Search

Background: Previous research has found that high-frequency energy of speech signals decreased while wearing face masks. However, no study has examined the specific spectral characteristics of fricative consonants and vowels and the perception of clarity of speech in mask wearing. Aims: To investigate acoustic-phonetic characteristics of fricative consonants and vowels and auditory perceptual rating of clarity of speech produced with and without wearing a face mask. Methods & Procedures: A total of 16 healthcare workers read the Rainbow Passage using modal phonation in three conditions: without a face mask, with a standard surgical mask and with a KN95 mask (China GB2626-2006, a medical respirator with higher barrier level than the standard surgical mask). Speech samples were acoustically analysed for root mean square (RMS) amplitude (A[subscript RMS]) and spectral moments of four fricatives /f/, /s/, /[voiceless palato-alveolar fricative]/ and /z/; and amplitude of the first three formants (A1, A2 and A3) measured from the reading passage and extracted vowels. Auditory perception of speech clarity was performed. Data were compared across mask and non-mask conditions using linear mixed models. Outcomes & Results: The A[subscript RMS] of all included fricatives was significantly lower in surgical mask and KN95 mask compared with non-mask condition. Centre of gravity of /f/ decreased in both surgical and KN95 mask while other spectral moments did not show systematic significant linear trends across mask conditions. None of the formant amplitude measures was statistically different across conditions. Speech clarity was significantly poorer in both surgical and KN95 mask conditions. Conclusions & Implications: Speech produced while wearing either a surgical mask or KN95 mask was associated with decreased fricative amplitude and poorer speech clarity.

Background: Sustained vowels are important vocal tasks that have been investigated in discriminating voice disorders using acoustic analysis. To date, no study has combined vowel acoustic measures only that evaluate major aspects of the pathological voice signals in voice disorder discrimination. Aims: To investigate the value of vowel acoustic measures that quantify glottal noise, signal stability, signal periodicity, spectral slope and overall voice quality in discriminating female speakers with and without voice disorders. Methods & Procedures: Sustained vowel /ɑ/ samples were extracted from 133 voice‐disordered female patients and 97 non‐voice disordered female speakers and were signal typed prior to analysis. Praat software was used to measure harmonics‐to‐noise ratio (HNR), glottal‐to‐noise excitation ratio (GNE), the standard deviation of fundamental frequency (F0SD) and cepstral peak prominence (CPPp); and the Analysis of Dysphonia in Speech and Voice (ADSV) program was used to measure CPPadsv, low/high spectral ratio (LH) and the cepstral/spectral index of dysphonia (CSID). Outcome measures included sensitivity, specificity, and discrimination accuracy. Outcomes & Results: As individual acoustic measures, only spectral‐based measures showed good (CPPadsv) and acceptable (CSID) discrimination results. The HNR, GNE and CPPp measures had acceptable sensitivity but poor or non‐acceptable specificity and discrimination accuracy. Logistic regression models with all Praat measures (F0SD, HNR, GNE, CPPp) plus ADSV measures (CPPadsv, LH or CSID) provided excellent sensitivity, good‐to‐excellent specificity and excellent discrimination accuracy. ROC analysis for all individual measures showed that CPPadsv, CSID, CPPp, GNE and F0SD had the highest area under the curve (AUC) values. Conclusions & Implications: A combination of acoustic measures that evaluate the major aspects of vocal dysfunction resulted in good to excellent voice discrimination outcomes. Individual acoustic measures had lower discrimination ability than combined measures. The findings implied that acoustic measures extracted from a prolonged vowel were useful in voice disorder discrimination. WHAT THIS PAPER ADDS: What is already known on this subject: Acoustic measures hold great value in discriminating voice disorders from normal voices. However, no study has evaluated discrimination values of a combination of sustained vowel acoustic measures that quantify additive noise, signal stability, signal periodicity, spectral slope and overall voice quality in single‐gender cohorts. Previous studies have not used signal typing (the classification of the acoustic signals) for time‐based measures, impacting the reliability of discrimination. What this study adds to the existing knowledge: This study was the first to implement signal typing to include sustained vowel samples of Types 1 and 2 signals for discrimination statistics. We showed that a combination of vocal acoustic measures using time‐ and spectral‐based extraction from the sustained /ɑ/ vowel evaluating additive noise, signal stability, signal periodicity, spectral slope and overall voice quality resulted in good to excellent sensitivity, specificity and discrimination accuracy. As individual measures, traditional time‐based measures such as HNR had rather limited discrimination values whilst spectral‐based measures provided higher discrimination values. Measures that are sensitive to signal types have low discrimination ability. What are the potential or actual clinical implications of this work?: The sustained vowel /ɑ/ is a relevant, universal vocal task for clinical application using acoustic measures to discriminate female speakers with and without voice disorders if signal typing is implemented. Clinical voice assessment using vowels may not be effective if relying solely on time‐based measurements. Spectral‐based measures perform better in voice disorder discrimination given their insensitivity to signal types. The most effective voice disorder discrimination could only be obtained using a combination of acoustic measures that quantify major phenomena in the signals of disordered voices. Using measures extracted from both programs, Praat and ADSV, is useful given that specific settings in a program may impact on discrimination accuracy. [ABSTRACT FROM AUTHOR]

Objective: To systematically evaluate the evidence for the reliability, sensitivity and specificity of existing measures of vowel-initial voice onset. Methods: A literature search was conducted across electronic databases for published studies (MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, PubMed Central, IEEE Xplore) and grey literature (ProQuest for unpublished dissertations) measuring vowel onset. Eligibility criteria included research of any study design type or context focused on measuring human voice onset on an initial vowel. Two independent reviewers were involved at each stage of title and abstract screening, data extraction and analysis. Data extracted included measures used, their reliability, sensitivity and specificity. Risk of bias and certainty of evidence was assessed using GRADE as the data of interest was extracted. Results: The search retrieved 6,983 records. Titles and abstracts were screened against the inclusion criteria by two independent reviewers, with a third reviewer responsible for conflict resolution. Thirty-five papers were included in the review, which identified five categories of voice onset measurement: auditory perceptual, acoustic, aerodynamic, physiological and visual imaging. Reliability was explored in 14 papers with varied reliability ratings, while sensitivity was rarely assessed, and no assessment of specificity was conducted across any of the included records. Certainty of evidence ranged from very low to moderate with high variability in methodology and voice onset measures used. Conclusions: A range of vowel-initial voice onset measurements have been applied throughout the literature, however, there is a lack of evidence regarding their sensitivity, specificity and reliability in the detection and discrimination of voice onset types. Heterogeneity in study populations and methods used preclude conclusions on the most valid measures. There is a clear need for standardisation of research methodology, and for future studies to examine the practicality of these measures in research and clinical settings. [ABSTRACT FROM AUTHOR]

Objectives: Ventilation using 100% oxygenation creates a risk of fire during laser microlaryngeal surgery (MLS). The purpose of this study is to describe the technique of transnasal high‐flow ventilation using laser safe (30%) oxygen conditions, measure the intraoperative real‐time laryngeal oxygen concentration, and examine patient saturation status using this technique. Methods: Prospective IRB approved study of patients undergoing tubeless laser MLS using high‐flow nasal oxygenation. Delivered oxygen concentration was reduced from 100% to 30% before lasering using an oxygen‐air blender then increased to 100% post‐laser procedure. Outcome measures included time for laryngeal oxygen concentration to equalize to laser safe levels; time to, methods of and duration of rescue ventilation; and desaturation rates and apnoeic times at both 100% and 30% oxygen deliveries. Results: Fifty patients were recruited (mean age = 47.4 years). Mean laryngeal oxygen concentration (%) at 100% and 30% deliveries was 98.46 and 31.45, respectively. Mean (SD) of laryngeal oxygen concentration equalization time to 30% (seconds) was 9.4 (3.69). At 30% oxygen delivery desaturation rate was faster and apneic time shorter compared with 100%. Eighteen patients required rescue (jet) ventilation and they had a faster apneic desaturation rate (%/minute) than patients not requiring rescue. Mean (SD) apneic time (minutes) at 30% delivery was 4.56 (2.25) and 4.41 (2.18) in rescue versus non‐rescue groups respectively. BMI was the only significant predictor of desaturation rate at 30% oxygen delivery. Conclusion: It is possible to achieve a safe time window for use of laser during MLS using transnasal humidified high‐flow ventilation by delivering 30% oxygen concentration. Level of Evidence: 4 Laryngoscope, 133:634–639, 2023 [ABSTRACT FROM AUTHOR]

Objectives: Previous research has shown that instructed manipulation of the false vocal fold activity (FVFA), true vocal fold mass (TVFM), and larynx height (LH) impacted on voice quality. It is not known whether these manipulations have any effect on voice onset. Vocal Rise Time (VRT) is an objective acoustic measure of voice onset, which has potential as an assessment tool in clinical settings. The present study aimed to investigate the effects of instructed manipulation of FVFA, TVFM, and LH on VRT., Study Design: Retrospective, observational study., Methods: Nine vocally trained participants (five females, four males) aged between 19 and 36years were instructed to perform differential manipulation of FVFA, TVFM, and LH while phonating the prolonged /ɑ/ vowel. Recorded voice samples were edited and analyzed using a novel Python-based application, the Voice Onset Analysis Tool (VOAT) to obtain VRT results. The VRT data were compared across conditions using repeated-measures analysis of variance, and were correlated against perceptual ratings of tone onset., Results: Reliability analysis showed excellent intra- and inter-rater agreement in VRT measurements using VOAT. All laryngeal parameters (FVFA, TVFM, and LH) showed statistically significant main effects on VRT. There was a consistent trend for thin TVFM, constricted FVFA, and lower LH to increase VRT values. However, post hoc analysis showed some statistically insignificant results possibly due to the small sample size. There was a weak positive correlation between VRT and perceptual tone onset ratings., Conclusion: VRT measurements using VOAT are highly reliable. All three laryngeal parameters were contributors to determining voice onset. Given the limited sample size, careful definition and standardization of VRT measurement protocol is needed for it to become a useful and reliable measure of voice onset in research and clinical settings., Competing Interests: Declaration of Competing 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 © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Late detection of hepatocellular carcinoma (HCC) results in an overall 5-year survival rate of less than 16%. Liquid biopsy (LB) assays based on detecting circulating tumor DNA (ctDNA) might provide an opportunity to detect HCC early noninvasively. Increasing evidence indicates that ctDNA detection using mutation-based assays is significantly challenged by the abundance of white blood cell-derived mutations, non-tumor tissue-derived somatic mutations in plasma, and the mutational tumor heterogeneity., Methods: Here, we employed concurrent analysis of cancer-related mutations, and their fragment length profiles to differentiate mutations from different sources. To distinguish persons with HCC (PwHCC) from healthy participants, we built a classification model using three fragmentomic features of ctDNA through deep sequencing of thirteen genes associated with HCC., Results: Our model achieved an area under the curve (AUC) of 0.88, a sensitivity of 89%, and a specificity of 82% in the discovery cohort consisting of 55 PwHCC and 55 healthy participants. In an independent validation cohort of 54 PwHCC and 53 healthy participants, the established model achieved comparable classification performance with an AUC of 0.86 and yielded a sensitivity and specificity of 81%., Conclusions: Our study provides a rationale for subsequent clinical evaluation of our assay performance in a large-scale prospective study., (© 2023. The Author(s).)