Journal of Voice最新文献

Objective: To perform the cross-cultural adaptation and validation of the Dyspnea Index (DI) in Brazilian Portuguese (BP).

Methods: This validation study followed the Consensus-based Standards for the Selection of Health Measurement Instruments recommendations. The translation was conducted in five stages: translation, synthesis, back translation, committee review, and pretest performance. The validation comprised the following steps: (a) construct validity, (b) criterion validity, (c) internal consistency, and (d) reproducibility. The study included 86 adults with dyspnea complaints in the dyspnea group (DG) and 46 adults without dyspnea complaints in the control group (CG), matched for age and gender. All participants completed the DI, the Vocal Handicap Index-10, and the Laryngeal Hypersensitivity Questionnaire. The DG completed the DI a second time.

Results: The item "the change in weather affects my breathing problem" did not reach agreement in the DI translation and required adjustments in the synthesis stage. In the pretest stage, all items had a lower proportion of "not applicable" responses, with P < 0.001. Construct validity confirmed a 10-item, one-factor structure. Internal consistency achieved a Cronbach's alpha of 0.941 and reproducibility yielded an intraclass correlation coefficient of 0.765. For criterion validity, the DI significantly distinguished the DG from the CG with higher scores (U = 434.5; P < 0.001) and showed parallel correlations with perceived vocal handicap (r = 0.232; P = 0.032) and laryngeal sensations (r = 0.400; P = 0.001).

Conclusion: The DI was cross-culturally adapted and validated in BP as the Índice de Dispneia. It has a 10-item, one-factor structure and is considered valid and reliable for self-administration in BP speakers.

Objective: The aim of this study is to evaluate the effect of two training modalities for auditory-perceptual evaluation of voice: online training and classroom training.

Materials and methods: A 2-arm randomized controlled trial was conducted with 115 first-year speech and language pathology students randomly divided in two groups. Group 1 was given access to the online training platform Voice-TT for 2 weeks; group 2 received a 90-minute standard classroom training in auditory-perceptual evaluation with GRBAS without access to online training. Two weeks later, the training modalities were changed. Before training and two weeks after each training stage, a rating experiment was conducted. A mixed models design was used to evaluate the effect of both training modalities on the agreement between student and expert ratings. Percentage agreement was calculated to investigate intrarater and inter-rater reliability.

Results: Students' agreement with expert ratings was significantly higher after online training for parameters G, B, and A. Students who received classroom training improved for parameter S. Additional classroom training after online training led to better agreement for parameters G and R, while additional online training following classroom training only improved the rating of parameter G. Although intrarater and inter-rater agreement improved after online and classroom training for both groups, the highest improvement was seen in the group that trained online first. There was no correlation between student-expert rating agreement and the duration and frequency of online training.

Conclusion: In this randomized controlled trial, online training with Voice-TT leads to a more reliable GRBAS rating for novice speech and language pathology students. Combined classroom and online training seems to be most effective when online training comes first.

Objective: Rutarin, an herbal formulation combining powdered seeds of Cydonia oblonga (quince) and aerial parts of Origanum majorana (marjoram), is used to address respiratory issues and enhance voice quality. This study investigates the effects of Rutarin on voice parameters, including fundamental frequency (F0), jitter, shimmer, harmonics-to-noise ratio (HNR), cepstral peak prominence (CPP), and smoothed cepstral peak prominence (CPPS).

Methods: Voice samples of 79 individuals who produced a sustained vowel /a/ were examined before and after consuming either Rutarin or warm water. The pretest vowel production was performed twice with a 5-minute interval between the first and second recordings before the actual test. Following consumption, the post test was performed five times for each participant at intervals immediately after drinking, 5, 15, 35, and 60 minutes. The repeated measure analysis of variance and Friedman test were employed to assess the within-subject differences, allowing the analysis of multiple conditions experienced by the same individual.

Results: Despite the recognized medicinal properties of its components, Rutarin did not produce significant improvements in voice quality compared to water. Water demonstrated notable effects on F0, jitter, HNR, CPP, and CPPS, particularly in male participants (P < 0.05).

Conclusion: Although Rutarin may offer some therapeutic advantages for throat and respiratory health, it does not appear to enhance vocal performance as claimed.

Integrating Convolutional Neural Networks and Vision Transformers in voice analysis has unveiled a new horizon in mental health identification. Human voice, a powerful indicator of mental health, was the focus of this study. Human voice data representing stable and unstable conditions were gathered from various mental health institutions in Bangladesh. The results of the experiment suggest that the proposed model achieved 91% accuracy, precision of 92% for the "Unstable" category and 90% for the "Stable" category, and recall of 91% for the "Stable" category and 92% for the "Unstable" category. In addition, a high F1 score of 91% was achieved. This study significantly contributes to computer-aided diagnosis in mental health by using deep learning (DL) to diagnose mental well-being. Our research underscores the substantial impact of DL on the advancement of mental health care, instilling hope for a brighter future in mental health care.

Objectives: In this study, we introduce an intervention based on two techniques: twang and medialization. The hypothesis is that a combination of these two techniques will enable trans women to gain feminine-sounding speech without vocal strain or harm.

Method: Five trans women took part in the study. A control group of five cisgender women and five cisgender men were included. A list of 14 monosyllabic words was created, where the vowel /ɑ/ was embedded in various consonant contexts. All participants were asked to read the word list three times, each time presented in a different order. The trans women read the word list before and after intervention. Acoustic analyses of fundamental frequency and the first, second, and third formant frequencies were conducted. For the perceptual analysis, 60 voice samples were selected from the entire material. Fifteen listeners were asked whether they perceived the voice samples as feminine, masculine, or uncertain. The listeners were also asked for gender judgments based on sentences read by the trans women after intervention.

Results: The acoustic analyses revealed an increase in fundamental frequencies and first, second, and third formants after intervention for all five trans women, approaching the values of the female controls. The perceptual judgments showed that the majority of the trans women voice samples were perceived as feminine after intervention.

Conclusions: Based on the acoustic analyses and the perceptual evaluations, the conclusion seems to show that the combination of the techniques twang and medialization enable the trans women to obtain feminine attribution. Nevertheless, the study is too small for generalizations. However, a take-home message is that it is appropriate to focus primarily on resonance, in addition to speaking fundamental frequency, to gain feminine-sounding speech.

Objective: We assessed the expression of glucose transporter (GLUT)-1 and hexokinase (HK)-Ⅱ in vocal cord leukoplakia (VCL) and investigated its clinical significance.

Methods: We collected 127 archival pathological specimens from patients with VCL, 29 from vocal cord polyps, and 31 with laryngeal carcinoma at our hospital between December 2018 and December 2022. GLUT-1 and HK-II expression was detected using immunohistochemistry.

Results: Significant differences were observed between the VCL and vocal cord polyp groups according to sex (P < 0.0001), smoking status (P = 0.001), and alcohol consumption (P = 0.007). GLUT-1 expression was observed in 36.2%, 20.7%, and 90.3% of patients with VCL, vocal cord polyps, and laryngeal carcinoma, respectively. GLUT-1 was highly expressed in severe dysplasia or carcinoma in situ (CIS) compared with vocal cord polyps (P < 0.001). GLUT-1 expression was lower in the VCL group than in the laryngeal carcinoma group (P < 0.001). HK-II expression was observed in 42.5%, 34.5%, and 80.6% of patients with VCL, vocal cord polyps, and laryngeal carcinoma, respectively. HK-II expression was significantly higher in severe dysplasia or CIS compared with vocal cord polyps (P = 0.004). HK-II expression was lower in the VCL group than in the laryngeal carcinoma group (P < 0.001). Both GLUT-1 expression (P < 0.001) and HK-II expression (P = 0.03) increased significantly with the degree of dysplasia. A significant correlation was observed between GLUT-1 and HK-II expression (r = 0.313, P < 0.001).

Conclusion: GLUT-1 and HK-II are significantly overexpressed in VCL patients. In VCL patients, GLUT-1 and HK-II expression levels increase proportionally with the degree of dysplasia.

Introduction: Many transgender individuals find their voice often not matching their gender identity. By using gender-affirming voice training, voice and communication specialists help transgender women find a voice that aligns with their gender identity. Short-term outcomes of voice training programs showed progress in listener perception, self-perception, and satisfaction of transgender women's voices. While some long-term results have been reported, most of these studies were retrospective. This prospective study examines the long-term effects, 3 months and 1 year after gender-affirming voice training in transgender women, on satisfaction, self-perception, and listeners' perception.

Methods and materials: Thirty transgender women followed a 10-week gender-affirming voice training program consisting of pitch elevation and articulation-resonance training. Self-perception and satisfaction of the transgender women were measured by the Trans Women Voice Questionnaire and a visual analogue scale where they had to score their current and ideal voice. Thirty nine listeners rated the trans women's voice samples by using a visual analogue scale ranging from very masculine to very feminine. Immediately after training, 3 months and 1 year after training, measurements were performed.

Results and discussion: Concerning self-perception and satisfaction of the voice, the effects observed immediately after training remained stable in the follow-up period. Thus, 3 months and 1 year after training, the participants perceived the voice-related impact on their daily life equal to the impact just after training discharge. Significant decreases in femininity ratings of listeners' perceptions were reported immediately after training and 3 months after training, although still being in the gender-ambiguous zone. No significant changes were reported between the 3 months and 1 year follow-up. Future studies should implement longer follow-up periods and qualitative components.

Objective: Using dynamic computed tomography (CT) to explore the structural characteristics of the larynx in patients with arytenoid dislocation and compare the impact of the dislocation course on the structural changes of the larynx.

Methods: Twenty-three patients with arytenoid dislocation and 10 healthy subjects were selected as the dislocation group and the normal group, respectively. The 23 patients with arytenoid dislocation were divided into groups with dislocation duration less than 3 months (group A) and dislocation duration more than 3 months (group B). Dynamic CT scans were performed on each subjects, and a series of images from inhalation to phonation were collected for three-dimensional reconstruction. The differences in bilateral vocal cord height, area of laryngeal chamber, and glottic gap between the three groups were compared.

Results: There were significant differences in bilateral vocal cord height and area of laryngeal chamber between dislocation group and the normal group. During phonation, the height difference between the bilateral vocal cords in group B was significantly smaller than that in group A. There was a significant difference in the area of the affected laryngeal chamber between groups A and B during inhalation to phonation (P < 0.05). The area of the affected laryngeal chamber in group B was larger than that in group A. There is no significant difference in the glottic gap ratio between the two dislocation groups.

Conclusions: Dynamic CT can quantitatively evaluate the structural characteristics of the larynx in patients with arytenoid dislocation. As the disease progresses, the structural characteristics of the larynx in patients with arytenoid dislocation will change.

Vocal warm-up is essential for achieving optimal vocal performance; however, traditional methods often neglect the role of core muscle stability. This study presents the Combined Vocal and Core Muscle Stability Warm-Up Method (C-VaC), which integrates core stability training with vocal exercises to improve vocal performance. The effectiveness of the C-VaC method was assessed among soprano majors at various stages using computer-assisted audio analysis for objective measurement. Comparative analyses of pitch accuracy, jitter, shimmer, and singing power ratio were conducted across different groups of singers undergoing both traditional and C-VaC warm-ups. The results indicate that the C-VaC method significantly enhances pitch accuracy and reduces acoustic perturbations. These findings provide valuable insights into optimizing warm-up protocols and propose a novel approach for improving vocal performance.