Randomized controlled trial on single dose steroid before thyroidectomy for benign disease to improve postoperative nausea, pain, and vocal function

OBJECTIVE: To evaluate the effects of a single preoperative dose of steroid on thyroidectomy outcomes. BACKGROUND: Nausea, pain, and voice alteration frequently occur after thyroidectomy. Because steroids effectively reduce nausea and inflammation, a preoperative administration of steroids could improve these thyroidectomy outcomes. METHODS: Seventy-two patients (men = 20, women = 52) undergoing thyroidectomy for benign disease were included in this randomized, controlled, 2 armed (group D: 8 mg dexamethasone, n = 37; group C: 0.9% NaCl, n = 35), double-blinded study (clinical trial number NCT00619086). Anesthesia, surgical procedures, antiemetics, and analgesic treatments were standardized. Nausea (0-3), pain (visual analog scale), antiemetic and analgesic requirements, and digital voice recording were documented before and 4, 8, 16, 24, 36, and 48 hours after surgery. Patients were followed-up 30 days after hospital discharge. RESULTS: Baseline characteristics were similar among the 2 treatment groups. Nausea was pronounced in the first 16 hours postoperatively (scores were <0.3 and 0.8-1.0 for group D and C, respectively (P = 0.005)), and was significantly lower in group D compared with group C during the observation period (P = 0.001). Pain diminished within 48 hours after surgery (visual analog scale 20 and 35 in group D and C, respectively (P = 0.009)). Antiemetic and analgesic requirements were also significantly diminished. Changes in voice mean frequency were less prominent in the dexamethasone group compared with the placebo group (P = 0.015). No steroid-related complications occurred. CONCLUSION: A preoperative single dose of steroid significantly reduced nausea, vomiting, and pain, and improved postoperative voice function within the first 48 hours (most pronounced within 16 hours) after thyroid resection; this strategy should be routinely applied in thyroidectomies.

Describing vocal performance of Portuguese cantadeiras of Alto Minho

Portugal has strong musical traditions, which have been perpetrated by decades through folkloristic activities. In folk groups from Alto Minho (north of Portugal), folk singing is mostly performed by cantadeiras, amateur female solo singers who learn this style orally. Their vocal characteristics are distinctive when compared with other regions of the country; however, deep understanding of these vocal practices is still missing. The present work aims at studying Alto Minho cantadeira’s vocal performance in a multidimensional perspective, envisioning social, cultural and physiological understanding of this musical style. Thus, qualitative and quantitative data analyses were carried out, to: (i) describe current performance practices, (ii) explore existent perceptions about most relevant voice features in this region, (iii) investigate physiological and acoustic properties of this style, and (iv) compare this style of singing with other non-classical singing styles of other countries. Dataset gathered involved: 78 groups whose members were telephone interviewed, 13 directors who were asked to fill in a questionnaire on performance practices, 1 cantadeira in a pilot study, 16 cantadeiras in preliminary voice recordings, 77 folk group members in listening tests, and 10 cantadeiras in multichannel recordings, including audio, ELG, air flow and intra-oral pressure signals. Data were analysed through thematic content analysis, descriptive and inferential statistics, hierarchical principal components, and multivariate linear regression models. Most representative voices have a high pitched and loud voice, with a bright timbre, predominance of chest register without excessive effort, and good text intelligibility with regional accent. High representativeness levels were obtained by few cantadeiras; these sing with high levels of subglottal pressure and vocal fold contact quotient, predominance of high spectrum energy and vocal loudness, corroborating indications of prevalence of pressed phonation. These vocal characteristics resemble belting in musical theatre and share similarities with country (USA) and ojikanje (Croatia) singing. Strategies that may contribute to the preservation of this type of singing and the vocal health of current cantadeiras are discussed, pointing at the direction of continuous education among folk groups, following practices that are already adopted elsewhere in Europe.

Noise robust voice activity detection using features extracted from the time-domain autocorrelation function

This paper presents a method of voice activity detection (VAD) for high noise scenarios, using a noise robust voiced speech detection feature. The developed method is based on the fusion of two systems. The first system utilises the maximum peak of the normalised time-domain autocorrelation function (MaxPeak). The second zone system uses a novel combination of cross-correlation and zero-crossing rate of the normalised autocorrelation to approximate a measure of signal pitch and periodicity (CrossCorr) that is hypothesised to be noise robust. The score outputs by the two systems are then merged using weighted sum fusion to create the proposed autocorrelation zero-crossing rate (AZR) VAD. Accuracy of AZR was compared to state of the art and standardised VAD methods and was shown to outperform the best performing system with an average relative improvement of 24.8% in half-total error rate (HTER) on the QUT-NOISE-TIMIT database created using real recordings from high-noise environments.

Perceptual and instrumental evaluation of voice and tongue function after carotid endarterectomy

Objective: Laryngeal and tongue function was assessed in 28 patients to evaluate the presence, nature, and resolution of superior recurrent laryngeal and hypoglossal nerve damage resulting from standard open primary carotid endarterectomy (CEA). Methods. The laryngeal and tongue function in 28 patients who underwent CEA were examined prospectively with various physiologic (Aerophone II, laryngograph, tongue transducer), acoustic (Multi-Dimensional Voice Program), and perceptual speech assessments. Measures were obtained from all participants preoperatively, and at 2 weeks and at 3 months postoperatively. Results. The perceptual speech assessment indicated that the vocal quality of roughness was significantly more apparent at the 2-week postoperative assessment than preoperatively. However, by the 3-month postoperative assessment these values had returned to near preoperative levels, with no significant difference detected between preoperative and 3-month postoperative levels or between 2-week and 3-month postoperative levels. Both the instrumental assessments of laryngeal function and the acoustic assessment of vocal quality failed to identify any significant difference on any measure across the three assessment periods. Similarly, no significant impairment in tongue strength, endurance, or rate of repetitive tongue movements was detected at instrumental assessment of tongue function. Conclusions: No permanent changes to vocal or tongue function occurred in this group of participants after primary CEA. The lack of any significant long-term laryngeal or tongue dysfunction in this group suggests that the standard open CEA procedure is not associated with high rates of superior recurrent and hypoglossal nerve dysfunction, as previously believed.

The delta-phase spectrum with application to voice activity detection and speaker recognition

For several reasons, the Fourier phase domain is less favored than the magnitude domain in signal processing and modeling of speech. To correctly analyze the phase, several factors must be considered and compensated, including the effect of the step size, windowing function and other processing parameters. Building on a review of these factors, this paper investigates a spectral representation based on the Instantaneous Frequency Deviation, but in which the step size between processing frames is used in calculating phase changes, rather than the traditional single sample interval. Reflecting these longer intervals, the term delta-phase spectrum is used to distinguish this from instantaneous derivatives. Experiments show that mel-frequency cepstral coefficients features derived from the delta-phase spectrum (termed Mel-Frequency delta-phase features) can produce broadly similar performance to equivalent magnitude domain features for both voice activity detection and speaker recognition tasks. Further, it is shown that the fusion of the magnitude and phase representations yields performance benefits over either in isolation.

Detecting Symbian OS malware through static function call analysis

Smartphones become very critical part of our lives as they offer advanced capabilities with PC-like functionalities. They are getting widely deployed while not only being used for classical voice-centric communication. New smartphone malwares keep emerging where most of them still target Symbian OS. In the case of Symbian OS, application signing seemed to be an appropriate measure for slowing down malware appearance. Unfortunately, latest examples showed that signing can be bypassed resulting in new malware outbreak. In this paper, we present a novel approach to static malware detection in resource-limited mobile environments. This approach can be used to extend currently used third-party application signing mechanisms for increasing malware detection capabilities. In our work, we extract function calls from binaries in order to apply our clustering mechanism, called centroid. This method is capable of detecting unknown malwares. Our results are promising where the employed mechanism might find application at distribution channels, like online application stores. Additionally, it seems suitable for directly being used on smartphones for (pre-)checking installed applications.

The Voice as Transcursive Inscriber: The Relation of Body and Instrument Understood through the Workings of a Machine

This article examines the relationship of the body with a musical instrument; specifically it looks at the vital threshold conditions that occur during the interplay of voice and instrument. By examining the work ‘IKAS’ (1982) for solo saxophone by German composer Hans-Joachim Hespos, the unusual timbral relationships created between vocal and instrumental sounds are exposed. I argue that this particular work highlights the performer/instrument relation as one marked by Gilles Deleuze’s notion of the workings of a machine and a machine’s relation to a ‘flow’, in particular a machine’s function with view to the break in the flow. By turning towards Deleuze’s concept of the machine, this article offers a slightly different vocabulary for music analysis, one that more easily encompasses certain works of the twentieth century, specifically those that are more timbre- than pitch-based.

A Novel Packet Marking Function for Real-Time Interactive MPEG-4 Video Applications in a Differentiated Services Network

The future convergence of voice, video and data applications on the Internet requires that next generation technology provides bandwidth and delay guarantees. Current technology trends are moving towards scalable aggregate-based systems where applications are grouped together and guarantees are provided at the aggregate level only. This solution alone is not enough for interactive video applications with sub-second delay bounds. This paper introduces a novel packet marking scheme that controls the end-to-end delay of an individual flow as it traverses a network enabled to supply aggregate- granularity Quality of Service (QoS). IPv6 Hop-by-Hop extension header fields are used to track the packet delay encountered at each network node and autonomous decisions are made on the best queuing strategy to employ. The results of network simulations are presented and it is shown that when the proposed mechanism is employed the requested delay bound is met with a 20% reduction in resource reservation and no packet loss in the network.

Triggering employee voice under the European Information and Consultation Directive: A non-union case study

The transposition of the 2002/14/EC Directive, establishing a general framework for information and consultation (I&C), has proven contentious in largely voluntarist systems of employment regulation. Receiving particular criticism is the employee ‘opt-in’ mechanism as a means to access I&C rights. For non-union employees in particular, the ability and potential to negotiate rights for I&C is widely seen to be problematic. This article uniquely examines the opt-in mechanism in the context of non-unionism, considering how non-union employers respond to non-union employees invoking their legislative rights to I&C. Drawing upon a case study conducted over four years in a large non-union multinational, the evidence shows how the opt-in and negotiation process function to the advantage of the employer rather than the intended regulatory impact to advance employee rights

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.

Perceptual and instrumental analysis of laryngeal function after traumatic brain injury in childhood

Objective: To investigate laryngeal function and phonatory disturbance in children with traumatic brain injury (TBI), using both perceptual and instrumental techniques. Design and participants: The performance of 16 individuals with moderate to severe TBI acquired in childhood and 16 nonneurologicatly impaired control subjects was compared on a battery of perceptual (Frenchay Dysarthria Assessment, speech sample analysis) and instrumental (Aerophone II, laryngograph) assessments. Results and conclusions: As a group, the children with TBI demonstrated normal, or only minimally impaired laryngeal function, when compared with the control group, which contrasts with the significant laryngeal impairment noted in adults after TBI. Several reasons for the different findings in relation to laryngeal function in adults and children after TBI are postulated: (1) differing types of injury usually incurred by adults and children may result in a relatively decreased degree of neurologic impairment in these children, (2) differences in recovery potential between adults and children, and (3) the pediatric larynx is still developing, hence it may be better able to compensate for any impairment incurred.

Effects of neurosurgical management of Parkinson's disease on speech characteristics and oromotor function

The present study examined the effects of neurosurgical management of Parkinson's disease (PD), including the procedures of pallidotomy, thalamotomy, and deep-brain stimulation (DBS) on perceptual speech characteristics, speech,, intelligibility and oromotor function in a group of 22 participants with PD. The surgical participant group was compared with a group of 25 non-neurologically impaired individuals matched for age and sex. In addition, the study investigated 16 participants with PD who did not undergo neurosurgical management to control for disease progression. Results revealed that neurosurgical intervention did not significantly change the surgical participants' perceptual speech dimensions or oromotor function despite significant postoperative improvements in ratings of general motor function and disease severity. Reasons why neurosurgical intervention resulted in dissimilar outcomes with respect to participants' perceptual speech dimensions and general motor function are proposed.

Impact of pallidotomy on physiological articulation function and speech intelligibility in Parkinsons disease

The objective of this study was to evaluate the effects of posteroventral pallidotomy on perceptual and physiological measures of articulatory function and speech intelligibility in Parkinson disease (M). The study examined 11 participants with M who underwent posteroventral pallidotomy Physiological measures of hp and tongue function. and perceptual measures of speech intelligibility were obtained prepallidotomy and 3 months postpallidotomy. The participants with PD were also assessed on the Unified Parkinsons Disease Rating Scale (UPDRS Part III) In addition, the study included a group of 16 participants with PD who did not undergo pallidotomy and a group of 30 nonneurologically impaired participants. Analyses of physiological articulatory function and speech intelligibility did not reveal corresponding improvements in motor speech function as observed in general limb motor function postpallidotomy. Overall, individual reliable change analyses revealed that the majority of surgical PD participants demonstrated no reliable change on perceptual and physiological measures of articulation. The cur rent study revealed preliminary evidence that articulatury function and speech intelligibility did not change following posteroventral pallidotomy in a group of individuals with PD.