BACKGROUND: The clinical application of voice technology provides novel opportunities in the field of telehealth. However, patients' readiness for this solution has not been investigated among patients with cardiovascular diseases (CVD). OBJECTIVE: This paper aims to evaluate patients' anticipated experiences regarding telemedicine, including voice conversational agents combined with provider-driven support delivered by phone. METHODS: A cross-sectional study enrolled patients with chronic CVD who were surveyed using a validated investigator-designed questionnaire combining 19 questions (eg, demographic data, medical history, preferences for using telehealth services). Prior to the survey, respondents were educated on the telemedicine services presented in the questionnaire while being assisted by a medical doctor. Responses were then collected and analyzed, and multivariate logistic regression was used to identify predictors of willingness to use voice technology. RESULTS: In total, 249 patients (mean age 65.3, SD 13.8 years; 158 [63.5%] men) completed the questionnaire, which showed good repeatability in the validation procedure. Of the 249 total participants, 209 (83.9%) reported high readiness to receive services allowing for remote contact with a cardiologist (176/249, 70.7%) and telemonitoring of vital signs (168/249, 67.5%). The voice conversational agents combined with provider-driven support delivered by phone were shown to be highly anticipated by patients with CVD. The readiness to use telehealth was statistically higher in people with previous difficulties accessing health care (OR 2.920, 95% CI 1.377-6.192) and was most frequent in city residents and individuals reporting a higher education level. The age and sex of the respondents did not impact the intention to use voice technology (P=.20 and P=.50, respectively). CONCLUSIONS: Patients with cardiovascular diseases, including both younger and older individuals, declared high readiness for voice technology.
- Klíčová slova
- acceptance, cardiovascular diseases, chatbot, smart speaker, telehealth, voice technology,
- MeSH
- kardiovaskulární nemoci terapie MeSH
- kvalita hlasu fyziologie MeSH
- lidé MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- technologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Voice tremor represents a common but frequently overlooked clinical feature of neurological disease. Therefore, we aimed to quantitatively and objectively assess the characteristics of voice tremor in a large sample of patients with various progressive neurological diseases. METHODS: Voice samples were acquired from 240 patients with neurological disease and 40 healthy controls. The robust automated method was designed, allowing precise tracking of multiple tremor frequencies and distinguish pathological from the physiological tremor. RESULTS: Abnormal tremor was revealed in Huntington's disease (65%), essential tremor (50%), multiple system atrophy (40%), cerebellar ataxia (40%), amyotrophic lateral sclerosis (40%), progressive supranuclear palsy (25%), Parkinson's disease (20%), cervical dystonia (10%), and multiple sclerosis (8%) but not in controls. Low-frequency voice tremor (<4 Hz) was common in all investigated diseases, whereas medium tremor frequencies (4-7 Hz) were specific for movement disorders of Parkinson's disease, multiple system atrophy, essential tremor, and cervical dystonia. CONCLUSIONS: Careful estimation of vocal tremor may help with accurate diagnosis and tailored treatment. SIGNIFICANCE: This study provides (i) more insights into the pathophysiology of vocal tremor in a wide range of neurological diseases and (ii) an accurate method for estimation of vocal tremor suitable for clinical practice.
- Klíčová slova
- Dysarthria, Phonatory instability, Tremulous, Vocal, Voice tremor,
- MeSH
- akustika řeči * MeSH
- dospělí MeSH
- elektromyografie metody MeSH
- esenciální tremor diagnóza patofyziologie MeSH
- Fourierova analýza * MeSH
- kvalita hlasu fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci nervového systému diagnóza patofyziologie MeSH
- poruchy hlasu diagnóza patofyziologie MeSH
- progrese nemoci * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
While vocal fold adduction is an important parameter in speech, relatively little has been known on the adjustment of the vocal fold adduction in singing. This study investigates the possibility of separate adjustments of cartilaginous and membranous vocal fold adduction in singing. Six female and seven male subjects, singers and non-singers, were asked to imitate an instructor in producing four phonation types: "aBducted falsetto" (FaB), "aDducted falsetto" (FaD), "aBducted Chest" (CaB), and "aDducted Chest" (CaD). The phonations were evaluated using videostroboscopy, videokymography (VKG), electroglottography (EGG), and audio recordings. All the subjects showed less posterior (cartilaginous) vocal fold adduction in phonation types FaB and CaB than in FaD and CaD, and less membranous vocal fold adduction (smaller closed quotient) in FaB and FaD than in CaB and CaD. The findings indicate that the exercises enabled the singers to separately manipulate (a) cartilaginous adduction and (b) membranous medialization of the glottis though vocal fold bulging. Membranous adduction (monitored via videokymographic closed quotient) was influenced by both membranous medialization and cartilaginous adduction. Individual control over these types of vocal fold adjustments allows singers to create different vocal timbres.
- MeSH
- fonace fyziologie MeSH
- glottis anatomie a histologie fyziologie MeSH
- hlasové řasy anatomie a histologie fyziologie MeSH
- hudba * MeSH
- kvalita hlasu fyziologie MeSH
- laryngeální chrupavky anatomie a histologie fyziologie MeSH
- lidé MeSH
- membrány anatomie a histologie fyziologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
The paper offers a new concept of studying abrupt chest-falsetto register transitions (jumps) based on the theory of nonlinear dynamics. The jumps were studied in an excised human larynx and in three living subjects (one female and two male). Data from the excised larynx revealed that a small and gradual change in tension of the vocal folds can cause an abrupt change of register and pitch. This gives evidence that the register jumps are manifestations of bifurcations in the vocal-fold vibratory mechanism. A hysteresis was observed; the upward register jump occurred at higher pitches and tensions than the downward jump. Due to the hysteresis, the chest and falsetto registers can be produced with practically identical laryngeal adjustments within a certain range of longitudinal tensions. The magnitude of the frequency jump was measured as the "leap ratio" F0F:F0C (fundamental frequency of the falsetto related to that of the chest register) and alternatively expressed as a corresponding musical interval, termed the "leap interval." Ranges of this leap interval were found to be different for the three living subjects (0-5 semitones for the female, 5-10 and 10-17 for the two males, respectively). These differences are considered to reflect different biomechanical properties of the vocal folds of the examined subjects. A small magnitude of the leap interval was associated with a smooth chest-falsetto transition in the female subject.
- MeSH
- akustika řeči MeSH
- dospělí MeSH
- fonace fyziologie MeSH
- Fourierova analýza MeSH
- hudba * MeSH
- kvalita hlasu fyziologie MeSH
- larynx fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- zvuková spektrografie * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- dospělí MeSH
- drama * MeSH
- kvalita hlasu fyziologie MeSH
- larynx patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci z povolání patofyziologie MeSH
- počítačové zpracování signálu přístrojové vybavení MeSH
- poruchy hlasu patofyziologie MeSH
- zvuková spektrografie přístrojové vybavení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH