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Objective: To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design: Cross-sectional observational research with a quantitative approach. Methods: A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results: The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions: The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.

Objetivo: Explorar los reportes de fonoaudiólogos colombianos acerca del entrenamiento y uso de la evaluación perceptual auditiva de la voz. Diseño de estudio: Se eligió un diseño de investigación observacional transversal con un enfoque cuantitativo. Metodología: Se diseñó y distribuyó un cuestionario digital para recopilar información sobre el proceso de formación de los profesionales y la implementación de procedimientos de evaluación perceptual auditiva. Se aplicaron estadísticas descriptivas y se ajustaron varios modelos lineales generalizados para determinar la influencia de ciertas variables en otras. Resultados: La encuesta recibió respuestas de 40 fonoaudiólogos, revelando que las escalas más utilizadas para la formación y la evaluación de la calidad vocal en el grupo son las estimaciones de magnitud directa (82.5% y 77.5%). Del mismo modo, en este grupo las tareas más frecuentemente utilizadas para la formación y el uso como estrategia de evaluación son las vocales (38%), seguidas por el habla espontánea (30%). La mayoría de los profesionales del grupo fueron formados utilizando un marco conceptual que involucra múltiples exposiciones a la calificación (42.5%). El uso de la estimación de magnitud directa en la formación con una voz normal mostró significancia (p = 0.015), al igual que el uso de la vocal /i/ en la formación con intervalos de igual apariencia (p = 0.013). Los modelos estadísticos que relacionan la escala utilizada con la escala en la que los participantes fueron entrenados también fueron significativos (p < 0.05). Conclusiones: La escala GRBAS es la herramienta de formación más utilizada por el grupo de fonoaudiólogos del estudio. Los esfuerzos futuros deberían centrarse en mejorar las prácticas de formación para la evaluación perceptual auditiva, explorar marcos conceptuales alternativos e incorporar referencias externas para mejorar la validez y la confiabilidad.

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This paper introduces a methodology tailored to capture, post-process, and replicate audio-visual data of outdoor environments (urban or natural) for VR experiments carried out within a controlled laboratory environment. The methodology consists of 360∘ video and higher order ambisonic (HOA) field recordings and subsequent calibrated spatial sound reproduction with a spherical loudspeaker array and video played back via a head-mounted display using a game engine and a graphical user interface for a perceptual experimental questionnaire. Attention was given to the equalisation and calibration of the ambisonic microphone and to the design of different ambisonic decoders. A listening experiment was conducted to evaluate four different decoders (one 2D first-order ambisonic decoder and three 3D third-order decoders) by asking participants to rate the relative (perceived) realism of recorded outdoor soundscapes reproduced with these decoders. The results showed that the third-order decoders were ranked as more realistic.

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INTRODUCTION: This study pursued two objectives: (1) to determine the potential association between listener (n = 51) judgments of 20 male tracheoesophageal speaker samples for two auditory-perceptual dimensions of voice, overall severity (OS) and listener comfort (LC); and (2) to assess the temporal and spectral acoustic correlates for these auditory-perceptual dimensions. METHODOLOGY: Three separate correlation analyses were performed to evaluate the association between OS and LC. First, scores of OS and LC from all listeners were pooled together, and then the correlation between OS and LC was computed. Second, scores of OS and LC were averaged over all listeners to derive a single estimate of OS and LC for each TE speaker sample; the correlation between the average OS and LC was then computed. Third, listener-to-listener variability in the association between OS and LC was evaluated by computing the correlation between OS and LC scores from each listener across all TE samples. Finally, two stepwise multiple regression models were created to relate the average LC score to spectral and temporal variation in the acoustic signal. RESULTS: While the pooled OS and LC scores had a moderate positive correlation (r = 0.66, p < 0.00001), the averaged OS and LC exhibited a near perfect positive correlation (r = 0.99, p < 0.00001). The significant differences between the pooled and averaged scores were explained by significant listener-to-listener variability in the association between OS and LC. OS and LC scores from 5 listeners had non-significant correlations, 10 had moderate correlations (r < 0.7), 35 listeners had high correlations (0.7 < r < 0.9), and 1 listener had a very high correlation (r < 0.9 < 1). Finally, the acoustic models created based on the spectral and temporal variations in the signal were able to account for 87.7% and 61.8% of variation in the average LC score. CONCLUSIONS: The strong correlations between OS and LC suggest that LC may, in fact, provide a more comprehensive auditory-perceptual surrogate for the voice quality of TE speakers. Although OS and LC are distinct conceptual dimensions, LC appears to have the advantage of assessing the social impact and potential communication disability that may exist in interactions between TE speakers and listeners.

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OBJECTIVE: 1. To investigate the discriminatory and diagnostic power of nonlinear dynamic analysis measures concerning voices from normal, benign, and malignant voice disorders. 2. To study the correlations of nonlinear dynamic analysis measures with perceptual ratings to evaluate the reliability of the objective acoustic analysis in predicting severity of voice. METHOD: The perturbation analysis metrics used were Jitter%, Shimmer%, and signal-to-noise ratio. The nonlinear dynamic analysis metrics used were spectrum convergence ratio (SCR), nonlinear energy difference ratio (NEDR), and rate of divergence (ROD). Subjects were enrolled and divided into three groups based on laryngeal pathology: normal, benign, and malignant. Vowel sound and reading samples were recorded. Perceptual evaluation was applied to these voice samples to investigate correlations between metrics and auditory perception. RESULT: Each metric was capable of discriminating laryngeal pathology, except for SCR in the case of distinguishing between benign and malignant pathologies. Perturbation analysis parameters had a moderate ability to differentiate between normal and benign pathologies, but were unable to characterize malignant pathologies for certain diseases, such as Reinke's edema. All metrics significantly correlated with perceptual G scores. Nonlinear dynamic analysis was superior when applied to cases of severe dysphonia, where linear metrics such as Jitter% and Shimmer% tended to lose utility. NEDR and ROD were successful at differentiating between the different pathologies, whereas SCR could not discriminate between the benign and malignant groups. CONCLUSION: Perturbation and nonlinear dynamic analyses are comparable in their discriminating power with respect to normal and benign voices, and normal and malignant voices. The nonlinear dynamic analysis metrics NEDR and ROD may be superior in clinical settings with respect to discriminating voice pathology ranging from mild pathological voice to severe dysphonia, and with respect to discriminating benign and malignant voice. SCR was found unable to discriminate pathological voices.

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OBJECTIVES: This study aimed to determine the effect of anchor voices and listener expertise on auditory-perceptual judgment of voice quality using the GRBAS scale. METHODS: This study utilized a modified crossover design with counterbalancing. Anchor voices for each parameter of the GRBAS scale were chosen based on expert consensus. A total of 28 participants were divided into three groups based on their expertise. The first and second groups consisted of nine undergraduate (UG) and nine postgraduate (PG) students of speech-language pathology. The third group consisted of 10 practicing speech-language pathologists (SLPs). These participants carried out auditory-perceptual judgment of 60 dysphonic voice samples under two counterbalanced experimental conditions (with and without anchor voices). Each of the three groups was randomly divided into two subgroups to balance the experimental conditions. Interrater reliability for each subgroup was calculated using Krippendorff's α and 95% confidence intervals. RESULTS: For all the groups involved in the study, interrater reliability was higher when anchor voices aided perceptual judgment for most parameters of the GRBAS scale. For the different parameters of GRBAS, interrater reliability for the UG group varied from fair (20 < α ≤ 40) to moderate (40 < α ≤ 60). In contrast, it was fair (20 < α ≤ 40) to substantial (60 < α ≤ 80) for the PG group and moderate (40 < α ≤ 60) to substantial (60 < α ≤ 80) for the SLP group. Variations in reliability were the least for the SLP group compared to the UG and PG groups. However, there were overlaps in interrater reliability between the groups, as revealed by the 95% confidence intervals. CONCLUSIONS: Anchor voices help improve the auditory-perceptual judgment of voice quality, especially interrater reliability. Listener expertise is also shown to influence the interrater reliability of auditory-perceptual judgment of voice quality.

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OBJECTIVE: This study aimed to compare the effect of experience on central auditory processing skills in voice therapists and other Speech-Language Pathologists in the auditory perceptual evaluation of voice. STUDY DESIGN: This research is a descriptive-analytical cross-sectional observational study. METHODS: Our study population includes three groups; first-year speech-language pathology students who have not undergone any training or education in the evaluation of auditory samples (group 1; n = 10), Speech-Language Pathologists who do not have any activity in the field of voice disorders (group 2; n = 10), and therapists who have at least 2 years of experience in auditory-perceptual judgment (group 3; n = 10). Initially, the participants underwent a basic audiological evaluation (Pure Tone Audiometry, Speech Recognition Threshold, Speech Discrimination Score, tympanometry, and acoustic reflex) to assess peripheral hearing. In the next step, the auditory processing skills of the participants were evaluated with the Buffalo model (staggered spondaic word (SSW) test, phonemic synthesis test (PST), speech in noise (SPN) test). In the third step, four recorded voice samples of patients with voice disorders and healthy individuals were randomly selected for auditory perceptual judgment. These samples were the same for all participants. All the voices were previously subjected to auditory perceptual analysis by two Speech-Language Pathologist who had at least 6 years of experience in the evaluation and treatment of voice disorders; the voices were played for participants to assess auditory perception using the grade, roughness, breathiness, asthenia, strain (GRBAS) scale. RESULTS: All subjects had normal hearing and auditory processing abilities but there were some differences among the groups in processing skills. A difference was found in the SSW-qualifier and SPN-R components between the three groups. The third group had significant differences with the other two groups in the evaluation of auditory perception in the components of R, B, and S (from the GRBAS scale) in voice number one, and the components of G, R, and A in voice number three. In voice number two, there was a correlation between the SSW order effect component and the G component, as well as between the PST component and the A component. In voice number three, there was a correlation between the SPN-L component and the G component, and between the SSW condition, SSW qualifier, and SSW All errors components with the S component. In voice number four, there was a correlation between the SSW-RC, SSW-LC, SSW condition, SSW competing, and SSW order effect components with the A component. Lastly, there was a correlation between the SSW order effect and SSW type A components with the R component in voice number three in group three. CONCLUSION: The results of the present study indicate that experience has an impact on auditory processing skills and the participants of the third group, who had more experience in the evaluation of voice disorders obtained better scores than the other two groups in the auditory processing skills. Additionally, the level of experience is related to the accuracy of auditory perceptual judgment of voice. The participants of the third group performed better than the other two groups, and the performance of the first and second groups was almost the same.

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OBJECTIVES: This study aimed to validate the Sunderland Tracheoesophageal Perceptual Scale (SToPS) in the Italian language by checking the inter- and intra-rater reliability. STUDY DESIGN: Scale validation METHODS: The validation of the tool involved the following steps: (1) translation and adaptation of the SToPS into Italian language; (2) recruitment of participants (60 laryngectomized patients with a voice prosthesis and 12 health professionals-six speech and language therapists (SLTs) and six ear, nose, and throat surgeons-classified into experienced (Exp) or not at assessing voice; (3) recording of patients' speech samples; (4) perceptual evaluation of recorded speech samples (test and retest) performed by the 12 health professionals; and (5) statistical analysis (quadratic weighted Cohen kappa and weighted kappa of Light coefficients). RESULTS: When all raters were considered as one group, an agreement ≥0.50 was reached for all parameters. The "ExpSLTs" group rated more reliably than the other groups, achieving a "good" intrarater agreement for 9/10 parameters. Despite the interrater coefficients were lower than the intrarater ones for all rater groups, "ExpSLTs" obtained the best levels of interrater agreement, achieving a level of agreement ≥0.50 for all parameters. Finally, considering intrarater+interrater agreement ("good + good" or "good + moderate"), the "ExpSLTs" group showed the greatest agreement, attaining all parameters that met the criteria for "good" or "moderate" agreement levels. CONCLUSIONS: The Italian version of SToPS can be considered a reliable tool. As in the original version, expert SLTs are the better judges for tracheoesophageal voice assessment.

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Science popularization is not only a prerequisite for national development, but also an effective means of enhancing citizens' personal quality. All sectors of society, represented by colleges and universities, bear the responsibility of promoting popular science. The integration of popular science and tourism in popular science tourism serves to advance both the field of popular science and the tourism industry simultaneously. The Guangzhou Higher Education Mega Center (HEMC) possesses abundant resources for science popularization and has the potential to develop popular science tourism, yet its current development in this area remains insufficient. This study utilizes Guangzhou HEMC as a case study and modifies the American Customer Satisfaction Index model by incorporating relevant questions pertaining to popular science tourism. A total of 280 valid questionnaires were collected through surveying, which were then analyzed to measure tourist satisfaction using the Tourist Satisfaction Index. The partial least squares structural equation model was employed for analysis, and on the basis of calculation results, the IPA map was constructed. The research revealed that tourists' satisfaction with popular science tourism at Guangzhou HEMC was suboptimal. Among the factors correlating to satisfaction, expectations, quality, and price are all important factors to consider when making a purchase decision; however, prioritizing expectations and quality can lead to greater satisfaction in the long run. Therefore, there is still ample room for improvement in the popular science tourism of HEMC Guangzhou. This can be achieved by intensifying publicity efforts, enhancing infrastructure, improving the quality and safety of catering services, strengthening the introduction and construction of popular science content, as well as appropriately reducing the price of popular science products and services.

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OBJECTIVE: The aim of this study is to construct a representative and comprehensive set of reliable anchor and training voice samples for all parameters and grades of the GRBAS-scale, in order to develop a standardized online training tool for perceptual voice evaluation. METHODS: 140 voice samples varying from normal to severely dysphonic, consisting of the vowel /a/ and a Dutch standard text, were recorded. Samples were duplicated and added to a data folder in random order. A panel of five highly experienced judges rated GRBAS parameters for each voice sample. Intra- and interrater reliability were determined using intraclass correlation coefficient (ICC) and percentage agreement. Samples with agreement percentages of >0.90 for at least one parameter were qualified as anchor voices, whereas samples with a percentage agreement between 0.70 and 0.80 were considered valid training samples. RESULTS: Intrarater reliability was moderate to good for all raters and parameters. Interrater reliability was good for parameter G and moderate for R, B, A and S. 83 samples were found to be valid anchor samples with 90-100% expert agreement for at least one parameter, covering all of the GRBAS parameter/score combinations. An additional 37 samples fulfilled the criteria for adoption in the online tool as a training sample, showing 70-80% agreement for one or more parameters. CONCLUSION: Based on well-defined and stringent selection criteria, this study identifies a substantial number of valid anchor and training voices that qualify for implementation in a standardized multi-level training tool for the auditory-perceptual evaluation of voice by means of the GRBAS scale.

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Vocal fatigue is known as a hyperfunctional voice disorder that can lead to other conditions, such as muscle tension dysphonia (MTD). Speech and language pathologists (SLPs) are professional voice users who may suffer from vocal fatigue due to heavy vocal demands. This study aimed at investigating the cepstral and perceptual dimensions of voice and their correlation in the SLPs with vocal fatigue. Twenty-six SLPs and senior speech therapy students (mean age = 27.11 ± 6.8 yrs), including men (n = 5) and women (n = 21), participated in this descriptive cross-sectional study. They had vocal fatigue according to the Vocal Fatigue Index (VFI). In acoustic assessment, cepstral analysis (CPP and CPPS) was performed using Praat software. The Persian version of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) was used to evaluate the overall severity of dysphonia. The correlation between these two evaluations was also investigated using IBM SPSS Statistics software version 23. Results revealed that the mean CPPS (13.716 ± 2.084) was lower than the cutoff point. Perceptual findings indicated that the mean overall severity (10.557 ± 11.210) fell in the normal variability of voice quality (NVVQ) range. In addition, cepstral and perceptual evaluations had no significant correlation (P > 0/05). The findings showed that auditory-perceptual evaluation considered the gold standard method of voice evaluation, cannot solely identify vocal fatigue. However, cepstral measures can help provide a more objective profile of vocal function in SLPs with vocal fatigue. Therefore, both of these evaluations are recommended for voice assessment of vocal fatigue.

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OBJECTIVE: The vibratory source for voicing in children with dysphonia is classified into three categories including a glottal vibratory source (GVS) observed in those with vocal lesions or hyperfunction; supraglottal vibratory sources (SGVS) observed secondary to laryngeal airway injuries, malformations, or reconstruction surgeries; and a combination of both glottal and supraglottal vibratory sources called mixed vibratory source (MVS). This study evaluated the effects of vibratory source on three primary dimensions of voice quality (breathiness, roughness, and strain) in children with GVS, SGVS, and MVS using single-variable matching tasks and computational measures obtained from bio-inspired auditory models. METHODS: A total of 44 dysphonic voice samples from children aged 4-11 years were selected. Seven listeners rated breathiness, roughness, and strain of 1000-ms /ɑ/ samples using single-variable matching tasks. Computational estimates of pitch strength, amplitude modulation filterbank output, and sharpness were obtained through custom-designed MATLAB algorithms. RESULTS: Perceived roughness and strain were significantly higher in children with SGVS and MVS compared to children with GVS. Among the computational measures, only the modulation filterbank output resulted in significant differences among vibratory sources; a posthoc test revealed that children with SGVS had greater amplitude modulation than children with GVS, as expected from their rougher voice quality. CONCLUSIONS: The results indicate that the output of an auditory amplitude modulation filterbank model may capture characteristics of SGVS that are strongly related to the rough voice quality.

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OBJECTIVE: Doctors, nowadays, primarily use auditory-perceptual evaluation, such as the grade, roughness, breathiness, asthenia, and strain scale, to evaluate voice quality and determine the treatment. However, the results predicted by individual physicians often differ, because of subjective perceptions, and diagnosis time interval, if the patient's symptoms are hard to judge. Therefore, an accurate computerized pathological voice quality assessment system will improve the quality of assessment. METHOD: This study proposes a self_attention-based system, with a deep learning technology, named self_attention-based bidirectional long-short term memory (SA BiLSTM). Different pitches [low, normal, high], and vowels [/a/, /i/, /u/], were added into the proposed model, to make it learn how professional doctors evaluate the grade, roughness, breathiness, asthenia, and strain scale, in a high dimension view. RESULTS: The experimental results showed that the proposed system provided higher performance than the baseline system. More specifically, the macro average of the F1 score, presented as decimal, was used to compare the accuracy of classification. The (G, R, and B) of the proposed system were (0.768±0.011, 0.820±0.009, and 0.815±0.009), which is higher than the baseline systems: deep neural network (0.395±0.010, 0.312±0.019, 0.321±0.014) and convolution neural network (0.421±0.052, 0.306±0.043, 0.3250±0.032) respectively. CONCLUSIONS: The proposed system, with SA BiLSTM, pitches, and vowels, provides a more accurate way to evaluate the voice. This will be helpful for clinical voice evaluations and will improve patients' benefits from voice therapy.

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INTRODUCTION: Singers have unique vocal demands, and if the voice is impaired there can be a negative impact on their quality of life. While a variety of options exist to assess vocal health, the utilization of cepstral peak prominence (CPP) has increased due to his reliability in some situations. However, it has not been utilized commonly in the singing population. This study sought to assess vocal health in singing students using noninvasive measures such as singing voice handicap index (SVHI) and consensus auditory perceptual evaluation of voice (CAPE-V) as well as CPP to provide preliminary information on this measure. METHODS: A prospective longitudinal study of singing students independent of year of training enrolled in a 2-credit voice lesson at an undergraduate School of Music was conducted. Non-invasive measures were used to evaluate the voice. All participants recorded the same spoken sentence at four equally spaced intervals throughout the semester using a ZOOM H4n Pro (two cardioid input microphone, Hauppauge, New Year). Participants completed SVHI at the time of each recording, and CAPE-V conducted by two speech language pathologists trained in voice. CPP was determined using running speech samples. RESULTS: A total of 23 singers completed the study (11 male, 12 female). There was a significant difference in SVHI at the first recording compared to the final recording (10.6 ± 4.6 vs 9.3 ± 5.9, P= 0.008). Similarly, there was a significant difference in CPP at the first recording compared to the final recording (9 ± 3 vs 9.4 ± 1.1, P < 0.001). However, no significant difference was seen with CAPE-V. CONCLUSION: Our results are similar to previous studies. There was no evidence in decline in objective and subjective vocal quality utilizing the measure included in our study.

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OBJECTIVES: Auditory-perceptual evaluation frameworks, such as the grade-roughness-breathiness-asthenia-strain (GRBAS) scale, are the gold standard for the quantitative evaluation of pathological voice quality. However, the evaluation is subjective; thus, the ratings lack reproducibility due to inter- and intra-rater variation. Prior researchers have proposed deep-learning-based automatic GRBAS score estimation to address this problem. However, these methods require large amounts of labeled voice data. Therefore, this study investigates the potential of automatic GRBAS estimation using deep learning with smaller amounts of data. METHODS: A dataset consisting of 300 pathological sustained /a/ vowel samples was created and rated by eight experts (200 for training, 50 for validation, and 50 for testing). A neural network model that predicts the probability distribution of GRBAS scores from an onset-to-offset waveform was proposed. Random speed perturbation, random crop, and frequency masking were investigated as data augmentation techniques, and power, instantaneous frequency, and group delay were investigated as time-frequency representations. RESULTS: Five-fold cross-validation was conducted, and the automatic scoring performance was evaluated using the quadratic weighted Cohen's kappa. The results showed that the kappa values of the automatic scoring performance were comparable to those of the inter-rater reliability of experts for all GRBAS items and the intra-rater reliability of experts for items G, B, A, and S. Random speed perturbation was the most effective data augmentation technique overall. When data augmentation was applied, power was the most effective for items G, R, A, and S; for Item B, combining group delay and power yielded additional performance gains. CONCLUSION: The automatic GRBAS scoring achieved by the proposed model using scant labeled data was comparable to that of experts. This suggests that the challenges resulting from insufficient data can be alleviated. The findings of this study can also contribute to performance improvements in other tasks such as automatic voice disorder detection.

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Auditory-perceptual rating of voice is one component of voice evaluation, and the CAPE-V is one of the tools for this purpose. Because of its advantages, the CAPE-V has been adapted into several languages. Accordingly, the adaptation of the CAPE-V into Malay is essential for its utility among the Malaysian population, which this study aimed to accomplish. This study involved translating the CAPE-V into Malay, termed the Malay CAPE-V, followed by establishing its validity. The translation processes (ie, forward translation and backward translation) involved four different translators ie, three speech-language therapists (SLTs), and one linguist with at least 14 years of experience. Most items were similarly translated, except for a few, which were subsequently accepted as similar, following consensus among the translators. In the examination of content validity, two raters (ie, SLTs) with at least 12 years of clinical experience reviewed and scored the tested items. Given that the scale-level content validity index average value (S-CVI/Ave) was above the acceptable level, all items were retained. The examination of construct validity and concurrent validity involved ratings of voice samples recorded from 38 participants, comprising 19 individuals with normal and disordered voices, respectively. The ratings were performed by three raters (ie, SLTs) with at least 12 years of clinical experience. For the construct validity, the Mann-Whitney U test indicated significantly higher scores of the vocal parameters of the Malay CAPE-V for the disordered voice group than for the normal voice group. Meanwhile, for the concurrent validity, the Spearman correlation indicated that all relationships between the scores of the vocal parameters of the Malay CAPE-V and GRBAS Scale were significant, with most of them achieving a very strong positive correlation. The results demonstrated that the Malay CAPE-V is a valid tool for an auditory-perceptual rating of voice among the Malaysian population.

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INTRODUCTION: Listener training is necessary to achieve agreement between perceptual ratings. However, evidence is limited regarding the effect of a training in the perceptual evaluation of cleft palate speech on the reliability of students in speech pathology. The aim of this study was to evaluate the short-term and longer-term effect of a training using the Belgian Dutch outcome tool for cleft palate speech on reliability and the students' experiences. METHODS: A 2-h training was provided during a specialist course for 31 first year master students in speech pathology. Information regarding listener characteristics, speech documentation and speech analysis (speech parameters and rating scales) was discussed. This last part focused on the Belgian Dutch outcome tool for speech in patients with cleft palate, including reference samples and consensus listening exercises. Pre training (T1) and post-training reliability (immediately following the training (T2) and one month later (T3)) were collected for the speech variables speech understandability, speech acceptability, hypernasality, hyponasality, nasal emission and nasal turbulence that were rated by means of ordinal scales. Inter-rater reliability was determined with interclass correlation coefficients whereas percentages of agreement were calculated for the intra-rater reliability. RESULTS: Qualitative inter-rater ICC categories improved for hyponasality and speech acceptability at T2 and T3, whereas the inter-rater reliability of the other variables remained stable regarding their interpreted categories. All ICC values quantitatively improved at T2, except hypernasality and nasal emission. At T3, three of those variables showed a small drop one month later. Regarding intra-rater reliability, a significant decrease for hypernasality and nasal turbulence was found at T2, whereas a significant increase was observed for nasal turbulence and speech acceptability at T3. All variables, except hypernasality, had improved intra-rater reliability at T3 in comparison with T1. Students experienced fewer difficulties with most variables after training. Evaluation of nasal emission and nasal turbulence remained however difficult and required, in the students' opinion, more attention. DISCUSSION & CONCLUSION: Overall a positive training effect was noted, especially regarding the inter-rater reliability and the students' confidence in perceptual ratings. However, it remains a challenge to achieve a positive training effect for all target variables that is maintained over-time.

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PURPOSE: To provide voice experts with a method for determining the likelihood ratio (LR) from the perceptual evaluation of distinctive voice attribute scores. The proposed method aims to obtain the similarity and typicality judgments made by forensic voice experts (FVEs) during the comparison of attributes in voice pairs. METHOD: It is based on the scoring method for LR calculation. In the first stage, 17 perceptual attributes grouped into six vocalic categories are specified. A novel graphical interface is used to obtain discriminative responses both globally and for each attribute from ten pairs of test sentences produced by the same and different speakers. The FVEs should discriminate whether the attributes are similar or different in each pair and should indicate the degree to which the attributes are present. In addition, for six specific attributes, the FVEs must decide whether the attribute is typical or atypical in the reference population. In the second stage, the mean score obtained in the first stage is converted to LR using probability density functions of listeners' responses to 1680 same/different speaker pairs discriminated for female and male speakers. RESULTS: The responses of the FVEs to the test pairs show the discriminatory power of the attributes, the incidence of the typicality factor on the final score and the performance of each FVE. With the application of the probability density functions obtained for the responses to pairs of the same or different origin taken from the reference population, the final scores are converted into LRs that are compared with the true conditions of each pair. CONCLUSIONS AND FUTURE WORK: The application of the developed system allows the global and discriminated evaluation of the perceptual attributes with high agreement in the comparison of pairs of voices. Obtaining the LRs allows associating the perceptual evaluation method with the automatic methods that are used nowadays. The responses of the FVEs taken as a reference, will allow training and evaluating the performance of young FVEs.

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The recovery of the tourism industry is an important issue that has attracted much attention during the COVID-19 pandemic. Sustainable and safe festival tourism is considered an effective way of aiding in the recovery of the industry. A face-to-face survey of participants in the Guangzhou Hanfu Festival was conducted to examine the relationship between fears of COVID-19, perceived risks, perceptual evaluations, festival attitudes, behavioral intentions, and crowding during this difficult time. Results clarified how fear affects behavioral intentions in festival research, and the mediation role of perceived risk and the moderation role of crowding was confirmed. A timely set of recommendations was provided to festival operators and local governments.

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Everyday observations indicate that creaky voice has become common in Finland in recent years. Previous studies suggest that this trend is also occurring in other countries. This cross-sectional study investigates the use of creaky voice among Finnish university students from the 1990's to the 2010's. Material was obtained from a sound archive. It consisted of 200 samples from normophonic speakers (95 males, 105 females; mean age 23.7 years, SD 3.3 years, range 19-35 years). Normophonia was checked by two speech therapists in a preliminary perceptual analysis. Thereafter, two voice specialists rated the amount of creak and strain. A scale of 0-4 was used (0 = none, 4 = a lot). The inter- and intrarater reliability for the listening evaluations were satisfactory (for creaky phonation, rho = 0.611, P < 0.001 for interrater reliability and rho = 0.540, P < 0.001 for intrarater reliability; for strain, rho = 0.463, P < 0.001 and rho = 0.697, P < 0.001 for inter- and intrarater reliability, respectively). These results revealed a significant increase in the amount of perceived creak in females (from 1.04, SD 0.69 to 1.55, SD 1.06; P < 0.05, Mann-Whitney U test). In males, no significant change was found. However, the frequency of creaky voice use increased in both genders. No male speakers from the 1990's were rated as using "a lot" of creaky voice, but 2.3% of male speakers from the 2010's received this rating. Male speakers who were rated "quite a lot" increased from 5.9% in the 1990's to 18.1% in the 2010's. Female speakers rated "a lot" increased from 0% to 6%, and female speakers rated "quite a lot" increased from 7% to 25.8% over the studied time periods. Creaky phonation and strain correlated slightly in males (rho = 0.24, P < 0.05) and moderately in females (rho = 0.55, P < 0.001). Age did not correlate with the amount of creaky phonation (rho = 0.005, P > 0.10 for males, rho = -0.011, P > 0.10 for females). It can be concluded that the prevalence of creaky voice has increased among young Finnish speakers, particularly females.

RESUMEN

Recent research describes the effect of Type 2 diabetes (T2D) on voice, suggesting that it can be diagnosed based on vocal clues. Although these studies have similar experimental designs with respect to the voice data and the analysis methods, the conclusions regarding the voice changes differ substantially and are at times contradictory. This is unexpected, since the mechanism of pathological deterioration behind the observed changes is the same. This year in an article published in J. of Voice it was suggested that vocal changes may be different among ethnicities. Before this hypothesis can be accepted, the study protocols should be improved and unified, to ensure that the empirical evidence is reliable. Additionally, given the recently published data about the temporal voice changes as a result of glucose swings, we propose that the persons in hypo- and hyperglycemic conditions should be excluded from the experiment. Since no study succeeded in diabetes detection, it is timely to mention that there is an alternative methodology for disease detection from voice, which is far more sensitive than the state of the art procedure. We propose a script that is available from the first author on request.

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