Dysphagia Presentation, Airway Invasion, and Gender Differences in a Clinically Based Sample of People with Parkinson's Disease.

Dysphagia in People with Parkinson's Disease (PWPD) is expected to occur in most individuals. The manifestation of dysphagia and its salient swallow dysfunction characteristics leading to decreased airway safety are not well understood. The aim of this study was to quantify dysphagia presentation and severity, examine contributors to airway invasion, and explore gender differences in dysphagia manifestation in PWPD. 60 PWPD in clinical, healthcare settings underwent a Videofluoroscopic Swallow Study (VFSS) after referral for complaints of dysphagia. VFSS records and videos were analyzed to obtain dysphagia diagnosis, Videofluoroscopic Dysphagia Scale (VDS) scores, laryngeal vestibule kinematic timings, and Penetration-Aspiration Scale scores. Frequencies of VDS component and PAS scores were examined. MANOVA and logistic regression analyses were used to identify predictors of penetration and aspiration. Pharyngeal stage dysphagia was prevalent throughout PWPD and presented more frequently than oral stage dysphagia. Pharyngeal residue was a significant predictor for aspiration events. Laryngeal vestibule closure reaction time (LVCrt) and duration time (LVCd) were significant predictors of airway invasion, as were bolus consistency and volume. LVCrt, LVCd, and pharyngeal stage VDS scores were significantly altered in men compared to women in PWPD. A broad clinical sample of PWPD displayed atypical frequencies of airway invasion and frequent atypical scores of oral and pharyngeal stage physiologies. Thicker and smaller bolus consistencies significantly reduced the odds of airway invasion. Men and women presented with significantly different swallow physiology including prolonged LVCrt, LVCd, and more frequent atypical scores of pharyngeal residue and laryngeal elevation.Journal instruction requires a country for affiliations; however, these are missing in affiliation [1, 2]. Please verify if the provided country are correct and amend if necessary.Yes, USA is correct as the provided country.

The maximum phonation time as marker for voice treatment efficacy: A network meta-analysis.

PURPOSE: There is a diversity in treatment approaches for voice therapy in which aerodynamic treatment effects between the approaches are lacking. The evidence of voice treatments on the maximum phonation time (MPT) was quantified using the statistical approach of a network meta-analysis (NMA). DATA SOURCES: Three databases and manual search from inception to November 2021 were evaluated. STUDY SELECTION: Studies were considered which were reports of randomised controlled/clinical trials (RCT) evaluating the efficacy of a specific voice therapy treatment using MPT as an outcome measure in adult participants with voice disorders. Studies were excluded if participants had been diagnosed with neurological-motor-speech disorders or who were vocally healthy. Furthermore, no medical, pharmacological, or technical instrumental treatments were used. DATA EXTRACTION AND SYNTHESIS: Preferred Reporting Items for systematic reviews and meta-analyses extension statement guidelines were followed. Two reviewers independently screened citations, extracted data, and assessed risk of bias using PEDro scale. Random effects model was used for meta-analysis. RESULTS: We identified finally 12 RCT studies (treatment groups n = 285, and control group without an intervention n = 62). Eight interventions were evaluated. The only effective intervention with a significant effect was vocal function exercises (VFE) (mean pre-post difference 6.16 s, 95% confidence interval, 1.18-11.13 s). CONCLUSIONS AND RELEVANCE: VFE effectively improved MPT from pre- to post-treatment in comparison with other voice interventions which were identified in the present NMA. Further high-quality intervention studies with large samples sizes, multidimensional measures, and homogeneous groups of dysphonia are needed to support evidence-based practice in laryngology.

Early Use of Remdesivir in Patients Hospitalized With COVID-19 Improves Clinical Outcomes: A Retrospective Observational Study.

BACKGROUND: Remdesivir treatment, like most antiviral drugs, is likely to be most effective when used early in the course of coronavirus disease 2019 (COVID-19). Optimal timing of remdesivir for the treatment of COVID-19 remains unclear. OBJECTIVES: The aim of this study was to determine whether early treatment with remdesivir improves clinical outcomes: length of stay, need for mechanical ventilation, and death. METHODS: We conducted a retrospective observational study of patients hospitalized with COVID-19 who received remdesivir therapy within 10 days of symptom onset at a large health system in Georgia, United States. RESULTS: We identified a total of 475 patients. Initiation of therapy 3 days or less from first positive SARS-CoV-2 improved length of stay (15.7 days) compared with those started on therapy more than 3 days after a positive test (19.3 days) (P = 0.03). In the ≤3 day group, further reduction in length of stay was seen in those with lower oxygen requirement at baseline (P < 0.0001). Length of stay was lower in the ≤3 day group both with and without the use of corticosteroids (P = 0.0003). The odds of requiring mechanical ventilation were higher for the >3 day group compared with the ≤3 day group (odds ratio, 1.5; 95% confidence interval, 0.8-2.7), and the odds of death were higher for the >3 day group versus the ≤3 day group (odds ratio, 1.74; 95% confidence interval, 0.9-3.2). CONCLUSIONS: Our data show that early treatment with remdesivir in patients hospitalized with COVID-19 shortened length of stay.

Soil degradation and recovery - Changes in organic matter fractions and structural stability.

The combination of concurrent soil degradation and restoration scenarios in a long-term experiment with contrasting treatments under steady-state conditions, similar soil texture and climate make the Highfield land-use change experiment at Rothamsted Research unique. We used soil from this experiment to quantify rates of change in organic matter (OM) fractions and soil structural stability (SSS) six years after the management changed. Soil degradation included the conversion of grassland to arable and bare fallow management, while soil restoration comprised introduction of grassland in arable and bare fallow soil. Soils were tested for clay dispersibility measured on two macro-aggregate sizes (DispClay 1-2 mm and DispClay 8-16 mm) and clay-SOM disintegration (DI, the ratio between clay particles retrieved without and with SOM removal). The SSS tests were related to soil organic carbon (SOC), permanganate oxidizable C (POXC) and hot water-extractable C (HWC). The decrease in SOC after termination of grassland was greater than the increase in SOC when introducing grassland. In contrast, it was faster to restore degraded soil than to degrade grassland soil with respect to SSS at macro-aggregate scale. The effect of management changes was more pronounced for 8-16 mm than 1-2 mm aggregates indicating a larger sensitivity towards tillage-induced breakdown of binding agents in larger aggregates. At microscale, SSS depended on SOC content regardless of management. Soil management affected macroscale structural stability beyond what is revealed from measuring changes in OM fractions, underlining the need to include both bonding and binding mechanisms in the interpretation of changes in SSS induced by management.

The effectiveness of voice therapy on voice-related handicap: A network meta-analysis.

BACKGROUND: Treatment approaches for voice therapy are diverse, yet their differential effects are not well understood. Evaluations of treatment effects across approaches are important for clinical guidance and evidence-based practice. OBJECTIVE OF REVIEW: To quantify the evidence of treatment effectiveness on the outcome measure Voice Handicap Index with the 30-items (VHI-30) from existing randomised controlled/clinical trials (RCT) of voice therapy using the statistical approach of a network meta-analysis (NMA) with a random effects model. TYPE OF REVIEW: Meta-analysis. SEARCH STRATEGY: We searched in MEDLINE (PubMed, 1950 to 2019), Embase (1974 to 2019) and Science Citation Index (1994 to 2019) using five key terms. The inclusion criteria were reports of randomised controlled/clinical trials (RCTs) published in English or German which evaluated the effectiveness of a specific voice therapy treatment using VHI-30 as an outcome measure in adult participants with non-organic or organic voice disorders. Studies were excluded if participants had been diagnosed with neurological motor speech disorders or who were vocally healthy. Furthermore, no medical, pharmacological or instrumental (eg voice amplification) treatments were considered. EVALUATION METHOD: The primary outcome variable was VHI-30 with a score from 0 to 120. The pre-post treatment change in VHI-30 scores was an average score of 13 points related to various VHI-30 test-retest results. RESULTS: We retrieved 464 publications (ie with duplicates) and included 13 RCTs, which evaluated nine interventions, in the final analysis. The most effective intervention with a significant and clinically relevant effect was Stretch-and-Flow Phonation (SFP) (mean pre-post difference -28.37, 95% confidence interval [CI], -43.05 to-13.68). Resonant Voice (RV), the Comprehensive Voice Rehabilitation Program (CVRP) and Vocal Function Exercises (VFE) also demonstrated significant improvements. CONCLUSIONS: Of the nine voice interventions identified with the present NMA, SFP, RVT, CVRP, and VFE effectively improved VHI-30 scores from pre- to post-treatment. SFP proved to be the most significant and clinically relevant treatment. Further contributions of high-quality intervention studies are needed to support evidence-based practice in vocology.

Short-term changes in soil pore size distribution: Impact of land use.

Changes in land use affect the pore size distribution (PSD) of the soil, and hence important soil functions such as gas exchange, water availability and plant growth. The objective of this study was to investigate potentially damaging and restorative soil management practices on soil pore structure. We quantified the rate of change in PSD six years after changes in land use taking advantage of the Highfield land-use change experiment at Rothamsted Research. This experiment includes short-term soil degradation and restoration scenarios established simultaneously within long-term contrasting treatments that had reached steady-state equilibrium. The land-use change scenarios comprised conversion to grassland of previously arable or bare fallow soil, and conversion of grassland to arable and bare fallow soils. In the laboratory, we exposed intact soil cores (100 cm3) to matric potentials ranging from -10 hPa to -1.5 MPa. Based on equivalent soil mass, the plant available water capacity decreased after conversion from grassland, whereas no change was observed after conversion to grassland. Structural void ratio decreased after termination of grassland and introduction of grassland in bare fallow soil, while no change was seen when changing arable to grassland. Consequently, it was faster to degrade than to restore a complex soil structure. The study illustrates that introducing grassland in degraded soil may result in short-term increase in soil density.

The effect of transcutaneous neuromuscular electrical stimulation on laryngeal vestibule closure timing in swallowing.

BACKGROUND: The purpose of this study was to investigate the effect of transcutaneous neuromuscular electrical stimulation (NMES) on the timing of laryngeal vestibule closure during the pharyngeal stage of swallowing in healthy adults. The theoretical framework proposed that NMES applied to these muscles would present a perturbation to laryngeal vestibular closure reaction time (the amount of time for the laryngeal vestibule to close once the swallowing reflex has been triggered) by providing an antagonistic force to the direction of vestibule closure. METHODS: Nine healthy adults (2 males, 7 females) received ten consecutive stimulations applied to the submandibular hyolaryngeal muscles while performing dry swallows. Laryngeal vestibule closure reaction time (LVCrt) and the laryngeal vestibule closure duration (LVCd) were measured from videoflouroscopic images pre-stimulation and post-stimulation. RESULTS: Results indicated a significant effect of stimulation on LVCrt but not LVCd. LVCrt was significantly reduced (timing was faster) during swallows immediately after stimulation compared to pre-stimulation. CONCLUSIONS: Findings from this study support the supposition that laryngeal muscles respond to perturbations via adaptation learning, which might be used for rehabilitation of neuromuscular swallowing impairment. This pilot study supports the need for further research.

Soil organic matter widens the range of water contents for tillage.

The effects of soil organic matter on the water contents for tillage were investigated by sampling soils with a uniform texture, but a range of soil organic carbon (SOC) from two long-term field experiments at Highfield in Rothamsted Research, UK and Askov Experimental Station, Denmark. The treatments studied in Highfield were Bare fallow (BF), Continuous arable rotation (A), Ley-arable (LA) and Grass (G); and in Askov: unfertilized (UNF), ½ mineral fertilizer (½ NPK), 1 mineral fertilizer (1NPK), and 1½ animal manure (1½AM). Minimally disturbed soil cores (100 cm3) were sampled per plot in both locations from 6 to 10 cm depth to generate water retention data. Soil blocks were also sampled at 6-15 cm depth to determine basic soil properties and to measure soil aggregate strength parameters. The range of soil water contents appropriate for tillage were determined using the water retention and the consistency approaches. SOC content in Highfield was in the order: G > LA = A > BF, and in Askov: 1½ AM > 1NPK = ½NPK > UNF. Results showed that different long-term management of the silt loam Highfield soil, and fertilization of the sandy loam Askov soil affected the mechanical properties of the soils- for Highfield soil, aggregates from the G treatment were stronger in terms of rupture energy when wet (-100 hPa matric potential) than the BF treatment. As the soil dried (-300 and -1000 hPa matric potentials), soil aggregates from the G treatment were relatively weaker and more elastic than the BF soil. Our study showed, for both Highfield and Askov soils, a strong positive linear increase in the range of water contents for tillage with increasing contents of SOC. This suggests that management practices leading to increased SOC can improve soil workability by increasing the range of water contents for tillage. We recommended using the consistency approach over the water retention approach for determining the range of water contents for tillage because it seems to give realistic estimates of the water contents for tillage.

CO2 exchange and evapotranspiration across dryland ecosystems of southwestern North America.

Global-scale studies suggest that dryland ecosystems dominate an increasing trend in the magnitude and interannual variability of the land CO2 sink. However, such analyses are poorly constrained by measured CO2 exchange in drylands. Here we address this observation gap with eddy covariance data from 25 sites in the water-limited Southwest region of North America with observed ranges in annual precipitation of 100-1000 mm, annual temperatures of 2-25°C, and records of 3-10 years (150 site-years in total). Annual fluxes were integrated using site-specific ecohydrologic years to group precipitation with resulting ecosystem exchanges. We found a wide range of carbon sink/source function, with mean annual net ecosystem production (NEP) varying from -350 to +330 gCm-2 across sites with diverse vegetation types, contrasting with the more constant sink typically measured in mesic ecosystems. In this region, only forest-dominated sites were consistent carbon sinks. Interannual variability of NEP, gross ecosystem production (GEP), and ecosystem respiration (Reco ) was larger than for mesic regions, and half the sites switched between functioning as C sinks/C sources in wet/dry years. The sites demonstrated coherent responses of GEP and NEP to anomalies in annual evapotranspiration (ET), used here as a proxy for annually available water after hydrologic losses. Notably, GEP and Reco were negatively related to temperature, both interannually within site and spatially across sites, in contrast to positive temperature effects commonly reported for mesic ecosystems. Models based on MODIS satellite observations matched the cross-site spatial pattern in mean annual GEP but consistently underestimated mean annual ET by ~50%. Importantly, the MODIS-based models captured only 20-30% of interannual variation magnitude. These results suggest the contribution of this dryland region to variability of regional to global CO2 exchange may be up to 3-5 times larger than current estimates.

Effects of 2 Resistive Exercises on Electrophysiological Measures of Submandibular Muscle Activity.

OBJECTIVE: To compare the electrophysiological activity in submandibular hyolaryngeal muscles during performance of 2 exercises that incorporate resistance against muscular contraction. DESIGN: Within-subject repeated-measures design. SETTING: Academic research laboratory. PARTICIPANTS: Healthy, young adult women (N=26; mean age, 24.1y) without a history of dysphagia, cervical spine conditions, neurologic disease, or head/neck cancer. INTERVENTIONS: Participants performed 2 isometric exercises requiring contraction against resistance to the submandibular hyolaryngeal muscles: one requiring jaw opening against a semirigid brace (chin-to-chest [CtC] exercise) and one requiring a chin tuck against an air-inflated rubber ball (chin tuck against resistance [CTAR] exercise). Measures of electrophysiology using surface electromyography (sEMG) were obtained during exercise performance. MAIN OUTCOME MEASURES: Microvolts as measured from sEMG electrode sensors placed on the skin surface above the hyolaryngeal muscles (surface of skin above geniohyoid, mylohyoid, and anterior digastric). Dependent variables included peak contraction amplitude (in µV) and mean contraction amplitude (in µV) across 10 seconds of sustained contraction. RESULTS: Significant effects of exercise on peak and mean contraction amplitudes were present when both exercises were compared with baseline sEMG activity. (P<.001 for both). Normalized values of peak contraction amplitude and mean contraction amplitude during performance of CtC were not significantly different compared with CTAR. CONCLUSIONS: This study provides supporting evidence for the influence of 2 published exercises on motor unit recruitment in the submandibular hyolaryngeal muscles, both of which have been previously proposed as rehabilitative modalities. Theoretical and clinical implications are discussed.

A retrospective study of long-term treatment outcomes for reduced vocal intensity in hypokinetic dysarthria.

BACKGROUND: Reduced vocal intensity is a core impairment of hypokinetic dysarthria in Parkinson's disease (PD). Speech treatments have been developed to rehabilitate the vocal subsystems underlying this impairment. Intensive treatment programs requiring high-intensity voice and speech exercises with clinician-guided prompting and feedback have been established as effective for improving vocal function. Less is known, however, regarding long-term outcomes of clinical benefit in speakers with PD who receive these treatments. METHODS: A retrospective cohort design was utilized. Data from 78 patient files across a three year period were analyzed. All patients received a structured, intensive program of voice therapy focusing on speaking intent and loudness. The dependent variable for all analyses was vocal intensity in decibels (dBSPL). Vocal intensity during sustained vowel production, reading, and novel conversational speech was compared at pre-treatment, post-treatment, six month follow-up, and twelve month follow-up periods. RESULTS: Statistically significant increases in vocal intensity were found at post-treatment, 6 months, and 12 month follow-up periods with intensity gains ranging from 5 to 17 dB depending on speaking condition and measurement period. Significant treatment effects were found in all three speaking conditions. Effect sizes for all outcome measures were large, suggesting a strong degree of practical significance. CONCLUSIONS: Significant increases in vocal intensity measured at 6 and 12 moth follow-up periods suggested that the sample of patients maintained treatment benefit for up to a year. These findings are supported by outcome studies reporting treatment outcomes within a few months post-treatment, in addition to prior studies that have reported long-term outcome results. The positive treatment outcomes experienced by the PD cohort in this study are consistent with treatment responses subsequent to other treatment approaches which focus on high-intensity, clinician guided motor learning for voice and speech production in PD. Theories regarding the underlying neurophysiological response to treatment will be discussed.

The Effect of Bolus Consistency and Sex on Electrophysiological Measures of Hyolaryngeal Muscle Activity During Swallowing.

The purpose of this study was to investigate the effect of bolus consistency and sex on the activity of the submandibular hyolaryngeal muscles during swallowing. Twenty young, healthy adults (10 males, 10 females) swallowed four types of bolus material (thin liquid, thick liquid, pudding, and cookie) while being measured with surface electromyography. Measurements of peak contraction amplitude and contraction duration were computed from recorded electromyographic signals. Results from statistical analyses revealed a significant effect of bolus consistency on measures of peak contraction amplitude, but not contraction duration. There were no significant effects of sex on either measure. Findings from this study further the body of knowledge in electrophysiological measurements acquired during swallowing and their potential clinical application during assessment and treatment of dysphagia.

The Effect of CAPE-V Sentences on Cepstral/Spectral Acoustic Measures in Dysphonic Speakers.

OBJECTIVE: To investigate the effect of connected speech stimuli from the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) on cepstral/spectral acoustic measurements. PATIENTS AND METHODS: Recordings from 20 participants seeking treatment for dysphonia were analyzed in this study. The participants read the 6 sentence stimuli from the CAPE-V at a comfortable pitch and loudness. Acoustic measures of cepstral peak prominence (CPP) and its standard deviation, the low-to-high spectral ratio and its standard deviation (LH and LHsd) and the multiparametric measure Cepstral Spectral Index of Dysphonia were acquired from each sentence recording and applied to analyses. RESULTS: A significant main effect for sentence type was present on the measurements of CPP, LH and LHsd. Post hoc pairwise comparisons revealed the most robust effect on CPP from the all-voiced sentence 'We were away a year ago'. For the measures of LH and LHsd, sentence effects were significant for the majority of comparisons. CONCLUSION: The connected speech stimuli from the CAPE-V affected cepstral/spectral acoustic measurements differentially. These findings support the rationale for using the various CAPE-V stimuli during clinical assessment, and indicate the need for further investigations to inform clinical practice.

The effect of age and vocal task on cepstral/spectral measures of vocal function in adult males.

This study investigated the effect of aging on cepstral/spectral acoustic measures calculated from clinical stimuli (vowels and sentences from the Consensus Auditory Perceptual Evaluation of Voice). Thirty younger adult males (20-49 years of age) and thirty older males (50-79 years of age) produced sustained vowels and read a connected speech stimulus which were applied to cepstral/spectral acoustic analyses to derive the multiparametric measure of Cepstral/Spectral Index of Dysphonia (CSID). Results indicated that older males exhibited significantly greater CSID measures than younger males in connected speech (p=0.001; d=0.98), but not the vowel. Linear regression revealed a moderate correlation between age and CSID in connected speech. These results further inform our understanding of how aging influences voice production in varied contexts and how commonly utilised clinical voice tasks subjected to cepstral/spectral acoustic analyses might differentially inform our knowledge of underlying vocal physiology.

The Efficacy of the Manual Circumlaryngeal Therapy for Muscle Tension Dysphonia: A Systematic Review and Meta-analysis.

OBJECTIVE: Muscle tension dysphonia (MTD) is the most common functional voice disorder. Behavioral voice therapy is the front-line treatment for MTD, and laryngeal manual therapy may be a part of this treatment. The objective of this study was to investigate the effect of manual circumlaryngeal therapy (MCT) on acoustic markers of voice quality (jitter, shimmer, and harmonics-to-noise ratio) and vocal function (fundamental frequency) through a systematic review with meta-analysis. DATA SOURCES: Four databases were searched from inception to December 2022, and a manual search was performed. REVIEW METHODS: The PRISMA extension statement for reporting systematic reviews incorporating a meta-analysis of health care interventions was applied, and a random effects model was used for the meta-analyses. RESULTS: We identified 6 eligible studies from 30 studies (without duplicates). The MCT approach was highly effective on acoustics with large effect sizes (Cohen's d > 0.8). Significant improvements were obtained in jitter in percent (mean difference of -.58; 95% CI -1.00 to 0.16), shimmer in percent (mean difference of -5.66; 95% CI -8.16 to 3.17), and harmonics-to-noise ratio in dB (mean difference of 4.65; 95% CI 1.90-7.41), with the latter two measurements continuing to be significantly improved by MCT when measurement variability is considered. CONCLUSION: The efficacy of MCT for MTD was confirmed in most clinical studies by assessing jitter, shimmer, and harmonics-to-noise ratio related to voice quality. The effects of MCT on the fundamental frequency changes could not be verified. Further contributions of high-quality randomized control trials are needed to support evidence-based practice in laryngology. Laryngoscope, 134:18-26, 2024.

Measurement of hyolaryngeal muscle activation using surface electromyography for comparison of two rehabilitative dysphagia exercises.

OBJECTIVE: To investigate the effects of a resistance-based chin-to-chest (CtC) exercise on measures of hyolaryngeal muscle activation compared with a head-lift exercise. DESIGN: Within-subject, repeated-measures design. SETTING: Academic research laboratory. PARTICIPANTS: Healthy young women (N=20) without a history of dysphagia, cervical spine conditions, neurologic disease, or head/neck cancer (mean age, 22.5y). INTERVENTIONS: All participants performed an isometric jaw-opening exercise against resistance (CtC) and an isometric head-lift exercise, both targeting activation in the hyolaryngeal (suprahyoid) muscles. The CtC exercise required jaw opening into a chin brace secured against the upper torso for a duration of 10 seconds. The isometric head-lift exercise required lifting and holding the head from a supine position for 10 seconds. The degree to which each exercise activated the suprahyoid muscles was measured using surface electromyography (sEMG). MAIN OUTCOME MEASURES: Microvolts as measured from sEMG sensors placed on the skin surface above the hyolaryngeal muscles (surface of skin above geniohyoid, mylohyoid, and anterior digastric). Dependent variables included the peak microvolts during 10 seconds of sustained contraction and the difference in microvolts from rest to peak contraction for each exercise. RESULTS: Activation in the hyolaryngeal musculature as measured via sEMG was significantly greater when participants performed the CtC exercise compared with the head-lift exercise. Measures of peak microvolts during contraction were significantly greater for CtC (t=10.72, P<.001) compared with the head-lift exercise, and difference measures in microvolts calculated between rest and contraction for each exercise revealed a 2-fold increase in hyolaryngeal muscular activation for CtC (t=8.27, P<.001). CONCLUSIONS: The isometric CtC exercise resulted in greater activation of the hyolaryngeal muscles compared with an isometric head-lift exercise. Results support the need for further investigations to determine whether the CtC exercise has a positive effect as a rehabilitative exercise for clinical populations with dysphagia secondary to upper esophageal sphincter dysfunction where hyolaryngeal excursion is a physiological impairment.

Laryngeal aging and acoustic changes in male rat ultrasonic vocalizations.

This study examined changes in the acoustic and temporal structure of ultrasonic vocalizations as a function of age and correlated acoustic changes with vocal fold microstructure. Ultrasonic vocalizations were recorded in three age groups of male rats: aged (24-26 months), middle-aged (17-18 months), and young (4-5 months). Acoustic and structural changes in vocal fold tissue were evident by 18 months of age. Histological analyses revealed decreased density of elastin and hyaluronic acid and increased collagen density in the middle-aged and aged groups compared to the young rats. Laryngeal microstructure correlated with some of the ultrasonic acoustic features. These results show that male Long Evans rats experience changes in ultrasonic acoustic structure by middle age, and these changes correlate with deterioration in laryngeal microstructure. Ultrasonic vocalizations can be used as a model system for age-related degeneration in vocal fold structure and function.

The Impact of Academic, Sociodemographic, and Program Growth Factors on Admission Offers to U.S. Graduate Education Programs in Communication Sciences and Disorders: National Trends in 2016-2020 Cycles.

PURPOSE: The purpose of this study was to investigate the impact of academic factors and sociodemographic factors on offers of admission to graduate education programs in communication sciences and disorders (speech-language pathology and audiology) in the United States. METHOD: A retrospective analysis of extant data from undergraduate students applying to graduate education programs through the Communication Sciences and Disorders Centralized Application Service (CSDCAS) was conducted. Descriptive, parametric, nonparametric, and multivariate hierarchical logistic modeling analyses were applied to data from 38,625 unique applicants across four consecutive application cycles from 2016 to 2020 to assess relationships between admission offers, and academic and sociodemographic factors. The academic factors included Graduate Record Examination (GRE) and grade point average (GPA; cumulative undergraduate GPA and cumulative communication sciences and disorders [CSD] GPA), and sociodemographic factors included race/ethnicity, age, disadvantaged socioeconomic status, first-generation status, and multilinguistic status. RESULTS: The rate of receiving an offer of admission continuously increased from 59.4% in the 2016-2017 cycle to 75.4% in the 2019-2020 cycle (p < .001). The significant predictors for admission offers across all four application cycles were GPA, GRE, and applicant age. While the odds ratios of GRE and age were relatively stable, the odds ratios of GPA had a decreasing trend. Bivariate analyses showed that students who were non-White, older, socioeconomically disadvantaged, first-generation, and nonmultilingual were significantly less likely to receive offers of admission than their counterparts, but the relationships between those sociodemographic factors, except for age, and admission offers diminished when all factors were considered in the logistic regression analyses. CONCLUSIONS: Academic and sociodemographic factors significantly affected the likelihood of obtaining at least one offer of admission to a graduate program in CSD at different levels. While the effect sizes were variable, these findings provide evidence-based guidance for admission committees seeking to improve the inclusiveness of admission processes and the realization of greater diversity across multidimensional domains (e.g., race/ethnicity, socioeconomic status, age).

Sociodemographic Characteristics of People in Leadership Positions of Graduate Programs in Communication Sciences and Disorders.

OBJECTIVES: Knowledge associated with the construct of leadership and the sociodemographic profiles of those in leadership positions within academic communication sciences and disorders (COSD) programs in the United States is limited. The purpose of this study was to investigate the sociodemographic profiles of people holding department chair and/or program director positions in accredited graduate speech-language pathology (SLP) and audiology (AUD) programs. METHODS: A cross-sectional observational investigation using public information was conducted to profile individuals in leadership positions of academic programs. Tabulated data included program variables (SLP, AUD, or SLP+AUD), degree offered, program level, and national ranking, in addition to sociodemographic variables of the individuals holding a leadership position. A multidimensional statistical analysis was employed to address three research questions examining: (a) the sociodemographic characteristics of people in COSD leadership positions, (b) gender distribution within leadership positions, and (c) national ranking of institutions from which leaders obtained their terminal degree. RESULTS: Data were acquired from 502 people holding a department chair or program director positions at 305 universities, representing 98% of all accredited graduate programs. Over 80% of leaders held a research doctorate (PhD) in COSD, and a large majority of all leadership positions were in standalone academic departments. A greater proportion of males held leadership positions when compared to the distribution of male members of the American Speech-Language-Hearing Association (ASHA), but the proportion of male academic leaders was equivalent to their representation among all male COSD faculty (20%). A larger proportion of academic COSD leaders tended to have earned their terminal degree from a highly ranked academic program. CONCLUSIONS: This study illuminates the current profiles of those in leadership positions of academic graduate programs in COSD. Given the critical shortage of qualified faculty to staff accredited COSD programs, findings from this study may inform potential solutions to the problem of faculty sufficiency to assume leadership roles.

Self-perceived affective, behavioral, and cognitive reactions associated with voice use in people with Parkinson's disease: a pilot study.

PURPOSE: This study aimed to compare the affective, behavioral, and cognitive reactions related to vocal function in people with Parkinson's disease (PWPD) and healthy controls using the Behavior Assessment Battery - Voice (BAB-Voice). The test's internal consistency was also described. METHODS: 31 PWPD and 19 healthy controls were recruited from September 2020 to March 2021. Participants completed four BAB-Voice subtests: Speech Situation Checklist - Emotional Reaction (SSC-ER), the Speech Situation Checklist - Speech Disruption (SSC-SD), Behavior Checklist (BCL), and Communication Attitude Test for Adults (BigCAT), describing the experienced negative emotional reaction, voice disruptions, coping behaviors, and negative attitude regarding communication respectively. Subtest scores were calculated and analyzed. RESULTS: The scores of the PWPD were significantly different from those of the controls (Pillai's Trace = 0.344, F[4] = 5.508, p = .001, ηp2 = .344): PWPD showed more negative emotions and voice problems, more coping behaviors, and more negative speech-related attitude compared to healthy controls. All subtests showed excellent internal consistency. CONCLUSIONS: The BAB-Voice proved a tool with a good internal consistency that measured different psychosocial reactions in PWPD versus controls. PWPD exhibited significantly more negative emotions and voice problems in specific speech situations, more coping behaviors, and a more negative speech-related attitude. The specificity of information obtained from the BAB-Voice may aid in improving the treatment planning of voice disorders in PWPD.