Is voice therapy an effective treatment for dysphonia? A randomised controlled trial

OBJECTIVES: To assess the overall efficacy of voice therapy for dysphonia. DESIGN: Single blind randomised controlled trial. SETTING: Outpatient clinic in a teaching hospital. Participants: 204 outpatients aged 17-87 with a primary symptom of persistent hoarseness for at least two months. INTERVENTIONS: After baseline assessments, patients were randomised to six weeks of either voice therapy or no treatment. Assessments were repeated at six weeks on the 145 (71%) patients who continued to this stage and at 12-14 weeks on the 133 (65%) patients who completed the study. The assessments at the three time points for the 70 patients who completed treatment and the 63 patients in the group given no treatment were compared. MAIN OUTCOME MEASURES: Ratings of laryngeal features, Buffalo voice profile, amplitude and pitch perturbation, voice profile questionnaire, hospital anxiety and depression scale, clinical interview schedule, SF-36. RESULTS: Voice therapy improved voice quality as assessed by rating by patients (P=0.001) and rating by observer (P<0.001). The treatment effects for these two outcomes were 4.1 (95% confidence interval 1.7 to 6.6) points and 0.82 (0.50 to 1.13) points. Amplitude perturbation showed improvement at six weeks (P=0.005) but not on completion of the study. Patients with dysphonia had appreciable psychological distress and lower quality of life than controls, but voice therapy had no significant impact on either of these variables. CONCLUSION: Voice therapy is effective in improving voice quality as assessed by self rated and observer rated methods

Analytic treatment of CRIB Quantum Memories for Light using Two-level Atoms

It has recently been discovered that the optical analogue of a gradient echo in an optically thick material could form the basis of a optical memory that is both completely efficient and noise free. Here we present analytical calculation showing this is the case. There is close analogy between the operation of the memory and an optical system with two beam splitters. We can use this analogy to calculate efficiencies as a function of optical depth for a number of quantum memory schemes based on controlled inhomogeneous broadening. In particular we show that multiple switching leads to a net 100% retrieval efficiency for the optical gradient echo even in the optically thin case.Comment: 10 page

Gradient Echo Quantum Memory for Light using Two-level Atoms

We propose a quantum memory for light that is analogous to the NMR gradient echo. Our proposal is ideally perfectly efficient and provides simplifications to current 3-level quantum memory schemes based on controlled inhomogeneous broadening. Our scheme does not require auxiliary light fields. Instead the input optical pulse interacts only with two-level atoms that have linearly increasing Stark shifts. By simply reversing the sign of the atomic Stark shifts, the pulse is retrieved in the forward direction. We present analytical, numerical and experimental results of this scheme. We report experimental efficiencies of up to 15% and suggest simple realizable improvements to significantly increase the efficiency.Comment: 4 pages, 4 figure

Perceived vocal morbidity in a problem asthma clinic

<p>Aims: Asthma treatment has the potential to affect patients' voices. We undertook detailed characterisation of voice morbidity in patients attending a problem asthma clinic, and we determined how patients' perceptions related to objective assessment by an experienced observer.</p> <p>Methods: Forty-three patients took part in the study. Subjects completed the self-administered voice symptom score (VoiSS) questionnaire and underwent digital voice recording. These voice recordings were scored using the grade–roughness–breathiness–asthenicity–strain system (GRBAS). Laryngoscopy was also performed.</p> <p>Results: The median VoiSS was 26 (range three to 83). VoiSS were significantly lower in the 17 patients with normal laryngeal structure and function (range four to 46; median 22), compared with the 26 patients with functional or structural laryngeal abnormality (range three to 83; median 33) (95 per cent confidence intervals for difference 0.0–21.0; p = 0.044). The overall grade score for the GRBAS scale did not differ between these two groups, and only 13 patients had a GRBAS score of one or more, recognised as indicating a voice problem. There were positive correlations between related GRBAS score and voice symptom score subscales. Although voice symptom scores were significantly more abnormal in patients with structural and functional abnormalities, this score performed only moderately well as a predictive tool (sensitivity 54 per cent; specificity 71 per cent). Nevertheless, the voice symptom score performed as well as the more labour-intensive GRBAS score (sensitivity 57 per cent; specificity 60 per cent). Patients' inhaled corticosteroid dose (median dose 1000 µg beclomethasone dipropionate or equivalent) had a statistically significant relationship with their overall grade score for the GRBAS scale (r = 0.56; p < 0.001), but not with their VoiSS. Only one patient had evidence of laryngeal candidiasis, and only two had any evidence of abnormality suggesting steroid-induced myopathy.</p> <p>Conclusions: Vocal morbidity is common in patients with asthma, and should not be immediately attributed to steroid-related candidiasis. The VoiSS merits further, prospective validation as a screening tool for ENT and/or speech and language therapy referral in patients with asthma.</p&gt

The evolution of bits and bottlenecks in a scientific workflow trying to keep up with technology: Accelerating 4D image segmentation applied to nasa data

In 2016, a team of earth scientists directly engaged a team of computer scientists to identify cyberinfrastructure (CI) approaches that would speed up an earth science workflow. This paper describes the evolution of that workflow as the two teams bridged CI and an image segmentation algorithm to do large scale earth science research. The Pacific Research Platform (PRP) and The Cognitive Hardware and Software Ecosystem Community Infrastructure (CHASE-CI) resources were used to significantly decreased the earth science workflow's wall-clock time from 19.5 days to 53 minutes. The improvement in wall-clock time comes from the use of network appliances, improved image segmentation, deployment of a containerized workflow, and the increase in CI experience and training for the earth scientists. This paper presents a description of the evolving innovations used to improve the workflow, bottlenecks identified within each workflow version, and improvements made within each version of the workflow, over a three-year time period

Method of extending hyperfine coherence times in Pr^3+:Y_2SiO_5

In this letter we present a method for increasing the coherence time of praseodymium hyperfine ground state transitions in Pr^3+:Y_2SiO_5 by the application of a specific external magnetic field. The magnitude and angle of the external field is applied such that the Zeeman splitting of a hyperfine transition is at a critical point in three dimensions, making the first order Zeeman shift vanishingly small for the transition. This reduces the influence of the magnetic interactions between the praseodymium ions and the spins in the host lattice on the transition frequency. Using this method a phase memory time of 82ms was observed, a value two orders of magnitude greater than previously reported. It is shown that the residual dephasing is amenable quantum error correction

Optimising the Efficiency of a Quantum Memory based on Rephased Amplified Spontaneous Emission

We studied the recall efficiency as a function of optical depth of rephased amplified spontaneous emission (RASE), a protocol for generating entangled light. The experiments were performed on the $^{3}\! H_{4}$ $\rightarrow$ $^{1}\! D_{2}$ transition in the rare-earth doped crystal Pr$^{3+}$:Y$_{2}$SiO$_{5}$, using a four-level echo sequence between four hyperfine levels to rephase the emission. Rephased emission was observed for optical depths in the range of $\alpha L$ = 0.8 to 2.0 with a maximum rephasing efficiency of 14 % observed while incorporating spin storage. This efficiency is a significant improvement over the previously reported non-classical result but is well short of the predicted efficiency. We discuss the possible mechanisms limiting the protocol's performance, and suggest ways to overcome these limits.Comment: 5 pages, 5 figure

Reliability of perceptions of voice quality: evidence from a problem asthma clinic population

<p>Introduction: Methods of perceptual voice evaluation have yet to achieve satisfactory consistency; complete acceptance of a recognised clinical protocol is still some way off.</p> <p>Materials and methods: Three speech and language therapists rated the voices of 43 patients attending the problem asthma clinic of a teaching hospital, according to the grade-roughness-breathiness-asthenicity-strain (GRBAS) scale and other perceptual categories.</p> <p>Results and analysis: Use of the GRBAS scale achieved only a 64.7 per cent inter-rater reliability and a 69.6 per cent intra-rater reliability for the grade component. One rater achieved a higher degree of consistency. Improved concordance on the GRBAS scale was observed for subjects with laryngeal abnormalities. Raters failed to reach any useful level of agreement in the other categories employed, except for perceived gender.</p> <p>Discussion: These results should sound a note of caution regarding routine adoption of the GRBAS scale for characterising voice quality for clinical purposes. The importance of training and the use of perceptual anchors for reliable perceptual rating need to be further investigated.</p&gt