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Purpose: Teachers are occupational voice users with significant vocal demand. This study examined if a vocal hygiene program could mitigate the effects of occupational vocal demand in primary school teachers across 1 month. Method: Sixty female teachers participated, with 30 in an experimental group receiving vocal hygiene education plus daily home practice for 1 month and 30 in a control group with no intervention. Their vocal changes across the month were quantified with (a) acoustic measures on fundamental frequency (f[subscript o]), vocal intensity, jitter and shimmer, harmonics-to-noise ratio, and smoothed cepstral peak prominence and (b) Voice Handicap Index (VHI-10) and Vocal Fatigue Index (VFI) scores. Results: Analysis of covariance showed significantly larger changes (significant decreases) in conversational f[subscript o] and in jitter for the experimental group relative to the control group. Post hoc pairwise comparisons following repeated-measures analysis of variance showed significant decreases in conversational f[subscript o] and in jitter across the month for the experimental group. No significant differences in VHI-10 and VFI scores were found between the groups. Conclusions: Vocal demand-related changes in acoustic measures could be partially mitigated with the vocal hygiene program. Future studies with a more refined intervention program and more long-term follow-up are recommended to better understand the long-term benefits of vocal hygiene programs on primary school teachers.

Purpose: This study attempted to develop and to preliminarily validate the Mandarin Chinese version of the Vocal Fatigue Index (VFI) as a standardized self-assessment questionnaire tool for potential clinical applications. Method: The experimental procedure involved (a) cross-cultural adaptation of the VFI into the Mandarin Chinese version (CVFI), (b) evaluation by an expert panel, (c) back translation, (d) pilot testing, and (e) validation of the questionnaire by three participant groups: 50 with voice disorders, 50 occupational voice users (at-risk group), and 50 with normal voice (control group). Internal consistency, test--retest reliability, content validity, and convergent validity of the CVFI were examined, and discriminatory ability (diagnostic accuracy) for distinguishing between the groups was evaluated. Results: Results showed high internal consistency (Cronbach's alpha [greater than or equal to] 0.8817 for the total CVFI scores for all groups), high test-retest reliability (intraclass correlation coefficients [greater than or equal to] 0.9072, p < 0.001 for the total CVFI scores for all groups), high content validity (total content validity index = 0.9368), and high convergent validity (Pearson r [greater than or equal to] 0.8155, p < 0.001 between the total CVFI scores and Factors 1 and 2 scores). Significant differences between the three groups were found in all scores. Receiver operating characteristic analysis revealed a high diagnostic accuracy for distinguishing between the disorders group and the normal group (area under the curve [greater than or equal to] 0.927, p < 0.001 for the total CVFI scores and Factors 1 and 2 scores), with cutoff scores of [greater than or equal to] 36 (total CVFI score), [greater than or equal to] 23.5 (Factor 1 score), [greater than or equal to] 7.5 (Factor 2 score), and [greater than or equal to] 6.5 (Factor 3 score). Conclusions: These findings suggested that the CVFI could be a reliable and valid self-assessment tool for the clinical evaluation of vocal fatigue in Mandarin Chinese-speaking populations. A full-scale validation study of the CVFI is recommended to verify these results.

Purpose: Auditory-perceptual evaluation is essential for the clinical assessment of voice disorders. Unstable perceptual voice evaluation has been shown for inexperienced listeners as compared to expert listeners. We examined the effects of perceptual training with external auditory anchors with and without immediate feedback on the evaluation of roughness and breathiness of natural, nonsynthesized speech stimuli (reading of a standard passage) in speech-language pathology students. Method: Perceptual voice evaluation and training with anchors using a visual analog scale was implemented with a computer software. Forty-eight speech-language pathology students were randomly assigned into three groups, feedback group (Group F), no feedback group (Group NF), and control group (Group C), attending one training session and four assessment sessions (before training, immediately after training, and 1 and 7 weeks after training). Group F received training with anchors with immediate feedback, Group NF received training without immediate feedback, and Group C received sham training (exposure session). Results: Training with anchors significantly increased the rating accuracy (agreement with expert ratings) on both roughness and breathiness for Group F, with the effects lasting for 7 weeks. No significant changes in rating accuracy with training were observed for Group NF and Group C. No improvements in intra- and interrater reliability as well as intrarater agreement were observed in all three groups, whereas interrater agreement on breathiness (but not roughness) significantly increased for all groups, with the effect lasting for 7 weeks only for Group F. Conclusions: These findings suggested that perceptual training with external auditory anchors and the use of immediate feedback could be effective for facilitating the development of perceptual voice evaluation skills in speech-language pathology students. Further studies involving more extensive training with stimuli covering a full range of dysphonia severity categories and improvements in design of the training protocol are recommended to verify these results.

Purpose: There is a lack of standardized Mandarin reading text material that could potentially elicit significant variations in fundamental frequency (F0) and in vocal intensity for clinical voice evaluation. In this study, a phonetically balanced "Three Bears Passage" was developed based on the classical "Goldilocks" story for this purpose. The hypothesis was that the vocal range (F0 range and Intensity range) elicited while reading aloud the passage could be similar to that of the voice range profile (VRP) obtained with sustained vowel production and significantly different from that while reading an existing standard Mandarin passage. Method: One hundred twenty young adults (60 men and 60 women, aged 25.22 ± 3.74 years) without vocal pathologies and vocal training participated in the study. Vocal range data, including F0-related measures and intensity-related measures, were obtained with Praat in order to construct VRPs for the sustained /a/ and to construct speech range profiles for passage reading. Results: F0 range and intensity range for the new passage were significantly larger than those for the existing Mandarin passage for both male and female participants. In particular, the F0 range for the passage was not significantly different from that of the VRP for male participants. Conclusions: These findings suggested that the new passage could allow individuals without vocal training to demonstrate a large vocal range in both F0 and vocal intensity, in a passage reading setting in a relatively short time. Further studies should be pursued with the passage to investigate the vocal range and vocal potential of individuals with voice disorders.

Purpose: Semi-occluded vocal tract (SOVT) exercises with tubes or straws have been widely used for a variety of voice disorders. Yet, the effects of longer periods of SOVT exercises (lasting for weeks) on the aging voice are not well understood. This study investigated the effects of a 6-week straw phonation in water (SPW) exercise program. Method: Thirty-seven elderly subjects with self-perceived voice problems were assigned into two groups: (a) SPW exercises with six weekly sessions and home practice (experimental group) and (b) vocal hygiene education (control group). Before and after intervention (2 weeks after the completion of the exercise program), acoustic analysis, auditory--perceptual evaluation, and self-assessment of vocal impairment were conducted. Results: Analysis of covariance revealed significant differences between the two groups in smoothed cepstral peak prominence measures, harmonics-to-noise ratio, the auditory--perceptual parameter of breathiness, and Voice Handicap Index-10 scores postintervention. No significant differences between the two groups were found for other measures. Conclusions: Our results supported the positive effects of SOVT exercises for the aging voice, with a 6-week SPW exercise program being a clinical option. Future studies should involve long-term follow-up and additional outcome measures to better understand the efficacy of SOVT exercises, particularly SPW exercises, for the aging voice.

The methodology to calculate the parasitic capacitances in differential symmetric inductors will be presented in this paper. Inspired by the proposed methodology, a method called selective metal parallel shunting (SMPS) can move [f.sub.Qmax] onto the desired frequency without additional processing steps. Based on the proposed methodology, a customized program is developed to predict [Q.sub.[max.sup.S]] and [f.sub.[Qmax.sup.S]] of on-chip inductors. Differential symmetric inductors and spiral ones with planar, all metal parallel shunting (AMPS), and SMPS configurations have been implemented in a 1P4M 0.35-[micro]m CMOS process to verify the proposed method. Moreover, three 2.3-2.4 GHz voltage-controlled oscillators (VCOs) using planar, AMPS, and SMPS inductors, have also been realized. The phase noise of the VCO using SMPS inductors can be improved by 9.3 and 6 dB at 100-kHz offset frequency, respectively, compared to the VCOs using planar and AMPS inductors. The proposed SMPS technique can not only be applicable to VCO but also other RF circuits. Index Terms--Distributed capacitance model, inducotr model, spiral inductors, stacked inductors, symmetric inductors, voltage controlled oscillator (VCO).

Objective: Previous theoretical analysis predicted that phonation threshold flow (PTF) could be a more sensitive aerodynamic measure than phonation threshold pressure (PTP) for reflecting glottal incompetence. This study investigated the feasibility of whether PTP and PTF may differentiate subjects with unilateral adductor vocal fold paralysis and paresis (UAVFP) from those without, and whether PTP and PTF could reflect the extent of incomplete glottal closure associated with UAVFP. Methods: PTP and PTF were quantified for 13 subjects with UAVFP and 21 control subjects with normal voice, and the normalized glottal gap area (NGGA) based on videostroboscopic image analysis was quantified for subjects with UAVFP. Results: Significant differences in both PTP and PTF were found between subjects with UAVFP and control subjects. Receiver operating characteristic analysis indicated a higher discriminatory ability of PTP for differentiating subjects with UAVFP from those without (area under the curve of 0.905 for PTP, 0.678 for PTF), yet a significant positive correlation was found between PTF and NGGA (Spearman's ρ = 0.571) but not between PTP and NGGA (ρ = −0.364). Conclusion: Results supported the feasibility of using PTP and PTF as potential diagnostic indicators for reflecting glottal closure in UAVFP, with PTP potentially more sensitive for differentiating subjects with and without incomplete glottal closure. These preliminary findings were limited by the small sample size, with further studies needed to verify whether PTF could be more sensitive for reflecting the extent of incomplete glottal closure, as predicted theoretically. Level of Evidence: 3 Laryngoscope, 131:E1598–E1604, 2021 [ABSTRACT FROM AUTHOR]

In this study, hetero-epitaxy of GaSe epilayers on a c-sapphire substrate achieved using molecular beam epitaxy was demonstrated. The GaSe epitaxial growth was monitored using in situ reflection high-energy electron diffraction (RHEED). Streak RHEED patterns showed a flat and highly crystalline situation. Furthermore, two RHEED patterns were observed after 15 min of growth, and they were correlated with the m-axis and a-axis of hexagonal GaSe. The single crystal of GaSe was verified using X-ray diffraction and high-resolution cross-section transmission electron microscopy. The full width at half-maximum of (0002) in the XRD rocking-curve spectrum of GaSe epilayer is obtain around 207 arcsec, which is the smallest value observed to date. The epitaxial growth of GaSe demonstrated the feasibility of growing large-area epilayers. [ABSTRACT FROM AUTHOR]