Search

To analyze the prevalence of work-related voice disorders (WRVD) among the voice professionals. The study protocol was registered in PROSPERO (CRD42021250121). The search was performed in the Embase, Lilacs, Medline, SCOPUS, and Web of Sciences databases. There were no limitations to the year of publication and the search included observational studies which reported data on the prevalence of dysphonia in voice professionals measured through vocal complaints, vocal self-assessment, the auditory-perceptual judgment of the voice, and laryngoscopy examinations. The critical appraisal instrument for studies reporting prevalence data was used to analyze the risk of bias of the studies. Data analysis was performed using Jamovi and R software with a significance level of 5%. The initial search identified 561 articles, 73 of which were finally included and analyzed. The total number of participants was 63,126. Dysphonia was diagnosed in 45,996 participants based on a vocal complaint, 12,843 using vocal self-assessment, 1,254 using the auditory-perceptual judgment, and 1,683 using laryngoscopies. The prevalence of total dysphonia was 44.0 (95% CI 38.47; 49.69). The prevalence of vocal complaints was 43.9% (95% CI 37.37; 50.52), 42.5% (95% CI 28.57; 57.08) for self-assessment, 53.0% (95% CI 29.87; 77.19) for auditory-perceptual judgment, and 36.9% (95% CI 18.62; 57.08) for laryngoscopic examination. In the auditory-perceptual judgment, voice professionals in class 3 (moderate quality, high demand) had a higher prevalence of dysphonia than those in class 4 (moderate quality, moderate demand) (P = 0.04). In the auditory-perceptual judgment (P = 0.04), there was a higher prevalence of dysphonia in teachers than among other voice professionals non-teachers, and in the laryngeal evaluation, no differences were found between professionals (P = 0.8). There was a high prevalence of dysphonia in voice professionals, especially in the detection by auditory-perceptual judgment. High vocal demand and being a teacher influenced the increase in the prevalence of WRVD. [ABSTRACT FROM AUTHOR]

To analyze the contribution of organizational, environmental, and personal factors in predicting dysphonia in professional voice users. This was a cross-sectional documentary study. The study sample consisted of 128 professional voice users (104 female and 24 male), with a mean age of 39.3 years. Dysphonia (laryngeal disorder associated with vocal complaints) was defined as the dependent variable. Organizational, environmental, and personal factors were defined as independent variables. Logistic regression models were used as predictive methods for data analysis. Evaluation and interpretation of the final model were performed using the ROC curve, odds ratio , and probability estimation. Professional voice users exposed to low humidity and who talked a lot on their phones were less likely to be dysphonic than individuals who were not exposed to these factors. Those exposed to excessive vocal demand and who reported talking with effort were more likely to be dysphonic than those who were not exposed to these factors. The accuracy of the prediction model was 80.8%. Exposure to low humidity and talking a lot on the phone were protective factors. However, excessive vocal demand and straining were risk factors for predicting the presence of dysphonia in professional voice users with high accuracy. [ABSTRACT FROM AUTHOR]

To analyze the effect of phonation in a glass tube immersed in water compared to other interventions on general degree of vocal deviation, fundamental frequency, sound pressure level, and vocal self-assessment in vocally healthy individuals. This is a systematic review and meta-analysis developed from the research question: "In vocally healthy individuals, what is the effect of phonation into a glass tube immersed in water versus other vocal interventions, other activities, or no intervention on general degree of vocal deviation, fundamental frequency, sound pressure level, and vocal self-assessment?" An electronic search was performed using Medline, LILACS, Cochrane Library, Embase, Web of Science, and SCOPUS databases, and a manual search was performed in the gray literature (Brazilian Digital Library of Theses and Dissertations and OpenGrey), the Journal of Voice, and the citations of the studies. Studies with (P) population of adults with healthy voices, (I) intervention with phonation into a glass tube immersed in water, (C) comparison with other vocal interventions, other activities, or no intervention, (O) outcomes of the general degree of vocal deviation, fundamental frequency, sound pressure level, and vocal self-assessment, and an (S) study with the experimental or quasi-experimental design were included. Risk of bias assessment and meta-analysis of the outcomes were performed. A total of 457 studies were found in the search; four were selected for the systematic review and meta-analysis. In the risk of bias assessment, there was an uncertain risk of selection and performance bias in 100% of the studies and uncertain risk of detection bias of 75%. All studies had an experimental design, and most of them were conducted on women. In the fundamental frequency analysis, there was no difference between the effect sizes of the interventions (z = 0.471, P = 0.638). In the vocal self-assessment, the estimated odds ratio was 1.31, showing a greater chance of improvement in the intervention group than with the comparison group (z = 3.45, P < 0.001). There were not enough studies to analyze the general degree of vocal deviation and sound pressure level outcomes. Phonation into a glass tube immersed in water has a greater positive effect on vocal self-assessment than other interventions in vocally healthy individuals. [ABSTRACT FROM AUTHOR]

to map the clinical parameters used in the speech-language pathology assessment of the chronic cough. a scoping review was performed to answer the clinical question: "What are the clinical parameters included in the speech-language pathology assessment of patients with chronic cough?" Evidence was searched by electronic and manual search. The electronic search included: MEDLINE, Cochrane Library, EMBASE, Web of Science, SCOPUS, and LILACS. Each database had a specific search strategy. The manual search included Journal of Voice, Chest, and Thorax, Brazilian Library of Theses and Dissertations, Open Grey, and Clinical Trials, in addition to scanning the references of the included studies. The extracted data considered information regarding the publication, sample, assessment, and measures used when assessing chronic cough. the electronic search found 289 studies; the manual search found 1036 studies; 12 were selected for the present study. The most used assessments were: self-assessment (75%), aerodynamic analysis (66.67%), the perceptual auditory judgment of the voice quality (58.33%), acoustic analysis of the voice (41.67%), cough frequency, and cough threshold (41.67%) and electroglottography (25%). the subjective instruments were used more frequently, while specific objective instruments, which are recent, were used less frequently. Complementary assessments such as vocal assessment, have been frequently used, also, with no other parameter. A lack of homogeneity was identified in the speech-language pathology assessment and measures of patients with chronic cough, thus, the comparison among studies and clinical analysis is difficult. [ABSTRACT FROM AUTHOR]

To analyze the efficacy of speech-language pathology therapy in the self-assessment, in the cough frequency, and the vocal quality of adults with chronic cough. This is a systematic review with meta-analysis that answered the clinical question: "In adults with chronic cough, what is the effect of the speech-language pathology therapy in the self-assessment, in the cough frequency, and the vocal quality, compared to another intervention?" (PROSPERO 2021/CRD42021226729). An electronic search (MEDLINE, Web of Science, EMBASE, SCOPUS, Cochrane Library, and Lilacs), and a manual search (Journal of Voice, Brazilian Library of Theses and Dissertations, Open Grey and Clinical Trials) with specific search strategies was performed. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials. Meta-analysis (standardized difference of means, Inverse Variance, and random effects model) and heterogeneity analysis (Chi², Tau², and I²) were performed. We found 610 studies and selected three. There was an uncertain risk of detection bias. The data were heterogeneous, and there was no difference between interventions in self-perception of cough severity (z = 0.09, P = 0.930; tau² = 0.65, I² = 90%) and in the self-perception of the effects of chronic cough on health status (z = 0.30, P = 0.77; tau² = 0.99, I² = 97%). The estimated mean difference was 0.97 to cough frequency, and it was differ significantly from zero (z = 4.47, P < 0.001) but the results are heterogeneous (Chi² (1) = 22.22, P < 0.001, I² = 95%). The speech-language pathology therapy had a greater effect size than the control interventions on cough frequency. However, in the subjects' perception, there were no differences between the interventions. [ABSTRACT FROM AUTHOR]

To compare the occurrence of vocal signs and symptoms before, during, and after coronavirus disease (COVID-19) and analyze possible risk factors for the persistence of these signs and symptoms after disease resolution. This was an observational, analytical, and cross-sectional study. The participants were 45 individuals of both sexes, with a mean age of 44 years, who were previously affected by COVID-19. All participants answered a questionnaire about sociodemographic data, smoking history, disease course, vocal complaints, and the vocal signs and symptoms list (SSL), referring to three timepoints (before, during, and after COVID-19). The most commonly reported vocal signs and symptoms before COVID-19 were phlegm (26.67%; n=12) and dry throat (24.44%; n=11). During COVID-19, the most frequent vocal signs and symptoms were tired voice after short-term use (73.33%; n=33) and dry throat (71.11%; n=32). After the disease, the most reported vocal signs and symptoms were dry throat (57.78%; n=26) and phlegm (53.33; n=24). The self-perception of vocal signs and symptoms before COVID-19 was lower than that during and after COVID-19 (P < 0.001). Vocal complaints after COVID-19 and oxygen therapy were predictors of self-perception of vocal signs and symptoms after COVID-19. Individuals affected by COVID-19 had a higher frequency of vocal signs and symptoms during the disease. However, after remission, the frequency of vocal signs and symptoms was higher than that at baseline. The need for oxygen therapy may indicate a risk for a higher occurrence of vocal signs and symptoms after COVID-19. [ABSTRACT FROM AUTHOR]

Objective: to compare the self-perception of vocal fatigue and use of singing voice during the COVID-19 pandemic between professional and amateur singers and to relate this self-perception with vocal use characteristics during this period. Methodology: Participants were 121 singers divided into professional singers group (PSG) (12 men and 20 women) comprising singers who depended exclusively on singing as a profession and an amateur singers group (ASG) (37 men and 52 women) of singers who did not depend exclusively on singing for their livelihood. All answered online questionnaires through Google Forms ®. Sociodemographic and vocal characteristics were investigated before and during the pandemic; symptoms of vocal fatigue were assessed through the vocal fatigue index (VFI); and self-perception of use of singing voice through the evaluation of the ability to sing easily protocol for Brazil (EASE-Br). Results: In the comparison between groups, the PSG presented higher scores of vocal fatigue in fatigue and vocal limitation (P = 0.045), vocal restriction (P = 0.002), and recovery with vocal rest (P = 0.008) domains than did the ASG. There was no difference between the groups regarding the use of singing voice. Based on the relationship between self-perception and vocal use characteristics during the pandemic, it was observed that the presence of vocal complaint was the only factor associated with self-perception of fatigue symptomatology in both groups. Regarding the self-perception of the current status of the singing voice, singing time, the presence of vocal complaints, the need to increase visual concentration, and the perception of vocal worsening during the pandemic were considered predictive for amateur singers. For professional singers, vocal complaints and vocal training were predictors for self-perception of the current status of the singing voice. Conclusion: Professional singers presented with higher scores of vocal fatigue than did amateur singers. The symptomatology of vocal fatigue was associated with the presence of vocal complaints in both groups. However, self-perception of the current status of the singing voice was different between the groups and was associated with vocal training for professional singers and characteristics of vocal demand of singing voice during the pandemic period for amateur singers. [ABSTRACT FROM AUTHOR]

To evaluate the validity of the Self-assessment of Communication Competence – SACCom by analyzing the communication competency of adult individuals using the item response theory (IRT). Overall, 778 individuals who responded to SACCom participated in this study. The initial version consisted of 20 polytomous items regarding communication skills. Polytomous answer keys to each item were ordered as follows: 1 - no, 2 - more or less, and 3 - yes. The IRT and the gradual response model, a 2-parameter logistic model for polytomous items, were used for validation. Due to problems in the preliminary analysis using the item characteristic curve (ICC), answer keys to SACCom items were reorganized in an ordinal dichotomous way. Response 1 was coded as 0 - no, while responses 2 and 3 were coded as 1 - yes. Item 9 of the ICC was problematic and did not add information to the instrument; hence, this item was excluded. SACCom, in its dichotomous format with 19 items, was unidimensional according to the eigenvalues graph and tetrachoric correlation analysis. The Cronbach's alpha coefficient showed an internal consistency value of 0.711. All item-total correlations were greater than 0.284. Item discrimination parameters ranged from a = 0.563 to a = 1.505, and the difficulty of the items ranged between b = –2.725 and b = 0.612. The likelihood ratio test showed that the model without restrictions best fit the data. ICC gleaned more information for individuals with lower communication skills. The 19-item, dichotomous SACCom is valid for the analysis of communication skills according to the IRT. [ABSTRACT FROM AUTHOR]

To map the execution of resonance tubes phonation immersed in water exercise in adults with healthy or altered voices. This study was a scoping review. An electronic search was performed using the following databases: MEDLINE, LILACS, SCOPUS, Web of Science, EMBASE, Cochrane Library, gray literature, and a manual search. A blinded review was performed by two authors to determine the selection and extraction procedures. Studies with adult participants with dysphonic or healthy voices who underwent intervention with phonation in a resonance tube immersed in water in the context of the vocal clinic, with an experimental intervention, quasi-experimental, or before and after the intervention were included. Data from the publication, sample, execution, and results obtained from the exercises were extracted by two blinded reviewers. Disagreements were resolved through consensus. The analysis was performed quantitatively. A total of 44 publications were analyzed. Among these, Brazilian studies were the most frequent, with a publication peak in 2020. The characterization of the sample was variable, with a higher frequency of participants of both sexes who were not voice professionals. The most frequent studies were before and after exercise with a resonance tube immersed in water, in one session, with an exercise execution time of 3 minutes; in cases of more than one series of executions, the 30-sseconds rest time was more frequent. The most used resonance tube was a flexible silicone tube, with a wall thickness of 0.1 mm, immersion container in a 500-, 510-, or 600-mL bottle, 2/3 filled with water, and the resonance tube immersed 2 cm from the water surface. The most used phonatory task was flow phonation with rounded lips similar to the articulation of the vowel /u/. Acoustic analysis and vocal self-assessment are the most commonly used outcome measures. The best results were obtained in the self-assessment. There is significant variability in the information on the execution of resonance tubes phonation immersed in water exercise influenced by vocal diagnosis and experience with previous vocal training. Studies on the effects of this exercise have been concentrated over the last decade and are of the vocal training and therapy. Acoustic and self-assessment measures were used to verify the results, with self-assessment being the outcome that most frequently indicated positive results. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to map the characteristics and effects of vocal training approaches in individuals with healthy voice. This is a scoping review based on three research questions: What are the interventions used for vocal training of individuals with healthy voice? What are their prescription parameters? What are their effects? The search was conducted electronically in the databases of Embase, Lilacs, Medline, Scopus, and Web of Science. The study selection was based on the reading of titles, abstracts, and full text, applying the eligibility criteria. Data related to the characteristics of the publication, sample, and intervention were extracted. Measures/outcomes and results were also extracted. Quantitative synthesis was performed, and the results were presented in descriptive format. In total, 221 studies were identified during the search, of which 23 were selected. The most frequently used approach in the vocal training of individuals with healthy voice was the Semi-Occluded Vocal Tract Exercise (SOVTE), mainly with tube and straw phonation. Many studies have focused on the immediate effect, with varying dosages. The main outcome measures were acoustic analysis, aerodynamic evaluation, electroglotography, and vocal self-assessment. Positive effects were mainly observed on aerodynamic and acoustic parameters. Only one study reported negative results in the self-assessment. The SOVTE is most frequently performed to provide an immediate effect in the acoustic analysis and has also demonstrated positive effects on vocal self-assessment. Medium and long-term effects and dosages are rarely reported and should be also investigated. [ABSTRACT FROM AUTHOR]

To verify the validity in the internal consistency in the spectrographic analysis protocol (SAP). Thirty-nine students of the Speech-Language Pathology graduate program and 38 speech-language pathologists, specialized in voice, participated in the study. The participants made visual inspections of 10 spectrograms and marked the items of the SAP. For analysis of the internal consistency in the SAP, the exploratory factor analysis (EFA) and confirmatory factor analysis were performed. Most items showed corrected item-total correlation above 0.3, indicating that the items have a good relationship with each other and with the SAP as a whole. Six items presented values below the average, suggesting the exclusion of these from the construct. However, three of these were maintained because they were judged as important parameters in clinical practice, requiring the training of judges when using the SAP to properly understand the items. The EFA regrouped the previous domains of the SAP into three factors. All items presented a factor load above 0.4, suggesting the retention of all, except for the items previously indicated, for exclusion. The confirmatory factor analysis corroborated with the EFA and its indexes. The SAP has good internal consistency. All items have a good degree of relationship with each other and contribute positively to the protocol as a whole. The final version of the SAP, at this stage, has 15 items (from the 25 items of the initial SAP version), distributed among three domains. [ABSTRACT FROM AUTHOR]

The present study aimed to characterize and to verify the relationship between shyness and self-assessment of vocal symptoms, public speaking, and aspects of daily communication. This is an observational, analytical, and cross-sectional study. Two hundred and sixty-four male and female participants, with a mean age of 21 years and without any vocal disorder. To measure the outcomes, the participants' scores were measured using the following self-assessment instruments: Revised Cheek and Buss Shyness Scale, Voice Symptom Scale, Self-Statements during Public Speaking Scale, and the Daily Communication Self-evaluation Questionnaire. A descriptive and inferential analysis of the data was performed. Shy persons had higher vocal symptomatology scores in the limitation, emotional, and total domain. Furthermore, they scored higher on the negative aspects of public speaking and lower on its positive aspects. In addition, they showed weaker loudness and higher pitch in daily communication, compared with nonshy persons. Statistically significant correlations were found between positive shyness scores and all domains of vocal symptoms, negative aspects of public speaking, and pitch in daily communication. However, negative correlation was found between the positive aspects of public speaking and loudness in daily communication. Shy persons have a higher self-evaluation with regard to the negative and less positive aspects of public speaking and most vocal symptoms, as well as weaker loudness and higher pitch in daily communication when compared to nonshy persons. The greater the perception of shyness, the greater the self-assessment with regard to daily communication and vocal symptoms and the negative aspects of public speaking. [ABSTRACT FROM AUTHOR]

To analyze if there is an influence of the body position and emission number in the results of the maximum phonation times (MPT) of adults without vocal complaints. This is an observational, analytical and cross-sectional study. Sixty subjects participated: 30 men and 30 women without vocal complaints. Subjects were instructed to stay in orthostatic or sitting position, according to the collection's order that was selected. The first 30 subjects were evaluated in order number 1 (sitting and orthostatic) and the other 30 subjects were evaluated in order number 2 (orthostatic and sitting), with a 5-minute interval between the emissions in the two positions. The MPT of vowels /a/, /i/, /u/, fricatives /s/ and /z/, and numbers were collected. After this, the subjects were instructed to do the same emissions mentioned above, but in another position (orthostatic or sitting). The values of MPT were statistically analyzed with both the Analysis of Variance (ANOVA) paired measures test to three criteria and the Tukey Test (P < 0.05). There was no difference between the MPT obtained in both positions. Males had all MPT higher than females. Regarding the emission number, there were differences for both sexes in the MPT of the vowel /a/ and the number counting. In general, it is concluded that there is no influence of body position in the results of voice temporal measures, but the sex and the number of the emissions influence the result of the MPT. [ABSTRACT FROM AUTHOR]

Summary Voice is an important gender marker in the transition process as a transgender individual accepts a new gender identity. The objectives of this study were to describe and relate aspects of a perceptual-auditory analysis and the fundamental frequency (F0) of male-to-female (MtF) transsexual individuals. A case-control study was carried out with individuals aged 19–52 years who attended the Gender Identity Program of the Hospital de Clínicas of Porto Alegre. Vocal recordings from the MtF transgender and cisgender individuals (vowel /a:/ and six phrases of Consensus Auditory Perceptual Evaluation Voice [CAPE-V]) were edited and randomly coded before storage in a Dropbox folder. The voices (vowel /a:/) were analyzed by consensus on the same day by two judge speech therapists who had more than 10 years of experience in the voice area using the GRBASI perceptual-auditory vocal evaluation scale. Acoustic analysis of the voices was performed using the advanced Multi-Dimensional Voice Program software. The resonance focus and the degrees of masculinity and femininity for each voice recording were determined by listening to the CAPE-V phrases, for the same judges. There were significant differences between the groups regarding a greater frequency of subjects with F0 between 80 and 150 Hz (P = 0.003), and a greater frequency of hypernasal resonant focus (P < 0.001) in the MtF cases and greater frequency of subjects with absence of roughness (P = 0.031) in the control group. The MtF group of individuals showed altered vertical resonant focus, more masculine voices, and lower fundamental frequencies. The control group showed a significant absence of roughness. [ABSTRACT FROM AUTHOR]

Summary Objectives The aim of this study was to review systematically the literature and to analyze the effectiveness of laryngeal manual therapy in addressing the overall severity of vocal deviation, the intensity of vocal and laryngeal symptoms, and musculoskeletal pain in adults with behavioral dysphonia. Study Design This is a systematic review and meta-analysis. Methods Two independent authors selected clinical trials that analyzed the effectiveness of laryngeal manual therapy compared with other interventions in the treatment of adults with behavioral dysphonia from the Cochrane Library, PubMed, Web of Science, and LILACS. The analyzed outcomes were the overall severity of vocal deviation, the intensity of vocal and laryngeal symptoms, and musculoskeletal pain. Data analysis was conducted based on the following steps: the assessment of the risk of bias, the measures of treatment effect and descriptive data analysis, the assessment of heterogeneity, subgroup analysis, sensitivity analysis, and the assessment of reporting biases. Results A total of 2135 studies were identified, three of which met the selection criteria. Data analysis showed an unclear risk of 100% of performance bias and 66% of detection bias, in addition to a 33% high risk of selection bias. Low statistical and clinical heterogeneities were found. In addition, no significant difference was found in the relative risk of improvement with laryngeal manual therapy and with other interventions in the analyzed outcomes. Conclusions Various types of laryngeal manual therapies are available with similar objectives and effects, but their effectiveness is equivalent to that of other interventions involving direct voice therapy in the rehabilitation of adults with behavioral dysphonia. [ABSTRACT FROM AUTHOR]

In most of the cases the magnetooptic Kerr effect (MOKE) techniques rely solely on the effects linear in magnetization ( M ). Nevertheless, a higher-order term being proportional to M 2 and called quadratic MOKE (QMOKE) can additionally contribute to experimental data. Handling and understanding the underlying origin of QMOKE could be the key to utilize this effect for investigation of antiferromagnetic materials in the future due to their vanishing first order MOKE contribution. Also, better understanding of QMOKE and hence better understanding of magnetooptic (MO) effects in general is very valuable, as the MO effect is very much employed in research of ferro- and ferrimagnetic materials. Therefore, we present our QMOKE and longitudinal MOKE spectroscopy setup with a spectral range of 0.8–5.5 eV. The setup is based on light modulation through a photoelastic modulator and detection of second-harmonic intensity by a lock-in amplifier. To measure the Kerr ellipticity an achromatic compensator is used within the setup, whereas without it Kerr rotation is measured. The separation of QMOKE spectra directly from the measured data is based on measurements with multiple magnetization directions. So far the QMOKE separation algorithm is developed and tested for but not limited to cubic (001) oriented samples. The QMOKE spectra yielded by our setup arise from two quadratic MO parameters G s and 2 G 44 , being elements of quadratic MO tensor G , which describes perturbation of the permittivity tensor in the second order in M . [ABSTRACT FROM AUTHOR]

Summary Objective The aim of this study was to verify the effect of the voiced oral high-frequency oscillation (VOHFO) on voice quality in acoustic voice symptoms and self-reported sensations in individuals with voice complaints and dysphonic voices, and in individuals with normal voices. Methods The participants, which included 60 individuals from 18 to 45 years of age, both genders, were divided into two groups: G1, 30 individuals without voice complaints and normal voices; and G2, 30 individuals with voice complaints and dysphonic voices. We used the following measures: acoustic analysis, voice and larynx symptom investigation, and phonation time before and after 3 minutes of performing the VOHFO technique. The sensations were reported only after the VOHFO technique. Data were analyzed using the Wilcoxon test ( P  ≤ 0.05), paired t test ( P  ≤ 0.05), and the Mann-Whitney test ( P  ≤ 0.05). Results After the VOHFO, in G1, there was an increased fundamental frequency (both genders), a higher voice turbulence index, and a decrease in dryness symptoms (women); in G2, there was a decrease in the following symptoms: strong voice, dryness and lump in the throat, sensitive throat (women), and roughness and weak voice (men). The phonation measures and sensations did not present differences. The soft phonation index decreased in G1 and increased in G2 (women), in addition to a significant decrease in strong voice and sensitive throat (women) and roughness (men) in G2. Conclusions The VOHFO technique improves the source-filter relationship and the severity of voice and larynx symptoms in dysphonic and normal individuals. Women improved more in terms of larynx symptoms, whereas men improved more in terms of voice symptoms. [ABSTRACT FROM AUTHOR]

To develop a validity profile for the cough severity index in the Brazilian Portuguese language (CSI-Br). The study sample consisted of 100 participants divided into Chronic Cough Group (CG; 50 individuals with a mean age of 46.4; standard deviation [SD]: 11.7) and Healthy Control Group (HCG; 50 individuals with a mean age of 33.0 [SD: 12.3]). The data collection procedures were as follows: (a) application of CSI-Br for all participants; (b) application of the Voice Handicap Index (VHI)-10 and the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ-Br) in the CG; (c) application of CSI-Br for test-retest reliability with an interim of between 2-14 days. The CSI-Br validation was composed of five stages: construct validity, reliability, reproducibility, convergent validity, and discriminant validity. In construct validity, the instrument identified two factors and explained 67.6% of the total variance. The reliability had a value of a=0.914. Reproducibility showed an ICC value of 0.909. CSI-Br showed a negative correlation with VHI-10 and a positive correlation with LHQ-Br in convergent validity. In discriminant validity, all items and factors differentiated participants in the CG from those in the HCG. The ten-item CSI-Br with two factors is reliable and valid for analyzing the severity of chronic cough symptoms in Brazilian individuals. [ABSTRACT FROM AUTHOR]

To analyze the validity of the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ-Br) in Brazilian Portuguese. The present study sample consisted of 89 individuals from the laryngeal hypersensitivity group and 41 individuals from the healthy group. The Newcastle Laryngeal Hypersensitivity Questionnaire's validation process for Brazilian Portuguese was composed of five stages: construct validity, reliability of internal consistency, and reliability regarding reproducibility, convergent validity, and discriminant validity. The software SPSS 25.0 was used. A significance level of 5% was considered statistically significant. In construct validation, it was observed that the instrument was unifactorial; however, it was necessary to exclude two items with a low commonality that did not fit the model. The final instrument consisted of 12 items, and a factor called total, which explained 70.55% of the variance. In the internal consistency analysis, Cronbach's alpha was 0.962. The reproducibility had an intraclass correlation coefficient (ICC) was 0.949. In terms of convergent validity, there was a negative correlation between the total domain of the LHQ-Br and the total Cough Severity Index translated and adapted for the Brazilian Portuguese (P = 0.001) and total Voice Handicap Index - 10 (P < 0.001). Discriminant validity showed that ten items and the total factor differentiated healthy group individuals from those in the laryngeal hypersensitivity group. The 12-item LHQ-Br is valid and reliable for measuring the self-perception of laryngeal sensation associated with Brazilian patients with laryngeal hypersensitivity syndrome. [ABSTRACT FROM AUTHOR]

Candiacervus sp.II is one of the deer species that inhabited the island of Crete during the Late Pleistocene. The species evolved on the island under a prolonged period of isolation and, as a consequence, developed a high degree of endemism. Fossils of this species have been discovered at many Cretan sites, including Liko cave (an attritional accumulation of several thousand fossils). In this paper, we present the results of a systematic analysis of the prevalence and anatomical distribution of bone lesions of Candiacervus sp.II, from that cave. We identified one metapodial with a healed fracture and nine (various) specimens with moderate to severe degenerative lesions of osteoarthritis. The lesions were evaluated macroscopically and radiographically, and they were classified as traumatic or degenerative. Degenerative lesions that affected adult individuals had prevalence rates below 5% and were attributed to environmental or nutritional causes. Representative bones were sampled for histological evaluation, to provide essential baseline data on possible underlying disorders. The aims of this study are to provide evidence for bone disease contributing to species morbidity, and to shed new light on causes and potential palaeoecological significance. [ABSTRACT FROM AUTHOR]

To investigate the self-perception of vocal fatigue symptoms and musculoskeletal pain in home office workers before and during the coronavirus disease (COVID-19) pandemic. A total of 424 individuals participated in this cross-sectional, observational, and descriptive study; they were stratified into the experimental group (EG), consisting of 235 individuals working from home office during the COVID-19 pandemic; and the control group (CG), with 189 individuals who continued to work in person during this period. All participants answered the vocal fatigue index and the musculoskeletal pain investigation questionnaires. The data were analyzed in a descriptive and inferential manner. Participants in the EG reported more vocal fatigue symptoms and musculoskeletal pain than those in the CG before the pandemic. However, during the pandemic, the EG presented a higher frequency of pain in the posterior of the neck, shoulder, upper back, and temporal and masseter muscles, while the CG presented a higher frequency of pain in the larynx. With regard to vocal fatigue, during the pandemic, EG had an increase in scores to factors such as tiredness and voice impairment, avoidance of voice use, and total scores. No such differences were noted in the CG. Workers who migrated to home offices during the COVID-19 pandemic are at risk of developing vocal disorders. [ABSTRACT FROM AUTHOR]

Objective. Relate respiratory muscle strength (RMS), sound pressure (SP) level, and vocal acoustic parameters to the abdominal circumference (AC) and nutritional status of children. Study Design. This is a cross-sectional study. Methods. Eighty-two school children aged between 8 and 10 years, grouped by nutritional states (eutrophic, overweight, or obese) and AC percentile (⩽25, 25-75, and ⩾75), were included in the study. Evaluations of maximal inspiratory pressure (IPmax) and maximal expiratory pressure (EPmax) were conducted using the manometer and SP and acoustic parameters through the Multi-Dimensional Voice Program Advanced (KayPENTAX, Montvale, New Jersey). Results. There were significant differences (P < 0.05) in the EPmax of children with AC between the 25th and 75th percentiles (72.4) and those less than or equal to the 25th percentile (61.9) and in the SP of those greater than or equal to the 75th percentile (73.4) and less than or equal to the 25th percentile (66.6). The IPmax, EPmax, SP levels, and acoustic variables were not different in relation to the nutritional states of the children. There was a strong and positive correlation between the coefficient of amplitude perturbations (shimmer), the harmonics-to-noise ratio and the variation of the fundamental frequency, respectively, 0.79 and 0.71. Conclusions. RMS and acoustic voice characteristics in children do not appear to be influenced by nutritional states, and respiratory pressure does not interfere with acoustic voice characteristics. However, localized fat, represented by the AC, alters the EPmax and the SP, each of which increases as the AC increases. [ABSTRACT FROM AUTHOR]

Most of the models, which are already a small number, for selection of the optimal spatial solutions of the corridor of line infrastructure facilities are based on the criteria of evaluation whose relevance has not been verified. As a set of criteria is a starting basis for development of the hierarchical model of decision-making for the evaluation and selection of the optimum spatial solutions corridors, so is the relevance of the optimal solution of the selected model is based on selected criteria so much in question. This paper develops a model for the formation of a set of criteria of evaluation of alternative spatial solutions corridor of the line infrastructure facilities respectively their identification, derivation and grouping (clastering) and verification of their relevance. The model consists of two inter-related and complex steps. In the first step is formed a set of preliminary criteria of decision-making, in four also complex sub-steps. In the second step, with the help of statistical methods, such as surveys, descriptive statics and the most important, the factor analysis, verifies the relevance of each of the criteria from the preliminary set individually, and verifies (or does not verify) hierarchical model of decision-making, with the verification of its factors, formed on the basis of this set of criteria. In this way is obtained a finite set of relevant criteria of decision-making. The optimal solution selected through hierarchical model based on a set of relevant criteria has credible relevance . [ABSTRACT FROM AUTHOR]

In this paper is developed a complex model for the evaluation and selection of the optimum spatial solutions of the corridor line infrastructural facility, which is characterized by multiactor and multicriteria approach. The model is based on the multiactor multicriteria analysis methodology (MAMCO - The Multi Actor Multi Criteria Analysis Methodology) where the relevant decision-making actors, verified by stakeholder analysis (The Stakeholdes analysis), based on the criteria of evaluation that are sorted in the proper hierarchy and whose relevance is confirmed by the factor analysis (the Factor analysis) using the evaluation and ranking of alternatives of the AHP method (the Analityc Hierarchy Process), which was selected by intelligent access with the help of decision tree (decision Tree), offered from a set of alternatives to choose the optimum solution, and the accuracy of their selection check by sensitivity analysis (sensitivity analisys) . [ABSTRACT FROM AUTHOR]

To analyze the vocal self-perception of individuals who wore face masks for essential activities and those who wore them for professional and essential activities during the coronavirus disease pandemic. This was an observational, descriptive, cross-sectional study. The study included 468 individuals who were stratified into two groups: the Working Group, comprising individuals who wore face masks for professional and essential activities during the pandemic; and the Essential Activities Group, with individuals who wore face masks only for essential activities during the pandemic. The outcome measures tested were self-perception of vocal fatigue, vocal tract discomfort, vocal effort, speech intelligibility, auditory feedback, and coordination between speech and breathing. Descriptive and inferential statistics were performed. Face masks increased the perception of vocal effort, difficulty in speech intelligibility, auditory feedback, and difficulty in coordinating speech and breathing, irrespective of usage. Individuals who wore face masks for professional and essential activities had a greater perception of symptoms of vocal fatigue and discomfort, vocal effort, difficulties in speech intelligibility, and in coordinating speech and breathing. Use of face masks increases the perception of vocal symptoms and discomfort, especially in individuals who wore it for professional and essential activities. [ABSTRACT FROM AUTHOR]

The paper analyzes research on the formula proposed by Bazant, where the existence of size effect is shown. The beams made of different types of concrete loaded at three points, with a slot in the middle of the beam, were experimentally burdened to the point of fracture. The fracture energy (Gf) and the characteristic length in the fracture zone (cf) were determined. For the experiment beams of common, high-quality, lightweight concrete and concrete with steel fibers were used. As the fifth sample ordinary concrete with a change in the width of the bearing under load was made. The maximum size of aggregate grain for the concrete is 10 mm. The beams for the experiment were of three different sizes, and three samples of each size. A total of 45 beams were used. Cross-section of beams was changed proportionally. [ABSTRACT FROM AUTHOR]

In this paper, consideration will be given to defining the system and development of a plan for solid municipal waste management. The initial steps are reflected in forming a group for developing the plan including partnerships of all interested actors. The planning period and any restrictions on the planning process are defined. The factors affecting the definition are discussed. All existing plans and mutual interactions are taken into consideration. The data as well as the information on the current situation are obtained and analyzed data and the condition evaluation is performed. Defining the system is a complex task that should be left to experts and competent individuals and organizations, in order to reduce the risk of wrong definition [ABSTRACT FROM AUTHOR]

Dentin contains 1-2 µm diameter tubules extending from the pulp cavity to near the junction with enamel. Peritubular dentin (PTD) borders the tubule lumens and is surrounded by intertubular dentin (ITD). Differences in PTD and ITD composition and microstructure remain poorly understood. Here, a (~200 nm)², 10.1 keV synchrotron X-ray beam maps X-ray fluorescence and X-ray diffraction simultaneously around tubules in 15-30 µm thick bovine and equine specimens. Increased Ca fluorescence surrounding tubule lumens confirms that PTD is present, and the relative intensities in PTD and ITD correspond to carbonated apatite (cAp) volume fraction of ~0.8 in PTD vs. 0.65 assumed for ITD. In the PTD near the lumen edges, Zn intensity is strongly peaked, corresponding to a Zn content of ~0.9 mg g-1 for an assumed concentration of ~0.4 mg g-1 for ITD. In the equine specimen, the Zn K-edge position indicates that Zn2+ is present, similar to bovine dentin (Deymier-Black et al., 2013), and the above edge structure is consistent with spectra from macromolecules related to biomineralization. Transmission X-ray diffraction shows only cAp, and the 00.2 diffraction peak (Miller-Bravais indices) width is constant from ITD to the lumen edge. The cAp 00.2 average preferred orientation is axisymmetric (about the tubule axis) in both bovine and equine dentin, and the axisymmetric preferred orientation continues from ITD through the PTD to the tubule lumen. These data indicate that cAp structure does not vary from PTD to ITD. [ABSTRACT FROM AUTHOR]

To complete the validation and to study the psychometric properties of the Brazilian Portuguese version of the Vocal Fatigue Index (IFV). This is a validation study of a diagnostic instrument utilizing a cross-sectional design and phases with quasi-experimental design. The total sample was composed of 212 participants, divided into two groups: Dysphonic Group and Vocally Healthy Group. All participants answered the VFI protocol. Data analysis consisted of the following steps: exploratory factor analysis, validity analysis, reliability analysis, sensitivity analysis, receiver operating characteristic, and area under the curve analysis. The Brazilian Portuguese version of the VFI called Índice de Fadiga Vocal-IFV , has 17 items and four factors. The IFV is a valid, reliable and sensible instrument to measure the self-perception of vocal fatigue. The threshold values for each factor was: 4.50 for tiredness and voice impairment; 3.50 for avoidance of voice use; 1.50 for physical discomfort and 8.50 for improvement of voice symptoms with rest. The threshold value for the total score was 11.50. The Brazilian Portuguese version of the VFI is a valid instrument to assess the self-perception of vocal fatigue, especially in dysphonic individuals. [ABSTRACT FROM AUTHOR]

To analyze the immediate effects of voiced high-frequency oscillation (VHFO) and Lax Vox technique on vocal quality and self-reported intensity of vocal and laryngeal symptoms in individuals with behavioral dysphonia. This experimental, prospective, randomized cross-over study, investigated thirty adults (15 women and 15 men) with behavioral dysphonia (vocal complaints, altered voice on auditory-perceptual evaluation, vocal nodules or mucosal thickening, and incomplete glottic closure). The outcome variables analyzed were auditory-perceptual analysis, acoustic analysis (voice quality characteristics), and self-reported intensities of vocal and laryngeal symptoms. Each participant performed two exercises—VHFO and Lax Vox technique—in a random sequence for 3 minutes. A 7-day washout period was provided between the exercises. The data were analyzed using the paired t-test and Wilcoxon test (P < 0.05). After VHFO, no significant difference was observed on auditory-perceptual evaluation in all participants, whereas the Lax Vox technique worsened breathiness among women (P = 0.027). VHFO significantly increased the fundamental frequency (P = 0.014) and decreased the noise harmonic ratios for women (P = 0.026). Among men, there was a decrease in shimmer parameter (P = 0.035). Moreover, symptoms such as "lump in the throat" (P = 0.005), "voice loss" (P = 0.017), and "high-pitched voice" (P = 0.023) decreased in women after VHFO, whereas in men, "itchiness" and "hoarseness" (P < 0.001) decreased after VHFO. The Lax Vox technique decreased "hoarseness" (P = 0.003) in women, without any effect in men. The VHFO exercise provided more positive immediate effects results than the Lax Vox technique regarding vocal quality and self-reported symptom intensity in participants with behavioral dysphonia. [ABSTRACT FROM AUTHOR]

To translate and cross-culturally adapt the Cough Severity Index to Brazilian Portuguese. This is a study with observational, cross-sectional, and analytical design. The procedure for translation and cross-cultural adaptation followed the recommendations of the Scientific Advisory Committee of the Medical Outcomes Trust and was performed in five stages: translation, synthesis, back translation, committee review, and pretesting. The sample for the pretest consisted of 34 participants with refractory chronic cough, 11 males and 23 females, with an average age of 48 years and 1 month. The title of the questionnaire, the answer options, and seven of the ten questions were agreed upon by three judges, the remaining three questions were retranslated by a fourth judge. After back-translation and committee review, editing of question five was necessary. The option "never" was more frequently selected for four questions and the option "always" for six questions. There was a significantly higher proportion of other response categories of the instrument compared to the response category "not applicable." This study resulted in the elaboration of a translated and cross-culturally adapted version of the Cough Severity Index in Brazilian Portuguese. [ABSTRACT FROM AUTHOR]

To compare vocal symptoms and self-regulatory behaviors between Chileans having behavioral dysphonia and those who were vocally healthy; and to correlate their vocal symptoms and self-regulatory behaviors. The 100 Chileans who participated in this study were divided into the dysphonic group (DG) having behavioral dysphonia and the vocally healthy group (VHG). The DG and VHG each had 50 participants (32 females and 18 males), whose mean ages were 28.3 and 28.6 years, respectively. The participants responded to the Chilean Spanish versions of the Short Self-Regulation Questionnaire (SSRQ-Ch) and Voice Symptom Scale (VoiSS) instruments. The data were analyzed using descriptive and inferential statistics. The VHG Chileans had significantly lower scores in the VoiSS domains and significantly higher scores in the total and impulse control domains of SSRQ-Ch as compared to the DG Chileans. There was a negative correlation between all VoiSS domains as well as the total and impulse control domains of SSRQ-Ch. The DG Chileans had more vocal symptoms and less self-regulation of general behavior and impulse control than the VHG Chileans. There was an inverse relationship between the frequency of vocal symptoms and the self-regulated general and impulse control behaviors. [ABSTRACT FROM AUTHOR]

This study aims to translate and cross-culturally adapt the throat scale of the Voice Handicap Index to the Brazilian Portuguese language.uracy. This was performed in five phases translation, synthesis, back translation, review, and pretest. Fifty subjects participated in the pretest, of which 22 participants had chronic cough, 13 had laryngopharyngeal reflux, and 15 had behavioral dysphonia. Of the 50 participants, 40 were female and 10 male, with an average age of 44 years and six months. In the translation process, only question four had to be translated by a fourth judge. After the back-translation and committee review steps, it was necessary to make adjustments to questions one, four, five, seven, eight, nine, and 10. With regard to question five, the "never" option was significantly associated with the clinical group with behavioral dysphonia (P = 0.016), and with regard to question eight, the option was occasionally significantly associated with the clinical group with laryngopharyngeal reflux (P = 0.015). For question six, all the response categories of the questionnaire, had a significantly higher proportion compared to "not applicable" (P < 0.001). For the other questions, no participants selected the "not applicable" option. The translation and cross-cultural adaptation of the throat scale of the Voice Handicap Index to Brazilian Portuguese was performed successfully; the Voice Handicap Index in Brazilian Portuguese prepared herein was called the Índice de Desvantagem Vocal-Garganta. [ABSTRACT FROM AUTHOR]

The primary objective was to analyze and compare the effects of the voiced high-frequency oscillation (VHFO) and Lax Vox techniques in different performance times. The secondary objective was to determine if there were any differences between the exercises in men and women. Thirty volunteers (15 male, 15 female) without vocal complaints or any history of dysphonia participated in this study. The volunteers performed the VHFO and the Lax Vox techniques with a week washout, and the performance times were 1- and 3-minute long with a 15-minute interval. They answered two questionnaires on vocal and laryngopharyngeal symptoms intensity self-assessment and had acoustic measurements (cepstral peak prominence-smoothed – CPPs – , alpha ratio, and L1–L0) obtained, before 1 minute (M0), after 1 minute (M1), and after 3 minutes (M3). They had their sustained vowel /a/ and number counting 1–10 recorded. Data were analyzed by using the repeated measures ANOVA (P < 0.05) and the post hoc Tukey's test. For vowel /a/, men had higher CPPs and lower alpha ratio values. For number counting, men had lower CPPs values, and for both genders there was an improvement after M1, which remained at M3. For the low-pitched voice symptom, men showed a decrease after M1, regardless of the exercise. Men had better results after VHFO, while women had better results after the Lax Vox technique for the tightness symptom. Regardless of exercise or gender, there was a decrease in tickling and irritated throat after M1, but at M3 their intensity tended to increase. The lump in the throat symptom decreased at M1 and remained at the same intensity at M3 regardless of exercise or gender. It is important to be aware of the voice effects and the patient reports when requesting 3 minutes of both exercises. Thus, the conclusion is that the best performance time is 1 minute. For most outcomes, there was no difference between exercises and participants' genders. However, for the low-pitched voice symptom, men benefited more from both exercises, and for tightness, men benefited more from VHFO; in contrast, women benefited more from the Lax Vox technique. Therefore, such gender differences should be considered when choosing these exercises. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the self-perception of vocal symptoms and relationship factors in Brazilian academic teacher. This was a cross-sectional study. The study sample consisted of 235 Brazilian academic teachers, of whom 103 were men and 132 women, aged between 26 and 67 years, and employed at 39 institutions. All participants filled out a questionnaire detailing the presence of vocal complaints, and occupation and sociodemographic information. The vocal symptoms were investigated using voice symptom scale. Academic teacher with vocal complaints showed a higher perception of vocal symptoms in all domains (P < 0.001 for all). Other factors did not result in any significant difference. The only factor that influences the self-perception of vocal symptoms in Brazilian academic teachers is the presence of vocal complaints. [ABSTRACT FROM AUTHOR]

To analyze the immediate effects of semioccluded vocal tract exercises on vocal quality and vocal self-assessment using resonance tube phonation in water in women without voice complaints, and to compare these results with those obtained using tongue trills and unvoiced fricative exercises. This was a quasi-experimental study. The participants were 30 women aged 18–39 years and without vocal complaints. All participants performed three exercises for 3 minutes: experimental exercise (EE: phonation into a resonance flexible tube in water exercise), control exercise (tongue trill exercise), and placebo exercise (PE: unvoiced fricative exercise). Three outcomes were analyzed—vocal self-assessment, auditory-perceptual evaluation, and acoustic analysis. The vocal self-assessment showed significantly greater improvement after EE than after the other exercises. There were no significant differences in auditory-perceptual evaluation or acoustic analyses in any of the voice exercises. The EE promoted an immediate positive effect in the subjective self-assessment, with better results compared with PE. However, the clinical vocal evaluation did not indicate immediate positive effects after 3 minutes of EE, control exercise, or PE. [ABSTRACT FROM AUTHOR]

To translate and cross-culturally adapt the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ) to the Brazilian Portuguese language. The translation and cross-cultural adaptation procedures were performed in five stages: translation, synthesis, back-translation, committee review, and pretest performance. At the end of the first four stages, a questionnaire was produced in Brazilian Portuguese, known as the Questionário Newcastle de Hipersensibilidade Laríngea (LHQ-Br). This version was given as a pretest to 31 participants with laryngeal hypersensitivity: 14 were in the muscle tension dysphonia clinical group, 10 in the refractory chronic cough group, and seven in the globus pharyngeus group. There was a difference in the frequency of occurrence choices in question five ("my throat is blocked"; P = 0.007) and question eight ("I have a sensation of something pushing on my chest"; P = 0.026), but in both questions, the frequency choice of "never" was significantly higher than the other options in all three clinical groups. The relative frequency of participants picking the 'nonapplicable' option in all clinical groups for all questions was zero. This study showed satisfactory results for the translation and cross-cultural adaptation of the LHQ to Brazilian Portuguese (LHQ-Br). [ABSTRACT FROM AUTHOR]

Adult T-cell leukemia/lymphoma has a unique relationship to bone including latency in the marrow, and development of bone invasion, osteolytic tumors and humoral hypercalcemia of malignancy. To study these conditions, we established and characterized a novel mouse model of ATL bone metastasis. Patient-derived ATL cell lines including three that do not express HTLV-1 oncoprotein Tax (ATL-ED, RV-ATL, TL-Om1), an in vitro transformed human T-cell line with high Tax expression (HT-1RV), and an HTLV-1 negative T-cell lymphoma (Jurkat) were injected intratibially into NSG mice, and were capable of proliferating and modifying the bone microenvironment. Radiography, μCT, histopathology, immunohistochemistry, plasma calcium concentrations, and qRT-PCR for several tumor-bone signaling mRNAs were performed. Luciferase-positive ATL-ED bone tumors allowed for in vivo imaging and visualization of bone tumor growth and metastasis over time. ATL-ED and HT-1RV cells caused mixed osteolytic/osteoblastic bone tumors, TL-Om1 cells exhibited minimal bone involvement and aggressive local invasion into the adjacent soft tissues, Jurkat cells proliferated within bone marrow and induced minimal bone cell response, and RV-ATL cells caused marked osteolysis. This mouse model revealed important mechanisms of human ATL bone neoplasms and will be useful to investigate biological interactions, potential therapeutic targets, and new bone-targeted agents for the prevention of ATL metastases to bone. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the immediate effects of voiced high-frequency oscillation (VHFO) and LaxVox exercises in vocally healthy subjects. Thirty adult subjects (15 women, 15 men) with no history of dysphonia or vocal complaints participated in the study. The subjects performed VHFO and LaxVox techniques for 3 minutes in a random order, with a washout period of 7 days. They answered a questionnaire for vocal/laryngeal intensity symptoms, and had maximum phonation time (MPT) /a/, /s/, /z/, and number counting measured. The vowel /a/ was also recorded before and after both techniques for acoustic analysis. After both techniques, the subjects answered a questionnaire about vocal, laryngeal, respiratory, and articulatory sensations. Data were analyzed using the Wilcoxon, and paired t and chi-square tests were used (P < 0.05), as required. There was an increase in high loudness symptom after LaxVox in women, whereas there was a decrease in painful throat, irritated throat, and low loudness symptoms after VHFO in men. After LaxVox, the MPT of /z/ increased in women and after VHFO, the MPT of /s/, /z/, and number counting increased in men. The fundamental frequency variability increased in women after VHFO. The sensations remained unchanged in both groups following the two exercises in women and men. VHFO and LaxVox techniques had similar effects on vocal and laryngeal symptoms, as a matter of fact, in terms of phonatory and acoustic measures. With regard to vocal symptoms, VHFO showed better immediate effects in men than in women. As a result, the hypothesis H0 is partially refuted. [ABSTRACT FROM AUTHOR]

Summary Objective This study aims to propose and analyze the effect of a voice therapy program (VTP) in women with behavioral dysphonia. Materials and Methods This is a controlled, blinded, and nonrandomized cohort study. Participants of this study were 22 women with behavioral dysphonia divided into two groups: G1, 11 women with behavioral dysphonia who received the VTP, and G2, 11 women with behavioral dysphonia who did not receive any intervention. Before and after 6 weeks, the outcome variables evaluated in both groups were auditory-perceptual evaluation of the global degree of vocal quality (vowel /a/ and counting), instrumental acoustic parameters, Voice-Related Quality of Life, vocal and larynx symptoms, and musculoskeletal pain. The statistical analysis used the Wilcoxon, chi-square, and Mann-Whitney tests (P < 0.05). Results After 6 weeks, we observed a significantly higher improvement in the general degree of vocal deviation in vowels, a reduced F0 and symptom of "fatigue while talking" in G1, and an increased "shoulder" pain intensity in G2. Both groups showed improvement in the socioemotional domain of Voice-Related Quality of Life. In addition, the comparison between the groups showed a significantly greater reduction in fundamental frequency and the "voice loss" symptom in G1 compared with G2. Conclusions The VTP using semioccluded vocal tract exercises obtained a positive effect on voice quality, symptoms, and musculoskeletal pain in women with behavioral dysphonia. The proposal, based on the taxonomy of voice therapy, seems to have promoted a phonatory balance, muscle relaxation, and improvement in the vocal resistance of this population. [ABSTRACT FROM AUTHOR]