Upward Inflections Research Articles

Circumstances Associated With Suicides Among Females-16 States, United States, 2005-2016.

Suicide rates in the United States have been consistently increasing since 2005 and increasing faster among females than among males. Understanding circumstances related to the changes in suicide may help inform prevention programs. This study describes the circumstances associated with suicides among females in the United States using the National Violent Death Reporting System. We analyzed the circumstances of suicides occurring from 2005 to 2016 in 16 states (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin) among females aged 10 years and above. We compared the percentages of circumstances reported for the entire sample, by age group, and by race/ethnicity. Trends in changes in the leading circumstances were analyzed using Joinpoint regression. From 2005 to 2016, there were 27,809 suicides among females 10 years and older in the 16 states. Overall, the 2 leading precipitating circumstances were current mental health problem and ever treated for mental health problem. The leading circumstances differed by demographics. Joinpoint analysis showed inflection points in reports of job problems, financial problems, and non-intimate partner relationship problems during 2005-2009. During 2010-2016, downward inflections were seen in reports of job problems and financial problems and upward inflections in substance abuse problems and a recent or impending crisis. These findings show changes by age group and race/ethnicity in the circumstances associated with suicides among females in the 16 states have occurred. Studying these shifts and identifying the most salient circumstances among female suicide decedents may help prevention programs adapt to different needs.

Speaking in Shakespeare's Voice: A Guide for American Actors by Linda Gates

Reviewed by: Speaking in Shakespeare's Voice: A Guide for American Actors by Linda Gates Julie Foh Speaking in Shakespeare's Voice: A Guide for American Actors. By Linda Gates. Evanston, IL: Northwestern University Press, 2019; pp. 248. Providing practical exercises, historical context, and the author's personal insight, Speaking in Shakespeare's Voice: A Guide for American Actors seeks to be an all-inclusive voice textbook for US actors who want to perform Shakespeare. Gates, who is head of voice in the Department of Theatre at Northwestern University and a very accomplished vocal coach, begins by making the argument that many American actors presently working in theatre "are still uncertain about how to perform Shakespeare's text" (3), and, with this book, she will "help all actors, but especially American actors, build the vocal skills and confidence necessary to speak Shakespeare's text and to communicate it to an audience" (3–4). To that end, the book provides instruction on the physical aspects of vocal production, the sounds of "Standard American English" (4), elements of Shakespeare's rhetoric and verse structure, and how to use these tools in performance. Additionally, Gates includes an appendix listing monologues and scenes that actors might use to practice these skills in a classroom setting or for an audition. After an introduction outlining the history of Shakespeare performance in the United States, the structure of the book follows the physical process of using language to communicate. The first three chapters include theory and exercises addressing the physical actions of voice work: breath, phonation, and speech sounds (vowels and consonants). The fourth and fifth chapters deal with those elements of voice work united into language: rhetoric and structure (verse and prose). The sixth chapter shifts back from the practical skills of performance of Shakespeare's text to historical context, asking the question, "Which text is Shakespeare's text?" (189). Interwoven throughout the entire book are excerpts from Shakespeare's writings, used as examples for the skills being practiced. Gates has chosen to draw all of these excerpts from Open Source Shakespeare, a free, online compilation of the Bard's works. In explaining her choice to write this book with American actors in mind, Gates describes a number of circumstances under which American actors might have soured on Shakespeare—a dry English class or a bad rehearsal process perhaps. She references the belief, held by some, that only classically trained British actors possess the ability to perform his text well. She seeks to prove to American actors that Shakespeare can belong to them as well, and one piece of evidence she offers to that end is that the pronunciation of Elizabethan British English (or "Original Pronunciation") was closer to the pronunciation of contemporary American English than it is to contemporary British English (by which she means Standard British, otherwise known as Received Pronunciation [RP]). There is evidence to support this assertion, and she cites David Crystal's research into Original Pronunciation several times in the book. So perhaps American actors speaking in their own voices can come close to speaking in Shakespeare's voice. In her chapter on "Breathing for Shakespeare's Text," she includes physical exercises for breath support and capacity so that actors may ultimately communicate longer, denser thoughts. She also describes the difference in function between rhetorical and grammatical uses of punctuation. A rhetorical use of punctuation will tell the speaker when to breathe so that the meaning of the thought is not interrupted by an inhalation. Also in this chapter, Gates advocates for a use of upward inflections right before those catch breaths at pieces of punctuation to keep the thought going until one reaches an end-stop. In her chapter on "Voice Work for Shakespeare," she includes physical exercises for resonance and for finding "optimal pitch" (38). These are common practices in the world of voice training; they come from a prescriptive approach to breath, voice, and text work. In telling the actor when precisely to breathe, when to upward inflect, and where in their pitch/resonance range to speak, Gates lays out a set of rules that could limit the range of the actor's choices. In her chapter on...

A population-based age-period-cohort study of colorectal cancer incidence comparing Asia against the West

BackgroundColorectal cancer (CRC) is the third most common cancer worldwide but incidence varied widely. Despite the role of genetics, CRC is also sensitive to macro-environmental factors. Few studies have ever compared across different countries/regions to suggest possible macro-environmental risk factors of CRC. We estimated the effects of age, period and cohort on the changes of incidence of colorectal cancer across different countries/regions. MethodsPoisson regression age-period-cohort (APC) models were conducted to estimate the age, period and cohorts effects on CRC incidence across the West (i.e., the UK, the US and Australia) and Asia (i.e. Japan, Hong Kong, Shanghai, Singapore and India). We maximized the length of the study period according to each country’s data availability. ResultsWestern populations show upward inflections for their 1950s–1960s cohorts, while Asian populations (except India) show downward inflections for their 1950s cohorts. Japanese population also shows upward inflections for its 1960s cohorts, similar to the Western populations. There are apparent upward inflections towards the more recent cohorts for Hong Kong, Shanghai and Singapore; nevertheless, the confidence intervals are wider towards the more recent cohorts. ConclusionOur findings imply an increasing risk of CRC in both Western and Asian populations as their younger cohorts reach older ages. These findings are consistent with the life course argument that macro-environmental changes associated with socio-economic development have specific effects that extend over the life course. Actions that pertain to altering lifestyle-related exposures over the life course are of great importance in combating young CRC risks in the future.

Laryngeal Manual Therapy as a Treatment for Impaired Production of tahrir Vibrato in Traditional Iranian Singers

Background: Iranian vibrato (tahrir) is a common feature of traditional Iranian singing. A unique feature of tahrir is a modulated voice quality perceived as a rhythmic falsetto voice break associated with upward pitch inflections. Laryngeal discomfort and impaired voice quality can occur in singers when they perform Iranian tahrir using an improper technique. Aim: A case series research design was used to explore voice treatment outcomes using laryngeal manual therapy (LMT) for treating voice problems associated with tahrir singing. Method: Four professional Iranian singers of the traditional style (3 men and 1 woman) were studied. All subjects reported difficulty executing tahrir during performances. They were assessed by a speech-language pathologist (SLP) specializing in the administration of LMT for voice disorders. Multidimensional assessments were made of the participants' vocal function using acoustic and auditory-perceptual evaluation, self-reports of the singers, and LMT assessments by the SLP before and after treatment. The therapeutic program implemented LMT techniques to release laryngeal joints and reduce muscular tension. Results: Pretreatment examination of the larynx and anterior neck musculature using palpation showed that the difficulties in producing tahrir vibrato were associated with a decreased thyrohyoid space and tension in the submental complex and sternocleidomastoid. Posttreatment examination showed an increased thyrohyoid space and reduced tension in the submental complex and sternocleidomastoid, associated with the singers' perception of reduced effort producing tahrir vibrato during singing. Conclusion:Tahrir vibrato requires specific training to prevent excessive tension in laryngeal and neck muscles. In the absence of such training, or in the context of excessive singing associated with fatigue, LMT may facilitate more efficient vocal production in tahrir singers.

The Use of the CUSUM Chart Method for Surveillance of Learning Effects and Quality of Care in Endovascular Procedures

Introduction Quality of care and learning effect surveillance are two mandatory responsibilities within a changing therapeutical paradigm. We aimed to evaluate the feasibility and value of CUSUM chart method in assessing performance in consecutive endovascular procedures done by vascular surgeons of a single department on aorto-iliac, femoropopliteal and renal artery occlusive disease. Material and method Data were collected in 405 consecutive patients, scheduled for endovascular intervention of aorto-iliac ( n = 131, 32.3%), femoropopliteal ( n = 142, 35%) and renal artery ( n = 132, 32.7%) occlusive disease during a 6-year period. Quality indicators included inability to cross the lesion, peri- and post-procedural complications and significant residual stenosis or occlusion at 1 month. CUSUM curves were generated for each territory globally and according to each quality indicator. The relevance of curve upward inflections was evaluated with Fisher’s Exact Test. Results Failure to cross the lesion occurred in 6.9% (aorto-iliac), 10.6% (femoropopliteal) and 2.3% (renal) of patients. One-hundredth twenty aorto-iliac, 127 femoropopliteal and 132 renal angioplasties were finally performed. Peri- and post-procedural complications appeared in 14.5% (aorto-iliac), 9.2% (femoropopliteal) and 2.3% (renal), while significant residual stenosis or occlusion was seen in 0.8%, 4.9% and 2.3% of patients, respectively. Aorto-iliac CUSUM curve showed two upward inflections at the beginning and the end of the period, both associated with peri- and post-procedural complications ( p = 0.002 and p = 0.0013) and the latter also with failure to cross the lesion ( p = 0.009). Femoro-popliteal CUSUM curve moved progressively upward during all the period, initially related to peri- and post-procedural complications ( p = 0.038) and later to failure to cross the lesion ( p = 0.004). Renal CUSUM curve didn’t show any upward inflection during the analysed period. Conclusion CUSUM curves are an excellent tool for measuring learning effect and quality of care within a changing paradigm, such it is the case of endovascular interventions. Curve upward inflections can be further interpreted according to the type of “failure” thus helping to evaluate their underlying causes.

Simulations of Flow in Crystalline Rock and Recharge from Overlying Glacial Deposits in a Hypothetical New England Setting

AbstractCross‐sectional, finite‐difference, steady‐state ground‐water‐flow models of a generalized New England landscape were constructed to examine the effects of hydraulic conductivity and topography on bulk‐fluid flow processes in fractured crystalline rock. The generalized landscape consists of a flat hilltop, a hillside that has a slope of 0.17 ft/ft, and a flat river valley. It includes three hydrogeologic units, stratified drift in the river valley, glacial till, and underlying crystalline rock.Distribution of recharge to and discharge from bedrock is affected by the presence of small topographic features, such as terraces on the hillside. Most of these terraces consist partly or entirely of sand, and they create localized areas of recharge to and discharge from bedrock. Maximum recharge to bedrock commonly occurs at downward inflections of the water table, and discharge occurs at upward inflections of the water table. These inflections of the water table are associated with inflections in topography because the shallow depth of water on hilltops and hillsides resemble the configuration of the land surface.Regional ground‐water flow in crystalline rock and distribution of bedrock recharge and discharge are also affected by heterogeneities in hydraulic conductivity of the bedrock. Vertical heterogeneity creates short, shallow flow paths in high‐relief terrain. Horizontal heterogeneity causes large variations in the size of bedrock recharge areas; in some cases the difference from homogeneous conditions is more than 50 percent.

Hysteresis at near-physiologic substrate concentrations underlies apparent sigmoid kinetics of the glucose-6-phosphatase system

Although Canfield and Arion (J. Bioi. Chem. 263, 7458–7460 (1990)) have described the kinetics as hyperbolic, Traxinger and Nordlie (J. Biol. Chem. 262, 10015–10019 (1987)) reported sigmoid kinetics in the glucose-6-phosphatase system of intact microsomes at near-physiologic glucose-6-P concentrations. We show here that apparent sigmoidal kinetics, most clearly seen as sharp upward inflections in Hanes plots as substrate concentration approaches zero, are a consequence of the hysteretic lag in product formation during the first minutes of incubation of the enzyme with low concentrations of substrate. The appearance of sigmoidicity, observed when reaction velocities are calculated from changes in P i concentration between 0 and 6 min of incubation, is not present when velocity is determined from slopes of [product]-time plots after linearity is achieved. The Km,glucose-6-P value, 0.86 mM, based on these hysteresis-corrected velocity values determined with intact microsomes from normal, control rats at low substrate concentrations, approached the upper limit of physiologic hepatic glucose-6-P concentrations. This suggests that glucose-6-phosphatase activity may be regulated by factors other than substrate concentrations alone. We propose that the hysteretic behavior, not sigmoid kinetics of the glucose-6-phosphatase enzyme system, may be a prime regulatory feature.

Heart and lung hypertrophy, changes in blood volume, hematocrit and plasma renin activity in rats chronically exposed to increasing carbon monoxide concentrations.

Changes in blood volume, heart and lung mass and composition and plasma renin activity were examined in two strains of male albino rats inhaling incrementally-increasing concentrations of CO: 250 ppm for 17 days, 500 ppm for 13-14 days, 750 ppm for 10 days, and 1300 ppm for 10 days. Blood volume increased 86% and erythrocyte mass increased 212% at 1300 ppm, while plasma volume was unchanged or decreased slightly. 'Real' hematocrit (hematocrit corrected for plasma trapping) increased from 50% in controls to a peak of 75% at 1300 ppm CO. Wet weight of right ventricle (RV) and combined right and left atria (2A) increased linearly with CO concentration, paralleling changes in blood volume; while real hematocrit increased non-linearly. Left ventricle + interventricular septum (LV + S) wet weight increased less than RV, but more in Sprague-Dawley than in Wistar rats. Plots of RV, LV + S and 2A weight vs real hematocrit showed sharp upward inflections at real hematocrit 65%, suggesting a possible role of increased viscosity in CO cardiomegaly at the higher hematocrit. Assymetric septal hypertrophy was not present. Lung weight increased with CO concentration, but was not due to increased lung blood volume or edema. Hydroxyproline measurements on heart and lung failed to show increased collagen content. Plasma renin activity measured by radioimmunoassay was depressed at 500 ppm, but was normal at 750 and 1300 ppm CO. Neither heart, lung, liver nor plasma renin measurements suggest congestive heart failure, supporting previous studies in the rat with chronic carboxyhemoglobinemia, in spite of enormously increased blood volume, hematocrit and heart weight.

Bud, root, and growth-regulator activity in Acer saccharum during the dormant season

Exposure of dormant sugar maple seedlings to over 2000 h of winter temperatures of 5 °C and below was required for rapid and normal growth when seedlings were transferred to a warm greenhouse and extended photoperiods. Although chilling requirements were not fully satisfied until mid-March, a resurgence of metabolic activity occurred in early February. There was a marked shift in the potential for budbreak from the axillary to the terminal buds, and a surge in root growth occurred after a period of inactivity when the ground was frozen from late December to mid-January. The water content of the buds followed a pattern similar to that of the roots. It fell to a plateau in late fall well before the soil froze but began a steady increase with the resumption of active root growth in February. Inhibitory substances present in the buds did not exhibit significant changes during the overwintering period. However, cytokinin activity was observed beginning in February at the same time that root growth and bud succulence showed upward inflections. By the beginning of April there were two distinct peaks of activity which persisted through budbreak in early May.Seedlings that were brought into the greenhouse in the fall and never exposed to chilling temperatures did not break dormancy or show significant cytokinin activity or exhibit the physiological changes that occur under normal winter conditions.

Sorption in the β-phases of transition metal(II) tetra-(4-methylpyridine) thiocyanates and related compounds

In addition to the previously known clathrate complexes with aromatic hydrocarbons and certain of their derivatives, the β-phases of MII(4-methylpyridine)4(SCN)2(where MII is a transition metal such as Co, Ni, or Mn) have now been found to sorb numerous other guest species. The β-phases behaved, like the zeolites, as crystals permanently porous in the absence of guest molecules, and the sorption isotherms were reversible.Sorption was investigated, often over a range of temperatures, for the following guest molecules: O2, N2, Ar, Kr, Xe; CH3Cl, CH2Cl2, CHCl3, CCl4; C1 to C6 n-paraffins; C6H6, toluene, ethylbenzene, and o-, m-, and p-xylene; cyclohexane; isopentane and 2,2,4-trimethylpentane; C1 to C6 primary alcohols derived from n-paraffins; CO2, CS2, and C2H5·O·C2H5. Sorption is related to size, shape, and polarity of the guest molecules.Isotherms were of Types I, IV, and V in Brunauer's classification. Isosteric heats of sorption were found to correlate with heats of vapourisation of the liquid sorbates, or their b.p.s, thus emphasising the physical nature of the sorption. For small molecules stepped isotherms or isotherms showing upward inflections were often observed. It is suggested that this behaviour arises from the reversible generation of extra sorption sites above certain threshold pressures.Of ligands other than 4-methylpyridine, 4-ethylpyridine gave a complex which sorbed benzene, toluene, ethylbenzene, and o- and p-xylene, but not m-xylene, CO2, Xe, or aliphatic compounds. Other pyridine-based ligands gave complexes which did not form clathrate phases.

Pitch and Duration Characteristics of the Oral Reading of Males on a Masculinity-Femininity Dimension

Certain vocal characteristics of 14 males were compared and rated on the basis of voice on a masculinity-femininity continuum. The voices consisted of the extremes of a larger population selected by faculty from the college student body. The relatively effeminate voices had a median pitch of 127 Hz; the relatively masculine voices, 100 Hz. If the median pitch of unselected American males is 130 Hz, it appears that effeminacy may be associated with voices considerably lower than the typical female pitch. The relatively effeminate voices also displayed a mean rate of pitch change during inflections greater than that of the relatively masculine voices with a greater difference for upward inflections. None of the other measured vocal characteristics discriminated between the two groups.