Speech Acoustic Parameters for Predicting Presbyphagia: A Preliminary Study in the Elderly Shanghainese Population.

PURPOSE: Age is a high-risk factor for dysphagia. Speech and swallowing share the same anatomical and neurophysiological basis. Their functions are closely related; hence, speech assessment can predict the risk of dysphagia. This study aimed to investigate the factors influencing presbyphagia in a normal elderly Shanghainese population by analyzing speech acoustic parameters. METHODS: Relevant speech acoustic parameters were compared between 15 people with dysphagia and 15 without dysphagia. After extracting sensitive speech acoustic parameters related to swallowing, changes in sensitive parameters were compared at different ages to analyze the relevant factors influencing presbyphagia in the normal elderly population. RESULTS: Eight speech acoustic parameters related to swallowing, including maximum phonation time (MPT), max F0, /ʔʌ/Jitter, /ʔʌ/L-DDK, /hʌ/L-DDK, /pataka/DDK, F1/a/, and vowel space area, were extracted after comparing the relevant data between the two groups. Analyzing the changes in each of these parameters between different age groups (age 18-39, 40-64, and 65 and above), we discovered that three speech acoustic parameters, including MPT, /hʌ/L-DDK, and /pataka/DDK, had statistical differences, with a decreasing trend in their mean values with increasing age. CONCLUSIONS: The elderly group had significantly lower MPT, /hʌ/L-DDK, and /pataka/DDK than the young and middle-aged groups. We hypothesized that reduced respiratory support and control, decreased range of mouth movements and coordination, closed control of the vocal cords, and inadequate airflow control in vocal cord abduction are risk factors for presbyphagia in the elderly Shanghainese population.

Cross-cultural adaptation and validation of vocal fatigue index (VFI) to Chinese language.

Objectives: This study aimed to translate the Vocal Fatigue Index (VFI) into Simplified Chinese and test its reliability and validity in mainland China. Methods: The original English version of the VFI was translated and adapted to a Simplified Chinese version (VFI -SC). Fifty-four participants with voice disorders and 21 healthy controls completed the VFI-SC. Sixteen participants with voice disorders completed it again two weeks later. Reliability, validity, and receiver operating characteristic (ROC) of the VFI-SC were analyzed. Results: The Cronbach's alpha values for the VFI factor scores were found to be 0.930 for tiredness and avoidance of voice use (factor 1), 0.878 for physical discomfort with voice use (factor 2), and 0.915 for improvement of symptoms with voice rest (factor 3). The test-retest reliability was 0.967 for all three factors. There was a significant difference between the total scores of the patient group and the control group (p < 0.01). Factor 1 and factor 2 were positively correlated with the Voice Handicap Index (VHI-30). The ROC curves showed acceptable intrinsic accuracies for factor 1 (AUC = 0.883), factor 2 (AUC = 0.901), and factor 3 (AUC = 0.800), with cutoff scores of 22, 7, and 9, respectively. Conclusions: This study provides preliminary evidence that the VFI-SC has good reliability and validity. It can be used to screen for clinical symptoms of voice fatigue in mainland China.

The Association between Parkinson's Disease and Congestive Heart Failure in Korea: A Nationwide Longitudinal Cohort Study.

The purpose of this nationwide longitudinal follow-up study is to investigate the relationship between Parkinson's disease (PD) and congestive heart failure (CHF) patients in Korea. Patient data were collected using the National Health Insurance Service (NHIS) Health Screening (HEALS) cohort. The International Classification of Diseases 10-CM code G-20 distinguished 6475 PD patients who were enrolled in the PD group. After removing 1039 patients who were not hospitalized or attended an outpatient clinic less than twice, the total number of participants was reduced to 5436 individuals. Then, 177 patients diagnosed before 1 January 2004 were removed for relevancy, leaving us with 5259 PD patients. After case-control matching was completed using 1:5 age- and gender-coordinated matching, 26,295 people were chosen as part of the control group. The Cox proportional hazards regression analysis and the Kaplan-Meier technique were used to assess the risk of CHF in patients with Parkinson's disease. After controlling for age and gender, the hazard ratio of CHF in the PD group was 5.607 (95% confidence interval (CI), 4.496-6.993). After that, the hazard ratio of CHF in the PD group was modified against for comorbid medical disorders, resulting in a value of 5.696 (95% CI, 4.566-7.107). In subgroup analysis, CHF incidence rates were significantly increased in the PD group compared to the control group (males and females; aged ≥ 65 and <65; the non-diabetes and diabetes, hypertension and non-hypertension, and dyslipidemia and non-dyslipidemia subgroups). This nationwide longitudinal study shows a higher incidence rate of CHF in PD patients.

Causal Effect of the 25-Hydroxyvitamin D Concentration on Cerebral Small Vessel Disease: A Mendelian Randomization Study.

BACKGROUND: Previous observational studies reported that a lower serum 25-hydroxyvitamin D [25(OH)D] concentration is associated with a higher burden of cerebral small vessel disease (cSVD). The causality of this association is uncertain, but it would be clinically important, given that 25(OH)D can be a target for intervention. We tried to examine the causal effect of 25(OH)D concentration on cSVD-related phenotypes using a Mendelian randomization approach. METHODS: Genetic instruments for each serum 25(OH)D concentration and cSVD-related phenotypes (lacunar stroke, white matter hyperintensity, cerebral microbleeds, and perivascular spaces) were derived from large-scale genome-wide association studies. We performed 2-sample Mendelian randomization analyses with multiple post hoc sensitivity analyses. A bidirectional Mendelian randomization approach was also used to explore the possibility of reverse causation. RESULTS: We failed to find any significant causal effect of 25(OH)D concentration on cSVD-related phenotypes (odds ratio [95% CI], 1.00 [0.87-1.16], 1.01 [0.96-1.07], 1.06 [0.85-1.33], 1.00 [0.97-1.03], 1.02 [0.99-1.04], 1.01 [0.99-1.04] for lacunar stroke, white matter hyperintensity, cerebral microbleeds, and white matter, basal ganglia, hippocampal perivascular spaces, respectively). These results were reproduced in the sensitivity analyses accounting for genetic pleiotropy. Conversely, when we examined the effects of cSVD phenotypes on 25(OH)D concentration, cerebral microbleeds were negatively associated with 25(OH)D concentration (0.94 [0.92-0.96]). CONCLUSIONS: Given the adequate statistical power (>0.8) of the analyses, our findings suggest that the previously reported association between 25(OH)D concentration and cSVD phenotypes might not be causal and partly attributed to reverse causation.

Laryngeal Diadochokinesis in the Mandarin Population.

INTRODUCTION: This study identifies the most suitable syllable for laryngeal diadochokinesis (LDDK) in Mandarin speakers. METHODS: One hundred and ten Mandarin speakers aged 18-83 years were used in the study. LDDK was assessed using quick repetitions of /ʔe/, /ʔi/, /ʔa/, /he/, /ha/, and /hi/. The observation index included the average rate (syllable/s) and regularity (%). RESULTS: In the various age groups, there was no significant difference in LDDK rate and regularity of adducted syllables (p > 0.05), and only the regularity of /ʔi/ is significantly different between aged 18-40 and 41-64 years (p = 0.040). When vocal fold adduction was compared between various syllables, there was no significant difference in LDDK rate and regularity (p > 0.05). In various age groups, the LDDK rate of abduction syllables is different (p < 0.05) compared with the LDDK regularity of abduction syllables (p > 0.05). In various abduction syllables, there is no difference in LDDK rate (p > 0.05); however, /ha/ and /hi/ have significant differences in LDDK regularity (p = 0.007). CONCLUSION: According to the preliminary data, /ʔa/ and /ha/ can be used as suitable indicators to analyse the coordination ability of the laryngeal movement of Mandarin speakers.

The Relationship between Rainfall Pattern and Epilithic Diatoms in Four Streams of Central-Western Korea for Three Years (2013-2015).

To study the effect of rainfall patterns on diatom communities in four major central western streams on the Korean Peninsula during the monsoon seasons of 2013 through 2015, we measured precipitation, environmental factors, and epilithic diatoms at 42 sites before (May) and after (August and September) each monsoon. The Mangyeonggang river and Sapgyocheon stream (SS) had a high percentage of low-permeability soil, and the stream had the highest proportion (49.1%) of surrounding land in urban areas. Precipitation and precipitation frequency was closely correlated with electrical conductivity and nutrients, and this was particularly evident in SS. Epilithic diatom abundance for the most abundant species as, Navicula minima, decreased in the stream in 2013 and 2014 and increased in 2015 when precipitation and precipitation frequency were low. This was not clearly distinguishable in the ecological characteristics of each watercourse's indicator species, except in SS. The dynamic community index was highest in 2015 (ca. 5.50), and the annual changes in the index were clearly shown in SS. The precipitation pattern and the dynamic community index were negatively correlated (r = -0.026~-0.385), and the precipitation within 2 weeks (r = -0.480 for SS) before the second sampling and the frequency of 10 mm of precipitation were closely correlated in the stream (r = -0.450 for SS). The distribution of epilithic diatoms in the four watercourses is therefore affected by monsoon precipitation and precipitation frequency, and the dynamic community index is determined by soil characteristics and land use.

Association between ischemic stroke and pyogenic spondylitis in Korea: Nationwide longitudinal cohort study.

OBJECTIVE: The purpose of this nationwide age- and sex- matched longitudinal study was to determine the pyogenic spondylitis (PS) increases the incidence of ischemic stroke (IS) in Korea. METHODS: From the National Health Insurance Service (NHIS), we collected the patient data for the period from January 1, 2004 to December 31, 2015. PS was classified according to the International Classification of Disease codes M46.2-M46.8, M49.2, and M49.3. By using a 1:5 age- and sex- stratified matching, a total of 628 patients and 3140 control subjects were included in the study. The IS incidence rates in PS and control group was calculated by using the Kaplan-Meier method. The outcome of hazard ratio of IS was estimated by Cox proportional hazards regression analyses. This study did not exclude PS as a result of postoperative complications. RESULTS: According to the study, 51 patients (8.12%) in the PS group and 201 patients (6.4%) in the control group experienced IS. The adjusted hazard ratio of IS in the PS group was 3.419 (95% CI: 2.473-4.729) after adjusting individual medical condition and demographics. Following the results of subgroup analysis, the risk ratio of IS was greater in most of the subgroup categories (male, female, age <65, age >65, non-diabetic, hypertensive, non-hypertensive, dyslipidemic and non-dyslipidemic subgroup). However, the risk of IS did not differ significantly in diabetic subgroup (95% CI: 0.953-4.360). CONCLUSIONS: The risk rate of IS increased in patient with pyogenic spondylitis.

The Relationship between Parkinson's Disease and Acute Myocardial Infarction in Korea : A Nationwide Longitudinal Cohort Study.

OBJECTIVE: The goal of the following statewide age and gender-coordinated cohort study in Korea is to find out if there is a link between acute myocardial infarction (AMI) and Parkinson's disease (PD). METHODS: Utilizing the National Health Insurance Sharing Service cohort, patient data were collected. Six thousand four hundred seventy-five individuals with PD were distinguished by utilizing the International Classification of Diseases 10 code G20 and have enrolled in the PD group. The number of participants decreased to 5259 after excluding 1039 patients who were hospitalized less than one time or who visited an outpatient clinic less than twice. Then, 26295 individuals were selected as part of the control group after case control matching was conducted through 1 : 5 age- and gender-coordinated matching. The Cox proportional hazard regression analysis and Kaplan-Meier method were utilized to analyze the likelihood of AMI in PD. RESULTS: After controlling for age and gender, the hazard ratio of AMI in the PD group was 3.603 (95% confidence interval [CI], 2.837-4.577). After that, the following hazard ratio of AMI in the PD group was modified against for co-morbid medical disorders, resulting in 3.551 (95% CI, 2.795-4.511). According to a subgroup analysis, in males and females aged <65 and aged ≥65 and in the non-diabetes and diabetes, hypertension and non-hypertension, dyslipidemia and non-dyslipidemia subgroups, the AMI incidence rates were dramatically higher in the PD group compared to that of the control. CONCLUSION: Individuals with PD have a greater chance of AMI, according to this cross-national study.

Prediction of Geosmin at Different Depths of Lake Using Machine Learning Techniques.

Geosmin is a major concern in the management of water sources worldwide. Thus, we predicted concentration categories of geosmin at three different depths of lakes (i.e., surface, middle, and bottom), and analyzed relationships between geosmin concentration and factors such as phytoplankton abundance and environmental variables. Data were collected monthly from three major lakes (Uiam, Cheongpyeong, and Paldang lakes) in Korea from May 2014 to December 2015. Before predicting geosmin concentration, we categorized it into four groups based on the boxplot method, and multivariate adaptive regression splines, classification and regression trees, and random forest (RF) were applied to identify the most appropriate modelling to predict geosmin concentration. Overall, using environmental variables was more accurate than using phytoplankton abundance to predict the four categories of geosmin concentration based on AUC and accuracy in all three models as well as each layer. The RF model had the highest predictive power among the three SDMs. When predicting geosmin in the three water layers, the relative importance of environmental variables and phytoplankton abundance in the sensitivity analysis was different for each layer. Water temperature and abundance of Cyanophyceae were the most important factors for predicting geosmin concentration categories in the surface layer, whereas total abundance of phytoplankton exhibited relatively higher importance in the bottom layer.

Association of Parkinson's disease with ischemic stroke in Korea: A nationwide longitudinal cohort study in Korea.

OBJECTIVE: The aim of this nationwide age- and sex- matched longitudinal follow up study is to determine the risk of Parkinson's disease (PD) associated with ischemic stroke in Korea. METHODS: Patient data were collected from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). PD was identified using the International Classification of Diseases (ICD) 10-CM code G 20. In total, 6,475 patients were enrolled in the PD group from the NHISS. After subtracting 1,039 patients who underwent hospitalization less than once or those who visited an outpatient clinic less than two times, 5,259 patients who were diagnosed after January 1, 2004 ultimately participated in this study. After case-control match was done through 1:5 age- and sex- stratified matching, 26,295 individuals were chosen as control. Kaplan-Meier method and Cox proportional hazard regression analysis were performed to evaluate the risk of ischemic stroke in PD. RESULTS: The hazard ratio of ischemic stroke in the PD group was 3.848 (95% confidence interval (confidence interval [CI]): 3.14-4.70) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in PD group was 3.885 (95% CI: 3.17-4.75) after adjusting for comorbidities. According to subgroup analysis, in male and female and non-diabetes and diabetes and non-hypertension and hypertension and dyslipidemia and non-dyslipidemia subgroups, ischemic stroke incidence rates were significantly higher in the PD group than those in the control group. CONCLUSIONS: This nationwide longitudinal study suggests an increased risk of ischemic stroke in PD patients.

DNA Methylation Changes Associated With Type 2 Diabetes and Diabetic Kidney Disease in an East Asian Population.

CONTEXT: There is a growing body of evidence that epigenetic changes including DNA methylation influence the risk of type 2 diabetes (T2D) and its microvascular complications. OBJECTIVE: We conducted a methylome-wide association study (MWAS) to identify differentially methylated sites (DMSs) of T2D and diabetic kidney disease (DKD) in a Korean population. METHODS: We performed an MWAS in 232 participants with T2D and 197 nondiabetic controls with the Illumina EPIC bead chip using peripheral blood leukocytes. The T2D group was subdivided into 87 DKD patients and 80 non-DKD controls. An additional 819 individuals from 2 population-based cohorts were used to investigate the association of identified DMSs with quantitative metabolic phenotypes. A mendelian randomization (MR) approach was applied to evaluate the causal effect of metabolic phenotypes on identified DMSs. RESULTS: We identified 8 DMSs (each at BMP8A, NBPF20, STX18, ZNF365, CPT1A, and TRIM37, and 2 at TXNIP) that were significantly associated with the risk of T2D (P < 9.0 × 10-8), including 3 that were previously known (DMSs in TXNIP and CPT1A). We also identified 3 DMSs (in COMMD1, TMOD1, and FHOD1) associated with DKD. With our limited sample size, we were not able to observe a significant overlap between DMSs of T2D and DKD. DMSs in TXNIP and CTP1A were associated with fasting glucose and glycated hemoglobin A1c. In MR analysis, fasting glucose was causally associated with DMS in CPT1A. CONCLUSION: In an East Asian population, we identified 8 DMSs, including 5 novel CpG loci, associated with T2D and 3 DMSs associated with DKD at methylome-wide statistical significance.

Association between ischemic stroke and seropositive rheumatoid arthritis in Korea: A nationwide longitudinal cohort study.

The purpose of this longitudinal follow-up study was to investigate the risk of ischemic stroke nationwide in patients with seropositive rheumatoid arthritis (RA) and controls who were matched in age and sex. Patient data were collected from the National Health Insurance Service (NHIS) Health Screening (HEALS) cohort. Using the International Classification of Diseases code M05 (seropositive RA), with a prescription of any disease-modifying anti-rheumatic drug (DMARD), RA was identified. A total of 2,765 patients and 13,825 control subjects were included in our study. The 12-year incidence of ischemic stroke in each group was calculated using the Kaplan-Meier method. The risk ratio of ischemic stroke was estimated using Cox proportional hazards regression. Sixty-four patients (2.31%) in the seropositive RA group and 512 (3.70%) in the control group experienced ischemic stroke (P < 0.001) during the follow-up period. The hazard ratio of ischemic stroke in the seropositive RA group was 1.32 (95% confidence interval (CI), 1.02-1.73) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in the seropositive RA group was 1.40 (95% CI, 1.07-1.82) after adjusting for demographics and comorbid medical disorders. According to the subgroup analysis, the hazard ratios of ischemic stroke risks in the female and hypertensive subgroups were 1.44 (95% CI, 1.05-1.97) and 1.66 (95% CI, 1.16-2.38), respectively. In the non-diabetes and non-dyslipidemia subgroups, the corresponding hazard ratios of ischemic stroke were 1.47 (95% CI, 1.11-1.95) and 1.43 (95% CI, 1.07-1.91). Seropositive RA patients have an increased risk of ischemic stroke. In female, hypertension, non-diabetes, and non-dyslipidemia RA subgroups, even without the traditional risk factors for stroke (except for hypertension), increased the risk, which could be potentially attributed to RA.

Causal relationship between the timing of menarche and young adult body mass index with consideration to a trend of consistently decreasing age at menarche.

Younger age at menarche (AAM) is associated with higher body mass index (BMI) for young women. Considering that continuous trends in decreasing AAM and increasing BMI are found in many countries, we attempted to assess whether the observed negative association between AAM and young adult BMI is causal. We included 4,093 women from the Korean Genome and Epidemiology Study (KoGES) and Healthy twin Study (HTS) with relevant epidemiologic data and genome-wide marker information. To mitigate the remarkable differences in AAM across generations, we converted the AAM to a generation-standardized AAM (gsAAM). To test causality, we applied the Mendelian randomization (MR) approach, using a genetic risk score (GRS) based on 14 AAM-associated single nucleotide polymorphisms (SNPs). We constructed MR models adjusting for education level and validated the results using the inverse-variance weighted (IVW), weighted median (WM), MR-pleiotropy residual sum and outliers test (MR-PRESSO), and MR-Egger regression methods. We found a null association using observed AAM and BMI level (conventional regression; -0.05 [95% CIs -0.10-0.00] per 1-year higher AAM). This null association was replicated when gsAAM was applied instead of AAM. Using the two-stage least squares (2SLS) approach employing a univariate GRS, the association was also negated for both AAM and gsAAM, regardless of model specifications. All the MR diagnostics suggested statistically insignificant associations, but weakly negative trends, without evidence of confounding from pleiotropy. We did not observe a causal association between AAM and young adult BMI whether we considered the birth cohort effect or not. Our study alone does not exclude the possibility of existing a weak negative association, considering the modest power of our study design.

Association of acute myocardial infarction with seropositive rheumatoid arthritis in Korea: A nationwide longitudinal cohort study.

BACKGROUND: The aim of this nationwide age- and sex matched longitudinal follow up study is to determine the risk of acute myocardial infarction (AMI) associated with the seropositive rheumatoid arthritis (RA) population in Korea. METHODS: Patient data were collected from the National Health Insurance Service Health Screening cohort. RA was identified using the International Classification of Diseases code M05 (seropositive RA), with a prescription of any disease-modifying anti-rheumatic drug (DMARD). A total of 2,765 patients were enrolled in the seropositive RA group from January 1, 2004 to December 31, 2015 from the NHIS. The control group consisted of 13,825 subjects. The 12-years AMI incidence rate for each group was calculated using the Kaplan-Meier method. A Cox proportional-hazards regression analysis was used to estimate the hazard ratio of AMI. RESULTS: During the follow-up period, 39 patients (1.41%) in the seropositive RA group and 111 (0.80%) in the control group experienced AMI (P = 0.003). The hazard ratio of AMI in the seropositive RA group was 3.879 (95% confidence interval (CI): 2.64-5.68) after adjusting for age and sex. The adjusted hazard ratio of AMI in the seropositive RA group was 4.212 (95% CI: 2.86-6.19) after adjusting for demographics and comorbid medical disorders. According to subgroup analysis, in male and female and the non-diabetes and non-hypertension and hypertension and dyslipidemia and non-dyslipidemia subgroups, AMI incidence rates were significantly higher in the seropositive RA group than in the control group. CONCLUSION: Our nationwide longitudinal study suggests an increased risk of AMI in seropositive RA patients.

Validation of the Dysphonia Severity Index in the Dr. Speech Program.

PURPOSE: The Dysphonia Severity Index (DSI) is an objective multiparameter index of voice quality that measures and describes overall voice quality. Some studies have suggested that the reliability of devices for DSI measurement should be examined. We explored the feasibility of DSI measurements using the Dr. Speech (DRS) device, verified its effectiveness for clinical voice measurements and intradevice reliability, and examined the correlation between the DSI and self-evaluations of voice problems. METHODS: Seventy adult participants (including individuals with voice problems and healthy adults) underwent objective and subjective voice assessments. These data were then used to establish a DSIDRS model and test the intradevice (DRS device and Praat software) reliability. The clinical validation of the DSIDRS was conducted by measuring the DSI of six other participants and comparing the observed and predicted perceived voice quality as expressed by the G score (of the GRBAS scale). Moreover, the relationship between the DSI measurements and participants' self-evaluations of voice problems was investigated by analyzing the correlation between the DSI and the Voice Handicap Index (VHI). RESULTS: The DSIDRS discriminated 80% of participants' voice quality ratings. There were strong correlations between the DSI and variables measured by the DRS device and Praat software. Furthermore, there was no significant correlation between the DSIDRS and VHI. CONCLUSION: The DRS device can perform DSI measurements. Objective voice measurements and perceptual voice ratings reflected different aspects of vocal function and its effects. These factors should be considered in clinical practice settings.

Benthic Diatom Communities in Korean Estuaries: Species Appearances in Relation to Environmental Variables.

In the Korean Peninsula's southern estuaries, the distributive characteristics of epilithic diatoms and the important environmental factors predicting species occurrence were examined. The collection of diatoms and measurements of water quality and land-use were performed every May between 2009 and 2016, with no influence from the Asian monsoon and snow. Throughout the study, 564 diatoms were classified with first and second dominant species of Nitzschia inconspicua and N. perminuta. Based on diatom appearance and standing crops, the 512 sampling stations were divided into four groups by cluster analysis, and two regions, namely the West and East Sea. Geographically, G1, G2, G3, and G4 were located in the East Sea, Southeast Sea, West Sea, and Southwest Sea, respectively. Canonical correspondence analysis (CCA) results indicated that environmental factors, such as turbidity, electric conductivity (EC), and total phosphorus (TP), significantly influenced the distribution of epilithic diatoms. A random forest model showed that major environmental factors influencing the diatom species appearance included EC, salinity, turbidity, and total nitrogen. This study demonstrated that the spatial distribution of epilithic diatoms in the southern estuaries of the Korean Peninsula was determined by several factors, including a geographically higher tidal current-driven turbidity increase and higher industrial or anthropogenic nutrient-loading.

Influence of gender and age on the Dysphonia Severity Index: A normative study in a Shanghainese population.

Dysphonia Severity Index (DSI) is an objective multi-parametric measurement of voice quality, which has been widely used in different countries. Studies indicate that DSI may be influenced by vocal pathology, age and geographical factors, whereas gender does not significantly affect DSI. The purpose of this study was to investigate the effects of gender and age on the DSI and related parameters in a Shanghainese population. The present study measured the DSI and the parameters maximum phonation time (MPT), highest fundamental frequency (HF0), lowest intensity (LI) and Jitter in 187 Shanghainese subjects, including 106 young adults aged 18-23 years (52 males and 54 females) and 81 children aged 7-9 years (44 boys and 37 girls). Two-way analysis of variance indicated that HF0 was significantly higher in female subjects than in male subjects, in both young adults and children. Gender was not significantly associated with MPT, LI, jitter or DSI. With regard to age, MPT and DSI were significantly higher in young adults than in children, and HF0 and LI were significantly lower. No significant associations between age and jitter were detected. In terms of clinic significance, the results of this study may contribute to the establishment of a normal reference range for Shanghainese DSI values, and the influence of gender and age on DSI and its separate components.

'Yummy Mummies': exploring sexuality in the antenatal and postnatal period.

Sexuality is often bound together with sexual function in contemporary sexual health literature; however, sexuality is a multidimensional phenomenon that has a broader historical concept and cultural meaning. In addition to a significant global decline in sexual function, women may experience decline in emotional satisfaction and physical pleasure up to 4.5 years after giving birth. Midwives have an important role in raising conversations about sexuality on a regular basis during antenatal visits, and informing couples about the decline of libido, desire and orgasm, which may lead to reduction in sexual intercourse frequency, particularly in the last trimester and puerperium.

Dialectal and gender differences in nasalance for a Mandarin population.

The purpose of this study was to determine whether there are dialectal and gender related differences in nasalance of main Mandarin vowels and three sentences in 400 Chinese normal adults. The mean nasalance score difference for dialect and gender was significant (p < .001) in all speech materials. For different dialects, the average nasalance scores show that Chongqing > Beijing > Shanghai > Guangzhou for the nasal sentence, oro-nasal sentence, /a/, /i/ and /u/. In addition, the average nasalance scores of females were higher than those of males for all speech materials in all dialects. The clinical significance of this study can be helpful in making nasalance clinical decisions for Chinese people with cleft palate, hearing disorders and dysarthria with resonance disorders. It also shows the theoretical and socio-cultural features for linguists considering dialects and gender.

Water quality improvement by natural plant-mineral composites and field temperatures of a eutrophic lake in South Korea.

To improve the water quality of Shingal Reservoir, a eutrophic lake in South Korea, field tests were performed to assess the influence of water temperature on water quality improvement (WQI) ability of domestic plant-mineral composites (PMCs). Interestingly, Cyanobacterium was found to be dominant even in low-temperature seasons, especially winter leading to more effective for diatom growth. Factors such as phytoplankton, biological oxygen demand (BOD) and phosphorous showed high WQI over 70% at 20 degrees C, but declined to 40% at temperatures above 25 degrees C. WQI for Cyanobacteria decreased with increasing water temperature, whereas for diatoms WQI was 90% regardless of water temperature. Additionally, bacterial density and total nitrogen showed very low WQI without water temperature. Collectively, the results indicate that high water temperature decreased WQI ability of a PMC to control phytoplankton (Microcystis aeruginosa) and increased their ability to control diatoms.