The effect of detoxification on acoustic features of Mandarin speech in male heroin users

This study aims to investigate the effect of detoxification on acoustic features of Mandarin speech. Speech recordings were collected from 66 male abstinent heroin users with different durations of drug detoxification, specifically early abstinent users with a detoxification duration of less than 2 years, sustained abstinent users with 2 years of detoxification, and long-term abstinent users with a detoxification duration of more than 2 years. The results of the acoustic analyses showed that early abstinent users exhibited lower loudness, relative energies of F1, F2, and F3, higher H1-A3, and fewer loudness peaks per second, as well as a longer average duration of unvoiced segments, compared to the sustained and long-term abstinent users. The findings suggest that detoxification may lead to a rehabilitation process in the speech production of abstinent heroin users (e.g., less vocal hoarseness). This study not only provides valuable insights into the effect of detoxification on speech production but also provides a theoretical basis for the speech rehabilitation and detoxification treatment of heroin users.

Patients' Demographics and Risk Factors in Voice Disorders: An Umbrella Review of Systematic Reviews

OBJECTIVES

This study aimed to provide a comprehensive overview of the systematic reviews that focus on the prevalence of voice disorders (VDs), associated risk factors, and the demographic characteristics of patients with dysphonia. An umbrella review was conducted to identify general research themes in voice literature that might guide future research initiatives and contribute to the classification of VDs as a worldwide health concern.

STUDY DESIGN

Umbrella review of systematic reviews.

METHODS

Pubmed/Medline and Embase were searched for eligible systematic reviews by two authors independently. Extracted data items included the study publication details, study design, characteristics of the target population, sample size, region/country, and incidence and/or prevalence of the VD(s) of interest.

RESULTS

Forty systematic reviews were included. Sixteen reported a meta-analysis. Great heterogeneity in methods was found. A total of 277,035 patients across the included studies were included with a prevalence ranging from 0%-90%. The countries represented best were the United States and Brazil, with 13 studies each. Aging, occupational voice use, lifestyle choices, and specific comorbidities, such as obesity or hormonal disorders, seem to be associated with an increased prevalence of dysphonia.

CONCLUSIONS

This review underscores the influence of VDs on distinct patient groups and the general population. A variety of modifiable or non-modifiable risk factors, having varied degrees of impact on voice qualities, have been identified. The overall effect of VDs is probably underestimated due to factors, such as sample size, patient selection, underreporting of symptoms, and asymptomatic cases. Employing systematic reviews with consistent methodologies and criteria for diagnosing VDs would enhance the ability to determine the prevalence of VDs and their impact.

E-Cigarette Vaping-Related Vocal Fold Injury: A Case Report

E-cigarettes heat a solution into an aerosol that is inhaled. This paper demonstrates that vaping can cause vocal fold injury such as the mucosal burn seen in the case presented.

Acoustic Characteristics of Mandarin Speech in Male Drug Users

AIM

Drug use/addiction has a profound impact on the physical and mental health of individuals. Previous studies have indicated that drug users may experience speech perception disorders, including speech illusion and challenges in recognizing emotional speech. However, the influence of drugs on speech production, as another crucial aspect of speech communication, has not been thoroughly examined. Therefore, the current study aimed to investigate how drugs affect the acoustic characteristics of speech in Chinese male drug users.

METHOD

Speech recordings were collected from a total of 160 male drug users (including 106 heroin users, 23 ketamine users, and 31 methamphetamine users) and 55 male healthy controls with no history of drug use. Acoustic analysis was conducted on the collected speech data from these groups, and classification analysis was performed using five supervised learning algorithms.

RESULTS

The results demonstrated that drug users exhibited smaller F0 standard deviation, reduced loudness, cepstral peak prominence, and formant relative energies, as well as higher H1-A3, longer unvoiced segments, and fewer voiced segments per second compared to the control group. The classification analyses yielded good performance in classifying drug users and non-drug users, with an accuracy above 86%. Moreover, the identification of the three groups of drug users achieved an accuracy of approximately 70%. Additionally, the study revealed different effects on speech production among the three types of drugs.

CONCLUSION

The above findings indicate the presence of speech disorders, such as vocal hoarseness, in drug users, thus confirming the assumption that the acoustic characteristics of speech in drug users deviates from the norm. This study not only fills the knowledge gap regarding the effects of drugs on the speech production of Chinese male drug users but also provides a more comprehensive understanding of how drugs impact human behaviors. Furthermore, this research provides theoretical foundations of detoxification and speech rehabilitation for drug users.

A cross-sectional survey: Exploring future healthcare workers' intention to use cannabis through extended theory of planned behavior

Cannabis is the most extensively abused drug, leading to multiple health burdens such as traffic accidents and psychosis. There is a global wave of legalization of recreational and medical cannabis. This study aimed to understand future healthcare workers' intention to use cannabis through extended Theory of Planned Behavior (TPB). An online cross-sectional survey on cannabis, including validated survey tools and questions on demographics, knowledge, and constructs of the TPB was designed, and distributed during virtual classes in late 2020. Responses were obtained from the Faculty of Medicine of a local university. Nine hundred ninety-six responses were collected, of which 629 were complete and analysed. Age was the only demographic variable associated with cannabis use intention (p = 0.029). Respondents with intention had better knowledge of cannabis. All TPB and additional constructs, including perceived behavioral control (COR = 3.44, 95% CI 2.72-4.35, p < 0.001), descriptive norm (COR = 2.24, 95% CI 1.81-2.77, p < 0.001), injunctive norm (COR = 0.51, 95% CI 0.42-0.61, p < 0.001), attitude (COR = 1.23, 95% CI 1.18-1.28, p < 0.001), knowledge (COR = 1.08, 95% CI 1.03-1.14), and perceived availability (COR = 2.75, 95% CI 2.22-3.40, p < 0.001) were individually associated with intention. In the final multiple logistic regression model adjusted for age, only attitude (AOR = 1.19, 95% CI 1.13-1.25, p < 0.001) and perceived availability (p = 0.004) showed statistically significant associations with intention. Descriptive norm (standardized coefficient = 0.570) had better explanatory power than the injunctive norm (standardized coefficient = -0.143) in the model. Perceived behavioral control was associated with intention among respondents with negative to neutral attitudes towards cannabis (AOR = 2.48, 95% CI 1.63-3.77, p < 0.001), but not among those with positive attitudes. All TPB constructs positively correlated with the intention to use cannabis. Changing the attitudes and perceived control on cannabis use may be useful in preventing cannabis use.

Adults with a history of recreational cannabis use have altered speech production

Stereotypical depictions of speech in cannabis users often suggest slow, laboured output, yet objective evidence supporting this assumption is extremely limited. We know that depressants or hallucinogenic drugs such as cannabis can cause acute changes in communication and speech rate, but the long-lasting effects of cannabis use on speech are not well described. The aim of this study was to investigate speech in individuals with a history of recreational cannabis use compared to non-drug-using healthy controls. Speech samples were collected from a carefully described cohort of 31 adults with a history of cannabis use (but not use of illicit stimulant drugs) and 40 non-drug-using controls. Subjects completed simple and complex speech tasks including a monologue, a sustained vowel, saying the days of the week, and reading a phonetically balanced passage. Audio samples were analysed objectively using acoustic analysis for measures of timing, vocal control, and quality. Subtle differences in speech timing, vocal effort, and voice quality may exist between cannabis and control groups, however data remain equivocal. After controlling for lifetime alcohol and tobacco use and applying a false discovery rate, only spectral tilt (vocal effort and intensity) differed between groups and appeared to change in line with duration of abstinence from cannabis use. Differences between groups may reflect longer term changes to the underlying neural control of speech. Our digital analysis of speech shows there may be a signal differentiating individuals with a history of recreational cannabis use from healthy controls, in line with similar findings from gait and hand function studies.

Cannabis related side effects in otolaryngology: a scoping review

BACKGROUND

Cannabis has been rapidly legalized in North America; however, limited evidence exists around its side effects. Health Canada defines side effect as a harmful and unintended response to a health product. Given drug safety concerns, this study's purpose was to review the unintended side effects of cannabis in otolaryngology.

METHODS

The Preferred Reporting Items For Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR) protocol was used to conduct a scoping review of the MEDLINE, EMBASE, CINAHL, and CENTRAL databases. (PROSPERO: CRD42020153022). English studies in adults were included from inception to the end of 2019. In-vitro, animal, and studies with n < 5 were excluded. Primary outcome was defined as unintended side effects (defined as any Otolaryngology symptom or diagnosis) following cannabis use. Oxford Centre for Evidence-Based Medicine: Levels of Evidence and risk of bias using the Risk of Bias in randomized trials (RoB 2) and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tools were assessed.. Two authors independently reviewed all studies; the senior author settled any discrepancies.

RESULTS

Five hundred and twenty-one studies were screened; 48 studies were analysed. Subspecialties comprised: Head and Neck (32), Otology (8), Rhinology (5), Airway (5), Laryngology (1). Cannabis use was associated with unintended tinnitus, vertigo, hearing loss, infection, malignancy, sinusitis, allergic rhinitis, thyroid dysfunction, and dyspnea. About half (54.1%) of studies showed increased side effects, or no change in symptoms following cannabis use. Oxford Levels of Evidence was 2-4 with substantial heterogeneity. Risk of bias assessment with RoB2 was low to high and ROBINS-1 was moderate to critical.

CONCLUSION

This was the first comprehensive scoping review of unintended side effects of cannabis in Otolaryngology. The current literature is limited and lacks high-quality research Future randomized studies are needed to focus on therapeutic effects of cannabis in otolaryngology. Substantial work remains to guide clinicians to suggest safe, evidence-based choices for cannabis use.

Cannabis Consumption Among Patients With a Voice Disorder: A Multicenter E-Survey Study

INTRODUCTION

Legalization of cannabis consumption in the United States (U.S.) has increased rapidly, impacting consumption rates in the general U.S.

POPULATION

The objective of this survey study was to establish prevalence estimates of cannabis consumption among voice patients, in addition to characterizing patterns of cannabis consumption.

METHODS

A multicenter, anonymous survey study of cannabis consumption took place at multidisciplinary tertiary voice care clinics in Portland, Oregon (PDX) and Pittsburgh, Pennsylvania (PIT) between April 2017 and December 2018. A convenience sample of 300 consecutively enrolled English-speaking patients 21 years and older with a voice disorder completed the survey. Data were obtained on the prevalence of cannabis consumption, frequency and methods of cannabis consumption, in addition to health impacts and demographics.

RESULTS

Agresti-Coull prevalence proportion estimates for cannabis consumption were higher among voice patients in PDX compared to PIT. Current consumers in PDX and PIT showed a similar frequency of cannabis consumption. Combustion methods (eg, joint) were more popular than non-combustion methods (eg, vaping) among current consumers; inhaled methods (eg, joint) were more popular than non-inhaled methods (eg, edibles). Though vocal handicap scores for current consumers were similar across sites and comparable to lifetime non-consumers who also were non-smokers of tobacco, a lifetime history of cannabis consumption was associated with vocal and overall health impacts.

CONCLUSIONS

Prevalence estimates for current cannabis consumption among voice patients from tertiary voice care clinics mirrored prevalence estimates reported for large, representative samples from Oregon and Pennsylvania. These findings provide valuable insight on the extent of cannabis consumption among voice patients.

The Effect of Marijuana on the Voice: A Pilot Study

Marijuana is derived from the cannabis sativa plant originating in central and southeast Asia. In recent years, there was increasing popularity and use of marijuana in addition to the legalization of its recreational use in eleven states. However, the effect of marijuana on the voice is still unclear.

OBJECTIVES

The purpose of this study was to determine the perceived impacts marijuana has on voice by surveying patients from a voice center. The inquiry included smoking, vaping, edible marijuana, and cannabidiol (CBD) oil.

METHODS AND MATERIALS

An anonymous, web-based questionnaire was sent to adult voice center patients. The survey was distributed using The Research Electronic Data Capture (RED-Cap) tool, hosted by Drexel University. The survey was designed to collect relevant demographic data, past laryngeal history, marijuana use history, and beliefs about effects of marijuana on voice.

RESULTS

The survey was sent to 434 voice patients, 42 patients responded to the survey (response rate 9.68%). The average age of respondents was 45.7 (13 were male, 27 were female, and 2 were transgender). Of all, 88.10% reported having never used tobacco, 9.52% were former tobacco users, and 2.38% were current tobacco users. Of all, 75.61% of the respondents reported having tried some form of marijuana during their lifetime (16.13% reported medical use, 45.16% reported recreational use). Out of all, 21.43% were frequent (monthly) users, and 39.29% were infrequent (yearly) marijuana smokers. They reported symptoms that they attributed to marijuana use, including hoarseness, breathiness, and weakness.

CONCLUSION

Marijuana may have negative effects on the voice.

VpALI-Vaping-related Acute Lung Injury: A New Killer Around the Block

The use of electronic cigarettes, known as vaping, has become increasingly popular over the past decade, particularly in the adolescent and young adult population, often exposing users to harmful chemicals. Vaping has been associated with a heterogeneous group of pulmonary disease. Recently, a multistate epidemic has emerged surrounding vaping-related acute lung injury, prompting the Centers for Disease Control and Prevention to list an official health advisory. In this review, we describe the current literature on the epidemiology, clinical significance, as well as recommended evaluation and treatment of vaping-related lung injury.

Aerosol Gas-Phase Components from Cannabis E-Cigarettes and Dabbing: Mechanistic Insight and Quantitative Risk Analysis

Consumption of cannabis by nontraditional methods has surged since the advent of legalization in North America and worldwide. Inhaling cannabis extracts using vaporizers and via dabbing has risen in popularity, while concerns over product safety have not hindered their proliferation. The work herein is the first step toward assessing the safety of vaporizing and dabbing concentrated cannabis extracts as a function of gas-phase reaction products. The gas-phase thermal degradants of Δ⁹-tetrahydrocannabinol (THC) have not been previously investigated. It was found that users may be exposed to concerning degradants such as methacrolein, benzene, and methyl vinyl ketone when using cartridge vaporizers and dabbing. It was shown that THC alone and mixed with terpenes generated similar degradation products and, most notably, elevated levels of isoprene. Importantly, it was shown that added terpenes led to higher levels of gas-phase products compared to THC alone. To estimate cancer and noncancer risks associated with exposure to these and other degradants, quantitative risk assessment was applied to experimentally determined values for dabbing and vaping and literature-sourced levels of hazardous components in cannabis smoke. Overall, gas-phase aerosol products had significantly lower values in dabbing and vaporizing compared to cannabis smoking, although these results should be interpreted in light of potential variations in degradant levels due to disparate usage patterns and the dangers of the higher aerosol concentration of THC.