Aim The global health pandemic caused by the SARS-coronavirus 2 (COVID-19) has led to the adoption of facemasks as a necessary safety precaution. Depending on the level of risk for exposure to the virus, the facemasks that are used can vary. The aim of this study was to examine the effect of different types of facemasks, typically used by healthcare professionals and the public during the COVID-19 pandemic, on measures of voice. Methods Nineteen adults (ten females, nine males) with a normal voice quality completed sustained vowel tasks. All tasks were performed for each of the six mask conditions: no mask, cloth mask, surgical mask, KN95 mask and, surgical mask over a KN95 mask with and without a face shield. Intensity measurements were obtained at a 1ft and 6ft distance from the speaker with sound level meters. Tasks were recorded with a 1ft mouth-to-microphone distance. Acoustic variables of interest were fundamental frequency (F0), and formant frequencies (F1, F2) for /a/ and /i/ and smoothed cepstral peak prominence (CPPs) for /a/. Results Data were analyzed to compare differences between sex and mask types. There was statistical significance between males and females for intensity measures and all acoustic variables except F2 for /a/ and F1 for /i/. Few pairwise comparisons between masks reached significance even though main effects for mask type were observed. These are further discussed in the article. Conclusion The masks tested in this study did not have a significant impact on intensity, fundamental frequency, CPPs, first or second formant frequency compared to voice output without a mask. Use of a face shield seemed to affect intensity and CPPs to some extent. Implications of these findings are discussed further in the article.

4. Laryngoscope, 128:1170-1175, 2018.

ProblemThe COVID-19 pandemic led to changes in both the clinical environment and medical education. The abrupt shift to telemedicine in March 2020, coupled with the recommendation that medical students pause in-person clinical rotations, highlighted the need for student training in telemedicine.

Telemedicine is now an established mode of clinical care for most medical specialties, and clinical teachers must teach and precept learners in this modality. However, faculty need training on how best to teach students when caring for patients via telemedicine. Effectively incorporating learners into telemedicine visits to optimize their education is a critical skill for clinical teachers. In this article, we review 12 practical tips unique to telemedicine to engage and educate undergraduate medical education learners in building their clinical skills. We outline synchronous and asynchronous elements before, during, and after the patient encounter to facilitate teaching while improving patient care. These principles can also be adapted for teaching in other health professions as well as postgraduate medical education.

The objectives of this study were to examine whether the personality trait of stress reaction (SR), as assessed with the Multidimensional Personality Questionnaire-Brief Form (MPQ-BF), (1) influences prefrontal and limbic area activity during overt sentence reading and if (2) SR and associated individual differences in prefrontal and limbic activations correlate with sensorimotor cortical activity during overt sentence reading. Ten vocally healthy adults (22-57 years) participated in a functional MRI study using an event-related sparse sampling design to acquire brain activation data during sentence production tasks (covert, whispered, overt). The outcome measure was the blood oxygenation level-dependent signal change in prefrontal, limbic, and primary somatosensory (S1) and motor cortices (M1). Significant positive correlations were found between SR scores and S1, dorsolateral prefrontal cortex (both r =.73, p <.05), and periaqueductal gray (r =.88, p <.01) activity. M1 activity was positively correlated with SR (r =.64, p <.05) and negatively with social potency (r = -.70, p <.05). Our findings suggest that motor cortical control subserving voice and speech production varies with expression of selected personality traits. Future studies should investigate the functional significance of personality differences in the central neural control of vocalization.