scholarly journals Glottal Aerodynamics Estimated From Neck-Surface Vibration in Women With Phonotraumatic and Nonphonotraumatic Vocal Hyperfunction

2020 ◽  
Vol 63 (9) ◽  
pp. 2861-2869
Author(s):  
Víctor M. Espinoza ◽  
Daryush D. Mehta ◽  
Jarrad H. Van Stan ◽  
Robert E. Hillman ◽  
Matías Zañartu
Keyword(s):  
Muscle Tension ◽  
Ambulatory Monitoring ◽  
Maximum Flow ◽  
Air Pressure ◽  
Control Group ◽  
Inverse Filtering ◽  
Linear Regression Models ◽  
Vocal Function ◽  
Surface Vibration ◽  
Vocal Hyperfunction

Purpose The purpose of this study was to determine whether estimates of glottal aerodynamic measures based on neck-surface vibration are comparable to those previously obtained using oral airflow and air pressure signals (Espinoza et al., 2017) in terms of discriminating patients with phonotraumatic and nonphonotraumatic vocal hyperfunction (PVH and NPVH) from vocally healthy controls. Method Consecutive /pae/ syllables at comfortable and loud level were produced by 16 women with PVH (organic vocal fold lesions), 16 women with NPVH (primary muscle tension dysphonia), and 32 vocally healthy women who were each matched to a patient according to age and occupation. Subglottal impedance-based inverse filtering of the anterior neck-surface accelerometer (ACC) signal yielded estimates of peak-to-peak glottal airflow, open quotient, and maximum flow declination rate. Average subglottal pressure and microphone-based sound pressure level (SPL) were also estimated from the ACC signal using subject-specific linear regression models. The ACC-based measures of glottal aerodynamics were normalized for SPL and statistically compared between each patient and matched-control group. Results Patients with PVH and NPVH exhibited lower SPL-normalized glottal aerodynamics values than their respective control subjects ( p values ranging from < .01 to .07) with very large effect sizes (1.04–2.16), regardless of loudness condition or measurement method (i.e., ACC-based values maintained discriminatory power). Conclusions The results of this study demonstrate that ACC-based estimates of most glottal aerodynamic measures are comparable to those previously obtained from oral airflow and air pressure (Espinoza et al., 2017) in terms of differentiating between hyperfunctional (PVH and NPVH) and normal vocal function. ACC-based estimates of glottal aerodynamic measures may be used to assess vocal function during continuous speech and enables this assessment of daily voice use during ambulatory monitoring to provide better insight into the pathophysiological mechanisms associated with vocal hyperfunction.

scholarly journals Glottal Aerodynamic Measures in Women With Phonotraumatic and Nonphonotraumatic Vocal Hyperfunction

2017 ◽  
Vol 60 (8) ◽  
pp. 2159-2169 ◽  
Author(s):  
Víctor M. Espinoza ◽  
Matías Zañartu ◽  
Jarrad H. Van Stan ◽  
Daryush D. Mehta ◽  
Robert E. Hillman
Keyword(s):  
Muscle Tension ◽  
Maximum Flow ◽  
Control Group ◽  
Inverse Filtering ◽  
Control Groups ◽  
Vocal Function ◽  
Vocal Hyperfunction ◽  
Subglottal Pressure ◽  
Pressure Peak ◽  
And Control

Purpose The purpose of this study was to determine the validity of preliminary reports showing that glottal aerodynamic measures can identify pathophysiological phonatory mechanisms for phonotraumatic and nonphonotraumatic vocal hyperfunction, which are each distinctly different from normal vocal function. Method Glottal aerodynamic measures (estimates of subglottal air pressure, peak-to-peak airflow, maximum flow declination rate, and open quotient) were obtained noninvasively using a pneumotachograph mask with an intraoral pressure catheter in 16 women with organic vocal fold lesions, 16 women with muscle tension dysphonia, and 2 associated matched control groups with normal voices. Subjects produced /pae/ syllable strings from which glottal airflow was estimated using inverse filtering during /ae/ vowels, and subglottal pressure was estimated during /p/ closures. All measures were normalized for sound pressure level (SPL) and statistically tested for differences between patient and control groups. Results All SPL-normalized measures were significantly lower in the phonotraumatic group as compared with measures in its control group. For the nonphonotraumatic group, only SPL-normalized subglottal pressure and open quotient were significantly lower than measures in its control group. Conclusions Results of this study confirm previous hypotheses and preliminary results indicating that SPL-normalized estimates of glottal aerodynamic measures can be used to describe the different pathophysiological phonatory mechanisms associated with phonotraumatic and nonphonotraumatic vocal hyperfunction.

scholarly journals Kalman Filter Implementation of Subglottal Impedance-Based Inverse Filtering to Estimate Glottal Airflow during Phonation

2021 ◽  
Author(s):  
Juan P. Cortés ◽  
Gabriel A. Alzamendi ◽  
Alejandro J. Weinstein ◽  
Juan I. Yuz ◽  
Víctor M. Espinoza ◽  
...  
Keyword(s):  
Kalman Filter ◽  
Reference Signal ◽  
Ambulatory Monitoring ◽  
Ground Truth ◽  
Inverse Filtering ◽  
Vocal Function ◽  
Non Invasive ◽  
Model Mismatch ◽  
Amplitude Estimation

Subglottal Impedance-Based Inverse Filtering (IBIF) allows for the continuous, non-invasive estimation of glottal airflow from a surface accelerometer placed over the anterior neck skin below the larynx, which has been shown to be advantageous for the ambulatory monitoring of vocal function. However, during long-term ambulatory recordings over several days, conditions may drift from the laboratory environment where the IBIF parameters were initially estimated due to sensor positioning, skin attachment, and temperature, among other factors. Observation uncertainties and model mismatch may result in significant deviations in the glottal airflow estimates, but are very difficult to quantify in ambulatory conditions due to a lack of a reference signal. To address this issue, we propose a Kalman filter implementation of the IBIF filter, which allows for both estimating the model uncertainty and adapting the airflow estimates to correct for signal deviations. One-way ANOVA results from laboratory experiments using the Rainbow Passage indicate a an improvement on amplitude-based measures for PVH subjects compared to IBIF which shows a statistically difference with respect to the reference oral airflow (p=0.02,F=4.1). MFDR from PVH subjects is slightly different to the oral airflow when compared to IBIF (p=0.04, F=3.3). Other measures did not have significant differences with either Kalman or IBIF, with the exception of H1H2, whose performance deteriorates for both methods. Overall, both methods show similar flottal airflow measures, with the advantage of Kalman by improving amplitude estimation. Moreover, Kalman filter deviations from the IBIF output airflow might suggest a better representation of some fine details in the ground-truth glottal airflow signal. Other applications may take more advantage from the adaptation offered by the Kalman filter implementation.

scholarly journals Kalman Filter Implementation of Subglottal Impedance-Based Inverse Filtering to Estimate Glottal Airflow during Phonation

2021 ◽  
Vol 12 (1) ◽  
pp. 401
Author(s):  
Juan P. Cortés ◽  
Gabriel A. Alzamendi ◽  
Alejandro J. Weinstein ◽  
Juan I. Yuz ◽  
Víctor M. Espinoza ◽  
...  
Keyword(s):  
Kalman Filter ◽  
Reference Signal ◽  
Ambulatory Monitoring ◽  
Maximum Flow ◽  
Ground Truth ◽  
P Value ◽  
Inverse Filtering ◽  
Velocity Signal ◽  
Modified Kalman Filter

Subglottal Impedance-Based Inverse Filtering (IBIF) allows for the continuous, non-invasive estimation of glottal airflow from a surface accelerometer placed over the anterior neck skin below the larynx. It has been shown to be advantageous for the ambulatory monitoring of vocal function, specifically in the use of high-order statistics to understand long-term vocal behavior. However, during long-term ambulatory recordings over several days, conditions may drift from the laboratory environment where the IBIF parameters were initially estimated due to sensor positioning, skin attachment, or temperature, among other factors. Observation uncertainties and model mismatch may result in significant deviations in the glottal airflow estimates; unfortunately, they are very difficult to quantify in ambulatory conditions due to a lack of a reference signal. To address this issue, we propose a Kalman filter implementation of the IBIF filter, which allows for both estimating the model uncertainty and adapting the airflow estimates to correct for signal deviations. One-way analysis of variance (ANOVA) results from laboratory experiments using the Rainbow Passage indicate an improvement using the modified Kalman filter on amplitude-based measures for phonotraumatic vocal hyperfunction (PVH) subjects compared to the standard IBIF; the latter showing a statistically difference (p-value =0.02, F=4.1) with respect to a reference glottal volume velocity signal estimated from a single notch filter used here as ground-truth in this work. In contrast, maximum flow declination rates from subjects with vocal phonotrauma exhibit a small but statistically difference between the ground-truth signal and the modified Kalman filter when using one-way ANOVA (p-value =0.04, F=3.3). Other measures did not have significant differences with either the modified Kalman filter or IBIF compared to ground-truth, with the exception of H1-H2, whose performance deteriorates for both methods. Overall, both methods (modified Kalman filter and IBIF) show similar glottal airflow measures, with the advantage of the modified Kalman filter to improve amplitude estimation. Moreover, Kalman filter deviations from the IBIF output airflow might suggest a better representation of some fine details in the ground-truth glottal airflow signal. Other applications may take more advantage from the adaptation offered by the modified Kalman filter implementation.

scholarly journals Individual Physical Activity Behaviour and Group Composition as Determinants of the Effectiveness of a Childhood Obesity Intervention Program

Obesity Facts ◽  
2020 ◽  
pp. 1-8
Author(s):  
Liesa Marie Lier ◽  
Christoph Breuer ◽  
Nina Ferrari ◽  
David Friesen ◽  
Fernanda Maisonave ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Physical Fitness ◽  
Intervention Program ◽  
Program Effectiveness ◽  
Physical Activity Behaviour ◽  
Control Group ◽  
Linear Regression Models ◽  
Physically Active ◽  
Gender Groups ◽  
Age Range

<b><i>Introduction:</i></b> Up to now, there is limited clarity on factors that determine the effectiveness of childhood obesity interventions. <b><i>Objective:</i></b> This study intends to uncover individual- and program-level predictors of BMI-SDS and fitness to achieve significant, sustainable health improvements. <b><i>Methods:</i></b> Data of 249 children with obesity or overweight who participated in an outpatient multidisciplinary program were analysed and compared to 54 waitlist controls. Linear regression models were used to examine associations between individual- and group-level variables and BMI-SDS and fitness. <b><i>Results:</i></b> Among intervention children, BMI-SDS decreased by 0.19 units and physical fitness increased by 11.5%, versus a BMI-SDS decrease of 0.07 and a 1.8% decrease in fitness in the control group. Participants who reported being physically active before the program start achieved greater improvements in BMI-SDS (β = –0.177, <i>p</i> &#x3c; 0.05) and physical fitness (β = 0.174, <i>p</i> &#x3c; 0.05) than inactive peers. BMI-SDS decreased significantly more for members of gender-heterogeneous groups (β = 0.194, <i>p</i> &#x3c; 0.05) with a narrow age range (β = 0.152, <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> The program under review is effective in counteracting juvenile obesity. The results give reason to believe that forming mixed-gender groups with a small age range and providing increased support for reportedly inactive children may improve program effectiveness.

Psychometric Analysis of an Ecological Vocal Effort Scale in Individuals With and Without Vocal Hyperfunction During Activities of Daily Living

2021 ◽  
pp. 1-16
Author(s):  
Katherine L. Marks ◽  
Alessandra Verdi ◽  
Laura E. Toles ◽  
Kaila L. Stipancic ◽  
Andrew J. Ortiz ◽  
...  
Keyword(s):  
Construct Validity ◽  
Intraclass Correlation ◽  
Muscle Tension ◽  
Voice Rehabilitation ◽  
Minimal Detectable Change ◽  
Retest Reliability ◽  
Vocal Hyperfunction ◽  
Before And After ◽  
Vocal Effort ◽  
Test Retest Reliability

Objective The purpose of this study was to examine the psychometric properties of an ecological vocal effort scale linked to a voicing task. Method Thirty-eight patients with nodules, 18 patients with muscle tension dysphonia, and 45 vocally healthy control individuals participated in a week of ambulatory voice monitoring. A global vocal status question was asked hourly throughout the day. Participants produced a vowel–consonant–vowel syllable string and rated the vocal effort needed to produce the task on a visual analog scale. Test–retest reliability was calculated for a subset using the intraclass correlation coefficient, ICC(A, 1). Construct validity was assessed by (a) comparing the weeklong vocal effort ratings between the patient and control groups and (b) comparing weeklong vocal effort ratings before and after voice rehabilitation in a subset of 25 patients. Cohen's d, the standard error of measurement ( SEM ), and the minimal detectable change (MDC) assessed sensitivity. The minimal clinically important difference (MCID) assessed responsiveness. Results Test–retest reliability was excellent, ICC(A, 1) = .96. Weeklong mean effort was statistically higher in the patients than in controls ( d = 1.62) and lower after voice rehabilitation ( d = 1.75), supporting construct validity and sensitivity. SEM was 4.14, MDC was 11.47, and MCID was 9.74. Since the MCID was within the error of the measure, we must rely upon the MDC to detect real changes in ecological vocal effort. Conclusion The ecological vocal effort scale offers a reliable, valid, and sensitive method of monitoring vocal effort changes during the daily life of individuals with and without vocal hyperfunction.

Anxiety, attentional control, and performance : quiet eye training in Division I baseball

2018 ◽  
Author(s):  
◽  
Meaghan C. Sullivan
Keyword(s):  
Attentional Control ◽  
Muscle Tension ◽  
Strong Support ◽  
Division I ◽  
Control Group ◽  
Gaze Behavior ◽  
Negative Effects ◽  
Quiet Eye ◽  
Interceptive Timing ◽  
Performance Under Pressure

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] The quiet eye (QE) represents the time needed to cognitively process information being fixated or tracked and to focus attention on the demands of the task (Vickers, 2009). Research indicates that an optimal combination of QE, attentional control, and gaze behavior is linked with superior skill execution (Harle and Vickers, 2001), and that the successful integration of these attentional behaviors may also combat the negative effects that anxiety can have on performance (e.g., Vine and Wilson, 2011). To advance the research on QE training in pressurized interceptive timing tasks (Vickers, 2016), this mixed-method study explored how QE training impacted the hitting performances of Division I baseball players during a pressure situation. The results showed that, despite experiencing more overall anxiety, the QE group maintained performance under pressure. A main effect for group also approached significance, with the QE group nearly outperforming the control group. However, this difference was not statistically significant. Regardless, analyses of the participants' written feedback indicated that the QE group reported greater task-focus, less distractibility, improved pitch perception, and reduced muscle tension. Taken together, these findings provide strong support for implementing QE training in interceptive timing tasks, particularly as it relates to preserving performance under pressure.

scholarly journals Negative Air Pressure on Wet Cupping in Decreasing Blood Pressures in Hypertensive Patients

2018 ◽  
Vol 7 (2) ◽  
pp. 116
Author(s):  
Budi Darmawan ◽  
Diyah Fatmasari ◽  
Rr. Sri Endang Pujiast
Keyword(s):  
Blood Pressure ◽  
Repeated Measures ◽  
Community Health Centers ◽  
Intervention Group ◽  
Air Pressure ◽  
Control Group ◽  
P Value ◽  
Decrease Blood Pressure ◽  
Blood Pressures ◽  
The Mean

Background: Wet cupping, furthermore mentioned cupping, decreases blood pressures through the level of negative air pressures added by hydrostatics filtration pressure to reinforce the power of fluids filtration in capillaries. However, an appropriate negative air pressure to decrease blood pressure remains an uncertainty.Purpose: This study aimed to analyze negative air pressure differences on cupping in decreasing blood pressures in hypertensive patients.Methods: This is a quasi-experimental design conducted in three Community Health Centers in Langsa City, Aceh, Indonesia. The samples were 36 hypertensive males with age from 45 to 55, who were randomly stratified into two groups with cupping pressures 400 mbar (n=18) as the control group; and 540 mbar (n=18) as the intervention group. The cupping session was performed to each group on T1 (alkahil) point and in the middle line of both shoulders blade points. The systolic blood pressure (SBP) and diastolic blood pressures (DBP) were measured by validated automatic sphygmomanometer. The follow-up periods were one week and two weeks. The data were then analyzed by repeated measures ANOVA.Results: Cupping pressure of 400 mbar decreased the mean of SBP and DPB with a p-value of 0.450 and 0.026, respectively after two weeks of intervention. Meanwhile, cupping pressure of 540 mbar decreased the mean of SBP and DBP with a p-value of 0.006 and 0.057, respectively. Tests of within-subjects resulted in the p-value of 0.250 (SBP) and 0.176 (DBP) after two weeks of intervention. There were no significant differences in SBP and DBP between the intervention group and the control group.Conclusion: The cupping pressure between 400 mbar and 540 mbar could reduce blood pressure; however, the cupping pressure of 540 mbar yielded greater effect in decreasing blood pressure than the 400 mbar. Negative air vacuum pressure loads on cupping to decrease blood pressure should be considered between 400 to 540 mbar, and further studies are needed.

scholarly journals Evaluating the use of gas discharge visualization to measure massage therapy outcomes

2015 ◽  
Vol 12 (3) ◽  
Author(s):  
Jolie Haun ◽  
Nitin Patel ◽  
Gary Schwartz ◽  
Cheryl Ritenbaugh
Keyword(s):  
Repeated Measures ◽  
Muscle Tension ◽  
Massage Therapy ◽  
Well Being ◽  
Gas Discharge ◽  
Self Report ◽  
Control Group ◽  
Therapy Outcomes ◽  
Repeated Measures Design ◽  
Whole Person

Abstract: The purpose of this study was to evaluate the short-term effects of massage therapy using gas discharge visualization (GDV), a computerized biophysical electrophoton capture (EPC), in tandem with traditional self-report measures to evaluate the use of GDV measurement to assess the bioenergetic whole-person effects of massage therapy.: This study used a single treatment group, pre–post-repeated measures design with a sample of 23 healthy adults. This study utilized a single 50-min full-body relaxation massage with participants. GDV measurement method, an EPC, and traditional paper-based measures evaluating pain, stress, muscle tension, and well-being were used to assess intervention outcomes.: Significant differences were found between pre- and post-measures of well-being, pain, stress, muscle tension, and GDV parameters. Pearson correlations indicate the GDV measure is correlated with pain and stress, variables that impact the whole person.: This study demonstrates that GDV parameters may be used to indicate significant bioenergetic change from pre- to post-massage. Findings warrant further investigation with a larger diverse sample size and control group to further explore GDV as a measure of whole-person bioenergetic effects associated with massage.

scholarly journals Cardiometabolic Outcomes of Women Exposed to Hyperglycaemia First Detected in Pregnancy at 3–6 Years Post-Partum in an Urban South African Setting

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A432-A433
Author(s):  
Veronique Nicolaou ◽  
Larske Soepnel ◽  
Naomi Sharlene Levitt ◽  
Kenneth Huddle ◽  
Kirsten Klipstein-Grobusch ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Post Partum ◽  
Subclinical Atherosclerosis ◽  
Surrogate Marker ◽  
Control Group ◽  
Linear Regression Models ◽  
Urban South ◽  
Increased Risk ◽  
African Setting ◽  
In Pregnancy

Abstract Objective: Comparison of cardiometabolic outcomes in women exposed to hyperglycaemia first detected in pregnancy (HFDP) and a control group 3–6 years post-partum in urban South Africa. Design and Methods: A comparative study was performed of 103 women exposed to HFDP and 101 not exposed to HFDP 3–6 years post-partum at Chris Hani Baragwanath Academic Hospital, Soweto. Index pregnancy data were obtained from medical records. Post-partum, participants were re-evaluated for biochemical analysis (two-hour 75gm OGTT, fasting insulin, lipids creatinine and glucose levels). Cardiovascular risk was assessed by estimation of the Framingham risk score (FRS). Carotid intima media thickness (CIMT) was used as a surrogate marker for subclinical atherosclerosis. Factors associated with progression to these cardiometabolic outcomes were assessed using multivariable logistic and linear regression models. Results: 46 (45.1%) HFDP-exposed women progressed to diabetes compared to 5 (5.0%) women in the control group (p&lt;0.001); only 20 (43.4%) of the HFDP group were aware of their diabetic status. Adjusted odds ratio (aOR, 95% confidence interval (CI)) of progressing to type 2 diabetes was 11.0 (3.3–36.2). Both 10-year estimated cardiovascular risk (FRS) and mean CIMT were statistically higher in the HFDP-exposed group (8.46 IQR 4.9–14.4; 0.48 mm IQR 0.44-0,53, respectively) compared to the control group (3.48 IQR 2.1–5.7; 0.46mm IQR 0.42–0.50 respectively) though mostly driven by age, systolic blood pressure and diabetes. Conclusion: African women with a history of HFDP have an increased risk of cardiometabolic conditions within 6 years post-partum in an urban sub-Saharan African setting.

Effect of alpha-blocker use on morbidity and lower urinary tract symptoms in patients undergoing transrectal ultrasound-guided prostate biopsy

2021 ◽  
pp. 039156032110383
Author(s):  
Remzi Salar ◽  
Güven Erbay
Keyword(s):  
Prostate Biopsy ◽  
Voiding Dysfunction ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Urine Volume ◽  
Maximum Flow ◽  
Control Group ◽  
Alpha Blocker ◽  
Urinary Tract Symptoms ◽  
Significant Difference

Objective: To evaluate voiding dysfunction and morbidity after transrectal ultrasound (TRUS)-guided prostate biopsy and to investigate whether pre-intervention alpha-blocker treatment had any effect on morbidity and voiding dysfunction. Material and methods: The study included 197 consecutive patients who underwent TRUS-guided prostate biopsy between January 2014 and January 2018. The patients were divided into two groups, those receiving alpha-blocker (silodosin) and those not receiving alpha-blocker treatment before the procedure (controls). All patients were evaluated before and one week after the procedure with the International Prostate Symptom Score (IPSS), measurements of maximum flow rate ( Qmax), post-void residual urine volume (PVR) and prostate volume, and procedure-related complications were also recorded. All analyzed parameters were compared by within-group and between-group evaluations. Results: There was no significant difference between the two groups in terms of IPSS, Qmax and prostate volume values before biopsy. In the follow-up evaluation performed on the seventh day after biopsy, IPSS, PVR and prostate volume were found to be increased, whereas Qmax was decreased in the control group ( p < 0.05). In the silodosin group, an increase in prostate volume was observed, but there were no significant changes in IPSS, Qmax and PVR values. Acute urinary retention (AUR) after the biopsy procedure developed in two patients (2%) in the silodosin group, and in nine patients (9.1%) in the control group ( p = 0.02). No significant difference was found between the two groups in terms of biopsy-related complications, except for AUR. Conclusion: We believe that alpha-blocker treatment initiated before biopsy may be advantageous in preventing voiding dysfunction that may develop after the procedure.

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