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Abstract Purpose Most patients with cancer lack the prognostic understanding necessary to make informed decisions. We tested the feasibility and acceptability of the Oncolo‐GIST (“Giving Information Strategically and Transparently, GIST”) intervention and explored its associations with patients' improved prognostic understanding. Methods The Oncolo‐GIST intervention distills prognostic discussions into easy‐to‐understand talking points. Patients with metastatic cancers that progressed on ≥1 line of chemotherapy and not expected to survive 12 months (n = 31) were recruited from October 2020 through November 2022. We compared patients who discussed their progressive scans with an oncologist trained in the GIST technique or not (i.e., usual care). A primary outcome was prognostic understanding (e.g., patients reporting a life‐expectancy of months) assessed within a week of the scan discussion visit. Results Oncologists (n = 4) appeared receptive to the Oncolo‐GIST intervention and scored nearly perfectly on post‐training tests of material mastery after a

Macroscelidid afrotherians and canid carnivorans possess four premolar loci, the first of which is not replaced. Previous work suggests that the first premolar in macroscelidids is a retained deciduous tooth, but in Canis it is a successional tooth with no milk precursor. We tested this contrasting interpretation of first premolar homology with data from ontogenetic anatomy and with area predictions from the inhibitory cascade (IC) model. Our results based on anatomy support previous interpretations that the functional first premolar is a retained deciduous tooth (dp1) with no successor in macroscelidids, and a successional tooth (p1) with no precursor in Canis. Hyracoids are among the few placental mammals that show replacement at the first premolar locus and show less deviation than other taxa of actual from predicted areas across the deciduous and molar toothrow. However, predicted vs. actual tooth areas can depart substantially from one another. At least without a better means of representing tooth size, the inhibitory cascade does not help to distinguish the deciduous from successional first premolar. This observation does not rule out the possibility that factors such as a size-shift within the toothrow (e.g., carnivoran carnassials) help to explain deviations from the inhibitory cascade model.

Suicide among physicians is a longstanding problem, with risk factors exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. In this article, we explore suicidal thoughts and behaviors among physicians and risk factors created or intensified by the work environment, such as overwork and loss of autonomy. We discuss the ways in which the COVID-19 pandemic has made the medical work environment more stressful (e.g. greater exposure to traumatic experiences and employment insecurity) and, consequently, elevated physician suicide risk. We also review evidence that the medical system in the United States has not adequately protected physicians' mental health. Lack of confidentiality, stigma, cost, and time, as well as intrusive medical licensing applications, remain barriers to physicians seeking help. Work pressures imposed by insurance companies and financial incentives to increase revenue while cutting costs compound physicians' work stress. We conclude that system-wide changes to the practice of medicine and policies regarding healthcare delivery are needed to improve physicians' work environments, as is research addressing the impact of the interventions to reduce their suicidal risk. The proposed changes, and greater access to timely and confidential mental health services amid and in the aftermath of the pandemic, may prove promising approaches to reduce physicians' suicide risk.