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Formants (vocal tract resonances) are increasingly analyzed not only by phoneticians in speech but also by behavioral scientists studying diverse phenomena such as acoustic size exaggeration and articulatory abilities of non-human animals. This often involves estimating vocal tract length acoustically and producing scale-invariant representations of formant patterns. We present a theoretical framework and practical tools for carrying out this work, including open-source software solutions included in R packages soundgen and phonTools. Automatic formant measurement with linear predictive coding is error-prone, but formant_app provides an integrated environment for formant annotation and correction with visual and auditory feedback. Once measured, formants can be normalized using a single recording (intrinsic methods) or multiple recordings from the same individual (extrinsic methods). Intrinsic speaker normalization can be as simple as taking formant ratios and calculating the geometric mean as a measure of overall scale. The regression method implemented in the function estimateVTL calculates the apparent vocal tract length assuming a single-tube model, while its residuals provide a scale-invariant vowel space based on how far each formant deviates from equal spacing (the schwa function). Extrinsic speaker normalization provides more accurate estimates of speaker- and vowel-specific scale factors by pooling information across recordings with simple averaging or mixed models, which we illustrate with example datasets and R code. The take-home messages are to record several calls or vowels per individual, measure at least three or four formants, check formant measurements manually, treat uncertain values as missing, and use the statistical tools best suited to each modeling context.
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Software , Humanos , Fonética , Fala/fisiologia , Acústica da Fala , Prega Vocal/fisiologia , AcústicaRESUMO
The perceived pitch of human voices is highly correlated with the fundamental frequency (f0) of the laryngeal source, which is determined largely by the length and mass of the vocal folds. The vocal folds are larger in adult males than in adult females, and men's voices consequently have a lower pitch than women's. The length of the supralaryngeal vocal tract (vocal-tract length; VTL) affects the resonant frequencies (formants) of speech which characterize the timbre of the voice. Men's longer vocal tracts produce lower frequency, and less dispersed, formants than women's shorter vocal tracts. Pitch and timbre combine to influence the perception of speaker characteristics such as size and age. Together, they can be used to categorize speaker sex with almost perfect accuracy. While it is known that domestic dogs can match a voice to a person of the same sex, there has been no investigation into whether dogs are sensitive to the correlation between pitch and timbre. We recorded a female voice giving three commands ('Sit', 'Lay down', 'Come here'), and manipulated the recordings to lower the fundamental frequency (thus lowering pitch), increase simulated VTL (hence affecting timbre), or both (synthesized adult male voice). Dogs responded to the original adult female and synthesized adult male voices equivalently. Their tendency to obey the commands was, however, reduced when either pitch or timbre was manipulated alone. These results suggest that dogs are sensitive to both the pitch and timbre of human voices, and that they learn about the natural covariation of these perceptual attributes.
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Voz , Lobos , Animais , Cães , Feminino , Humanos , Masculino , Percepção da Altura Sonora , Caracteres Sexuais , Fala , Acústica da FalaRESUMO
PURPOSE: To evaluate the anatomical changes in kidney orientation in prone position with use of horizontal or vertical bolster alignment. METHODS: Patients having renal stone(s) on ultrasonogram or X-ray underwent split bolus computed-tomo-urography (CTU) in prone position with horizontal and vertical bolster positions. CTUs were read by a single radiologist to quantify the cranio-caudal, antero-posterior, side to side and rotational movements of kidneys as relevant to prone percutaneous nephrolithotomy. RESULTS: 19 adult patients with 38 renal units and mean basal metabolic index of 25.6 kg/m2 underwent CTU. Greater inferior displacement of both kidneys was seen with horizontal bolsters as compared to vertical bolsters. The right upper calyceal-diaphragm distance was 2.1 ± 1.5 cm and the lower calyceal-diaphragm distance was 2.0 ± 1.6 cm greater with the horizontal bolsters (p < 0.01). Similarly, the displacement on the left side was 1.5 ± 0.8 cm and 1.4 ± 0.8 cm, respectively (p < 0.01). Horizontal bolsters also result in significantly longer calyceal-skin distance at both poles of both kidneys [right upper: 0.4 ± 0.5 cm (p < 0.01), right lower: 0.8 ± 0.7 cm (p < 0.01), left upper: 0.4 ± 0.6 cm (p = 0.02), left lower: 0.8 ± 1.1 cm (p < 0.01)] and wider erector spinae-mid posterior calyceal-colon angle (124.8 v/s 110.0 on the right and 96.2 v/s 85.7 on the left) (p < 0.01). CONCLUSION: Horizontal bolsters provide significantly more caudal displacement of the kidneys; the right kidney being displaced more as compared to the left. However, there is also an increase in the skin-calyceal distance with horizontal as compared to the vertical bolsters. These assessments may help the surgeons decide optimal bolster position individualized to the patient.
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Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/métodos , Posicionamento do Paciente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Decúbito VentralRESUMO
OBJECTIVE: To investigate how listeners use fundamental frequency, implied vocal tract length, and source spectral tilt to infer speaker gender. METHODS: Sound files each containing the vowels /i, æ, É, u/ interspersed by brief silences were synthesized. Each of the 210 stimuli was a combination of 10 values for fundamental frequency and 7 values for implied vocal tract length (and the associated formant frequencies) ranging from male-typical to female-typical, and 3 values for source spectral tilt approximating the voice qualities of breathy, normal, and pressed. Twenty-three listeners judged each synthesized "speaker" as "female" or "male." Generalized linear mixed model analysis was used to determine the extent to which fundamental frequency, implied vocal track length, and spectral tilt influenced listener judgment. RESULTS: Increasing fundamental frequency and decreasing implied vocal tract length resulted in increased probability of female judgment. Two interactions were identified: An increase in fundamental frequency and also a decrease in source spectral tilt (more negative) resulted in a greater increase in the probability of female judgment when the vocal tract length was relatively short. CONCLUSIONS: The relationships among fundamental frequency, implied vocal tract length, source spectral tilt, and probability of female judgment changed across the range of normal values, suggesting that the relative contributions of fundamental frequency and implied vocal tract length to gender perception varied over the ranges studied. There was no threshold of fundamental frequency or implied vocal tract length that dramatically shifted the perception between male and female.
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Body size is an important determinant of resource and mate competition in many species. Competition is often mediated by conspicuous vocal displays, which may help to intimidate rivals and attract mates by providing honest cues to signaler size. Fitch proposed that vocal tract resonances (or formants) should provide particularly good, or honest, acoustic cues to signaler size because they are determined by the length of the vocal tract, which in turn, is hypothesized to scale reliably with overall body size. There is some empirical support for this hypothesis, but to date, many of the effects have been either mixed for males compared with females, weaker than expected in one or the other sex, or complicated by sampling issues. In this paper, we undertake a direct test of Fitch's hypothesis in two canid species using large samples that control for age- and sex-related variation. The samples involved radiographic images of 120 Portuguese water dogs Canis lupus familiaris and 121 Russian silver foxes Vulpes vulpes. Direct measurements were made of vocal tract length from X-ray images and compared against independent measures of body size. In adults of both species, and within both sexes, overall vocal tract length was strongly and significantly correlated with body size. Effects were strongest for the oral component of the vocal tract. By contrast, the length of the pharyngeal component was not as consistently related to body size. These outcomes are some of the clearest evidence to date in support of Fitch's hypothesis. At the same time, they highlight the potential for elements of both honest and deceptive body signaling to occur simultaneously via differential acoustic cues provided by the oral versus pharyngeal components of the vocal tract.
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Speech is more intelligible when it is spoken by familiar than unfamiliar people. If this benefit arises because key voice characteristics like perceptual correlates of fundamental frequency or vocal tract length (VTL) are more accurately represented for familiar voices, listeners may be able to discriminate smaller manipulations to such characteristics for familiar than unfamiliar voices. We measured participants' (N = 17) thresholds for discriminating pitch (correlate of fundamental frequency, or glottal pulse rate) and formant spacing (correlate of VTL; 'VTL-timbre') for voices that were familiar (participants' friends) and unfamiliar (other participants' friends). As expected, familiar voices were more intelligible. However, discrimination thresholds were no smaller for the same familiar voices. The size of the intelligibility benefit for a familiar over an unfamiliar voice did not relate to the difference in discrimination thresholds for the same voices. Also, the familiar-voice intelligibility benefit was just as large following perceptible manipulations to pitch and VTL-timbre. These results are more consistent with cognitive accounts of speech perception than traditional accounts that predict better discrimination.
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Percepção da Fala , Voz , Humanos , Fala , Cognição , Frequência CardíacaRESUMO
On the one hand, the relationship between formant frequencies and vocal tract length (VTL) has been intensively studied over the years. On the other hand, the connection involving mel-frequency cepstral coefficients (MFCCs), which concisely codify the overall shape of a speaker's spectral envelope with just a few cepstral coefficients, and VTL has only been modestly analyzed, being worth of further investigation. Thus, based on different statistical models, this article explores the advantages and disadvantages of the latter approach, which is relatively novel, in contrast to the former which arises from more traditional studies. Additionally, VTL is assumed to be a static and inherent characteristic of speakers, that is, a single length parameter is frequently estimated per speaker. By contrast, in this paper we consider VTL estimation from a dynamic perspective using modern real-time Magnetic Resonance Imaging (rtMRI) to measure VTL in parallel with audio signals. To support the experiments, data obtained from USC-TIMIT magnetic resonance videos were used, allowing for the 2D real-time analysis of articulators in motion. As a result, we observed that the performance of MFCCs in case of speaker-dependent modeling is higher, however, in case of cross-speaker modeling, which uses different speakers' data for training and evaluating, its performance is not significantly different of that obtained with formants. In complement, we note that the estimation based on MFCCs is robust, with an acceptable computational time complexity, coherent with the traditional approach.
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Developmental dyscalculia is a neurodevelopmental disorder specific to arithmetic learning even with normal intelligence and age-appropriate education. Difficulties often persist from childhood through adulthood lowering the individual's quality of life. However, the neural correlates of developmental dyscalculia are poorly understood. This study aimed to identify brain structural connectivity alterations in developmental dyscalculia. All participants were recruited from a large scale, non-referred population sample in a longitudinal design. We studied 10 children with developmental dyscalculia (11.3 ± 0.7 years) and 16 typically developing peers (11.2 ± 0.6 years) using diffusion-weighted magnetic resonance imaging. We assessed white matter microstructure with tract-based spatial statistics in regions-of-interest tracts that had previously been related to math ability in children. Then we used global probabilistic tractography for the first time to measure and compare tract length between developmental dyscalculia and typically developing groups. The high angular resolution diffusion-weighted magnetic resonance imaging and crossing-fiber probabilistic tractography allowed us to evaluate the length of the pathways compared to previous studies. The major findings of our study were reduced white matter coherence and shorter tract length of the left superior longitudinal/arcuate fasciculus and left anterior thalamic radiation in the developmental dyscalculia group. Furthermore, the lower white matter coherence and shorter pathways tended to be associated with the lower math performance. These results from the regional analyses indicate that learning, memory and language-related pathways in the left hemisphere might be related to developmental dyscalculia in children.
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To evaluate the factors affecting urinary leakage post percutaneous nephrolithotomy. To define those at high risk in whom a double J stent for 4 weeks or external ureteral catheter fixation for at least 3 days is indicated at the end of procedure. A total of 140 patients who underwent single-stage Percutaneous Nephrolithotomy (PCNL) with single or multiple accesses were included between February 2014 and March 2019. A detailed history, laboratory and radiological investigations were performed on all patients. All patients were classified according to postoperative urinary leakage into three groups. We defined leakage as a leakage from percutaneous puncture site. Group 1 (90 patients), No leakage was defined as leakage < 12 hours. In group 2 (32 patients), short-term leakage was defined as leakage 12-48 hours, and in Group 3 (18 patients), prolonged urinary leakage > 48 hours. Patients with short-term and prolonged urinary leakage had a significantly shorter access tract. Most patients (93.8%) with short-term leakage had an access tract of 71-90 mm, while > 50% of patients (55.6) with prolonged leakage had an access tract of 51-70 mm (p <0.001). Multivariate ordinal regression revealed that Operative time, length of the access tract and parenchymal thicknesses significantly predict short-term and prolonged leakage. For predicting the prolonged urinary leakage, the length of access tract and parenchymalthickness showed significant areas under the curve (AUC); 78% (95% CI: 69 - 85, p = 0.002) and 94% (95% CI: 87 - 97, p <0.001), respectively. Operative time, length of the access tract and parenchymal thickness significantly predict short-term and prolonged leakage.
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Nefrolitotomia Percutânea , Humanos , Nefrolitotomia Percutânea/efeitos adversos , Punções , Cateteres Urinários , Duração da Cirurgia , Período Pós-OperatórioRESUMO
When producing intimidating aggressive vocalizations, humans and other animals often extend their vocal tracts to lower their voice resonance frequencies (formants) and thus sound big. Is acoustic size exaggeration more effective when the vocal tract is extended before, or during, the vocalization, and how do listeners interpret within-call changes in apparent vocal tract length? We compared perceptual effects of static and dynamic formant scaling in aggressive human speech and nonverbal vocalizations. Acoustic manipulations corresponded to elongating or shortening the vocal tract either around (Experiment 1) or from (Experiment 2) its resting position. Gradual formant scaling that preserved average frequencies conveyed the impression of smaller size and greater aggression, regardless of the direction of change. Vocal tract shortening from the original length conveyed smaller size and less aggression, whereas vocal tract elongation conveyed larger size and more aggression, and these effects were stronger for static than for dynamic scaling. Listeners familiarized with the speaker's natural voice were less often 'fooled' by formant manipulations when judging speaker size, but paid more attention to formants when judging aggressive intent. Thus, within-call vocal tract scaling conveys emotion, but a better way to sound large and intimidating is to keep the vocal tract consistently extended.
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Sport-related concussion (SRC) is an important public health issue. White-matter alterations after SRC are widely studied by neuroimaging approaches, such as diffusion magnetic resonance imaging (MRI). Although the exact anatomical location of the alterations may differ, significant white-matter alterations are commonly observed in long fiber tracts, but are never proven. In the present study, we performed streamline tractography to characterize the association between tract length and white-matter microstructural alterations after SRC. Sixty-eight collegiate athletes diagnosed with acute concussion (24-48 h post-injury) and 64 matched contact-sport controls were included in this study. The athletes underwent diffusion tensor imaging (DTI) in 3.0 T MRI scanners across three study sites. DTI metrics were used for tract-based spatial statistics to map white-matter regions-of-interest (ROIs) with significant group differences. Whole-brain white-mater streamline tractography was performed to extract "affected" white-matter streamlines (i.e., streamlines passing through the identified ROIs). In the concussed athletes, streamline counts and DTI metrics of the affected white-matter fiber tracts were summarized and compared with unaffected white-matter tracts across tract length in the same participant. The affected white-matter tracts had a high streamline count at length of 80-100 mm and high length-adjusted affected ratio for streamline length longer than 80 mm. DTI mean diffusivity was higher in the affected streamlines longer than 100 mm with significant associations with the Brief Symptom Inventory score. Our findings suggest that long fibers in the brains of collegiate athletes are more vulnerable to acute SRC with higher mean diffusivity and a higher affected ratio compared with the whole distribution.
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Traumatismos em Atletas , Concussão Encefálica , Futebol Americano , Substância Branca , Humanos , Imagem de Tensor de Difusão/métodos , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/patologia , Concussão Encefálica/diagnóstico por imagem , Concussão Encefálica/patologia , Substância Branca/patologia , Futebol Americano/lesõesRESUMO
Vocal tract elongation, which uniformly lowers vocal tract resonances (formant frequencies) in animal vocalizations, has evolved independently in several vertebrate groups as a means for vocalizers to exaggerate their apparent body size. Here, we propose that smaller speech-like articulatory movements that alter only individual formants can serve a similar yet less energetically costly size-exaggerating function. To test this, we examine whether uneven formant spacing alters the perceived body size of vocalizers in synthesized human vowels and animal calls. Among six synthetic vowel patterns, those characterized by the lowest first and second formant (the vowel /u/ as in 'boot') are consistently perceived as produced by the largest vocalizer. Crucially, lowering only one or two formants in animal-like calls also conveys the impression of a larger body size, and lowering the second and third formants simultaneously exaggerates perceived size to a similar extent as rescaling all formants. As the articulatory movements required for individual formant shifts are minor compared to full vocal tract extension, they represent a rapid and energetically efficient mechanism for acoustic size exaggeration. We suggest that, by favouring the evolution of uneven formant patterns in vocal communication, this deceptive strategy may have contributed to the origins of the phonemic diversification required for articulated speech. This article is part of the theme issue 'Voice modulation: from origin and mechanism to social impact (Part II)'.
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Voz , Acústica , Animais , Tamanho Corporal , Fala , Vocalização AnimalRESUMO
BACKGROUND: The aim of this study was to determine the normal reference values for olfactory sulcus depth, olfactory tract length and olfactory bulb volume in the paediatric population with routine magnetic resonance imaging (MRI) and determine the relationship, if any, between these values and patient sex and age. MATERIALS AND METHODS: Ninety patients with a median age of 8 years (age range: 3-17 years), consisting of 45 males and 45 females with normal brain MRI scans were evaluated. The patients were divided into three subgroups based on age range, with n = 30 per subgroup; group 1: young children (3-6 years), group 2: children (7-11 years) and group 3: adolescents (12-17 years). In the cranial MRI examination of all groups, the right, left and total olfactory bulb volume values were measured in mm3, the right and left olfactory tract length values and the right and left olfactory sulcus depth values were calculated manually in mm. Demographic data including sex and age were recorded. RESULTS: There was no significant difference between the age groups in terms of sex. Right-left olfactory sulcus depth; right-left olfactory tract length and right-left total olfactory bulb volume values increased significantly when they are compared in terms of age groups (p < 0.0001, = 0.028; < 0.0001, < 0.0001; < 0.0001, < 0.0001; < 0.0001, respectively). There was no significant difference between right and left olfactory tract length and olfactory bulb volumes in all groups (p = 0.792 and p = 0.478), but the right olfactory sulcus depth was significantly larger than the left (p = 0.003). CONCLUSIONS: Especially as the age progresses, olfactory tract length and olfactory bulb volume dimensions of olfactory nerve and olfactory sulcus depth should be checked during diagnosis of respective illnesses in paediatric population.
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Transtornos do Olfato , Bulbo Olfatório , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Masculino , Bulbo Olfatório/diagnóstico por imagem , Córtex Pré-FrontalRESUMO
Admixture is increasingly being recognized as an important factor in evolutionary genetics. The distribution of genomic admixture tracts, and the resulting effects on admixture linkage disequilibrium, can be used to date the timing of admixture between species or populations. However, the theory used for such prediction assumes selective neutrality despite the fact that many famous examples of admixture involve natural selection acting for or against admixture. In this paper, we investigate the effects of positive selection on the distribution of tract lengths. We develop a theoretical framework that relies on approximating the trajectory of the selected allele using a logistic function. By numerically calculating the expected allele trajectory, we also show that the approach can be extended to cases where the logistic approximation is poor due to the effects of genetic drift. Using simulations, we show that the model is highly accurate under most scenarios. We use the model to show that positive selection on average will tend to increase the admixture tract length. However, perhaps counter-intuitively, conditional on the allele frequency at the time of sampling, positive selection will actually produce shorter expected tract lengths. We discuss the consequences of our results in interpreting the timing of the introgression of EPAS1 from Denisovans into the ancestors of Tibetans.
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Deriva Genética , Seleção Genética , Alelos , Frequência do Gene , Genética Populacional , Desequilíbrio de LigaçãoRESUMO
Damage to the fornix leads to significant memory impairment and executive dysfunction and is associated with dementia risk. We sought to identify if fornix integrity and fiber length are disrupted in mild cognitive impairment (MCI) and how they associate with cognition. Data from 14 healthy older adult controls (HCs) and 17 subjects with non-amnestic MCI (n-aMCI) were analyzed. Diffusion tensor imaging (DTI) at 1.5 Tesla MRI was performed to enable manual tracing of the fornix and calculation of DTI parameters. Higher fractional anisotropy of body and column of the fornix was associated with better executive functioning and memory, more strongly in the HC than in the n-aMCI group. Fornix fiber tract length (FTL) was associated with better executive function, more strongly in the n-aMCI than in the HC group, and with better memory, more strongly in the HC than in the n-aMCI group. These results highlight a decline in the contributions of the fornix to cognition in n-aMCI and suggest that maintenance of fornix FTL is essential for sustaining executive functioning in people with n-aMCI.
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Purpose Essential tremor (ET) is the most common movement disorder. In recent years, an increasing number of studies have shown that this disease also has a variety of non-motor findings and may be of a neurodegenerative nature. This study aimed to evaluate the olfactory bulb volume (OBV) and the olfactory tract length (OTL) and to demonstrate possible neurodegeneration in ET patients using magnetic resonance imaging (MRI). Methods The study included 30 ET patients (mean age=29.53±11.82 years) and 30 healthy controls (mean age=30.00±11.68 years). In the cranial MRI examination of both groups, the right, left and total OBV values ââwere measured in mm3 and the right and left OTL values ââwere calculated manually in mm. Results There was no significant difference between the patient and control groups in the measured OBV values, but the OTL value of the patient group was statistically significantly lower than the control group. Conclusion Our study showed that the olfactory system might be involved in ET cases. We think that olfactory dysfunction, one of the non-motor symptoms in ET, can be clearly elucidated through both anatomical and functional studies, to be conducted with larger patient groups.
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Cochlear implant (CI) users find it extremely difficult to discriminate between talkers, which may partially explain why they struggle to understand speech in a multi-talker environment. Recent studies, based on findings with postlingually deafened CI users, suggest that these difficulties may stem from their limited use of vocal-tract length (VTL) cues due to the degraded spectral resolution transmitted by the CI device. The aim of the present study was to assess the ability of adult CI users who had no prior acoustic experience, i.e., prelingually deafened adults, to discriminate between resynthesized "talkers" based on either fundamental frequency (F0) cues, VTL cues, or both. Performance was compared to individuals with normal hearing (NH), listening either to degraded stimuli, using a noise-excited channel vocoder, or non-degraded stimuli. Results show that (a) age of implantation was associated with VTL but not F0 cues in discriminating between talkers, with improved discrimination for those subjects who were implanted at earlier age; (b) there was a positive relationship for the CI users between VTL discrimination and speech recognition score in quiet and in noise, but not with frequency discrimination or cognitive abilities; (c) early-implanted CI users showed similar voice discrimination ability as the NH adults who listened to vocoded stimuli. These data support the notion that voice discrimination is limited by the speech processing of the CI device. However, they also suggest that early implantation may facilitate sensory-driven tonotopicity and/or improve higher-order auditory functions, enabling better perception of VTL spectral cues for voice discrimination.
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Implantes Cocleares , Testes de Discriminação da Fala , Percepção da Fala , Adulto , Cognição , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Segregating and understanding speech in complex environments is a major challenge for hearing-impaired (HI) listeners. It remains unclear to what extent these difficulties are dominated by direct interference, such as simultaneous masking, or by a failure of the mechanisms of stream segregation. This study compared older HI listeners' performance with that of young and older normal-hearing (NH) listeners in stream segregation tasks involving speech sounds. Listeners were presented with sequences of speech tokens, each consisting of a fricative consonant and a voiced vowel (CV). The CV tokens were concatenated into interleaved sequences that alternated in fundamental frequency (F0) and/or simulated vocal tract length (VTL). Each pair of interleaved sequences was preceded by a "word" consisting of two random tokens. The listeners were asked to indicate whether the word was present in the following interleaved sequences. The word, if present, occurred within one of the interleaved sequences, so that performance improved if the listeners were able to perceptually segregate the two sequences. Although HI listeners' identification of the speech tokens in isolation was poorer than that of the NH listeners, HI listeners were generally able to use both F0 and VTL cues to segregate the interleaved sequences. The results suggest that the difficulties experienced by HI listeners in complex acoustic environments cannot be explained by a loss of basic stream segregation abilities.
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Envelhecimento/psicologia , Sinais (Psicologia) , Perda Auditiva/psicologia , Acústica da Fala , Percepção da Fala , Qualidade da Voz , Estimulação Acústica , Adolescente , Adulto , Fatores Etários , Idoso , Audiometria de Tons Puros , Audiometria da Fala , Limiar Auditivo , Compreensão , Feminino , Audição , Perda Auditiva/diagnóstico , Perda Auditiva/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Inteligibilidade da Fala , Adulto JovemRESUMO
OBJECTIVE: To prospectively compare the Guy's Stone Score (GSS), S.T.O.N.E. [stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence or stone density (E)] score and the Clinical Research Office of the Endourological Society (CROES) nephrolithometric nomogram to predict percutaneous nephrolithotomy (PCNL) success rate and assess the correlation with perioperative complications. PATIENTS AND METHODS: We prospectively evaluated all consecutive PCNL patients at our institute between 1 November 2013 and 31 May 2015. The above scoring systems were applied to preoperative non-contrast computed tomography and the practical difficulties in such applications were noted. Perioperative complications and the stone-free rate (SFR) were also recorded. Receiver operating characteristic curves were drawn and the areas under curves were compared and appropriate statistical analysis done. RESULTS: In all, 48 renal units were included in the study. The overall SFR was 62.2%. The presence of staghorn stones (ß = 27.285, 95% confidence interval 1.19-625.35; P = 0.039) was the only significant variable associated with the residual stones on multivariate analysis. Stone-free patients had significantly lower median GSS (2 vs 4) and S.T.O.N.E. scores (6 vs 10) and higher median CROES scores (83% vs 63%) (all P < 0.001) compared to residual-stone patients. All scoring systems were significantly associated with SFR (all P < 0.001). There was no significant difference in the areas under curves of the scoring systems (0.858, 0.923, and 0.931, respectively). Furthermore, all scoring systems had weak correlations with Clavien-Dindo classified complications (r = 0.29, P = 0.045; r = 0.40, P = 0.005 and r = -0.295, P = 0.04, respectively). We found no standardisation for the measurement of stone dimensions, tract length, Hounsfield units, and staghorn definition. CONCLUSIONS: All scoring systems equally predicted SFR and had a weak correlation with Clavien-Dindo complications. Standardisation is needed for the variables in which they have been found deficient.
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Whispered vowels, produced with no vocal fold vibration, lack the periodic temporal fine structure which in voiced vowels underlies the perceptual attribute of pitch (a salient auditory cue to speaker sex). Voiced vowels possess no temporal fine structure at very short durations (below two glottal cycles). The prediction was that speaker-sex discrimination performance for whispered and voiced vowels would be similar for very short durations but, as stimulus duration increases, voiced vowel performance would improve relative to whispered vowel performance as pitch information becomes available. This pattern of results was shown for women's but not for men's voices. A whispered vowel needs to have a duration three times longer than a voiced vowel before listeners can reliably tell whether it's spoken by a man or woman (â¼30 ms vs. â¼10 ms). Listeners were half as sensitive to information about speaker-sex when it is carried by whispered compared with voiced vowels.