Organized vibration of the vocal folds is critical to high quality voice production. When the vocal folds oscillate, the superficial tissue of the vocal fold is displaced in a wave-like fashion, creating the so called “mucosal wave”. Because the mucosal wave is dependent on vocal fold structure, physical alterations of that structure cause mucosal wave abnormalities. Visualization and quantification of mucosal wave properties have become useful parameters in diagnosing and managing vocal fold pathology. Mucosal wave measurement provides information about vocal fold characteristics that cannot be determined with other assessment techniques. Here, we discuss the benefits, disadvantages, and clinical applicability of the different mucosal wave measurement techniques, such as electroglottography (EGG), photoglottography (PGG), and ultrasound and visualization techniques that include videokymography (VKG), stroboscopy, and high-speed digital imaging (HSDI). The various techniques and their specific uses are reviewed with the intention of helping researchers and clinicians choose a method for a given situation and understand its limitations as well as its potential applications. Recent applications of these techniques for quantitative assessment demonstrate that additional research must be conducted to realize the full potential of these tools. Evaluations of existing research and recommendations for future research are given to promote both the quantitative study of the mucosal wave through accurate and standardized measurement of mucosal wave parameters and the development of reliable methods with which physicians can diagnose vocal disorders.

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Objective Evaluate the effect of vocal fold surface dehydration on mucosal wave amplitude and frequency. Study Design Controlled test-retest. Setting Larynges were mounted on an excised larynx phonation system and attached to a pseudolung in a triple-walled sound-attenuated room that eliminated background noise and maintained a stabilized room temperature and humidity level. Subjects and Methods High-speed video was recorded for eight excised canine larynges during exposure to dehumidified air at 20 cm H2O. Control trials consisted of high-speed videos recorded for two excised canine larynges during exposure to humidified air at the same pressure. Results In the majority of larynges, increased levels of dehydration were correlated with decreased amplitude and frequency. The slope of the linear regression fitted to the change in amplitude (p=0.003) as well as the percent change (p<0.001) between the initial and final trials were significantly decreased in dehydrated larynges. These measurements with respect to the change in frequency were also significantly decreased in dehydrated larynges (p<0.001; p=0.027). Conclusion Vocal fold surface dehydration caused a decrease in mucosal wave amplitude and frequency. This study provides objective, quantitative support for the mechanism of voice deterioration observed after extreme surface dehydration.

Chronic viral hemorrhagic septicemia virus (VHSV) infections were established in a laboratory stock of Pacific herring Clupea pallasii held in a large-volume tank supplied with pathogenfree seawater at temperatures ranging from 6.8 to 11.6°C. The infections were characterized by viral persistence for extended periods and near-background levels of host mortality. Infectious virus was recovered from mortalities occurring up to 167 d post-exposure and was detected in normal-appearing herring for as long as 224 d following initial challenge. Geometric mean viral titers were generally as high as or higher in brain tissues than in pools of kidney and spleen tissues, with overall prevalence of infection being higher in the brain. Upon re-exposure to VHSV in a standard laboratory challenge, negligible mortality occurred among groups of herring that were either chronically infected or fully recovered, indicating that survival from chronic manifestations conferred protection against future disease. However, some survivors of chronic VHS infections were capable of replicating virus upon re-exposure. Demonstration of a chronic manifestation of VHSV infection among Pacific herring maintained at ambient seawater temperatures provides insights into the mechanisms by which the virus is maintained among populations of endemic hosts. KEY WORDS: Viral hemorrhagic septicemia · VHS · Pacific herring Resale or republication not permitted without written consent of the publisherDis Aquat Org 93: [43][44][45][46][47][48][49] 2010 tion. Recognizing the unlikelihood that this narrow R 0 range persists for extended periods in dynamic natural systems like the NE Pacific, it is hypothesized that alternative or complementary VHSV perpetuation strategies exist in wild populations of Pacific herring. Thus, while only acute manifestations of VHS have been reported, lower levels of mortality are difficult to observe in the ocean, and the occurrence of subacute forms of the disease could easily go unnoticed. Recognition of subacute forms of VHS in Pacific herring, analogous to those known to occur in cultured rainbow trout Oncorhynchus mykiss in Europe (Smail 1999), could offer an alternative means by which the virus may be maintained in populations without the need for exclusive reliance on transmission of acute disease within a narrow R 0 range.Here, we report the results of long-term laboratory studies of VHSV-exposed Pacific herring that resulted in atypical disease manifestations that were characterized by tempered and prolonged mortality. The purpose of this study was to describe the kinetics of these subacute VHS outbreaks and to determine whether survivors were protected against future infections or disease. MATERIALS AND METHODSEstablishment of subacute and persistent VHSV infections. Sub-acute and persistent VHSV infections were initiated among laboratory-reared, age 1+ yr, specific pathogen-free (SPF) Pacific herring (n = 3668). The fish were housed in a 2.5 m diameter (3200 l) circular tank provided with flowing, processe...

The COVID-19 pandemic led to numerous measures to mitigate the spread of SARS-CoV-2, including cancellations of gatherings, closure of businesses and schools, social distancing, wearing face masks, and other hygiene measures. 1 These may have unintended positive associations with reducing other respiratory infections. As antibiotics are frequently inappropriately prescribed for viral respiratory diseases, 2 we hypothesized that a decreased respiratory virus incidence would be associated with reduced ambulatory antibiotic orders.Methods | We conducted a pre-post study consisting of a pre-COVID-19 pandemic period (July 2018 to February 2020), a 1-month run-in period (March 2020), and a COVID-19 pandemic period (April 2020 to February 2021). This study received an institutional review board exemption from the University of Wisconsin because it used aggregate prescribing data only, without any patient or clinician identifiers. The Wisconsin State Laboratory of Hygiene provided weekly statewide surveillance polymerase chain reaction data for the following respiratory viruses: influenza, respiratory syncytial virus, human parainfluenza virus, human metapneumovirus, seasonal coronavirus, adenovirus, and enterovirus/ rhinovirus. University of Wisconsin Health is a large, academic health system that serves southern Wisconsin, with more than 80 ambulatory sites and 7 000 000 annual ambulatory encounters. Ambulatory antibiotic prescribing data were collected for all University of Wisconsin Health ambulatory clinics, visit types (eg, in person, telemedicine, and telephone), and ages. We calculated the number of monthly antibiotic prescriptions per 1000 patient encoun-