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The present study focused on the identification of emotions in cross-cultural conditions on different continents and among subjects with divergent language backgrounds. The aim was to investigate whether the perception of the basic emotions from nonsense vocal samples was universal, dependent on voice quality, musicality, and/or gender. Listening tests for 350 participants were conducted on location in a variety of cultures: China, Egypt, Estonia, Finland, Russia, Sweden, and the USA. The results suggested that the voice quality parameters played a role in the identification of emotions without the linguistic content. Cultural background may affect the interpretation of the emotions more than the presumed universality. Musical interest tended to facilitate emotion identification. No gender differences were found. [ABSTRACT FROM PUBLISHER]

In the Mang (Hmongic) dialect of Shuijingping, Guizhou, China, vowels are raised in certain tonal contexts. When a syllable bearing the historical A2 tone occurs in sandhi context, it surfaces with a low tone (historical S) and a raised vowel nucleus. When a syllable bearing the C2 tone occurs out of sandhi context, it also surfaces with a raised vowel. In most other documented cases of tone-vowel quality interactions, there is some factor, such as syllable structure, metrical structure, or vowel duration that mediates between tone and vowel quality. These earlier analyses cannot be straightforwardly extended to Shuijingping Mang since no synchronic mediating factor seems to be present. However, this paper shows that, historically, there was another mediating factor between tone and vowel quality, namely voice quality. It is common for tones in East and Southeast Asian languages to have characteristic phonation types. It is also common for phonation type to affect vowel quality. Comparative evidence shows that the tones that condition the vowel alternation in the present-day language historically underwent a tonally-driven breathy-modal voice alternation. Subsequently, the tonal grammar has changed; however, vowel raising remains as a synchronic alternation. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies reported discrepant vocal qualities associated with different languages. However, possible physical differences associated with speakers of different ethnicities were not accounted for. The present study attempted to examine the effect of language on one's voice quality by eliminating the potential effects of physical differences associated with speakers of different languages., Methods: Sixteen Chinese and fourteen Americans who were proficient in both Mandarin Chinese and English were recruited. They were instructed to read one Chinese and one English passage. Time-domain and long-term average spectral analyses were carried out, and speaking fundamental frequency (sF0), jitter, shimmer, and first spectral peak (FSP), mean spectral energy (MSE), and spectral tilt (ST) were measured using Praat., Results: Acoustic measures revealed no differences in sF0, FSP, and ST between Americans and Chinese. However, jitter, shimmer, and MSE values appeared to be affected by ethnicity (Chinese vs. Americans). Jitter and shimmer tended to be greater when someone was speaking his/her mother tongue. For language effect, Chinese was found to be associated with a faster rate of vocal fold vibration than English. MSE was higher for Chinese than English produced by Chinese, but not by American speakers, despite the similar ST in both languages., Discussion/conclusion: Based on speech samples obtained from the balanced groups of bilingual speakers, the findings confirmed the presence of language effect on one's voice quality. Laryngeal activity appeared to be affected by the language being spoken., (© 2022 The Author(s). Published by S. Karger AG, Basel.)

Objective: Pulmonary nodules (PNs) are one of the imaging manifestations of early lung cancer screening, which should receive more attention. Traditional Chinese medicine believes that voice changes occur in patients with pulmonary diseases. The purpose of this study is to explore the differences in phonetic characteristics between patients with PNs and able-bodied persons., Methods: This study explores the phonetic characteristics of patients with PNs in order to provide a simpler and cheaper method for PN screening. It is a case-control study to explore the differences in phonetic characteristics between individuals with and without PNs. This study performed non-parametric statistics on acoustic parameters of vocalizations, collected from January 2017 to March 2018 in Shanghai, China, from these two groups; it explores the differences in third and fourth acoustic parameters between patients with PNs and a normal control group. At the same time, computed tomography (CT) scans, course of disease, combined disease and other risk factors of the patients were collected in the form of questionnaire. According to the grouping of risk factors, the phonetic characteristics of the patients with PNs were analyzed., Results: This study was comprised of 200 patients with PNs, as confirmed by CT, and 86 healthy people that served as a control group. Among patients with PNs, 43% had ground glass opacity, 32% had nodules with a diameter ≥ 8 mm, 19% had a history of smoking and 31% had hyperlipidemia. Compared with the normal group, there were statistically significant differences in pitch, intensity and shimmer in patients with PNs. Among patients with PNs, patients with diameters ≥ 8 mm had a significantly higher third formant. There was a significant difference in intensity, fourth formant and harmonics-to-noise ratio (HNR) between smoking and non-smoking patients. Compared with non-hyperlipidemia patients, the pitch, jitter and shimmer of patients with PNs and hyperlipidemia were higher and the HNR was lower; these differences were statistically significant., Conclusion: This measurable changes in vocalizations can be in patients with PNs. Patients with PNs had lower and weaker voices. The size of PNs had an effect on the phonetic formant. Smoking may contribute to damage to the voice and formant changes. Voice damage is more pronounced in individuals who have PNs accompanied by hyperlipidemia., Competing Interests: Conflicts of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.)

In Shanghai Chinese as well as many other Wu dialects, breathy voice is a well-documented accompaniment of the low-register tone syllables with obstruent as well as sonorant onsets. But Shanghai Chinese is rapidly changing and the breathy voice associated with low-register tones tends to disappear in young speakers' productions. In this study, we asked whether breathy voice is nevertheless still perceived and whether it pushes tone identification toward low-register tones. We conducted forced-choice tone identification tests on young native listeners of Shanghai Chinese, using low-high register tone continua-from tone T3 (23) to tone T2 (34)-imposed on base syllables with either modal or breathy voice quality, and beginning with various onset consonants. We used continua constructed from either naturally produced or synthesized syllables. Our results show that breathy voice does bias tone identification responses toward the low-register tone T3. This result held for both synthesized and natural stimuli, except for the /m/-onset stimuli derived from naturally produced syllables. We propose that the phonetic change at issue-loss of breathiness in production-is not due to misperception but reflects the ever-stronger influence of Standard Mandarin Chinese. In other words, this particular case of sound change seems to be led by production rather than perception. It remains an open question whether this kind of sound change is only determined by sociolinguistic factors (here, the dominance of Mandarin Chinese) or is independently motivated by phonetic and/or phonological factors.

Three electroglottographic parameters, fundamental frequency, contact quotient, and speed quotient were analyzed for two singers of Young girl role in Kunqu Opera. Each singer performed three conditions, singing, stage speech, and reading lyrics. The phonation types adopted in different conditions were explored based on electroglottographic parameters. Fundamental frequency, contact quotient, and speed quotient showed different distributions among conditions. Five phonation types were used in singing and stage speech, which include (1) breathy voice, (2) modal voice with low degree of posterior glottal adduction, (3) modal voice, (4) falsetto, and (5) falsetto with high degree of posterior glottal adduction. The phonation strategies partly showed differences between singers. Different phonation type collocations were employed in singing and stage speech. The relationship between phonation types and pitch was complex. The phonation types actually used were different from and more complex than those in traditional Kunqu Opera singing theory., (Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: We aimed to delineate the acoustic characteristics of the Laodan and Qingyi role in Peking Opera and define glottis closure states and mucosal wave changes during singing in the two roles., Methods: The range of singing in A4 (440 Hz) pitch in seven female Peking Opera singers was determined using two classic pieces of Peking Opera. Glottal changes during singing were examined by stroboscopic laryngoscope. The fundamental frequency of /i/ in the first 15 seconds of the two pieces and the /i/ pitch range were determined. The relative length of the glottis fissure and the relative maximum mucosal amplitude were calculated., Results: Qingyi had significantly higher mean fundamental frequency than Laodan. The long-term average spectrum showed an obvious formant cluster near 3000 Hz in Laodan versus Qingyi. No formant cluster was observed in singing in the regular mode. Strobe laryngoscopy showed complete glottal closure in Laodan and incomplete glottal closure in Qingyi in the maximal glottis closure phase. The relative length of the glottis fissure of Laodan was significantly lower than that of Qingyi in the singing mode. The relative maximum mucosal amplitude of Qingyi was significantly lower than that of Laodan., Conclusion: The Laodan role and the Qingyi role in Peking Opera sing in a fundamental frequency range compatible with the respective use of da sang (big voice) and xiao sang (small voice). The morphological patterns of glottal changes also indicate that the Laodan role and the Qingyi role sing with da sang and xiao sang, respectively., (Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objectives: The purposes of this study were to adapt and validate the English version of the pediatric Voice-Related Quality of Life questionnaire into Mandarin Chinese, and to determine the cutoff point for screening children with and without voice disorders., Methods: A total of 377 parents were enrolled from May 2016 to June 2017, including 195 parents of children with voice disorder (patient group) and 182 parents of children without voice disorder (control group). The internal consistency, test-retest, contents and clinical validity, and sensitivity and specificity were analyzed. The clinical cutoff point was determined., Results: The questionnaire showed strong internal consistency in the patient group (α = 0.89 for the total score, α = 0.88 for the social-emotional domain, and α = 0.81 for the physical functioning domain) and good test-retest reliability (intra-class correlation coefficient = 0.93), as well as moderate to strong contents validity (r = 0.72-0.95). The total score and subscales scores in the patient group were significantly higher than the control group (P < 0.001). The mean score of the physical functioning domain was lower than that of the social-emotional domain in the patient group. The clinical cutoff point was 96.25 (sensitivity = 78.0%, specificity = 100.0%)., Conclusion: The Mandarin Chinese version of pediatric Voice-related Quality of Life questionnaire was a valid and reliable questionnaire, which can be used as a screening test for the pediatric population with and without voice disorders., (Copyright © 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: The objective of this study was to examine the perceptual structure and acoustic characteristics of speech of patients with adductor spasmodic dysphonia (ADSD) in Mandarin., Study Design: Case-Control Study MATERIALS AND METHODS: For the estimation of dysphonia level, perceptual and acoustic analysis were used for patients with ADSD (N = 20) and the control group (N = 20) that are Mandarin-Chinese speakers. For both subgroups, a sustained vowel and connected speech samples were obtained. The difference of perceptual and acoustic parameters between the two subgroups was assessed and analyzed., Results: For acoustic assessment, the percentage of phonatory breaks (PBs) of connected reading and the percentage of aperiodic segments and frequency shifts (FS) of vowel and reading in patients with ADSD were significantly worse than controls, the mean harmonics-to-noise ratio and the fundamental frequency standard deviation of vowel as well. For perceptual evaluation, the rating of speech and vowel in patients with ADSD are significantly higher than controls. The percentage of aberrant acoustic events (PB, frequency shift, and aperiodic segment) and the fundamental frequency standard deviation and mean harmonics-to-noise ratio were significantly correlated with the perceptual rating in the vowel and reading productions., Conclusions: The perceptual and acoustic parameters of connected vowel and reading in patients with ADSD are worse than those in normal controls, and could validly and reliably estimate dysphonia of ADSD in Mandarin-speaking Chinese., (Copyright © 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: The goals of this research are (1) to establish normative nasalance values for bilingual Mandarin-English speakers and compare values to those of previously reported monolingual Mandarin speakers, and (2) to examine whether sex, age, dialect, and language proficiency affect levels of nasalance among Mandarin-English speakers in both English and Mandarin., Design: All participants recorded the speech stimuli, constructed to include oral sentences, nasal sentences, oronasal sentences, and vowels /ɑ, i, u/ in Mandarin and English. Nasalance measurements were recorded using the Nasometer II 6450., Participants and Setting: A total of 45 (20 males and 25 females) native Mandarin speakers between 20 and 54 years of age from mainland China participated in the study., Results: Mean nasalance scores of the Mandarin oral sentence (Mean [M] = 17.64, standard deviation [SD] = 7.33), oronasal sentence (M = 54.62, SD = 7.81), and nasal sentence (M = 68.73, SD = 8.09) are reported. Mean nasalance scores of the English oral sentence (M = 20.02, SD = 7.83), oronasal sentence (M = 58.71, SD = 7.59), and nasal sentence (M = 65.27, SD = 7.45) are reported. A repeated measures analysis of variance showed significant sex difference in nasalance scores for English stimuli ( P = .031) and Mandarin stimuli ( P = .040). There was no significant effects of age, dialect, and language proficiency on Mandarin or English stimuli., Conclusions: This is the first study to report normative values for Mandarin-English speakers using the Nasometer II. Values reported can be used for objective assessment of bilingual speakers.

The aim of this study was to investigate the difference and correlation between the Voice-Related Quality of Life (V-RQOL) and the Voice Activity and Participation Profile (VAPP) among teachers.The participants were 672 teachers (218 males and 454 females, male-to-female ratio = 0.48:1) whose vocal cords were examined using a Strobolaryngoscope. Questionnaire results were obtained for both the V-RQOL and the VAPP.Of the 672 participants, 322 teachers had voice disorders while 350 teachers did not. The most common voice complaint was hoarseness (n = 250), and the most common throat complaint was foreign body sensation (n = 129) in teachers with voice disorders. Chronic laryngitis (n = 162, 50.3%), vocal cord polyps (n = 92, 28.6%), and vocal cord nodules (n = 43.13.4%) were the most frequent diagnoses in teachers with voice disorders. Significant differences were seen on the V-RQOL and the VAPP scores between teachers with and without voice disorders, and between female and male teachers. Differences were also observed among teachers from different grades, and among different types of voice-related diseases. Moderate-to-strong correlations were observed between the VAPP total score and those for all the subscales of the VAPP and between the VAPP total score and the V-RQOL score (P < .001).Teachers with voice disorders have a significantly poorer voice-related quality of life than those without voice disorders, as do female teachers compared with male teachers. Different groups of voice disorders have different effects on teachers' voice-related quality of life, and primary school teachers suffer from a poorer voice-related quality of life than do high school teachers. A moderate-to-strong correlation was found between the results of the V-RQOL and the VAPP scores.

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

Objectives: Recent research on the signal value of masculine physical characteristics in men has focused on the possibility that such characteristics are valid cues of physical strength. However, evidence that sexually dimorphic vocal characteristics are correlated with physical strength is equivocal. Consequently, we undertook a further test for possible relationships between physical strength and masculine vocal characteristics., Methods: We tested the putative relationships between White UK (N = 115) and Chinese (N = 106) participants' handgrip strength (a widely used proxy for general upper-body strength) and five sexually dimorphic acoustic properties of voices: fundamental frequency (F0), fundamental frequency's SD (F0-SD), formant dispersion (Df), formant position (Pf), and estimated vocal-tract length (VTL)., Results: Analyses revealed no clear evidence that stronger individuals had more masculine voices., Conclusions: Our results do not support the hypothesis that masculine vocal characteristics are a valid cue of physical strength., (© 2018 Wiley Periodicals, Inc.)

This study used the perceptual-migration paradigm to explore whether Mandarin tones and syllable rhymes are processed separately during Mandarin speech perception. Following the logic of illusory conjunctions, we calculated the cross-ear migration of tones, rhymes, and their combination in Chinese and English listeners. For Chinese listeners, tones migrated more than rhymes. For English listeners, the opposite pattern was found. The results lend empirical support to autosegmental theory, which claims separability and mobility between tonal and segmental representations. They also provide evidence that such representations and their involvement in perception are deeply shaped by a listener's linguistic experience.

Right Dislocation (RD) has been suggested to be a focus marking device carrying an affective function motivated by limited planning time in conversation. The current study investigated the effects of genre type, planning load and affective function on the use of RD in Cantonese monologues. Discourse data were extracted from a recently developed corpus of oral narratives in Cantonese Chinese containing language samples from 144 native Cantonese speakers evenly distributed in age, education levels and gender. Three genre types representing different structures, styles and degrees of topic familiarity were chosen for an RD analysis: procedural description, story-telling and recount of personal event. The results revealed that genre types and planning load influenced the rate of RD occurrence. (1) Specifically, the lowest proportion of RD occurred in procedural description, assumed to be the most structured genre; whereas the highest rate was found in personal event recount, considered to be the most stylized and less structured genre. (2) The highest proportion of RD appeared near the end of a narrative, where heavier cognitive load is demanded compared with the beginning of a narrative; moreover, RD also tended to co-occur with disfluency. (3) There was a high percentage of RD tokens in the personal event recount for expressing explicit emotions; and (4) a lower rate of occurrence of RD was found in monologues than previous studies based on conversations. The overall findings suggest that the use of RD is sensitive to genre structure and style, as well as planning load effects.

Objectives: The purpose of this study was to investigate the validity and reliability of the translated Chinese version of the Speech Handicap Index (SHI) questionnaire for Chinese-speaking patients with oral and oropharyngeal cancer., Methods: The original English version of the SHI was translated into Chinese. Forty-two consecutive patients with oral and oropharyngeal cancer were included in the study. All subjects were asked to complete the Chinese version of the SHI and the University of Washington Quality of Life Questionnaire (UWQOL V.04). Fifteen patients were randomly retested on both questionnaires 2 weeks later. The internal consistency, test-retest reliability, construct validity, and group validity of the Chinese version of the SHI were tested using Cronbach α, Spearman correlation coefficient (r), and Mann-Whitney U tests. Descriptive and bivariate statistics were computed, and the P value was set to 0.05., Results: The Cronbach α for the total SHI, the speech domain, and the psychosocial domain were 0.96, 0.90, and 0.92, respectively. The test-retest reliability scores for the total SHI, the speech domain, the psychosocial domain, and the overall question were 0.94, 0.97, 0.90, and 0.83, respectively. To measure construct validity, Spearman correlation coefficients between different items of the SHI and the UWQOL were all >0.4, which signified a moderate to significant correlation. There were significant differences between patient groups when divided by age, clinical stage, educational level, radiotherapy, and reconstruction, on all or on parts of the various SHI domains., Conclusions: The Chinese version of the SHI is a valid and reliable tool for the speech assessment of patients with oral and oropharyngeal cancer., (Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to establish a multiparameter voice assessment profile using objective multiparameter test and subjective voice quality assessment., Methods: We assessed 50 patients with voice disorders before and after operation. The assessment incorporates (1) subjective voice quality assessment, (2) patients' self-assessment, and (3) objective acoustic analysis. The subjective voice quality assessment uses GRABS system to evaluates the grade of hoarseness (G), proposed by the Japanese Society for Logopedics and Phoniatrics. Patients' self-assessment is modified based on the Chinese version of voice handicap index (VHI) scale, composed of functional (F), physiological (P), emotional (E) part, and a total score (T). The acoustical analysis evaluate the patients' voice sample by voice analysis software "Dr. Speech". Three parameters, jitter (J), shimmer(S), and normalized noise energy (NNE), were taken in analysis., Results: We observed high correlations among subentries F, P, and the total score TvH of the VHI scale in patients' subjective assessment. Parameter E does not correlate well with other assessed parameters. The Chinese version of VHI, which incorporate multifactors including age, education, and especially the cultural difference may account for the inconsistent correction in parameter E. In the objective acoustic analysis, high correlation among the three parameters J, S, and NNE is observed., Conclusion: Systemic assessment combining a subjective voice quality assessment, an objective acoustic analysis, and a self-assessment is helpful in clinical practice in the diagnosis and treatment for voice disorders. The E component in VHI scale assessment may not be a reliable parameter to evaluate treatment outcome., (Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Equivalent sound level (Leq), sound pressure level (SPL), and fundamental frequency (F0) are analyzed in each of five Kunqu Opera roles, Young girl and Young woman, Young man, Old man, and Colorful face. Their pitch ranges are similar to those of some western opera singers (alto, alto, tenor, baritone, and baritone, respectively). Differences among tasks, conditions (stage speech, singing, and reading lyrics), singers, and roles are examined. For all singers, Leq of stage speech and singing were considerably higher than that of conversational speech. Interrole differences of Leq among tasks and singers were larger than the intrarole differences. For most roles, time domain variation of SPL differed between roles both in singing and stage speech. In singing, as compared with stage speech, SPL distribution was more concentrated and variation of SPL with time was smaller. With regard to gender and age, male roles had higher mean Leq and lower average F0, MF0, as compared with female roles. Female singers showed a wider F0 distribution for singing than for stage speech, whereas the opposite was true for male singers. The Leq of stage speech was higher than in singing for young personages. Younger female personages showed higher Leq, whereas older male personages had higher Leq. The roles performed with higher Leq tended to be sung at a lower MF0., (Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)

Esophageal (SE) and tracheoesophageal (TE) speech are the most commonly used alaryngeal voicing types after total laryngectomy-a surgical procedure of removing a pathological larynx. Both SE and TE voices show more aperiodicity than normal laryngeal (NL) voices, and the vocal characteristics of alaryngeal voices are notoriously difficult to extract. The present study investigated the difference in vocal characteristics among NL, SE, and TE voices using perception measures and nonlinear dynamical analysis. Correlation dimension (D(2)) and sample entropy (SampEn) were obtained from 90 voice samples produced by 10 TE, 10 SE, and 10 NL male Cantonese speakers. Correlation between nonlinear dynamical parameters and perceptual ratings of different voices was also examined. Results show that both D(2) and SampEn values were significantly higher for TE and SE voices than NL voice. The overall perceptual judgment of SE and TE voice quality was negatively correlated with D(2) and SampEn. This finding supports the validity of using nonlinear dynamical parameters in assessing voice quality. Results of the present study also indicate that nonlinear dynamical analysis could be a supplemental tool to traditional acoustic analysis, especially for analyzing the voice quality of alaryngeal speech., (Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)

Objectives: To investigate the characteristics of the simplified Chinese versions of the Voice Handicap Index (VHI)., Methods: Cluster analysis was performed on the VHI scores of 1766 dysphonic patients to screen for items to compile different simplified Chinese VHI versions. The VHI scores of 3825 dysphonic patients (in which 424 patients have undertaken surgical treatment) and 120 control subjects were assessed using the simplified versions, and the results were compared between the simplified versions and the original version., Results: Two simplified versions of VHI-10 (10 items) and VHI-13 (13 items) were compiled after the cluster analysis. Their internal consistency reliabilities were 0.939 and 0.936, the test-retest reliability coefficients were 0.995 and 0.993, and their correlation coefficients to the original VHI questionnaire were 0.972 and 0.973, respectively. The scores of VHI-10 and VHI-13 were significantly higher in dysphonic patients than in control subjects (Z=17.42, Z=17.46; P=0.000). The mean ratios of the VHI-10 and VHI-13 scores to the original VHI questionnaire scores in dysphonic groups were found to be consistently greater than expected (0.333 and 0.433, respectively). The VHI scores from the simplified versions were classified on the basis of the overall grade severity of dysphonia according to the physicians' subjective auditory assessment, and when the scores among the different groups were compared, there was a statistical difference between the VHI-10 and VHI-13 scores (Z=5.735-9.861, P=0.000). The VHI-10 and VHI-13 patient scores declined significantly after treatment (P<0.05)., Conclusions: Both of the simplified Chinese versions, VHI-10 and VHI-13, had good reliability and validity. They could be used in the dysphonic self-assessment as the simplified Chinese VHI questionnaire. VHI-10 was found to be more concise and more widely applicable than VHI-13., (Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)

Objective: To investigate the prevalence of throat disease in secondary school teachers of Urumqi., Method: Use Stage-Two random sampling at 11689 teachers from 109 secondary schools in Urumqi; Draw 3 217 from 11689 teachers in 109 secondary schools to accept voice self-assessment questionnaire survey and routine examination of throat, and the one who were confirmed abnormal in routine inspection would be underway stroboscopic laryngoscopy., Result: The total illness prevalence rate of throat disease in secondary school teachers of Urumqi is 28.23%; there is no statistic difference of illness prevalence rate between male and female teachers (P > 0.05). However, results showed statistical significance of illness prevalence rate in teachers of different racial-groups with different years of teaching experience (P < 0.05). Teachers who have 5 to 15 years of teaching experience suffer a high incidence of throat diseases. Among eight racial groups involved in investigation, Kazak teachers are in the highest illness prevalence rate. The results of assessment for voice disorder index between teachers with and without throat diseases showed statistical difference in total score TVH (P < 0.05), which is shown significant in the physical and emotional areas (P < 0.05), while there is no statistical difference in function. Diseases of pharyngeal portion are mainly chronic pharyngitis and hyperplastic tonsil in tongue root; Diseases of laryngeal portion are mainly chronic laryngitis and vocal nodule for female, while mainly chronic laryngitis and vocal polypus for male., Conclusion: There is no significant difference in illness prevalence rate of throat disease for secondary school teachers in Urumqi between genders; the highest prevalence rate is in teachers who have 5 to 15 years teaching experience; among different racial groups, Kazak teachers are of the highest illness prevalence rate; the illness prevalence of throat diseases is related with voice disorder index.

Objective: Smoking results in a voice change, and the perception by smokers of an abnormal voice may encourage quitting behavior. Moreover, a disordered voice is often the first sign of vocal pathology. Efforts to evaluate voice have focused on classical acoustic analysis; however, nonlinear dynamic analysis has been shown to be a reliable objective method for the evaluation of voice. We compare the discriminatory ability of these two methods when applied to normal and smokers' voices., Study Design: Prospective study., Methods: The study included 73 subjects, 36 nonsmokers and 37 smokers. A segment of sustained vowel production was obtained from each subject. Acoustic dimension and correlation dimension (D2) analyses were applied to the data. Results were compared with a Mann-Whitney rank sum test, logistic regression, and receiver operating characteristics (ROC) analysis., Results: D2 values for smokers were significantly higher than D2 values for nonsmokers (P<0.001). Jitter and shimmer analysis showed higher values for these parameters among smokers. Logistic regression indicated a higher predictive power with D2, and ROC analysis found no significant difference between the analysis methods., Discussion: This study indicated that D2 is highly sensitive to changes associated with smoking and has the potential to be implemented clinically as an indicator of abnormal voice. Further research could focus on using nonlinear dynamic analysis to create a normative database, producing standards for monitoring voice changes caused by cigarette smoking., (Copyright © 2011 The Voice Foundation. All rights reserved.)

Objectives: To investigate the characteristics and clinical application of Mandarin Chinese version of the Voice Handicap Index (VHI)., Methods: A cross-culture adaptation was used to develop the Mandarin Chinese version of the VHI. The translated version was then administered to 1766 dysphonic patients and 120 control subjects; 210 of the patients were treated with phonosurgery or BOTOX injection. Disorders were chronic laryngitis, benign vocal fold disorders, pathologic sulcus vocalis, benign or malignant tumors of vocal fold, spasmodic dysphonia (SD) and unilateral vocal fold paralysis (UVFP), and functional dysphonia., Results: The Cronbach's α score for the overall VHI was 0.956; the functional, physical, and emotional subscales had values of 0.922, 0.872, and 0.933, respectively. The test-retest reliability coefficient was 0.991 (P<0.01). Correlations between the subscales and the overall VHI as well as among the subscales were all significant (P<0.01) Principal-component analysis revealed six-factor eigenvalues exceeding 1, explaining 75.39% of the total variance. The total VHI scores and subscale scores were statistically higher for dysphonic groups (P<0.001). The order of disease classification from highest score to lowest score was: SD, functional dysphonia, UVFP, sulcus vocalis, benign and malignant tumor, benign vocal fold disorders, and chronic laryngitis. The emotional scores were the highest in SD, and followed by functional dysphonia; the physical scores were the highest in the other groups. Treatment leads to statistically improvement in VHI scores (P<0.05)., Conclusion: The Mandarin Chinese version of VHI appears to be a reliable and valid tool in assessing dysphonia in Mandarin Chinese speakers., (Copyright © 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)

The objective of this study was to design a voice training program for Chinese speakers, and to evaluate its efficacy. It was a prospective, randomized, case-control study practiced in three middle schools in Beijing, China. Teachers in the treatment group received voice training for 4 weeks, whereas the control group subjects received no treatment. The voice training program, which was adapted for Chinese, contained vocal hygiene education and group voice training. The outcome was assessed by voice handicap index (VHI), maximum phonation time (MPT) and acoustic analysis parameters including, noise to harmonic ratio (NHR), jitter and shimmer. The results showed that at the onset of the study, no significant differences were found between the subjects in two groups for VHI, MPT and NHR. VHI of treatment group subjects who received voice training decreased significantly, whereas VHI of control group subjects showed no significant change. Treatment group MPT was significantly increased after training, whereas the control group one presented no significant change during the same period. NHR in treatment group decreased significantly after training, whereas the one in control group showed no significant change. There were no significant changes for jitter and shimmer in both groups before and after the study. So we conclude that the voice training program is suitable to treat voice diseases, particularly for middle school teachers. This result provided reliable evidence for carrying out further voice training in China.

Objective: To analyze the complications of transoral laser surgery (TLS) for larynx tumors in a single center institution, and to highlight its possible risks., Methods: This is a retrospective study of the peri- and post-operative complications of 500 patients who underwent TLS from November 2001 to July 2008 in the Department of Otolaryngology, Head and Neck Surgery, Anhui Provincial Hospital, Anhui Medical University, Hefei, China., Results: The total rate of complications was 10.2%. The major complications accounted for 0.8%, including one ignition, one post-operative bleeding, one dyspnea, and one laryngeal web; and the minor ones were found in 47 of 500 patients (9.4%), including 30 patients with suspension laryngoscopy related complications. A higher incidence of complications was observed in patients with larynx carcinoma than those with benign/precancerous lesions (p=0.00)., Conclusion: Peri- and post-operative complications after TLS for benign larynx tumors are relatively rare events, but are relatively frequent for larynx cancers. Every surgeon who performs laser surgery should have a clear concept of management for these complications, and strategies to avoid these complications should be performed.

The aims of this study were to provide a perceptual speech 'profile' for Cantonese speakers with hypokinetic dysarthria, to examine the reliability of non-expert listeners in perceptual judgements of dysarthric speech, and to investigate cross-language differences in profiles of hypokinetic dysarthria. Participants included 19 speakers with Parkinson's disease and 10 speech-language pathologists who served as listeners. Listeners rated 21 speech dimensions, using seven-point interval scales. Mean intralistener agreement was 94.52% and mean interlistener reliability was 0.88 (Cronbach's alpha). Mean scale values (MSV) for each dimension ranged from 3.37 to 1.36. The perceptual profile of Cantonese hypokinetic dysarthria was largely similar to profiles for English and Japanese speakers; notable differences are discussed. Possible reasons for the relatively high reliability obtained are presented.

The purpose of the present study was to compare the speech performance of four types of alaryngeal phonation-electrolaryngeal (EL), pneumatic artificial laryngeal (PA), tracheoesophageal (TE), and standard esophageal (SE) speech-by adult Cantonese-speaking laryngectomees. Subjective ratings of (1) voice quality, (2) articulation proficiency, (3) quietness of speech, (4) pitch variability, and (5) overall speech intelligibility were given by eight naive individuals who had no prior experience with any form of alaryngeal speech. Results indicated that SE and TE speech was perceived to be more hoarse than PA and EL speech. EL speech was associated with significantly less pitch variability, and PA speakers produced speech with the least amount of perceived noise. However, articulation proficiency and overall speech intelligibility were found to be comparable in all four types of alaryngeal speakers.

This paper describes the use of electropalatography (EPG) in the treatment of a speech disorder in a Cantonese-speaking woman who had primary repair of the palate at age 13. A multiple-baseline approach was used to document treatment efficacy using electropalatography. The client showed rapid improvement in articulatory placement, with generalization to nontarget phonemes. In addition, improvement was noted in her manner of articulation, with a reduction of nasal emission. The relationship between articulatory placement errors and nasal emission in late repair cleft is discussed. Explanations for the effectiveness of EPG with this client are offered.