Direct and Indirect Effects of IQ, Parental Help, Effort, and Mathematics Self-Concept on Mathematics Achievement

This study examined the structural relationships among cognitive constructs (intelligence and achievement) and affective constructs (perceived parental help, effort and self-concept). It was proposed that the relationships are not invariant across gender. The sample consisted of 219 boys and 133 girls from elementary and preparatory public schools in Al Ain in the United Arab Emirates. Intelligence (IQ) was measured by the Test of Non-verbal Intelligence (TONI) and parental help was measured by 4-Likert-type items. Effort was measured by 4-Likert-type items. Self-concept (SC) was measured by 8-Likert-type items taken from the SDQ I (Abu-Hilal, 2000). Mathematic Achievement was the scores of students in mathematics from school records. The structural model assumed that IQ would have an effect on parental help, effort, SC and achievement. Parental help would have an effect on effort, SC and achievement. Also, effort would have an effect on SC and achievement. Finally, SC would have an effect on achievement. The structural model was tested for invariance across gender. The measurement model proved to be invariant across gender and so was the structural model. The non-constrained model indicated that the structural relationships among the variables do vary according to gender. For example, boys benefited from parental help by exerting more effort while girls did not. Boys with high IQ exerted more effort than boys with low IQ; but girls with high IQ exerted the same amount of effort as girls with low IQ. The model explained 45% and 39% of the variance in math scores for boys and girls, respectively

The impact of a teacher preparation programs on professional teaching competencies – Female novice teachers’ perspectives

This study explored early career teachers’ perspectives on their competencies in professional teaching in Qatar. Using a mixed-method research design, this study drew on empirical data from ninetlyfive survey respondents and ten individual interviews with teachers who were in their first four years of working in Qatari governmental schools. The findings of this study indicate that professional teaching competencies are strongly related to professional training through a teacher preparation program. This study identified a few of the specific challenges that novice teachers encounter and revealed a significant need to address these challenges to maintain their competencies. The study contributes to the literature by investigating novice teachers’ perspectives on their teaching competencies as supported by their teacher preparation program. More efforts to bridge the gaps between programs and schools are needed to prepare teachers in their early careers better

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Effect of Volatile Fatty Acids Accumulation on Biogas Production by Sludge-Feeding Thermophilic Anaerobic Digester and Predicting Process Parameters

Sewage sludge represents an important resource for reuse in the wastewater treatment field. Hence, thermophilic anaerobic digestion (TAD) could be an alternative technique to recover renewable resources from sludge. In the TAD biodegradation process, volatile fatty acids (VFAs) are the intermediate products of methanogenesis. However, the higher formation and accumulation of VFAs leads to microbial stress, resulting in acidification and failure of the digester. Therefore, several batch TADs have been investigated to evaluate the VFAs production from sludge and their impact on biogas generation and biodegradation efficiency. Three types of sewage sludges, e.g., primary sludge (PS), secondary sludge (SS), and mixed sludge (MS) were used as substrates to estimate the accumulation of VFAs and yield of methane gas. The system showed the maximum total VFAs accumulation from both PS and MS as 824.68 &plusmn; 0.5 mg/L and 236.67 &plusmn; 0.5 mg/L, respectively. The dominant VFA accumulation was identified as acetic acid, the main intermediate by-product of methane production. The produced biogas from PS and MS contained 66.75 &plusmn; 0.5% and 52.29 &plusmn; 0.5% methane, respectively. The high content of methane with PS-feeding digesters was due to the higher accumulation of VFAs (i.e., 824.68 &plusmn; 0.5 mg/L) in the TAD. The study also predicted the design parameters of TAD process by fitting the lab-scale experimental data with the well-known first-order kinetic and logistic models. Such predicted design parameters are significantly important before the large-scale application of the TAD process

Effect of Volatile Fatty Acids Accumulation on Biogas Production by Sludge-Feeding Thermophilic Anaerobic Digester and Predicting Process Parameters

Sewage sludge represents an important resource for reuse in the wastewater treatment field. Hence, thermophilic anaerobic digestion (TAD) could be an alternative technique to recover renewable resources from sludge. In the TAD biodegradation process, volatile fatty acids (VFAs) are the intermediate products of methanogenesis. However, the higher formation and accumulation of VFAs leads to microbial stress, resulting in acidification and failure of the digester. Therefore, several batch TADs have been investigated to evaluate the VFAs production from sludge and their impact on biogas generation and biodegradation efficiency. Three types of sewage sludges, e.g., primary sludge (PS), secondary sludge (SS), and mixed sludge (MS) were used as substrates to estimate the accumulation of VFAs and yield of methane gas. The system showed the maximum total VFAs accumulation from both PS and MS as 824.68 ± 0.5 mg/L and 236.67 ± 0.5 mg/L, respectively. The dominant VFA accumulation was identified as acetic acid, the main intermediate by-product of methane production. The produced biogas from PS and MS contained 66.75 ± 0.5% and 52.29 ± 0.5% methane, respectively. The high content of methane with PS-feeding digesters was due to the higher accumulation of VFAs (i.e., 824.68 ± 0.5 mg/L) in the TAD. The study also predicted the design parameters of TAD process by fitting the lab-scale experimental data with the well-known first-order kinetic and logistic models. Such predicted design parameters are significantly important before the large-scale application of the TAD process

An Evaluation of the Effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) for the Management of Treatment-Resistant Depression with Somatic Attributes: A Hospital-Based Study in Oman

Depressive illnesses in non-Western societies are often masked by somatic attributes that are sometimes impervious to pharmacological agents. This study explores the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for people experiencing treatment-resistant depression (TRD) accompanied by physical symptoms. Data were obtained from a prospective study conducted among patients with TRD and some somatic manifestations who underwent 20 sessions of rTMS intervention from January to June 2020. The Hamilton Rating Scale for Depression (HAMD) was used for clinical evaluation. Data were analysed using descriptive and inferential techniques (multiple logistic regression) in SPSS. Among the 49 participants (mean age: 42.5 ± 13.3), there was a significant reduction in posttreatment HAMD scores compared to baseline (t = 10.819, p < 0.0001, and 95% CI = 8.574–12.488), indicating a clinical response. Approximately 37% of the patients responded to treatment, with higher response rates among men and those who remained in urban areas, had a history of alcohol use, and were subjected to the standard 10 HZ protocol. After adjusting for all extraneous variables, the rTMS protocol emerged as the only significant predictor of response to the rTMS intervention. To our knowledge, this is the first study to examine the effectiveness of rTMS in the treatment of somatic depression

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic

Aim This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS-CoV-2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age >70 years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks