Nasalization Amplitude-Timing Characteristics of Speakers With and Without Cleft Palate

2017 ◽  
Vol 55 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Youkyung Bae
Keyword(s):  
Cleft Palate ◽  
Model Fit ◽  
Temporal Domain ◽  
Temporal Relationships ◽  
Practical Guidelines ◽  
Rate Controlled ◽  
The Mean ◽  
Nasal Consonant ◽  
Accuracy Rates ◽  
Nasal Resonance

Objectives: To examine the amplitude-temporal relationships of acoustic nasalization in speakers with a range of nasality and to determine the extent to which each domain independently predicts the speaker’s perceived oral-nasal balance. Design: Rate-controlled speech samples, consisting of /izinizi/, /azanaza/, and /uzunuzu/, were recorded from 18 participants (14 with repaired cleft palate and 4 without cleft palate) using the Nasometer. The mean nasalance of the entire mid-vowel–nasal consonant–vowel (mid-VNV) sequence (amplitude-domain) and the duration of the nasalized segment of the mid-VNV sequence (temporal-domain) were obtained based on nasalance contours. Results: Strong linear and vowel-dependent relationships were observed between the 2 domains of nasalization (adjusted R2 = 71.5%). Both the amplitude- and temporal-domain measures were found to reliably predict the speaker’s perceived oral-nasal balance, with better overall model fit and higher classification accuracy rates observed in /izinizi/ and /uzunuzu/ than in /azanaza/. Despite poor specificity, the temporal-domain measure of /azanaza/ was found to have a strong correlation with the participants’ Zoo passage nasalance scores ( rs = .897, p < .01), suggesting its potential utility as a severity indicator of perceived nasality. Conclusions: With the use of relatively simple speech tasks and measurements representing the amplitude and temporal domains of nasalization, the present study provided practical guidelines for using the Nasometer in assessing patients with oral-nasal resonance imbalance. Findings suggest that both domain measures of nasalization should be examined across different vowel contexts, given that each domain may provide clinically relevant, yet different, information.

scholarly journals Nonlinear Dynamic Analysis of Vowels in Cleft Palate Children with or without Hypernasality

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Katsuaki Mishima ◽  
Hiroyuki Nakano ◽  
Tatsushi Matsumura ◽  
Norifumi Moritani ◽  
Seiji Iida ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Nonlinear Dynamic ◽  
Nonlinear Dynamic Analysis ◽  
Correlation Coefficients ◽  
Voice Signal ◽  
The Mean ◽  
The Difference ◽  
The Relationship ◽  
The Voice ◽  
Nasal Resonance

Objectives. To clarify the difference between Lyapunov exponents (LEs) for cleft palate (CP) patients with hypernasality versus without hypernasality and to investigate the relationship between their LEs and nasalance scores (NSs).Material and Methods. Six CP patients with severe hypernasality (mean age 9.2 years) and six CP patients without hypernasality (mean age 8.0 years) were enrolled. Five Japanese vowels were recorded at 44.1 KHz, and the NSs were measured simultaneously. The mean first LE (mLE1) from all one-second intervals was computed.Results. The mLE1for /o/ in patients with hypernasality was significantly higher than that in patients without hypernasality. The correlation coefficients between the mLE1and NS for all vowels were not statistically different.Conclusion. The voice signal of /o/ for the patients with hypernasality was more instable than in those without hypernasality. The chaotic phenomenon was independent of nasal resonance in CP voice.

scholarly journals The updated Charlson comorbidity index is a useful predictor of mortality in patients with Staphylococcus aureus bacteraemia

2018 ◽  
Vol 146 (16) ◽  
pp. 2122-2130 ◽  
Author(s):  
H. G. Ternavasio-de la Vega ◽  
F. Castaño-Romero ◽  
S. Ragozzino ◽  
R. Sánchez González ◽  
M. P. Vaquero-Herrero ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Charlson Comorbidity Index ◽  
Regression Models ◽  
Model Fit ◽  
Logistic Regression Models ◽  
Relevant Variables ◽  
Comorbidity Index ◽  
The Mean ◽  
Related Mortality ◽  
Better Than

AbstractThe objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.

Validation of the Modified Rhinoplasty Assessment Scale (Photographic)

2021 ◽  
pp. 000348942110652
Author(s):  
Sinehan B. Bayrak ◽  
Joseph Penn ◽  
Jinxiang Hu ◽  
John David Kriet ◽  
Clinton D. Humphrey
Keyword(s):  
Study Design ◽  
Retrospective Cohort ◽  
Lateral View ◽  
Descriptive Statistics ◽  
Model Fit ◽  
Assessment Scale ◽  
Frontal View ◽  
Reliable Instrument ◽  
Facial Plastic ◽  
The Mean

Objective: To validate the modified Rhinoplasty Assessment Scale (Photographic) (mRASP). Study Design: Retrospective cohort study. Methods: Study design—Photographs for 100 rhinoplasty patients from 2 facial plastic surgeons were compiled. Photos included 6 views. Each facial plastic surgeon reviewed all views. Nasal appearance was evaluated using the mRASP. Statistical analysis—A validation study was conducted, including descriptive statistics, reliability, and construct validity. Mean and standard deviations were used to describe the scores. Results: Eighty female (mean RASP score = 14.89, SD = 7.04) and 20 male (mean RASP score = 19.83, SD = 10.09) patients were included. The mean of the total score on the instrument was 15.88 (SD = 7.98). Cronbach’s alpha was .81, and inter-rater reliability measured as a Pearson product-moment correlation was .74. The CFA model fit the frontal view (χ2 = 32.47 ( P = .04), CFI = .99, TLI = .99, RMSEA = .05, SRMR = .05), basal view (χ2 = 4.55 ( P = .33), CFI = .98, TLI = .96, RMSEA = .03, SRMR = .23), and lateral view (χ2 = 39.52 ( P = .40), CFI = 1.0, TLI = 1.0, RMSEA = .0, SRMR = .05) data well. Conclusion: The mRASP is a reliable instrument that can be used to assess nasal form via frontal, lateral, and basal photographs of patients. This provides facial plastic surgeons with a validated tool to evaluate rhinoplasty outcomes.

The Correlation between Nasalance and a Differentiated Perceptual Rating of Speech in Dutch Patients with Velopharyngeal Insufficiency

2002 ◽  
Vol 39 (3) ◽  
pp. 277-284 ◽  
Author(s):  
Kornelis H.D.M. Keuning ◽  
George H. Wieneke ◽  
Hans A. Van Wijngaarden ◽  
Philippe H. Dejonckere
Keyword(s):  
Cleft Palate ◽  
Correlation Coefficients ◽  
University Hospital ◽  
Velopharyngeal Insufficiency ◽  
Visual Analog Scales ◽  
Cleft Palate Speech ◽  
Normal Text ◽  
The Mean ◽  
Lower Correlation ◽  
Nasal Emission

Objective: The correlation between the nasalance score and the perceptual rating of several aspects of speech of speakers with velopharyngeal insufficiency (VPI) by six speech-language pathologists was evaluated. Procedure: The overall grade of severity, hypernasality, audible nasal emission, misarticulations, and intelligibility were rated on visual analog scales. Speech samples with a normal distribution of phonemes (normal text [NT]) and those free of nasal consonants (denasal text [DT]) of 43 patients with VPI were used. Mean nasalance scores were computed for the speech samples, and Spearman correlation coefficients were computed between the mean nasalance score and the five parameters of the differentiated rating. Setting: The Institute of Phoniatrics, Utrecht University Hospital, The Netherlands. Results: The correlation coefficient between the mean nasalance and the perceptual rating of hypernasality ranged among judges from .31 to .56 for NT speech samples and .36 to .60 for DT speech samples. Only small differences were found between speech pathologists with and without expertise in cleft palate speech. The rating of the overall grade of severity appeared to correlate quite well with the rating of the intelligibility (rNT = .77, rDT = .79). Lower correlation coefficients, ranging from .34 to .71, were found between overall grade of severity and hypernasality, audible nasal emission, and mis-articulations. Conclusions: A low correlation between the nasalance and the perceptual rating of hypernasality was found. The parameter overall grade of severity appeared to be determined mainly by the parameter intelligibility. Expertise in rating of cleft palate speech does not guarantee a high correlation between instrumental measurement and perceptual rating.

Nasalance Scores in Wearers of a Palatal Lift Prosthesis in Comparison with Normative Data for Japanese

2004 ◽  
Vol 41 (3) ◽  
pp. 315-319 ◽  
Author(s):  
Takashi Tachimura ◽  
Yasuko Kotani ◽  
Takeshi Wada
Keyword(s):  
Cleft Palate ◽  
Outcome Measures ◽  
Normative Data ◽  
Normal Limits ◽  
Velopharyngeal Incompetence ◽  
The Mean ◽  
Velopharyngeal Function ◽  
Normative Score ◽  
Nasal Emission ◽  
Normal Controls

Objective This study was designed to examine whether nasalance score is changed in association with placement of a palatal lift prosthesis (PLP) and whether normative data previously reported are applicable to evaluate the effect of a PLP on velopharyngeal function as it relates to nasality. Design Nasalance scores were obtained as subjects read the Kitsutsuki Passage three times with the PLP in place and then removed. Participants Forty-three children (mean age 9.0 years, SD = 3.6 years) with repaired cleft palate who were treated with a PLP were selected as subjects. Their speech was characterized by nasal emission of air, slight hypernasality without a PLP but within normal limits with a PLP in place, or both. Main Outcome Measures Comparisons were made between normative scores and the average mean nasalance score of subjects with and without the PLP. Results Average values of the mean nasalance score for subjects were 17.3% (SD 7.6%) with the PLP in place and 33.5% (SD 13.3%) without the PLP in place. These scores were greater than the mean score of 9.1% (SD 3.9%) obtained from normal controls previously reported. Conclusion A PLP can decrease nasalance scores for speakers with repaired cleft palate who exhibit velopharyngeal incompetence. It was suggested that the normative score obtained from normal adult speakers is not applicable to evaluate the effect of a PLP to improve velopharyngeal function for children wearing the PLP.

scholarly journals Frequency of homologous blood transfusion in patients undergoing cleft lip and palate surgery

2010 ◽  
Vol 43 (01) ◽  
pp. 054-059
Author(s):  
Wasiu L. Adeyemo ◽  
Mobolanle O. Ogunlewe ◽  
Ibironke Desalu ◽  
Akinola L. Ladeinde ◽  
Titilope A. Adeyemo ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Cleft Palate ◽  
Teaching Hospital ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Teaching ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
The Mean

ABSTRACT Aim: The study aims to determine the frequency of homologous blood transfusion in patientsundergoing cleft lip and palate surgery at the Lagos University Teaching Hospital, Nigeria. Setting and Design: A prospective study of transfusion rate in cleft surgery conducted at the Lagos University Teaching Hospital, Nigeria. Material and Methods: One hundred consecutive patients who required cleft lip and palate surgery were recruited into the study. Data collected included age, sex and weight of patients, type of cleft defects, type of surgery done, preoperative haematocrit, duration of surgery, amount of blood loss during surgery, the number of units of blood cross-matched and those used. Each patient was made to donate a unit of homologous blood prior to surgery. Results: There were 52 females and 48 males with a mean age of 64.4 ± 101.1 months (range, 3-420 months). The most common cleft defect was isolated cleft palate (45%) followed by unilateral cleft lip (28%). Cleft palate repair was the most common procedure (45%) followed by unilateral cleft lip repair (41%). The mean estimated blood loss was 95.8 ± 144.9 ml (range, 2-800ml). Ten (10%) patients (CL=2; CP=5, BCL=1; CLP=2) were transfused but only two of these were deemed appropriate based on percentage blood volume loss. The mean blood transfused was 131.5 ± 135.4ml (range, 35-500ml). Six (60%) of those transfused had a preoperative PCV of < 30%. Only 4.9% of patients who had unilateral cleft lip surgery were transfused as compared with 50% for CLP surgery, 11% for CP surgery, and 10% for bilateral cleft lip surgery. Conclusions: The frequency of blood transfusion in cleft lip and palate surgery was 10% with a cross-match: transfusion ratio of 10 and transfusion index of 0.1. A “type and screen” policy is advocated for cleft lip and palate surgery.

Change in Levator Veli Palatini Muscle Activity for Patients with Cleft Palate in Association with Placement of a Speech-Aid Prosthesis

2002 ◽  
Vol 39 (5) ◽  
pp. 503-508 ◽  
Author(s):  
Takashi Tachimura ◽  
Kanji Nohara ◽  
Yoshinori Fujita ◽  
Takeshi Wada
Keyword(s):  
Cleft Palate ◽  
Pressure Change ◽  
Mean Value ◽  
Emg Activity ◽  
Reserve Capacity ◽  
Activity Levels ◽  
Levator Veli Palatini ◽  
Velopharyngeal Incompetence ◽  
Velopharyngeal Closure ◽  
The Mean

Objective: The purpose of this study was to examine whether a speech-aid prosthesis normalizes the activity of the levator veli palatini muscle for patients with cleft palate who exhibit velopharyngeal incompetence. Design: Each subject was instructed to produce repetitions of /mu/, /u/, /pu/, /su/, and /tsu/ and to blow with maximum possible effort. Electromyographic (EMG) activity of the levator veli palatini muscle was recorded with and without a hybrid speech-aid prosthesis in place. Participants: The participants were five patients with repaired cleft palate who were routinely wearing a hybrid speech-aid prosthesis. Results: With the prosthesis in place, the mean value of levator activity changed positively in relation to oral air-pressure change during blowing. Differences in levator activity in relation to speech samples were similar to those in normal speakers. With the prosthesis in place, levator activity for speech tasks was less than 50% of the maximum levator activity for all subjects. The findings were similar to those reported previously for normal speakers. Conclusion: Placement of the prosthesis changed EMG activity levels of the levator veli palatini muscle to levels that are similar to normal speakers. It is possible that, with the increase in the differential levator activity between speech and a maximum force task, the velopharyngeal mechanism has a greater reserve capacity to maintain velopharyngeal closure compared with the noprosthesis condition.

Comparison of Obstructive Sleep Apnea Syndrome in Children with Cleft Palate following Furlow Palatoplasty or Pharyngeal Flap for Velopharyngeal Insufficiency

2004 ◽  
Vol 41 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Yu-Fang Liao ◽  
M. Samuel Noordhoff ◽  
Chiung-Shing Huang ◽  
Philip K. T. Chen ◽  
Ning-Hung Chen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Palate ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Velopharyngeal Insufficiency ◽  
Obstructive Sleep ◽  
The Mean ◽  
Pharyngeal Flap ◽  
Apnea Syndrome

Objective To evaluate the incidence and severity of obstructive sleep apnea syndrome (OSAS) in patients with cleft palate having a Furlow palatoplasty or pharyngeal flap for correction of velopharyngeal insufficiency (VPI). Patients A total of 48 nonsyndromic children with repaired cleft palate with VPI were enrolled in the study. Twenty of the children had a Furlow palatoplasty (F group) and 28 children had a pharyngeal flap (P group) for correction of VPI. Interventions An overnight polysomnography evaluation was done to evaluate the incidence and severity of OSAS 6 months or more postoperatively. Main Outcome Measures Symptoms of OSAS, respiratory disturbance index (RDI), oxyhemoglobin desaturation index (DI), and sleep stages were measured. Results In the P group, the mean percentage of stage 2 sleep was lower than the F group (p < .05). The mean RDI and DI were larger in the P group, compared with the F group (p < .001). The incidence and severity of OSAS were higher in the P group, compared with the F group (p < .001 and p = 0.05, respectively). Conclusions A Furlow palatoplasty should be used in deference to a pharyngeal flap whenever possible on the basis of the preoperative evaluation of VPI because of the decreased incidence and severity of OSAS.

Application of Program Evaluation and Review Technique (PERT) within a Curriculum Development Project

1986 ◽  
Vol 8 (1) ◽  
pp. 47-58
Author(s):  
Carol Foster ◽  
James R. Lent
Keyword(s):  
Program Evaluation ◽  
Product Development ◽  
Development Project ◽  
Educational Systems ◽  
Staff Members ◽  
Accountability System ◽  
Temporal Relationships ◽  
The Mean ◽  
Long Range Planning ◽  
Time Required

There is a need for accurate procedures for monitoring both process and productivity in educational systems. An accountability system was developed as part of a federal project to develop curriculum materials for individuals who have mental retardation (Project MORE). The accountability system was designed to monitor the development and completion of 46 products and to produce cost estimates. A 34-step process lattice was constructed to describe the procedures used in product development and then a PERT (Program Evaluation and Review Technique) chart was designed to show the temporal relationships among the 34 steps. Data were collected on how long each step in the lattice required for completion. These data were then used to predict the product development that was feasible over the next three years. It was predicted that each product would require 490 days. These data were then used to make yearly projections. After one year's data were collected these projections were compared to actual productivity. While there was a fair amount of variability across these steps, and the project has undergone extensive changes in both personnel and physical location, the mean actual time required was within one month of the original estimates. The use of the PERT has proven useful for doing long-range planning, for supervising the activity of a federal project; and for training new staff members in a fairly complex set of procedures.

Ecotourism Destination Assessment using Tourist Potential Index in Zhemgang Dzongkhag, Bhutan

2020 ◽  
Vol 7 (2) ◽  
pp. 1-11
Author(s):  
Jigme Dorji ◽  
Dhan Gurung ◽  
Om Katel
Keyword(s):  
Resource Availability ◽  
Forest Cover ◽  
Scenic Beauty ◽  
The Past ◽  
Potential Index ◽  
Local Standard ◽  
Practical Guidelines ◽  
Tourism Resources ◽  
The Mean ◽  
International Visitors

Zhemgang is increasingly becoming a preferred destination for nature-based tourism with the increasing number of international visitors from 165 to 346 between 2013 and 2019. The attractions that contribute to the increasing number of visitors are 225,361.47 ha (94.17%) of area under forest cover, rich biodiversity, unexplored scenic beauty and unique Kheng culture. In the past years, five local standard hotels, five ecolodges and two homestays have added bed nights of international visitors from 420 in 2013 to 931 in 2018. This study was conducted to assessed 10 potential ecotourism destinations in Zhemgang on the basis of resource availability and preferential appeal by promoters for tourism resources using Tourist Potential Index (TPI). The TPI was found ranging between 17 and 31.75.The mean rank of the destinations varies between 1.47 and 9.47 and there is significance difference in resources appealed by the tour operators on resources availability in the destinations considered for this study; (χ2(2) = 229.07, p = 0.00). The TPI may be useful indicator in developing practical guidelines for tourism resources development in the region.

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