Morphological and acoustic modeling of the vocal tract.

In speech production, the anatomical morphology forms the substrate on which the speakers build their articulatory strategy to reach specific articulatory-acoustic goals. The aim of this study is to characterize morphological inter-speaker variability by building a shape model of the full vocal tract including hard and soft structures. Static magnetic resonance imaging data from 41 speakers articulating altogether 1947 phonemes were considered, and the midsagittal articulator contours were manually outlined. A phoneme-independent average-articulation representative of morphology was calculated as the speaker mean articulation. A principal component analysis-driven shape model was derived from average-articulations, leading to five morphological components, which explained 87% of the variance. Almost three-quarters of the variance was related to independent variations of the horizontal oral and vertical pharyngeal lengths, the latter capturing male-female differences. The three additional components captured shape variations related to head tilt and palate shape. Plane wave propagation acoustic simulations were run to characterize morphological components. A lengthening of 1 cm of the vocal tract in the vertical or horizontal directions led to a decrease in formant values of 7%-8%. Further analyses are required to analyze three-dimensional variability and to understand the morphological-acoustic relationships per phoneme. Average-articulations and model code are publicly available (https://github.com/tonioser/VTMorphologicalModel).

Past and Trends in Cough Sound Acquisition, Automatic Detection and Automatic Classification: A Comparative Review.

Cough is a very common symptom and the most frequent reason for seeking medical advice. Optimized care goes inevitably through an adapted recording of this symptom and automatic processing. This study provides an updated exhaustive quantitative review of the field of cough sound acquisition, automatic detection in longer audio sequences and automatic classification of the nature or disease. Related studies were analyzed and metrics extracted and processed to create a quantitative characterization of the state-of-the-art and trends. A list of objective criteria was established to select a subset of the most complete detection studies in the perspective of deployment in clinical practice. One hundred and forty-four studies were short-listed, and a picture of the state-of-the-art technology is drawn. The trend shows an increasing number of classification studies, an increase of the dataset size, in part from crowdsourcing, a rapid increase of COVID-19 studies, the prevalence of smartphones and wearable sensors for the acquisition, and a rapid expansion of deep learning. Finally, a subset of 12 detection studies is identified as the most complete ones. An unequaled quantitative overview is presented. The field shows a remarkable dynamic, boosted by the research on COVID-19 diagnosis, and a perfect adaptation to mobile health.

The Cross-Modal Effects of Sensory Deprivation on Spatial and Temporal Processes in Vision and Audition: A Systematic Review on Behavioral and Neuroimaging Research since 2000.

One of the most significant effects of neural plasticity manifests in the case of sensory deprivation when cortical areas that were originally specialized for the functions of the deprived sense take over the processing of another modality. Vision and audition represent two important senses needed to navigate through space and time. Therefore, the current systematic review discusses the cross-modal behavioral and neural consequences of deafness and blindness by focusing on spatial and temporal processing abilities, respectively. In addition, movement processing is evaluated as compiling both spatial and temporal information. We examine whether the sense that is not primarily affected changes in its own properties or in the properties of the deprived modality (i.e., temporal processing as the main specialization of audition and spatial processing as the main specialization of vision). References to the metamodal organization, supramodal functioning, and the revised neural recycling theory are made to address global brain organization and plasticity principles. Generally, according to the reviewed studies, behavioral performance is enhanced in those aspects for which both the deprived and the overtaking senses provide adequate processing resources. Furthermore, the behavioral enhancements observed in the overtaking sense (i.e., vision in the case of deafness and audition in the case of blindness) are clearly limited by the processing resources of the overtaking modality. Thus, the brain regions that were previously recruited during the behavioral performance of the deprived sense now support a similar behavioral performance for the overtaking sense. This finding suggests a more input-unspecific and processing principle-based organization of the brain. Finally, we highlight the importance of controlling for and stating factors that might impact neural plasticity and the need for further research into visual temporal processing in deaf subjects.

Characterization of inter-speaker articulatory variability: A two-level multi-speaker modelling approach based on MRI data.

Speech communication relies on articulatory and acoustic codes shared between speakers and listeners despite inter-individual differences in morphology and idiosyncratic articulatory strategies. This study addresses the long-standing problem of characterizing and modelling speaker-independent articulatory strategies and inter-speaker articulatory variability. It explores a multi-speaker modelling approach based on two levels: statistically-based linear articulatory models, which capture the speaker-specific articulatory variability on the one hand, are in turn controlled by a speaker model, which captures the inter-speaker variability on the other hand. A low dimensionality speaker model is obtained by taking advantage of the inter-speaker correlations between morphology and strategy. To validate this approach, contours of the vocal tract articulators were manually segmented on midsagittal MRI data recorded from 11 French speakers uttering 62 vowels and consonants. Using these contours, multi-speaker models with 14 articulatory components and two morphology and strategy components led to overall variance explanations of 66%-69% and root-mean-square errors of 0.36-0.38 cm obtained in leave-one-out procedure over the speakers. Results suggest that inter-speaker variability is more related to the morphology than to the idiosyncratic strategies and illustrate the adaptation of the articulatory components to the morphology.

Gender incongruence and the brain - Behavioral and neural correlates of voice gender perception in transgender people.

The phenomenon of gender incongruence is hypothesized to arise from a discrepant sexual development of the brain and the genitals, contingent on genetic and hormonal mechanisms. We aimed at visualizing transgender identity on a neurobiological level, assuming a higher functional similarity to individuals of the aspired rather than assigned sex. Implementing a gender perception paradigm featuring male and female voice stimuli, behavioral and functional imaging data of transmen were compared to men and women, and to transwomen, respectively. Men had decreased activation in response to voices of the other sex in regions across the frontoparietal and insular cortex, while the activation patterns of women and transmen were characterized by little or no differentiation between male and female voices. Further, transmen had a comparatively high discrimination performance for ambiguous male voices, possibly reflecting a high sensitivity for voices of the aspired sex. Comparing transmen and transwomen yielded only few differences in the processing of male compared to female voices. In the insula, we observed a pattern similar to that of men and women, the neural responses of the transgender group being in accordance with their gender identity rather than assigned sex. Notwithstanding the similarities found dependent on biological sex, the findings support the hypothesis of gender incongruence being a condition in which neural processing modes are partly incongruent with one's assigned sex.

The contribution of phonation type to the perception of vocal emotions in German: an articulatory synthesis study.

Vocal emotions are signaled by specific patterns of prosodic parameters, most notably pitch, phone duration, intensity, and phonation type. Phonation type was so far the least accessible parameter in emotion research, because it was difficult to extract from speech signals and difficult to manipulate in natural or synthetic speech. The present study built on recent advances in articulatory speech synthesis to exclusively control phonation type in re-synthesized German sentences spoken with seven different emotions. The goal was to find out to what extent the sole change of phonation type affects the perception of these emotions. Therefore, portrayed emotional utterances were re-synthesized with their original phonation type, as well as with each purely breathy, modal, and pressed phonation, and then rated by listeners with respect to the perceived emotions. Highly significant effects of phonation type on the recognition rates of the original emotions were found, except for disgust. While fear, anger, and the neutral emotion require specific phonation types for correct perception, sadness, happiness, boredom, and disgust primarily rely on other prosodic parameters. These results can help to improve the expression of emotions in synthesized speech and facilitate the robust automatic recognition of vocal emotions.

Sex matters: Neural correlates of voice gender perception.

The basis for different neural activations in response to male and female voices as well as the question, whether men and women perceive male and female voices differently, has not been thoroughly investigated. Therefore, the aim of the present study was to examine the behavioral and neural correlates of gender-related voice perception in healthy male and female volunteers. fMRI data were collected while 39 participants (19 female) were asked to indicate the gender of 240 voice stimuli. These stimuli included recordings of 3-syllable nouns as well as the same recordings pitch-shifted in 2, 4 and 6 semitone steps in the direction of the other gender. Data analysis revealed a) equal voice discrimination sensitivity in men and women but better performance in the categorization of opposite-sex stimuli at least in men, b) increased responses to increasing gender ambiguity in the mid cingulate cortex and bilateral inferior frontal gyri, and c) stronger activation in a fronto-temporal neural network in response to voices of the opposite sex. Our results indicate a gender specific processing for male and female voices on a behavioral and neuronal level. We suggest that our results reflect higher sensitivity probably due to the evolutionary relevance of voice perception in mate selection.

Digital Health and Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Survey Study for Designing a Digital Learning Toolbox App.

BACKGROUND: The digital age has introduced opportunities and challenges for clinical education and practice caused by infinite incoming information and novel technologies for health. In the interdisciplinary field of communication sciences and disorders (CSD), engagement with digital topics has emerged slower than in other health fields, and effective strategies for accessing, managing, and focusing on digital resources are greatly needed. OBJECTIVE: We aimed to conceptualize and investigate preferences of stakeholders regarding a digital learning toolbox, an app containing a library of current resources for CSD. This cross-sectional survey study conducted in German-speaking countries investigated professional and student perceptions and preferences regarding such an app's features, functions, content, and associated concerns. METHODS: An open web-based survey was disseminated to professionals and students in the field of CSD, including speech-language pathologists (SLPs; German: Logopäd*innen), speech-language pathology students, phoniatricians, otolaryngologists, and medical students. Insights into preferences and perceptions across professions, generations, and years of experience regarding a proposed app were investigated. RESULTS: Of the 164 participants, an overwhelming majority (n=162, 98.8%) indicated readiness to use such an app, and most participants (n=159, 96.9%) perceived the proposed app to be helpful. Participants positively rated app functions that would increase utility (eg, tutorial, quality rating function, filters based on content or topic, and digital format); however, they had varied opinions regarding an app community feature. Regarding app settings, most participants rated the option to share digital resources through social media links (144/164, 87.8%), receive and manage push notifications (130/164, 79.3%), and report technical issues (160/164, 97.6%) positively. However, significant variance was noted across professions (H3=8.006; P=.046) and generations (H3=9.309; P=.03) regarding a username-password function, with SLPs indicating greater perceived usefulness in comparison to speech-language pathology students (P=.045), as was demonstrated by Generation X versus Generation Z (P=.04). Participants perceived a range of clinical topics to be important; however, significant variance was observed across professions, between physicians and SLPs regarding the topic of diagnostics (H3=9.098; P=.03) and therapy (H3=21.236; P<.001). Concerns included technical challenges, data protection, quality of the included resources, and sustainability of the proposed app. CONCLUSIONS: This investigation demonstrated that professionals and students show initial readiness to engage in the co-design and use of an interdisciplinary digital learning toolbox app. Specifically, this app could support effective access, sharing, evaluation, and knowledge management in a digital age of rapid change. Formalized digital skills education in the field of CSD is just a part of the solution. It will be crucial to explore flexible, adaptive strategies collaboratively for managing digital resources and tools to optimize targeted selection and use of relevant, high-quality evidence in a world of bewildering data.

Digital Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Interdisciplinary and Exploratory Analysis of Content, Organizing Structures, and Formats.

BACKGROUND: The digital revolution is rapidly transforming health care and clinical teaching and learning. Relative to other medical fields, the interdisciplinary fields of speech-language pathology (SLP), phoniatrics, and otolaryngology have been slower to take up digital tools for therapeutic, teaching, and learning purposes-a process that was recently expedited by the COVID-19 pandemic. Although many current teaching and learning tools have restricted or institution-only access, there are many openly accessible tools that have gone largely unexplored. To find, use, and evaluate such resources, it is important to be familiar with the structures, concepts, and formats of existing digital tools. OBJECTIVE: This descriptive study aims to investigate digital learning tools and resources in SLP, phoniatrics, and otolaryngology. Differences in content, learning goals, and digital formats between academic-level learners and clinical-professional learners are explored. METHODS: A systematic search of generic and academic search engines (eg, Google and PubMed); the App Store; Google Play Store; and websites of established SLP, phoniatrics, and otolaryngology organizations was conducted. By using specific search terms and detailed inclusion and exclusion criteria, relevant digital resources were identified. These were organized and analyzed according to learner groups, content matter, learning goals and architectures, and digital formats. RESULTS: Within- and between-learner group differences among 125 identified tools were investigated. In terms of content, the largest proportion of tools for academic-level learners pertained to anatomy and physiology (60/214, 28%), and that for clinical-professional learners pertained to diagnostic evaluation (47/185, 25.4%). Between groups, the largest differences were observed for anatomy and physiology (academic-level learners: 60/86, 70%; clinical-professional learners: 26/86, 30%) and professional issues (8/28, 29% vs 20/28, 71%). With regard to learning goals, most tools for academic-level learners targeted the performance of procedural skills (50/98, 51%), and those for clinical-professional learners targeted receptive information acquisition (44/62, 71%). Academic-level learners had more tools for supporting higher-level learning goals than clinical-professional learners, specifically tools for performing procedural skills (50/66, 76% vs 16/66, 24%) and strategic skills (8/10, 80% vs 2/10, 20%). Visual formats (eg, pictures or diagrams) were dominant across both learner groups. The greatest between-group differences were observed for interactive formats (45/66, 68% vs 21/66, 32%). CONCLUSIONS: This investigation provides initial insights into openly accessible tools across SLP, phoniatrics, and otolaryngology and their organizing structures. Digital tools in these fields addressed diverse content, although the tools for academic-level learners were greater in number, targeted higher-level learning goals, and had more interactive formats than those for clinical-professional learners. The crucial next steps include investigating the actual use of such tools in practice and students' and professionals' attitudes to better improve upon such tools and incorporate them into current and future learning milieus.

Digital Health and Digital Learning Experiences Across Speech-Language Pathology, Phoniatrics, and Otolaryngology: Interdisciplinary Survey Study.

BACKGROUND: Advances in digital health and digital learning are transforming the lives of patients, health care providers, and health professional students. In the interdisciplinary field of communication sciences and disorders (CSD), digital uptake and incorporation of digital topics and technologies into clinical training programs has lagged behind other medical fields. There is a need to understand professional and student experiences, opinions, and needs regarding digital health and learning topics so that effective strategies for implementation can be optimized. OBJECTIVE: This cross-sectional survey study aims to interdisciplinarily investigate professional and student knowledge, use, attitudes, and preferences toward digital health and learning in the German-speaking population. METHODS: An open-ended, web-based survey was developed and conducted with professionals and students in CSD including phoniatricians and otolaryngologists, speech-language pathologists (German: Logopäd*innen), medical students, and speech-language pathology students. Differences in knowledge, use, attitudes, and preferences across profession, generation, and years of experience were analyzed. RESULTS: A total of 170 participants completed the survey. Respondents demonstrated greater familiarity with digital learning as opposed to eHealth concepts. Significant differences were noted across profession (P<.001), generation (P=.001), and years of experience (P<.001), which demonstrated that students and younger participants were less familiar with digital health terminology. Professional (P<.001) and generational differences were also found (P=.04) in knowledge of digital therapy tools, though no significant differences were found for digital learning tools. Participants primarily used computers, tablets, and mobile phones; non-eHealth-specific tools (eg, word processing and videoconferencing applications); and digital formats such as videos, web courses, and apps. Many indicated a desire for more interactive platforms, such as virtual reality. Significant differences were found across generations for positive views toward digitalization (P<.001) and across profession for feelings of preparedness (P=.04). Interestingly, across profession (P=.03), generation (P=.006), and years of experience (P=.01), students and younger participants demonstrated greater support for medical certification. Commonly reported areas of concern included technical difficulties, quality and validity of digital materials, data privacy, and social presence. Respondents tended to prefer blended learning, a limited to moderate level of interactivity, and time and space-flexible learning environments (63/170, 37.1%), with a notable proportion still preferring traditional time and space-dependent learning (49/170, 28.8%). CONCLUSIONS: This comprehensive investigation into the current state of CSD student and professional opinions and experiences has shown that incorporation of digital topics and skills into academic and professional development curricula will be crucial for ensuring that the field is prepared for the ever-digitalizing health care environment. Deeper empirical investigation into efficacy and acceptance of digital learning and practice strategies and systematic training and practical organizational supports must be planned to ensure adaptive education and practice.

Automatic vocal tract landmark localization from midsagittal MRI data.

The various speech sounds of a language are obtained by varying the shape and position of the articulators surrounding the vocal tract. Analyzing their variations is crucial for understanding speech production, diagnosing speech disorders and planning therapy. Identifying key anatomical landmarks of these structures on medical images is a pre-requisite for any quantitative analysis and the rising amount of data generated in the field calls for an automatic solution. The challenge lies in the high inter- and intra-speaker variability, the mutual interaction between the articulators and the moderate quality of the images. This study addresses this issue for the first time and tackles it by means of Deep Learning. It proposes a dedicated network architecture named Flat-net and its performance are evaluated and compared with eleven state-of-the-art methods from the literature. The dataset contains midsagittal anatomical Magnetic Resonance Images for 9 speakers sustaining 62 articulations with 21 annotated anatomical landmarks per image. Results show that the Flat-net approach outperforms the former methods, leading to an overall Root Mean Square Error of 3.6 pixels/0.36 cm obtained in a leave-one-out procedure over the speakers. The implementation codes are also shared publicly on GitHub.

Auditory and Visual Response Inhibition in Children with Bilateral Hearing Aids and Children with ADHD.

Children fitted with hearing aids (HAs) and children with attention deficit/hyperactivity disorder (ADHD) often have marked difficulties concentrating in noisy environments. However, little is known about the underlying neural mechanism of auditory and visual attention deficits in a direct comparison of both groups. The current functional near-infrared spectroscopy (fNIRS) study was the first to investigate the behavioral performance and neural activation during an auditory and a visual go/nogo paradigm in children fitted with bilateral HAs, children with ADHD and typically developing children (TDC). All children reacted faster, but less accurately, to visual than auditory stimuli, indicating a sensory-specific response inhibition efficiency. Independent of modality, children with ADHD and children with HAs reacted faster and tended to show more false alarms than TDC. On a neural level, however, children with ADHD showed supra-modal neural alterations, particularly in frontal regions. On the contrary, children with HAs exhibited modality-dependent alterations in the right temporopolar cortex. Higher activation was observed in the auditory than in the visual condition. Thus, while children with ADHD and children with HAs showed similar behavioral alterations, different neural mechanisms might underlie these behavioral changes. Future studies are warranted to confirm the current findings with larger samples. To this end, fNIRS provided a promising tool to differentiate the neural mechanisms underlying response inhibition deficits between groups and modalities.

fNIRS Assessment of Speech Comprehension in Children with Normal Hearing and Children with Hearing Aids in Virtual Acoustic Environments: Pilot Data and Practical Recommendations.

The integration of virtual acoustic environments (VAEs) with functional near-infrared spectroscopy (fNIRS) offers novel avenues to investigate behavioral and neural processes of speech-in-noise (SIN) comprehension in complex auditory scenes. Particularly in children with hearing aids (HAs), the combined application might offer new insights into the neural mechanism of SIN perception in simulated real-life acoustic scenarios. Here, we present first pilot data from six children with normal hearing (NH) and three children with bilateral HAs to explore the potential applicability of this novel approach. Children with NH received a speech recognition benefit from low room reverberation and target-distractors' spatial separation, particularly when the pitch of the target and the distractors was similar. On the neural level, the left inferior frontal gyrus appeared to support SIN comprehension during effortful listening. Children with HAs showed decreased SIN perception across conditions. The VAE-fNIRS approach is critically compared to traditional SIN assessments. Although the current study shows that feasibility still needs to be improved, the combined application potentially offers a promising tool to investigate novel research questions in simulated real-life listening. Future modified VAE-fNIRS applications are warranted to replicate the current findings and to validate its application in research and clinical settings.

Voice Function in Gender-Diverse People Assigned Female at Birth: Results From a Participant-Centered Mixed-Methods Study and Implications for Clinical Practice.

Purpose The purpose of this study was to investigate whether there were indications of restrictions to voice function in our group of gender-diverse people assigned female at birth (GD peopleAFAB) and whether the participants would benefit from professional voice support. Method We conducted a descriptive, cross-sectional, mixed-methods study combining qualitative content analyses of semistructured interviews, phoniatric examinations, and acoustical voice analyses. Fourteen German-speaking GD peopleAFAB participated. The data were examined for indications of restrictions to voice function according to the results of participant self-evaluation, auditory-perceptual analyses, laryngostroboscopic examinations, and acoustical measurements. Results All participants presented with indications of restrictions to voice function, with vocal power, voice quality, singing voice, laryngeal function, pitch range/variability, and vocal control having found to be most frequently affected (in over 60% of participants). Sixty-four percent of participants expressed an interest in professional voice support, with clinicians and researchers recommending professional voice support for 67% and 71%, respectively. Conclusions GD peopleAFAB may experience restrictions to a range of domains of voice function and request or be recommended to participate in professional voice support. Research into this area needs to be intensified so that a more in-depth understanding of the potential voice problems GD peopleAFAB might experience can be produced and members of this group can be provided with more comprehensive, evidence-based, and high-quality professional support if and when they need it.

Do Transmasculine Speakers Present With Gender-Related Voice Problems? Insights From a Participant-Centered Mixed-Methods Study.

Purpose: The purpose of this study was to investigate whether there are indications of gender-related voice problems in our transmasculine participants and to analyze how discrepancies between participant self-evaluations and researcher-led examinations can be best negotiated to ensure a participant-centered interpretation. Method: We conducted a participant-centered mixed-methods study combining qualitative content analyses of semistructured interviews, acoustical voice analyses, and an examination of gender attributions to voice. Fourteen German-speaking transmasculine people, 14 cisfemale control persons, and 7 cismale control persons participated. The data were examined for indications of gender-related voice problems pertaining to vocal gender presentation and gender attribution to voice received from others. Results: Eleven participants (79%) presented with indications of gender-related voice problems. Problems included dissatisfaction with gender-related voice features, difficulties with control of vocal gender presentation, and mismatch between desired gender attribution and gender attributions received from others. Discrepancies between participant self-evaluations and researcher-led examinations were observed in a number of cases. Conclusion: Transmasculine speakers may experience a range of gender-related voice problems. Research and clinical practice with transmasculine people need to be adapted to better match the diversity of the population and the complexity of the processes that shape the production of speaker vocal gender in interaction.

A non-language-specific speech test to evaluate the speech of cleft patients from different language and cultural backgrounds - A pilot study.

Cleft speech tests are not universally available. We developed a tool to fill this gap, especially in the context of a cleft mission setting. We performed a pilot study to evaluate the test's ability to differentiate between the speech of cleft patients and healthy individuals from three different language backgrounds. We used 78 made-up, nonsensical syllables to evaluate hypernasality, nasal emissions, and consonant errors. Cleft (n = 41) and non-cleft (n = 39) individuals from three countries were included in this study. Two speech and language pathologists, blinded to the examination, rated the audio recording independently. Patients from Germany (n = 12; mean age 15.2), Iran (n = 14; mean age 7), and India (n = 15; mean age 14.7 years) were evaluated. We observed a significant difference in each category (p < 0.05) between patients and control subjects of the same language and cultural background. Hypernasality was affected the most. The test proved to possess the correct phonetic characteristics to reveal and provoke relevant cleft speech pathologies independent of cultural and language backgrounds. The test sounds posed no articulatory difficulties to non-cleft individuals, with some exceptions regarding non-specific consonant errors. A comparison with other existing tests will further illuminate its value as a speech test.

Transmasculine People's Voice Function: A Review of the Currently Available Evidence.

OBJECTIVES: This study aims to evaluate the currently available discursive and empirical data relating to those aspects of transmasculine people's vocal situations that are not primarily gender-related, to identify restrictions to voice function that have been observed in this population, and to make suggestions for future voice research and clinical practice. METHODS: We conducted a comprehensive review of the voice literature. Publications were identified by searching six electronic databases and bibliographies of relevant articles. Twenty-two publications met inclusion criteria. Discourses and empirical data were analyzed for factors and practices that impact on voice function and for indications of voice function-related problems in transmasculine people. The quality of the evidence was appraised. RESULTS: The extent and quality of studies investigating transmasculine people's voice function was found to be limited. There was mixed evidence to suggest that transmasculine people might experience restrictions to a range of domains of voice function, including vocal power, vocal control/stability, glottal function, pitch range/variability, vocal endurance, and voice quality. CONCLUSIONS: More research into the different factors and practices affecting transmasculine people's voice function that takes account of a range of parameters of voice function and considers participants' self-evaluations is needed to establish how functional voice production can be best supported in this population.

Do long-term tongue piercings affect speech quality?

PURPOSE: To explore possible effects of tongue piercing on perceived speech quality. METHODS: Using a quasi-experimental design, we analyzed the effect of tongue piercing on speech in a perception experiment. Samples of spontaneous speech and read speech were recorded from 20 long-term pierced and 20 non-pierced individuals (10 males, 10 females each). The individuals having a tongue piercing were recorded with attached and removed piercing. The audio samples were blindly rated by 26 female and 20 male laypersons and by 5 female speech-language pathologists with regard to perceived speech quality along 5 dimensions: speech clarity, speech rate, prosody, rhythm and fluency. RESULTS: We found no statistically significant differences for any of the speech quality dimensions between the pierced and non-pierced individuals, neither for the read nor for the spontaneous speech. In addition, neither length nor position of piercing had a significant effect on speech quality. The removal of tongue piercings had no effects on speech performance either. Rating differences between laypersons and speech-language pathologists were not dependent on the presence of a tongue piercing. CONCLUSIONS: People are able to perfectly adapt their articulation to long-term tongue piercings such that their speech quality is not perceptually affected.

Male-to-female gender dysphoria: Gender-specific differences in resting-state networks.

INTRODUCTION: Recent research found gender-related differences in resting-state functional connectivity (rs-FC) measured by functional magnetic resonance imaging (fMRI). To the best of our knowledge, there are no studies examining the differences in rs-FC between men, women, and individuals who report a discrepancy between their anatomical sex and their gender identity, i.e. gender dysphoria (GD). METHODS: To address this important issue, we present the first fMRI study systematically investigating the differences in typical resting-state networks (RSNs) and hormonal treatment effects in 26 male-to-female GD individuals (MtFs) compared with 19 men and 20 women. RESULTS: Differences between male and female control groups were found only in the auditory RSN, whereas differences between both control groups and MtFs were found in the auditory and fronto-parietal RSNs, including both primary sensory areas (e.g. calcarine gyrus) and higher order cognitive areas such as the middle and posterior cingulate and dorsomedial prefrontal cortex. Overall, differences in MtFs compared with men and women were more pronounced before cross-sex hormonal treatment. Interestingly, rs-FC between MtFs and women did not differ significantly after treatment. When comparing hormonally untreated and treated MtFs, we found differences in connectivity of the calcarine gyrus and thalamus in the context of the auditory network, as well as the inferior frontal gyrus in context of the fronto-parietal network. CONCLUSION: Our results provide first evidence that MtFs exhibit patterns of rs-FC which are different from both their assigned and their aspired gender, indicating an intermediate position between the two sexes. We suggest that the present study constitutes a starting point for future research designed to clarify whether the brains of individuals with GD are more similar to their assigned or their aspired gender.

A method for measurement of the vocal tract impedance at the mouth.

In this contribution a method is presented for the measurement of vocal tract resonances. The technique uses a non-invasive acoustic excitation of the vocal tract and a fast and robust detection. The method is an alternative to the linear predictive coding (LPC) analysis for patients with voice and speech disorders. Sweep signals are emitted and recorded simultaneously from the small end of a tube placed in front of the mouth opening. The use of a pressure sensor and a velocity sensor provides a direct measurement of the vocal tract impedance at the mouth (VTMI). For selected sustained German vowels, and some consonants, a comparison of results from LPC analysis and VTMI measurements is given. The results indicate a good agreement in the frequency range from 500 to 5,000 Hz. The feasibility of the VTMI method for diagnostic and therapeutic applications is subject to current research.