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BackgroundCancer survivors are at increased risk for chronic insomnia, even years after treatment completion. As insomnia is associated with a variety of long-term health consequences, access to insomnia treatment is critically important for the survivor population. Cognitive behavioral therapy for insomnia (CBTI) is the recommended first-line treatment for insomnia but remains largely unavailable to survivors. Treatment barriers include geographic limitations, a shortage of trained providers, and demanding treatment regimens. Designed with these limitations in mind, the Sleep Treatment Education Program (STEP-1) delivers components of CBTI in a low-intensity educational intervention delivered online. ObjectiveThis is a phase II pilot randomized controlled trial. The primary aims are to test the efficacy of STEP-1 to improve (1) insomnia symptoms and (2) mood in cancer survivors compared to a control condition. The secondary aims will (1) explore participant factors associated with clinically significant response, (2) evaluate acceptability of the control intervention, (3) explore feasibility of delivering individualized coaching sessions for participants who do not have a significant response to STEP-1, and (4) describe participants’ satisfaction with STEP-1 and suggestions for improvement. MethodsThis 2-arm randomized controlled trial enrolled 70 off-treatment cancer survivors aged 40-89 years with clinically significant insomnia. Participants are randomized to receive either the STEP-1 intervention or control condition (relaxation education); interventions are delivered in one-on-one, synchronous, virtual videoconference sessions by trained interventionists. The STEP-1 intervention presents educational information on the development of insomnia after cancer and offers suggestions for improving insomnia symptoms based on the CBTI elements of sleep hygiene, stimulus control, and cognitive restructuring. With the interventionist, participants review the suggestions and develop a personalized sleep action plan for implementation. The relaxation education session provides information on the potential benefits of relaxation and how to independently access online relaxation exercises. The Insomnia Severity Index is used to measure insomnia symptoms, and the Profile of Mood States Short Form is used to measure mood at baseline and 4 and 8 weeks after intervention. The primary end point is change in the Insomnia Severity Index score at 8 weeks, and the secondary end point is change in mood symptoms (Profile of Mood States Short Form) at 8 weeks. ResultsThis trial was funded in July 2022. Enrollment and data collection began in February 2023 and concluded in October 2024, with 70 participants enrolled. The analysis will begin in fall 2024, and the results are expected in winter 2025. ConclusionsTrial results will determine if STEP-1 effects go beyond those that could be attributed to placebo and other nonspecific treatment factors. Should results support the efficacy of STEP-1 to improve mood and insomnia symptoms, we anticipate developing efficacy and implementation trials of STEP-1 in larger and more diverse samples. Trial RegistrationClinicalTrials.gov NCT05519982; https://clinicaltrials.gov/study/NCT05519982 International Registered Report Identifier (IRRID)DERR1-10.2196/60762

Introduction Addressing childhood obesity risk factors like home environment, parental roles, excess weight, physical activity and healthy eating among Latino/Hispanic (L/H) families living in rural communities is an important priority. However, evidence supporting these interventions among L/H families living in rural communities is missing. Our trial will use cultural adaptation and implementation science frameworks to evaluate the feasibility of delivering a culturally appropriate family-based childhood obesity (FBCO) programme via an automated telephone system (interactive voice response) to L/H families in rural Nebraska.Methods and analysis A mixed-methods feasibility trial for L/H families with overweight or obese children. Aim 1 will focus on collaboratively adapting and evaluating all intervention materials to fit the rural L/H community profile better, including translation of materials to Spanish, culturally relevant content and images, and use of health communication strategies to address different levels of health literacy. In aim 2, a 6-month feasibility trial with contextual evaluation will randomise 48 dyads (parent and child) to either Family Connections (FC; n=29) or a waitlist standard-care group (n=29) to determine overall study reach, preliminary effectiveness in reducing child body mass index (BMI) z-scores, potential for programme adoption, implementation and sustainability through local health departments (RE-AIM outcomes). We will also evaluate health department perceptions of the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) constructs (innovation, context, recipient characteristics) and FC participants’ view of the intervention (ie, relative advantage, observability, trialability, complexity, compatibility). The study will answer three critical questions: (1) is a telephone-delivered FBCO programme in rural Nebraska culturally relevant, usable and acceptable by L/H families?; (2) is a telephone-delivered FBCO programme effective at reducing BMI z-scores in L/H children living in rural Nebraska? and (3) what real-world institutional and contextual factors influence the impact of the intervention and might affect its potential ability to sustainably engage a meaningful population of L/H families who stand to benefit?Ethics and dissemination This protocol was approved by the University of Nebraska Medical Center Institutional Review Board (IRB#:0745-20-EP). Dissemination of findings will occur through ClinicalTrials.gov, in scientific forums and to the local rural communities, pilot data to inform the design of a larger clinical trial.Trial registration number NCT04731506.

Purpose: The present study aimed to determine the potential impact of scleral lenses on intraocular pressure (IOP) by analysing the Bruch's membrane opening-minimum rim width (BMO-MRW) while the lenses are worn, in a population with keratoconus., Methods: Participants were required to have keratoconus and be successfully fitted with scleral lenses for at least 3 months. A new pair of optimised scleral lenses was provided before the study. During the first session, corneal biomechanics was assessed using an air tonometer, coupling Scheimpflug technology. Then, a scan of the optic nerve was carried out using optical coherence tomography (OCT) at 2 h intervals for 6 h. Particular attention was paid to identifying the BMO-MRW, which represents the smallest distance between the BMO and the internal limiting membrane. These tests were repeated, respecting the time at which the initial measurements were taken, while the scleral lens was worn. Results from only one eye were analysed., Results: A statistically significant change of 10.5 ± 3.6 μm (95% CI [241.3-473.1]; p = 0.02) in BMO-MRW was observed after 6 h of scleral lens wear, compared to measurements without lenses (4.8 ± 3.4 μm; 95% CI [285.1-439.7]; p = 0.18). The fluctuation was greater in participants with keratoconus than found in a previous study of regular corneas., Conclusion: BMO-MRW became significantly thinner after 6 h of scleral lens wear compared with measurements without lenses. These variations may be associated with a rise in IOP during lens wear. Close monitoring for optic head changes should be carried out for patients at risk. These results should be compared with future longer-term studies including a larger cohort of patients., (© 2024 The Author(s). Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)

Background: Clinical supervision by psychiatric liaison clinicians is frequently provided in medical settings such as oncology and palliative care, but rarely in endocrinology. Consequently, the specific psychosocial issues faced by endocrinologists in their daily clinical practice and how they deal with them remain largely unknown. We aimed to explore individual supervisions of endocrinologists to gain insight into what kind of clinical situations they present, how they react to them and how this is worked through in supervision., Methods: The data set consisted of eight audio-recorded first supervision sessions of endocrinologists conducted by liaison psychiatry clinicians, which were transformed into written core stories accounting for key components of each session. A secondary analysis of these core stories was conducted using an interpretative approach, focusing on (i) the types of clinical situations and (ii) the supervisees' counter-attitudes towards patients. Additionally, particular attention was given to how the supervisors worked through these elements., Results: Endocrinologists presented patients who did not adhere to treatment, behaved inexplicably, or held moral values that differed from their own. Challenged by these situations, supervisees experienced negative emotions (e.g., anxiety, irritation, guilt), associated with behavioral reactions (e.g., avoidance) and/or defensive stances (e.g., denial, rationalization). In half of the supervisions, addressing these difficulties allowed supervisees to link key characteristics of the patient interaction with their own unresolved issues; in the other half, supervisees were less inclined to confront themselves with their own contributions to the patient interaction and the supervisor adopted a more active stance, making specific contributions (e.g. support, advise)., Conclusions: The findings call for training programs addressing "difficult" patients and advocate for closer collaboration between endocrinologists and liaison psychiatry clinicians., Competing Interests: Declarations. Ethics approval and consent to participate: The study was submitted to the local ethics committee (Commission cantonale d’éthique de la recherche sur l’être humain (CER-VD)) and was deemed exempt from approval. Participating endocrinologists were orally informed about the study, received an information sheet, and provided written consent. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Tumor hypoxia, an integral biomarker to guide radiotherapy, can be imaged with 18 F-fluoromisonidazole ( 18 F-FMISO) hypoxia PET. One major obstacle to its broader application is the lack of standardized interpretation criteria. We sought to develop and validate practical interpretation criteria and a dedicated training protocol for nuclear medicine physicians to interpret 18 F-FMISO hypoxia PET. Methods: We randomly selected 123 patients with human papillomavirus-positive oropharyngeal cancer enrolled in a phase II trial who underwent 123 18 F-FDG PET/CT and 134 18 F-FMISO PET/CT scans. Four independent nuclear medicine physicians with no 18 F-FMISO experience read the scans. Interpretation by a fifth nuclear medicine physician with over 2 decades of 18 F-FMISO experience was the reference standard. Performance was evaluated after initial instruction and subsequent dedicated training. Scans were considered positive for hypoxia by visual assessment if 18 F-FMISO uptake was greater than floor-of-mouth uptake. Additionally, SUV max was determined to evaluate whether quantitative assessment using tumor-to-background ratios could be helpful to define hypoxia positivity. Results: Visual assessment produced a mean sensitivity and specificity of 77.3% and 80.9%, with fair interreader agreement (κ = 0.34), after initial instruction. After dedicated training, mean sensitivity and specificity improved to 97.6% and 86.9%, with almost perfect agreement (κ = 0.86). Quantitative assessment with an estimated best SUV max ratio threshold of more than 1.2 to define hypoxia positivity produced a mean sensitivity and specificity of 56.8% and 95.9%, respectively, with substantial interreader agreement (κ = 0.66), after initial instruction. After dedicated training, mean sensitivity improved to 89.6% whereas mean specificity remained high at 95.3%, with near-perfect interreader agreement (κ = 0.86). Conclusion: Nuclear medicine physicians without 18 F-FMISO hypoxia PET reading experience demonstrate much improved interreader agreement with dedicated training using specific interpretation criteria., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)

Collusions, interpersonal phenomena with an impact on patients, significant others, clinicians, and care, are mainly described in the psychotherapeutic literature but also occur in the medical setting. Comprehended as an unconscious bond between two or more persons from a psychotherapeutic perspective, definitions and collusive situations described in the medical setting vary. The question arises whether medical collusions, compared to collusions occurring in the psychiatric setting emerge in different clinical situations or are not identified as transference-countertransference experiences, since there is less sensitivity for the unconscious dimensions of care. We systematically reviewed the medical literature on collusions. Even though a read threat, avoidance of unpleasant feelings (mainly anxiety), runs through the described collusions, the unconscious dimensions and associated defensive maneuvers are rarely evoked. Given the expressed desire to act on collusions in medicine, involving third-party psychiatric liaison clinicians, who supervise clinicians, and hereby help to disentangle collusions, could be beneficial., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

At present, suicidal patients are still hospitalized to reduce their risk of committing a life-threatening act. Yet suicide research, long dominated by the ambition to identify people at risk, shows that the prediction model is largely ineffective. The time has come for a paradigm shift to: give up categorizing patients according to their risk; recognize that hospitalization, if not accompanied by a well-defined purpose, can become iatrogenic; formulate achievable short-term objectives, guiding such hospitalizations on the basis of a reproducible empirical model and demonstrating its benefits beyond keeping the patient alive. Interventions aim thus to reduce distress, personalize care and promote the change required by the suicidal crisis., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Corneal techniques for enhancing near and intermediate vision to correct presbyopia include surgical and contact lens treatment modalities. Broad approaches used independently or in combination include correcting one eye for distant and the other for near or intermediate vision, (termed monovision or mini-monovision depending on the degree of anisometropia) and/or extending the eye's depth of focus [1]. This report reviews the evidence for the treatment profile, safety, and efficacy of the current range of corneal techniques for managing presbyopia. The visual needs and expectations of the patient, their ocular characteristics, and prior history of surgery are critical considerations for patient selection and preoperative evaluation. Contraindications to refractive surgery include unstable refraction, corneal abnormalities, inadequate corneal thickness for the proposed ablation depth, ocular and systemic co-morbidities, uncontrolled mental health issues and unrealistic patient expectations. Laser refractive options for monovision include surface/stromal ablation techniques and keratorefractive lenticule extraction. Alteration of spherical aberration and multifocal ablation profiles are the primary means for increasing ocular depth of focus, using surface and non-surface laser refractive techniques. Corneal inlays use either small aperture optics to increase depth of field or modify the anterior corneal curvature to induce corneal multifocality. In presbyopia correction by conductive keratoplasty, radiofrequency energy is applied to the mid-peripheral corneal stroma, leading to mid-peripheral corneal shrinkage and central corneal steepening. Hyperopic orthokeratology lens fitting can induce spherical aberration and correct some level of presbyopia. Postoperative management, and consideration of potential complications, varies according to technique applied and the time to restore corneal stability, but a minimum of 3 months of follow-up is recommended after corneal refractive procedures. Ongoing follow-up is important in orthokeratology and longer-term follow-up may be required in the event of late complications following corneal inlay surgery., Competing Interests: Declaration of competing interest Jennifer P. Craig, Connie Chen, Obinwanne Chukwuemeka Jr, Lucia Pelosini, Michael T.M. Wang, Mohammed Ziaei have no declarations of competing interest. Allon Barsamm is a paid Consultant for Schwind eye tech solutions. Neema Ghorbani-Mojarrad provides consultancy to CooperVision, Eyerising International and Hoya and has had grant funding from CooperVision, Eyerising International, Hoya, Menicon, Rodenstock and SILMO Academy. Florian Kretz provides consultancy to Carl Zeiss Meditech, Teleon, VSY, BVI and Elios. Langis Michaud provides consultancy to Johnson and Johnson Vision, Bausch + Lomb. Johnny Moore provides consultancy to Zeiss and Cristalens. Andrew M J Turnbull is a paid consultant for Rayner, Thea, Scope and Bausch + Lomb. Stephen J. Vincent has had grant funding from CooperVision and Menicon. James S. Wolffsohn has received grant funding from Alcon and Rayner, is a paid consultant for Alcon, Atia Vision and Bausch + Lomb, and has stock ownership in Wolffsohn Research Ltd., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The advent of antiretroviral therapy has markedly improved the life expectancy of individuals with HIV, leading to a shift in clinical focus from managing opportunistic infections to addressing chronic conditions, such as atherosclerotic cardiovascular disease (ASCVD). Emerging evidence highlights an elevated risk of ASCVD among people living with HIV, characterized by a higher incidence of acute myocardial infarction, ischemic stroke, and heart failure compared with the general population. This review examines the epidemiology, pathophysiology, and management of ASCVD in the context of HIV. It explores the interplay between HIV infection, antiretroviral therapy, and traditional cardiovascular risk factors, underscoring the need for comprehensive cardiovascular risk reduction strategies tailored to people living with HIV. Through synthesizing data from clinical trials, observational studies, and basic research, the review aims to enhance understanding of HIV-associated ASCVD and inform healthcare practices to improve the longevity and quality of life for this patient population., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The unregulated drug toxicity crisis in British Columbia (BC), Canada, has claimed over 14,000 lives since 2016. The crisis is shaped by prohibitionist policies that has led to the contamination of the unregulated drug supply, resulting in a surge of fatal and non-fatal overdose events. The criminalization of drug users exacerbates this situation, pushing individuals into carceral systems for the possession of and/or social practices related to drug use. This commentary examines the involvement of policing in the development, and throughout the first 15 months of its implementation, of BC's decriminalization framework. We highlight concerns regarding police discretion, the expansion of scope, and the interweaving of carceral logics into policies that purport to be public health-oriented., Competing Interests: Declaration of competing interest There are no conflicts of interest to declare from any of the authors., (Copyright © 2024. Published by Elsevier B.V.)

Objectives: To evaluate the retinal response to myopic defocus after the wear of soft multifocal contact lenses with high addition through electroretinography., Methods: Twenty-seven participants meeting inclusion criteria were enrolled. Tropicamide 1% drops (2) were instilled. Participants were then fitted with three different contact lenses: a single-vision spherical lens (SE +3.00 D), L1, serving as a control, and two soft multifocal lens designs (SE +3.00 D/add +10 D), one with a central distance zone of 4.0 mm (L2) and one with a central distance zone of 7.0 mm (L3). A global flash multifocal electroretinography was performed. Direct component (DC) amplitude, DC peak time, induced component (IC) amplitude, and IC peak time were recorded. Waveforms were grouped into five concentric areas, covering from 0° to 24° of retinal eccentricity. Differences of L2/L3 versus L1 were analyzed with t tests. Finally, correlations were calculated between the percentage of defocus in the pupil area versus the electroretinography results., Results: Results show that the DC amplitude, caused mainly by photoreceptors and bipolar cells, is not influenced by the design of the lenses. The IC amplitude, however, is significantly decreased when the lens with a smaller optical zone (L2) is worn. This significant difference only concerns the ring 5, which corresponds to a retinal eccentricity of 15.7° to 24.0°., Conclusion: Soft multifocal lens designs influence the peripheral retinal reaction to defocus. A larger treatment zone seems to significantly impact the retinal response to defocus between 15.7° and 24.0° of eccentricity from the macula., Competing Interests: L. Michaud: Honorarium (speaker fees) and research funds received from Alcon, Bausch and Lomb, Cooper Vision, Johnson & Johnson Vision Care. The remaining authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Contact Lens Association of Ophthalmologists.)

Visual biofeedback (vFB) during quiet stance has been shown to improve postural control. While this improvement has been quantified by a reduction in the center of pressure (COP) sway, the effect on COP complexity remains unexplored. As such, 20 young adults (12 females; aged 23.63 ± 3.17 years) were asked to remain in a static upright posture under different visual biofeedback magnitude (no feedback [NoFB], magnified by 1 [vFB1], magnified by 5 [vBF5] and magnified by 10 [vBF10]). In addition to confirming, through traditional COP variables (i.e. standard deviation, mean velocity, sway area), that vFB scaling improved postural control, results also suggested changes in COP complexity. Specifically, sample entropy and wavelet analysis showed that increasing the vFB scale from 1:1 to 1:5 and 1:10 led to a more irregular COP and a shift toward higher frequency. Together, and particularly from a complexity standpoint, these findings provided additional understandings of how vFB and vFB scaling improved postural control., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The ongoing overdose and drug toxicity crisis in North America has contributed momentum to the emergence of safer supply prescribing and programs in Canada as a means of providing an alternative to the highly volatile unregulated drug supply. The implementation and scale-up of safer supply have been met with a vocal reaction on the part of news media commentators, conservative politicians, recovery industry representatives, and some prominent addiction medicine physicians. This reaction has largely converged around several narratives, based on unsubstantiated claims and anecdotal evidence, alleging that safer supply programs are generating a "new opioid epidemic", reflecting an emerging alignment among key institutional and political actors. Employing situational analysis method, and drawing on the policy studies and social science scholarship on moral panics, this essay examines news media coverage from January to July 2023, bringing this into dialogue with other existing empirical sources on safer supply (e.g. Coroner's reports, program evaluations, debates among experts in medical journals). We employ eight previously established criteria delineating moral panics to critically appraise public dialogue regarding safer supply, diverted medication, and claims of increased youth initiation to drug use and youth overdose. In detailing the emergence of a moral panic regarding safer supply, we trace historic continuities with earlier drug scares in Canadian history mobilized as tools of racialized poverty governance, as well as previous backlashes towards healthcare interventions for people who use drugs (PWUD). The essay assesses the claims of moral entrepreneurs against the current landscape of opioid use, diversion, and overdose among youth, notes the key role played by medical expertise in this and previous moral panics, and identifies what the convergence of these narratives materialize for PWUD and healthcare access, as well as the broader policy responses such narratives activate., Competing Interests: Declaration of competing interest The authors confirm that they have no conflicts of interest to report., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

The emergence of compulsive drug-seeking habits, a hallmark feature of substance use disorder, has been shown to be predicated on the engagement of dorsolateral striatal control over behaviour. This process involves the dopamine-dependent functional coupling of the anterior dorsolateral striatum (aDLS) with the nucleus accumbens core, but the mechanisms by which this coupling occurs have not been fully elucidated. The striatum is tiled by a syncytium of astrocytes that express the dopamine transporter (DAT), the level of which is altered in individuals with heroin use disorder. Astrocytes are therefore uniquely placed functionally to bridge dopamine-dependent mechanisms across the striatum. Here we tested the hypothesis that exposure to heroin influences the expression of DAT in striatal astrocytes across the striatum before the development of DLS-dependent incentive heroin seeking habits. Using Western-blot, qPCR, and RNAscope™, we measured DAT protein and mRNA levels in whole tissue, culture and in situ astrocytes from striatal territories of rats with a well-established cue-controlled heroin seeking habit and rats trained to respond for heroin or food under continuous reinforcement. Incentive heroin seeking habits were associated with a reduction in DAT protein levels in the anterior aDLS that was preceded by a heroin-induced reduction in DAT mRNA and protein in astrocytes across the striatum. Striatal astrocytes were also shown to be susceptible to direct dopamine- and opioid-induced downregulation of DAT expression. These results suggest that astrocytes may critically regulate the striatal dopaminergic adaptations that lead to the development of incentive heroin seeking habits., (© 2024 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Psychiatrists play a crucial role in evaluating requests and treatment indications for individuals experiencing gender incongruence, while also providing support throughout the transition process. Their work involves addressing both the psychological and somatic aspects of this journey, facilitating the profound identity changes it entails., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Aims : Most studies on the impact of COVID-19 have shown a decrease or no change in unassisted suicide rates, but effects on assisted suicide have not been studied. We aimed to estimate the association between the COVID-19 pandemic and both types of suicide. Methods : Between 2017 and 2021, 1280 assisted suicides and 535 unassisted suicides were recorded in three Swiss cantons. We conducted descriptive and time series analyses on monthly suicide rates, categorized by gender. Results : Among women, a decrease in assisted suicide rates was found during the acute phases of the pandemic. Among men, assisted suicide rates increased gradually from the onset of the pandemic. Regarding unassisted suicide rates, no significant change was observed in women, while in men, there was a decrease, which was larger at the end than at the onset. Conclusions : COVID-19 had contrasting effects on assisted and unassisted men and women suicide rates., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Time around parturition is a stressful period for both bitches and their puppies. The use of probiotics has been proposed, e.g., in pigs, to improve health status of sows, their reproductive performances and in turn, the health and performance of their progeny. The objective of the present study was to evaluate the impact, on both dams and puppies, of a supplementation of bitches with the live yeast Saccharomyces cerevisiae var. boulardii CNCM I-1079 (SB-1079) during the second part of the gestation and the lactation period. A total of 36 bitches of medium and large-sized breeds were enrolled. They were divided into two groups, one of which received 1.3 × 10 9 colony forming units of live yeast per day. At dam's level, SB-1079 yeast shaped a different microbiota structure between the two groups just after whelping, impacted alpha diversity and some plasma metabolites related to energy metabolism. Regarding reproductive performances, SB-1079 improved gross energy of the colostrum (1.4 vs. 1.2 kcal of ME/g) as well as the concentration of protein in milk at Day 7 after parturition (10.4 vs. 7.6%). SB-1079 also reduced the odds of having low birth weight in the litter. At puppy's level, a modulation of immunometabolic phenotype is suggested by the observation of increased growth rates during the early pediatric period (i.e., between 21 and 56 days of life, 225 vs. 190%) and a decrease of the IL-8:IL-10 ratio after vaccination against rabies (4.2 vs. 16.9). Our findings suggest that SB-1079 supplementation during gestation and lactation has the potential to enhance health of bitches and in turn health of puppies through maternal programming., Competing Interests: AM, AR, MC, and EA were employed by the company Lallemand SAS. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Garrigues, Mugnier, Chastant, Sicard, Martin, Svilar, Castex, Ramis-Vidal, Rovere, Michaud, David, Mansalier, Rodiles, Mila and Apper.)

Objective: Clinical supervision of oncology clinicians by psycho-oncologists is an important means of psychosocial competence transfer and support. Research on this essential liaison activity remains scarce. The aim of this study was to assess the impact of supervision on oncology clinicians' feelings towards patients presented in supervision., Methods: Oncology clinicians' (n = 23) feelings towards patients presented in supervision were assessed with the Feeling Word Checklist (FWC). The FWC was filled in by supervisees prior and after their supervision sessions (n = 91), which were conducted by experienced supervisors (n = 6). Pre- post-modification of feelings was evaluated based on a selection of FWC items, which were beforehand considered as likely to change in a beneficial supervision. Items were evaluated on session level using t-tests for dependent groups. Composite scores were calculated for feelings expected to raise and feelings expected to decrease and analysed on the level of supervisees., Results: Feelings related to threats, loss of orientation or hostility such as "anxious", "overwhelmed", "impotent", "confused", "angry", "depreciated" and "guilty" decreased significantly after supervision, while feelings related to the resume of the relationship ("attentive", "happy"), a better understanding of the patient ("empathic"), a regain of control ("confident") and being "useful" significantly increased. Feeling "interested" and "calm" remained unchanged. Significant increase or decrease in the composite scores for supervisees confirmed these results., Conclusions: This study demonstrates modification of feelings towards patients presented in supervision. This modification corresponds to the normative, formative, and especially restorative function (support of the clinician) of supervision., (© 2024 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)

Pulmonary hypertension (PH) may be the result of many different pathological processes. PH is a rare but recognized vascular complication following major lung resection. We describe the diagnosis and management of moderate PH resulting more than 50 years in a patient who underwent a total unilateral pneumonectomy in infancy. Unfortunately, patients who undergo pneumonectomy will likely go on to develop PH and their functional status will be greatly impacted. In the case presented, we report on a patient whose PH and symptoms improved following off-label WHO group 1 treatment., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Osseous involvement by diffuse large B-cell lymphoma (DLBCL-bone) is a heterogeneous disease. There is limited data regarding response assessment by positron emission tomography with fluorodeoxyglucose, which may demonstrate residual avidity despite a complete response. We analyzed clinical data of patients with newly diagnosed DLBCL and identified all cases with DLBCL-bone. End of treatment scans were reviewed by two independent experts classifying osseous lesions into Deauville (DV) ≤3; DV ≥4, or reactive uptake in the bone marrow (M), site of fracture (F) or surgery (S). We compared outcomes of DLBCL-bone to other extranodal sites (EN) matched on International Prognotic Index features and regimen. Of 1,860 patients with DLBCL (bone 16%; EN 45%; nodal 39%), 41% had localized disease and 59% advanced. Only 9% (n=27) of patients with initial bone involvement had residual fluorodeoxyglucose avidity at the osseous site. In half of these cases, the uptake was attributed to F/S/M, and of the remaining 13, only two were truly refractory (both with persistent disease at other sites). Overall survival and progression-free survival (PFS) were found to be similar for early- stage nodal DLBCL and DLBCL-bone, but inferior in EN-DLBCL. Advanced-stage disease involving the bone had a similar 5-year PFS to nodal disease and EN-DLBCL. After matching for International Prognotic Index and treatment regiments, PFS between bone and other EN sites was similar. Osseous involvement in DLBCL does not portend a worse prognosis. End of treatment DV ≥4 can be expected in 5-10% of cases, but in the absence of other signs of refractory disease, may be followed expectantly.