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SiC/SiC composites are studied for their potential use in the next generation of nuclear reactors. A multiscale approach is under development to construct a predictive modelling of their complex damageable mechanical behaviour due to their heterogeneous microstructure. This paper focuses on the damage characterisation of the composite at the scale of the tow at room temperature, both in terms of its spatial distribution and its chronology. Such observations are necessary to validate a multiscale damage modelling at the microscopic scale. The nonlinear behaviour is related to the accumulation of damages such as matrix cracking, fibre/matrix debonding and finally fibre breaking. Therefore, in-situ tensile tests were carried out on SiC/SiC minicomposites using scanning electron microscopy. Specific procedures could be used to get statistical data on the crack evolution. The first results especially show that the growth of the crack openings over the global strain is related to inter-crack distance. This test was complemented by a microtomographic investigation, conducted at the ESRF, performed on a minicomposite submitted to a tensile load. An analysis conducted on the 3D image of a crack shows a slow propagation of the matrix cracking through the minicomposite section.

Parametric approaches have been used widely to model animal growth and study the impact of growth profile on performance. Individual variation is often not considered in such approaches. However, non-parametric modelling allows this. Such an approach, based on spline functions, was used to study the importance of growth profiles from age 0 to 15 months (i.e. insemination) on milk yield and composition in primiparous cows. A dataset of 447 heifers was used for analysis of growth performance; 296 of them were also used to study impact on lactation. All of them originated from a French experimental herd and were born between 1986 and 2006. Clustering methods were also tested. Comparison of spline methods showed that a cubic spline interpolation method, with no smoothing parameter, was best suited to studying heifer growth. Similarly, partitioning around medoids proved the most accurate clustering method for classifying heifer growth into groups. The results of these analyses agreed with those previously published, supporting the utility of these methods. A final study on the impact of breakdowns in the growth curves was performed. A breakdown was considered only when the derivative of the interpolation function was negative or zero. Of the 447 heifers initially used, 125 (Gr0), 175 (Gr1) and 147 (Gr2) had no, one, or two or more breakpoints during the 0–15 months of age period. Milk yield on a 305 d basis was significantly reduced with an increased number of breakpoints (6548 v. 6828 and 6905 kg for Gr2, Gr1 and Gr0 animals, respectively). Fat content was also higher in Gr2 than in Gr0 groups, but overall, no difference in total fat or protein-corrected milk production was noted. The intersection between groups for growth and groups for breakdowns confirmed that animals with two or more breakdowns belonged more frequently to the group with the lowest growth performance. These results offer the possibility of analysing large databases, originating from an automatic collecting system (e.g. milking robots) or from different herds, breeds, genetics, etc. These approaches could also be used for studies on body score index, girth development, lactation profiles, etc. and in other species, such as dairy goats or beef cattle. They could find use in the development of new models of prediction, e.g. the probability of heat appearance on an animal basis, which could be included among useful management tools. [ABSTRACT FROM PUBLISHER]

The tensile behavior of CVI SiC/SiC composites with Hi-Nicalon type-S (Hi-NicalonS) or Tyranno-SA3 (SA3) fibers was investigated using minicomposite test specimens. Minicomposites contain a single tow. The mechanical behavior was correlated with microstructural features including tow failure strength and interface characteristics. The Hi-NicalonS fiber-reinforced minicomposites exhibited a conventional damage-tolerant response, comparable to that observed on composites reinforced by untreated Nicalon or Hi-Nicalon fibers and possessing weak fiber/matrix interfaces. The SA3 fiber-reinforced minicomposites exhibited larger interfacial shear stresses and erratic behavior depending on the fiber PyC coating thickness. Differences in the mechanical behavior were related to differences in the fiber surface roughness. [ABSTRACT FROM AUTHOR]

Shear rate is significantly lower in the superficial femoral compared with the brachial artery in the supine posture. The relative shear rates in these arteries of subjects in the upright posture (seated and/or standing) are unknown. The purpose of this investigation was to test the hypothesis that upright posture (seated and/or standing) would produce greater shear rates in the superficial femoral compared with the brachial artery. To test this hypothesis, Doppler ultrasound was used to measure mean blood velocity (MBV) and diameter in the brachial and superficial femoral arteries of 21 healthy subjects after being in the supine, seated, and standing postures for 10 mm. MBV was signifi- cantly higher in the brachial compared with the superficial femoral artery during upright postures. Superficial femoral artery diameter was significantly larger than brachial artery diameter. However, posture had no significant effect on either brachial or superficial femoral artery diameter. The calculated shear rate was significantly greater in the brachial (73 ± 5, 91 ± 11, and 97 ± 13 s') compared with the superficial femoral (53 ± 4, 39 ± 77, and 44 ± 5 s~) artery in the supine, seated, and standing postures, respectively. Contrary to our hypothesis, our current findings indicate that mean shear rate is lower in the superficial femoral compared with the brachial artery in the supine, seated, and standing postures. These findings of lower shear rates in the superficial femoral artery may be one mechanism for the higher propensity for atherosclerosis in the arteries of the leg than of the arm. [ABSTRACT FROM AUTHOR]

The article focuses on a study that examined the tensile behavior of Chemical Vapor Infiltration (CVI) silicon carbide/silicon carbide (SiC/SiC) reinforced with Hi-Nicalon S or SA3 fibers. The results indicate that the Hi-Nicalon S fiber reinforced minicomposites exhibited a conventional response, comparable to that one observed on composites reinforced with as-received Nicalon or Hi-Nicalon S fibers and possessing weak fiber and matrix interfaces.

Abstract Neonatal Borna disease virus (BDV) infection of the rat brain is associated with microglial activation and damage to certain neuronal populations. Since persistent BDV infection of neurons is nonlytic in vitro, activated microglia have been suggested to be responsible for neuronal cell death in vivo. However, the mechanisms of activation of microglia in neonatally BDV-infected rat brains remain unclear. Our previous studies have shown that activation of microglia by BDV in culture requires the presence of astrocytes as neither the virus nor BDV-infected neurons alone activate microglia. Here, we evaluated the mechanisms whereby astrocytes can contribute to activation of microglia in neuron-glia-microglia mixed cultures. We found that persistent infection of neuronal cells leads to activation of uninfected astrocytes as measured by elevated expression of RANTES. Activation of astrocytes then produces activation of microglia as evidenced by increased formation of round-shaped, MHCI-, MHCII- and IL-6-positive microglia cells. Our analysis of possible molecular mechanisms of activation of astrocytes and/or microglia in culture indicates that the mediators of activation may be soluble heat-resistant, low molecular weight factors. The findings indicate that astrocytes may mediate activation of microglia by BDV-infected neurons. The data are consistent with the hypothesis that microglia activation in the absence of neuronal damage may represent initial steps in the gradual neurodegeneration observed in brains of neonatally BDV-infected rats.

Abstract: The purpose of the present study is to characterize matrix crack propagation and fiber breaking occurrences within SiC/SiC minicomposite in order to validate later on a multiscale damage model at the local scale. An in situ X-ray microtomography tensile test was performed at the European Synchrotron Radiation Facility (ESRF, ID19 beamline) in order to obtain 3-dimensional (3D) images at six successive loading levels. Results reveal a slow and discontinuous propagation of matrix cracks, even after the occurrence of matrix crack saturation. A few fiber failures were also observed. However, radiographs of the whole length (14mm) of the minicomposites under a load and after the failure were more appropriate to get statistical data about fiber breaking. Thus, observations before the ultimate failure revealed only a few fibers breaking homogeneously along the minicomposite. In addition, an increase in fiber breaking density in the vicinity of the fatal matrix crack was observed after failure. These experimental results are discussed in regards to assumptions used in usual 1-dimensional (1D) models for minicomposites. [Copyright &y& Elsevier]

Background: Gene expression data from pancreatic cancer, histologically normal tissue adjacent to the cancer and normal pancreas reveals that adjacent normal has already acquired a number of transcriptional alterations and is not, therefore, an appropriate baseline for comparison with cancers. (Gadaleta et al., 2011) The purpose of this study was to determine if this is also the case for breast cancer and, if so, to identify the differences in gene expression between adjacent normal and normal breast. Methods: RNA-Seq data from breast cancer and adjacent normal was downloaded from the TCGA (The Cancer Genome Atlas) data portal. The epithelia from 20 frozen tissue cores from healthy premenopausal donors to the Susan G. Komen for the the Cure® Tissue Bank at the IU Simon Cancer Center were microdissected and the RNA isolated. RNA-seqeuncing was carried out using the Life Technologies SOLiD Platform. RPKM gene expression values from TCGA and sequencing of the Komen normal tissues were merged, quantile normalized, and batch effect corrected. Normalization and differential gene expression was performed using Partek Genomics Suite. Results: Principal component analysis (PCA) reveals complete separation between adjacent normal and healthy normal breast tissue. Setting a maximum FDR (false discover rate) of 5%, 2239 genes are differentially expressed between adjacent normal and healthy normal. Ingenuity pathway analysis reveals that the Fos, Jun and TGFbeta pathways are active in the adjacent normal. Conclusions: Tissue adjacent to a primary breast cancer is not normal when using healthy breast tissue as a comparator. As RNA-Seq data is digital, it is possible to quantify the changes in gene expression starting from healthy normal to normal adjacent to tumor to tumor. Increasing and decreasing gene expression values provide clues to the fundamental molecular changes occurring in histologically normal appearing adjacent tissue. The differences in gene expression we have identified are some of the earliest changes in breast carcinogenesis and provide insight into the etiology of this disease and, potentially, its prevention. [ABSTRACT FROM AUTHOR]

Objective: Xanomeline and trospium chloride (formerly known as KarXT), a novel M 1 /M 4 muscarinic receptor agonist, demonstrated efficacy across phase 2 and 3 trials as monotherapy for the treatment of inpatients with acute schizophrenia on the Positive and Negative Syndrome Scale total score primary endpoint. In the phase 2 trial, xanomeline/trospium improved performance on a cognitive outcome measure in the subgroup of participants with clinically significant baseline cognitive impairment. The authors sought to confirm this finding using data from two phase 3 trials., Methods: Data were pooled from two 5-week inpatient trials of xanomeline/trospium monotherapy in patients with acute schizophrenia. The statistical analysis plan prespecified comparisons of cognitive composite score changes between xanomeline/trospium and placebo in the full sample and the cognitively impaired (≤1 SD below norms at baseline) subgroup., Results: There was no significant xanomeline/trospium effect in the full sample (N=357); however, in the impaired subgroup, xanomeline/trospium (N=71) had a significantly greater benefit for cognition compared with placebo (N=66; least squares mean difference=0.31, SE=0.10; d=0.54). The xanomeline/trospium effect size increased significantly with a more stringent baseline impairment threshold (≤-1.5 SD; d=0.80). Improvements in cognition were minimally correlated with concurrent changes in total, positive, and negative symptoms in both treatment groups., Conclusions: Participants with acute schizophrenia with prespecified impairments demonstrated significant cognitive improvement with xanomeline/trospium compared with placebo. This result directly confirms earlier findings. This benefit is not attributable to changes in symptoms, despite substantial evidence of efficacy for psychosis. Evaluation of xanomeline/trospium's potential for cognitive enhancement in a well-controlled trial of stable patients with cognitive impairment is warranted., Competing Interests: Dr. Horan, Dr. Sauder, Dr. Ramsay, and Dr. Yohn are employees of Bristol Myers Squibb. Dr. Harvey has received consulting fees or travel reimbursement from Alkermes, Boehringer-Ingelheim, Bristol Myers Squibb, Karuna Therapeutics, Merck, Minerva Neuroscience, and Sunovion/DSP; he has received royalties for the Brief Assessment of Cognition in Schizophrenia (owned by WCG); and he is chief scientific officer of i-Function, Inc., and a scientific consultant for EMA Wellness, Inc. Dr. Ramsay holds and is owed restricted stock units at Bristol Myers Squibb. Dr. Keefe has served as a consultant for Biogen, Boehringer-Ingelheim, Bristol Myers Squibb, Gedeon Richter, Neurocrine Pangea, Recognify, Sirtsei, Vandria, and WCG; he has received royalties for the BACS, SCoRS, and VRFCAT; he has received support from Boehringer Ingelheim for attending meetings and/or travel; and he has participated in data safety monitoring boards or advisory boards for Boehringer-Ingelheim, Karuna, Merck, and Neurocrine. Dr. Davis has served as a consultant for Abyrx, Arkana Laboratories, Boehringer Ingelheim, Bristol Myers Squibb, Eikonoklastes Therapeutics, Harm Reduction Therapeutics, LyGenesis, Renerva, University of North Carolina School of Medicine, Division of Nephropathology, and VeraSci. Dr. Paul was an employee of and had a leadership/fiduciary role at Karuna Therapeutics at the time this research was conducted, and he has a leadership/fiduciary role at Sage Therapeutics and Voyager Therapeutics; he holds equity in Eli Lilly, NeuMarker, Rapport Therapeutics, Sage Therapeutics, Seaport Therapeutics, and Voyager Therapeutics. Dr. Brannan was an employee of Karuna Therapeutics at the time this research was conducted and is currently a consultant for Bristol Myers Squibb.

Background: Age-related vocal atrophy (ARVA) causes vocal fold bowing, impacting communication and quality of life. The assessment of vocal fold bowing is largely subjective. Glottal Image Capture (GlottIC) is a new mobile application that helps quantify vocal fold bowing. We aim through this study to assess its reliability, compare it to manual calculation method, and compare differences between visual-perceptual bowing severity ratings., Methods: Ten raters independently quantified Bowing Index (BI) using GlottIC from 10 videostroboscopic images among individuals with ARVA. There was 100% duplication of images to facilitate intra-rater reliability analyses using Pearson's correlation. Inter-rater reliability was quantified using Intraclass Correlation Coefficient (ICC) for experienced and novice raters. The correlation between manual calculations using ImageJ and GlottIC was analyzed., Results: The intra-rater reliability for total BI was strong (r = 0.822, p < 0.001). The inter-rater reliability for BI, calculated using ICC, was (ICC = 0.720; 95% CI: 0.579-0.852), indicating good consistency among the raters. Experts had higher ICC (ICC = 0.808; 95% CI: 0.678-0.906) compared to novice raters (ICC = 0.651; 95% CI: 0.468-0.816). There was a positive correlation between GlottIC and manual BI (r = 0.811, p < 0.001). As the BI increased, the bowing severity, based on visual-perceptual ratings, also increased (p < 0.001)., Conclusion: GlottIC is a reliable mobile application that can quantify vocal fold bowing in patients with ARVA with high intra- and inter-rater reliability. GlottIC BI measurments are highly correlated with manual BI and visual-perceptual ratings of bowing severity. Further improvements in reliability may be achieved with more robust rater training and automated technologies., Level of Evidence: Level 3 Laryngoscope, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

In the 5-week, randomized, double-blind, placebo-controlled EMERGENT-1 (NCT03697252), EMERGENT-2 (NCT04659161), and EMERGENT-3 (NCT04738123) trials, xanomeline and trospium chloride (formerly known as KarXT) significantly improved symptoms of schizophrenia and was generally well tolerated. We pooled data from the EMERGENT trials to further characterize the efficacy of xanomeline/trospium and provide sufficient statistical power to analyze responses in participant subgroups. In pooled analyses, xanomeline/trospium significantly improved Positive and Negative Syndrome Scale (PANSS) total score at week 5 versus placebo (least squares mean difference, -9.9; 95% confidence interval, -12.4, -7.3; p < 0.0001; Cohen's d effect size, 0.65). PANSS subscale and Clinical Global Impression-Severity scores also improved significantly with xanomeline/trospium versus placebo. Subgroup analyses consistently favored xanomeline/trospium over placebo regardless of differences in participant age, sex, race, body mass index, and baseline PANSS total score. These results add to existing evidence demonstrating robust and reliable improvements in symptoms with xanomeline/trospium across a broad spectrum of people with schizophrenia., (© 2024. The Author(s).)

Introduction: The bowing index (BI) and normalized glottal gap area (NGGA) are used to quantify vocal fold morphology in ARVA; however, the influence of the distance between the flexible laryngoscope lens and the target area is not known. The goal is to test whether the endoscopic distance impacts vocal fold morphology measurements in patients with ARVA during flexible video laryngostroboscopy (VLS)., Method: Patients with ARVA who underwent VLS were included. Images were classified into near (close to the petiole of the epiglottis) and far (below nasopharynx, with tongue base and entire epiglottis visible) conditions. BI was calculated using a mobile application, and NGGA was measured using ImageJ., Results: This study included 23 patients; the mean age was 77 ± 7 years. Mean BI measured at the near distance was higher than far distances with a mean difference of 1.94 (95% CI: 0.92-2.96, p = 0.001). NGGA showed difference with changed distance -0.24 (95% CI: -0.48 to 0.01, p < 0.05).When stratifying patients into two groups based on median BI measurement, there was a statistically significant difference between near and far conditions, with increased BI in the near condition for patients above the median (p < 0.05), but no difference between the near and far condition for patients with BI below the median., Conclusion: The BI and NGGA were impacted by the endoscopic distance during flexible VLS. BI was significantly higher in the near condition compared with the far condition. The difference in BI between the near and far conditions was more pronounced when the vocal fold bowing was greater. These findings call for heightened awareness of measurement discrepancies secondary to the endoscopic distance during flexible laryngostroboscopy., Level of Evidence: 2 Laryngoscope, 134:4649-4655, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: Age-related vocal atrophy (ARVA) negatively impacts voice and quality of life (QOL). This study aims to determine utility-based QOL in ARVA patients, correlate findings with traditional patient-reported outcome measures (PROMs), and generate utility-based inferences., Methods: Forty ARVA patients were prospectively recruited from a tertiary care center. Health utility was measured using standard gamble, time trade-off, and visual analog scale, assessing participants' current health states relative to defined comparison states (blindness/death). Traditional PROMs (Voice Handicap Index-10 [VHI-10] and Voice-Related Quality of Life Scale [V-RQOL]) were also collected. Descriptive and paired statistics were performed to determine health utility, and Pearson correlation assessed the association between PROMs and health utilities., Results: Mean health utility in ARVA was 0.84 ± 0.22, 0.88 ± 0.17, and 0.62 ± 0.25 using standard gamble, time trade-off, and visual analog scale, respectively. There were positive correlations between V-RQOL and time trade-off (r = 0.66; p < 0.0001) as well as with standard gamble (r = 0.47; p = 0.002). Participants with ARVA reported no difference in health utility impact between their voice impairment and monocular blindness (Mean dif 10.9; 95% CI -1.6, 23.5; p = 0.101). Patients with ARVA were willing to part with an average 4.6 ± 6.1 years of life to restore normal voice., Conclusions: ARVA patients view their voice impairment as a significant health decrement, comparable to monocular blindness. These findings underscore the substantial impact of ARVA on QOL and highlight the need for continued research and new therapies., Level of Evidence: 4 Laryngoscope, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Background: For patients with clinically node-positive (cN+) breast cancer undergoing neoadjuvant chemotherapy (NAC), retrieving previously clipped, biopsy-proven positive lymph nodes during sentinel lymph node biopsy [i.e., targeted axillary dissection (TAD)] may reduce false negative rates. However, the overall utilization and impact of clipping positive nodes remains uncertain., Patients and Methods: We retrospectively analyzed cN+ ISPY-2 patients (2011-2022) undergoing axillary surgery after NAC. We evaluated trends in node clipping and associations with type of axillary surgery [sentinel lymph node (SLN) only, SLN and axillary lymph node dissection (ALND), or ALND only] and event-free survival (EFS) in patients that were cN+ on a NAC trial., Results: Among 801 cN+ patients, 161 (20.1%) had pre-NAC clip placement in the positive node. The proportion of patients that were cN+ undergoing clip placement increased from 2.4 to 36.2% between 2011 and 2021. Multivariable logistic regression showed nodal clipping was independently associated with higher odds of SLN-only surgery [odds ratio (OR) 4.3, 95% confidence interval (CI) 2.8-6.8, p < 0.001]. This was also true among patients with residual pathologically node-positive (pN+) disease. Completion ALND rate did not differ based on clip retrieval success. No significant differences in EFS were observed in those with or without clip placement, both with or without successful clip retrieval [hazard ratio (HR) 0.85, 95% CI 0.4-1.7, p = 0.7; HR 1.8, 95% CI 0.5-6.0, p = 0.3, respectively]., Conclusion: Clip placement in the positive lymph node before NAC is increasingly common. The significant association between clip placement and omission of axillary dissection, even among patients with pN+ disease, suggests a paradigm shift toward TAD as a definitive surgical management strategy in patients with pN+ disease after NAC., (© 2024. The Author(s).)

Background: Many adolescent and young adult (AYA) patients with breast cancer (BC) receive adjuvant therapy as initial treatment, with long-term bone marrow suppression as a potential complication, but no studies have evaluated the impact of race/ethnicity on the development of bone marrow suppression in AYA BC survivors., Patients and Methods: Female patients ages 15-39 years diagnosed with BC (2006-2018) and surviving ≥ 2 years were identified from the California Cancer Registry and linked to statewide hospitalization data. We estimated the cumulative incidence of developing late effects of bone marrow suppression, such as leukopenia, anemia, thrombocytopenia, bleeding, and infection/sepsis, during hospital discharge diagnoses present ≥ 2 years after diagnosis. We examined the impact of sociodemographic and clinical factors on late effects using multivariate Cox proportional hazards regression., Results: Of 11,293 patients, 42.8% were non-Hispanic (nH) White, 28.8% Hispanic, 19.5% nH Asian/Pacific Islander, and 7.5% nH Black. In multivariable analyses, nH Blacks had the highest risk (versus nH Whites) of anemia [hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.47-2.02], leukopenia (HR 1.56, CI 1.14-2.13), thrombocytopenia (HR 1.46, CI 1.08-1.99), major infection/sepsis (HR 1.64, CI 1.4-1.92), and bleeding (HR 1.89, CI 1.39-2.58). Hispanics had a higher risk of developing anemia (HR 1.17, CI 1.04-1.32), bleeding (HR 1.4, CI 1.12-1.76), and major infections/sepsis (HR 1.36, CI 1.21-1.52). Asian/Pacific Islanders had only a higher risk of developing bleeding (HR 1.33, CI 1.03-1.72). Patients from a low neighborhood socioeconomic status had a 20% higher risk of infection/sepsis (HR 1.21, CI 1.1-1.34), but there were no associations for the other late effects., Conclusions: We identified that AYAs of nH Black, Hispanic, and Asian/Pacific Islander race/ethnicity are at an increased risk of several late effects after adjuvant therapy compared with nH White patients. From these data, providers can implement early/frequent screening of hematologic late effects in these high-risk survivors., (© 2024. Society of Surgical Oncology.)

Among the goals of patient-centric care are the advancement of effective personalized treatment, while minimizing toxicity. The phase 2 I-SPY2.2 trial uses a neoadjuvant sequential therapy approach in breast cancer to further these goals, testing promising new agents while optimizing individual outcomes. Here we tested datopotamab-deruxtecan (Dato-DXd) in the I-SPY2.2 trial for patients with high-risk stage 2/3 breast cancer. I-SPY2.2 uses a sequential multiple assignment randomization trial design that includes three sequential blocks of biologically targeted neoadjuvant treatment: the experimental agent(s) (block A), a taxane-based regimen tailored to the tumor subtype (block B) and doxorubicin-cyclophosphamide (block C). Patients are randomized into arms consisting of different investigational block A treatments. Algorithms based on magnetic resonance imaging and core biopsy guide treatment redirection after each block, including the option of early surgical resection in patients predicted to have a high likelihood of pathological complete response, the primary endpoint. There are two primary efficacy analyses: after block A and across all blocks for the six prespecified breast cancer subtypes (defined by clinical hormone receptor/human epidermal growth factor receptor 2 (HER2) status and/or the response-predictive subtypes). We report results of 103 patients treated with Dato-DXd. While Dato-DXd did not meet the prespecified threshold for success (graduation) after block A in any subtype, the treatment strategy across all blocks graduated in the hormone receptor-negative HER2 - Immune - DNA repair deficiency - subtype with an estimated pathological complete response rate of 41%. No new toxicities were observed, with stomatitis and ocular events occurring at low grades. Dato-DXd was particularly active in the hormone receptor-negative/HER2 - Immune - DNA repair deficiency - signature, warranting further investigation, and was safe in other subtypes in patients who followed the treatment strategy. ClinicalTrials.gov registration: NCT01042379 ., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Purpose: The purpose of this study was to understand the role of implicit racial bias in auditory-perceptual evaluations of dysphonic voices by determining if a biasing effect exists for novice listeners in their auditory-perceptual ratings of Black and White speakers., Method: Thirty speech-language pathology graduate students at Boston University listened to audio files of 20 Black speakers and 20 White speakers of General American English with voice disorders. Listeners rated the overall severity of dysphonia of each voice heard using a 100-unit visual analog scale and completed the Harvard Implicit Association Test (IAT) to measure their implicit racial bias., Results: Both Black and White speakers were rated as less severely dysphonic when their race was labeled as Black. No significant relationship was found between Harvard IAT scores and differences in severity ratings by race labeling condition., Conclusions: These findings suggest a minimizing bias in the evaluation of dysphonia for Black patients with voice disorders. These results contribute to the understanding of how a patient's race may impact their visit with a clinician. Further research is needed to determine the most effective interventions for implicit bias retraining and the additional ways that implicit racial bias impacts comprehensive voice evaluations., Competing Interests: Declaration of Competing Interest C.E. Stepp has received consulting fees from Altec, Inc. and Delsys, Inc., companies focused on developing and commercializing technologies related to human movement. Stepp's interests were reviewed and are managed by Boston University in accordance with their conflict of interest policies., (Copyright © 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)