUND AND OBJECTIVES
Supplemental Nutrition Assistance Program (SNAP) benefits are designed to buffer families from food insecurity, but studies suggest that most benefits are used by midmonth. In this study, we examined whether the home food environment varies across the SNAP benefits cycle among participating families .

METHODS
Participants in this mixed-methods study were 30 SNAP participants who were primary caregivers of a child ages 4–10 years. The home food environment was measured 1 week before SNAP benefit replenishment and again within 1 week after replenishment by using the Home Food Inventory. Household food insecurity was assessed by using the US Department of Agriculture Household Food Security Survey. Wilcoxon rank tests were used to evaluate changes in median Home Food Inventory subscales and food insecurity pre- to post-replenishment. Qualitative interviews with participating caregivers were conducted to explore contextual factors influencing the home food environment across the benefits cycle.

RESULTS
Participants had significantly fewer types of vegetables (median: 7.0 vs 8.5, median difference 1.73, 95% confidence interval: 0.5–2.5, P = .03) and higher food insecurity pre- versus post-replenishment (median: 4.0 vs 2.0, median difference 1, 95% confidence interval: 0.1–1.5, P = .03). Caregivers described employing a variety of intentional strategies to reduce cyclic variation in food availability.

CONCLUSIONS
Findings suggest that there is relatively limited cyclic variation in the home food environment among families participating in SNAP. This may be explained by a number of assistance programs and behavioral strategies caregivers used to make food last and buffer against scarcity. Future research should evaluate the relationship between the degree of home food environment changes and child health outcomes.
Differences in Lifetime Earning Potential Between Pediatric and Adult Physicians
Authors: Catenaccio Eva , Rochlin Jonathan M. , Simon Harold K. 
Published: July 2021

OBJECTIVES
Compare lifetime earning potential between academic pediatric and adult medicine generalists and subspecialists. Evaluate the effect of decreasing the length of training for pediatric subspecialties whose length of training is longer than that for the adult medicine counterpart.

METHODS
Using compensation and debt data from national physician surveys for 2019–2020, we estimated and compared the lifetime earning potential for academic pediatric and adult physicians.

RESULTS
Lifetime earning potential was higher for adult physicians than for pediatric physicians across all comparable areas of both general and subspecialty academic practice. The lifetime earning potentials for adult physicians averaged 25% more, or $1.2 million higher, than those of the corresponding pediatric physicians. These differences predominantly were not attributable to unequal training length: when we modeled a shortened length of training for pediatric subspecialists, lifetime earning potential for adult subspecialists still averaged 19% more than that for pediatric subspecialists. For both pediatric and adult medicine, the primarily inpatient, procedure-oriented subspecialties had higher lifetime earning potential than the outpatient, less procedure-oriented subspecialties.

CONCLUSIONS
Wide differences in lifetime earning potential between pediatric and adult physicians reflected lower compensation in pediatrics, rather than any differences in training length. Inpatient-based, more procedure-oriented subspecialties had higher lifetime earning potential than outpatient-based, less procedure-oriented subspecialties. Interventions that improve the lifetime earning potential of general pediatrics and the pediatric subspecialties, as well as the less procedure-oriented subspecialties across both pediatric and adult medicine, have the potential to impact both clinical practice and access to care.
Integration of complete elemental mass-balanced stoichiometry and aqueous-phase chemistry for bioprocess modelling of liquid and solid waste treatment systems − Part 2: Bioprocess stoichiometry
Authors: CJ Brouckaert  , GA Ekama  , BM Brouckaert  , DS Ikumi  
Published: July 2021

Bioprocesses interact with the aqueous environment in which they take place. Integrated bioprocess and three-phase (aqueous−gas−solid) multiple strong and weak acid/base system models are currently being developed for a range of wastewater treatment applications including anaerobic digestion, biological sulphate reduction, autotrophic denitrification, biological desulphurization and plant-wide water and resource recovery facilities. In order to model, measure and control such integrated systems, a thorough understanding of the interactions between the bioprocesses and aqueous phase multiple strong and weak acid/bases are required. In the first of this series of five papers, the generalized procedure for deriving bioprocess stoichiometric equations was explained. This second paper presents the stoichiometric equations for the major biological processes and shows how their structure can be analysed to provide insight into how bioprocesses interact with the aqueous environment. Such insight is essential for confident, effective and reliable use of model development protocols and algorithms. It shows that the composite parameters, total oxygen demand (TOD, electron donating capacity) and alkalinity (proton accepting capacity), are conserved in bioprocess stoichiometry and their changes in the aqueous phase can be calculated from the bioprocess components. In the third paper, the measurement of the organics composition is presented. The link between the modelling and measurement frameworks of the aqueous phase, which uses the composite parameter alkalinity, is described in the fourth paper. Aqueous ionic speciation modelling is described in detail in the fifth.
Chemical composition of rain at a regional site on the South African Highveld
Authors: L Kok  , PG van Zyl  , JP Beukes  , J-S Swartz  , RP Burger  , Suria Ellis  , M Josipovic  , V Vakkari  , L Laakso  , M Kulmala  
Published: July 2021

Relatively limited data have been published on the chemical composition of wet deposition for South Africa, which is considered an important source region for atmospheric pollutants. Concentrations and wet deposition fluxes of ionic species determined in rain samples collected from December 2014 to April 2018 at a regional site, Welgegund, are presented, and contextualised by wet deposition composition in the north-eastern interior of South Africa. 89% of rain samples collected during the sampling period complied with the data quality objectives of the World Meteorological Organisation. The total ionic concentration of rainwater at Welgegund was similar to that at two regional sites located within proximity of industrial activities. The pH of rainwater (4.80) was comparable to that determined at two rural background sites, which indicated increased neutralisation. Similarly to the other sites located in the South African interior, SO42- was the most abundant species in rain, with concentrations thereof in the same order as SO42- levels determined at the two industrially influenced sites. Lower sulphur and nitrogen fluxes at Welgegund were attributed to lower average annual rainfall. The anthropogenic (industrial) source group had the largest contribution to wet deposition chemical composition, which signified the influence of major source regions in the South African interior that impact Welgegund. Relatively large contributions were also calculated from marine and crustal sources. The influence of agricultural activities was also evident, while biomass burning had the lowest contribution due to open biomass burning occurring mainly during the dry season.
Tıpta uzmanlık alanlarının toplumsal cinsiyet açısından değerlendirilmesi
Authors: YILMAZ Necla , ALKAN Ahmet , ERTÜMER Ayşe Gülen , KUH Zeynep 
Published: July 2021

Amaç: Araştırma ile tıpta uzmanlık alanlarının toplumsal cinsiyete göre farklılık arz edip etmediğinin belirlenmesi amaçlanmaktadır. Ayrıca, uzmanlık alanlarının, yan dal uzmanlık alanlarının, hekimlerin unvanı ve hastanenin mülkiyetinin cinsiyete göre farklılık arz edip etmediğinin belirlenmesi hedeflenmiştir.
Gereç ve Yöntem: Tanımlayıcı nitelikte tasarlanan araştırma ile Türkiye’deki 88 kamu ve vakıf üniversitesine bağlı tıp fakültesinde görev yapan 23.473 hekim belirli kriterlere göre incelenmiştir.
Bulgular: Kadın hekimler Tıbbi Patoloji, Deri ve Zührevi Hastalıklar, Histoloji ve Embriyoloji, Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları, Fiziksel Tıp ve Rehabilitasyon, Aile Hekimliği; erkek hekimler ise Ortopedi ve Travmatoloji, Üroloji, Beyin ve Sinir Cerrahisi, Genel Cerrahi, Kalp Damar Cerrahisi, Plastik, Rekonstrüktif ve Estetik Cerrahi, Kardiyoloji, Kulak Burun Boğaz Hastalıkları, Göğüs Cerrahisi, Ağız, Yüz ve Çene Cerrahisi alanlarında yoğunlaşmışlardır. Branşlara göre kadın ve erkek hekimler arasındaki bu farklılaşma istatistiksel olarak anlamlıdır. Dahili, cerrahi ve temel tıp bilimlerinin cinsiyete göre dağılımları arasındaki fark istatistiksel olarak anlamlı iken, yan dal uzmanlık alanlarındaki bu farklılık istatistiksel olarak anlamlı değildir.
Sonuç: Temel uzmanlık alanları arasında toplumsal cinsiyete göre farklılaşma görülmektedir. Cerrahi branşlara yönelik erkeksilik, dahili ve temel tıp branşlarına yönelik ise kadınsılık algısı vardır ve hekimlerin uzmanlık alanı tercihlerinin toplumun onlara yüklediği cinsiyetçi rollerden bağımsız olmadığı söylenebilir..