A qualitative systematic review of the significance of adjuvant therapy in patients with low-risk endometrial cancer presenting positive peritoneal cytology: a relevant study to the guideline update for endometrial cancer by the Japan society of gynecologic oncology guideline committee.

In association with an update of the Japan Society of Gynecologic Oncology clinical practice guidelines for endometrial cancer in 2023, a systematic review was conducted about the therapeutic benefit of adjuvant therapy on patients with early-stage endometrial carcinoma, who presented positive peritoneal cytology (PPC) without the risk factors for recurrence. The systematic review only included two eligible retrospective studies. Both studies included patients with risk factors for recurrence. A nationwide study in the United States reported that adjuvant chemotherapy was associated with the reduced risk of death among patients with stages I-II endometrial cancer with PPC by multivariate, propensity score-adjusted analysis. Another single-center study in Japan reported no association between adjuvant chemotherapy and relapse-free survival among patients with stage IA endometrial cancer by univariate analysis. This systematic review identified that evidence was limited with conflicting results. Continuous evaluation is warranted to address this clinical question.

Relaxation dynamics of higher excited states of perylene-substituted perylene bisimide derivatives.

Stepwise two-photon absorption processes have received considerable attention, especially in photocatalysis, due to their relatively lower power threshold, characteristic spatial selectivity, amplification of chemical reactions, and so on. Meanwhile, studies on the relaxation dynamics of higher excited states in condensed systems have been limited for several molecular systems due to the short-lived nature of these states. In this study, we synthesized perylene-substituted perylene bisimide (PBI) and its derivate as model compounds and investigated their excited-state dynamics, including higher excited states, using pump-repump-probe spectroscopy. We revealed that these molecules form charge-transfer (CT) states instantaneously after the excitation, regardless of whether it is the perylene moiety or the PBI moiety that is excited. The lifetime of the CT state was shorter when the distance between the donor (perylene) and the acceptor (PBI) was shorter. Moreover, we also revealed that a higher-lying CT state generated by the stepwise excitation of the CT state using a 740-nm pulse induced Stark effect to the neighboring perylene moiety. The Stark effect not only gives more detailed information about the CT state, but also presents the possibility of new photofunctions, such as instantaneous modulation of the electronic state to achieve optimal electronic properties. These insights contribute to understanding advanced photochemical reactions and would be important for exploring photocatalytic reactions involving higher excited states.

Quality of care measurement for patients with ovarian cancer in Japan.

AIM: Quality of care is important to reduce disease progression, and improve both survival and quality of life. The Japan Society of Gynecologic Oncology has published treatment guidelines to promote standardized high-quality care for ovarian cancer in Japan. We developed quality indicators based on the guideline recommendations and used them on large datasets of health service use to examine the quality of ovarian cancer care. METHODS: A panel of experts developed the indicators using a modified Delphi method. Adherence to each indicator was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2018. All patients receiving first-line treatment at participating facilities were included. The adherence rates were returned to participating hospitals, and reasons for nonadherence were collected. A total of 580 hospitals participated, and the study examined the care received by 6611 patients with ovarian cancer and 1879 with borderline tumors using 11 measurable quality indicators. RESULTS: The adherence rate ranged from 22.6% for "Estrogen replacement within 6 months of operation" to 93.5% for "Bleomycin, etoposide, and cisplatin for germ cell tumor more than Stage II." Of 580 hospitals, 184 submitted the reasons for nonadherence. CONCLUSIONS: The quality of ovarian cancer care should be continuously assessed to encourage the use of best practices. These indicators may be a useful tool for this purpose.

A Hexaarylbiimidazole-Terarylene Hybrid: Visible-to-NIR-II Absorption via Sequential Photochromic Reactions.

A synergetic interaction between two or more photochromic chromophores has a potential to achieve advanced photochemical properties beyond conventional photochromic molecules and to realize photochemical control of complex systems using only a single molecule. Herein, we report a hybrid photochromic molecule consisting of hexaarylbiimidazole (HABI) and terarylene that exhibits multi-state photochromism. The biphotochrome hybrid shows four-state photochromic reaction involving sequentially proceeding photoreactions. The UV or visible light irradiation to the biphotochrome leads to the C-N bond breaking reaction of the HABI in preference to the ring-closing reaction of the 6π-electron system in the terarylene unit, leading two terarylene radical molecules. The photogenerated terarylene radical further exhibits the 6π-electrocyclization reaction by UV irradiation. The delocalized π-radical on the closed-ring form of the terarylene is efficient to enhance the photosensitivity to the NIR-I and -II region. Furthermore, a recombination reaction of radicals between the open- and closed-ring isomers of terarylene affords an unprecedented photochromic dimer as a structural isomer of the initial molecule. This is a consequence of the sequential hybrid photochromic system involving the HABI and terarylene units.

Multiphoton-driven Photocatalytic Defluorination of Persistent Perfluoroalkyl Substances and Polymers by Visible Light.

Perfluoroalkyl substances (PFASs) and fluorinated polymers (FPs) have been extensively utilized in various industries, whereas their extremely high stability poses environmental persistence and waste treatment. Current decomposition approaches of PFASs and FPs typically require harsh conditions such as heating over 400°C. Thus, there is a pressing need to develop a new technique capable of decomposing them under mild conditions. Here, we demonstrated that perfluorooctanesulfonate (PFOS), known as a "persistent chemical," and Nafion, a widely utilized sulfonated FP for ion-exchange membranes, can be efficiently decomposed into fluorine ions under ambient conditions via the irradiation of visible LED light onto semiconductor nanocrystals (NCs). PFOS was completely defluorinated within 8-h irradiation of 405-nm LED light, and the turnover number of the C-F bond dissociation per NC was 17200. Furthermore, 81% defluorination of Nafion was achieved for 24-h light irradiation, demonstrating the efficient photocatalytic properties under visible light. We revealed that this decomposition is driven by cooperative mechanisms involving light-induced ligand displacements and Auger-induced electron injections via hydrated electrons and higher excited states. This study not only demonstrates the feasibility of efficiently breaking down various PFASs and FPs under mild conditions but also paves the way for advancing toward a sustainable fluorine-recycling society.

A Nonlinear Photochromic Reaction Based on Sensitizer-Free Triplet-Triplet Annihilation in a Perylene-Substituted Rhodamine Spirolactam.

Nonlinear photochromic reactions that work with weak incoherent light are important for molecular operations with high spatial resolution and multiple photofunctions based on single molecules. However, nonlinear photochromic compounds generally require complex molecular design, restricting accessibility in various fields. Herein, we report nonlinear photochromic properties in a perylene-substituted rhodamine spirolactam derivative (Rh-Pe), which is synthesized from rhodamine B in facile procedures. Direct excitation of Rh-Pe produces the triplet excited state via the charge-transfer (CT) state. The triplet excited state causes triplet-triplet annihilation to bring the generation of the intensely colored ring-open form with nonlinear behavior. Furthermore, green- and red-light-induced photochromism was achieved in Rh-Pe using triplet sensitizers, although Rh-Pe can be directly excited only by ultraviolet and blue light. Our findings are expected to contribute to the development of photofunctional materials showing nonlinear behavior and low-energy light responsivity.

Excited State Engineering in Ag29 Nanocluster through Peripheral Modification with Silver(I) Complexes for Bright Near-Infrared Photoluminescence.

The optical property of an ionic metal nanocluster (NC) is affected by the ionic interaction with counter ions. Here, we report that the modification of trianionic [Ag29(BDT)12(TPP)4]3- NC (BDT: 1.3-benzenedithiol; TPP: triphenylphosphine) with silver(I) complexes led to the intense photoluminescence (PL) in the near-infrared (NIR) region. The binding of silver(I) complexes to the peripheral region of Ag29 NC is confirmed by the single-crystal X-ray diffraction (SCXRD) measurement, which is further supported by electrospray ionization mass spectrometry (ESI-MS) and nuclear magnetic resonance (NMR) spectroscopy. The change of excited-state dynamics by the binding of silver(I) complexes is discussed based on the results of a transient absorption study as well as temperature-dependent PL spectra and PL lifetime measurements. The modification of Ag29 NCs with cationic silver(I) complexes is considered to give rise to a triplet excited state responsible for the intense NIR PL. These findings also afford important insights into the origin of the PL mechanism as well as the possible light-driven motion in Ag29-based NCs.

Substituent-Dependent Photoexcitation Processes of π-Stacked Ion Pairs.

Porphyrin ion pairs, the charge of which is delocalized in core units, form tightly associated structures through i π-i π interactions. 5,10,15-Triphenyl-substituted porphyrin-AuIII complex, which is favorable for forming stacked structures in the form of a stable ion, has been synthesized. Ion-pair metathesis based on the hard and soft acids and bases theory enabled combination with porphyrin anions possessing electronic states controlled by electron-donating and electron-withdrawing groups. Transient absorption spectroscopy suggested that the lifetimes of the radical pairs generated by photoinduced electron transfer of the ion pairs could be controlled by a judicious combination of the anions and cations.

Serum CA125 level as predictors of the efficacy of olaparib maintenance therapy for platinum-sensitive relapsed ovarian cancer.

AIM: Ovarian cancer is a gynecological malignancy with a poor prognosis. For platinum-sensitive relapsed ovarian cancer, maintenance therapy with poly-ADP ribose polymerase (PARP) inhibitors after chemotherapy is considered; however, olaparib treatment does not always lead to sufficient progression-free survival (PFS). This study aimed to identify factors that predict the efficacy of maintenance therapy using olaparib in platinum-sensitive relapsed ovarian cancer. METHODS: Twenty-seven patients with platinum-sensitive relapsed ovarian cancer, who received initial treatment and showed complete or partial response to prior chemotherapy at our hospital, were included. The primary outcome was the time from the end of previous platinum-based chemotherapy to disease progression (PFS). The Kaplan-Meier method was used to generate time-to-event curves for PFS; multivariate analysis was performed using the Cox proportional hazards regression model. RESULTS: The median PFS was 12 months (95% confidence interval [CI]: 8.3-15.8). Before olaparib administration, the median PFS was 12 months in the <4.1 neutrophil-to-lymphocyte ratio group and 4 months in the ≥4.1 group, with PFS being significantly better in the <4.1 group (log-rank: p = 0.023). When comparing serum cancer antigen 125 (CA125) levels, the median PFS was 13 months in the <18 U/mL group and 6 months in the >18 U/mL group (log-rank: p = 0.022). Multivariate Cox regression analysis revealed that CA125 was the factor affecting PFS (hazard ratio: 4.85; 95% CI: 1.53-15.38). CONCLUSIONS: Serum CA125 levels at olaparib initiation in patients with platinum-sensitive relapsed ovarian cancer may predict PFS as an effect of maintenance therapy using olaparib to treat recurrent disease.

Recent advances in low-power-threshold nonlinear photochromic materials.

Incoherent nonlinear photophysical and photochemical processes based on stepwise two-photon absorption (2PA) processes have been recently used in materials science owing to their unique photoresponses beyond one-photon processes and lower power thresholds to induce the processes than those of coherent nonlinear optical processes. Among them, nonlinear photochromic materials have received considerable attention because they exhibit unconventional photoresponses compared with other incoherent nonlinear processes such as low-power-threshold nonlinear photoresponses with unimolecular systems, gated photochemical reactions and oxygen-insensitive nonlinear photoresponses. Nonlinear photochromic materials are important not only for colorimetric materials, but also for emergent materials that can enrich the next-generation society such as dynamic holographic materials, which are promising for three-dimensional displays. In this tutorial review, we introduce low-power-threshold nonlinear photochromic materials using stepwise 2PA processes. First, we explain the fundamental concepts of photochemistry as well as photochromic reactions. We attempt to provide an intuitive understanding of incoherent nonlinear optical processes using these fundamental concepts. Then, we introduce several recent examples and potential applications of nonlinear photochromic materials. This tutorial review is important for understanding the scientific progress related to these fields and provides a simple unified picture of the incoherent nonlinear optical properties of different types of photofunctional materials.

π-Stacked Ion Pairs: Tightly Associated Charged Porphyrins in Ordered Arrangement Enabling Radical-Pair Formation.

π-Electronic ion pairs are of interest for fabricating electronic materials that use intermolecular interactions based on electrostatic and dispersion forces, defined as iπ-iπ interactions, to provide dimension-controlled assemblies. Porphyrin ions, whose charge is delocalized in the core units, are suitable for ordered arrangement and assemblies by ion pairing. Herein, charged porphyrins were found to form solid-state assemblies and solution-state stacked ion pairs according to the peripheral electron-donating groups (EDGs) and electron-withdrawing groups (EWGs). The concentration-dependent 1H NMR signal shifts of a porphyrin ion pair, comprising a meso-EWG cation and a meso-EWG anion, provided a hetero-dimerization constant of 2.8 × 105 M-1 in CD2Cl2 at 20 °C. In the ion pair of a meso-EWG cation and a meso-EDG anion, the electron transfer in the steady and excited states according to solvent polarity and photoexcitation, respectively, produced the radical pairs. The electron spin resonance analysis in frozen toluene revealed the formation of a heterodiradical in a closely stacked structure by the antiferromagnetic dipolar interaction and temperature-dependent spin transfer behavior.

Novel anti-GARP antibody DS-1055a augments anti-tumor immunity by depleting highly suppressive GARP+ regulatory T cells.

Regulatory T (Treg) cells, which are essential for maintaining self-tolerance, inhibit anti-tumor immunity, consequently hindering protective cancer immunosurveillance, and hampering effective anti-tumor immune responses in tumor-bearing hosts. Here, we show that depletion of Treg cells via targeting glycoprotein A repetitions predominant (GARP) induces effective anti-tumor immune responses. GARP was specifically expressed by highly suppressive Treg cells in the tumor microenvironment (TME) of multiple cancer types in humans. In the periphery, GARP was selectively induced in Treg cells, but not in effector T cells, by polyclonal stimulation. DS-1055a, a novel afucosylated anti-human GARP monoclonal antibody, efficiently depleted GARP+ Treg cells, leading to the activation of effector T cells. Moreover, DS-1055a decreased FoxP3+CD4+ T cells in the TME and exhibited remarkable anti-tumor activity in humanized mice bearing HT-29 tumors. We propose that DS-1055a is a new Treg-cell-targeted cancer immunotherapy agent with augmentation of anti-tumor immunity.

Photochromism of colloidal ZnO nanocrystal powders under ambient conditions.

Zinc oxide (ZnO) nanocrystals (NCs) exhibit photochromic reactions under specific conditions upon ultraviolet light irradiation. Since the color is originated from the excited electrons at the conduction band of ZnO NCs, the photoinduced absorption is observed only in the solution with hole acceptors under inert conditions. ZnO is earth-abundant and less toxic than many other substances, and has been widely used in various industrial fields. If the photochromic reaction of ZnO can be observed consistently under ambient conditions, the material may pave the way for large-scale photochromic applications such as in pigments, windows, and building materials in addition to conventional photochromic applications. In this study, we synthesize hydrophilic ZnO NCs and observe the solid-state photochromic reactions in the visible to mid-infrared regions even in humid-air conditions. We reveal that the coloration of powders of ZnO NCs under ambient conditions originates mainly from two factors: (1) charge separation induced by hole trapping by water molecules adsorbed on the surface of NCs, and (2) deceleration of the reactions involving the electrons in the conduction band of ZnO NCs with molecular oxygen and the adsorbed water molecules.

Electron-donating curved π-electronic systems that complex with buckyballs.

Modifications in curved π-electronic systems, dipyrrolylbenzodiazepines, resulted in various derivatives with modulated electronic properties and assembly behaviour. The electron-rich pyrrole-based curved π-system exhibited C60 complexation in the form of a hydrogen-bonding cyclic hexamer, giving rise to solid-state photo-induced electron transfer as elucidated by transient absorption spectroscopy.

Excited-state dynamics of dipyrrolyldiketone difluoroboron complexes.

Anion-responsive photofunctional materials have been extensively studied because anions are important for biotic activity and constitute the building blocks of elegant supramolecular architectures. A number of fluorescent anion receptors that can probe anions in their environments have been reported, but the excited states of many of these molecules remain elusive. Studies on excited-state dynamics provide fruitful information for optimizing the emission properties, minimizing the photodegradation and photorelease of anions, and exploring novel photofunctions. In this study, we investigated the excited-state dynamics of an aryl-substituted dipyrrolyldiketone difluoroboron complex, a π-conjugated anion receptor, by time-resolved visible and infrared absorption spectroscopy and emission decay measurements combined with quantum chemical calculations. Anion binding was found to alter the radiative and nonradiative rate constants and the excited-state absorption of the anion receptor. In contrast, the molecular structures and binding abilities were similar in the S0 and S1 states.

Sentinel node navigation surgery in cervical cancer: a systematic review and metaanalysis.

Sentinel node navigation surgery (SNNS) is used in clinical practice for the treatment of cervical cancer. This study aimed to elucidate the appropriate sentinel lymph node (SLN) mapping method and assess the safety and benefits of SNNS. We searched the PubMed, Ichushi, and Cochrane Library databases for randomized controlled trials (RCT) and studies on SLN in cervical cancer from January 2012 to December 2020. Two authors independently assessed study quality and extracted data. We quantitatively analyzed the detection rate, sensitivity/specificity, and complications and reviewed information, including the survival data of SLN biopsy (SLNB) without pelvic lymphadenectomy (PLND). The detection rate of SLN mapping in the unilateral pelvis was median 95.7% and 100% and in the bilateral pelvis was median 80.4% and 90% for technetium-99 m (Tc) with/without blue dye (Tc w/wo BD) and indocyanine green (ICG) alone, respectively. The sensitivity and specificity of each tracer were high; the area under the curve of each tracer was 0.988 (Tc w/wo BD), 0.931 (BD w/wo Tc), 0.966 (ICG), and 0.977 (carbon nanoparticle). Morbidities including lymphedema, neurological symptoms and blood loss were associated with PLND. One RCT and five studies all showed SNNS without systematic PLND does not impair recurrence or survival in early-stage cervical cancer with a tumor size ≤ 2-4 cm. Both Tc w/wo BD and ICG are appropriate SLN tracers. SNNS can reduce the morbidities associated with PLND without affecting disease progression in early-stage cervical cancer.

Dynamic Spin-Spin Interaction Observed as Interconversion of Chemical Bonds in Stepwise Two-Photon Induced Photochromic Reaction.

Biradicaloids in π-conjugated organic molecules have been extensively studied in recent years because of the fundamental insights into the chemical bonds and unique optical, electrical, and magnetic properties. Several studies have reported that the spin-spin interactions of biradicaloids with flexible molecular frameworks dynamically evolve correlating with molecular structural changes. Although these dynamic behaviors will provide important insights into the relationship between molecular structures and spin properties, studies on such behaviors have been limited to two-spin systems. Here, we investigated the stepwise photochromic properties of biphotochromic molecules involving multiple spin interactions by double-pulse laser flash photolysis. The one-photon photochromic reaction generates the o-biradical form as the open-closed form, which thermally isomerizes to the o-quinoidal form and reaches the thermal equilibrium state between them. The additional absorption of a photon by the open-closed form leads to the photochromic reaction of the other photochromic unit, resulting in the generation of unpaired spins at the p-position of the central aromatic bridge of the biradical or quinoidal form. Under the situation, while the interaction between the unpaired spins and the o-biradical preferentially produces the p-quinoidal form in which the antiferromagnetic interaction at the p-position is dominant, that between the spins and the o-quinoidal form kinetically produces the bis(o-quinoidal) form followed by the thermal isomerization to the thermodynamically stable p-quinoidal form. These dynamic spin-spin interactions along with the rearrangement of chemical bonds will give a deeper understanding of the singlet biradicaloids and that to bridge organic multiradicals in molecular systems to cooperative spin behaviors in bulk materials.

Fast T-Type Photochromism of Colloidal Cu-Doped ZnS Nanocrystals.

This paper reports on durable and nearly temperature-independent (at 298-328 K) T-type photochromism of colloidal Cu-doped ZnS nanocrystals (NCs). The color of Cu-doped ZnS NC powder changes from pale yellow to dark gray by UV light irradiation, and the color changes back to pale yellow on a time scale of several tens of seconds to minutes after stopping the light irradiation, while the decoloration reaction is accelerated to submillisecond in solutions. This decoloration reaction is much faster than those of conventional inorganic photochromic materials. The origin of the reversible photoinduced coloration is revealed to be a strong optical transition involving a delocalized surface hole which survives over a minute after escaping from intraparticle carrier recombination due to electron-hopping dissociation. ZnS NCs can be easily prepared in a water-mediated one-pot synthesis and are less toxic. Therefore, they are promising for large-scale photochromic applications such as windows and building materials in addition to conventional photochromic applications. Moreover, the present study demonstrates the importance of excited carrier dynamics and trap depths, resulting in coloration over minutes not only for photochromic nanomaterials but also for various advanced photofunctional materials, such as long persistent luminescent materials and photocatalytic nanomaterials.

Dipyrrolyldiketone PtII Complexes: Ion-Pairing π-Electronic Systems with Various Anion-Binding Modes.

A variety of π-electronic ion-pairing assemblies can be constructed by combining anion complexes of π-electronic systems and countercations. In this study, a series of anion-responsive π-electronic molecules, dipyrrolyldiketone PtII complexes containing a phenylpyridine ligand, were synthesized. The resulting PtII complexes exhibited phosphorescence emission, with higher emission quantum yields (0.30-0.42) and microsecond-order lifetimes, and solution-state anion binding, as revealed by our spectroscopic analyses. These PtII complexes displayed solid-state ion-pairing assemblies, exhibiting various anion-binding modes, which derived from pyrrole-inverted and pyrrole-non-inverted conformations, and packing structures, with the contribution of charge-by-charge assemblies, which were dependent on the substituents in the PtII complexes and the geometries and electronic states of their countercations.

Clinicopathological characteristics and prognostic factors of ovarian granulosa cell tumors: A JSGO-JSOG joint study.

OBJECTIVES: The aim of this study was to elucidate the clinicopathological features of ovarian granulosa cell tumors (GCTs) and to identify the prognostic factors. METHODS: The Japanese Society of Gynecologic Oncology (JSGO) conducted an observational retrospective cohort study of women with GCTs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology (JSOG) between 2002 and 2015. Clinicopathological features, including lymph node metastasis, were evaluated. In addition, we performed a prognostic analysis of patients between 2002 and 2011 for whom survival data were available. Kaplan-Meier and multivariate Cox proportional hazards analyses were performed. RESULTS: We identified 1426 patients with GCTs. Of the 222 patients who underwent lymph node dissection, 10 (4.5%) had lymph node metastasis. The incidence of lymph node metastasis in patients with pT1, pT2, and pT3 was 2.1%, 13.3%, and 26.7%, respectively (p < 0.001). Prognostic analysis was performed on 674 patients. In the multivariate Cox regression analysis, residual disease after initial surgery (hazard ratio (HR) = 10.39, 95% confidence interval (CI) = 3.15-34.29) and lymph node metastasis (HR = 5.58, 95% CI = 1.62-19.19) were independent risk factors for cancer-specific survival. CONCLUSIONS: In the initial surgery for GCTs, lymph node dissection can be omitted if the operative finding is pT1. In cases of pT2 or higher, lymph node dissection should be considered. Debulking is critical for achieving no gross residual tumor at the end of the surgery.