GRAMMATICAL GENDER & LINGUISTIC RELATIVITY: DOES THE GRAMMATICAL GENDER NATIVE ARABIC SPEAKERS ASSIGN NEUTRAL NOUNS AFFECT HOW THEY PERCEIVE THEM?

While some Native Arabic speakers assign a certain grammatical gender to neutral nouns based on whether they perceive them to be either a male/masculine or female/feminine like, others assign them a grammatical gender arbitrarily. This research aims to find out 1. whether there is a tendency among Native Arabic speakers to assign neutral nouns male grammatical gender as a result of the Arabic language’s tendency to assign neutral nouns male grammatical gender. It also aims to find out 2. what rationale the Native Arabic speakers have for their grammatical gender assignment of neutral nouns despite the Arabic language's grammatical gender assignment to nouns being arbitrary, in addition to 3. whether or not the participants would assign nouns they find feminine-like a female grammatical gender and nouns that they perceive as masculine-like a male grammatical gender, or would just assign a grammatical gender arbitrarily. This paper's findings showed that the majority of participants of both genders (i.e., males and females) tended to assign male grammatical gender to most of the neutral nouns, as 10 nouns out of 14 were assigned a male grammatical gender by the majority of both male and female participants. The participants stated that they did not perceive the nouns they assigned a male grammatical gender masculine-like but rather assigned them a male grammatical gender either arbitrarily or by default as the Arabic language tends to assign male grammatical gender to neutral nouns, whereas the majority stated that they assigned certain neutral nouns such as my knife and Falafel a female grammatical gender not because they perceived them as feminine-like, but rather because this is what they heard/acquired from those surrounding them. Therefore, the grammatical gender assignment of nouns was not semantic but rather morphological and syntactic and was done by the addition of affixation either to the noun itself or to its adjective.  Article visualizations

Rethinking Ductility -- A Study Into the Size-Affected Fracture of Polymers

Ductility quantifies a material's capacity for plastic deformation, and it is a key property for preventing fracture driven failure in engineering parts. While some brittle materials exhibit improved ductility at small scales, the processes underlying this phenomenon are not well understood. This work establishes a mechanism for the origin of ductility via an investigation of size-affected fracture processes and polymer degree of conversion (DC) in two-photon lithography (TPL) fabricated materials. Microscale single edge notch bend ($\mu$SENB) specimens were written with widths from 8 to 26 $\mu$m and with different laser powers and post-write thermal annealing to control the DC between 17\% and 80\%. We find that shifting from low to high DC predictably causes a $\sim$3x and $\sim$4x increase in strength and bending stiffness, respectively, but that there is a corresponding $\sim$6x decrease in fracture energy from 180 $J/m^2$ to 30 $J/m^2$. Notably, this reduced fracture energy is accompanied by a ductile-to-brittle transition (DBT) in the failure behavior. Using finite element analysis, we demonstrate that the DBT occurs when the fracture yielding zone size ($r_p$) approaches the sample width, corresponding with a known fracture size-affected transition from flaw-based to strength-based failure. This finding provides a crucial insight that ductility is a size-induced property that occurs when features are reduced below a characteristic fracture length scale and that strength, stiffness, and toughness alone are insufficient predictors of ductility.Comment: 17 pages, 6 figure

Predictors of Knowledge and Perception of Family Planning Among Men in Urban Areas in Northwest Nigeria

Introduction: The use of family planning (FP) methods has remained low in Nigeria despite the high fertility rate and unmet need; partly because men are excluded in FP programs. Most studies on FP were carried out among married women and information about men was acquired from their wives. Unfortunately, such information may not be accurate. Aims: The study aimed to determine the predictors of FP knowledge and perception among men in urban areas in the Northwestern part of Nigeria. Subjects and Methods: The study was cross‑sectional in design, carried out in urban areas in Northwest Nigeria among 167 married men in November 2017 enrolled through a multi‑stage sampling technique. Data collection was done with a structured questionnaire which  was interviewer‑administered. SPSS version 23 was used to analyze the data. Results: The majority (75, 45.5%) had poor knowledge of FP and 118 (71.5%) had a positive perception of FP. Social class (adjusted odds ratio [aOR]: 15.75, 95% confidence interval [CI] = 2.14–116.03) and perception (aOR: 0.13, 95% CI = 0.03–0.59) were the predictors of good FP knowledge while knowledge (aOR = 0.10, CI: 0.02–0.51) predicted positive perception on FP. Conclusion: Knowledge of FP was poor; the perception of the majority was positive. There is a need by the Sokoto State Government,  Local Government Areas, and religious leaders to increase information on FP, especially on the benefits and methods, and the need for males to participate in FP through the enlightenment of the public using the media, schools, and worship places. Keywords: Family planning, knowledge, men, northwest, perception, urban area

Enhanced methane production from anaerobic co-digestion of wheat straw rice straw and sugarcane bagasse: A kinetic analysis

Future energy and environmental issues are the major driving force towards increased global utilization of biomass, especially in developing countries like Pakistan. Lignocellulosic residues are abundant in Pakistan. The present study investigated the best-mixed proportion of mechanically pretreated lignocellulosic residues i.e., wheat straw and rice straw (WSRS), bagasse and wheat straw (BAWS), bagasse, and rice straw (BARS), bagasse, wheat straw, and rice straw (BAWSRS) through anaerobic co-digestion. Anaerobic batch mode bioreactors comprising of lignocellulosic proportions and control bioreactors were run in parallel at mesophilic temperature (35 degrees C) for the substrate to inoculum (S/I) ratio of 1.5 and 2.5. Maximum and stable biomethane production was observed at the substrate to inoculum (S/I) ratio of 1.5, and the highest biomethane yield 339.0089123 NmLCH4/gVS was achieved by co-digestion of wheat straw and rice straw (WSRS) and lowest 15.74 NmLCH4/gVS from bagasse and rice straw (BARS) at 2.5 substrates to inoculum ratio. Furthermore, anaerobic reactor performance was determined by using bio-kinetic parameters i.e., production rate (Rm), lag phase (lambda), and coefficient of determination (R2). The bio-kinetic parameters were evaluated by using kinetic models; first-order kinetics, Logistic function model, Modified Gompertz Model, and Transference function model. Among all kinetic models, the Logistic function model provided the best fit with experimental data followed by Modified Gompertz Model. The study suggests that a decrease in methane production was due to lower hydrolysis rate and higher lignin content of the co-digested substrates, and mechanical pretreatment leads to the breakage of complex lignocellulosic structure. The organic matter degradation evidence will be utilized by the biogas digesters developed in rural areas of Pakistan, where these agricultural residues are ample waste and need a technological solution to manage and produce renewable energy.Web of Science1113art. no. 606

A Triad of Temporomandibular Joint Ankylosis, Mandibular Retrognathia and Severe Obstructive Sleep Apnoea: Case report

The surgical management of paediatric patients with temporomandibular joint (TMJ) ankylosis, mandibular retrognathia and obstructive sleep apnoea (OSA) is challenging. We report a nine-year-old boy who presented to the Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with complaints of limited mouth opening, loud snoring and excessive daytime sleepiness. He was diagnosed with TMJ ankylosis, mandibular retrognathia and severe OSA. The patient initially underwent mandibular distraction and, subsequently, release of the TMJ ankylosis and rib graft reconstruction. The overall patient outcome was successful, with improvement in OSA-related symptoms, good facial symmetry and adequate mouth opening. Keywords: Temporomandibular Joint Disorders; Temporomandibular Ankylosis; Retrognathia; Obstructive Sleep Apnea; Case Report; Oman

Surgical Approaches to Congenital Anomalies of Esophagus

With prevalence of about 1 in 3000 live births, pediatric surgeons commonly deal with esophageal abnormalities, which may provide substantial clinical complications. Surprisingly, the embryologic processes underlying esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), one of the hallmark disease entities of pediatric surgery, have only lately been largely uncovered. When it comes to the treatment of congenital esophageal abnormalities, notably esophageal atresia and tracheoesophageal fistula, surgical methods are essential. In order to address the anatomical abnormalities and restore normal function, surgical correction is often necessary in the care of congenital esophageal anomalies, including esophageal atresia and tracheoesophageal fistula. In this review we are going to cover surgical approaches to repair those malformations, long-term outcomes, and latest developments in esophageal surgical approaches

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely