Health policy competencies in regional organizations: a retrospective analysis for 76 regional organizations from 1945 to 2015.

BACKGROUND: Health policy competencies of regional organizations include mandates to create regional health laws and policies, as well as authorities that allow member states to undertake collective actions in the health field. The examination of the health policy competencies of regional organizations is essential, as it constitutes an important prerequisite for regional organizations to govern regional health. This study aims to map the development trajectory of health policy competencies in regional organizations worldwide and investigate their potential correlates. This will contribute to the enhanced promotion of both existing and new regional health cooperation. METHODS: This retrospective analysis utilized the health policy competencies of the 76 regional organizations worldwide from 1945 to 2015, as investigated in the Regional Organizations Competencies Database. By aggregating member state data from various sources such as the IHME Global Burden of Disease 2019, the World Bank, and the World Trade Organization, we extracted the mean values and coefficients of variation for the covariates in regional organization characteristics, socioeconomic and demographic factors, health status and health-system capacity. The correlation between changes in the health policy scope of regional organizations and independent variables was analyzed using Poisson pseudo-likelihood regression with multiple levels of fixed effects. RESULTS: From 1945 to 2015, the number of regional organizations with health policy competencies experienced a slow growth stage before 1991 and an explosive growth stage post-1991. By 2015, 48 out of the 71 existing regional organizations had developed their health policy competencies, yet 26 (54.2%) of these organizations possessed only 1-2 health policy competencies. An enhancement in the health policy scope of a regional organization correlated with its founding year, a greater number of policy fields, higher under-five mortality, and larger disparities in trade and healthcare access and quality indexes among member states. In contrast, larger disparities in population, under-five mortality and health worker density among member states, along with more hospital beds per capita, were negatively correlated with the expansion of a regional organization's health policy scope. CONCLUSION: Since 1991, there has been a surge of interest in health among regional organizations, although health remains a secondary priority for them. The health policy competencies of regional organizations are pivotal for promoting social equity within regional communities. Its establishment is also closely linked to the level and disparities among member states in aspects such as trade, population, child mortality rates, and health system capacity.

Mechanism Exploration of Environmental Pollutants on Premature Ovarian Insufficiency: a Systematic Review and Meta-analysis.

As a public health problem, premature ovarian insufficiency leads to infertility or sub-fertility. In addition to premature ovarian insufficiency (POI) increases the lifetime risk of bone fragility, cardiovascular disease, and cognitive impairment. To investigate the effects of environmental pollutants on the occurrence of POI and explore its mechanism, we conducted a computer search for articles published in electronic databases by December 13, 2022. Three reviewers independently examined all included studies and scored the qualities of included studies using the Newcastle-Ottawa Scale criteria. In this meta-analysis, eight clinical studies as well as ten preclinical findings showed a pooled OR of 2.331 and 95% CI of 1.968-2.760. This confirms that environmental pollutants, including POPs, heavy metals, PAEs, PAHs, cosmetic and pharmaceutical products, and cigarette smoke, are indeed significant risk factors for POI. In addition, it is demonstrated from the results of this study that signaling pathway of calcium and PI3K Akt and Xpnpep2, Col1, Col3, Col4, Cx43, Egr3, Tff1, and Ptgs2 genes may all be involved in the process. Environmental pollutants, including POPs, heavy metals, PAEs, PAHs, cosmetic and pharmaceutical products, and cigarette smoke, are indeed significant risk factors for POI.

Improved multi-objective differential evolution algorithm based on a decomposition strategy for multi-objective optimization problems.

Many real-world engineering problems need to balance different objectives and can be formatted as multi-objective optimization problem. An effective multi-objective algorithm can achieve a set of optimal solutions that can make a tradeoff between different objectives, which is valuable to further explore and design. In this paper, an improved multi-objective differential evolution algorithm (MOEA/D/DEM) based on a decomposition strategy is proposed to improve the performance of differential evolution algorithm for practical multi-objective nutrition decision problems. Firstly, considering the neighborhood characteristic, a neighbor intimacy factor is designed in the search process for enhancing the diversity of the population, then a new Gaussian mutation strategy with variable step size is proposed to reduce the probability of escaping local optimum area and improve the local search ability. Finally, the proposed algorithm is tested by classic test problems (DTLZ1-7 and WFG1-9) and applied to the multi-objective nutrition decision problems, compared to the other reported multi-objective algorithms, the proposed algorithm has a better search capability and obtained competitive results.

Barriers and enablers in the implementation of a quality improvement program for acute coronary syndromes in hospitals: a qualitative analysis using the consolidated framework for implementation research.

BACKGROUND: Ischemic heart disease causes a high disease burden globally and numerous challenges in treatment, particularly in developing countries such as China. The National Chest Pain Centers Program (NCPCP) was launched in China as the first nationwide, hospital-based, comprehensive, continuous quality improvement (QI) program to improve early diagnosis and standardized treatment of acute coronary syndromes (ACS) and improve patients' clinical outcomes. With implementation and scaling up of the NCPCP, we investigated barriers and enablers in the NCPCP implementation process and provided examples and ideas for overcoming such barriers. METHODS: We conducted a nationally representative survey in six cities in China. A total of 165 key informant interviewees, including directors and coordinators of chest pain centers (CPCs) in 90 hospitals, participated in semi-structured interviews. The interviews were transcribed verbatim, translated into English, and analyzed in NVivo 12.0. We used the Consolidated Framework for Implementation Research (CFIR) to guide the codes and themes. RESULTS: Barriers to NCPCP implementation mainly arose from nine CFIR constructs. Barriers included the complexity of the intervention (complexity), low flexibility of requirements (adaptability), a lack of recognition of chest pain in patients with ACS (patient needs and resources), relatively low government support (external policies and incentives), staff mobility in the emergency department and other related departments (structural characteristics), resistance from related departments (networks and communications), overwhelming tasks for CPC coordinators (compatibility), lack of available resources for regular CPC operations (available resources), and fidelity to and sustainability of intervention implementation (executing). Enablers of intervention implementation were inner motivation for change (intervention sources), evidence strength and quality of intervention, relatively low cost (cost), individual knowledge and beliefs regarding the intervention, pressure from other hospitals (peer pressure), incentives and rewards of the intervention, and involvement of hospital leaders (leadership engagement, engaging). CONCLUSION: Simplifying the intervention to adapt routine tasks for medical staff and optimizing operational mechanisms between the prehospital emergency system and in-hospital treatment system with government support, as well as enhancing emergency awareness among patients with chest pain are critically important to NCPCP implementation. Clarifying and addressing these barriers is key to designing a sustainable QI program for acute cardiovascular diseases in China and similar contexts across developing countries worldwide. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry ( ChiCTR 2100043319 ), registered 10 February 2021.

Comparison Between Combination of Resonant Voice Therapy and Vocal Hygiene Education and Vocal Hygiene Education Only for Female Elementary School Teachers.

OBJECTIVE: The study compares the rehabilitation outcome of two voice intervention methods for female elementary school teachers with self-reported voice disorders. METHODS: A total of 34 female teachers from two primary schools volunteered in the study. Participants from one school were assigned to the experimental group (16 teachers), who received the combination of vocal hygiene education and resonant voice therapy. Participants from the other school were assigned to the control group (18 teachers), who received vocal hygiene education only. Pre- and post-treatment data were compared. RESULT: The total score of the Voice Handicap Index (VHI) decreased significantly from 12.19 ± 8.58 to 8.63 ± 7.27 (P < 0.05); the functional score of VHI significantly decreased from 5.38 ± 3.9 to 3.81 ± 3.62 (P < 0.05). No statistical significance was found in physiological and emotional scores of VHI. No statistical significance was found in the control group. In the experimental group, the maximum phonation time was increased from 14.34 ± 6.80s to 17.21 ± 6.06s (P < 0.05), Jitter decreased from 0.45% ± 0.13% to 0.26% ± 0.05% (P < 0.05), and Shimmer decreased from 0.21 ± 0.10. to 0.12 ± 0.03 (P < 0.05). Furthermore, the harmonic to noise ratio increased from 23.06 ± 2.99 to 25.23 ± 1.92 (P < 0.05), Spectrum Convergence Ratio increased from 0.53 ± 0.12 to 0.60 ± 0.11 (P < 0.05), yet no statistical significance was found in Nonlinear Energy Difference Ratio data for the experimental group. No statistical significance was found in the control group. In the auditory perception assessment (GRBAS), the G score decreased from 1.19 ± 0.54 to 0.81 ± 0.40 (P < 0.05), and the R score decreased from 1.19 ± 0.54 to 0.75 ± 0.45 (P < 0.05) in the experimental group. No statistical significance was found in the B, A, and S scores in the experimental group; moreover, none of the GRBAS scores in the control group demonstrated statistical significance. In the voice type component profile (VTC), the proportion of VTC1 of the experimental group increased significantly, while the proportions of VTC3 and VTC4 decreased significantly, indicating the improvement of voice quality was obvious after the intervention. The proportions of VTC of the control group did not demonstrate significant change. CONCLUSION: The results of this study show that a combination of vocal hygiene education and resonant voice therapy can significantly improve the voice function of professional voice users and effectively improve their voice quality. In this study, the professional voice users receiving vocal hygiene education only did not show significant improvement of their voice quality.

Contrasting Trends of Primary Liver Cancer Mortality in Chinese Mongol and Non-Mongol.

BACKGROUND: This study aims to investigate the temporal trend as well as the burden of primary liver cancer among Mongol and non-Mongol in China. MATERIALS AND METHODS: The registered data from up to 20 monitoring points in the periods of 2008 to 2015 in Inner Mongolia were used to calculate and model the trend of liver cancer among Mongol and non-Mongol using log-linear regression. Logistic regression was used to characterise the risk of liver cancer by using hospitalization records from 2008 to 2017. RESULTS: Over the study period, significant reduction of liver cancer mortality was found among non-Mongol population (4.8/100,000 from 23.7/100,000 to 18.9/100,000, p=0.04), while the increase of liver cancer mortality was observed among the Mongolian population (8.4/100,000 from 10.7/100,000 to 19.1/100,000, p=0.02), particularly the Mongol from East (25.5/100,000 from 11.2/100,000 to 36.7/100,000, p=0.005). Comparing to the non-Mongol patients with primary liver cancer, the Mongolian patients were more likely to be from East Inner Mongolia (aOR=3.65, 95% CI:2.75-4.87) and those residing in urban area (aOR=2.11, 95%CI: 1.55-2.91). In 2015, a total of 3056 primary liver cancer deaths could be converted if the four known risk factors (HBV, Hepatitis C Virus, alcohol consumption and smoking) could be prevented. HBV remained to be the leading risk factor of liver cancer (PAF=56%, contributing to 2616 deaths) with the highest among the Mongol from East (PAF=65.1%, contributing to 763 deaths). CONCLUSION: The continuing increase of primary liver cancer among Mongol suggested further interventions were needed to combat its burden.

Socioeconomic status and depressive symptoms in older people with the mediation role of social support: A population-based longitudinal study.

BACKGROUND: Depressive symptoms has become an increasingly important public health issue, contributing to disability and disease burden around the world. Higher socioeconomic status (SES) has been found to be associated with lower prevalence of depression, but there are few studies about the older Chinese adults with long-term follow up and rigorous prospective design. Meanwhile, there is little conclusive evidence about the mechanisms through which SES influences the onset of depressive symptoms. OBJECTIVE: To prospectively examine the association of baseline socioeconomic factors with the risks of developing depressive symptoms during 7-year follow up in older Chinese population, and to study the mechanism by which SES impacts the prevalence of depressive symptoms. METHODS: A total of 5677 individuals over 45 years who participated in an ongoing nationally representative prospective cohort study, China Health and Retirement Longitudinal Study, were free from depressive symptoms at baseline, and completed 7-year follow-up were included. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale score. Cox proportional hazards regression models were used to examine the association of SES and the incidence of depressive symptoms in 2011 to 2018. Generalized structural equation model was used to analyze the mediation effects of social support on the relation between SES and depressive symptoms. RESULTS: During the 7-year follow-up, 2398 (42.2%) cases were identified as depressive symptoms. Compared with the lowest level of household income, participants with the highest level of household income had a 20% reduction in risk (95% CI, 0.70-0.92, P < 0.001). Participants who had junior high school or above education had a 41% lower risk of depressive disorders compared with illiterate participants (95% CI, 0.52-0.69, P < 0.001). The relationship between SES and depressive symptoms was partially mediated by the social support, where higher social support was negatively associated with depressive symptoms. The proportion of mediation effect was even larger for women compared with men. CONCLUSION: Socioeconomic factors were independently associated with the development of depressive symptoms, and the relationship was partially mediated by social support. Social support could be an effective intervention to alleviate the negative effects of lower SES on mental health. Multiple-level policies should precisely target low-SES groups, and timely intervention to promote social support for this group should be used to reduce the influence of depression on individuals, family as well as the whole society.

Synergistic effect of alternating current and sulfate-reducing bacteria on corrosion behavior of X80 steel in coastal saline soil.

With the development of electrified railways and high-voltage transmission lines, it is often inevitable that buried metal structures are subjected to interference from the alternating current (AC) induced by the neighboring power facilities. Commonly found in soil, sulfate-reducing bacteria (SRB) have the capability to accelerate metal corrosion. In this paper, with electrochemical methods, surface analysis techniques, and weight-loss test, the influence of AC and SRB on the X80 steel corrosion behavior was explored in coastal saline soil. The results revealed that the 100 A m-2 AC inhibited the growth of the sessile and planktonic SRB cell. Under the action of 100 A m-2 AC, the metabolic activity of viable bacteria was enhanced, and the process of extracellular electron transfer was accelerated. When both AC and SRB were introduced, the maximum pit depth (76.2 µm) increased significantly to be 15 times higher than in the control condition (4.9 µm). Both SRB and AC played a role in enhancing corrosion. The corrosion rate of the AC-influenced specimen was far higher than that of the SRB-influenced specimen, while SRB and AC produced a synergistic effect on the enhanced corrosion of the specimen.

Public Opinion Early Warning Agent Model: A Deep Learning Cascade Virality Prediction Model Based on Multi-Feature Fusion.

With the rapid popularity of agent technology, a public opinion early warning agent has attracted wide attention. Furthermore, a deep learning model can make the agent more automatic and efficient. Therefore, for the agency of a public opinion early warning task, the deep learning model is very suitable for completing tasks such as popularity prediction or emergency outbreak. In this context, improving the ability to automatically analyze and predict the virality of information cascades is one of the tasks that deep learning model approaches address. However, most of the existing studies sought to address this task by analyzing cascade underlying network structure. Recent studies proposed cascade virality prediction for agnostic-networks (without network structure), but did not consider the fusion of more effective features. In this paper, we propose an innovative cascade virus prediction model named CasWarn. It can be quickly deployed in intelligent agents to effectively predict the virality of public opinion information for different industries. Inspired by the agnostic-network model, this model extracts the key features (independent of the underlying network structure) of an information cascade, including dissemination scale, emotional polarity ratio, and semantic evolution. We use two improved neural network frameworks to embed these features, and then apply the classification task to predict the cascade virality. We conduct comprehensive experiments on two large social network datasets. Furthermore, the experimental results prove that CasWarn can make timely and effective cascade virality predictions and verify that each feature model of CasWarn is beneficial to improve performance.

Longer Cochlear Implant Experience Leads to Better Production of Mandarin Tones for Early Implanted Children.

OBJECTIVES: Children with cochlear implants (CIs) face challenges in acquiring tones, since CIs do not transmit pitch information effectively. It has been suggested that longer CI experience provides additional benefits for children implanted early, enabling them to achieve language abilities similar to that of normal-hearing (NH) children (Colletti 2009). Mandarin is a tonal language with four lexical tones and a neutral tone (T0), characterized by distinct pitch and durational patterns. It has been suggested that early implantation (i.e., before 2 years) greatly benefits the acquisition of Mandarin tones by children with CIs (Tang et al. 2019c). In this study, we extend those findings to investigate the effect of CI experience on the acquisition of Mandarin tones for children implanted early. We asked the extent to which they were able to produce distinct pitch and durational patterns of both lexical tones and T0 as a function of CI experience, and the extent to which their tonal productions were acoustically like that of NH children. DESIGN: Forty-four NH 3-year olds and 28 children implanted with CIs between 1 and 2 years, aged 3 to 7, were recruited. The children with CIs were grouped according to the length of CI experience: 3 to 6 years, 2 to 3 years, and 1 to 2 years. Lexical tone and T0 productions were elicited using a picture-naming task. Tonal productions from the children with CIs were acoustically analyzed and compared with those from the NH children. RESULTS: Children with 3 to 6 years of CI experience were able to produce distinct pitch and durational patterns for both lexical tones and T0, with NH-like acoustic realizations. Children with 2 to 3 years of CI experience were also able to produce the expected tonal patterns, although their productions were not yet NH-like. Those with only 1 to 2 years of CI experience, however, were not yet able to produce the distinct acoustic patterns for either lexical tones or T0. CONCLUSIONS: These results provide acoustic evidence demonstrating that, when Mandarin-speaking children are implanted before the age of 2, only those with 3 to 6 years of experience were able to produce NH-like tones, including both lexical tone and T0. Children with shorter CI experience (less than 3 years) were unable to produce distinct acoustic patterns for the different tones. This suggests that at least 3 years of CI experience is still needed for early implanted children to acquire tonal distinctions similar to those of NH 3-year olds.

A Measurement Model of Mutual Influence for Information Dissemination.

The recent development of the mobile Internet and the rise of social media have significantly enriched the way people access information. Accurate modeling of the probability of information propagation between users is essential for studying information dissemination issues in social networks. As the dissemination of information is inseparable from the interactions between users, the probability of propagation can be characterized by such interactions. In general, there are differences in the dissemination modes of information that carry different topics in a real social network. Using these factors, we propose a method (TMIVM) to measure the mutual influence between users at the topic level. The method associates two vectorization parameters for each user-an influence vector and a susceptibility vector-where the dimensions of the vector represent different topic categories. The magnitude of the mutual influence between users on different topics can be obtained by the product of the corresponding elements of the vectors. Specifically, in this article, we fit a social network historical information cascade data through Survival Analysis to learn the parameters of the influence and susceptibility vectors. The experimental results on a synthetic data set and a real Microblog data set show that this method better measures the propagation probability and information cascade predictions compared to other methods.

The development of abstract representations of tone sandhi.

Phonological processes result in surface variants of the same words across phonological contexts, posing potential word learning challenges for children. Mandarin tone sandhi is a tonal process changing Tone 3 (T3) in different tonal and syntactic contexts, resulting in allophonic variants of T3 in connected speech. Previous studies found that Mandarin-learning 3-year-olds were able to productively apply tone sandhi processes in novel compounds, correctly using the allophonic variants of T3 in appropriate tone sandhi contexts (Tang et al., 2018, 2019). However, it remains unclear how these variants are represented in children's mental lexicon. This study, therefore, examined Mandarin-learning children's perceptual representation of allophonic variants of T3. Ninety-four 3- to 5-year-olds and 29 adults were tested. Sensitivity to allophonic mispronunciations of T3 syllables in novel tone sandhi compounds was measured using a visual fixation procedure. The results showed that children, like adults, treated tone sandhi mispronunciations as target-like. Thus, in recognizing novel tone sandhi words, Mandarin-speaking children exhibit flexibility in accommodating the allophonic variants of T3, suggesting that they have developed an abstract T3 category in their mental lexicon. The findings reveal the effect of phonological processes in shaping children's phonological representations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The waterfall pattern of suicide mortality in Inner Mongolia for 2008-2015.

AIM: This study aims to determine the characteristics and severity of suicide mortality in Inner Mongolia between 2008 and 2015. METHODS: The death data between 2008 and 2015 was collected from the Death Registry System,1 and the suicide mortality were calculated. Suicide mortality for total of eight years and two periods (2008-2011 and 2012-2015) were tested by the X2-test. Logistic regression analysis was used to test the risk of suicide between these two observation periods by gender and region. The age-specific suicide mortality was displayed through a semi-logarithmic line chart using Pearson's correlation coefficients. Then, the prohibited pesticides and proportion of organophosphorus pesticides were calculated. RESULTS: The suicide mortality (7.20/105) in 2008-2011 was higher than the suicide mortality (4.84/105) in 2012-2015 (X2 = 62.28, P = 0.00). Intentional self-poisoning by and exposure to pesticides2 and intentional self-harm by hanging3 were the two main ways of suicide, accounting for nearly 80%. The all-cause suicide mortality increased with age (r = 0.837, P = 0.005) in 2008-2011 and (r = 0.863, P = 0.003) in 2012-2015, and suicide mortality was higher in males than in females. LIMITATION: The DRS did not provide the pesticides used by people who committed suicide by pesticide poisoning. CONCLUSION: Suicide mortality dropped like a waterfall in Inner Mongolia between 2008 and 2015, and the most obvious drop was pesticide suicide.The general drop in suicide mortality, especially the drop in pesticide poisoning suicide mortality, may be attributable to social policies that benefited the residents and the prohibition of selected pesticides. Favorable policies can effectively decrease suicide mortality.

The Acquisition of Mandarin Tonal Processes by Children With Cochlear Implants.

Purpose Children with cochlear implants (CIs) face challenges in acquiring tonal languages, as CIs do not efficiently code pitch information. Mandarin is a tonal language with lexical tones and tonal processes such as neutral tone and tone sandhi, exhibiting contextually conditioned tonal realizations. Previous studies suggest that early implantation and long CI experience facilitate the acquisition of lexical tones by children with CIs. However, there is lack of acoustic evidence on children's tonal productions demonstrating that this is the case, and it is unclear whether and how children with CIs are able to acquire contextual tones. This study therefore examined the acoustic realization of both lexical tones and contextual tones as produced by children fitted with CIs, exploring the potential effects of age at implantation and length of CI experience on their acquisition of the Mandarin tonal system. Method Seventy-two Mandarin-learning preschoolers with CIs, varying in age at implantation (13-42 months) and length of CI experience (2-49 months), and 44 normal hearing 3-year-old controls were recruited. Tonal productions were elicited from both groups using picture-naming tasks and acoustically compared. Results Only the early implanted group (i.e., implanted before the age of 2 years) produced normal-like lexical tones and generally had contextual tones approximating those of the normal-hearing children. The other children, including those with longer CI experience, did not have typical tonal productions; their pitch patterns for lexical tones tended to be flatter, and contextual tone productions were unchanged across tonal contexts. Conclusion Children with CIs face challenges in acquiring Mandarin tones, but early implantation may help them to develop normal-like lexical tone categories, which further facilitates their implementation of contextual tones. Supplemental Material https://doi.org/10.23641/asha.8038889.

On the Implicit Anaphoric Argument of Relational Nouns in Mandarin Chinese.

This paper provides experimental and theoretical evidence for the syntactic realization of an implicit possessor argument in Relational Nouns (RNs, e.g. father) in Mandarin Chinese. The results of Experiment 1 show that the antecedent of the implicit argument in RNs must be a noun phrase (NP) in the sentence where the RN is located, rather than an NP in the discourse context. Experiment 2 shows that the implicit argument of RNs must be bound by a c-commanding NP. The results exclude the possibility that the RNs' implicit argument is a pronominal that would link to a contextually salient NP and would not require a c-commanding referential antecedent. Rather, the experimental results show that the identification of the antecedent of the RNs' implicit argument is constrained by the same principle of binding theory that constrains the reflexive zìjǐ 'self', specifically requiring a c-commanding antecedent.

The effect characteristics of temperature on stroke mortality in Inner Mongolia and globally.

The current study investigated the correlation between stroke mortality and temperature. Monthly and seasonal variations in stroke mortality were plotted and daily stroke-related deaths were calculated. The lag times were calculated using the time series analysis. The correlation between stroke incidence and the diurnal temperature range (DTR) was analyzed using case-crossover analysis. Global stroke mortality was described in five latitudes. In the eastern region of Inner Mongolia, the stroke mortality was 174.18/105, about twice of that of the midwestern regions (87.07/105), and temperature was negatively correlated with stroke mortality. Mortality peaked in the winter and troughed in the summer (χ2 = 13.634, P < 0.001). The days in which stroke-related deaths were greater than ten occurred between late October and early April. The effect of temperature on stroke incidence occurred during a lag time of 1 (P = 0.024) or 2 months (P = 0.039). A DTR over 13 °C was positively correlated (r = 0.95, P = 0.004) with stroke with a lag time of 1 day. The effect of temperature on stroke was shown to be the same for various populations. As the latitude increases, stroke mortality also increases with latitudes > 40°; the highest mortality was 188.05/105 at the highest latitude. Only in relatively cold regions as the temperature decreases does stroke mortality increase for various populations. Differences in the time lag as well as in the DTR lag and DTR critical point vary for both the temperature and region.

Acquisition of weak syllables in tonal languages: acoustic evidence from neutral tone in Mandarin Chinese.

Weak syllables in Germanic and Romance languages have been reported to be challenging for young children, with syllable omission and/or incomplete reduction persisting till age five. In Mandarin Chinese, neutral tone (T0) involves a weak syllable with varied pitch realizations across (preceding) tonal contexts and short duration. The present study examined how and when T0 was acquired by 108 Beijing Mandarin-speaking children (3-5 years) relative to 33 adult controls. Lexicalized (familiar) and non-lexicalized (unfamiliar) T0 words were elicited in different preceding tonal contexts. Unlike previous reports, the present study revealed that children as young as three years have already developed a phonological category for T0, exhibiting contextually conditioned tonal realizations of T0 for both familiar and unfamiliar items. However, mastery of adult-like pitch and duration implementation of T0 is a protracted process not completed until age five. The implications for the acquisition of weak syllables more generally are discussed.

Effects of occupation on intracerebral hemorrhage-related deaths in Inner Mongolia.

This study assessed the relationship between occupation and Intracerebral Hemorrhage-related deaths and compared the differences in ICH-related deaths rates between the eastern and midwestern regions of Inner Mongolia. We used the case-control method. Cases included Intracerebral Hemorrhage-related deaths that occurred from 2009 to 2012 in Inner Mongolia while controls included non-circulatory system disease deaths that occurred during the same period. Odds ratios (ORs) for Intracerebral Hemorrhage-related deaths were calculated using logistic regression analysis, estimated according to occupation, and adjusted for marital status and age. The Intracerebral Hemorrhage mortality rate in the eastern regions (125.19/100000) was nearly 3 times higher than that in the midwestern regions (45.31/100000). ORs for agriculture-livestock workers, service professionals and general workers, professional workers and senior officials were in descending order. The age-adjusted OR for Intracerebral Hemorrhage-related deaths was lowest in unmarried men senior officials (OR 0.37, 95% CI 0.14-0.99). The Intracerebral Hemorrhage mortality rate in the eastern regions was much higher than that of the midwestern regions, since about 90% of Intracerebral Hemorrhage-related deaths in the eastern regions were those of agriculture-livestock workers who has the largest labor intensity of any other occupation assessed.

Analgesic effect of preoperative dezocine-based local anesthesia in patients undergoing inguinal hernia repair.

OBJECTIVE: This study was performed to investigate the analgesic effects of intramuscular injection of dezocine-based local anesthesia in patients undergoing inguinal hernia repair. METHODS: A total of 120 patients underwent local herniorrhaphy from July 2015 to December 2016 and were randomly divided into 2 groups: the dezocine group, in which a preoperative intramuscular injection of dezocine was administered, and the control group, in which no dezocine injection was administered. The patients' pain and comfort levels were evaluated at 30 minutes, 2 hours, 6 hours, 12 hours, and 24 hours postoperatively. RESULTS: The visual analog scale scores at 30 minutes, 2 hours, 6 hours, 12 hours, and 24 hours were significantly lower in the dezocine than control group. In the Bruggemann comfort scale evaluation, patients who received dezocine injections showed significantly greater comfort than those in the control group at 30 minutes, 2 hours, 6 hours, 12 hours, and 24 hours. No adverse reactions occurred in the dezocine group. CONCLUSIONS: Dezocine-based local anesthesia can attenuate postoperative pain and increase the comfort level during and after herniorrhaphy.

Five-Year-olds' Acoustic Realization of Mandarin Tone Sandhi and Lexical Tones in Context Are Not Yet Fully Adult-Like.

Large numbers of children around the world are learning tone languages, but few studies have examined the acoustic properties of children's early tone productions. Even more scarce are acquisition studies on tone sandhi, a tone change phenomenon which alters the surface realization of lexical tones. Two studies using perceptual coding report the emergence of lexical tone and tone sandhi at around 2 years (Li and Thompson, 1977; Hua and Dodd, 2000). However, the only acoustic study available shows that 3-year-olds are not yet adult-like in their lexical tone productions (Wong, 2012). This raises questions about when children's productions become acoustically adult-like and how their tone productions differ from those of adults. These questions were addressed in the current study which compared Mandarin-speaking pre-schoolers' (3-5-year-olds) tone productions to that of adults. A picture naming task was used with disyllabic real words familiar to pre-schoolers. Overall children produced appropriate tone contours for all tones, i.e., level for tone 1, rising for tones 2, 3 and full sandhi, falling for tone 4 and half sandhi. However, children's productions were not adult-like for tones 3, 4, and the sandhi forms, in terms of coordinating pitch range, slope and curvature, with little evidence of development across ages. These results suggest a protracted process in achieving adult-like acoustic realization of both lexical and sandhi tones.