[Low-dose methotrexate: Indications and side effects, particularly in cases of diffuse interstitial pneumonia]. / Méthotrexate à faible dose : indications et effets secondaires, en particulier en cas de pneumopathie interstitielle diffuse.

INTRODUCTION: Methotrexate (MTX) is a folate antagonist used as an immunosuppressant in a number of conditions, including rheumatoid arthritis (RA). Low-dose MTX (MTX-LD) is associated with a risk of haematological, hepatic, gastrointestinal and pulmonary toxicity, which may up until now have limited its use. STATE OF THE ART: In RA, data from retrospective cohorts have reported a possible excess risk of methotrexate toxicity in cases of underlying interstitial lung disease (ILD). However, recent prospective and retrospective multicentre studies have found no such increased risk, and have reassuringly concluded that MTX-LD can be prescribed in cases of RA-associated ILD (RA-ILD). PERSPECTIVES AND CONCLUSIONS: Current recommendations are not to delay the introduction of MTX in patients with RA at risk of developing ILD or in the presence of RA-ILD with mild to moderate respiratory impairment.

[The lie: Hiding to tell, telling to hide]. / Le mensonge : cacher pour dire, dire pour cacher.

We all lie. Some more than others, and others still have made it a way of life in relationships. There is a fine line between the normal and the pathological. It is certainly more psychologically comfortable to side with the truth than with lies. So what is it that drives the liar to stick to his guns?

Bluff Indicators in Medical and Dental Tele-Consultation: A Review.

The global lockdowns have resulted in the popularisation of tele-consultation. Also the anxiety about dental visits and hospital-acquired infections in patients and incidences of dishonesty are increased. Tele-consultation includes patient data collected on phone calls, text messages, and video calls. Bluffing or providing false information is one of the dark realities of clinical practice. Dishonesty might affect the treatment success and spread of contamination. During normal and epidemic eras, skills for honesty and bluff identification are required during tele-consultation to protect patients and doctors from hospital-acquired infection in further one-to-one treatment meetings.

Parenting by Lying.

Parenting by lying is a practice in which parents lie to their children to influence their emotions or behavior. Recently, researchers have tried to document the nature of this phenomenon and to understand its causes and consequences. The present research provides an overview of the research in the emerging field, describes some key theoretical and methodological challenges in studying this topic, and proposes a theoretical framework for understanding parenting by lying and for guiding future research to advance our knowledge about this understudied parenting practice.

Parenting by lying and children's lying to parents: The moderating role of children's beliefs.

How are children socialized about lying? One way is parental modeling of lying given that parents tell various lies to their children for parenting purposes, which is a practice known as parenting by lying. Importantly, how children perceive and interpret the lying behavior around them may be crucial to how they then learn to lie. Yet, we do not know how children's perceptions of different types of parental lies drive this socialization. In a comprehensive birth cohort of parent-child dyads (N = 564; children aged 11 and 12 years) in Singapore, we collected multi-informant reports of instrumental lies (parental lies told for child compliance) and white lies (parental lies told to instill positive emotions), children's belief in parental lies, and children's lying to parents. We found greater consistency in parent and child reports of instrumental lies than of white lies and that children reported greater belief in instrumental lies than in white lies. Children's reported exposure to instrumental lies was associated with greater lying to parents. However, for white lies this relationship was evident only when children had moderate to low beliefs in parental lies. Examining the interplay between parental lies and children's beliefs in those lies, the current study illuminates the potential pathways to children's lying behaviors.

A Cross-sectional Study on the Impact of Educational Status on Physical Activity Level in Danish and English Adults With Type 1 Diabetes.

OBJECTIVES: Physical activity is associated with improved health in people with type 1 diabetes. However, physical activity level may be associated with socioeconomic status. The primary aim of this study was to investigate the association between education level and physical activity level among people with type 1 diabetes. METHODS: In this cross-sectional study, data on physical activity level (high or low) was measured using the Saltin-Grimby Physical Activity Level Scale, and education level (low, medium, or high) was self-reported. RESULTS: Respondents were recruited from outpatient clinics (Steno Diabetes Centre Aarhus, Denmark; Nordsjællands Hospital, Denmark; or Sheffield Diabetes and Endocrine Centre, United Kingdom), by health-care personnel from September 2019 to July 2021. A total of 324 people with type 1 diabetes were included (54% male, median age 50 years [interquartile range 30-60 years]). Education level was low in 10%, medium in 33%, and high in 57%. A logistic regression analysis, adjusted for age, sex, cohabitation status and nationality, found that a medium vs. high education level was associated with lower odds of a high physical activity level (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.32-0.94, p=0.029), while no association was found for low vs. high education level with high physical activity level (OR 0.56, 95% CI 0.25-1.29, p=0.173). CONCLUSIONS: Medium education level compared with a high education level was associated with a lower level of physical activity in people with type 1 diabetes. Health-care professionals are advised to be attentive of physical activity levels among people with type 1 diabetes.

A call for mindfulness-based interventions for cannabis-use disorders.

Cannabis use is being increasingly liberalized worldwide, and an increasing prevalence of cannabis-use disorder (CUD) is observed. The few current therapeutic options for CUD are only modestly effective. Mindfulness-based interventions offer promising prospects for the management of substance-use disorders. However, despite proliferating literature on mindfulness and substance use, few studies have explored mindfulness in terms of cannabis use and CUD. There are many possibilities for the implementation of mindfulness-based interventions for cannabis use reduction, especially for younger users, who are more vulnerable to cannabis-related harms. Accordingly, large controlled trials are needed to reliably assess the potential of such interventions.

Sur lies élevage practice to modulate the features of red wines from calcareous soils with different textures.

BACKGROUND: In Sicilian calcareous soils, red wines often display unripeness and bitterness features. To enhance wine quality, we employed the 'sur lies élevage' technique, involving prolonged contact of dead yeast cells with the wine to favor the extraction of yeast cellular components through cell lysis. The 7 month treatment utilized two types of Chardonnay lies: fresh and previously matured. To overcome challenges in retrieving lies from red winemaking, we have recovered the lies from a white winemaking. Additionally, the lies underwent a preliminary passage on a red wine to minimize color adsorption on yeast cell walls. RESULTS: The sur lies treatment effectively reduced astringency, bitterness, and brown pigment in wines, with partial removal of red color. It successfully eliminated quercetin aglycone and induced remarkable changes in the aromatic profile, showing increased ethyl esters and relative fatty acids. Sensory evaluations revealed sur lies-treated wines had fruitier and more complex characteristics compared to untreated wines. Matured lies had a greater impact on enhancing fruitiness than fresh lies. CONCLUSIONS: The treatments mitigated the unripeness and bitterness of studied wines. Sur lies treatment improved the aromatic profile, leading to fruitier and more complex notes, enhancing overall sensory quality. Matured lies showed greater efficacy in elevating fruitiness than fresh lies. These findings highlight the value of the sur lies technique in enhancing the quality and sensory attributes of Nero d'Avola and Syrah wines from Sicilian calcareous soils. © 2023 Society of Chemical Industry.

Moral evaluations of children's truths and lies in a prosocial context: The role of reputation.

The current investigation examined the influence of a child's reputation on 7- to 12-year-olds' (Study 1; N = 146) and parents' (Study 2; N = 198) moral evaluations of the child's blunt truths (i.e., truths told despite possible hurt feelings) and prosocial lies (i.e., lies told to protect another's feelings). In Study 1, children were read a series of vignettes in which a child, described as being smart, kind, or clean (with clean serving as the irrelevant control reputation), told either the blunt truth or a prosocial lie that varied in content (opinions or facts). In Study 2, parents evaluated the same vignettes and reputations as in Study 1 with the addition of a troublemaker reputation. The reputation of the child protagonist significantly influenced both children's and parents' moral evaluations. Children rated the kind child's lies more positively, and parents rated the smart child's truths and lies less positively, than those of the clean (control) child when told about opinions. No differences were noted in the facts content condition. Findings suggest that a child's perceived reputation may influence both children's and adults' moral interpretations of the child's honesty behaviors.

ON GROTSTEIN'S 'TRUTH' IN BION'S THEORY OF 'O'.

In this thought-provoking exploration, the author examines Grotstein's seminal work, "The Seventh Servant: The Implications of a Truth Drive in Bion's Theory of 'O'" (2004), and its relevance to the psychoanalytic concepts of truth and lies. Drawing on Bion's K-link and Klein's epistemophilia, the paper argues that Grotstein's concept of a "truth drive" is part of a transformative paradigmatic shift in psychoanalysis, emphasizing a focus on ontology and the process of being with the analysand. The commitment to truth in psychoanalytic practice demands ongoing examination, open-mindedness, and a willingness to embrace bodily sensations, proto-emotions, and new thoughts. Grotstein proposes that the truth drive is a universal human force that compels individuals towards emotional growth and explains why analysands can accept the analyst's interpretation of painful psychical realities. The intersection between curiosity and evolving 'O' exceeds epistemophilia, bridging knowledge and the unknown for optimal truth-seeking. The paper briefly explores the connections between Heidegger's "Dasein," "Aletheia," and Foucault's "Parrhesia," further supporting Grotstein's discovery. Additionally, it addresses the challenge of distinguishing healthy truth pursuit from pathological manifestations and presents a captivating clinical vignette illustrating Grotstein's response to this question. Finally, the paper delves into Bion's puzzling observation that all thoughts as ordinarily known are lies, augmenting the notion of universal emotional truth and its complexities in the clinical context.

'A Home to the Lie': The Contemporary (Per)version of Truth.

This paper explores the contemporary trend towards relativization and perversion of truth increasingly prominent in American culture, which, in Bion's terminology (1970), has become an ever more hospitable "home to the lie." The anti-COVID vaccine movement emerging in the United States in 2021, and its related network of conspiracy theories, is presented as an example. To make sense of these phenomena the author presents clinical vignettes illustrating (1) Bion's (1970) notions of catastrophic change, the lie/thinker relation, and the messianic idea; (2) Freud's (1921) thinking on group leaders; and (3) Matte-Blanco's (1975) bi-logical theory of mind. According to Bion, the lie is mobilized to avoid the psychological upheaval associated with catastrophic change. The author suggests that developments in American life experienced as threatening catastrophic change provide a hospitable environment for the lie, making the recognition of truth more elusive. In line with Matte-Blanco's bi-logical theory, the author suggests that creation of opportunities for dialogue giving weight to both conscious and unconscious ways of thinking is necessary for re-establishing a culture of truth.

Testing Causal Effects of Empathy on Children's Prosociality in Politeness Dilemmas - An Intervention Study.

Empathy is commonly considered a driver of prosociality in child ontogeny, but causal assumptions regarding this effect mostly rely on correlational research designs. Here, 96 urban German children (5-8 years; 48 girls; predominantly White; from mid-to-high socioeconomic backgrounds) participated in an empathy intervention or a control condition before prosocial behaviors (polite lie-telling: rating the drawing as good; prosocial encouragement: utterances interpreted as cheering up the artist) were assessed in an art-rating task. Contrasting children's empathy at baseline with their empathy after the intervention indicated promoted empathy compared to the control group. Despite the intervention's effect on children's empathy, there were no simultaneous changes in prosocial behaviors. At the same time, children's empathy at baseline was associated with their prosocial encouragement. These results indicate conceptual associations between children's empathy and prosociality. However, they do not support strict causal claims regarding this association in middle childhood. Further applications of the novel short-time intervention to address causal effects of empathy on prosociality and other developmental outcomes are discussed.

Agentic and communal narcissism in predicting different types of lies in romantic relationships.

Several studies have investigated a potential positive association between agentic narcissism and general dishonesty, revealing both supportive and contradicting evidence. Few have focused on dishonesty within romantic relationships, a phenomenon that occurs in almost all partnerships. With the present research, we first aimed to extend existing literature on narcissism by including its two complementary facets (i.e., agentic and communal narcissism). Second, we aimed to improve the understanding of narcissists' lying behavior in the context of partnerships by distinguishing between two different types of lies (i.e., self-centered and other-oriented lies). We hypothesized that both, people higher in agentic and communal narcissism, will report increased dishonesty toward their romantic partners (Hypothesis 1). Given the self-benefit function of self-centered lies and given that agentic narcissists aim to fulfill their relationship-based motives by agentic means, we predict agentic narcissism (compared with communal narcissism) will be a stronger predictor for self-centered lies (Hypothesis 1a). Given the other-benefiting function of other-oriented lies and given that communal narcissists aim to fulfill their motive of self-enhancement by communal means, we predict that communal narcissism (compared with agentic narcissism) will be a stronger predictor for other-oriented lies (Hypothesis 1b). In two preregistered online studies (N = 298: N = 256) we showed that people higher in agentic narcissism believed to be good liars, but this does not lead to higher self-reported frequencies of other-oriented and self-centered lies within romantic relationships historically; communal narcissism was also not related to self-reported deception. Limitations and directions for future research are discussed.

[Translation and adaptation of a tool prescribing errors related to computerized physician order entry coding to the French hospital background]. / Traduction et adaptation au contexte hospitalier français d'un outil de codification des erreurs de prescription liées aux logiciels.

Prescribing errors related to computerized physician order entry are current and may have serious consequences for patients. They can be detected by pharmacists during prescriptions analysis and lead to pharmacist's interventions. In France, few monocentric studies have studied Pharmacist Interventions triggered by prescribing errors identified as System-Related Errors (PISREs) in French hospitals. However, their respective analysis method prevent any comparison between computerized physician order entry systems in order to identify the safest and rule out the most dangerous. A computerized physician prescribing error related to the software is characterized by its causes, consequences and mechanism of occurrence. US researchers have developed and validated a tool to classify and illustrate these three characteristics. The objectives of this article are to present this tool, to propose a French adaptation and to describe the perspectives analyze and understand prescription errors related to computerized physician order entry based on data of Act-IP©. The adaptation was performed using PISREs extracted from the Act-IP© observatory of the French Society of Clinical Pharmacy. Each item of the codification is illustrated with an example of PI. We are considering a training plan in order to allow wide use of this tool. Once adopted this tool, the next step will be to organize a prospective multicenter study including as many computerized prescription order entry systems as possible. The aim of this study will be identifying the safest systems. Consequently, it will then be possible to have arguments to qualify the most dangerous and thus propose their withdrawal from the market.

Don't be deceived: bald-faced lies are deceitful assertions.

The traditional conception of lying, according to which to lie is to make an assertion with an intention to deceive the hearer, has recently been put under pressure by the phenomenon of bald-faced lies i.e. utterances that prima facie look like lies but because of their blatancy allegedly lack the accompanying intention to deceive. In this paper we propose an intuitive way of reconciling the phenomenon of bald-faced lies with the traditional conception by suggesting that the existing analyses of the phenomenon overlook a non-obvious category of hearers whom the speakers of bald-faced lies intend to deceive. Those hearers are institutions represented by the people involved, such as courts or secret police. We also criticize two recent rival accounts (Jessica Keiser's and Daniel Harris's) that attempt to save the traditional conception by saying that some bald-faced lies are not assertions, because they are conventional-rather than illocutionary-speech acts.

Bringing a mentalizing framework to understanding mothers with addiction: The groundbreaking work of Nancy E. Suchman.

Nancy Suchman is remembered as a pioneer whose mentalization-based intervention-Mothering from the Inside Out (MIO)-transformed the treatment of parents struggling with substance use disorders. Specifically, Suchman's work highlighted the neural mechanisms underlying substance use disorders and identified the promotion of parental mentalizing as a key therapeutic focus in enhancing early parent-child relationships. Her work transformed parenting support models for this population of parents. Several randomized controlled trials (RCT) show the effectiveness of MIO in promoting parental reflective functioning (PRF) and positive relational outcomes in parents with substance use disorders and their children. Suchman's MIO model has since been extended to parenting in many contexts. She is also remembered as a generous colleague, a gifted researcher and clinician, and an inspiration to generations of researchers and practitioners working with parents who aspire to raise healthy, secure children despite multiple challenges and adversities. This special issue compiles the work of researchers inspired by Suchman as they carry on her legacy in examining aspects of parental mentalization. Collectively, the research presented yields confirmation of MIO core assumptions, offers new insights into roles of positive sentiment and savoring in mentalization processes, and presents evaluations of MIO in multiple contexts and with new adaptations.

A Nancy Suchman se le recuerda como una pionera cuya intervención basada en la mentalización-Cuidados Maternales de Dentro hacia Afuera (MIO)- transformó el tratamiento de progenitores luchando con trastornos de uso de sustancias. Específicamente, el trabajo de Suchman enfatizó los mecanismos neurales subyacentes en los trastornos de uso de sustancias e identificó el promover la mentalización del progenitor como un enfoque terapéutico clave para mejorar las tempranas relaciones progenitor-niño. Su trabajo transformó los modelos de apoyo a la crianza para este grupo de progenitores. Varios ensayos controlados al azar muestran la eficacia del MIO en cuanto a promover el funcionamiento con reflexión del progenitor y los resultados de una positiva relación en progenitores con trastornos de uso de sustancias y sus niños. El modelo MIO de Suchman desde su creación ha sido expandido a la crianza en muchos contextos. A ella también se le recuerda como una colega generosa, una investigadora y profesional clínica talentosa y como una inspiración para generaciones de investigadores y practicantes profesionales que trabajan con progenitores que aspiran a criar niños saludables y seguros, a pesar de múltiples retos y circunstancias adversas. Este número especial recopila el trabajo de investigadores inspirados por Suchman a medida que ellos continúan el legado en cuanto a examinar aspectos de la mentalización del progenitor. Colectivamente, la investigación presentada aporta la confirmación de las suposiciones centrales del MIO, ofrece nuevas ideas acerca del papel del sentimiento positivo y el aprecio detenido en los procesos de mentalización, y presenta evaluaciones del MIO en contextos múltiples y con nuevas adaptaciones.

Nous honorons et nous souvenons de Nancy Suchman en tant que pionnière dont l'intervention basée sur la mentalisation - le Maternage de l'Intérieur, en anglais Mothering from the Inside Out (MIO) - a transformé le traitement de parents aux prises avec la toxicomanie. Plus particulièrement le travail de Suchman a mis en lumière les mécanismes neuronaux sous-jacents aux troubles lié à l'usage d'une substance et il a aussi identifié la promotion de la mentalisation parentale comme une cible thérapeutique clé pour l'amélioration des relations précoces parent-enfant. Son travail a transformé les modèles de soutien parental pour cette population de parents. Plusieurs essais contrôlés randomisés montrent l'efficacité du MOI pour la promotion du fonctionnement de réflexion parental et des résultats relationnels positifs pour des parents ayant un trouble lié à l'usage d'une substance et leurs enfants. Le modèle MOI de Suchman a depuis été étendu au parentage dans de nombreux contextes. Nous nous souvenons aussi de Nancy Suchman comme étant une collègue généreuse, une chercheuse et une clinicienne talentueuse et une inspiration pour des générations de chercheurs et professionnels travaillant avec des parents qui aspirent à élever des enfants sécures, en bonne santé, malgré de grands défis et l'adversité à laquelle ils peuvent faire face. Ce numéro spécial compile le travail de chercheurs du monde entier, inspiré par Suchman, alors qu'ils perpétuent son héritage en examinant des aspects de la mentalisation parentale. Collectivement ces recherches compilées ici proposent la confirmation des hypothèses principales du MOI, offrent de nouvelles perspectives quant aux rôles du sentiment positif et du fait de savourer dans les processus de mentalisation et présentent des évaluations du MOI dans des contextes multiples et avec de nouvelles adaptations.

Safety and efficacy of immunotherapy according to the age threshold of 80 years.

BACKGROUND: To compare safety and efficacy of ICIs among patients<80 and those ≥80 years of age. METHODS: A single-center retrospective observational cohort study comparing patients<80 and ≥80 years of age matched for cancer site (lung vs others) and participation in a clinical trial. PRIMARY ENDPOINT: grade ≥2 toxicity during the first three months of ICI therapy. The two groups were compared using univariate and multivariate regression. RESULTS: Two hundred and ten consecutive patients were recruited, with the following characteristics: mean age: 66.5±16.8, 20% aged ≥80 years, 75% male, 97% ECOG-PS ≤ 2, 78% G8-index ≤ 14/17, 80% lung or kidney cancer, and 97% metastatic cancer. The grade ≥2 toxicity rate during the first three months of ICI therapy was 68%. Patients aged ≥80 years of age had a more significant (P<0.05) proportion of grade ≥2 non-hematological toxicities (64% vs 45%) than those aged<80 years: rash (14% vs 4%), arthralgia (7.1% vs 0.6%), colitis (4.7% vs 0.6%), cytolysis (7.1% vs 1.2%), gastrointestinal bleeding (2.4% vs 0%), onycholysis (2.4% vs 0%), oral mucositis (2.4% vs 0%), psoriasis (2.4% vs 0%), or other skin toxicities (25% vs 3%). Efficacy among patients ≥80 and<80 years of age was comparable. CONCLUSIONS: Although non-hematological toxicities affected 20% more patients aged ≥80 years, hematological toxicities and efficacy were comparable between patients aged ≥80 and<80 years with advanced cancer and treated with ICIs.

[Alpha-blockers or hexanic extract of Serenoa repens for 6 months: sub-analysis of the PERSAT study]. / Alpha-bloquants ou extrait hexanique de Serenoa repens pendant 6 mois : sous-analyse de l'étude PERSAT.

OBJECTIVE: The objective of this sub-analysis of the PERSAT study was to evaluate the efficacy of hexanic extract of S. Repens (HESr) and alpha-blockers (AB), at 6 months in patients with moderate to severe LUTS/BPH. METHODS: The PERSAT observational study was conducted in France by general practitioners on patients with BPH with an IPSS≥12 score. The primary endpoint was the percentage of responders (decrease in total IPSS score ≥ 3) at 6 months. Improvement in quality of life (IPSS-QoL) as well as patient satisfaction were also measured. RESULTS: Of the 759 patients in the study, 324 treated with HESr and 309 with AB were reviewed at 6 months, with no change in treatment during follow-up. Characteristics at inclusion were globally similar with a mean IPSS of 18.2±4.9. The response rates at 6 months (IPSS-total decrease ≥ 3) were 93.7% and 94.8% for patients treated with HESr and AB, with a mean decrease in IPSS score of 10.1±5.6 points, which reached 13.6 and 14.8 points respectively, in severe patients (IPSS>19), without major difference between groups. More than 95% of HESr or AB patients reported a significant overall improvement in their LUTS/BPH. The most frequently reported adverse events with AB were ejaculation disorders (4.9%) and hypotension (4.2%) and with HESr digestive disorders (1.5%). CONCLUSION: This sub-analysis of the PERSAT cohort reported the clinical efficacy of HESr and AB as a first-line treatment in the management of moderate or severe LUTS/BPH patients.