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Research on post-repair representations of garden path sentences has found that readers systematically arrive at misinterpretations even after displaying evidence of reanalysis (Christianson et al., 2001; Ferreira et al., 2001). These comprehension errors have been attributed to the semantic interpretation associated with the incorrect parse persisting past disambiguation, but less is known about the mechanism driving this phenomenon (Sturt, 2007; Slattery et al., 2013). A speeded auditory comprehension experiment examined the depth of semantic processing as an independent influence on the strength of semantic persistence, drawing on known effects of pitch accent on the processing of focus-related semantic meaning (Fraundorf et al., 2010). Participants heard garden path sentences with early/late-closure ambiguity (e.g., While Anna dressed the baby stopped crying) with a sharply rising pitch accent on either the unambiguous adjunct subject or the ambiguously transitive adjunct verb, followed by a comprehension question that probed whether the incorrect late-closure analysis persisted. Since the pitch accent is often a strong cue for semantic focus when it occurs in prosodically marked phrase-medial positions, we reasoned that a deeper semantic processing would be facilitated for the late-closure analysis only when the verb receives a pitch accent. Findings indicate that a pitch accent on the verb significantly decreased accuracy without a corresponding increase on response time, suggesting that a deeper semantic processing of the erroneous parse can strengthen its resistance to revision without necessarily interfering with the process of structure-building.

Purpose The current study examines the overlapping victimizations of sexual assault, sexual harassment, and stalking. Method An online data collection platform was used to recruit participants and data analysis examined relationship abuse and stalking victimization experiences and victim harms (e.g., resource losses, negative identity perceptions, sexual autonomy, and current mental health symptoms) for ex-partner stalking victims who were sexually assaulted during the abusive relationship (n = 392) compared to ex-partner stalking victims who were not sexually assaulted during the relationship (n = 169). Results Results found that over half of the women sexually assaulted during the relationship reported sexual assault while being stalked compared to a small proportion of women not sexually assaulted during the relationship. Sexual harassment experiences were pervasive regardless of relationship sexual assault victimization. However, women sexually assaulted during the relationship experienced increased coercive control, sexual harassment, resource losses, safety concerns, sexual difficulties, and current mental health symptoms than stalking victims who were not sexually assaulted during the relationship. Multivariate results found that younger age, higher safety efficacy, and fewer sexual difficulties were significantly associated with higher sexual autonomy while younger age, increased safety concerns, lower safety efficacy, increased resource losses, and increased sexual difficulties were significantly associated with increased recent PTSD and depression/anxiety symptoms. Conclusion The current study results suggest that it is important to examine a wide scope of victim harms and that helping victims with safety planning in intimate relationships as well as to protect resource losses may be crucial for their recovery journey., Author(s): TK Logan [sup.1] , Jennifer Cole [sup.1] Author Affiliations: (1) https://ror.org/02k3smh20, grid.266539.d, 0000 0004 1936 8438, University of Kentucky, , 333 Waller Ave, Suite 480, 40504, Lexington, KY, USA [...]

Introduction: Much of Yemen’s infrastructure and healthcare system has been destroyed by the ongoing civil war that began in late 2014. This has created a dire situation that has led to food insecurity, water shortages, uncontrolled outbreaks of infectious disease and further failings within the healthcare system. This has greatly impacted the practice of emergency medicine (EM), and is now compounded by the coronavirus disease 2019 (COVID-19) global pandemic. Methods: We conducted a systematic review of the current state of emergency and disaster medicine in Yemen, followed by unstructured qualitative interviews with EM workers, performed by either direct discussion or via phone calls, to capture their lived experience, observations on and perceptions of the challenges facing EM in Yemen. We summarize and present our findings in this paper. Results: Emergency medical services (EMS) in Yemen are severely depleted. Across the country as a whole, there are only 10 healthcare workers for every 10,000 people – less than half of the WHO benchmark for basic health coverage – and only five physicians, less than one third the world average; 18% of the country’s 333 districts have no qualified physicians at all. Ambulances and basic medical equipment are in short supply. As a result of the ongoing war, only 50% of the 5056 pre-war hospitals and health facilities are functional. In June 2020, Yemen recorded a 27% mortality rate of Yemenis who were confirmed to have COVID-19, more than five times the global average and among the highest in the world at that time. Conclusion: In recent years, serious efforts to develop an advanced EM presence in Yemen and cultivate improvements in EMS have been stymied or have failed outright due to the ongoing challenges. Yemen’s chronically under-resourced healthcare sector is ill-equipped to deal with the additional strain of COVID-19.

Understanding and responding to adverse human health impacts of global environmental change will be a major priority of 21st century public health professionals. The emerging field of planetary health aims to face this challenge by studying and promoting policies that protect the health of humans and of the Earths natural systems that support them. Public health, drawing on its experience of guiding policies to improve population health, has contributed to planetary healths development. Yet, few public health practitioners are familiar with planetary healths systems-oriented approaches for understanding relationships between economic development, environmental degradation, and human health. In this narrative review, we present key planetary health concepts and show how systems thinking has guided its development. We discuss historical approaches to studying impacts of economic development on human health and the environment. We then review novel conceptual frameworks adopted by planetary health scientists to study and forecast impacts of policies that influence human health and Earths natural systems at varying spatiotemporal scales. We conclude by presenting examples of how applying the Doughnut model (an economic framework where the needs of people are met without overshooting the worlds ecological limits) could guide policies for promoting health co-benefits to humans and natural systems.

This paper presents a case study of Fulani herdsmen in Nigeria, whose traditional ethnoveterinary practices risk being lost as the country transitions to more intensive and enclosed livestock practices. We use a planetary health framing to make visible the value of indigenous practices that are less damaging to the environment, animal welfare, and human health. Through ethnographic observation, focus group discussions (FGDs), and key stakeholder interviews, we show that the Fulani use a complex system of herbal medicines and traditional herding practices to maintain herd health, and to manage and treat animal disease when it arises. However, their traditions often sit uncomfortably with commercial farming practices. As traditional Fulani grazing lands are eroded, dispossessed Fulani take employment from businessmen farmers. Both parties' inexperience with shed hygiene, artificial feed, and less environmentally resilient crossbreeds leads to an increased incidence of infectious disease. This, in turn, drives the higher use of antibiotics. There is, thus, a 'causal chain' of underlying drivers that lead, through poorer environmental, animal, and human health, to the increased use of antibiotics. The antibiotic resistance that emerges from this chain threatens human health now and in the future. Through a planetary health framing, we advocate for a deeper understanding of the knowledge held by Fulani herdsmen and their traditional ethnoveterinary practices as an alternative to increasing antibiotic use (ABU). [ABSTRACT FROM AUTHOR]

Purpose: In this study, we investigated how the direction and timing of a perturbation in voice pitch auditory feedback during phrasal production modulated the magnitude and latency of the pitch-shift reflex as well as the scaling of acoustic production of anticipatory intonation targets for phrasal prominence and boundary. Method: Brief pitch auditory feedback perturbations (±200 cents for 200-ms duration) were applied during the production of a target phrase on the first or the second word of the phrase. To replicate previous work, we first measured the magnitude and latency of the pitch-shift reflex as a function of the direction and timing of the perturbation within the phrase. As a novel approach, we also measured the adjustment in the production of the phrase-final prominent word as a function of perturbation direction and timing by extracting the acoustic correlates of pitch, loudness, and duration. Results: The pitch-shift reflex was greater in magnitude after perturbations on the first word of the phrase, replicating the results from Mandarin speakers in an American English-speaking population. Additionally, the production of the phrase-final prominent word was acoustically enhanced (lengthened vowel duration and increased intensity and fundamental frequency) after perturbations earlier in the phrase, but more so after perturbations on the first word in the phrase. Conclusion: The timing of the pitch perturbation within the phrase modulated both the magnitude of the pitch-shift reflex and the production of the prominent word, supporting our hypothesis that speakers use auditory feedback to correct for immediate production errors and to scale anticipatory intonation targets during phrasal production.

RationalePulmonary arterial hypertension (PAH) is characterized by vascular cell proliferation and endothelial cell apoptosis. TLR3 (Toll-like receptor 3) is a receptor for double-stranded RNA and has been recently implicated in vascular protection.ObjectivesTo study the expression and role of TLR3 in PAH and to determine whether a TLR3 agonist reduces pulmonary hypertension in preclinical models.MethodsLung tissue and endothelial cells from patients with PAH were investigated by polymerase chain reaction, immunofluorescence, and apoptosis assays. TLR3-/- and TLR3+/+ mice were exposed to chronic hypoxia and SU5416. Chronic hypoxia or chronic hypoxia/SU5416 rats were treated with the TLR3 agonist polyinosinic/polycytidylic acid (Poly[I:C]).Measurements and main resultsTLR3 expression was reduced in PAH patient lung tissue and endothelial cells, and TLR3-/- mice exhibited more severe pulmonary hypertension following exposure to chronic hypoxia/SU5416. TLR3 knockdown promoted double-stranded RNA signaling via other intracellular RNA receptors in endothelial cells. This was associated with greater susceptibility to apoptosis, a known driver of pulmonary vascular remodeling. Poly(I:C) increased TLR3 expression via IL-10 in rat endothelial cells. In vivo, high-dose Poly(I:C) reduced pulmonary hypertension in both rat models in proof-of-principle experiments. In addition, Poly(I:C) also reduced right ventricular failure in established pulmonary hypertension.ConclusionsOur work identifies a novel role for TLR3 in PAH based on the findings that reduced expression of TLR3 contributes to endothelial apoptosis and pulmonary vascular remodeling.

BackgroundBacteriuria contributes to antibiotic overuse through treatment of asymptomatic bacteriuria (ASB) and long durations of therapy for symptomatic urinary tract infections (UTIs), yet large-scale evaluations of bacteriuria management among inpatients are lacking.MethodsInpatients with bacteriuria were classified as asymptomatic or symptomatic based on established criteria applied to data collected by manual chart review. We examined frequency of treatment of ASB, factors associated with treatment of ASB, durations of therapy, and frequency of complications including Clostridium difficile infection, readmission, and all-cause mortality within 28 days of discharge.ResultsAmong 2225 episodes of bacteriuria, 64% were classified as ASB. After excluding patients with non-UTI indications for antibiotics, 72% of patients with ASB received antibiotics. When evaluating only patients not meeting SIRS criteria, 68% of patients with ASB received antibiotics. The mean (±SD) days of antibiotic therapy for ASB, cystitis, CA-UTI and pyelonephritis were 10.0 (4.5), 11.4 (4.7), 12.0 (6.1), and 13.6 (5.3), respectively. In sum, 14% of patients with ASB were treated for greater than 14 days, and fluoroquinolones were the most commonly used empiric antibiotic for ASB [245/691 (35%)]. Complications were rare but more common among patients with ASB treated with antibiotics.ConclusionsThe majority of bacteriuria among inpatient veterans is due to ASB with high rates of treatment of ASB and prolonged durations of therapy for ASB and symptomatic UTIs.