Caution: Content warnings do not reduce stress, study shows

Peer-Reviewed Publication

ASSOCIATION FOR PSYCHOLOGICAL SCIENCE

Advocates for the use of trigger warnings suggest that they can help people avoid or emotionally prepare for encountering content related to a past trauma. But trigger warnings may not fulfill either of these functions, according to an analysis published in Clinical Psychological Science, a journal of the Association for Psychological Science.  

Instead, warnings appear to heighten the anticipatory anxiety a person may feel prior to viewing sensitive material while making them no less likely to consume that content, wrote Victoria M. E. Bridgland of Flinders University, and Payton J. Jones and Benjamin W. Bellet of Harvard University. Additionally, participants’ distress levels after viewing potentially triggering material were the same regardless of whether or not they received a warning. 

“When people see trigger warnings it makes them feel anxious, but that anxiety doesn’t seem to be any sort of helpful emotional preparation,” Bridgland said. “We need more strategies to give people versus just putting a warning on something and assuming that is going to give them a toolkit for mental health.” 

Bridgland, Jones, and Bellet reached their conclusions by comparing the results of 12 studies about the effects of content warnings on participants’ negative emotional reactions, avoidance behavior, and comprehension. The majority of these studies included a mix of participants who were trauma survivors and people who did not report a history of traumatic experiences. The researchers’ analysis resulted in four findings: 

• Warnings increase anticipatory anxiety. Across five studies, participants who read content warnings were more anxious prior to viewing potentially triggering material than those who did not. 
• Warnings did not influence emotional reactions to content. Across nine studies, content warnings did not affect participants’ feelings of distress, fear, or anxiety after viewing sensitive content. 
• Warnings do not increase avoidance. Across five studies, participants viewed troubling content at about the same rate regardless of whether or not they received a trigger warning.  
• Warnings do not impact comprehension. Across three studies, content warnings did not affect participants’ understanding of written material. 

“Existing published research almost unanimously suggests that trigger warnings do not mitigate distress,” Bridgland and colleagues wrote. “Indeed, trigger warnings (including those used in the current studies) typically warn people about the distressing reactions they may have but do not explain how to reduce these reactions.” 

These findings also suggest that people do not use content warnings to avoid viewing triggering content, even when they have the option to do so, the researchers noted. This may be due to a “forbidden fruit” effect, which could make potentially aversive material more tempting to viewers. 

Given that many people do not use content warnings to avoid troubling material, Bridgland’s ongoing research suggests that emotional-regulation training could help people use these warnings to better prepare themselves beforehand.

Reporters may request a copy of this article by emailing news@psychologicalscience.org

The Association for Psychological Science is the home of thousands of leading psychological science researchers, practitioners, teachers, and students from around the world. APS is dedicated to advancing scientific psychology across disciplinary and geographic borders and committed to disseminating psychological science to the general public; promoting the integration of scientific perspectives across our diverse field and with other scientific disciplines; incentivizing global collaboration among researchers; catalyzing the further development of psychological science; and promoting the application of psychological science to public policy.

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JOURNAL

Clinical Psychological Science

DOI

10.1177/21677026231186625 

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

A Meta-Analysis of the Efficacy of Trigger Warnings, Content Warnings, and Content Notes

 

A cheaper, safer alternative to lithium-ion batteries: Aqueous rechargeable batteries

Automatic conversion of hydrogen gas into water makes batteries safer. A breakthrough technology for the commercialization of cheaper, safer aqueous rechargeable batteries.

Peer-Reviewed Publication

NATIONAL RESEARCH COUNCIL OF SCIENCE & TECHNOLOGY

 

IMAGE: 

CAUSES OF HYDROGEN GENERATION AND INCESSANT ACCUMULATION WITHIN THE CELL IN THE AQUEOUS RECHARGEABLE BATTERIES

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CREDIT: KOREA INSTITUTE OF SCIENCE AND TECHNOLOGY

This summer, the planet is suffering from unprecedented heat waves and heavy rainfalls. Developing renewable energy and expanding associated infrastructure has become an essential survival strategy to ensure the sustainability of the planet in crisis, but it has obvious limitations due to the volatility of electricity production, which relies on uncertain variables like labile weather conditions. For this reason, the demand for energy storage systems (ESS) that can store and supply electricity as needed is ever-increasing, but lithium-ion batteries (LIBs) currently employed in ESS are not only highly expensive, but also prone to potential fire, so there is an urgent need to develop cheaper and safer alternatives.

A research team led by Dr. Oh, Si Hyoung of the Energy Storage Research Center at the Korea Institute of Science and Technology (KIST) has developed a highly safe aqueous rechargeable battery that can offer a timely substitute that meets the cost and safety needs. Despite of lower energy density achievable, aqueous rechargeable batteries have a significant economic advantage as the cost of raw materials is much lower than LIBs. However, inveterate hydrogen gas generated from parasitic water decomposition causes a gradual rise in internal pressure and eventual depletion of the electrolyte, which poses a sizeable threat on the battery safety, making commercialization difficult.

Until now, researchers have often tried to evade this issue by installing a surface protection layer that minimizes the contact area between the metal anode and the electrolyte. However, the corrosion of the metal anode and accompanying decomposition of water in the electrolyte is inevitable in most cases, and incessant accumulation of hydrogen gas can cause a potential detonation in long-term operation.

To cope with this critical issue, the research team has developed a composite catalyst consisting of manganese dioxide and palladium, which is capable of automatically converting hydrogen gas generated inside the cell into water, ensuring both the performance and safety of the cell. Manganese dioxide does not react with hydrogen gas under normal circumstances, but when a small amount of palladium is added, hydrogen is readily absorbed by the catalysts, being regenerated into water. In the prototype cell loaded with the newly developed catalysts, the internal pressure of the cell was maintained well below the safety limit, and no electrolyte depletion was observed.

The results of this research effectively solves one of the most concerning safety issues in the aqueous batteries, making a major stride towards commercial application to ESS in the future. Replacing LIBs by cheaper and safer aqueous batteries can even trigger a rapid growth of global market for ESS.

"This technology pertains to a customized safety strategy for aqueous rechargeable batteries, based on the built-in active safety mechanism, through which risk factors are automatically controlled." said Dr. Oh, Si Hyoung of KIST. "Moreover, it can be applied to various industrial facilities where hydrogen gas leakage is one of major safety concerns (for instance, hydrogen gas station, nuclear power plant etc) to protect public safety."

Proposed strategy for securing safety of the aqueous rechargeable batteries via water-regeneration

Role of composite catalysts in activating water-regeneration chemical reaction

CREDIT

Korea Institute of Science and Technology

KIST was established in 1966 as the first government-funded research institute in Korea. KIST now strives to solve national and social challenges and secure growth engines through leading and innovative research. For more information, please visit KIST’s website at https://eng.kist.re.kr/

This research was supported by the Ministry of Science and ICT (Minister Lee Jong-ho) through the Nano Future Material Source Technology Development Project and the Mid-Career Researcher Support Project, and the results were published on August 1 in the international journal Energy Storage Materials (IF 20.4).

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JOURNAL

Energy Storage Materials

DOI

10.1016/j.ensm.2023.102881 

ARTICLE TITLE

Highly safe aqueous rechargeable batteries via electrolyte regeneration using Pd-MnO2 catalytic cycle

 

Caution, ocelot crossing: special wildlife exits on busy roads help protect endangered cat

Range of species learn to use newly designed wildlife exits to avoid being trapped on highways

Peer-Reviewed Publication

FRONTIERS

 

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TEXAS OCELOT, LEOPARDUS PARDALIS ALBESCENS, IN THE VICINITY OF THE HIGHWAY

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CREDIT: KLINE LAB, UNIVERSITY OF TEXAS RIO GRANDE VALLEY

The Texas ocelot (Leopardus pardalis albescens) is endangered due to historic hunting, habitat loss, inbreeding, and traffic collisions. Today, only between 50 and 80 ocelots remain in the US, exclusively in Willacy and Cameron counties in southern Texas. These two populations are isolated from the larger one in northwestern Mexico by highways and urban development.

“Here we show that a range of species, including middle-sized carnivores such as bobcats and coyotes, successfully use wildlife exits, a new type of mitigation structure specifically designed for the US endangered ocelot,” said first author Zarina Sheikh, a former graduate student at the University of Texas Rio Grande Valley, about their new study in Frontiers in Ecology and Evolution.

Fencing can trap wildlife on roads

In Texas, continuous chain-link fencing along highways has long been used to reduce the mortality of wildlife from traffic collisions. But this can backfire: it can trap animals that manage to enter the highway and become trapped, for example by jumping over or burrowing under the fencing.

To enable ocelots to leave highways back into nature, novel exits were designed in 2018 by the Texas Department of Transportation. These are openings in the fencing approximately 46cm across at their widest, 13cm across at their narrowest, and 60cm high – funnel-shaped to encourage ocelots to use them exclusively in the desired direction, away from the highway and back into the surrounding habitat.

The present study tested if the wildilfe exits are correctly used by medium-sized carnivores in Texas. It was done along an 11.9-km-long stretch of State Highway 100 between Los Fresnos and Laguna Vista, between February 2019 and November 2020. In 2018, 10 wildlife exits had been installed along this stretch.

Wildlife cameras

Two automatic wildlife cameras were installed at each wildlife exit, one facing inward and another outward. The cameras were inspected every month, with their images downloaded and sorted into species.

“We anticipated that the extreme rarity of ocelots would limit the amount of data collected on that species. For this reason, we also focused on more common bobcats and coyotes, as they have similar habitats, diets, body sizes, and behaviors as ocelots, with overlapping home ranges between them,” said Kevin Ryer, a co-author and research associate at the same university.

The results showed that the wildlife exits were used by 10 mammal species to exit the highway, ranging in size from black-tailed jackrabbits and Virginia opossums to bobcats and coyotes. For the latter two species, activity peaked around 10pm and then again between midnight and dawn.

Not unexpectedly given their rarity, ocelots themselves have not yet been photographed to use the exits during the study, although they have been captured by additional automatic cameras in the vicinity of the highway. However, the observation that coyotes and bobcats use them correctly implies that ocelots are likely to do so too.

As expected, the largest local species, such as white-tailed deer, nilgai, and javelina, were unable to use the narrow wildlife exits. For these species, additional mitigating structures, such as tunnels and crossing grids are also installed along Texas highways.

Not only for ocelots
The authors conclude that the exits function as designed, but ongoing research aims for improvements to exclude wildlife from using them in the wrong direction. These novel wildlife exits have the potential to be a valuable conservation measure on Texas highways.

Senior author Dr Richard Kline, a professor at the same university, said: “Wildlife collision mitigation is less expensive to implement during the construction phase of highways than retrofitting mitigation after construction. Although the entire wildlife community near the highway should be considered when planning mitigation, endangered species should be the focus.”

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JOURNAL

Frontiers in Ecology and Evolution

DOI

10.3389/fevo.2023.1235223 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Use and effectiveness of wildlife exits designed for ocelots and other mesocarnivores on a South Texas highway

ARTICLE PUBLICATION DATE

13-Oct-2023

Bobcat, Lynx rufus

Two coyotes, Canis latrans, using a wildlife exit to leave the road

Texas tortoise, Gopherus berlandieri.

Nine-banded armadillo, Dasypus novemcinctus.

Female white-tailed deer, Odocoileus virginianus.

American hog-nosed skunk, Conepatus leuconotus.

CREDIT

Kline Lab, University of Texas Rio Grande Valley

 

Electrons & photons - the greatest match of all time

Peer-Reviewed Publication

INSTITUTE OF PHYSICAL CHEMISTRY OF THE POLISH ACADEMY OF SCIENCES

 

IMAGE: 

IN ELECTROCHEMICAL MEASUREMENTS, EVERY DETAIL MATTERS. BY CUTTING AWAY THE NOISE, THE RESEARCHERS CREATED ORDER OUT OF CHAOS. AND ALL THIS TO INCREASE THE SENSITIVITY OF THE STUDY OF EVEN SINGLE MOLECULES. SOURCE: IPC PAS, PHOTO: GRZEGORZ KRZYZEWSKI

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CREDIT: SOURCE: IPC PAS, PHOTO: GRZEGORZ KRZYZEWSKI

With recent improvements in instrumentation and confinement techniques, the detection of molecules using electrochemical techniques has become easier than ever before; however, there are still many conditions which restrict the electrochemical detection of single molecules and ultra-fast processes at the molecular level. All of this is due to the presence of a limit of detection, which is set by the minimum number of electrons that can be observed passing through an electrochemical system during a measurement. This is a serious problem for diagnostic devices based on electrochemistry, so many efforts are being made to find alternatives to overcome the electrochemical detection limit. Recently, scientists from the Institute of Physical Chemistry of the Polish Academy of Sciences (IPC PAS) provided insight into electrochemistry performed below the limit of detection and into the prospects for applying the proposed solution in fields where that limit is still an issue. Let us take a closer look at their work.

 

Electrochemistry is a branch of science concerned with the relationship between chemical changes and electrical charges. Electrochemical processes have significant practical applications in many areas of science and everyday life. There are several electroanalytical methods, each of which can be used to study numerous processes. Corrosion? Electrochemical techniques can be used to detect the formation of pits as small as several nanometres under environmental conditions. What about energy storage? Batteries for portable electronics and electric cars, fuel cells, and even photovoltaics are based on electrochemical processes. The detection of certain molecules in food samples, pharmaceutical mixtures, wastewater, and even biological fluids can be performed by capturing certain electrochemical signals. Through this, it is possible to accurately assess the content of molecules of interest in a sample under investigation.

 

The electrochemical methods used to detect molecules with high sensitivity have been greatly updated since the methods used by Michael Faraday almost two centuries ago. Researchers are constantly trying to make our lives easier by increasing the sensitivity of electrochemical techniques towards the detection limit of such chemicals. However, despite the broad use of electrochemical methods in everyday life, the detection of single molecules, particles, and redox processes at a molecular level is still challenging and needs an amplification approach to deal with the low numbers of electrons passed during the measurement. Furthermore, the thermal and statistical motion of electrons in electrical circuits adds some background noise which means more than 2100 electrons are required in order to even see an electrochemical event. This translates to thousands of molecules reacting at the electrode, far from the dream of single molecule detection. However, this limit can be overcome by converting electrochemical charges into photons, which can be detected even if only one photon is present.

 

Analytical Chemistry recently published an article on this very topic written by researchers from the Nanoelectrochemistry group at the Institute of Physical Chemistry of the Polish Academy of Sciences (IPC PAS). An increased sensitivity towards the detection of charge-transfer processes was demonstrated through the measurement of fluorescence induced in a closed bipolar electrochemical setup. In this unique setup, the oxidation of an analyte in one cell was used to concurrently drive the oxidation of fluorogenic redox compound, Amplex Red, in another cell.

 

“We demonstrated the use of a luminescent molecule to measure charges close to the electrochemical limit of quantification and compared the efficiencies of the reaction under different experimental timescales. This is a large step toward the quantitative conversion of sub-detection limit electrochemical signals into more sensitive photon signals. This advancement will improve the sensitivity of single-entity electrochemistry and sensing applications that use remote optical reporting, allowing smaller nanoparticles and lower concentrations of analyte to be detected.” - explained Dr. Steven Linfield, one of the researchers behind the publication.

 

The integrated fluorescence signal caused by the passage of charge was measured, and the results revealed a linear relationship between the charge passed and the fluorescence signal, depending on the experiment's timeframe. Microelectrodes were used for their low capacitance and rapid establishment of a steady-state diffusion field, which allowed the researchers to approach the electrochemical limits of quantification without appreciable capacitive current.

 

“In our work, we presented an alternative system for remote reporting in which fluorescence is induced through microelectrodes in a closed bipolar electrochemical cell in three-electrode driving mode. To report on electrochemistry measured in the detection cell, we need an understanding of the processes which may occur in the reporting cell and how the design of the closed bipolar cell can influence the reporting process.” - Comments Dr. Wojciech Nogala, the principal investigator of the project.

 

This alternative system not only provides the possibility for the direct thermodynamic control of electrochemical processes, but also enables observation of the fluorogenic reaction induced by either reduction or oxidation processes. Thanks to these experiments, it is now possible to see currents that are close to the limit of quantification. This outcome could revolutionize the detection of discrete signals given by many molecules that are normally not detectable using classical electrochemical setups and opens up the possibility of sensing molecules at ultralow concentrations.

 

So, where might the results of these studies be applied? Well, one application is in the sensing of clinically relevant biomolecules at low concentrations, which may bring us closer to earlier diagnosis and treatment of various diseases. Another can be detection of particular chemicals in food or environment with higher sensitivity than before. Detecting molecules with a higher sensitivity can enhance the analytical capabilities of various sectors and can aid in the development of novel sensors in many aspects of life.

 

This publication is part of a project that has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement no. 847413. This work was also published as part of an international co-financed project founded from the program of the Minister of Science and Higher Education entitled ”PMW” in the years 2020–2024; agreement no. 5005/H2020-MSCA-COFUND/2019/2, National Science Centre (NCN, Poland) agreements no. UMO-2016/23/B/ST4/02868, and 2020/39/B/ST4/01523.

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JOURNAL

Analytical Chemistry

DOI

10.1021/acs.analchem.3c00694 

 

Most Canadians with arthritis and disabling chronic pain are in excellent mental health

More than three quarters of Canadians living with arthritis and debilitating chronic pain are free of all psychiatric disorders, including depression, and more than half are happy and in excellent mental health

Peer-Reviewed Publication

UNIVERSITY OF TORONTO

Toronto, Canada

A new study published by researchers at the University of Toronto indicates a very high level of resilience among Canadians with arthritis whose activities were restricted due to pain.

The vast majority (76%) of these individuals were free of any mental illness in the past year, including depression.  The paper was published online this week in PLOS ONE.

More than half (56%) of the respondents went beyond just being free of psychiatric disorders to achieving excellent mental health.  The definition of excellent mental health sets a very high bar. To be defined in excellent mental health, respondents had to achieve three things: 1) almost daily happiness or life satisfaction in the past month, 2) high levels of social and psychological well-being in the past month, and 3) freedom from generalized anxiety disorder and depressive disorders, suicidal thoughts and substance dependence for at least the preceding full year.

"We were so encouraged to learn that the majority of older Canadians with arthritis who were in debilitating chronic pain had excellent mental health. These findings bring a hopeful message to those living with disabling pain and their families as well as to clinicians addressing their physical and mental health care needs,” says the study’s senior author, Esme Fuller-Thomson.  Fuller-Thomson is Director of the U of T Institute for Life Course and Aging and Professor at the Factor-Inwentash Faculty of Social Work (FIFSW) and the Department of Family & Community Medicine.

Consistent with earlier studies, this study found insomnia to be negatively associated with mental health.  

“These findings underscore the importance of health professionals asking about sleep problems, particularly as chronic pain can undermine the quality of sleep,” says co-author Denise Marshall, a recent graduate of U of T’s FIFSW. “Among individuals with chronic pain, cognitive behavioral therapy or CBT has been shown to significantly reduce insomnia. CBT is an already established effective and relatively rapid treatment for depression and anxiety in the general population, and among those with chronic pain.”

Those with a confidant were much more likely to be in complete mental health than those without a confidant (60% vs 8%, respectively).

“Confidants are an important source of emotional and instrumental support,” says co-author Matthew Moses, also a recent graduate of the U of T’s FIFSW. “Although the exact mechanisms by which a confidant supports mental health are not fully understood, we hypothesize that the provision of emotional support can help enhance self-esteem and help the individual buffer general stress associated with the chronic pain.”  

Other factors associated with excellent mental health in the year preceding the survey included having no previous history of major depressive disorder and/or generalized anxiety disorder.

“The current research shifts away from a deficit-focused approach to mental health among individuals with arthritis, and instead uses a strengths-based perspective to explore factors associated with resilience in individuals with arthritis who are experiencing chronic and disabling pain.” says co-author Sally Abudiab, who also recently graduated from U of T’s FIFSW.

The study investigated factors associated with mental flourishing in a nationally representative sample of 620 Canadian adults drawn from the Canadian Community Health Survey-Mental Health who had been diagnosed with arthritis who are living with disabling chronic pain. This research was supported by the Social Sciences and Humanities Research Council Grant # 435-2016-0660 (PI: Esme Fuller-Thomson).

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JOURNAL

PLoS ONE

DOI

10.1371/journal.pone.0291722 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Flourishing mental health despite disabling chronic pain: Findings from a nationally representative sample of Canadians with arthritis.

ARTICLE PUBLICATION DATE

11-Oct-2023

 

County-level social vulnerability, metropolitan status, and availability of home health services

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: This study found differences in Medicare-funded home-based clinical care provision across the U.S. by county-level Social Vulnerability Index (a measure of socioeconomic deprivation), suggesting inequitable care access among homebound Medicare beneficiaries. Almost one-quarter of counties had low availability of home-based medical care clinicians coupled with high socioeconomic disadvantage. 

Authors: Harriet Mather, M.D., of the Icahn School of Medicine at Mount Sinai in New York, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2023.37508)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

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Health insurance and differences in infant mortality rates

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: In this study of more than 13 million infants, maternal Medicaid insurance was associated with increased risk of infant mortality at the population level in the U.S. Novel strategies are needed to improve access to care, quality of care, and outcomes among women and infants enrolled in Medicaid. 

Authors: Colm P. Travers, M.D., of the University of Alabama at Birmingham, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2023.37690)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

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Race and ethnicity and primary language in emergency department triage

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: In this study of 249,000 visits to seven academic and community hospital emergency departments, patients who identified as Black, Hispanic, and Other race and ethnicity were assigned less acute Emergency Severity Index scores than their white peers despite having received more involved physician workups, suggesting some degree of mistriage. Clinical decision support systems might reduce these disparities but would require careful calibration to avoid replicating bias. 

Authors: Joshua W. Joseph, M.D., M.S., M.B.E., of Brigham and Women’s Hospital in Boston, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/  

(doi:10.1001/jamanetworkopen.2023.37557)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

 

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The burden of lung cancer in women compared with men in the US

JAMA Oncology

Peer-Reviewed Publication

JAMA NETWORK

About The Study: Based on high-quality population-based data, this study found that the higher lung cancer incidence in women than in men has not only continued in individuals younger than 50 years but also now extends to middle-aged adults as younger women with a high risk of the disease enter older age. Reasons for this shift are unclear because the prevalence and intensity of smoking are not higher in younger women compared with men except for a slightly elevated prevalence among those born in the 1960s. 

Authors: Ahmedin Jemal, D.V.M., Ph.D., of the American Cancer Society in Atlanta, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamaoncol.2023.4415)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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JOURNAL

JAMA Oncology