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Purpose: Hypofractionated radiotherapy (HFRT) is being used more frequently for many common cancer sites. Conventionally fractionated radiotherapy treatment regimens have remained the standard of care when radiotherapy is indicated for soft tissue sarcoma (STS). The aim of this study is to systematically review published data on the use of pre-operative hypofractionated radiotherapy as part of a curative treatment paradigm in patients with soft tissue sarcoma. Herein we summarise current evidence for the use of hypofractionated radiotherapy in the pre-operative treatment of STS., Methods and Materials: We conducted a database search for prospectively or retrospectively collected data on patients with a diagnosis of soft tissue sarcoma treated with HFRT. Studies evaluating soft tissues sarcoma of all histological subtypes affecting extremities or trunk were included in the search. Articles were screened by two independent reviewers for inclusion in this review. Patient, treatment, toxicity and outcome data was recorded and collated from selected studies., Results: 25 articles are included in this review. Nine prospective trials have been published since 2020. Dose fractionations range from 25-40Gy in 5 fractions or 28-42.75Gy in 8-15 fractions. Local control and overall survival outcomes are consistent with historical data for conventionally fractionated radiotherapy. Acute toxicity and wound complication rates are in keeping with acceptable results. Late toxicity data is limited and requires longer follow up. Rates of pathological complete response are promising across all studies., Conclusions: There is a growing body of evidence supporting hypofractionation as safe and effective in the pre-operative treatment of STS. This review highlights potential areas that could be further investigated to optimise pre-operative treatment for soft tissue sarcoma., Competing Interests: Declaration of competing interest None for all above authors., (Copyright © 2024. Published by Elsevier Inc.)

Voices elicit rich first impressions of what the person we are hearing might be like. Research stresses that these impressions from voices are shared across different listeners, such that people on average agree which voices sound trustworthy or old and which do not. However, can impressions from voices also be shaped by the 'ear of the beholder'? We investigated whether - and how - listeners' idiosyncratic, personal preferences contribute to first impressions from voices. In two studies (993 participants, 156 voices), we find evidence for substantial idiosyncratic contributions to voice impressions using a variance portioning approach. Overall, idiosyncratic contributions were as important as shared contributions to impressions from voices for inferred person characteristics (e.g., trustworthiness, friendliness). Shared contributions were only more influential for impressions of more directly apparent person characteristics (e.g., gender, age). Both idiosyncratic and shared contributions were reduced when stimuli were limited in their (perceived) variability, suggesting that natural variation in voices is key to understanding this impression formation. When comparing voice impressions to face impressions, we found that idiosyncratic and shared contributions to impressions similarly across modality when stimulus properties are closely matched - although voice impressions were overall less consistent than face impressions. We thus reconceptualise impressions from voices as being formed not only based on shared but also idiosyncratic contributions. We use this new framing to suggest future directions of research, including understanding idiosyncratic mechanisms, development, and malleability of voice impression formation., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

When listeners hear a voice, they rapidly form a complex first impression of who the person behind that voice might be. We characterize how these multivariate first impressions from voices emerge over time across different levels of abstraction using electroencephalography and representational similarity analysis. We find that for eight perceived physical (gender, age, and health), trait (attractiveness, dominance, and trustworthiness), and social characteristics (educatedness and professionalism), representations emerge early (~80 ms after stimulus onset), with voice acoustics contributing to those representations between ~100 ms and 400 ms. While impressions of person characteristics are highly correlated, we can find evidence for highly abstracted, independent representations of individual person characteristics. These abstracted representationse merge gradually over time. That is, representations of physical characteristics (age, gender) arise early (from ~120 ms), while representations of some trait and social characteristics emerge later (~360 ms onward). The findings align with recent theoretical models and shed light on the computations underpinning person perception from voices., Competing Interests: Competing interests statement:The authors declare no competing interest.

Spontaneous and conversational laughter are important socio-emotional communicative signals. Neuroimaging findings suggest that non-autistic people engage in mentalizing to understand the meaning behind conversational laughter. Autistic people may thus face specific challenges in processing conversational laughter, due to their mentalizing difficulties. Using fMRI, we explored neural differences during implicit processing of these two types of laughter. Autistic and non-autistic adults passively listened to funny words, followed by spontaneous laughter, conversational laughter, or noise-vocoded vocalizations. Behaviourally, words plus spontaneous laughter were rated as funnier than words plus conversational laughter, and the groups did not differ. However, neuroimaging results showed that non-autistic adults exhibited greater medial prefrontal cortex activation while listening to words plus conversational laughter, than words plus genuine laughter, while autistic adults showed no difference in medial prefrontal cortex activity between these two laughter types. Our findings suggest a crucial role for the medial prefrontal cortex in understanding socio-emotionally ambiguous laughter via mentalizing. Our study also highlights the possibility that autistic people may face challenges in understanding the essence of the laughter we frequently encounter in everyday life, especially in processing conversational laughter that carries complex meaning and social ambiguity, potentially leading to social vulnerability. Therefore, we advocate for clearer communication with autistic people., (© The Author(s) 2024. Published by Oxford University Press.)

Background: Palliative radiotherapy (PRT) is commonly used to treat symptoms of advanced cancer. PRT has been associated with elevated 30-day mortality (30DM). A Rapid Access Palliative Clinic (RAPC) can streamline the treatment process for patients receiving treatment., Aims: We reviewed the PRT practices in a radiation oncology network in Ireland, and the implementation of a RAPC. Patient outcomes were assessed to inform future treatment decisions., Methods: A retrospective review of all patients who received PRT over 6 months in 2018 in St. Luke's Radiation Oncology Network (SLRON) was undertaken. We assessed 30DM rates, demographics and referral to specialist palliative care (SPC) services. Subsequently, a retrospective analysis was conducted of a RAPC which ran for 6 months from 2019 to 2020. We assessed treatment data and mortality., Results: Over 6 months, 645 patients commenced PRT in the SLRON. The 30DM for this cohort was 15.8% (n = 102), with most patients having lung primaries. Of the 30DM cohort, only 55% (n = 56) were referred to SPC services and only 26.4% (n = 27) had performance status recorded. Over 6 months, 40 patients attended 28 RAPCs. Of these, 88% (n = 35) received PRT. Single fraction therapy was utilised in 60% and 48% of patients underwent CT simulation and treatment on the same day. Ultimately, 75% of patients received SPC referral., Conclusions: Referral rates to SPC services and documentation of performance status were low in our 30DM retrospective review cohort. The RAPC facilitated quick treatment turnaround, fewer hospital visits and referral to SPC services., (© 2023. The Author(s).)

We regularly form impressions of who a person is from their voice, such that we can readily categorise people as being female or male, child or adult, trustworthy or not, and can furthermore recognise who specifically is speaking. How we establish mental representations for such categories of person characteristics has, however, only been explored in detail for voice identity learning. In a series of experiments, we therefore set out to examine whether and how listeners can learn to recognise a novel person characteristic. We specifically asked how diagnostic acoustic properties underpinning category distinctions inform perceptual judgements. We manipulated recordings of voices to create acoustic signatures for a person's handedness (left-handed vs. right-handed) in their voice. After training, we found that listeners were able to successfully learn to recognise handedness from voices with above-chance accuracy, although no significant differences in accuracy between the different types of manipulation emerged. Listeners were, furthermore, sensitive to the specific distributions of acoustic properties that underpinned the category distinctions. We, however, also find evidence for perceptual biases that may reflect long-term prior exposure to how voices vary in naturalistic settings. These biases shape how listeners use acoustic information in the voices when forming representations for distinguishing handedness from voices. This study is thus a first step to examine how representations for novel person characteristics are established, outside of voice identity perception. We discuss our findings in light of theoretical accounts of voice perception and speculate about potential mechanisms that may underpin our results., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The voice is a variable and dynamic social tool with functional relevance for self-presentation, for example, during a job interview or courtship. Talkers adjust their voices flexibly to their situational or social environment. Here, we investigated how effectively intentional voice modulations can evoke trait impressions in listeners (Experiment 1), whether these trait impressions are recognizable (Experiment 2), and whether they meaningfully influence social interactions (Experiment 3). We recorded 40 healthy adult speakers' whilst speaking neutrally and whilst producing vocal expressions of six social traits (e.g., likeability, confidence). Multivariate ratings of 40 listeners showed that vocal modulations amplified specific trait percepts (Experiments 1 and 2), which could be explained by two principal components relating to perceived affiliation and competence. Moreover, vocal modulations increased the likelihood of listeners choosing the voice to be suitable for corresponding social goals (i.e., a confident rather than likeable voice to negotiate a promotion, Experiment 3). These results indicate that talkers modulate their voice along a common trait space for social navigation. Moreover, beyond reactive voice changes, vocal behaviour can be strategically used by talkers to communicate subtle information about themselves to listeners. These findings advance our understanding of non-verbal vocal behaviour for social communication., (© 2023. The Author(s).)

We rarely become familiar with the voice of another person in isolation but usually also have access to visual identity information, thus learning to recognize their voice and face in parallel. There are conflicting findings as to whether learning to recognize voices in audiovisual vs audio-only settings is advantageous or detrimental to learning. One prominent finding shows that the presence of a face overshadows the voice, hindering voice identity learning by capturing listeners' attention (Face Overshadowing Effect; FOE). In the current study, we tested the proposal that the effect of audiovisual training on voice identity learning is driven by attentional processes. Participants learned to recognize voices through either audio-only training (Audio-Only) or through three versions of audiovisual training, where a face was presented alongside the voices. During audiovisual training, the faces were either looking at the camera (Direct Gaze), were looking to the side (Averted Gaze) or had closed eyes (No Gaze). We found a graded effect of gaze on voice identity learning: Voice identity recognition was most accurate after audio-only training and least accurate after audiovisual training including direct gaze, constituting a FOE. While effect sizes were overall small, the magnitude of FOE was halved for the Averted and No Gaze conditions. With direct gaze being associated with increased attention capture compared to averted or no gaze, the current findings suggest that incidental attention capture at least partially underpins the FOE. We discuss these findings in light of visual dominance effects and the relative informativeness of faces vs voices for identity perception., (© 2023 The Authors. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

Objective: To compare the incidence of grade ≥2 gastrointestinal (GI) or genitourinary (GU) toxicity for patients undergoing 3DRT versus IMRT in the postoperative setting for endometrial cancer., Methods: Eligible patients were post-operatively randomly assigned to one of two parallel groups in a 1:1 ratio, to have their RT delivered using either a 3DRT technique or using IMRT. The prescription dose was 45 Gy in 25 fractions over 5 weeks followed by vaginal vault brachytherapy. Toxicity was graded according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 3.0. Fisher's exact tests were used to test for associations between toxicity and arm. Differences in dosimetric parameters for patients with or without toxicity were tested using Mann-Whitney U -tests., Results: 84 patients with a median age of 62 were evaluable for primary outcome. The median follow-up was 52 months. 14 (35%) participants from the 3DRT arm and 15 (34%) from the IMRT arm experienced acute grade ≥2 GI toxicity with older patients having a statistically higher risk of grade ≥2 acute GI toxicity. 20 (50%) participants from the 3DRT arm and 25 (57%) from the IMRT arm experienced acute grade ≥2 GI or GU toxicity ( p = .662). 12 (30%) patients from the 3DRT arm and 17 (39%) from the IMRT arm experienced acute grade ≥2 GU toxicity ( p = .493)., Conclusion: Although IMRT can reduce dose to normal tissue, in this study no benefit in acute GI or GU toxicity outcome was seen.

Listeners spontaneously form impressions of a person from their voice: Is someone old or young? Trustworthy or untrustworthy? Some studies suggest that these impressions emerge rapidly (e.g., < 400 ms for traits), but it is unclear just how rapidly different impressions can emerge and whether the time courses differ across characteristics. I presented 618 adult listeners with voice recordings ranging from 25 ms to 800 ms in duration and asked them to rate physical (age, sex, health), trait (trustworthiness, dominance, attractiveness), and social (educatedness, poshness, professionalism) characteristics. I then used interrater agreement as an index for impression formation. Impressions of physical characteristics and dominance emerged fastest, showing high agreement after only 25 ms of exposure. In contrast, agreement for trait and social characteristics was initially low to moderate and gradually increased. Such a staggered time course suggests that there could be a temporo-perceptual hierarchy for person perception in which faster impressions could influence later ones.

When seeing a face or hearing a voice, perceivers readily form first impressions of a person's characteristics-are they trustworthy, do they seem aggressive? One of the key claims about trait impressions from faces and voices alike is that these impressions are formed rapidly. For faces, studies have systematically mapped this rapid time course of trait impressions, finding that they are well formed and stable after approximately 100 ms of exposure. For voices, however, no systematic investigation of the time course of trait perception exists. In the current study, listeners provided trait judgments (attractiveness, dominance, trustworthiness) based on recordings of 100 voices that lasted either 50, 100, 200, 400, or 800 ms. Based on measures of intra- and interrater agreement as well as correlations of mean ratings for different exposure conditions, we find that trait perception from voices is indeed rapid. Unlike faces, however, trait impressions from voices require longer exposure to develop and stabilize although they are still formed by 400 ms. Furthermore, differences in the time course of trait perception from voices emerge across traits and voice gender: The formation of impressions of attractiveness and dominance required less exposure when based on male voices, whereas impressions of trustworthiness evolved over a more gradual time course for male and female voices alike. These findings not only provide the first estimate of the time course of the formation of voice trait impressions, but they also have implications for voice perception models where voices are regarded as "auditory faces." (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Experimental findings for trait impressions from voices are often discussed in relation to potential evolutionary origins. This commentary takes Sutherland and Young's (2022) account of the different potential origins of facial trait impressions to suggest that vocal trait impressions should also be viewed as having been shaped by cultural and individual learning., (© The Author. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

When seeing someone's face or hearing their voice, perceivers routinely infer information about a person's age, sex and social traits. While many experiments have explored how individual person characteristics are perceived in isolation, less is known about which person characteristics are described spontaneously from voices and faces and how descriptions may differ across modalities. In Experiment 1, participants provided free descriptions for voices and faces. These free descriptions followed similar patterns for voices and faces - and for individual identities: Participants spontaneously referred to a wide range of descriptors. Psychological descriptors, such as character traits, were used most frequently; physical characteristics, such as age and sex, were notable as they were mentioned earlier than other types of descriptors. After finding primarily similarities between modalities when analysing person descriptions across identities, Experiment 2 asked whether free descriptions encode how individual identities differ. For this purpose, the measures derived from the free descriptions were linked to voice/face discrimination judgements that are known to describe differences in perceptual properties between identity pairs. Significant relationships emerged within and across modalities, showing that free descriptions indeed encode differences between identities - information that is shared with discrimination judgements. This suggests that the two tasks tap into similar, high-level person representations. These findings show that free description data can offer valuable insights into person perception and underline that person perception is a multivariate process during which perceivers rapidly and spontaneously infer many different person characteristics to form a holistic impression of a person., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

When hearing a voice, listeners can form a detailed impression of the person behind the voice. Existing models of voice processing focus primarily on one aspect of person perception - identity recognition from familiar voices - but do not account for the perception of other person characteristics (e.g., sex, age, personality traits). Here, we present a broader perspective, proposing that listeners have a common perceptual goal of perceiving who they are hearing, whether the voice is familiar or unfamiliar. We outline and discuss a model - the Person Perception from Voices (PPV) model - that achieves this goal via a common mechanism of recognising a familiar person, persona, or set of speaker characteristics. Our PPV model aims to provide a more comprehensive account of how listeners perceive the person they are listening to, using an approach that incorporates and builds on aspects of the hierarchical frameworks and prototype-based mechanisms proposed within existing models of voice identity recognition., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2023.)

In the current study, we examine and compare the effects of talker and accent familiarity in the context of a voice identity sorting task, using naturally varying voice recording samples from the TV show Derry Girls. Voice samples were thus all spoken with a regional accent of UK/Irish English (from [London]derry). We tested four listener groups: Listeners were either familiar or unfamiliar with the TV show (and therefore the talker identities) and were either highly familiar or relatively less familiar with Northern Irish accents. Both talker and accent familiarity significantly improved accuracy of voice identity sorting performance. However, the talker familiarity benefits were overall larger, and more consistent. We discuss the results in light of a possible hierarchy of familiarity effects and argue that our findings may provide additional evidence for interactions of speech and identity processing pathways in voice identity perception. We also identify some key limitations in the current work and provide suggestions for future studies to address these., (© 2022. The Author(s).)

The "ventriloquism effect" describes an illusory phenomenon where the perceived location of an auditory stimulus is pulled toward the location of a visual stimulus. Ventriloquists use this phenomenon to create an illusion where an inanimate puppet is perceived to speak. Ventriloquists use the expression and suppression of their own and the puppet's mouth movements as well the direction of their respective eye gaze to maximize the illusion. While the puppet's often exaggerated mouth movements have been demonstrated to enhance the ventriloquism effect, the contribution of direct eye gaze remains unknown. In Experiment 1, participants viewed an image of a person's face while hearing a temporally synchronous recording of a voice originating from different locations on the azimuthal plane. The eyes of the facial stimuli were either looking directly at participants or were closed. Participants were more likely to misperceive the location of a range of voice locations as coming from a central position when the eye gaze of the facial stimuli were directed toward them. Thus, direct gaze enhances the ventriloquist effect by attracting participants' perception of the voice locations toward the location of the face. In an exploratory analysis, we furthermore found no evidence for an other-race effect between White vs Asian listeners. In Experiment 2, we replicated the effect of direct eye gaze on the ventriloquism effect, also showing that faces per se attract perceived sound locations compared with audio-only sound localization. Showing a modulation of the ventriloquism effect by socially-salient eye gaze information thus adds to previous findings reporting top-down influences on this effect., (© 2022. The Author(s).)

Previous research suggests that familiarity with a voice can afford benefits for voice and speech perception. However, even familiar voice perception has been reported to be error-prone, especially in the face of challenges such as reduced verbal cues and acoustic distortions. It has been hypothesized that such findings may arise due to listeners not being "familiar enough" with the voices used in laboratory studies, and thus being inexperienced with their full vocal repertoire. Extending this idea, voice perception based on highly familiar voices-acquired via substantial, naturalistic experience-should therefore be more robust than voice perception from less familiar voices. We investigated this proposal by contrasting voice perception of personally familiar voices (participants' romantic partners) versus lab-trained voices in challenging experimental tasks. Specifically, we tested how differences in familiarity may affect voice-identity perception from nonverbal vocalizations and acoustically modulated speech. Large benefits for the personally familiar voice over a less familiar, lab-trained voice were found for identity recognition, with listeners displaying both highly accurate yet more conservative recognition of personally familiar voices. However, no familiar-voice benefits were found for speech perception in background noise. Our findings suggest that listeners have fine-tuned representations of highly familiar voices that result in more robust and accurate voice recognition despite challenging listening contexts, yet these advantages may not always extend to speech perception. We conclude that familiarity with voices is indeed on a continuum, with identity perception for personally familiar voices being highly accurate. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Identity perception often takes place in multimodal settings, where perceivers have access to both visual (face) and auditory (voice) information. Despite this, identity perception is usually studied in unimodal contexts, where face and voice identity perception are modelled independently from one another. In this study, we asked whether and how much auditory and visual information contribute to audiovisual identity perception from naturally-varying stimuli. In a between-subjects design, participants completed an identity sorting task with either dynamic video-only, audio-only or dynamic audiovisual stimuli. In this task, participants were asked to sort multiple, naturally-varying stimuli from three different people by perceived identity. We found that identity perception was more accurate for video-only and audiovisual stimuli compared with audio-only stimuli. Interestingly, there was no difference in accuracy between video-only and audiovisual stimuli. Auditory information nonetheless played a role alongside visual information as audiovisual identity judgements per stimulus could be predicted from both auditory and visual identity judgements, respectively. While the relationship was stronger for visual information and audiovisual information, auditory information still uniquely explained a significant portion of the variance in audiovisual identity judgements. Our findings thus align with previous theoretical and empirical work that proposes that, compared with faces, voices are an important but relatively less salient and a weaker cue to identity perception. We expand on this work to show that, at least in the context of this study, having access to voices in addition to faces does not result in better identity perception accuracy., (© 2021 The Authors. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Listeners can perceive a person's age from their voice with above chance accuracy. Studies have usually established this by asking listeners to directly estimate the age of unfamiliar voices. The recordings used mostly include cross-sectional samples of voices, including people of different ages to cover the age range of interest. Such cross-sectional samples likely include not only cues to age in the sound of the voice but also socio-phonetic cues, encoded in how a person speaks. How age perpcetion accuracy is affected when minimizing socio-phonetic cues by sampling the same voice at different time points remains largely unknown. Similarly, with the voices in age perception studies being usually unfamiliar to listeners, it is unclear how familiarity with a voice affects age perception. We asked listeners who were either familiar or unfamiliar with a set of four voices to complete an age discrimination task: listeners heard two recordings of the same person's voice, recorded 15 years apart, and were asked to indicate in which recording the person was younger. Accuracy for both familiar and unfamiliar listeners was above chance. While familiarity advantages were apparent, accuracy was not particularly high: familiar and unfamiliar listeners were correct for 68.2% and 62.7% of trials, respectively (chance = 50%). Familiarity furthermore interacted with the voices included. Overall, our findings indicate that age perception from voices is not a trivial task at all times - even when listeners are familiar with a voice. We discuss our findings in the light of how reliable voice may be as a signal for age., (© 2021 The Authors. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Unimodal and cross-modal information provided by faces and voices contribute to identity percepts. To examine how these sources of information interact, we devised a novel audio-visual sorting task in which participants were required to group video-only and audio-only clips into two identities. In a series of three experiments, we show that unimodal face and voice sorting were more accurate than cross-modal sorting: While face sorting was consistently most accurate followed by voice sorting, cross-modal sorting was at chancel level or below. In Experiment 1, we compared performance in our novel audio-visual sorting task to a traditional identity matching task, showing that unimodal and cross-modal identity perception were overall moderately more accurate than the traditional identity matching task. In Experiment 2, separating unimodal from cross-modal sorting led to small improvements in accuracy for unimodal sorting, but no change in cross-modal sorting performance. In Experiment 3, we explored the effect of minimal audio-visual training: Participants were shown a clip of the two identities in conversation prior to completing the sorting task. This led to small, nonsignificant improvements in accuracy for unimodal and cross-modal sorting. Our results indicate that unfamiliar face and voice perception operate relatively independently with no evidence of mutual benefit, suggesting that extracting reliable cross-modal identity information is challenging., (© 2021. The Author(s).)

Humans have a remarkable capacity to finely control the muscles of the larynx, via distinct patterns of cortical topography and innervation that may underpin our sophisticated vocal capabilities compared with non-human primates. Here, we investigated the behavioural and neural correlates of laryngeal control, and their relationship to vocal expertise, using an imitation task that required adjustments of larynx musculature during speech. Highly trained human singers and non-singer control participants modulated voice pitch and vocal tract length (VTL) to mimic auditory speech targets, while undergoing real-time anatomical scans of the vocal tract and functional scans of brain activity. Multivariate analyses of speech acoustics, larynx movements and brain activation data were used to quantify vocal modulation behaviour and to search for neural representations of the two modulated vocal parameters during the preparation and execution of speech. We found that singers showed more accurate task-relevant modulations of speech pitch and VTL (i.e. larynx height, as measured with vocal tract MRI) during speech imitation; this was accompanied by stronger representation of VTL within a region of the right somatosensory cortex. Our findings suggest a common neural basis for enhanced vocal control in speech and song. This article is part of the theme issue 'Voice modulation: from origin and mechanism to social impact (Part I)'.

Research on within-individual modulation of vocal cues is surprisingly scarce outside of human speech. Yet, voice modulation serves diverse functions in human and nonhuman nonverbal communication, from dynamically signalling motivation and emotion, to exaggerating physical traits such as body size and masculinity, to enabling song and musicality. The diversity of anatomical, neural, cognitive and behavioural adaptations necessary for the production and perception of voice modulation make it a critical target for research on the origins and functions of acoustic communication. This diversity also implicates voice modulation in numerous disciplines and technological applications. In this two-part theme issue comprising 21 articles from leading and emerging international researchers, we highlight the multidisciplinary nature of the voice sciences. Every article addresses at least two, if not several, critical topics: (i) development and mechanisms driving vocal control and modulation; (ii) cultural and other environmental factors affecting voice modulation; (iii) evolutionary origins and adaptive functions of vocal control including cross-species comparisons; (iv) social functions and real-world consequences of voice modulation; and (v) state-of-the-art in multidisciplinary methodologies and technologies in voice modulation research. With this collection of works, we aim to facilitate cross-talk across disciplines to further stimulate the burgeoning field of voice modulation. This article is part of the theme issue 'Voice modulation: from origin and mechanism to social impact (Part I)'.

When presented with voices, we make rapid, automatic judgements of social traits such as trustworthiness-and such judgements are highly consistent across listeners. However, it remains unclear whether voice-based first impressions actually influence behaviour towards a voice's owner, and-if they do-whether and how they interact over time with the voice owner's observed actions to further influence the listener's behaviour. This study used an investment game paradigm to investigate (1) whether voices judged to differ in relevant social traits accrued different levels of investment and/or (2) whether first impressions of the voices interacted with the behaviour of their apparent owners to influence investments over time. Results show that participants were responding to their partner's behaviour. Crucially, however, there were no effects of voice. These findings suggest that, at least under some conditions, social traits perceived from the voice alone may not influence trusting behaviours in the context of a virtual interaction.

Familiar and unfamiliar voice perception are often understood as being distinct from each other. For identity perception, theoretical work has proposed that listeners use acoustic information in different ways to perceive identity from familiar and unfamiliar voices: Unfamiliar voices are thought to be processed based on close comparisons of acoustic properties, while familiar voices are processed based on diagnostic acoustic features that activate a stored person-specific representation of that voice. To date no empirical study has directly examined whether and how familiar and unfamiliar listeners differ in their use of acoustic information for identity perception. Here, we tested this theoretical claim by linking listeners' judgements in voice identity tasks to complex acoustic representation - spectral similarity of the heard voice recordings. Participants (N = 177) who were either familiar or unfamiliar with a set of voices completed an identity discrimination task (Experiment 1) or an identity sorting task (Experiment 2). In both experiments, identity judgements for familiar and unfamiliar voices were guided by spectral similarity: Pairs of recordings with greater acoustic similarity were more likely to be perceived as belonging to the same voice identity. However, while there were no differences in how familiar and unfamiliar listeners used acoustic information for identity discrimination, differences were apparent for identity sorting. Our study therefore challenges proposals that view familiar and unfamiliar voice perception as being at all times distinct. Instead, our data suggest a critical role of the listening situation in which familiar and unfamiliar voices are evaluated, thus characterising voice identity perception as a highly dynamic process in which listeners opportunistically make use of any kind of information they can access., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Human faces and voices are rich sources of information that can vary in many different ways. Most of the literature on face/voice perception has focused on understanding how people look and sound different to each other (between-person variability). However, recent studies highlight the ways in which the same person can look and sound different on different occasions (within-person variability). Across three experiments, we examined how within- and between-person variability relate to one another for social trait impressions by collecting trait ratings attributed to multiple face images and voice recordings of the same people. We find that within-person variability in social trait evaluations is at least as great as between-person variability. Using different stimulus sets across experiments, trait impressions of voices are consistently more variable within people than between people-a pattern that is only evident occasionally when judging faces. Our findings highlight the importance of understanding within-person variability, showing how judgments of the same person can vary widely on different encounters and quantify how this pattern differs for voice and face perception. The work consequently has implications for theoretical models proposing that voices can be considered "auditory faces" and imposes limitations to the "kernel of truth" hypothesis of trait evaluations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Information associated with the self is prioritized relative to information associated with others and is therefore processed more quickly and accurately. Across three experiments, we examined whether a new externally-generated voice could become associated with the self and thus be prioritized in perception. In the first experiment, participants learned associations between three unfamiliar voices and three identities (self, friend, stranger). Participants then made speeded judgements of whether voice-identity pairs were correctly matched, or not. A clear self-prioritization effect was found, with participants showing quicker and more accurate responses to the newly self-associated voice relative to either the friend- or stranger- voice. In two further experiments, we tested whether this prioritization effect increased if the self-voice was gender-matched to the identity of the participant (Experiment 2) or if the self-voice was chosen by the participant (Experiment 3). Gender-matching did not significantly influence prioritization; the self-voice was similarly prioritized when it matched the gender identity of the listener as when it did not. However, we observed that choosing the self-voice did interact with prioritization (Experiment 3); the self-voice became more prominent, via lesser prioritization of the other identities, when the self-voice was chosen relative to when it was not. Our findings have implications for the design and selection of individuated synthetic voices used for assistive communication devices, suggesting that agency in choosing a new vocal identity may modulate the distinctiveness of that voice relative to others., (© 2020 The Authors. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Previous studies have shown that face-voice matching accuracy is more consistently above chance for dynamic (i.e. speaking) faces than for static faces. This suggests that dynamic information can play an important role in informing matching decisions. We initially asked whether this advantage for dynamic stimuli is due to shared information across modalities that is encoded in articulatory mouth movements. Participants completed a sequential face-voice matching task with (1) static images of faces, (2) dynamic videos of faces, (3) dynamic videos where only the mouth was visible, and (4) dynamic videos where the mouth was occluded, in a well-controlled stimulus set. Surprisingly, after accounting for random variation in the data due to design choices, accuracy for all four conditions was at chance. Crucially, however, exploratory analyses revealed that participants were not responding randomly, with different patterns of response biases being apparent for different conditions. Our findings suggest that face-voice identity matching may not be possible with above-chance accuracy but that analyses of response biases can shed light upon how people attempt face-voice matching. We discuss these findings with reference to the differential functional roles for faces and voices recently proposed for multimodal person perception.

Background and Purpose: Recently, the SIOP-RTSG developed a highly-conformal flank target volume definition for children with renal tumors. The aims of this study were to evaluate the inter-clinician delineation variation of this new target volume definition in an international multicenter setting and to explore the necessity of quality assurance., Materials and Methods: Six pediatric renal cancer cases were transferred to ten radiation oncologists from seven European countries ('participants'). These participants delineated the pre- and postoperative Gross Tumor Volume (GTV pre/post ), and Clinical Target Volume (CTV) during two test phases (case 1-2 and 3-4), followed by guideline refinement and a quality assurance phase (case 5-6). Reference target volumes (TV ref ) were established by three experienced radiation oncologists. The Dice Similarity Coefficient between the reference and participants (DSC ref/part ) was calculated per case. Delineations of case 5-6 were graded by four independent reviewers as 'per protocol' (0-4 mm), 'minor deviation' (5-9 mm) or 'major deviation' (≥10 mm) from the delineation guideline using 18 standardized criteria. Also, a major deviation resulting in underestimation of the CTV ref was regarded as an unacceptable variation., Results: A total of 57/60 delineation sets were completed. The median DSC ref/part for the CTV was 0.55 without improvement after sequential cases (case 3-4 vs. case 5-6: p = 0.15). For case 5-6, a major deviation was found for 5/18, 12/17, 18/18 and 4/9 collected delineations of the GTV pre , GTV post , CTV-T and CTV-N, respectively. An unacceptable variation from the CTV ref was found for 7/9 participants for case 5 and 6/9 participants for case 6., Conclusion: This international multicenter delineation exercise demonstrates that the new consensus for highly-conformal postoperative flank target volume delineation leads to geometrical variation among participants. Moreover, standardized review showed an unacceptable delineation variation in the majority of the participants. These findings strongly suggest the need for additional training and centralized pre-treatment review when this target volume delineation approach is implemented on a larger scale., Competing Interests: 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., (© 2021 The Author(s).)

From only a single spoken word, listeners can form a wealth of first impressions of a person's character traits and personality based on their voice. However, due to the substantial within-person variability in voices, these trait judgements are likely to be highly stimulus-dependent for unfamiliar voices: The same person may sound very trustworthy in one recording but less trustworthy in another. How trait judgements differ when listeners are familiar with a voice is unclear: Are listeners who are familiar with the voices as susceptible to the effects of within-person variability? Does the semantic knowledge listeners have about a familiar person influence their judgements? In the current study, we tested the effect of familiarity on listeners' trait judgements from variable voices across 3 experiments. Using a between-subjects design, we contrasted trait judgements by listeners who were familiar with a set of voices - either through laboratory-based training or through watching a TV show - with listeners who were unfamiliar with the voices. We predicted that familiarity with the voices would reduce variability in trait judgements for variable voice recordings from the same identity (cf. Mileva, Kramer & Burton, Perception, 48, 471 and 2019, for faces). However, across the 3 studies and two types of measures to assess variability, we found no compelling evidence to suggest that trait impressions were systematically affected by familiarity., (© 2020 The Authors. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

For decades, radiotherapy with two opposing photon beams has been the standard technique used to cover the flank target volume in paediatric patients with renal tumours. Nowadays, many institutes are implementing advanced radiotherapy techniques that spare healthy tissue. To decrease the radiotherapy dose to healthy structures while preserving oncological efficacy, the conventional approach of flank irradiation has been adapted into a guideline for highly conformal flank target-volume delineation by paediatric radiation oncologists and representatives of the International Society of Paediatric Oncology's Renal Tumour Study Group (SIOP-RTSG) board during four live international consensus meetings. The consensus was refined by delineation exercises and videoconferences by ten collaborating paediatric radiation oncologists. The final guideline includes eight chronological steps to generate the tumour bed and clinical, internal, and planning target volumes, and it describes the optional use of surgical clips to optimise treatment planning. This guideline will be added into the radiotherapy guideline of the UMBRELLA SIOP-RTSG protocol for paediatric renal tumours to improve international consistency of highly conformal flank target-volume delineation., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Identity sorting tasks, in which participants sort multiple naturally varying stimuli of usually two identities into perceived identities, have recently gained popularity in voice and face processing research. In both modalities, participants who are unfamiliar with the identities tend to perceive multiple stimuli of the same identity as different people and thus fail to "tell people together." These similarities across modalities suggest that modality-general mechanisms may underpin sorting behaviour. In this study, participants completed a voice sorting and a face sorting task. Taking an individual differences approach, we asked whether participants' performance on voice and face sorting of unfamiliar identities is correlated. Participants additionally completed a voice discrimination (Bangor Voice Matching Test) and a face discrimination task (Glasgow Face Matching Test). Using these tasks, we tested whether performance on sorting related to explicit identity discrimination. Performance on voice sorting and face sorting tasks was correlated, suggesting that common modality-general processes underpin these tasks. However, no significant correlations were found between sorting and discrimination performance, with the exception of significant relationships for performance on "same identity" trials with "telling people together" for voices and faces. Overall, any reported relationships were however relatively weak, suggesting the presence of additional modality-specific and task-specific processes.

We investigated the effects of two types of task instructions on performance on a voice sorting task by listeners who were either familiar or unfamiliar with the voices. Listeners were asked to sort 15 naturally varying stimuli from two voice identities into perceived identities. Half of the listeners sorted the recordings freely into as many identities as they perceived; the other half were forced to sort stimuli into two identities only. As reported in previous studies, unfamiliar listeners formed more clusters than familiar listeners. Listeners therefore perceived different naturally varying stimuli from the same identity as coming from different identities, while being highly accurate at telling apart the stimuli from different voices. We further show that a change in task instructions - forcing listeners to sort stimuli into two identities only - helped unfamiliar listeners to overcome this selective failure at 'telling people together'. This improvement, however, came at the cost of an increase in errors in telling people apart. For familiar listeners, similar non-significant trends were apparent. Therefore, even when informed about correct number of identities, listeners may fail to accurately perceive identity further highlighting that voice identity perception in the context of natural within-person variability is a challenging task. We discuss our results in terms of similarities and differences to findings in the face perception literature and their importance in applied settings, such as forensic voice identification., (© 2019 The British Psychological Society.)

High variability training has been shown to benefit the learning of new face identities. In three experiments, we investigated whether this is also the case for voice identity learning. In Experiment 1a, we contrasted high variability training sets - which included stimuli extracted from a number of different recording sessions, speaking environments and speaking styles - with low variability stimulus sets that only included a single speaking style (read speech) extracted from one recording session (see Ritchie & Burton, 2017 for faces). Listeners were tested on an old/new recognition task using read sentences (i.e. test materials fully overlapped with the low variability training stimuli) and we found a high variability disadvantage. In Experiment 1b, listeners were trained in a similar way, however, now there was no overlap in speaking style or recording session between training sets and test stimuli. Here, we found a high variability advantage. In Experiment 2, variability was manipulated in terms of the number of unique items as opposed to number of unique speaking styles. Here, we contrasted the high variability training sets used in Experiment 1a with low variability training sets that included the same breadth of styles, but fewer unique items; instead, individual items were repeated (see Murphy, Ipser, Gaigg, & Cook, 2015 for faces). We found only weak evidence for a high variability advantage, which could be explained by stimulus-specific effects. We propose that high variability advantages may be particularly pronounced when listeners are required to generalise from trained stimuli to different-sounding, previously unheard stimuli. We discuss these findings in the context of mechanisms thought to underpin advantages for high variability training., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The human voice is a highly flexible instrument for self-expression, yet voice identity perception is largely studied using controlled speech recordings. Using two voice-sorting tasks with naturally varying stimuli, we compared the performance of listeners who were familiar and unfamiliar with the TV show Breaking Bad . Listeners organised audio clips of speech with (1) low-expressiveness and (2) high-expressiveness into perceived identities. We predicted that increased expressiveness (e.g., shouting, strained voice) would significantly impair performance. Overall, while unfamiliar listeners were less able to generalise identity across exemplars, the two groups performed equivalently well when telling voices apart when dealing with low-expressiveness stimuli. However, high vocal expressiveness significantly impaired telling apart in both the groups: this led to increased misidentifications , where sounds from one character were assigned to the other. These misidentifications were highly consistent for familiar listeners but less consistent for unfamiliar listeners. Our data suggest that vocal flexibility has powerful effects on identity perception, where changes in the acoustic properties of vocal signals introduced by expressiveness lead to effects apparent in familiar and unfamiliar listeners alike. At the same time, expressiveness appears to have affected other aspects of voice identity processing selectively in one listener group but not the other, thus revealing complex interactions of stimulus properties and listener characteristics (i.e., familiarity) in identity processing.

Our voices sound different depending on the context (laughing vs. talking to a child vs. giving a speech), making within-person variability an inherent feature of human voices. When perceiving speaker identities, listeners therefore need to not only 'tell people apart' (perceiving exemplars from two different speakers as separate identities) but also 'tell people together' (perceiving different exemplars from the same speaker as a single identity). In the current study, we investigated how such natural within-person variability affects voice identity perception. Using voices from a popular TV show, listeners, who were either familiar or unfamiliar with this show, sorted naturally varying voice clips from two speakers into clusters to represent perceived identities. Across three independent participant samples, unfamiliar listeners perceived more identities than familiar listeners and frequently mistook exemplars from the same speaker to be different identities. These findings point towards a selective failure in 'telling people together'. Our study highlights within-person variability as a key feature of voices that has striking effects on (unfamiliar) voice identity perception. Our findings not only open up a new line of enquiry in the field of voice perception but also call for a re-evaluation of theoretical models to account for natural variability during identity perception., (© 2018 The Authors. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Models of voice perception propose that identities are encoded relative to an abstracted average or prototype. While there is some evidence for norm-based coding when learning to discriminate different voices, little is known about how the representation of an individual's voice identity is formed through variable exposure to that voice. In two experiments, we show evidence that participants form abstracted representations of individual voice identities based on averages, despite having never been exposed to these averages during learning. We created 3 perceptually distinct voice identities, fully controlling their within-person variability. Listeners first learned to recognise these identities based on ring-shaped distributions located around the perimeter of within-person voice spaces - crucially, these distributions were missing their centres. At test, listeners' accuracy for old/new judgements was higher for stimuli located on an untrained distribution nested around the centre of each ring-shaped distribution compared to stimuli on the trained ring-shaped distribution.

Acute skin toxicity in adjuvant breast radiation can be reduced with modern radiotherapy (RT) techniques. However, having reviewed the literature, we found no dosimetric constraint for acute skin toxicity that would be applicable to modern RT planning. This study aimed to identify dosimetric factors that are associated with higher rates of acute skin toxicity. A retrospective review was carried out including women who received adjuvant forward-planned intensity-modulated radiotherapy (IMRT) after breast-conserving surgery. Acute skin toxicity grade was prospectively recorded. A total of 131 patients were analyzed. On multivariate analysis, the V105% > 30 cc (p = 0.013) and the use of conventional fractionation (CF) (p = 0.001) were statistically significant for acute skin toxicity. On literature review, current quantitative dosimetric parameters that have shown statistical significance include a V107% > 3 cc in hypofractionation (HF), V107% > 9 cc in CF, treated volume 110% > 5.13%, and V107% > 28.6%. There is little evidence on the predictive value of clinically applicable dosimetric factors in acute skin toxicity. Given the recent improvements in RT planning, we would consider a V107% or a V110% too high a dosimetric value to be useful for the majority of patients. We have shown that a V105% of greater than 30 cc is significantly associated with acute skin toxicity, controlling for other variables. We suggest that this is currently the most useful modifiable parameter available to reduce skin toxicity and is applicable to modern RT planning. We also suggest that consideration be given to hypofractionated schedules to further reduce acute skin toxicity., (Copyright © 2018. Published by Elsevier Inc.)

Human voices are extremely variable: The same person can sound very different depending on whether they are speaking, laughing, shouting or whispering. In order to successfully recognise someone from their voice, a listener needs to be able to generalize across these different vocal signals ('telling people together'). However, in most studies of voice-identity processing to date, the substantial within-person variability has been eliminated through the use of highly controlled stimuli, thus focussing on how we tell people apart. We argue that this obscures our understanding of voice-identity processing by controlling away an essential feature of vocal stimuli that may include diagnostic information. In this paper, we propose that we need to extend the focus of voice-identity research to account for both "telling people together" as well as "telling people apart." That is, we must account for whether, and to what extent, listeners can overcome within-person variability to obtain a stable percept of person identity from vocal cues. To do this, our theoretical and methodological frameworks need to be adjusted to explicitly include the study of within-person variability.

Geometric uncertainties in radiotherapy are conventionally addressed by defining a safety margin around the radiotherapy target. Misappropriation of such margins could result in disease recurrence from geometric miss or unnecessary irradiation of normal tissue. Numerous quantitative organ motion studies in adults have been published, but the first paediatric-specific studies were only published in recent years. In the very near future, intensity-modulated proton beam therapy and magnetic resonance-guided radiotherapy will be clinically implemented in the UK. Such techniques offer the ability to deliver radiotherapy to the pinnacle of precision and accuracy, if geometric uncertainty relating to internal organ motion and deformation can be optimally managed. The optimal margin to account for internal organ motion in children remains largely undefined. Continuing efforts to characterise motion in children and young people is necessary to optimally define safety margins and to realise the full potential of intensity-modulated radiotherapy, magnetic resonance-guided radiotherapy and intensity-modulated proton beam therapy. This overview offers a timely review of published reports on paediatric organ motion, in anticipation of the increasing application of advanced radiotherapy techniques in paediatric radiotherapy., (Copyright © 2018. Published by Elsevier Ltd.)