Investigating potential disparities by exploring time to surgical thyroid cancer treatment.

(1) Delays in initial treatment have been a frequently used metric for assessing disparities in medicine; however, there has been sparse literature on treatment delays in thyroid cancer. We therefore aimed to assess disparities by investigating the association between race/ethnicity, insurance type, and socioeconomic status and time to surgical treatment of thyroid cancer. (2) A retrospective chart review was conducted to collect demographic and clinical data from 443 surgical thyroid cancer patients at Mount Sinai Hospital in 2018-2019. We investigated the time between thyroid cancer diagnosis and surgery by race/ethnicity, insurance, and income groups. (3) Univariate analysis showed that race/ethnicity, insurance type, and SES alone were not statistically significant predictors of earlier time to treatment (p = 0.766, 0.339, 0.435, respectively). On multivariable linear regression, time between diagnosis and surgical treatment was not significantly different for racial minorities compared to non-Hispanic White patients, patients with Medicare/Medicaid compared to private insurance, and patients with lowest income quartile (<$54,585) compared to those with the highest (≥$116,560). (4) Present study showed no significant delays in treatment for different racial/ethnic, insurance, and income groups.

Anxiety and Depression as Potential Predictors for Shorter Time to Undergo Initial Surgical Treatment for Papillary Thyroid Cancer.

(1) Background: A pre-existing psychiatric condition may impact decision making by patients and/or physicians following a thyroid cancer diagnosis, such as potentially electing surgery over active surveillance, thus shortening the time to cancer removal. This is the first study to investigate the association between pre-existing anxiety and/or depression and time to receive surgical treatment for thyroid cancer. (2) Methods: Retrospective data were collected from 652 surgical thyroid cancer patients at our institution from 2018 to 2020. We investigated the time between thyroid cancer diagnosis and surgery, comparing patients with pre-existing anxiety and/or depression to those without. (3) Results: Patients with anxiety, depression, and both anxiety and depression had a significantly shorter time between diagnosis and surgery (51.6, 57, and 57.4 days, respectively) compared to patients without (111.9 days) (p = 0.002, p = 0.004, p = 0.003, respectively). (4) Conclusions: Although little is known about the impact of pre-existing psychiatric conditions in the decision-making process for thyroid cancer surgery, this present study showed that anxiety and/or depression may lead to more immediate surgical interventions. Thus, psychiatric history may be an important factor for physicians to consider when counseling patients with thyroid cancer.

Clinical and Therapeutic Considerations for Older Adults with Head and Neck Cancer.

Approximately 30% of patients with head and neck squamous cell carcinoma (HNSCC) are at least 70 years of age, and this percentage is expected to increase as the population increases and lives longer. Elderly patients are underrepresented in head and neck oncology clinical trials, and there is minimal evidence on the management of HNSCC for this population. Subsequently, despite their best intentions, physicians may unknowingly recommend an ill-suited course of therapy, which may result in suboptimal oncological or functional outcomes or adverse events. Surgical approaches have the potential to carry a higher risk of morbidity and mortality in older adults, especially in patients with multiple comorbidities. Definitive radiation therapy treatment in patients with HNSCC frequently involves 7 weeks of daily radiation, sometimes with concurrent chemotherapy, and this demanding treatment can be difficult for older adult patients, which may lead to treatment interruptions, potential removal of concurrent systemic therapy, compromised outcomes, and diminished quality of life. There are clinical trials currently underway investigating altered fractionation regimens and novel, less toxic systemic treatments in this population. This review provides an overview of how best to approach an older adult with HNSCC, from initial work-up to treatment selection.

Endosulfan use and the risk of thyroid cancer: an ecological study.

Endosulfan, an organochlorine pesticide, has been understudied in the literature on thyroid cancer. The aim of this ecological study was to assess the correlation between endosulfan exposure and thyroid cancer incidence rates (IRs) in the United States (US). Age-adjusted thyroid cancer IRs per 100,000 people per state for the years 1999 to 2019 were obtained from the Center for Disease Control and Prevention (CDC). To assess the state-level use of endosulfan, data were obtained from the US Geological Survey (USGS). Endosulfan usage estimates (kilograms/acres cropland; quintiles) and thyroid cancer IRs were mapped together. The correlation between age-adjusted thyroid cancer IRs and statewide endosulfan use was calculated using the Spearman correlation. Overall endosulfan usage in the US trended downwards between 1992 and 2007 (T = -0.77; P < 0.001), while thyroid cancer IR trended upwards between 1999 and 2019 (T = 0.69; P < 0.001). There was a statistically significant correlation between 1992 endosulfan use and 2012 (r = 0.32; P = 0.03) and 2014 (r = 0.32; P = 0.03) thyroid cancer IRs. Although restrictions on endosulfan use seem effective, the potential impact of endosulfan exposure remains due to the persistent, semi-volatile, bioaccumulative, and biomagnifying properties of endosulfan metabolites in particular, indicating the need for future thyroid research of highly exposed populations.

The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field.

In this commentary, we describe the potential of highly ablative doses utilizing Stereotactic Body Radiation Therapy (SBRT) in single or few fractions to enhance immune-responsiveness, how timing of this approach in combination with immune-checkpoint inhibitors may augment treatment-effect, and whether Personalized Ultrafractionated Stereotactic Adaptive Radiation Therapy (PULSAR) is an avenue for future advancement in the continued endeavor to foster a systemic effect of therapy beyond the radiation treatment field. The ablative potential of SBRT may support an increase in tumor-antigen presentation, enhancement of immune-stimulatory components, and an improvement in tumor-microenvironment immune cell infiltration. Furthermore, the latest advancement of ablative radiation delivery is PULSAR-based therapy, whereby ablative doses are delivered in pulses of treatment that may be several weeks apart, combined with adaptive treatment to tumor changes across time. The benefits of this novel approach include the ability to optimize direct tumor control by assessment of tumor size and location via dedicated imaging acquired prior to each delivered pulse, and further potentiation of immune recognition through combination with concurrent immune-checkpoint blockade.

Single-virus assay reveals membrane determinants and mechanistic features of Sendai virus binding.

Sendai virus (SeV, formally murine respirovirus) is a membrane-enveloped, negative-sense RNA virus in the Paramyxoviridae family and is closely related to human parainfluenza viruses. SeV has long been utilized as a model paramyxovirus and has recently gained attention as a viral vector candidate for both laboratory and clinical applications. To infect host cells, SeV must first bind to sialic acid glycolipid or glycoprotein receptors on the host cell surface via its hemagglutinin-neuraminidase (HN) protein. Receptor binding induces a conformational change in HN, which allosterically triggers the viral fusion (F) protein to catalyze membrane fusion. While it is known that SeV binds to α2,3-linked sialic acid receptors, and there has been some study into the chemical requirements of those receptors, key mechanistic features of SeV binding remain unknown, in part because traditional approaches often convolve binding and fusion. Here, we develop and employ a fluorescence microscopy-based assay to observe SeV binding to supported lipid bilayers (SLBs) at the single-particle level, which easily disentangles binding from fusion. Using this assay, we investigate mechanistic questions of SeV binding. We identify chemical structural features of ganglioside receptors that influence viral binding and demonstrate that binding is cooperative with respect to receptor density. We measure the characteristic decay time of unbinding and provide evidence supporting a "rolling" mechanism of viral mobility following receptor binding. We also study the dependence of binding on target cholesterol concentration. Interestingly, we find that although SeV binding shows striking parallels in cooperative binding with a prior report of Influenza A virus, it does not demonstrate a similar sensitivity to cholesterol concentration and receptor nanocluster formation.

A recurrent MORC2 mutation causes Charcot-Marie-Tooth disease type 2Z.

We found a p.Ala406Val (c.1217C > T) mutation in MORC2 in three individuals, from two families. All three individuals were evaluated and clinical electrophysiology was completed. The neuropathy began in childhood to early adulthood, with distal weakness progressing to proximal weakness. Vinblastine (for Hodgkin lymphoma) acutely worsened the weakness in one patient. This finding confirms that that the p.Ala406Val mutation in MORC2 causes severe neuropathy. In addition, we report the first case of vinblastine neurotoxicity in Charcot-Marie-Tooth disease type 2Z.

Natural history of Charcot-Marie-Tooth disease type 2A: a large international multicentre study.

Mitofusin-2 (MFN2) is one of two ubiquitously expressed homologous proteins in eukaryote cells, playing a critical role in mitochondrial fusion. Mutations in MFN2 (most commonly autosomal dominant) cause Charcot-Marie-Tooth disease type 2A (CMT2A), the commonest axonal form of CMT, with significant allelic heterogeneity. Previous, moderately-sized, cross sectional genotype-phenotype studies of CMT2A have described the phenotypic spectrum of the disease, but longitudinal natural history studies are lacking. In this large multicentre prospective cohort study of 196 patients with dominant and autosomal recessive CMT2A, we present an in-depth genotype-phenotype study of the baseline characteristics of patients with CMT2A and longitudinal data (1-2 years) to describe the natural history. A childhood onset of autosomal dominant CMT2A is the most predictive marker of significant disease severity and is independent of the disease duration. When compared to adult onset autosomal dominant CMT2A, it is associated with significantly higher rates of use of ankle-foot orthoses, full-time use of wheelchair, dexterity difficulties and also has significantly higher CMT Examination Score (CMTESv2) and CMT Neuropathy Score (CMTNSv2) at initial assessment. Analysis of longitudinal data using the CMTESv2 and its Rasch-weighted counterpart, CMTESv2-R, show that over 1 year, the CMTESv2 increases significantly in autosomal dominant CMT2A (mean change 0.84 ± 2.42; two-tailed paired t-test P = 0.039). Furthermore, over 2 years both the CMTESv2 (mean change 0.97 ± 1.77; two-tailed paired t-test P = 0.003) and the CMTESv2-R (mean change 1.21 ± 2.52; two-tailed paired t-test P = 0.009) increase significantly with respective standardized response means of 0.55 and 0.48. In the paediatric CMT2A population (autosomal dominant and autosomal recessive CMT2A grouped together), the CMT Pediatric Scale increases significantly both over 1 year (mean change 2.24 ± 3.09; two-tailed paired t-test P = 0.009) and over 2 years (mean change 4.00 ± 3.79; two-tailed paired t-test P = 0.031) with respective standardized response means of 0.72 and 1.06. This cross-sectional and longitudinal study of the largest CMT2A cohort reported to date provides guidance for variant interpretation, informs prognosis and also provides natural history data that will guide clinical trial design.

Leaky expression of channelrhodopsin-2 (ChR2) in Ai32 mouse lines.

Optogenetics enables the selective activation of genetically-targeted neuronal populations using light-sensitive ion channels. Genetic strategies using Cre-dependent mouse strains, especially the Ai32 line expressing Channelrhodopsin (ChR2)-EYFP fusion protein, have been a popular means to drive opsin expression in a cell-type specific manner. Here we report a low level of leaky 'off-target' (Cre-independent) ChR2-EYFP expression in Ai32/Ai32 homozygous mice throughout the nervous system. This leaky off-target expression was characterized in multiple prevalent nervous system regions using anti-EYFP immunostaining. Expression of full-length ChR2-EYFP protein was confirmed using immunoprecipitation followed by Western blotting. Notably, light stimulation of these ChR2-EYFP expressing neurons in the spinal cord dorsal horn did not induce detectable photocurrents in juvenile 4-week old mice. Given the wide use of the Ai32 line by many labs, our results suggest researchers should be vigilant of possible off-target ChR2-EYFP expression in their region of interest, especially when generating Ai32/Ai32 homozygotes to drive high levels of ChR2-EYFP expression in adult mice.

A contribution to the elemental profile of the leaf samples of newly developed Cabernet Franc varieties.

The elemental profile of the leaf samples of three Cabernet Franc clone candidates recently developed in Serbia (Nos. 02, 010 and 012) obtained in the last phase of clonal selection was examined within this study by ICP-OES. Optimal content of Al, Fe, Cu and Zn, the metals well known for their links with a number of neurodegenerative disorders including Alzheimer's disease, has actually highlighted the potential of the leaf sample No. 10 to afford a novel food supplement of natural origin possessing well balanced metal ingredients. Furthermore, lower content of some other elements (Cr, Mn, Ni and Pb) thoroughly supports such a claiming. Finally, the most favourable K/Na ratio observed for the aforementioned sample points out its likely cardioprotectivity. However, two other Cabernet Franc clone candidates might also be recommended for breeding in the same or similar viticultural conditions, since all obtained values were below toxic ones for human consumption.

Wine Chemical Composition and Radical Scavenging Activity of Some Cabernet Franc Clones.

BACKGROUND: Three clones of Cabernet Franc (Nos. 02, 010 and 012) were selected in the last phase of clonal selection in Serbia. Wines made from each clone were assessed for quality parameters and taste during five consecutive vintages (2008-2012) and compared to the standard. The wine quality was determined based on the following parameters: alcohol, total extract, anthocyanins, tannins, pH, titratable acidity, volatile acidity, aldehydes, esters and reducing sugars, relative density, ash, colour, tonality, and tasting score. In the last year of the study, grapes and wines of Cabernet Franc clones and a standard were subjected to a chemical analysis of their phenolic composition, resveratrol and radical scavenging activity. In the last year of the study, grapes and wines of Cabernet Franc clones and a standard were subjected to a chemical analysis of their phenolic composition, resveratrol and radical scavenging activity. METHODS: Chemical analyses of grapes and wines along with sensory and radical scavenging activity evaluations were done according to the standard procedures. RESULTS: The wines of the clone No. 010 showed some superior properties compared to the other two clones and the standard; in five-year period the average concentration of anthocyanins (179±3.8 mg/L) and polyphenolics (1.85±0.02 g/L) was significantly higher than in wines of clones and the standard, (168-173 mg/L and 1.63-1.74 g/L for anthocyanins and phenolics, respectively). Furthermore, the same clone had a higher alcohol content (13.97±0.03%) in each year of the study, which indicated that it ripened faster than other clones (13.06-13.08 %) and compared to the standard (13.04±0.07%). This finding suggested that the clone No. 010 could possibly have a significant economic impact and further increase popularity of Cabernet Franc in a cooler climate viticultural region. It was also found to have the highest contents of aldehydes (488±1.54 mg/L) and esters (322±0.71 mg/L) compared to aldehydes (452-467 mg/L) and esters (290-310 mg/L) measured in other wines. Finally, the highest amount of phenolic compounds (1220±40 mg/kg) and resveratrol (70±3.3 mg/kg) were found in the grapes of the clone No. 010. The present study revealed a strong correlation of total phenolic contents and anthocyanins with radical scavenging activities (0.936 and 0.929, P<0.001, respectively) indicating that this activity of wines was derived mainly from their phenolic compounds. CONCLUSION: The wine of the clone No. 010 contained the highest concentration of aldehydes, esters, anthocyanins, polyphenolics and resveratrol and consequently achieved the best tasting score. This clone may offer a new Cabernet Franc wine with geographical indication.

Viticultural and chemical characteristics of Muscat Hamburg preselected clones grown for table grapes.

BACKGROUND: Clonal selection is one of the tools used for grapevine improvement and therefore is very important for obtaining clones with better characteristics than the variety population. The aim of this study was to select superior grapevines of Vitis vinifera L. cv. Muscat Hamburg grown for fresh consumption. RESULTS: The viticultural parameters and fruit composition of 35 selected vines were determined during a 5-year period. The evaluated parameters showed high variability among selected vines. The significant effect of vintage was observed for all descriptors with the exception of the number of seeds per berry and sugar concentration. Additionally, all vines were examined for their tolerance to low temperatures and the results showed 73% and 90% of primary bud injury at -20 and -25 °C, respectively. In relation to berry classification, the percentage of first-class grapes ranged from 60% to 69% for all selected grapevines. Multivariate statistical analysis was performed to classify grapevines based on their performance. CONCLUSION: Fourteen grapevines were identified as the most promising among the 35 vines initially planted, based on high yield, bunch and berry weight, sugar content and percentage of first-grade grapes. Those grapevines were selected for the next phase of the clonal selection. This study highlighted the importance of clonal selection for improvement of the variety population. © 2016 Society of Chemical Industry.

Impact of Clonal Variability on Phenolics and Radical Scavenging Activity of Grapes and Wines: A Study on the Recently Developed Merlot and Cabernet Franc Clones (Vitis vinifera L.).

In this study, grapes and corresponding wines of Merlot /No 022, 025 and 029/ and Cabernet Franc /No 02, 010 and 012/ clones (recently developed) were evaluated regarding the total phenolic content, total anthocyanin content, and radical scavenging activity, aiming to better understand their quality and market potential. The nineteen individual polyphenols were quantified in studied grape samples using UHPLC coupled to a triple-quadrupole mass spectrometer. The mother grapes and wines were used as the relevant standards. In the grape, studied characteristics were monitored at three stages of berry development: green berry, véraison and mature berry. The mature grape of clones presented high values of total phenolics (3.81-10.89 g gallic acid equivalent kg-1 frozen weight), anthocyanin content (359.00-1668.18 mg malvidin-3-O-glucoside kg-1 frozen weight) and the radical scavenging activity (41.37-80.48 mmol trolox equivalent kg-1 frozen weight) depending on the clone. Grapes and wines of Merlot No 025 and Cabernet Franc No 010 stood out with the highest values of all three parameters. Generally, the high correlation was observed between TPC and RSA values for green berries and mature grapes, as well as for wine samples. The most abundant phenolics in both Merlot and Cabernet Franc grapes were gallic acid, p-hydroxybenzoic acid, ferulic acid, catechin, epicatechin, gallocatechin gallate, catechin gallate, and rutin. Catechin, epicatechin, epigallocatechin, and catechin gallate, typical for the ripe grape of Merlot and Cabernet Franc clones, showed significant correlation with RSA values. Concentrations of individual polyphenols varied depending on the sample being studied and berry development stages. Merlot No 025 and Cabernet Franc No 010 grapes showed particularly interesting attributes for the production of high quality wines.

The natural product content of the selected Cabernet Franc wine samples originating from Serbia: a case study of phenolics.

This work aimed to evaluate the content of selected phenolic natural products in the wine samples made of three new Serbian Cabernet Franc clones (Nos. 02, 010 and 012, respectively) and mother vine (used as the relevant standard) during the period 2008-2012. Compared with all other wine samples, the Cabernet Franc wine of the clone No. 010 was found to have the highest total content of polyphenolics (1.85 ± 0.02 g/L) and anthocyanins (178.55 ± 3.75 mg/L). In addition, its Folin-Ciocalteu index (36.86 ± 0.12) stood out among the examined samples. Finally, the same wine was enriched with ellagic and gallic acids (3.44 ± 0.29 and 27.46 ± 0.21 mg/L, respectively), catechin (135.16 ± 6.47 mg/L) and epicatechin (51.33 ± 2.33 mg/L), the natural products known to exert significant lipid-lowering effects. Taken all together, the clone No. 010 developed in Serbia may offer new Cabernet Franc wine with geographical indication.

Phenolic natural products of the wines obtained from three new Merlot clone candidates.

This work aimed to evaluate the total contents of polyphenolics (the Ribereau-Gayon-Maurié procedure), anthocyanins (using pH differential method) and tannins (the Nègre procedure) as well as the content of phenolic acids (using UPLC/MS chromatography), respectively of the wines obtained from three new Merlot clone candidates in the perennial clonal selection. The aforementioned chemical parameters were determined in the samples covering the period 2009-2012. In comparison both with the standard Merlot wine (mother vine) and the wines obtained from other two clone candidates, the Merlot wine of the clone candidate No. 022 was found to have the highest total content of all three examined components 1.89 ± 0.05 g/L (polyphenolics), 185.59 ± 5.00 mg/L (anthocyanins) and 1.11 ± 0.03 g/L (tannins), as well as six phenolic acids including gallic acid (25.49 ± 0.27 mg/L). These findings are in good agreement with the observed trend for the viticultural parameters indicating the clone candidate No. 022 as more promising than mother.