ESGO-ESMO-ESP consensus conference recommendations on ovarian cancer: pathology and molecular biology and early, advanced and recurrent disease.

The European Society of Gynaecological Oncology, the European Society for Medical Oncology (ESMO) and the European Society of Pathology held a consensus conference (CC) on ovarian cancer on 15-16 June 2022 in Valencia, Spain. The CC panel included 44 experts in the management of ovarian cancer and pathology, an ESMO scientific advisor and a methodologist. The aim was to discuss new or contentious topics and develop recommendations to improve and harmonise the management of patients with ovarian cancer. Eighteen questions were identified for discussion under four main topics: (i) pathology and molecular biology, (ii) early-stage disease and pelvic mass in pregnancy, (iii) advanced stage (including older/frail patients) and (iv) recurrent disease. The panel was divided into four working groups (WGs) to each address questions relating to one of the four topics outlined above, based on their expertise. Relevant scientific literature was reviewed in advance. Recommendations were developed by the WGs and then presented to the entire panel for further discussion and amendment before voting. This manuscript focuses on the recommendation statements that reached a consensus, their voting results and a summary of evidence supporting each recommendation.

Absence of Spontaneous Magnetic Fields due to Time-Reversal Symmetry Breaking in Bulk Superconducting UTe_{2}.

We have investigated the low-temperature local magnetic properties in the bulk of molten salt-flux (MSF)-grown single crystals of the candidate odd-parity superconductor UTe_{2} by zero-field muon spin relaxation (µSR). In contrast to previous µSR studies of UTe_{2} single crystals grown by a chemical vapor transport method, we find no evidence of magnetic clusters or electronic moments fluctuating slow enough to cause a discernible relaxation of the zero-field µSR asymmetry spectrum. Consequently, our measurements on MSF-grown single crystals rule out the generation of spontaneous magnetic fields in the bulk that would occur near impurities or lattice defects if the superconducting state of UTe_{2} breaks time-reversal symmetry. This result suggests that UTe_{2} is characterized by a single-component superconducting order parameter.

Trends in Nicotine Strength in Electronic Cigarettes Sold in the United States by Flavor, Product Type, and Manufacturer, 2017-2022.

INTRODUCTION: Most e-cigarettes contain highly addictive nicotine. This study assessed trends in nicotine strength in e-cigarettes sold in the United States during January 2017-March 2022. AIMS AND METHODS: We obtained January 2017-March 2022 national retail e-cigarette sales data from NielsenIQ. We assessed monthly average nicotine strength overall, by e-cigarette product and flavor type, and manufacturer. A Joinpoint regression model assessed the magnitude and significance of changes in nicotine strength. RESULTS: During January 2017-March 2022, monthly average nicotine strength of e-cigarette products increased from 2.5% to 4.4%, an average of 0.8% per month (p < .001). Monthly average nicotine strength of disposable e-cigarettes increased the most (average monthly percentage change [AMPC] = 1.26%, p < .001) as compared to prefilled pods (AMPC = 0.6%, p < .001) and e-liquids (AMPC = 0.5%, p = .218). Monthly average nicotine strength for all flavors of e-cigarette products increased except for mint-flavored products. Increases were greatest for beverage-flavored products (AMPC = 2.1%, p < .001), followed by menthol-flavored products (AMPC = 1.2%, p < .001). Among the top 10 e-cigarette manufacturers assessed, monthly average nicotine strength decreased for Juul Labs products from 5% to 4.7% (AMPC = -0.1%, p < .001) but increased significantly for five manufacturers' products and remained unchanged at 5%-6% for four manufacturers' products. CONCLUSIONS: Monthly average nicotine strength of e-cigarette products increased overall, for most product and flavor types, and for some manufacturers in the United States during the study period. Imposing maximum limits on nicotine strength of e-cigarettes together with other evidence-based tobacco control strategies can help reduce the use of e-cigarettes among youth and increase tobacco product cessation among adults. IMPLICATIONS: From January 2017 to March 2022, the monthly average nicotine strength of disposable e-cigarettes increased substantially and exceeded prefilled pods since May 2020. E-cigarettes with menthol flavor and youth-appealing flavors, like fruit, also had sharp increases in monthly average nicotine strength. Among the top 10 e-cigarette manufacturers, monthly average nicotine strength increased or remained unchanged at a high nicotine level for all manufacturers' products, except Juul Lab's products. Comprehensive strategies including restricting sales of all flavored e-cigarettes, restricting youth tobacco product access, and imposing maximum limits on nicotine strength may help reduce youth e-cigarette use and increase tobacco cessation.

Changes in Sales of Tobacco and Nicotine Replacement Therapy Products Before and During the COVID-19 Pandemic.

INTRODUCTION: The COVID-19 pandemic and its associated social distancing policies such as lockdowns and quarantine influenced people's lives and health behaviors. We comprehensively assessed national trends in sales of cigarettes, cigars, e-cigarettes, and over-the-counter nicotine replacement therapy (NRT) products before and during the pandemic, allowing for cross-product comparisons. Stockpiling behavior was also assessed. METHODS: We used US national tobacco and over-the-counter NRT retail store scanner data (excluding internet, specialty/vape store, and prescription sales) collected at 4-week intervals by NielsenIQ from December 2018 to June 2021. We applied an interrupted time-series model to assess differences in tobacco product and NRT unit sales before and during the pandemic. We defined the prepandemic period as December 16, 2018, through April 4, 2020, pandemic as starting on April 5, 2020, through June 26, 2021, and the stockpiling period as one 4-week period before the pandemic started. RESULTS: Four-week cigarette, e-cigarette, and cigar unit sales on average increased by 11.5% (P = .006), 37.1% (P < .001), and 26.1% (P < .001) respectively, while 4-week NRT unit sales decreased on average by 13.1% (P < .001), during the pandemic compared with the prepandemic period. Stockpiling was associated with increases in sales of all tobacco products and NRT products. CONCLUSION: Unit sales of assessed tobacco products increased while NRT unit sales decreased during the COVID-19 pandemic, compared with the prepandemic period. These changes may suggest an increase in the intensity of tobacco product use or stockpiling of tobacco products among people who use tobacco.

A Novel Technique to Mitigate the Data Redundancy and to Improvise Network Lifetime Using Fuzzy Criminal Search Ebola Optimization for WMSN.

Wireless Multimedia Sensor Network (WMSN) is a powerful technology that is widely used to gather data and monitor the actual environment for analysis. Furthermore, multimedia applications' needs and the features, such as constrained latency and high bandwidth consumption, complicate the design of WMSN routing protocols. Despite several methods, the trouble of designing WMSNs routing protocol remains a hurdle. The miniaturization and enhancement of hardware facilitate an extensive range of applications in the military and public sectors. On the contrary, the streaming of multimedia content is captured and generated due to some event-triggered surveillance for a long duration of time. Hence, it is necessary for wireless multimedia sensor network (WMSN) to provide a strong hardware foundation, thereby satisfying Quality of Service (QoS) requirements. Initially, the network is clustered into several clusters and the nodes with rich resources are chosen as cluster heads. The significant intention of this paper is to eliminate data redundancy and to select optimal cluster heads, thereby minimizing the energy consumption. Therefore, this paper proposes a novel Fuzzy Criminal Search Ebola Optimization (FCSEO) algorithm for optimal selection of cluster heads. In addition to this, the data redundancy present in the proposed algorithm is mitigated and thus the network lifetime is enhanced. Finally, extensive experimentation is carried out for various performance measures to determine the efficiency of the proposed approach.

Do We Trust the Crowd? Effects of Crowdsourcing on Perceived Credibility of Online Health Information.

Crowdsourcing websites such as Wikipedia have become go-to places for health information. To what extent do we trust such health content that is generated by other Internet users? Will it make a difference if such entries are curated by medical professionals? Does the affordance of crowdsourcing make users feel like they themselves could be contributors, and does that influence their credibility judgments? We explored these questions with a 2 (Crowdsourcing: absence vs. presence) × 2 (Professional source: absence vs. presence) × 2 (Message: sunscreen vs. milk) between-subjects experiment (N = 189). Two indirect paths for crowdsourcing effects were found. The crowd-as-source path suggests that crowdsourcing negatively affects content credibility through decreased source trustworthiness and information completeness. In contrast, the self-as-source path indicates that crowdsourcing elevates source trustworthiness via heightened interactivity and sense of control. Although the additional professional source raises perceived gatekeeping on the site, it does not have substantial influence on credibility judgments. Theoretical and practical implications of the findings are discussed.

Are We More Reactive to Persuasive Health Messages When They Appear in Our Customized Interfaces? The Role of Sense of Identity and Sense of Control.

Online users today are provided with a variety of customization tools to build their own information environment. A growing number of public health messages reach their target audiences via these digital venues. Given the deeply personal and individualized nature of customized environments, do online users show lesser reactance to persuasive health messages? Or, are they more likely to show reactance because they feel intruded upon? We conducted a 2 (Customization: present vs. absent) × 2 (Message threat: high vs. low) experiment (N = 145) to find out. Data showed that interface customization increases the sense of control and sense of identity among users. Sense of control is positively associated with threat to freedom of action, causing more affective reactance. In contrast, a sense of identity is negatively associated with anger toward the persuasive message. Theoretical and practical implications for online health campaigns are discussed.

Can Interactive Media Attenuate Psychological Reactance to Health Messages? A Study of the Role Played by User Commenting and Audience Metrics in Persuasion.

Health advocacy messages can generate psychological reactance and lead to message rejection. Could we offset this negative outcome by providing more agency and interactivity to message receivers? Are individuals more likely to be receptive if health campaigns provided them an opportunity to comment on the advocacy messages? Will they be more likely to follow the advocated behavior if a lot of other receivers have expressed approval of those messages, i.e., will they follow the bandwagon and show lesser reactance? We investigated these questions by conducting a 2 (bandwagon cue: strong vs. weak) X 2 (comment action: presence vs. absence) X 2 (message threat: high vs. low) between-subjects experiment (N = 179) with an online health message. Findings suggest that strong bandwagon cues can reduce reactance and improve persuasion by eliciting bandwagon perceptions. Comment action is associated with a strong sense of agency, which positively predicts intention to follow the message recommendation. Technological affordances interact with threat level of the message and with each other in influencing users' evaluation and acceptance of persuasive health messages.

Older Adults' Activities on Facebook: Can Affordances Predict Intrinsic Motivation and Well-Being?

This study investigated how older adults' use of specific features on Facebook is associated with intrinsic motivation and well-being. A content analysis and an online survey were conducted with Facebook users older than 60 years (N = 202). Results showed that profile customization and commenting are positively associated with feelings of autonomy and relatedness, respectively, both predictors of enjoyment on Facebook. Posting photos is positively associated with a feeling of competence, which is related to well-being. The findings advance knowledge about the theoretical mechanisms underlying effects of Facebook use on well-being, and provides design recommendations that address older users' needs.

Changes in Sales of E-Cigarettes, Cigarettes, and Nicotine Replacement Therapy Products Before, During, and After the EVALI Outbreak.

INTRODUCTION: In 2019, an outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) occurred in the US. We used Nielsen retail sales data to assess trends in sales of e-cigarettes, cigarettes, and nicotine replacement therapy (NRT) products before, during, and after the EVALI outbreak. METHODS: Monthly unit sales of e-cigarettes, cigarettes, and NRT products overall and by product type were assessed during January 2019 through June 2020 by using an interrupted time series model. Two time points were specified at the period ending July 13, 2019, and the period ending February 22, 2020, to partition before, during, and after the outbreak period. Sales trends by aggregated state-level EVALI case prevalence (low, medium, and high) were assessed to investigate interstate variations in changes of sales coinciding with the EVALI outbreak. RESULTS: Monthly e-cigarette sales increased 3.5% (P < .001) before the outbreak and decreased 3.1% (P < .001) during the outbreak, with no significant changes after the outbreak. Monthly cigarette sales increased 1.6% (P < .001) before the outbreak, decreased 1.8% (P < .001) during the outbreak, and increased 2.7% (P < .001) after the outbreak. NRT sales did not change significantly before or during the outbreak but decreased (2.8%, P = .01) after the outbreak. Sales trends by state-level EVALI case prevalence were similar to national-level sales trends. CONCLUSION: Cigarette and e-cigarette sales decreased during the EVALI outbreak, but no changes in overall NRT sales were observed until after the outbreak. Continued monitoring of tobacco sales data can provide insight into potential changes in use patterns and inform tobacco prevention and control efforts.

U.S. healthcare spending attributable to cigarette smoking in 2014.

INTRODUCTION: Cigarette smoking continues to be the leading cause of preventable disease and death in the U.S. Smoking also carries an economic burden, including smoking-attributable healthcare spending. This study assessed smoking-attributable fractions in healthcare spending between 2010 and 2014, overall and by insurance type (Medicaid, Medicare, private, out-of-pocket, other federal, other) and by medical service (inpatient, non-inpatient, prescriptions). METHODS: Data were obtained from the 2010-2014 Medical Expenditure Panel Survey linked to the 2008-2013 National Health Interview Survey. The final sample (n = 49,540) was restricted to non-pregnant adults aged 18 years or older. Estimates from two-part models (multivariable logistic regression and generalized linear models) and data from 2014 national health expenditures were combined to estimate the share of and total (in 2014 dollars) annual healthcare spending attributable to cigarette smoking among U.S. adults. All models controlled for socio-demographic characteristics, health-related behaviors, and attitudes. RESULTS: During 2010-2014, an estimated 11.7% (95% CI = 11.6%, 11.8%) of U.S. annual healthcare spending could be attributed to adult cigarette smoking, translating to annual healthcare spending of more than $225 billion dollars based on total personal healthcare expenditures reported in 2014. More than 50% of this smoking-attributable spending was funded by Medicare or Medicaid. For Medicaid, the estimated healthcare spending attributable fraction increased more than 30% between 2010 and 2014. CONCLUSIONS: Cigarette smoking exacts a substantial economic burden in the U.S. Continuing efforts to implement proven population-based interventions have been shown to reduce the health and economic burden of cigarette smoking nationally.

Folic acid supplementation in postmenopausal women with hot flushes: phase III randomised double-blind placebo-controlled trial.

OBJECTIVE: To assess whether folic acid supplementation ameliorates hot flushes. DESIGN: Double-blind, placebo-controlled randomised trial. SETTING: Nine hospitals in England. POPULATION: Postmenopausal women experiencing ≥50 hot flushes weekly. METHODS: Women (n = 164) were randomly assigned in a 1:1 ratio to receive folic acid 5 mg tablet or placebo daily for 12 weeks. Participants recorded frequency and severity of hot flushes in a Sloan Diary daily and completed Greene Climacteric and Utian Quality of Life (UQoL) Scales at 4-week intervals. MAIN OUTCOME MEASURES: The change in daily Hot Flush Score at week 12 from randomisation based on Sloan Diary Composite Score B calculation. RESULTS: Data of 143 (87%) women were available for the primary outcome. The mean change (SD) in Hot Flush Score at week 12 was -6.98 (10.30) and -4.57 (9.46) for folic acid and placebo group, respectively. The difference between groups in the mean change was -2.41 (95% CI -5.68 to 0.87) (P = 0.149) and in the adjusted mean change -2.61 (95% CI -5.72 to 0.49) (P = 0.098). Analysis of secondary outcomes indicated an increased benefit in the folic acid group regarding changes in total and emotional UQoL scores at week 8 when compared with placebo. The difference in the mean change from baseline was 5.22 (95% CI 1.16-9.28) and 1.88 (95% CI 0.23-3.52) for total and emotional score, respectively. CONCLUSIONS: The study was not able to demonstrate that folic acid had a statistically significant greater benefit in reducing Hot Flush Score over 12 weeks in postmenopausal women when compared with placebo. TWEETABLE ABSTRACT: Folic acid may ameliorate hot flushes in postmenopausal women but confirmation is required from a larger study.

Discovery of a potent G-protein-coupled receptor 119 agonist for the treatment of type 2 diabetes.

The ever-growing prevalence of Type-2 diabetes in the world has an urgent need for multiple orally effective agents that can regulate glucose homeostasis. G-Protein coupled receptor 119 (GPR 119) agonists have demonstrated the glucose-dependent insulin secretion and showed beneficial effects on glycemic control in humans and/or relevant animal models. Herein, we describe our efforts towards identification of a potent and oral GPR 119 agonist 13c (ZY-G19), which showed in vitro potency in the cell-based assay and in vivo efficacy without exerting any significant signs of toxicity in relevant animal models.

Isotope-specific reactions of acetonitrile (CH3CN) with trapped, translationally cold CCl.

The gas-phase reaction of CCl+ with acetonitrile (CH3CN) is studied using a linear Paul ion trap coupled to a time-of-flight mass spectrometer. This work builds on a previous study of the reaction of CCl+ with acetylene [K. J. Catani et al., J. Chem. Phys. 152, 234310 (2020)] and further explores the reactivity of CCl+ with organic neutral molecules. Both of the reactant species are relevant in observations and models of chemistry in the interstellar medium. Nitriles, in particular, are noted for their relevance in prebiotic chemistry and are found in the atmosphere of Titan, one of Saturn's moons. This work represents one of the first studied reactions of a halogenated carbocation with a nitrile and the first exploration of CCl+ with a nitrile. Reactant isotopologues are used to unambiguously assign ionic primary products from this reaction: HNCCl+ and C2H3 +. Branching ratios are measured, and both primary products are determined to be equally probable. Quantum chemical and statistical reaction rate theory calculations illuminate pertinent information for interpreting the reaction data, including reaction thermodynamics and a potential energy surface for the reaction, as well as rate constants and branching ratios for the observed products. In particular, the reaction products and potential energy surface stimulate questions regarding the strength and role of the nitrile functional group, which can be further explored with more reactions of this class.

Correction: A multi-component reaction for the synthesis of pyrido [1,2-b] isoquinoline derivatives via the [3 + 2] cycloaddition reaction between alkynes and in situ generated isoquinolinium ylides.

Correction for 'A multi-component reaction for the synthesis of pyrido [1,2-b] isoquinoline derivatives via the [3 + 2] cycloaddition reaction between alkynes and in situ generated isoquinolinium ylides' by Sundar S. Shinde et al., Org. Biomol. Chem., 2019, 17, 4121-4128, DOI: 10.1039/C9OB00560A.

What Happens When You Click and Drag: Unpacking the Relationship between On-Screen Interaction and User Engagement with an Anti-Smoking Website.

Interactive media provide a physically active experience for users to click, slide, mouseover, and zoom-in/out, but how this increased amount of on-screen interaction is associated with cognitive and attitudinal outcomes has remained unexplored. We tackled this issue by conducting an online study where we recorded the amount of on-screen interaction on a targeted interactive feature, sliders, and correlated it with user engagement, attitudes toward anti-smoking messages, and smoking outcome beliefs, while controlling their baseline smoking outcome beliefs (N = 149). We found that the number of clicks and drags on sliders was positively associated with their attitudes toward anti-smoking messages and smoking outcome belief, but only among nonsmokers who are power users of technology. An increase in perceptual bandwidth influenced by interacting with the slider was significantly correlated with greater user engagement among these users. In contrast, for smokers who are not power users, greater on-screen interaction showed a negative correlation with their user engagement mediated by an increase in defensive processing.

Can Mobile Apps Motivate Fitness Tracking? A Study of Technological Affordances and Workout Behaviors.

Can workout apps actually motivate users to sustain an exercise routine? If so, what are the key characteristics of these apps that engage long-term users? We conducted a content analysis to find out. Guided by the Motivational Technology Model and Self-Determination Theory, we explored the relationship between technological affordances of BodySpace, a highly ranked body building and weightlifting app, and behavioral outcomes (number of workouts tracked, weight lifted, and cardio hours) and goal attainment rate (percentage of body fat and weight goal achieved). A total of 682 profiles were used for analysis, revealing that the use of features of the app that elicit relatedness, autonomy, and competence predicted exercise outcomes. However, these relationships were moderated by gender, consistent with prior research on the differential workout motivations between males and females.

Ligand Crosslinking Boosts Thermal Transport in Colloidal Nanocrystal Solids.

The ongoing interest in colloidal nanocrystal solids for electronic and photonic devices necessitates that their thermal-transport properties be well understood because heat dissipation frequently limits performance in these devices. Unfortunately, colloidal nanocrystal solids generally possess very low thermal conductivities. This very low thermal conductivity primarily results from the weak van der Waals interaction between the ligands of adjacent nanocrystals. We overcome this thermal-transport bottleneck by crosslinking the ligands to exchange a weak van der Waals interaction with a strong covalent bond. We obtain thermal conductivities of up to 1.7 Wm-1 K-1 that exceed prior reported values by a factor of 4. This improvement is significant because the entire range of prior reported values themselves only span a factor of 4 (i.e., 0.1-0.4 Wm-1 K-1 ). We complement our thermal-conductivity measurements with mechanical nanoindentation measurements that demonstrate ligand crosslinking increases Young's modulus and sound velocity. This increase in sound velocity is a key bridge between mechanical and thermal properties because sound velocity and thermal conductivity are linearly proportional according to kinetic theory. Control experiments with non-crosslinkable ligands, as well as transport modeling, further confirm that ligand crosslinking boosts thermal transport.

Correction: Safety and utility of image-guided research biopsies in relapsed high-grade serous ovarian carcinoma-experience of the BriTROC consortium.

This article was originally published under a CC BY NC SA License, but has now been made available under a CC BY 4.0 License.

Chronic hyponatremia and association with osteoporosis among a large racially/ethnically diverse population.

Chronic hyponatremia may contribute to decreased bone density. We studied 341,003 men and women who underwent DXA testing and observed that individuals with chronic hyponatremia (sodium < 135 mEq/L) had an 11% greater likelihood of having osteoporosis. There was a dose-dependent effect with lower sodium and stronger association with osteoporosis. INTRODUCTION: Chronic hyponatremia has been associated with both neurologic deficits and increased risk of gait abnormalities leading to falls and resultant bone fractures. Whether chronic hyponatremia contributes to decreased bone density is uncertain. We evaluated whether chronic, mild hyponatremia based on serial sodium measurements was associated with increased risk of osteoporosis within a large, ethnically diverse population. METHODS: This is a retrospective cohort study between January 1, 1998 and December 31, 2014 within Kaiser Permanente Southern California, an integrated healthcare delivery system. Men and women were aged ≥ 55 years with ≥ 2 serum sodium measurements prior to dual-energy X-ray absorptiometry (DXA) testing. Time-weighted (TW) mean sodium values were calculated by using the proportion of time (weight) elapsed between sodium measurements and defined as < 135 mEq/L. Osteoporosis defined as any T-score value ≤ - 2.5 of lumbar spine, femoral neck, or hip. RESULTS: Among 341,003 individuals with 3,330,903 sodium measurements, 11,539 (3.4%) had chronic hyponatremia and 151,505 (44.4%) had osteoporosis. Chronic hyponatremic individuals had an osteoporosis RR (95% CI) of 1.11 (1.09, 1.13) compared to those with normonatremia. A TW mean sodium increase of 3 mEq/L was associated with a lower risk of osteoporosis [adjusted RR (95% CI) 0.95 (0.93, 0.96)]. A similar association was observed when the arithmetic mean sodium value was used for comparison. CONCLUSIONS: We observed a modest increase in risk for osteoporosis in people with chronic hyponatremia. There was also a graded association between higher TW mean sodium values and lower risk of osteoporosis. Our findings underscore the premise that chronic hyponatremia may lead to adverse physiological effects and responses which deserves better understanding.