Auditory- Perceptual and Pupillometric Evaluations of Dysphonic Voices

Background: This thesis reports the findings of three projects that included pupillometric and auditory-perceptual evaluation of three voice quality features (strain, roughness, and breathiness, respectively), and measurement of perceived listening effort. Methods: In the first study, speech samples from individuals with adductor spasmodic dysphonia (AdSD) were perceptually evaluated by both naïve and experienced listeners on the feature of vocal strain and listening effort. In the second project, speech samples of postlaryngectomy tracheoesophageal (TE) speakers were rated by two groups of naïve listeners on vocal roughness and listening effort; one group was provided with audio anchors, the other without. The final study focused on perceptual evaluation of breathiness and listening effort in talkers with vocal fold paralysis (VFP). The VFP speech samples were rated by two groups (with and without audio anchors). In all three studies, listeners’ pupillary responses also were collected (EyeLink 1000) while listening to and perceptually rating voice stimuli. Findings: Data obtained from the pupillary assessment, peak pupil dilation (PPD), may indicate a listener’s cognitive load when perceptually evaluating disordered voices. Results revealed high correlations between each of the voice dimensions and listening effort. Also, various degrees of correlations were observed between perceptual ratings and PPD. In the first study, high correlations were found between PPD and perceptual ratings for naïve listeners. A listener’s previous exposure and training evoked different pupillary behavior when compared to naïve listeners. In the second study, moderate correlations were found between perceptual dimensions and PPD values of the with–anchor group; extra cognitive load was attributed to the inclusion of anchors. Anchors also improved interrater reliability for this listener group. In the third project, again correlation was observed between perceptual ratings and PPD. The inclusion of anchor did not improve reliability over the no-anchor group. Similar to the second study, PPD measures of the with-anchor group were impacted by the use of anchors. 2 Conclusions: Overall, our data offer valuable insights into auditory- perceptual evaluation of voice quality, the influence of listener experience, previous exposure to dysphonic voices, inclusion/exclusion of audio anchors, and voice features and the potential physiological or cognitive responses to dysphonic voices

An auditory-perceptual and pupillometric study of vocal strain and listening effort in adductor spasmodic dysphonia

© 2020 by the authors. This study evaluated ratings of vocal strain and perceived listening effort by normal hearing participants while listening to speech samples produced by talkers with adductor spasmodic dysphonia (AdSD). In addition, objective listening effort was measured through concurrent pupillometry to determine whether listening to disordered voices changed arousal as a result of emotional state or cognitive load. Recordings of the second sentence of the Rainbow Passage produced by talkers with varying degrees of AdSD served as speech stimuli. Twenty naïve young adult listeners perceptually evaluated these stimuli on the dimensions of vocal strain and listening effort using two separate visual analogue scales. While making the auditory-perceptual judgments, listeners\u27 pupil characteristics were objectively measured in synchrony with the presentation of each voice stimulus. Data analyses revealed moderate-to-high inter- and intra-rater reliability. A significant positive correlation was found between the ratings of vocal strain and listening effort. In addition, listeners displayed greater peak pupil dilation (PPD) when listening to more strained and effortful voice samples. Findings from this study suggest that when combined with an auditory-perceptual task, non-volitional physiologic changes in pupil response may serve as an indicator of listening and cognitive effort or arousal

Liability and Compensation Regime for Oil Pollution Damage under International Conventions

Before the twentieth century, there was little concern with ship-source oil pollution at sea. Increase of shipping activities and in particular happening of disasters, the most important of which is the Torrey Canyon, alerted the thinking of legislators as to seriousness of the problem of marine pollution. The result of their efforts in private law domain was creating the Civil Liability Convention at the first stage which provides liability and compensation regime for oil pollution at sea. Later on, the second tier of the regime was provided by adoption of the Fund Convention which was designed to link closely with the CLC, to and its purpose is to pay compensation to victims of oil pollution damage at sea in cases where the amounts recoverable under the CLC are inadequate. The final step to provide a comprehensive compensation regime was taken by adoption of Bunkers Convention whose purpose is to ensure that adequate compensation is available to the victims of damages caused by oil spills from bunkers. The CLC is considered as a revolutionary regime comparing with the traditional remedy of common law of torts by imposing strict liability and compulsory insurance on the shipowners. Since such regime was rather successful in proving compensation to victims, the Fund Convention and Bunkers Convention follow the patterns of the CLC in many aspects. The insurance industry and in particular the P&I Clubs have an effective role in achieving a comprehensive regime aimed by the international conventions. Hence, this thesis examines the main features of the concerning conventions as well as the role of P&I Clubs in providing the compensation regime

Discharge against medical advice from a Tehran emergency department

Purpose The purpose of this paper is to identify the main reasons for discharge against medical advice (DAMA) in the emergency department (ED) of a teaching hospital in Tehran, Iran. Design/methodology/approach This cross-sectional study was conducted on all the patients who left the ED of a referral teaching hospital against medical advice (AMA) in 2008. A questionnaire was filled out for each patient to determine the reasons behind patient leaving AMA. Findings In total, 12.8 percent of the patients left the hospital AMA. Dissatisfaction with being observed in the ED, having a feeling of recovery and hospital personnel encouraging patients to leave the hospital were the main reasons for leaving the hospital AMA. Practical implications Like many other centers, the results showed that poor communication skill and work overload were the main contributing factors to DAMA. The center managed to improve patient satisfaction and thus lowered DAMA rates following this study. Considering the similarities reported in the reports and that of other studies, it could be concluded that policy makers in other centers can also benefit from the results to adopt effective approaches to reduce DAMA rate. Originality/value To the knowledge no study has evaluated the rate and the reasons behind DAMA in the Iranian EDs

Association of vitamin D receptor gene variants with polycystic ovary syndrome: A case control study

Background: Vitamin D and insulin play an important role in susceptibility to polycystic ovary syndrome (PCOS), and therefore vitamin D receptor (VDR), parathyroid hormone (PTH), and insulin receptor (INSR) gene variants might be involved in the pathogenesis of PCOS. Objective: The present study was designed to investigate the possible associations between polymorphisms in VDR, PTH, and INSR genes and the risk of PCOS. Materials and Methods: VDR, PTH, and INSR gene variants were genotyped in 35 women with PCOS and 35 controls using Polymerase chain reaction – Restriction fragment length polymorphism method. Furthermore, serum levels of glucose and insulin were measured in all participants. Results: No significant differences were observed for the VDR FokI, VDR Tru9I, VDR TaqI, PTH DraII, INSR NsiI, and INSR PmlI gene polymorphisms between the women with PCOS and controls. However, after adjustment for confounding factors, the VDR BsmI “Bb” genotype and the VDR ApaI "Aa" genotype were significantly under transmitted to the patients (p= 0.016; OR= 0.250; 95% CI= 0.081-0.769, and p= 0.017; OR= 0.260; 95% CI= 0.086-0.788, respectively). Furthermore, in the women with PCOS, insulin levels were lower in the participants with the INSR NsiI "NN" genotype compared with those with the "Nn + nn" genotypes (P= 0.045). Conclusion: The results showed an association between the VDR gene BsmI and ApaI polymorphisms and PCOS risk. These data also indicated that the INSR "NN" genotype was a marker of decreased insulin in women with PCOS. Our findings, however, do not lend support to the hypothesis that PTH gene DraII variant plays a role in susceptibility to PCOS