Monitoring treatment of vocal fold paralysis by biomechanical analysis of voice

A case study of vocal fold paralysis treatment is described with the help of the voice quality analysis application BioMet®Phon. The case corresponds to a description of a 40 - year old female patient who was diagnosed of vocal fold paralysis following a cardio - pulmonar intervention which required intubation for 8 days and posterior tracheotomy for 15 days. The patient presented breathy and asthenic phon ation, and dysphagia. Six main examinations were conducted during a full year period that the treatment lasted consisting in periodic reviews including video - endostroboscopy, voice analysis and breathing function monitoring. The phoniatrician treatment inc luded 20 sessions of vocal rehabilitation, followed by an intracordal infiltration with Radiesse 8 months after the rehabilitation treatment started followed by 6 sessions of rehabilitation more. The videondoscopy and the voicing quality analysis refer a s ubstantial improvement in the vocal function with recovery in all the measures estimated (jitter, shimmer, mucosal wave contents, glottal closure, harmonic contents and biomechanical function analysis). The paper refers the procedure followed and the results obtained by comparing the longitudinal progression of the treatment, illustrating the utility of voice quality analysis tools in speech therapy.

Vibrato in singing voice: the link between source-filter and sinusoidal models

The application of inverse filtering techniques for high-quality singing voice analysis/synthesis is discussed. In the context of source-filter models, inverse filtering provides a noninvasive method to extract the voice source, and thus to study voice quality. Although this approach is widely used in speech synthesis, this is not the case in singing voice. Several studies have proved that inverse filtering techniques fail in the case of singing voice, the reasons being unclear. In order to shed light on this problem, we will consider here an additional feature of singing voice, not present in speech: the vibrato. Vibrato has been traditionally studied by sinusoidal modeling. As an alternative, we will introduce here a novel noninteractive source filter model that incorporates the mechanisms of vibrato generation. This model will also allow the comparison of the results produced by inverse filtering techniques and by sinusoidal modeling, as they apply to singing voice and not to speech. In this way, the limitations of these conventional techniques, described in previous literature, will be explained. Both synthetic signals and singer recordings are used to validate and compare the techniques presented in the paper.

Speech Analysis using Modern Techniques of Nonlinear Dynamics

Medical fields requires fast, simple and noninvasive methods of diagnostic techniques. Several methods are available and possible because of the growth of technology that provides the necessary means of collecting and processing signals. The present thesis details the work done in the field of voice signals. New methods of analysis have been developed to understand the complexity of voice signals, such as nonlinear dynamics aiming at the exploration of voice signals dynamic nature. The purpose of this thesis is to characterize complexities of pathological voice from healthy signals and to differentiate stuttering signals from healthy signals. Efficiency of various acoustic as well as non linear time series methods are analysed. Three groups of samples are used, one from healthy individuals, subjects with vocal pathologies and stuttering subjects. Individual vowels/ and a continuous speech data for the utterance of the sentence "iruvarum changatimaranu" the meaning in English is "Both are good friends" from Malayalam language are recorded using a microphone . The recorded audio are converted to digital signals and are subjected to analysis.Acoustic perturbation methods like fundamental frequency (FO), jitter, shimmer, Zero Crossing Rate(ZCR) were carried out and non linear measures like maximum lyapunov exponent(Lamda max), correlation dimension (D2), Kolmogorov exponent(K2), and a new measure of entropy viz., Permutation entropy (PE) are evaluated for all three groups of the subjects. Permutation Entropy is a nonlinear complexity measure which can efficiently distinguish regular and complex nature of any signal and extract information about the change in dynamics of the process by indicating sudden change in its value. The results shows that nonlinear dynamical methods seem to be a suitable technique for voice signal analysis, due to the chaotic component of the human voice. Permutation entropy is well suited due to its sensitivity to uncertainties, since the pathologies are characterized by an increase in the signal complexity and unpredictability. Pathological groups have higher entropy values compared to the normal group. The stuttering signals have lower entropy values compared to the normal signals.PE is effective in charaterising the level of improvement after two weeks of speech therapy in the case of stuttering subjects. PE is also effective in characterizing the dynamical difference between healthy and pathological subjects. This suggests that PE can improve and complement the recent voice analysis methods available for clinicians. The work establishes the application of the simple, inexpensive and fast algorithm of PE for diagnosis in vocal disorders and stuttering subjects.

Relative entropy measures applied to healthy and pathological voice characterization

Nowadays, noninvasive methods of diagnosis have increased due to demands of the population that requires fast, simple and painless exams. These methods have become possible because of the growth of technology that provides the necessary means of collecting and processing signals. New methods of analysis have been developed to understand the complexity of voice signals, such as nonlinear dynamics aiming at the exploration of voice signals dynamic nature. The purpose of this paper is to characterize healthy and pathological voice signals with the aid of relative entropy measures. Phase space reconstruction technique is also used as a way to select interesting regions of the signals. Three groups of samples were used, one from healthy individuals and the other two from people with nodule in the vocal fold and Reinke`s edema. All of them are recordings of sustained vowel /a/ from Brazilian Portuguese. The paper shows that nonlinear dynamical methods seem to be a suitable technique for voice signal analysis, due to the chaotic component of the human voice. Relative entropy is well suited due to its sensibility to uncertainties, since the pathologies are characterized by an increase in the signal complexity and unpredictability. The results showed that the pathological groups had higher entropy values in accordance with other vocal acoustic parameters presented. This suggests that these techniques may improve and complement the recent voice analysis methods available for clinicians. (C) 2008 Elsevier Inc. All rights reserved.

Consequences of Chronic Nasal Obstruction on the Laryngeal Mucosa and Voice Quality of 4- to 12-Year-Old Children

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Electroglottographic analysis of actresses and nonactresses' voices in different levels of intensity

Background: Previous studies with long-term average spectrum (LTAS) showed the importance of the glottal source for understanding the projected voices of actresses. In this study, electroglottographic (EGG) analysis was used to investigate the contribution of the glottal source to the projected voice, comparing actresses and nonactresses' voices, in different levels of intensity. Method: Thirty actresses and 30 nonactresses sustained vowels in habitual, moderate, and loud intensity levels. The EGG variables were contact quotient (CQ), closing quotient (QCQ), and opening quotient (QOQ). Other variables were sound pressure level (SPL) and fundamental frequency (F0). A KayPENTAX EGG was used. Variables were inputted in a general linear model. Results/Discussion: Actresses showed significantly higher values for SPL, in all levels, and both groups increased SPL significantly while changing from habitual to moderate and further to loud. There were no significant differences between groups for EGG quotients. There were significant differences between the levels only for F0 and CQ for both groups. Conclusion: SPL was significantly higher among actresses in all intensity levels, but in the EGG analysis, no differences were found. This apparently weak contribution of the glottal source in the supposedly projected voices of actresses, contrary to previous LTAS studies, might be because of a higher subglottal pressure or perhaps greater vocal tract contribution in SPL. Results from the present study suggest that trained subjects did not produce a significant higher SPL than untrained individuals by increasing the cost in terms of higher vocal fold collision and hence more impact stress. Future researches should explore the difference between trained and nontrained voices by aerodynamic measurements to evaluate the relationship between physiologic findings and the acoustic and EGG data. Moreover, further studies should consider both types of vocal tasks, sustained vowel and running speech, for both EGG and LTAS analysis. © 2013 The Voice Foundation.

Voice disorders in teachers: clinical, videolaryngoscopical, and vocal aspects

Dysphonia is more prevalent in teachers than among the general population. The objective of this study was to analyze clinical, vocal, and videolaryngoscopical aspects in dysphonic teachers. Ninety dysphonic teachers were inquired about their voice, comorbidities, and work conditions. They underwent vocal auditory-perceptual evaluation (maximum phonation time and GRBASI scale), acoustic voice analysis, and videolaryngoscopy. The results were compared with a control group consisting of 90 dysphonic nonteachers, of similar gender and ages, and with professional activities excluding teaching and singing. In both groups, there were 85 women and five men (age range 31-50 years). In the controls, the majority of subjects worked in domestic activities, whereas the majority of teachers worked in primary (42.8%) and secondary school (37.7%). Teachers and controls reported, respectively: vocal abuse (76.7%; 37.8%), weekly hours of work between 21 and 40 years (72.2%; 80%), under 10 years of practice (36%; 23%), absenteeism (23%; 0%), sinonasal (66%; 20%) and gastroesophageal symptoms (44%; 22%), hoarseness (82%; 78%), throat clearing (70%; 62%), and phonatory effort (72%; 52%). In both groups, there were decreased values of maximum phonation time, impairment of the G parameter in the GRBASI scale (82%), decrease of F0 and increase of the rest of acoustic parameters. Nodules and laryngopharyngeal reflux were predominant in teachers; laryngopharyngeal reflux, polyps, and sulcus vocalis predominated in the controls. Vocal symptoms, comorbidities, and absenteeism were predominant among teachers. The vocal analyses were similar in both groups. Nodules and laryngopharyngeal reflux were predominant among teachers, whereas polyps, laryngopharyngeal reflux, and sulcus were predominant among controls.

Analysis of nonlinear dynamics of vocal folds using high-speed video observation and biomechanical modeling

Primary voice production occurs in the larynx through vibrational movements carried out by vocal folds. However, many problems can affect this complex system resulting in voice disorders. In this context, time-frequency-shape analysis based on embedding phase space plots and nonlinear dynamics methods have been used to evaluate the vocal fold dynamics during phonation. For this purpose, the present work used high-speed video to record the vocal fold movements of three subjects and extract the glottal area time series using an image segmentation algorithm. This signal is used for an optimization method which combines genetic algorithms and a quasi-Newton method to optimize the parameters of a biomechanical model of vocal folds based on lumped elements (masses, springs and dampers). After optimization, this model is capable of simulating the dynamics of recorded vocal folds and their glottal pulse. Bifurcation diagrams and phase space analysis were used to evaluate the behavior of this deterministic system in different circumstances. The results showed that this methodology can be used to extract some physiological parameters of vocal folds and reproduce some complex behaviors of these structures contributing to the scientific and clinical evaluation of voice production. (C) 2010 Elsevier Inc. All rights reserved.

Neurological Disease Detection and Monitoring from Voice Production

The dramatic impact of neurological degenerative pathologies in life quality is a growing concern. It is well known that many neurological diseases leave a fingerprint in voice and speech production. Many techniques have been designed for the detection, diagnose and monitoring the neurological disease. Most of them are costly or difficult to extend to primary attention medical services. Through the present paper it will be shown how some neurological diseases can be traced at the level of phonation. The detection procedure would be based on a simple voice test. The availability of advanced tools and methodologies to monitor the organic pathology of voice would facilitate the implantation of these tests. The paper hypothesizes that some of the underlying mechanisms affecting the production of voice produce measurable correlates in vocal fold biomechanics. A general description of the methodological foundations for the voice analysis system which can estimate correlates to the neurological disease is shown. Some study cases will be presented to illustrate the possibilities of the methodology to monitor neurological diseases by voice

Eteva Järvenpään perhepalvelukeskuksen lyhytaikaishoidon suunnittelun kehittäminen

Objectives. The thesis objective was to analyze how person-centred planning is applied to develop short term care in interaction between the disabled children, their families and the workers of the family service centre of Eteva Järvenpää. The thesis contributes to developing the methods of person-centred planning. I applied theoretical frameworks of activity theory and developmental work research, family-based work framework and disability phenomenon. The research questions were: What development needs did the families of disabled children have for the services? How were viewpoints of disabled children, their families and Eteva workers noticed in person-centred planning in the interaction between the disabled children, their families and Eteva workers? What disturbances and development challenges emerged during the person-centred planning? Methods. I first analysed the local history of the disability sector and the short term care to analyse challenges arising from the local history. The actural research material consisted of interviews with four families, two person-centred planning discussions and two discussions where the person-centred planning was reflected by the families.I used interaction voice analysis as defined by the activity theory and developmental work research. From the recorded interviews and discussions I analysed scripts, disturbances, innovation attempts and innovations. From the discussions I analysed also the interaction types (cooperation, coordination and communication). Results and conclusions. As problems, the families considered the scarce resources and the inflexibility of services. The challenges of developing the short term care were how to transfer information from short term care to home, how to develop activities for the children and how to take into account the individual needs of the children in the short term care. Both from the local history analysis and from the family interviews arised the conflict between caring and fulfilling the individual needs. In person-centred planning, the voice of the child was either interpreted by other family members or guided by family members or workers. I modelled the progress of person-centred planning in a two-dimensional coordination. Person-centred planning should be deepened in cooperation between the child, the family and the workers in everyday situations at home and during the short term care. The challenge is to expand person-centred planning to become cross-organizational cooperation connecting the actors of the child s service network in everyday life. Avainsanat Nyckelord - Keywords short term care, activity theory and developmental work research, person-centred planning, disability

Voz e emoção em português europeu

No trabalho apresentado realiza-se uma primeira descrição de voz e emoção para o Português Europeu. Estudamos, utilizando como base estudos realizados em diversas línguas (finlandês; inglês; alemão), os parâmetros relacionados com voz e que variam consoante a emoção que expressamos. Analisamos assim os parâmetros relacionados com a frequência Fundamental (F0) com a perturbação (jitter) com a amplitude (shimmer) e com aspectos relacionados com o ruído (HNR). Trata-se de um estudo abrangente que estudando voz e a sua relação/variação de acordo com a emoção o faz em três vertentes: patologia de voz de origem psicogénica (carácter emocional); emoção produzida por actores e a análise de emoção espontânea. Conseguindo, como trabalho pioneiro nesta área, valores para todos estes tipos de produção. Salientamos o facto de no nosso trabalho apenas existir a análise de voz sem recurso a expressão facial ou à postura dos indivíduos. Para que pudéssemos realizar estudos comparativos com os dados que íamos recolhendo em cada corpus (patologia; emoção por actor e emoção espontânea), procurámos utilizar sempre os mesmos métodos de análise (Praat; SFS; SPSS, Hoarseness Diagram – para a análise de voz com patologia - e o sistema Feeltrace - para as emoções espontâneas). Os estudos e análises relativos à emoção produzida por actores são complementados por testes de percepção aplicados a falantes nativos de Inglês Americano e a falantes de Português Europeu. Este teste, juntamente com a análise da emoção espontânea, permitiu-nos retirar dados particulares relativos à língua portuguesa. Apesar de haver tanto na expressão como na percepção de emoções muitas características consideradas universais, em Português percebe-se algo de peculiar. Os valores para a expressão neutra; tristeza e alegria são todos muito próximos, ao contrário do que acontece noutras línguas. Além disso estas três emoções (de famílias distintas) são as que mais dificuldades causam (aos dois grupos de informantes) em termos de distinção no teste de percepção. Poderá ser esta a particularidade da expressão da emoção no Português Europeu, podendo estar ligada a factores culturais. Percebe-se ainda, com este trabalho, que a emoção expressa pelo actor se aproxima da emoção espontânea. No entanto, alguns parâmetros apresentam valores diferentes, isto porque o actor tem a tendência de exagerar a emoção. Com este trabalho foram criados corpora originais que serão um recurso importante a disponibilizar para futuras análises numa área que é ainda deficitária, em termos de investigação científica, em Portugal. Tanto os corpora, como respectivos resultados obtidos poderão vir a ser úteis em áreas como as Ciências da Fala; Robótica e Docência.

Assessment of PD Speech Anomalies @ Home

Background: Voice processing in real-time is challenging. A drawback of previous work for Hypokinetic Dysarthria (HKD) recognition is the requirement of controlled settings in a laboratory environment. A personal digital assistant (PDA) has been developed for home assessment of PD patients. The PDA offers sound processing capabilities, which allow for developing a module for recognition and quantification HKD. Objective: To compose an algorithm for assessment of PD speech severity in the home environment based on a review synthesis. Methods: A two-tier review methodology is utilized. The first tier focuses on real-time problems in speech detection. In the second tier, acoustics features that are robust to medication changes in Levodopa-responsive patients are investigated for HKD recognition. Keywords such as Hypokinetic Dysarthria , and Speech recognition in real time were used in the search engines. IEEE explorer produced the most useful search hits as compared to Google Scholar, ELIN, EBRARY, PubMed and LIBRIS. Results: Vowel and consonant formants are the most relevant acoustic parameters to reflect PD medication changes. Since relevant speech segments (consonants and vowels) contains minority of speech energy, intelligibility can be improved by amplifying the voice signal using amplitude compression. Pause detection and peak to average power rate calculations for voice segmentation produce rich voice features in real time. Enhancements in voice segmentation can be done by inducing Zero-Crossing rate (ZCR). Consonants have high ZCR whereas vowels have low ZCR. Wavelet transform is found promising for voice analysis since it quantizes non-stationary voice signals over time-series using scale and translation parameters. In this way voice intelligibility in the waveforms can be analyzed in each time frame. Conclusions: This review evaluated HKD recognition algorithms to develop a tool for PD speech home-assessment using modern mobile technology. An algorithm that tackles realtime constraints in HKD recognition based on the review synthesis is proposed. We suggest that speech features may be further processed using wavelet transforms and used with a neural network for detection and quantification of speech anomalies related to PD. Based on this model, patients' speech can be automatically categorized according to UPDRS speech ratings.

Taxonomia e biogeografia da espécie politípica Herpsilochmus rufimarginatus (TEMMINCK, 1822) (Aves: THAMNOPHILIDAE)

The genus Herpsilochmus is composed mainly of cryptic species, among them is Herpsilochmus rufimarginatus, which is currently represented by four subspecies: H. r. rufimarginatus, H. r. frater, H. r. scapularis and H. r. exiguus. Differences in plumage and vocalization suggest that there are more than one species involved in this complex. Thus this and other subspecific taxa need urgent revision, the disjunct distribution of this species also allows us to infer the relationship between birds that occur in this biome and / or different centers of endemism. This study aims to make a taxonomic revision of the taxa included in the complex time Herpsilochmus rufimarginatus based on morphological, morphometric, vocals and geographical distribution of this bird. Besides creating distribution models current potential and make the reconstruction of the distribution bygone using ecological niche modeling, and testing the niche conservatism and divergence between different subspecies. Consultations for examination of the skins of specimens of the museums: Museum of Zoology, University of São Paulo (MZUSP), National Museum of Rio de Janeiro (MN) and Emilio Goeldi Museum of Pará (MPEG), and the skins deposited at the collection of Ornithological Federal University of Rio Grande do Norte (COUFRN). We studied the following measures length of specimens: exposed culmen, culmen and total culmen nostril, tarsus, wing and tail flattened. The voice analysis was performed with vocalizations banks and / or digital banks people where 17 voice parameters were measured. This information and more available in the literature were used to assemble a bunch of data under the limit distribution of taxa and generate ecological niche models. This analyzes carried out in the program Maxent, having as model selection criterion the AUC, and the models were greater than 0.80 are considered good models. Environmental data for the realization of the modeling were downloaded on the website of Worldclim. The morphometric information, vocals and geographic distribution point for the separation of these taxa to be considering various uni and multivariate analyzes. The potential distribution models performed well (AUC> 0.80), and its distribution associated with environmental characteristics of the Amazon forest and Atlantic forest (forests of south and southeast, northeast and forest). The reconstruction of the distribution indicates a possible contact between the southern part of the Atlantic forest in the northern part of the Amazon. The analysis of niche overlap showed a low overlap between taxa and comparisons between the null model and the generated overlay link probably occurring niche conservatism. The data suggest that the taxa that occur in the Amazon and Atlantic forest represent three distinct species

Dysphonia and laryngeal sequelae in paracoccidioidomycosis patients: a morphological and phoniatric study

The larynx is the third most commonly involved organ in paracoccidioidomycosis (PCM). While a few studies have evaluated laryngeal sequelae, there have not been any investigations of voice abnormalities in PCM patients. To evaluate persistent dysphonia and laryngeal lesions, we studied 15 normal subjects and 30 post-treatment PCM patients, i.e., 15 with only pulmonary and 15 with both laryngeal and pulmonary involvement. Perceptual and acoustic voice analysis were performed with all patients, while endoscopic studies were also conducted with the 15 laryngeal patients. Voice analysis showed instability by perceptual analysis (P < 0.01) in both groups, but more severe dysphonia was noted in the laryngeal group (P < 0.01). The dysponia, seen in 66.7% of these patients (dysphonia index < 7.0), was characterized by roughness and breathness. The Dr. Speech (Tiger Electronics) analysis program did not accept five voices from the laryngeal group due to the severe dysphonia. Jitter was elevated in five laryngeal lesion patients. Endoscopy showed that 80% of patients with laryngeal lesion had two or more laryngeal structures involved. Vocal fold alterations were seen in all laryngeal lesion patients, which included involvement of the arythenoids, epiglottis, and vestibular folds. This first functional study of laryngeal sequelae in PCM revealed frequent and severe dysphonia that may have important social consequences for patients.

O espectro médio de longo termo na pesquisa e na clínica fonoaudiológica.

BACKGROUND: One of the great difficulties in evaluating a voice is the judgment of quality through the perceptual auditive analysis--although frequently used--, as it is influenced by socioeconomic and cultural aspects as well as individual preferences. Many are the adjectives and methods used in this assessment, especially because of the subjectivity involved in the process, leading to incompatibilities between listeners and difficulties in reaching a consensus on the use of this or that terminology. In such a context, the voice laboratory and more specifically the acoustic computerized analysis, has guided and complemented speech-language treatments. Among the several possibilities of spectrographic analysis, the (Long-Term Average Spectrum--LTAS) quantifies the quality of voices, pointing differences between gender, age, professional--spoken and sang--and dysphonic voices. The LTAS has been used a lot in researches that investigate voice. As it evidences the contribution of the glottic source and of resonance to the quality of voice, it provides objective parameters for the evaluation of this aspect which usually depends on our auditive perception. AIM: to demonstrate how LTAS can be applied in voice research and in the speech-language therapy practice, describing both the technical aspects required for the production and interpretation of results, and its limitations. CONCLUSION: The area of voice research has developed a lot in these last two decades especially because of the advent of the voice and speech laboratory. For this reason, the knowledge about the applicability of more tools for voice analysis, as the LTAS, as well as the existing need for more studies in this area, will most certainly contribute for the creation of new research areas not only in the field of professional voice but also in the field of therapy.