Search

BackgroundHepatic arterial infusion chemotherapy (HAIC) with the FOLFOX regimen has demonstrated efficacy in patients with unresectable hepatocellular carcinoma (HCC). The combined targeted and immunotherapy has emerged as a first-line treatment for liver cancer. In this study, we investigated the clinical efficacy and safety of FOLFOX-HAIC in combination with targeted immunotherapy in patients with untreated, unresectable HCC.Materials and methodsData were collected from patients with initially unresectable HCC treated at Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, from June 2022 to June 2023. Tumor response and survival outcomes were assessed following the FOLFOX-HAIC combined with targeted immunotherapy, The safety was also evaluated through the incidence of related adverse events.ResultsA total of 51 eligible patients were recruited. The objective response rate (ORR) based on mRECIST and RECIST 1.1 criteria were 60.8% and 45.1%, respectively. The surgical conversion rate was 25.5%. The median progression-free survival (PFS) was 15.2 months. The 1-year overall survival rate was 88.2%. Adverse events were observed in 98% patients, with 23.5% experiencing grade 3 or 4 adverse events.ConclusionThe FOLFOX-HAIC combined with targeted immunotherapy regimen is effective in patients with unresectable HCC, demonstrated by a high surgical conversion rate and manageable adverse effects. This regimen represents a potential novel first-line treatment option for HCC.

BackgroundGastric cancer (GC) is one of the leading causes of cancer-related death in China, and with the extensive development of conversion therapy, the treatment of advanced unresectable gastric cancer (AUGC) patients has ushered in a new dawn. This study aimed to analyze the efficacy of conversion therapy in AUGC patients and explored the relevant factors affecting the efficacy.MethodWe collected information from GC patients who received conversion therapy from this center and designed a retrospective study.ResultsWe collected relevant clinical data from 160 patients with AUGC. A total of 120 patients who underwent routine R0 resection were identified as conversion cases. A total of 25 patients (15.6%) achieved pCR, 92 patients (57.5%) achieved objective response rate (ORR), 140 patients (87.5%) achieved disease control rate (DCR), and 20 cases (12.5%) observed tumor progression. There were 86 patients who achieved pathological downgrading, with a total downgrading rate of 53.8%. Among the 160 patients, 37 patients (23.1%) had postoperative complications of varying degrees. A total of 72 patients (45.0%) had tumor recurrence/progression at the end of follow-up. The last chemotherapy and surgery (CST) (OR = 1.046, 95% CI 1.013–1.081, p = 0.006), tumor invasion (OR = 32.096, 95% CI 5.091–202.349, p < 0.001), and distant metastasis (OR = 7.050, 95% CI 1.888–26.323, p = 0.004) were independent factors influencing the efficacy of conversion therapy.ConclusionConversion therapy may have a good therapeutic efficacy for AUGC, and some clinical factors affect the efficacy response.

The diagnosis and treatment of head and neck undifferentiated carcinoma (HNUC) present significant challenges. Herein, we present the case of a patient with advanced HNUC who underwent conversion surgery following treatment with a combination of pembrolizumab and nimotuzumab. During therapy, histological transformation from undifferentiated to sarcomatoid carcinoma was detected at the primary site. This case not only highlights the potential of immune combination-targeted therapy to reduce tumour burden and increase the surgical options for patients, but also reveals the complex alterations in tumour biology that may occur during treatment. It emphasizes the necessity for routine pathological assessments throughout the therapeutic regimen to guide personalised therapeutic strategies and optimise patient prognoses.

With the continuous emergence of biotherapy drugs in recent years, great progress has been made in the systemic therapy for advanced liver cancer. Immune checkpoint inhibitors combined with anti-angiogenic targeted drugs has become the first-line regimen recommended for the treatment of advanced liver cancer and has achieved clear oncology benefits and survival benefits. The regimens for immunotherapy combined with local treatment continue to emerge and have clearly improved objective response rate, and targeted and immune therapeutic regimens combined with sequential surgical treatment are reshaping the treatment pattern of advanced liver cancer and have finally improved radical surgical resection rate and long-term survival rate. Such changes in treatment guided by immunotherapy with or without targeted therapy have brought great challenges and thus require meticulous thoughts. With exploration of immune and targeted therapies combined with sequential surgical regimen as an example, there is a series of new problems and challenges before they are widely applied in routine diagnosis and treatment, including the selection of drug combination regimens, the evaluation of therapeutic efficacy, the treatment of toxic and side effects, surgical standards and timing, postoperative adjuvant treatment regimens, the validation of long-term survival benefits, and the selection of second-line treatment regimens for primary and secondary drug resistance. This article puts forward some suggestions and thoughts for several key aspects. [ABSTRACT FROM AUTHOR]

Progress in the systemic therapies, represented by the molecular target therapies and immune checkpoint inhibitors (ICIs), have significantly improved the prognosis of unresectable hepatocellular carcinoma (uHCC), but long term survial remains limitted. As one of the major combination of systemic and surgical therapies, conversion therapy provides potentially curative opportunity to some uHCC patients. It is widely reported from different domestic centers.The first Chinese expert consensus about it was released in 2021. Yet at the same time, there are many key issues in the practice and theory remains to be resolved. Actively thinking, exploring and finally resolving these issues are essential for establishing and promoting the standardized theoretical system of uHCC conversion therapy.

Surgery is still the first choice for patients with hepatocellular carcinoma(HCC). However, about 70% of HCC patients in China are first diagnosed in the advanced stage and have lost the opportunity for surgery. Recently, the rapid development of systematic therapy has brought new hope for patients with advanced HCC. The combination of molecular targeted therapy and immunotherapy with or without local therapy significantly improves the survival of advanced HCC and alters the landscape of surgical treatment in advanced HCC. In addition, systemic therapy also brings new opportunities for perioperative treatment of HCC patients. Conversion therapy, neoadjuvant therapy, and postoperative adjuvant therapy can increase the chances of surgical treatment, reduce the risk of postoperative metastasis and recurrence, and prolong the overall survival of HCC patients. Systematic therapy based on molecular targeted therapy and immunotherapy has been applied through the whole process of HCC surgical treatment, and has completely altered the surgery paradigm of HCC. However, further research is needed to determine the optimal combination protocol, screen the sensitive populations, address drug resistance, and reduce systemic adverse events.

Gastric cancer is one of the common malignant tumors of digestive system in our country. The proportion of patients in advanced and late stage is large, and the choice of perioperative treatment program is always difficult in clinic. For most locally advanced gastric cancer, compared with standard radical surgery combined with postoperative adjuvant chemotherapy, perioperative treatment mode may further improve the survival of patients. However, the efficacy of conventional chemotherapy regimen has reached a plateau, while the progress of traditional molecular targeted therapy is relatively slow. In recent years, with the increasing role of immunotherapy in the treatment of advanced gastric cancer, more and more clinical studies have shown that immunotherapy can also achieve better efficacy in perioperative gastric cancer patients. This article reviewed the research progress of immunotherapy in perioperative gastric cancer in recent years.

Wenxuan Li,1,&ast; Zhikai Zheng,2,3,&ast; Jiongliang Wang,2,3,&ast; Tianqing Wu,2,3,&ast; Juncheng Wang,2,3 Yangxun Pan,2,3 Jinbin Chen,2,3 Dandan Hu,2,3 Li Xu,2,3 Yaojun Zhang,2,3 Minshan Chen,2,3 Zhongguo Zhou2,3 1Cancer Center, Affiliated Dongguan Hospital, Southern Medical University, Dongguan, Guangdong, People’s Republic of China; 2Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China; 3State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Juncheng Wang; Zhongguo Zhou, Department of Liver Surgery, Sun Yat-sen University Cancer Center, Dongfeng Road East 651, Guangzhou, Guangdong, 510060, People’s Republic of China, Tel +86-20-87343115 ; +86-20-87343117, Email wangjch@sysucc.org.cn; zhouzhg@sysucc.org.cnPurpose: The aim of this study was to investigate the efficacy and safety of conversion surgery for advanced hepatocellular carcinoma (HCC) after hepatic arterial infusion chemotherapy (HAIC).Patients and Methods: Data from 172 HCC patients treated at Sun Yat-sen University Cancer Center between January 2016 and June 2021 with effective assessment of HAIC treatment response were retrospectively analyzed. Clinical pathological data, treatment process, survival, and occurrence of adverse events were recorded. Patients were grouped according to whether they achieved imaging remission after HAIC, underwent conversion surgery, and met the surgical resection criteria. Efficacy and safety were analyzed.Results: The median progression-free survival (PFS) and overall survival (OS) in the imaging remission group were 8.6 months and 26.3 months, respectively, which were longer than the 4.6 months (P< 0.05) and 15.6 months (P< 0.05) in the nonremission group. Compared with 6.7 months and 18.9 months in the HAIC maintenance group, the median PFS and median OS in the conversion surgery group were 16.5 months (P< 0.05) and 45.0 months (P< 0.05), but there was a higher risk of treatment-related hemoglobin decrease, alanine aminotransferase increase, aspartate aminotransferase increase, and total bilirubin increase (P< 0.05). The risk of biliary fistula, abdominal hemorrhage and ascites in the HAIC conversion surgery group was higher than that of the single surgery group (P< 0.05). Compared with the conversion surgery group, the median PFS and median OS of patients in the HAIC maintenance group who met the resection criteria were shorter: 7.1 months (P< 0.05) and 21.7 months (P< 0.05), respectively. All adverse events during the study were less than moderate, and no toxicity-related deaths occurred during follow-up.Conclusion: HAIC-based conversion therapy had acceptable toxic effects and could effectively stabilize intrahepatic lesions in advanced HCC, improve the survival benefit of patients, and provide some patients with the opportunity for conversion surgery to further improve prognosis.Keywords: hepatic arterial infusion chemotherapy, advanced hepatocellular carcinoma, conversion therapy

Background: Conversion therapy practices (CTPs) are discredited efforts that target lesbian, gay, bisexual, trans, queer, Two-Spirit, or other (LGBTQ2S+) people and seek to change, deny, or discourage their sexual orientation, gender identity, and/or gender expression. This study aims to investigate the prevalence of CTPs across Canadian provinces and territories and identify whether CTP bans reduce the prevalence of CTPs. Methods: We collected 119 CTPs from 31 adults (18+) in Canada who have direct experience with CTPs, know people who have gone to CTPs, or know of conversion therapy practitioners using a 2020 anonymous online survey. Mapping analysis was conducted using ArcGIS Online. CTP prevalence was compared between provinces/territories with and without bans using chi-square tests. Results: Three provinces and eleven municipalities had CTP bans. The prevalence of CTPs in provinces/territories with bans was 2.34 per 1,000,000 population (95% CI 1.65, 3.31). The prevalence of CTPs in provinces/territories without bans was 4.13 per 1,000,000 population (95% CI 3.32, 5.14). Accounting for the underlying population, provinces/territories with the highest prevalence of CTPs per 1,000,000 population were New Brunswick (6.69), Nova Scotia (6.50), and Saskatchewan (6.37). Conclusions: Findings suggest only 55% of Canadians were protected under CTP bans. The prevalence of CTPs in provinces/territories without bans was 1.76 times greater than provinces/territories with bans. CTPs are occurring in most provinces/territories, with higher prevalence in the west and the Atlantic. These findings and continued efforts to monitor CTP prevalence can help inform policymakers and legislators as society is increasingly acknowledging CTPs as a threat to the health and well-being of LGBTQ2S+ people.

BackgroundAdolescents today have unprecedented and uninterrupted access to news and current events through broadcast and social media. Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) adolescents may be especially cognizant of media and public discourse pertaining to law and policy changes affecting the legal rights of their communities. The minority stress framework explains how sociopolitical discourse impacts mental health among sexual and gender minority youths.ObjectivesThis paper identifies and describes contemporary sociopolitical and legal issues that may impact LGBTQ adolescents' mental health.MethodsAuthors describe the minority stress framework as applied to gender and sexual identity and explore key sociopolitical and legal topics relevant to LGBTQ adolescents, including employment; medical care bans; health insurance coverage; conversion therapy; religious exemptions in health care; housing rights; and rights in schools and school districts, including participation in sports.ResultsLGBTQ youth experience rejection, prejudice, and discrimination directly through adverse legislative or administrative action and more pervasively through the dominant cultural beliefs and sociopolitical messaging that such developments manifest.ConclusionMental health clinicians who are aware of legal issues and sociopolitical debate pertinent to LGBTQ rights are better prepared to address their significant impact on LGBTQ adolescents' mental health.

Within the UK a polarised and politicised discourse exists that attempts to pitch transgender identities in opposition to discourses on sexual orientations. This suggests that interventions assisting clients in their understanding of one, would be detrimental on exploration of the other i.e., to be affirming of gender identity is to cause conversion of sexuality and vice versa. This paper attempts to address some of the problems with this oppositional critique and solve some of the practical problems that the theorist and/or clinician may encounter while attempting to help their clients within the realm of psychological therapies. It does so through Deleuzian ontologies of difference, coupled with Bhaskarian critical realism. We aim to present a (re)consideration of the biopsychosocial model of Health. The recent publication of the International Classification of Diseases 11th Edition and its reclassification of trans aetiology as a Disorder of Sexual Development has presented a conceptual shift from gender dysphoria towards a gender incongruence model (WHO 2022). The aim of this article therefore is to develop practice by enhancing the conceptual toolbox of the clinician and therapist working with Gender Sex and Relationship Diversities (GSRD). Thereby enabling them to better approach a wider diversity of clients safely. This paper explores current conversations and ideas around the phenomenon of trans gender identities and minority orientations. It aims to present an ethical model which can inform the clinical practice of therapists and is underpinned by a critical realist interpretation of biological, psychological and sociological aspects of the mind and body. Overall, the paper acts as a call to action against conversion practices which aim to position trans experience and sexual attraction in opposition to each other. [ABSTRACT FROM AUTHOR]

This article provides a historical overview of the use of LSD in therapy and its connection to social issues in the 1960s and 1970s. It discusses how LSD was initially supported by the media and medical establishment, but also used in attempts to change or suppress homosexuality. The article explores the ethical considerations and impact of LSD on understandings of gender, behavior, and sexuality. It also examines the migration of LSD to the urban gay party scene and its role in shaping gay culture. The text emphasizes the prevailing social attitudes and prejudices of the time, as well as the influence of psychiatric theories on the treatment of homosexuality. It concludes by suggesting the importance of considering organic culture and social relationships when evaluating the legitimacy of psychedelics. [Extracted from the article]

Research arising from conversion practices, also known as conversion therapy and sexual orientation and gender identity change efforts, has generally been underpinned by an emancipatory discourse that has evolved to counter harmful practices by evidencing associated harms and estimating prevalence. Little attention, however, has focused on what is required to support survivors, inclusive of those currently or those having previously experienced conversion efforts. Within a context of Aotearoa New Zealand having recently criminalised conversion practices, this study adopted an in-depth qualitative research design, informed by a dual adherence to life history and an empowerment methodology. Twenty-three religious conversion practice survivors, who had experienced religious conversion practices across a range of Christian identified faith settings, were interviewed. Participants had a median age of 34 and the majority identified as New Zealand European, cisgender, and gay. Participant narratives were discursively analysed. Three primary discourses were identified that inform the needed development of interventions and supports: 1) pervasive framing of conversion practices as harm, rather than spiritual abuse, has minimised the impacts of conversion practices. Rather, conceptualising conversion as spiritual abuse positions conversion practices as requiring urgent intervention and ongoing support, inclusive of the development of policy and operational responses; 2) the coercive nature of spiritual abuse needs to be appreciated in terms of spiritual, social, and structural entrapment; 3) the metaphor of a pipeline was enlisted to encapsulate the need for a multidimensional array of interventions to ensure those entrapped within spiritual abuse have a "pipeline to safety". Holistic survivor-centric conversion-related responses to spiritual abuse are required. These need to be informed by an understanding of entrapment and the associated need for holistic responses, inclusive of extraction pathways and support for those entrenched within abusive religious settings, support immediately after leaving abusive environments, and support throughout the survivors' healing journeys. [ABSTRACT FROM AUTHOR]

The article "Family Matters: Exposure to Gender-Affirming or Gender-Denying Practices Following Gender Identity Milestones" examines the impact of gender identity milestones on the experiences of transgender youth in the United States. The study reveals that transgender children in supportive family environments are less likely to undergo conversion therapy and more likely to receive hormone replacement therapy (HRT), while those in unsupportive family environments are more likely to undergo conversion therapy and have limited access to HRT. The research underscores the significance of family support in safeguarding transgender youth and offers new insights into the well-being outcomes associated with gender identity milestones. The study also emphasizes the need for policies that promote access to gender-affirming care, prohibit conversion therapy, and highlights the role of family and community support in mitigating mental health risks for transgender youth. [Extracted from the article]

Metastatic colorectal cancer requires a multidisciplinary and individualized approach. Herein, we reported the case of a young woman diagnosed with metastatic rectal cancer who received an individualized multimodal treatment strategy that resulted in a remarkable survival. There were several particular aspects of this case, such as the early onset of the disease, the successful use of conversion therapy, the application of liquid biopsy to guide treatment, and the specific nature of the bone metastasis. To offer more insights for navigating such challenges in patients with metastatic colorectal cancer, we have conducted a literature review to find more data related to the particularities of this case. The incidence of early onset colorectal cancer is on the rise. Data suggests that it differs from older-onset colorectal cancer in terms of its pathological, epidemiological, anatomical, metabolic, and biological characteristics. Conversion therapy and surgical intervention provide an opportunity for cure and improve outcomes in metastatic colorectal cancer. It is important to approach each case individually, as every patient with limited liver disease should be considered as a candidate for secondary resection. Moreover, liquid biopsy has an important role in the individualized management of metastatic colorectal cancer patients, as it offers additional information for treatment decisions. [ABSTRACT FROM AUTHOR]

Systemic therapy is typically the primary treatment choice for hepatocellular carcinoma (HCC) patients with extrahepatic metastases. Some patients may achieve partial response (PR) or complete response (CR) with systemic treatment, leading to the possibility of their primary tumor becoming resectable. This study aimed to investigate whether these patients could achieve longer survival through surgical resection of their primary tumor. We retrospectively collected data from 150 HCC patients with extrahepatic metastases treated at 15 different centers from January 1st, 2015, to November 30th, 2022. We evaluated their overall survival (OS) and progress-free survival (PFS) and analyzed risk factors impacting both OS and PFS were analyzed. Patients who received surgical treatment had longer OS compared to those who did not (median OS 16.5 months vs. 11.3 months). However, there was no significant difference in progression-free survival between the two groups. Portal vein invasion (P = 0.025) was identified as a risk factor for poor prognosis in patients, while effective first-line treatment (P = 0.039) and surgical treatment (P = 0.005) were protective factors. No factors showed statistical significance in the analysis of PFS. Effective first-line treatment (P = 0.027) and surgical treatment (P = 0.006) were both independent protective factors for prolonging patient prognosis, while portal vein invasion was an independent risk factor (P = 0.044). HCC patients with extrahepatic metastases who achieve PR/CR with conversion therapy may experience longer OS through surgical treatment. This study is the first to analyze the clinical outcomes of patients receiving surgical treatment for HCC with extrahepatic metastases. [ABSTRACT FROM AUTHOR]

Purpose: To explore the efficacy and safety of FOLFOXIRI plus cetuximab regimen as conversion therapy for patients with unresectable RAS/BRAF wildtype colorectal liver-limited metastases (CLM). Patients and methods: This was a dual-center, phase II trial with the rate of no evidence of disease (NED) achieved as the primary endpoint. All enrolled patients with initially unresectable left-sided RAS/BRAF wild-type colorectal liver-limited metastases received a modified FOLFOXIRI plus cetuximab regimen as conversion therapy. Results: Between October 2019 and October 2021, fifteen patients were enrolled. Nine patients (60%) achieved NED. The overall response rate (ORR) was 92.9%, and the disease control rate (DCR) was 100%. The median relapsefree survival (RFS) was 9 (95% CI: 0-20.7) months. The median progression-free survival (PFS) was 13.0 months (95% CI: 5.7-20.5), and the median overall survival (OS) was not reached. The most frequently occurring grade 3-4 adverse events were neutropenia (20%), peripheral neurotoxicity (13.3%), diarrhea (6.7%), and rash acneiform (6.7%). Conclusion: The FOLFOXIRI plus cetuximab regimen displayed tolerable toxicity and promising anti-tumor activity in terms of the rate of NED achieved and response rate in patients with initially unresectable left-sided RAS/BRAF wildtype CLM. This regimen merits further investigation. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma is a rather common malignant tumor. Most patients with hepatocellular carcinoma receive their diagnosis at an advanced stage, at which surgical resection is no longer appropriate. A growing body of research has demonstrated the value of convention therapy for patients with intermediatestage hepatocellular carcinoma, while specific application protocols and treatment guidelines are not well developed. Emerging clinical researches suggest that a tyrosine kinase inhibitor in combination with an immune checkpoint inhibitor is a reasonable strategy for unresectable hepatocellular carcinoma. However, there are relatively few reports on the efficacy of apatinib and camrelizumab in the treatment of hepatocellular carcinoma. We were able to successfully remove one patient's hepatocellular carcinoma after 8 cycles of conversion therapy with apatinib (250 mg orally every day) and camrelizumab (200 mg intravenously every 2 weeks). The patient continued to receive the same dose of 16 cycles of apatinib and camrelizumab after hepatectomy. By the time of this study, the patient has completed 18 months of follow-up, and no tumor recurrence or metastasis was found in tumor markers and imaging examinations. Apatinib in combination with camrelizumab is an effective therapy for the treatment of advanced hepatocellular carcinoma, and surgical resection after this conversion therapy may provide patients with long-term oncological benefits. However, this requires more samples to validate the conclusion. [ABSTRACT FROM AUTHOR]

Simple Summary: Surgery with adequate lymphadenectomy (D2) currently represents the standard of care for resectable gastric cancer under most guidelines. However, super-extended lymphadenectomy (D2plus) may offer better locoregional control in advanced stages with a high risk of metastases to third-level nodes. In recent years, preoperative chemotherapy has become a novel issue in patients with locally advanced gastric cancer. To date, only a few studies have evaluated D2plus lymphadenectomy in patients with locally advanced or oligometastatic gastric cancer after preoperative therapy. The present study included a large series when compared with the current literature and reports limited morbidity/mortality rates and relevant survival outcomes. Super-extended (D2plus) lymphadenectomy after chemotherapy has been reported in only a few studies. This retrospective study evaluates survival outcomes in a Western cohort of locally advanced or oligometastatic gastric cancer patients who underwent D2plus lymphadenectomy after neoadjuvant chemotherapy. A total of 97 patients treated between 2010 and 2022 were included. Of these, 62 had clinical stage II/III disease, and 35 had stage IV disease. Most patients (65%) received preoperative DOC/FLOT chemotherapy. The mean number of lymph nodes harvested was 39. Pathological positive nodes in the posterior/para-aortic stations occurred in 17 (17.5%) patients. Lymphovascular invasion, ypN stage, clinical stage, and perineural invasion were predictive factors for positive posterior/para-aortic nodes. Postoperative complications occurred in 21 patients, whereas severe complications (grade III or more) occurred in 9 cases (9.3%). Mortality rate was 1%. Median overall survival (OS) was 59 months (95% CI: 13–106), with a five-year survival rate of 49 ± 6%; the five-year OS after R0 surgery was 60 ± 7%. In patients with positive posterior/para-aortic nodes, the median OS was 15 months (95% CI: 13–18). D2plus lymphadenectomy after chemotherapy for locally advanced or oligometastatic gastric cancer is feasible and associated with low morbidity/mortality rates. The incidence of pathological metastases in posterior/para-aortic nodes is not negligible even after systemic chemotherapy, with poor long-term survival. [ABSTRACT FROM AUTHOR]

Given the religious groundings that support the practice of gender identity change efforts (GICE), we sought to explore the beliefs of Christian religious leaders about this practice and their understanding of marginalized gender identities. Nineteen religious leaders mainly from diverse Mainline Christian Protestant traditions were interviewed. Queer theory‐informed thematic analysis revealed two themes related to participants' beliefs about transgender and nonbinary identities: (1) Transgender and nonbinary identities are normative and authentic and (2) God created gender diversity. The analyses also highlighted two themes reflecting the pastors' beliefs about GICE: (1) GICE is harmful and (2) Therapy should affirm transgender and nonbinary identities. Finally, the thematic analysis exploring participants' messages for couple and family therapists could be organized into two themes: (1) Christian religious beliefs do not justify the use of GICE and (2) Therapists should be helpful and not harmful. Implications for couple and family therapists are also discussed. [ABSTRACT FROM AUTHOR]

Conversion therapy is a set of practices that aim to alter an individual's sexual orientation or gender identity. This review aimed to explore the medico-socio-legal implications of conversion therapy in the context of the Indian subcontinent. Review of medical literature has shown that conversion therapy does not lead to changes in sexual orientation or gender identity. Conversion therapy caused significant medical harm to LGBTQ+ (Lesbian, Gay, Bisexual. Transgender, Queer/Questioning, and spectrum) individuals. LGBTQ+ individuals who underwent conversion therapy were reportedly 4.6 and 3.1 times more likely to suffer from suicidality and depression, respectively, as compared to the general population. Sociocultural and religious factors further lead to the continued practice of conversion therapy and perpetuated the harms caused by the practice. Delays in adequate action by healthcare professional organizations and medical regulatory systems, as well as a lack of discussion among the public about conversion therapy and, more broadly, the experience of LGBTQ+ individuals, contributed to the continued practice of conversion therapy. A multidisciplinary, evidence-based policy framework is required to address the medical, social and legal issues surrounding conversion therapy in the Indian subcontinent. [ABSTRACT FROM AUTHOR]

Objectives. To examine inequities in conversion practice exposure across intersections of ethnoracial groups and gender identity in the United States. Methods. Data were obtained from The Population Research in Identity and Disparities for Equality Study of sexual and gender minority people from 2019 to 2021 (n = 9274). We considered 3 outcomes: lifetime exposure, age of first exposure, and period between first and last exposure among those exposed to conversion practices. We used log-binomial, Cox proportional hazards, and negative binomial models to examine inequities by ethnoracial groups and gender identity adjusting for confounders. We considered additive interaction. Results. Conversion practice prevalence was highest among minoritized ethnoracial transgender and nonbinary participants (TNB; 8.6%). Compared with White cisgender participants, minoritized ethnoracial TNB participants had twice the prevalence (prevalence ratio = 2.16; 95% confidence interval [CI] = 1.62, 2.86) and risk (hazard ratio = 2.04; 95% CI = 1.51, 2.69) of conversion practice exposure. Furthermore, there was evidence of a positive additive interaction for age of first exposure. Conclusions. Minoritized ethnoracial TNB participants were most likely to recall experiencing conversion practices. Public Health Implications. Policies banning conversion practices may reduce the disproportionate burden experienced by minoritized ethnoracial TNB participants. (Am J Public Health. 2024;114(4):424–434. https://doi.org/10.2105/AJPH.2024.307580) [ABSTRACT FROM AUTHOR]

Background The difference in the prognoses between treatment with surgical therapy and continuation of local-plus-systemic therapy following successful down-staging of intermediate-advanced hepatocellular carcinoma (HCC) remains unclear. Methods Data of 405 patients with intermediate-advanced HCC treated at 30 hospitals across China from January 2017 to July 2022 were retrospectively reviewed. All patients received local-plus-systemic therapy and were divided into the surgical (n  = 100) and nonsurgical groups (n  = 305) according to whether they received surgical therapy. The differences between long-term prognoses of the 2 groups were compared. Subgroup analysis was performed in 173 HCC patients who met the criteria for surgical resection following down-staging. Results Multivariable analysis of all patients showed that surgical therapy, hazard ratio (HR): 0.289, 95% confidence interval, CI, 0.136-0.613) was a protective factor for overall survival (OS), but not for event-free survival (EFS). Multivariable analysis of 173 intermediate-advanced HCC patients who met the criteria for surgical resection after conversion therapy showed that surgical therapy (HR: 0.282, 95% CI, 0.121-0.655) was a protective factor for OS, but not for EFS. Similar results were obtained after propensity score matching. For patients with Barcelona Clinic Liver Cancer stage B (HR: 0.171, 95% CI, 0.039-0.751) and C (HR: 0.269, 95% CI, 0.085-0.854), surgical therapy was also a protective factor for OS. Conclusions Overall, for patients with intermediate-advanced HCC who underwent local-plus-systemic therapies, surgical therapy is a protective factor for long-term prognosis and can prolong OS, and for those who met the surgical resection criteria after conversion therapy, surgical therapy is recommended. [ABSTRACT FROM AUTHOR]

Background: Data on the long-term oncological outcomes of patients who undergo conversion surgery (CS) in gastric cancer (GC) patients with peritoneal metastasis (PM) are limited. Methods: GC patients with PM who received intraperitoneal (ip) and systemic chemotherapy between April 2015 and January 2021 were enrolled. Multivariate analysis was performed to identify risk factors associated with survival. Clinicopathological and survival outcomes were compared between those with CS and those without CS (NCS). The paclitaxel (PTX) plus tegafur–gimeracil–oteracil potassium capsules (S-1) (PS) + ip PTX and oxaliplatin plus S-1 (SOX) + ip PTX groups were matched in a 1:1 ratio using propensity score matching. Oncological and survival data were collected and analyzed. Results: A total of 540 patients who received ip chemotherapy via subcutaneous port and systemic chemotherapy were analyzed and 268 patients were enrolled, including 113 who underwent CS and 155 who did not. Overall survival (OS) were 27.0 months and 11.8 months in the CS and NCS groups (P < 0.0001), respectively. R0 resection was an independent prognostic factor for patients who underwent CS. The OS of patients with or without ovariectomy was 21.3 or 12.0 months (P < 0.0001). No difference of clinicopathological and survival outcomes was found between the PS + ip PTX and SOX + ip PTX groups. Conclusion: Conversion therapy is safe and adverse events were manageable. CS improves the survival of GC patients with PM after ip and systemic chemotherapy. R0 is an important prognostic factor. Furthermore, outcomes are comparable between the PS + ip PTX and SOX + ip PTX groups. [ABSTRACT FROM AUTHOR]

Background: Hepatic artery infusion chemotherapy (HAI) has been proposed as a valuable adjunct for multimodal therapy of primary and secondary liver malignancies. This review provides an overview of the currently available evidence of HAI, taking into account tumor response and long-term oncologic outcome. Summary: In colorectal liver metastases (CRLM), HAI in combination with systemic therapy leads to high response rates (85–90%) and conversion to resectablity in primary unresectable disease in up to 50%. HAI in combination with systemic therapy in CRLM in the adjuvant setting shows promising long-term outcomes with up to 50% 10-year survival in a large, non-randomized single-center cohort. For hepatocellular carcinoma patients, response rates as high as 20–40% have been reported for HAI and long-term outcomes compare well to other therapies. Similarly, survival for patients with unresectable intrahepatic cholangiocarcinoma 3 years after treatment with HAI is reported as high as 34%, which compares well to trials of systemic therapy where 3-year survival is usually below 5%. However, evidence is mainly limited by highly selected, heterogenous patient groups, and outdated chemotherapy regimens. The largest body of evidence stems from small, often non-randomized cohorts, predominantly from highly specialized single centers. Key Message: In well-selected patients with primary and secondary liver malignancies, HAI might improve response rates and, possibly, long-term survival. Results of ongoing randomized trials will show whether a wider adoption of HAI is justified, particularly to increase rates of resectability in advanced malignant diseases confined to the liver. [ABSTRACT FROM AUTHOR]

Though increasing numbers of racially and ethnically minoritized (REM) individuals earn PhDs and national initiatives focus on faculty diversity, challenges persist in recruiting, hiring, and retaining REM faculty. While a pervasive issue nationally, the literature predominantly focuses on faculty diversity at research‐intensive institutions. This exploratory case study pilots a readiness instrument to evaluate the commitment and willingness of a biomedical department at a primarily undergraduate institution to embrace faculty diversity before initiating a postdoctoral faculty conversion program. We introduce the Community Readiness Model (CRM) into an academic context, offering academic departments a robust framework and tool to evaluate readiness and capacity to recruit, retain, and support REM faculty. Practical Takeaways: Academic departments can be conceived of as a type of community.The adapted Department Readiness Tool can be a valuable method of evaluating a department's readiness to support the success of underrepresented minority faculty.Departments may score highly on some areas of readiness but relatively low on others, which provides insight into where time and resources should be invested to improve readiness. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the efficacy and safety of conversion surgery for advanced hepatocellular carcinoma (HCC) after hepatic arterial infusion chemotherapy (HAIC). Patients and Methods: Data from 172 HCC patients treated at Sun Yat-sen University Cancer Center between January 2016 and June 2021 with effective assessment of HAIC treatment response were retrospectively analyzed. Clinical pathological data, treatment process, survival, and occurrence of adverse events were recorded. Patients were grouped according to whether they achieved imaging remission after HAIC, underwent conversion surgery, and met the surgical resection criteria. Efficacy and safety were analyzed. Results: The median progression-free survival (PFS) and overall survival (OS) in the imaging remission group were 8.6 months and 26.3 months, respectively, which were longer than the 4.6 months (P<0.05) and 15.6 months (P<0.05) in the nonremission group. Compared with 6.7 months and 18.9 months in the HAIC maintenance group, the median PFS and median OS in the conversion surgery group were 16.5 months (P<0.05) and 45.0 months (P<0.05), but there was a higher risk of treatment-related hemoglobin decrease, alanine aminotransferase increase, aspartate aminotransferase increase, and total bilirubin increase (P<0.05). The risk of biliary fistula, abdominal hemorrhage and ascites in the HAIC conversion surgery group was higher than that of the single surgery group (P<0.05). Compared with the conversion surgery group, the median PFS and median OS of patients in the HAIC maintenance group who met the resection criteria were shorter: 7.1 months (P<0.05) and 21.7 months (P<0.05), respectively. All adverse events during the study were less than moderate, and no toxicity-related deaths occurred during follow-up. Conclusion: HAIC-based conversion therapy had acceptable toxic effects and could effectively stabilize intrahepatic lesions in advanced HCC, improve the survival benefit of patients, and provide some patients with the opportunity for conversion surgery to further improve prognosis. [ABSTRACT FROM AUTHOR]

Background: Conversion therapy practices (CTPs) are discredited efforts that target lesbian, gay, bisexual, trans, queer, Two-Spirit, or other (LGBTQ2S+) people and seek to change, deny, or discourage their sexual orientation, gender identity, and/or gender expression. This study aims to investigate the prevalence of CTPs across Canadian provinces and territories and identify whether CTP bans reduce the prevalence of CTPs. Methods: We collected 119 CTPs from 31 adults (18+) in Canada who have direct experience with CTPs, know people who have gone to CTPs, or know of conversion therapy practitioners using a 2020 anonymous online survey. Mapping analysis was conducted using ArcGIS Online. CTP prevalence was compared between provinces/territories with and without bans using chi-square tests. Results: Three provinces and eleven municipalities had CTP bans. The prevalence of CTPs in provinces/territories with bans was 2.34 per 1,000,000 population (95% CI 1.65, 3.31). The prevalence of CTPs in provinces/territories without bans was 4.13 per 1,000,000 population (95% CI 3.32, 5.14). Accounting for the underlying population, provinces/territories with the highest prevalence of CTPs per 1,000,000 population were New Brunswick (6.69), Nova Scotia (6.50), and Saskatchewan (6.37). Conclusions: Findings suggest only 55% of Canadians were protected under CTP bans. The prevalence of CTPs in provinces/territories without bans was 1.76 times greater than provinces/territories with bans. CTPs are occurring in most provinces/territories, with higher prevalence in the west and the Atlantic. These findings and continued efforts to monitor CTP prevalence can help inform policymakers and legislators as society is increasingly acknowledging CTPs as a threat to the health and well-being of LGBTQ2S+ people.

The article discusses the barriers that transgender individuals face when seeking gender-affirming care, such as the requirement for assessments of gender identity or dysphoria and strict age requirements. The author argues that these barriers should be reconsidered in light of the principle of gender self-determination, which asserts that individuals have the right to define and express their own gender identity. The article emphasizes that gender-affirming care is not a means of treating pathology but rather a way for individuals to shape themselves from a gendered perspective. The author concludes by calling on healthcare providers to examine their gatekeeping practices and justify any barriers to gender-affirming care. [Extracted from the article]

Patient V., 16 years old, studies in the 10th grade of high school. He consulted me in order to correct his homosexual desire on the initiative of his parents who, unlike him, regarded his sexual orientation as pathology. Under their strong psychological pressure he agreed on conversion therapy, since it, in his opinion, would not deteriorate him but would be better for his parents. On the moment of his visit the heterosexual component of sexual desire was entirely absent. His platonic (romantic) libido to girls was awakened at the age of 8-9, and the erotic one at the age of 10. His erotic desire to males was awakened at the age of 12-13, and the sexual desire a year later. At the age of 13 he arrived at the conclusion that he was a gay. When the patient was 14 he liked his classmate of the same age, whom he did not confess in it. They had companionship and “friendship”. He interacted with that boy during 1-1.5 years. At the age of 15 he had his first homosexual contact with a 36-year-old male. The patient had more than 20 sexual contacts with men aged 17-36. Any manifestations of gender incongruence had never been observed. His andrological status have no pathology. The provided correction was as follows: 1. Cognitive influences targeted at formation of the patient’s beliefs about advantages of the heterosexual lifestyle. 2. Hypnosuggestive correction. Programming was targeted at suggestion of futility of the homosexual lifestyle, removal of the homosexual desire and saturation with the heterosexual one, formation of associations between homosexuality and unpleasant sensations and landscapes, negative social consequences of homosexual relations, mental disorders and somatic problems observed in homosexuals. Hypnotic suggestions were also carried out aimed at changing the aesthetic and sexual perception of female and male persons, increasing sexual attraction to girls and women. A normal course of heterosexual masturbation was programmed. Besides, we performed modelling of the normal course of sexual intercourses with persons of the female sex in the hypnotic state. 3. Sexual-behavioural training (sex therapy) using masturbation of the heterosexual character with involvement of porn resources from Internet. Naturally, any use of homosexual plots during masturbation was strictly prohibited. 4. Also the patient was charged with a task to form an ideal of female beauty by focusing his attention on persons of the female sex both in the real life and in Internet. Twenty-one sessions of hypnosuggestive corrections were conducted. In the process of the provided therapy the homosexual component of libido was decreasing, while the heterosexual one was increasing. After the 18th session of hypnosis the heterosexual desire was expressed by 100% and the homosexual one by 0%. Then 3 more sessions of hypnosis were conducted in order to secure the achieved results. An inquiry of the patient 4 months later after the performed correction demonstrated their stability.

Jia-Yi Wu,1,2,&ast; Jun-Yi Wu,1,2,&ast; De-Yi Liu,1,&ast; Han Li,1,&ast; Shao-Wu Zhuang,3 Bin Li,4 Jian-Yin Zhou,5 Jing-Yao Huang,6 Zhi-Bo Zhang,7 Shu-Qun Li,8 Mao-Lin Yan,1,2 Yao-Dong Wang1,2 1Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China; 2Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, Fujian Province, People’s Republic of China; 3Department of Interventional Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People’s Republic of China; 4Department of Hepato-Biliary-Pancreatic and Vascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, People’s Republic of China; 5Department of Hepatobiliary Surgery, Zhongshan Hospital of Xiamen University, Xiamen, Fujian Province, People’s Republic of China; 6Department of Interventional Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, People’s Republic of China; 7Department of Hepatopancreatobiliary Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China; 8Department of Hepatobiliary Pancreatic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Mao-Lin Yan; Yao-Dong Wang, The Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Dongjie Road 134, Fuzhou, Fujian Province, 350001, People’s Republic of China, Tel +86 591-88217140 ; +86 591-88217130, Fax +86 591-87557768, Email yanmaolin74@163.com; wangyaodongfjsl@163.comBackground: This study aimed to determine whether salvage hepatectomy offers prognostic advantages for unresectable hepatocellular carcinoma (uHCC) patients with clinical complete response (cCR) after conversion therapy.Methods: A total of 74 consecutive uHCC patients with cCR after conversion therapy at seven major cancer centers in China between October 2018 and December 2021 were included. One-to-one propensity score matching (PSM) was performed to minimize the influence of potential confounders. Disease-free survival (DFS) and overall survival (OS) rates were compared between the surgical group and the non-surgical group.Results: Before PSM, 45 patients received salvage hepatectomy, and 29 patients received nonsurgical treatment. The 1-, 2-, and 3-year DFS rates were 77.8%, 61.5%, and 61.5% in the surgical group and 81.2%, 60.9%, and 60.9% in the non-surgical group, respectively. The 1-, 2-, and 3-year OS rates were 92.9%, 92.9%, and 69.7% in the surgical group and 100%, 70%, and 70% in the non-surgical group, respectively. There were no statistical differences in DFS and OS between groups [hazard ratio (HR)=0.715, 95% confidence interval (CI): 0.250– 2.043, p=0.531; HR=0.980, 95% CI: 0.177– 5.418, p=0.982, respectively]. After PSM, 26 pairs of patents were selected; there remained no significant differences in DFS and OS between these two groups (HR=1.547, 95% CI: 0.512– 4.669, p=0.439; HR=1.024, 95% CI: 0.168– 6.242, p=0.979, respectively).Conclusion: Through the study, it tend to show that salvage hepatectomy may be not essential for uHCC patients with cCR, especially for patients with a high risk of surgical complications. Prospective trials with long term follow-up are warranted to evaluate this treatment option.Plain Language Summary: To date, there is limited evidence on the prognosis of the unresectable hepatocellular carcinoma (uHCC) patients with clinical complete response (cCR), and the necessity of salvage surgery remains controversial. In this study, they compare and evaluate therapeutic benefits of salvage hepatectomy and nonsurgical treatment in the management of uHCC patients with cCR after conversion therapy. Finally, a total of 74 consecutive uHCC patients with cCR after conversion therapy at seven major cancer centers in China were included. There were no statistically significant differences for disease-free survival and overall survival were observed before and after propensity score matching. They revealed that cCR after conversion therapy led to a good prognosis for patients with uHCC. Furthermore, nonsurgical treatment provided similar survival benefits to those of salvage hepatectomy, suggesting that salvage hepatectomy may be not essential for uHCC patients with cCR.Keywords: conversion therapy, hepatocellular carcinoma, overall survival, disease-free survival, salvage surgery

Background: This study evaluates the efficacy of alpha-fetoprotein (AFP) response as a surrogate marker for determining recurrence-free survival (RFS) in patients with unresectable hepatocellular carcinoma (uHCC) who undergo salvage hepatectomy following conversion therapy with tyrosine kinase inhibitor (TKI) and anti-PD-1 antibody-based regimen. Methods: This multicenter retrospective study included 74 patients with uHCC and positive AFP (>20 ng/mL) at diagnosis, who underwent salvage hepatectomy after treatment with TKIs and anti-PD-1 antibody-based regimens. The association between AFP response--defined as a ≥ 80% decrease in final AFP levels before salvage hepatectomy from diagnosis--and RFS post-hepatectomy was investigated. Results: AFP responders demonstrated significantly better postoperative RFS compared to non-responders (P<0.001). The median RFS was not reached for AFP responders, with 1-year and 2-year RFS rates of 81.3% and 70.8%, respectively. In contrast, AFP non-responders had a median RFS of 7.43 months, with 1-year and 2-year RFS rates at 37.1% and 37.1%, respectively. Multivariate Cox regression analysis identified AFP response as an independent predictor of RFS. Integrating AFP response with radiologic tumor response facilitated further stratification of patients into distinct risk categories: those with radiologic remission experienced the most favorable RFS, followed by patients with partial response/stable disease and AFP response, and the least favorable RFS among patients with partial response/stable disease but without AFP response. Sensitivity analyses further confirmed the association between AFP response and improved RFS across various cutoff values and in patients with AFP ≥ 200 ng/mL at diagnosis (all P<0.05). Conclusion: The "20-80" rule based on AFP response could be helpful for clinicians to preoperatively stratify the risk of patients undergoing salvage hepatectomy, enabling identification and management of those unlikely to benefit from this procedure. [ABSTRACT FROM AUTHOR]

The aims of this study were to identify Australian mental health practitioners’ knowledge of what LGBTQA+ conversion practices are and their perceptions of impacts on survivors. We interviewed 18 mental health workers from a range of clinical modalities who were practicing in Australia. We used reflexive thematic analytic techniques to identify themes that characterized Australian mental health practitioners’ knowledge of LGBTQA+ conversion practices and perceptions of the impacts of such practices on survivors. Practitioners’ understandings of what constitutes LGBTQA+ conversion practices were varied and derived from a range of sources, and practitioners’ perceptions of the impacts that conversion practices had on survivors ranged from undeveloped to nuanced. Generalist and specialist practitioners provided vastly different responses. We identified the following four themes: (1) inexperienced practitioners’ understandings were limited and reliant on stereotypes about conversion practices; (2) specialist practitioners’ understandings were refined and match experiences reported by survivors; (3) generalist practitioners emphasized specific and undeveloped negative impacts; (4) specialist practitioners were aware of deeper harms and the need for sustained support. These themes may be translated into strategies to facilitate improved services offered by practitioners, which may assist survivors in managing and coping with the trauma associated with exposure to these practices. [ABSTRACT FROM AUTHOR]

Background: The synergistic effectiveness of combining immune checkpoint inhibitors with targeted therapies has shown promise in improving the conversion rate for unresectable hepatocellular carcinoma (HCC) patients to a potentially resectable status. However, the efficacy of this approach in the context of HCC with extrahepatic metastasis remains to be conclusively determined. Case presentation: We report a rare case of advanced HCC with extrahepatic metastasis who achieved long-term survival by a combination of systemic therapy (sintilimab and sorafenib) followed by laparoscopic hepatectomy. A 63-year-old man presented at our hospital with discomfort on the right side of his waist. An enlarged right hepatic lobe mass was subsequently revealed by CT scan. The patient's medical history, including a prior infection with hepatitis B virus, cirrhosis of the liver and an alpha-fetoprotein (AFP) level measuring 41.28 ng/ml substantiated the clinical diagnosis of HCC. On October 30th, 2019, the patient received 200 mg sintilimab intravenously (q3w) plus 200-400 mg BID sorafenib orally, along with antiviral therapy. After six cycles, his disease achieved partial response (PR). On April 26th, 2021, He underwent a laparoscopic hepatectomy. The patient achieved a sustained period of no evidence of disease for 2.5 years and with drug-free survival for 2 years after the resection. His current overall survival is estimated at approximately 4 years. Conclusions: This case highlights the potential of combining sintilimab and sorafenib in transforming HCC with extrahepatic metastasis into a condition amenable to surgical resection, suggesting that this treatment approach, followed by surgery, may lead to complete remission. [ABSTRACT FROM AUTHOR]

Simple Summary: A review was conducted to examine treatment strategies for oligo-recurrence with a controlled primary lesion and sync-oligometastases with an active primary lesion in esophageal squamous cell carcinoma. Although oligo-recurrence cases with possible therapeutic interventions had better outcomes, there may be selection bias due to retrospective studies. However, it is very clear that a small number of cases of oligometastases can be cured by local therapy, including surgical resection of metastases and radical chemoradiotherapy. The results of several ongoing clinical trials may lead to new treatment strategies for patients with oligometastases from esophageal squamous cell carcinoma in the future. Patients with oligometastases show distant relapse in only a limited number of regions. Local therapy such as surgical resection, radiotherapy, chemoradiotherapy, and radiofrequency ablation for the relapsed sites may thus improve patient survival. Oligometastases are divided into oligo-recurrence and sync-oligometastases. Oligo-recurrence indicates a primary lesion that is controlled, and sync-oligometastases indicate a primary lesion that is not controlled. The management of oligo-recurrence and sync-oligometastases in esophageal squamous cell carcinoma has not been clearly established, and treatment outcomes remain equivocal. We reviewed 14 articles, including three phase II trials, that were limited to squamous cell carcinoma. Multimodal treatment combining surgical resection and chemoradiotherapy for oligo-recurrence of esophageal squamous cell carcinoma appears to be a promising treatment. With the development of more effective chemotherapy and regimens that combine immune checkpoint inhibitors, it will become more likely that sync-oligometastases that were unresectable at the initial diagnosis can be brought to conversion surgery. Currently, a randomized, controlled phase III trial is being conducted in Japan to compare a strategy for performing definitive chemoradiotherapy and, if necessary, salvage surgery with a strategy for conversion surgery in patients who can be resected by induction chemotherapy. [ABSTRACT FROM AUTHOR]

Immunotherapy has demonstrated a role in the therapeutic landscape of a small subset of patients with colorectal carcinoma (CRC) that harbor a microsatellite instability (MSI-H) status due to a deficient DNA mismatch repair (dMMR) system. The remarkable responses to immune checkpoint inhibitors (ICIs) are now being tested in the neoadjuvant setting in localized CRC, where the dMMR/MSI-H status can be found in up to 15% of patients, with remarkable results obtained in NICHE2 and 3 trials, among others. This case series aims to report our experience at a tertiary center and provide a comprehensive analysis of the possible questions and challenges to overcome if ICIs were established as standard of care in a neoadjuvant setting, as well as the potential role they may have as conversion therapy not only in locoregional advanced CRC but also in oligometastatic disease. [ABSTRACT FROM AUTHOR]

Therapies for patients with unresectable hepatocellular carcinoma (uHCC) are currently popular. Current first-line standard-of-care treatments for uHCC are systematic therapies. However, treatments that combine locoregional therapy with systemic therapy are widely accepted in China and have demonstrated high rates of tumor response and conversion to resection with manageable toxicity. A literature review was performed by searching published literature in PubMed and Web of Science up to December 2023 for relevant articles on the use of triple therapy (transarterial chemoembolization combined with lenvatinib and anti--PD-1 antibodies) in uHCC. This review concentrates on the efficacy and safety of triple therapy with Chinese characteristics in patients with uHCC and describes the outcome of conversion surgery, degree of pathological necrosis, and effect prediction. This article will contribute to a comprehensive understanding of the role of triple therapy with Chinese characteristics in patients with uHCC. [ABSTRACT FROM AUTHOR]

This article situates Joseph Nicolosi's first book, Reparative Therapy of Male Homosexuality, in historical context. Nicolosi, a Catholic clinical psychologist, was one of the most vocal practitioners of sexual orientation change efforts (SOCE) from the early 1990s until his death in 2017, and in these decades, the Christian Right became a key supporter of SOCE. In this article, I argue that two features of Nicolosi's book appealed to the Christian Right. First, Nicolosi relied on psychoanalytic thought to pathologize not only same-sex sexual desires but also poor parenting. The use of psychoanalytic thought was of particular interest to conservative Christians who believed that American fathers had forfeited their role as strong patriarchs. Second, Nicolosi's approach to therapy, which included changing one's dress and mannerisms and assertiveness training, stressed that same-sex desires could be eliminated through behavioral reconditioning. Nicolosi's psychological eclecticism, a common feature for mental health practitioners at the end of the twentieth century, has not been emphasized in prior scholarship on reparative therapy. Importantly, the psychological eclecticism practiced by Nicolosi became common within the Christian Right after the publication of Reparative Therapy of Male Homosexuality. By offering a close reading of Reparative Therapy of Male Homosexuality, this article demonstrates the interrelationship between one of the core texts of the ex-gay movement and the psychological and religious thought of the Christian Right at the turn of the twenty-first century. [ABSTRACT FROM AUTHOR]

This special feature of Cognitive and Behavioral Practice serves to remind psychological scientists and other mental health clinicians of the importance of understanding our responsibilities in the field with specific reference to sexual orientation and gender identity "conversion therapy" efforts: from considering our ethical responsibilities in our practice (Davison) to understanding the widespread iatrogenic impacts of "conversion therapy" practice in all its subtleties (Anderson et al.), from staying abreast of the contemporary anti-LGBTQ+ talking points (Haldeman) to understanding how this rhetoric targets specific subpopulations in the U.S. currently (Hope & Puckett). We conclude this special series by reminding the reader that structures within our institutions and day-to-day functioning uphold and foster an unethical and iatrogenic practice. We point out the need to be alert. Clinical psychological science is not value-free. Pretending that it is serves the obfuscation of scientific findings and equips scholars who hold vested interests in seeing the dangerous practice of "conversion therapy" legitimized and disseminated in a larger scale. [ABSTRACT FROM AUTHOR]

• New threats emerging with antitransgender and gender diverse legislation in many U.S. states. • Brief review of the sociopolitical climate, impact of the climate on TGD people, and challenges faced by mental health providers serving TGD clients. • Recommendations for supporting TGD clients in the current sociopolitical context and a call for advocacy. Despite efforts to improve the sociopolitical landscape for sexual and gender minorities, including legislation to ban sexual orientation and gender identity change efforts (SOGICE), new threats have arisen with a sharp increase in state legislatures enacting anti-TGD (transgender and gender diverse) legislation. Some of these laws and the accompanying hostile climate may prevent mental health providers from providing the best evidence-based care for their TGD clients. This paper briefly reviews the current sociopolitical climate, the impact of the climate on TGD people, and challenges faced by mental health providers serving TGD clients. We conclude with recommendations for supporting TGD clients in the current sociopolitical context and a call for advocacy to continue efforts to ban SOGICE and protect access to social, legal, and medical gender affirmation for youth and adults. [ABSTRACT FROM AUTHOR]

The civil rights of LGBTQ persons throughout the U.S. are currently under attack by conservative right-wing extremists who would roll back antidiscrimination protections and prohibit access to care for trans youth, among other things. The exercise of religious freedom is often used as the basis for these initiatives, but these efforts are tantamount to the imposition of religious beliefs on vulnerable communities. The solution for LGBTQ persons offered by the extreme right wing is often sexual orientation/gender identity change efforts, or SOGICE, commonly known as so-called "conversion therapy," despite the lack of efficacy and adverse consequences of these methods. SOGICE bans have been instituted in many jurisdictions because of potential harm to the public. Strategies for protecting such bans are discussed. [ABSTRACT FROM AUTHOR]