Search

Introduction: Paediatric uveitis is a rare disease. It can affect any segment and have various etiologies, including infectious, autoimmune, and masquerade diseases. The pupose of this study is to analyse and present the demographic data in paediatric uveitis in a Swiss cohort. Knowledge of local demography may guide targeted work up and treatment. Methods: Single center retrospective study from January 2012 to June 2022. Patients under 18 years of age with uveitis were eligible for inclusion. Demographics (age at first presentation, sex), ocular signs (affected eye segment, laterality, visual acuity; VA, Snellen, decimal, clinical course), and systemic finding were analysed. Frequencies and descriptive statistics were computed, non-parametric tests and odds ratio were applied for sample comparisons. Local ethics committee approved this study. Results: Data from 93 of 133 identified patients were available. 51% were female, mean age at first presentation was 12 years, 60% had bilateral disease. 68% were of non-infectious etiology. Most common identified etiology was toxoplasmosis (20%), followed by JIA (8%) and herpetic (8%). No associated infectious cause or systemic disease was found in 44% of the cases. Most presented with anterior uveitis (50%), followed by posterior (28%), intermediate (20%), and panuveitis (2%). 80% of anterior uveitis were non-infectious; 81% of posterior uveitis were infectious. Bilateral disease was strongly associated with non-infectious uveitis (93%), whereas unilateral disease was more likely to be of an infectious cause (70%); odds ratio = 31. Mean VA of affected eyes at first presentation was 0.79. VA was significantly worse in cases with infectious uveitis compared to non-infectious uveitis (p = 0.007). Nearly a third of affected eyes showed at least one complication. This did not differ between in non-infectious and infectious uveitis cases. Conclusion: Bilateral disease is strongly suggestive of non-infectious uveitis. Unilateral and posterior disease is suggestive of an infectious cause, with toxoplasmosis being the most often diagnosed cause of uveitis in this cohort. Knowledge of demography is important for specialists to target workup and introduce treatment. [ABSTRACT FROM AUTHOR]

In many Western countries, the ideology of intensive parenting has gained prominence in the discourse of experts, policymakers, and within popular culture. This ideology emphasizes deep parental involvement in emotional, physical, and financial aspects (Lee et al., 2014). Meeting these demanding standards can exert significant pressure on parents, especially on mothers often considered as the primary caregiver. Moreover, these pressures may prompt parents to be highly, and potentially overly, involved in their children's lives. Using data from 146 parent dyads (N = 292 parents; Mage = 47.57 years) of Swiss adolescents, the study explores parental perceptions of pressure to be a perfect parent and its association with one positive (responsiveness) and two negative types of involvement (overprotection and overvaluation). Thereby, we estimated Actor-Partner Interdependence Models (APIM) to examine mutual influences between mothers and fathers. The results indicated that mothers reported experiencing significantly more pressure than fathers. We found evidence for a positive association between perceptions of pressure and parental overprotection among both parents. The results also showed that there was a significant association between feelings of pressure and overvaluation, but only among fathers. Associations between pressure and responsiveness were not significant, and no significant partner effects were observed in any of the models. In conclusion, mothers particularly face heightened pressure to be perfect parents, but both parents may adapt their parenting strategies in response to perceived pressure to be perfect as a parent. These findings highlight the potential issues associated with societal pressures on parents and their impact on parenting behavior. [ABSTRACT FROM AUTHOR]

Background: Cuffed endotracheal tubes (cETT) pose the potential advantage of an infrequent need for reintubation in pediatric patients compared to uncuffed tubes. The aim of this study was to investigate tube exchange rates using second generation Microcuff® pediatric endotracheal tubes (PET) with an adapted sizing recommendation in a large single institution cohort of children and to identify potential variables associated with an elevated risk of tube exchange. Methods: Patient data obtained from the electronic patient data management system of the Department of Anesthesia, University Children's Hospital Zurich, Switzerland, were retrospectively assessed for demographic and anthropometric information, size of the internal tube diameter used for positive pressure ventilation and divergence from the size recommendation chart. Results: Data from 14,188 children younger than 16 years (median 5.3 years) and weighing at least 3 kg who underwent oral or nasal tracheal intubation using second generation Microcuff® PET between 2009 and 2015 were included. Of 13,219 oral tracheal intubations 12,049 (84.9%) were performed according to the manufacturer's size recommendation and 1170 with divergent endotracheal tubes. The odds ratio (OR) of oral reintubation was 0.13% (95% confidence interval 0.08–0.22%) for cases using the manufacture's size recommendation correctly and 22.74% (95% confidence interval 20.42–25.23%) for patients intubated with a not recommended tube (p < 0.0001). Conclusion: These findings indicate that the second generation Microcuff® PETs can be reliably used with low tube exchange rates across the entire pediatric age range when the tube size is selected according to the manufacturer's size recommendation chart. Adherence to the manufacturer's tube size recommendation is urgently advised. [ABSTRACT FROM AUTHOR]

This article examines the disparities between the (existing and planned) business and human rights (BHR) legislations in Switzerland and the European Union (EU). More specifically, (i) the key differences that exist between the Swiss and EU BHR legislations are identified, and (ii) the proposed amendments to the Swiss BHR legislation to reach the desired harmonization with the EU framework are put forward. The Swiss BHR legislation, implemented in stages on 1 January 2021 and 1 January 2023, encompasses provisions related to 'transparency on non-financial matters', 'transparency in raw material companies', and 'due diligence and transparency in relation to minerals and metals from conflict-affected areas and child labor'. The EU BHR legal framework, however, has undergone a major overhaul, with the recent adoption of the Corporate Sustainability Reporting Directive (CSRD) and the Directive on Corporate Sustainability Due Diligence (CSDDD) that introduce additional obligations. These EU regulations have (or will have) important extraterritorial effects, including on Swiss undertakings operating—directly or indirectly—in the EU. To prevent Swiss companies from being subject to a diverse array of regulations (with an increased risk of sanctions in case of non-compliance), a reform of the Swiss BHR legislation is needed to ensure harmonization with EU BHR legislation. This article also serves as a resource if full equivalence between them is sought. [ABSTRACT FROM AUTHOR]

Contemplative approaches rooted in Buddhist traditions have been linked to the attenuation of response to social stress. Anticipatory cognitive appraisals of social situations potentially represent a mechanism explaining the stress-reducing effects of contemplative practices. The cognitive appraisal of threat is associated with an anticipated loss of social self-esteem. In contrast, the cognitive appraisal of challenge involves recognizing the potential for gain or growth in stressful situations and is associated with a more adaptive cardiovascular response. In this secondary analysis of a randomized controlled experiment performed in Switzerland, we evaluated the effects of two contemplative interventions on cognitive appraisals of challenge and threat and associated physiological profiles. The interventions were a standard Mindfulness-Based Stress Reduction (MBSR) program and a new program (MBSR-B), which included several elements from Buddhist practices. After an eight-week intervention, participants completed the Trier Social Stress Test (TSST) and underwent the assessment of primary cognitive appraisals and cardiovascular response to stress. The results demonstrated greater challenge appraisal in the MBSR (n = 20) and MBSR-B (n = 21) groups compared to Control (n = 24), and MBSR-B participants scored higher on the challenge than threat appraisal. At the physiological level, the groups did not differ on changes in cardiac output and total peripheral resistance. Still, an exploratory analysis demonstrated that the MBSR-B group's cardiovascular profile best resembled challenge appraisal. The results suggest that contemplative approaches foster challenge appraisal, contributing to a more adaptive response to stress. [ABSTRACT FROM AUTHOR]

Purpose: International English language publication activities in orthopaedic surgery comparing the years 2008/09 to 2018/19 were analyzed. Methods: 20 international journals listed on PubMed were examined. The impact factor (IF) for each journal was determined using the InCites Journal Citation Report. Results: 9,205 publications in 2008/09 and 15,549 in 2018/19 with 21,435 cumulative IF (CIF) in 2008/09 and 50,552 in 2018/19 were registered. Most publications consisted of narrative reviews (42.0%), followed by clinical studies (22.0%), experimental investigations (16.9%), randomized controlled trials (6.0%), and meta-analyses (5.6%). The highest increase in publications was observed for narrative reviews from 33.5% in 2008/09 to 41.1% in 2018/19. The USA had the highest number of publications (2,981 and 4,796), followed by UK (806 and 879) and Germany (606 and 922) in 2008/09 and 2018/19, resp. Per 1 Mio inhabitants, Switzerland (13.6 and 28.4), Sweden (10.9 and 18.1), the Netherlands (9.6 and 15.4), and Denmark (9.0 and 21.8) were the most productive countries in 2008/09 and 2018/19, resp. Conclusions: International publishing activity in orthopaedic surgery has increased substantially over the last 10 years. The quality of the published articles has not increased in the same way, as evidenced by the disproportionate rise in narrative reviews. Over the entire period, the US were the leader with respect to number of publications and CIF. In terms of population, however, smaller countries such as Switzerland and Sweden were much more active. [ABSTRACT FROM AUTHOR]

Social stereotypes influence people's perceptions of nationalities. To categorize the stereotypes about existing nationalities in Switzerland, the stereotype content model can be used. People with nationalities that are associated with low warmth and competence are at risk of being perceived as outgroup members and of being discriminated against, whereas people with nationalities that are rated as high in warmth and competence are more likely to be perceived as ingroup members and are therefore better accepted. Warmth is negatively associated with competition while competence is positively associated with status. Students (N = 101) from various universities in the German-speaking part of Switzerland rated 70 nationalities along the dimensions of warmth, competence, competition, and status. The cluster analyses revealed four groups of nationalities along the dimensions warmth and competence. Levels in status and competition differed between those four clusters. In line with prior research, a negative relationship was found between competition and warmth and a positive relationship between status and competence. These findings allow to understand social stereotypes of nationalities based on empirical evidence. More importantly, the clusters can be used in future studies to compare groups of people with different nationalities who have specific stereotyping experiences. [ABSTRACT FROM AUTHOR]

Background: New care models are needed for the increasing elderly, chronically ill, and multimorbid population, especially in primary healthcare. Rural regions are particularly affected where bottlenecks in provision of care and a shortage of health professionals are emerging. To address these challenges, nurse practitioners have been implemented in Swiss general practices to improve primary healthcare of chronically ill people. Aim: We aimed to explore Swiss primary healthcare delivery for chronically ill people in general practices with and without nurse practitioners and identify similarities and differences in these general practices. Methods: We conducted multiple case studies. Data were collected using interviews, observations, patient records, and questionnaires. We described the similarities and differences by drawing on Wagner's Chronic Care Model and applied deductive thematic cross-case analysis. We included five general practices located in rural areas in Switzerland, with nurse practitioners in two general practices. A total of 34 patients and 26 health professionals were included. The Enhancing the QUAlity and Transparency Of health Research (EQUATOR) reporting standards for organizational case studies were used. Results: Similarities were that chronically ill patients valued to be perceived as a whole person; guidelines for multimorbidity and reimbursement of relevant services such as coordination were limited. Differences in general practices with nurse practitioners were unclear role allocation, criteria for patient referral were missing and interprofessional teams were in an extended process of change. Nurse practitioners provided a bridge between the general practices and local home healthcare organizations, thereby, strengthening interface management and obtaining a more comprehensive nursing perspective. Conclusion: This study highlights that new models of care can better respond to patients' needs as additional nursing skills are available. Interprofessional teams undergo substantial changes in the new care model requiring a revision of existing structures. [ABSTRACT FROM AUTHOR]

Copyright of HeilberufeSCIENCE is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Children's exposure to intimate partner violence (IPV) is a form of child abuse and can have serious detrimental consequences on their health and well-being. Research has shown that a strong relationship with a caring adult, often the mother, is a protective factor against those consequences. For this reason, this study attempts to understand the overall experiences of victimized mothers with perpetrators, professionals, and institutions in the years following IPV disclosure. Methods: We conducted 20 semi-structured individual interviews in Switzerland in 2020 with former patients who had been provided with a clinical forensic consultation between 2011 and 2014. The participants had reported IPV between 2011 and 2014 and had at least one minor child at the time. Results: Victimized mothers continued to experience harmful behaviors from perpetrators/fathers after IPV disclosure. They reported feeling in danger and that the perpetrators/fathers benefited from a certain level of impunity. In parallel, the mothers were held accountable for the safety and well-being of their children in this context. These overall and multi-year experiences had short-term and long-term negative impacts on the mothers' and children's health, financial and administrative situation, relationship, and on school life. In this sample, the years following IPV disclosure were characterized by an enduring sense of ordeal. Conclusions: The professional and institutional handling of IPV situations, in relation to both victims and perpetrators, can endanger victimized mothers and their children and put them at risk of adverse consequences after IPV disclosure. Avenues for change to better protect mother and child and to provide relief to the mothers as an important protective factor for their children are discussed. [ABSTRACT FROM AUTHOR]

Copyright of ProCare is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

"Flavescence dorée" (FD) is a quarantine grapevine disease associated with FD phytoplasmas (FDp). In Switzerland, FD was identified in 2004 in the southernmost part of Canton Ticino (TI) and then rapidly propagated throughout the entire regional winegrowing area despite the mandatory control measures. The reported widespread distribution of gone-wild grapevines (GWGV) in TI raised the hypothesis of a potential role of GWGV as an FDp reservoir and as a habitat for FDp vectors. To test this assumption, GWGV and FDp vectors were sampled in 13 plots to attest their infection status and compare the FDp genetic profiles. The primary (Scaphoideus titanus) and best-candidate alternative (Orientus ishidae) vectors were collected throughout the season and were found in moderate to high abundance in all the study area. The infection rate of both GWGV and S. titanus followed the historical gradient of S. titanus arrival and dispersal in TI with a clear geographic distinction between the southern and northern part of TI. Interestingly, the rate measured for S. titanus was similar to that observed in highly FD-infested cultivated vineyards. Moreover, the genetic profiles of the infected GWGV and S. titanus samples were identical to those commonly observed in cultivated vineyards (map M54). Importantly, four specimens of O. ishidae were also found harboring the same genotype. This study emphasizes the importance of GWGV (and abandoned vineyards) and alternative vectors for the FD epidemics in FD-infested regions, as well as a potential origin for FD outbreaks in areas currently designated as FDp-free. [ABSTRACT FROM AUTHOR]

Background: Collaborations are an essential element of scientific activity and particularly important in fields such as pediatric anesthesiology, where the evidence base in general is relatively limited. A recent scientometric analysis revealed a geographic diversification of publication activity in pediatric anesthesiology within the last two decades, accompanied by a surge in international collaborations. Objectives: Given the hypothesis of a similar growth in the activity and dynamics of publications in pediatric anesthesiology, the objective of this scientometric study was to analyze the publication activity and collaboration habits in research in pediatric anesthesiology from Germany, Austria and Switzerland (D-A-CH). Method: This secondary analysis identified all publications on pediatric anesthesiology with an affiliation from the D‑A-CH countries between 2001 and 2020 from PubMed and Web of Science. The query parameters included the timeframe 2001–2020, authors' affiliations tied to anesthesiology departments (using various forms of the term "anesthesia"), and the mention of pediatric interest in titles or abstracts. The data underwent standardization to account for linguistic variations. The publications were assigned to a state, city and institution based on the correspondence address, to a year based on the publication date and to a source based on the journal. The primary endpoint was publication activity and dynamics, represented by the number of publications and the respective growth rates (calculated as the linear regression slope). Secondary endpoints included the share of collaborations within and outside the D‑A-CH region (at the country and institutional level), the distribution of publication activity and the most prominent sources of publications. Results: Between 2001 and 2020 a total of 3406 publications on pediatric anesthesiology involving authors from the D‑A-CH countries were identified. Of these 2807 (82.4%) had a correspondence address in D‑A-CH. The average annual growth rate of publications with a correspondence address was + 2.9% for the D‑A-CH countries and + 7.7% for publications with collaborations. The number of publications in which an institution from D‑A-CH was named as a coauthor from a correspondence address outside D‑A-CH also increased by an average of 7.4% per year during the study period. The majority of collaborations occurred between institutions within the D‑A-CH region, although Swiss institutions exhibited a much higher proportion of collaborations outside the region. Of all publications with a correspondence address 90% originated from 46 cities. The most prominent source was Die Anästhesiologie for publications from Germany, and Pediatric Anesthesia for publications from Austria and Switzerland. Conclusion: The number of publications in pediatric anesthesiology from the D‑A-CH countries has increased over the past two decades, accompanied by a surge in collaborations. It is hoped that increased collaboration will contribute to a higher level of evidence in pediatric anesthesiology care. [ABSTRACT FROM AUTHOR]

This study aims to provide a national overview of procedural sedation and analgesia practices within Pediatric Emergency Departments in Switzerland, focusing on the availability of pharmacologic agents, the presence of safety protocols, the utilization of non-pharmacological interventions, and to identify specific local limitations. We conducted a detailed subgroup analysis of Swiss data from a European cross-sectional survey on emergency department pediatric Procedural Sedation and Analgesia (PSA) practice, isolating data from Swiss sites. The survey, conducted between November 2019 and March 2020, covered various aspects of procedural sedation and analgesia practices. The survey included nine Swiss sites, treating a total of 252,786 patients in 2019. Topical analgesia, inhaled equimolar nitrous oxide-oxygen mixture, and ketamine were largely available. All sites had nurse-directed triage protocols in place; however, opioid administration was included in the protocols in only 66% of sites. Only 33% of hospitals reported common use of intravenous sedation. Barriers to procedural sedation and analgesia implementation included staffing shortages (89% of sites) and lack of dedicated spaces (78%). Conclusions: Despite a broad array of pharmacological and options available in Swiss Pediatric Emergency Departments, challenges remain in standardizing practices across the country. Limited space and staffing and enhancing training on non-pharmacological interventions were identified as potential areas for improving pain and anxiety management in pediatric emergency care. This study underscores the need for national guidelines to harmonize emergency department PSA practices across Switzerland, ensuring all children have access to effective and evidence-based procedural comfort. What is Known: • Recent research, conducted in European emergency departments, suggests that in pediatric Procedural Sedation and Analgesia (PSA) resources are limited, and practice is heterogeneous What is New: • Swiss pediatric hospitals offer a wide range of pharmacological options for pain and anxiety management. However, significant barriers to PSA were identified. These include external control of intravenous sedation and insufficient integration of non-pharmacological interventions, such as child life specialists and procedural hypnosis. National guidelines are needed to harmonize PSA practices [ABSTRACT FROM AUTHOR]

Copyright of Die Radiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lamanema chavezi is an entero-hepatic strongylid parasite specific to South American camelids. It has been reported only on few occasions outside South America. Due to its hepatic migration, it can cause extensive liver damage, leading to granulomatous and fibrotic hepatitis and manifesting with lethargy, anorexia, and even death. We are reporting the second case of L. chavezi infection in Europe and the first in Switzerland. The patient was a three-year old neutered male llama (Lama glama). Clinical examination revealed bloody mucous discharge from the anus. Fecal sedimentation/flotation revealed strongylid eggs consistent with L. chavezi, which were molecularly confirmed by a PCR targeting the ITS2 plus 5.8S and 28S rDNA flanking regions and amplicon sequencing. Eighteen weeks after administration of a single dose of eprinomectin (0.2 mg/kg i.m.), no further L. chavezi eggs were detected in the feces. The source of infection could not be traced back. The entire herd consisted of llamas bred in Switzerland. L. chavezi has been rarely reported outside South America, but its potential for pathogenicity and establishment should not be underestimated. Fecal sedimentation/flotation techniques should be routinely performed to ensure early detection of the parasite. [ABSTRACT FROM AUTHOR]

Purpose: Children with congenital heart disease (CHD) from low- to middle-income countries (LMIC) are suspected to have a high prevalence of antibiotic-resistant microorganisms (ARMOs) carriage, but data are currently lacking. Carriage of ARMOs could impact the post-operative course in pediatric intensive care unit (PICU). The aim of the study was to assess the prevalence of ARMOs carriage in children with CHD from LMIC and its impact on post-operative outcomes. Methods: This was a retrospective monocentric study from 01/2019 to 12/2022. Included patients were children (0–18 years) from a LMIC admitted after CHD surgery and with AMRO screening performed the week before. Infections and post-operative evolution were compared based on ARMOs carriage status. Findings: Among 224 surgeries (median age 38.5 months (IQR 22–85.5)), ARMOs carriage was evidenced in 95 cases (42.4%). Main organisms isolated were Extended Spectrum Beta-Lactamase (ESBL) producing E. coli (75/224) 33.5%)) and ESBL-K. pneumoniae (30/224) 13.4%)). Median mechanical ventilation duration was 1 day (IQR 0–1), PICU stay 3 days (IQR 2–4) and hospital stay 6.5 days (IQR 5–10). A total of 17 infectious episodes occurred in 15 patients, mostly consisting in hospital-acquired pneumonia (HAP) (12/17). Only two infections were caused by a colonizing ARMO. Occurrence of infections and patients' outcome were similar between ARMO carriers and non-carriers. Higher use of carbapenems (6 (6.3%) vs 1 (0.8%), p = 0.04) and a trend to a higher use of vancomycin (14 (13.7%) vs 9 (6.9%), p = 0.04) in case of ARMOs carriage. Applying current guidelines, negative swab screening could have led to sparing most of empirical vancomycin therapy (11/12) for HAP based on current guidelines. Conclusion: Prevalence of AMROs carriage is high in children from LMIC and has a limited impact on patients' outcome. However, ARMOs carriage leads to higher consumption of antibiotics. Screening may help saving use of broad-spectrum antibiotic in non-carrier patients. [ABSTRACT FROM AUTHOR]

Background: Previous retrospective research has shown that maintaining prone positioning (PP) for an average of 40 h is associated with an increase of survival rates in intubated patients with COVID-19-related acute respiratory distress syndrome (ARDS). This study aims to determine whether a cumulative PP duration of more than 32 h during the first 2 days of intensive care unit (ICU) admission is associated with increased survival compared to a cumulative PP duration of 32 h or less. Methods: This study is an ancillary analysis from a previous large international observational study involving intubated patients placed in PP in the first 48 h of ICU admission in 149 ICUs across France, Belgium and Switzerland. Given that PP is recommended for a 16-h daily duration, intensive PP was defined as a cumulated duration of more than 32 h during the first 48 h, whereas standard PP was defined as a duration equal to or less than 32 h. Patients were followed-up for 90 days. The primary outcome was mortality at day 60. An Inverse Probability Censoring Weighting (IPCW) Cox model including a target emulation trial method was used to analyze the data. Results: Out of 2137 intubated patients, 753 were placed in PP during the first 48 h of ICU admission. The intensive PP group (n = 79) had a median PP duration of 36 h, while standard PP group (n = 674) had a median of 16 h during the first 48 h. Sixty-day mortality rate in the intensive PP group was 39.2% compared to 38.7% in the standard PP group (p = 0.93). Twenty-eight-day and 90-day mortality as well as the ventilator-free days until day 28 were similar in both groups. After IPCW, there was no significant difference in mortality at day 60 between the two-study groups (HR 0.95 [0.52–1.74], p = 0.87 and HR 1.1 [0.77–1.57], p = 0.61 in complete case analysis or in multiple imputation analysis, respectively). Conclusions: This secondary analysis of a large multicenter European cohort of intubated patients with ARDS due to COVID-19 found that intensive PP during the first 48 h did not provide a survival benefit compared to standard PP. [ABSTRACT FROM AUTHOR]

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent neurological disorder, but its diagnosis remains challenging. Dual-task (DT) walking performance is a reliable indicator of iNPH but less is known about the role of cognitive reserve (CR) in predicting DT walking performance. Aims: The objective of this study was to evaluate the contribution of CR on DT walking in healthy controls (HC) and in iNPH patients (iNPH-P). Methods: 68 iNPH-P (77.2 +/- 6.7 years old) and 28 HC (74.5 +/- 5.7 years old) were evaluated on their single-task walking (Vsimple) and on 4 DT walking (walking and counting or counting backwards, naming animals, naming words beginning with the letter P) (Vcount, VcountB, Vanimals and Vletter respectively). The contribution of CR on the different DT walking speeds was compared between HC and iNPH-P. In iNPH-P, the contribution of CR on the walking speeds was compared with regard to other cognitive, functional, and socio-demographic variables. Results: Simple linear regression demonstrated a moderate influence of CR on single and DT walking speed in iNPH-P (β > 0.3, p <.001) but not in HC where the relation was not significant. In iNPH-P, results showed that CR played a major role in explaining each of the single and DT walking speeds with NPH-scale. Conclusion: As CR could be improved through the life cycle, these results support the idea of developing and supporting physical activity programs that will enrich social, physical, and cognitive resources to protect against age-related functional decline, especially in iNPH-P patients where the age-related deficits are greater. [ABSTRACT FROM AUTHOR]

X-rays have been observed in natural downward cloud-to-ground lightning for over 20 years and in rocket-triggered lightning for slightly less. In both cases, this energetic radiation has been detected during the stepped and dart leader phases of downward negative flashes. More recently, X-rays have also been reported during the dart leader phase of upward negative flashes. In this study, we present the observations of four upward positive lightning flashes from the Säntis Tower (2.5 km ASL) in Switzerland. These consist of the simultaneous records of electric current passing through the tower, and electric field strength and X-ray flux 20 m from the tower base. One of the flashes was captured by a high-speed camera operating at 24,000 frames per second, stills from which are also presented. We detected X-rays during the initial phase of upward negative leader propagation, which can be associated with the leader-stepping process from electric field and current waveforms. To the best of our knowledge, this is the first time that such measurements are reported in the literature. The obtained time-synchronised data confirm that the X-ray emissions detected are associated with the initial steps of the upward negative leader. The frequency and energy of X-ray pulses appear to decrease as functions of time, with pulses disappearing altogether within the first millisecond of the leader initiation. X-ray emission also appears to be correlated with the maximum current-derivative and the electric field change of leader steps, consistent with cold electron runaway. These observations contribute to improving our understanding of upward lightning, which is a primary source of damage to tall structures such as wind turbines and telecommunications towers, as well as aircraft during takeoff and landing. [ABSTRACT FROM AUTHOR]

While activating RET fusions are identified in various cancers, lung cancer represents the most common RET fusion-positive tumor. The clinical drug development of RET inhibitors in RET fusion-positive lung cancers naturally began after RET fusions were first identified in patient tumor samples in 2011, and thereafter paralleled drug development in RET fusion-positive thyroid cancers. Multikinase inhibitors were initially tested with limited efficacy and substantial toxicity. RET inhibitors were then designed with improved selectivity, central nervous system penetrance, and activity against RET fusions and most RET mutations, including resistance mutations. Owing their success to these rationally designed features, the first-generation selective RET tyrosine kinase inhibitors (TKIs) had higher response rates, more durable disease control, and an improved safety profile compared to the multikinase inhibitors. This led to lung and thyroid cancer, and later tumor-agnostic regulatory approvals. While next-generation RET TKIs were designed to abrogate uncommon on-target (e.g., solvent front mutation) resistance to selpercatinib and pralsetinib, many of these drugs lacked the selectivity of the first-generation TKIs, raising the question of what the future holds for drug development in RET-dependent cancers. [ABSTRACT FROM AUTHOR]

Switzerland is an ichthyosaur country: it has a rich record of marine reptile fossils, particularly the fish-shaped ichthyosaurs, and the according research. Here, we provide an overview over the 12 or more genera and at least 13 species plus numerous fragmentary remains of ichthyosaurs from the Triassic to the Cretaceous that have been discovered in twelve cantons thus far, of which four species are based on Swiss holotypes. This wealth of ichthyosaur species can be explained by their abundance in the Middle Triassic conservation deposits (Konservat Lagerstätte) of Monte San Giorgio, as well as occasional discoveries in strata of Middle Triassic to Early Cretaceous age. The moderate abundance of outcrops in reasonable conditions in combination with the long history of palaeontological research in Switzerland explains this good fossil record. In addition to this unique overview, we provide more data for further studies and update the knowledge of these taxa. [ABSTRACT FROM AUTHOR]

Summary: This multicentre, prospective cohort study measured the effect of romosozumab for 12 months on bone mineral density, taking into account prior therapies. Prior antiresorptive therapy blunted the BMD response to romosozumab, and the duration was correlated with BMD changes at both the lumbar spine and total hip. Introduction: In Switzerland, romosozumab is administered to high-risk osteoporosis patients. Our study aimed to assess the effect of romosozumab on bone mineral density (BMD), taking into account prior therapies. Methods: This multicentre, prospective cohort study measured the effect of romosozumab for 12 months in patients in a nationwide Swiss osteoporosis registry. BMD and bone turnover marker (P1NP and CTX) changes were measured and compared between pre-treated and treatment naïve patients. Results: Ninety-nine patients (92 women and 7 men, median age 71 years [65, 76]) were enrolled from January 2021 to December 2023. Among them, 22 had no prior treatment before romosozumab, while 77 had previous therapy (including 23 with a history of prior teriparatide therapy), with a median duration of 6 years [4, 11] of cumulative antiresorptive treatment. Over 12 months, romosozumab led to BMD changes of 10.3% [7.5, 15.5] at the lumbar spine, 3.1% [1.1, 5.8] at the total hip and 3.1% [0.5, 5.3] at the femoral neck, indicating notable variability. Significantly lower BMD responses were observed in pre-treated patients, with the duration of prior antiresorptive therapy inversely associated with BMD increases at the lumbar spine and hip. Other predictors of BMD changes at the total hip included baseline T-scores at the hip, body mass index and baseline CTX level, while the BMD response at the lumbar spine was associated with the lumbar spine T-score at baseline, age and baseline CTX level. Conclusion: Prior antiresorptive therapy blunted the BMD response to romosozumab, and the duration was correlated with BMD changes at both the lumbar spine and total hip. [ABSTRACT FROM AUTHOR]

The study aims to describe couples' changes in sexuality after non-metastatic breast cancer from a longitudinal perspective. Our research question was: how do couples experience the cancer-induced change in sexual frequency and what are the reasons evoked to explain this kind of change over time? Forty heterosexual couples participated in a semi-structured interview three months and two years after surgery. A reflexive thematic analysis was conducted on a specific question about sexuality from a larger interview guide. The results showed that couples follow multiple trajectories regarding sexuality after the onset of oncological treatment. Most couples experienced temporary or more lasting changes, mainly associated with altered body image and pain. Some stopped having sexual activities at the beginning of treatment but resumed sexuality two years later; others were unable to restore sexuality. However, some couples stayed sexually active all along the cancer journey, showing that cessation of any sexual activity is not inevitable. Sexuality represents a significant long-term issue for breast cancer survivors and their partners. Prompt treatment can prevent sexual difficulties from crystallizing, while preserving the individual well-being and the quality of the couple's relationship. Health professionals should be aware of the need to screen early for sexual changes, while reevaluating the couple's situation regularly during care. [ABSTRACT FROM AUTHOR]

The educational outcomes of the descendants of migrants are important indicators of migrants' incorporation into host societies and an indicator of intergenerational social im/mobility. This paper examines this relationship using data from a survey that follows a cohort of young adults, born between 1988 and 1997, who grew up in Switzerland. It looks at the relationship between the educational output of respondents and their parental migratory background, with the theoretical consideration that the family's social capital is a starting point in the descendants' trajectories. The paper is based on secondary data and exploratory cross-sectional quantitative analyses. The results highlight first a correspondence between migrant parents' national origins and their socio-economic status—in other words, an 'ethno-class'. Second, they show differences in educational outcomes between migrants' descendants and native Swiss as well as between the migrants' descendants themselves—which indicates a segmented incorporation process for both the first and the second generation, in confirmation of previous research. Third, results show that parental background and language region of residence are statistically significant in determining the level of education achieved by the migrants' descendants, especially those with a low socio-economic status. Their social mobility is 'limited', and they remain mostly in vocational education. The paper concludes that the Swiss school system still fails to include the most unprivileged and that a glass ceiling remains for them. [ABSTRACT FROM AUTHOR]

Evidence shows that during birth women frequently experience unconsented care, coercion, and a loss of autonomy. For many countries, this contradicts both the law and medical ethics guidelines, which emphasize that competent and fully informed women's autonomy must always be respected. To better understand this discordance, we empirically describe perinatal maternity care providers' and women's moral deliberation surrounding coercive measures during birth. Data were obtained from 1-on-1 interviews with providers (N = 15) and women (N = 14), and a survey of women (N = 118). Analyses focused on an in-depth exploration of responses to a question on the permissibility of coercion in birth whose wording was borrowed from a Swiss medical-ethical guideline. Reasons for and against a principle permissibility of coercive measures in birth were grouped into clusters of reasons to build a coherent explanatory framework. Factors considered morally relevant when deliberating on coercion included women's decisional capacity, beneficence/non-maleficence, authority through knowledge on the part of providers, flaws of the medical system, or the imperative to protect the most vulnerable. Also, we identified various misconceptions, such as the conviction that a pathological birth can justify coercion or that fetal rights can justifiably infringe on women's autonomy. Information and education on the issue of coercion in birth are urgently needed to enable women to fully exercise their reproductive autonomy, to prevent long-term adverse health outcomes of women and children, and to reconcile the medical vigilance which has lead to a reduction of perinatal morbidity and mortality with women's enfranchisement in their own care. [ABSTRACT FROM AUTHOR]

The judiciary is a foundation of democracy, upholding the rule of law and protecting rights. Efficient court administration is vital for public trust, justice, and timely proceedings. Currently, courts face challenges such as inconsistencies, adjournments, and absence of transparency, undermining the justice system. Traditional manual processes and paper-based documentation cause significant backlogs, slow resolutions, and limited public access. As case volumes and complexities rise, modernizing court administration through digital transformation is progressively critical. Currently, many countries are integrating technologies in the courts for its administration and other activities. In recent years, courts and judges have been subjected to pressure to improve performance, uplifting judicial effectiveness to a top priority. Subsequently, several countries have integrated simplification and digitization strategies in judicial initiatives to enhance court efficiency. Switzerland's Justitia 4.0 and Brazil's PJE are notable initiatives that focused to strengthen court administration through digitalization. These aspects motivated this study to examine the detailed integration of industry 4.0 technologies such as the Internet of things, cloud computing, blockchain, big data analytics, robotics, drones, Metaverse, digital twins, and artificial intelligence for court administration with digitalized infrastructure. According to the study, integrating these technologies in less complex cases helps minimize expenditures and save time, making to resolve cases conveniently, efficiently, and superiorly. The study also identified the challenges and issues associated with industry 4.0 technologies such as evidence gathering, evidence preservation, robot judges for pre-judgment analysis, and judgment delivery, which future studies need to be explored. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between pre-pandemic objective and subjective cognitive functioning and sustained Internet use during the pandemic among older adults in Switzerland. Data from 1299 respondents of the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2019/2020 and a supplementary technology use questionnaire during the pandemic in 2021 were used. Cognitive functioning was assessed in 2019/2020 through objective measures (delayed and immediate memory, verbal fluency) and self-rated memory. Sustained Internet use was defined as having used the Internet at least once in the past seven days in 2019/2020 and reporting daily or weekly use in 2021. We found that 73.1% of respondents consistently used Internet between 2019/2020 and 2021. Using multivariable probit regression models controlling for sociodemographic and health variables, we found that higher global cognition z-scores, especially in immediate and delayed memory, were associated with a higher likelihood of sustained Internet use. Additionally, respondents with good, very good, or excellent self-rated memory were more likely to sustain their Internet use. These findings highlight the potential critical role of cognitive health in shaping older adults' digital engagement, suggesting that cognitive assessments and training should be further considered in digital literacy initiatives for this population. [ABSTRACT FROM AUTHOR]

Growing evidence suggests that experiences with police are associated with a range of negative mental health problems among youth. This study examined the impact of negative police contact on changes in adolescent internalizing problems, measured by anxiety and depression. Six waves of data from a longitudinal study in Zurich, Switzerland were used in order to assess the direct relations between first reported police contact in the years prior to the survey moment and internalizing problems at the time of the survey and follow-up waves. The sample consists of a cohort of youth (max n = 1353, 49.4% females) spanning ages 11 to 24 (mean age and SD at each wave = 11.32 (0.37), 13.67 (0.36), 15.44 (0.36), 17.45 (0.37), 20.58 (0.38), 24.46 (0.38)). Specifically, difference-in-differences techniques for multiple time periods were employed to assess the average treatment effects for the treated population (first contact with police) compared to those who were never treated (never had contact). Across all models, police contact did not lead to an increase in internalizing problems. These results diverge from previous studies mostly conducted in the United States, and possible explanations including differences in historical contexts of policing, juvenile justice, health care, and dosage of intrusive contacts are discussed. [ABSTRACT FROM AUTHOR]

Purpose: With dairy products and fish being major sources of iodine in Switzerland, the growing popularity of plant-based alternatives may impact iodine nutrition. This study aimed to assess the iodine content in plant-based dairy and fish alternatives available in the Swiss market and compare them with conventional products. Methods: In 2022, a market survey was conducted in Zurich, Switzerland, to identify the plant-based dairy and fish alternatives available and assess their iodine content. To evaluate the impact of plant-based alternatives on iodine consumption in Switzerland, we modeled dietary scenarios by substituting the intake of dairy and fish items with plant-based alternatives. In addition, we investigated fortification with calcium, vitamins B2, B12, and D. Results: Out of 477 identified products, only four milk-alternative products were iodine fortified (median iodine concentration: 22.5 μg/100 ml). The median iodine concentration in unfortified plant-based alternatives was negligible compared to conventional dairy and fish products (milk: 0.21 vs 9.5 μg/100 ml; yogurt 0.36 vs 6.1 μg/100 g; cheese: 0.10 vs 20 μg/100 g; fish 0.50 vs 44 μg/100 g). Three portions of dairy per day as recommended by the Swiss Food Pyramid provide 25% of the RDA for iodine (150 μg/day), whereas substituting those with unfortified alternatives provides only 0.7% of the RDA. Conclusion: Only four out of 477 plant-based alternative products are iodine fortified in the Swiss market. Thus, the risk for consumers to miss out on the ca. 25% of the RDA for iodine by consuming plant-based alternatives is high, placing them at a risk for inadequate iodine intake. [ABSTRACT FROM AUTHOR]

Importance and objective: Self-reported caffeine consumption has been widely used in research while it may be subject to bias. We sought to investigate the associations between self-reported caffeine consumption and plasma levels of caffeine and its two main metabolites (paraxanthine and theophylline) in the community. Methods: Data from two population-based studies (SKIPOGH1 and 2 (N = 1246) and CoLaus|PsyCoLaus (N = 4461)) conducted in Switzerland were used. Self-reported caffeine consumption was assessed using questionnaires. Plasma levels of caffeine and its metabolites were quantified by ultra-high performance liquid chromatography coupled to a tandem quadrupole mass spectrometer. Results: In both studies, mean log plasma levels of caffeine and its two metabolites were over 6.48 (plasma levels = 652 ng/ml) when no caffeine consumption was reported. Subsequently, nonlinear associations between log plasma levels and self-reported caffeine consumption were observed in SKIPOGH, with a change of the slope at 3–5 cups of espresso per day in SKIPOGH1 but not SKIPOGH2. In CoLaus|PsyCoLaus, increased daily consumption of caffeinated beverages was associated with increased log plasma levels with a change of the slope at 3 cups. In both studies, declared caffeine consumption higher than 3–5 cups per day was not associated with higher plasma levels of caffeine and its metabolites. Conclusion: Self-reports of no or low caffeine consumption and consumption of more than 3–5 cups of coffee should be interpreted with caution, with possible under- or over-estimation. Quantifying plasma levels of caffeine and its metabolites may contribute to a better estimation of caffeine intake. [ABSTRACT FROM AUTHOR]

Background: Self-rated health is a subjective yet valuable indicator of overall health status, influenced by various factors including physical, psychological, and socio-economic elements. Self-rated health could be telling and used by primary care physicians to evaluate overall present and predictive health. Design: This study investigates the longitudinal evolution of self-rated health in Switzerland during the COVID-19 pandemic, focusing on the association of persistently favorable self-rated health with various predictors. Participants: This study based on the Specchio cohort, a population-based digital study in Geneva Switzerland, involved participants completing questionnaires from 2021 to 2023. Main Measures: Self-rated health was assessed alongside factors like physical and mental health, socio-economic status, and lifestyle behaviors. Key Results: The study included 7006 participants in 2021, and 3888 participants who answered all three follow-ups (2021, 2022, and 2023). At baseline, 34.9% of individuals reported very good, 54.6% reported good, 9.6% reported average, and 1.0% reported poor to very poor self-rated health. Overall, 29.1% had a worsening in their self-rated health between 2021 and 2023. A subset of participants (12.1%) maintained very good self-rated health throughout, demonstrating persistently favorable self-rated health during the COVID-19 pandemic. Positive health behaviors were associated with persistently favorable self-rated health (exercise aOR 1.13 [1.03–1.24]; healthy diet aOR 2.14 [1.70–2.68]; less screen time aOR 1.28 [1.03–1.58]; and better sleep quality aOR 2.48 [2.02–3.04]). Mental health and social support also played significant roles. Conclusion: The study underscores the significance of healthy lifestyle choices and social support in maintaining favorable self-rated health, particularly during challenging times like the COVID-19 pandemic. Primary care physicians should focus on promoting these factors, integrating these actions in their routine consultations, and advising patients to undertake in socially engaging activities to improve overall health perceptions and outcomes. [ABSTRACT FROM AUTHOR]

In response to extreme conditions, government endowed with extraordinary powers in the form of a state of exception, released from the norms of a rule of law legal order, has been accepted as a modern political institution with an essential role in safeguarding democracy. It is only then, that a democratic government may achieve effective measures necessary to best address the extremities unfolding. The lack of public law theory legitimizing such an institution, alongside the heavy reliance on the medieval principle necessitas legem non habet as the institution's theoretic premise, prompt contemporary theorist Giorgio Agamben to question the role of the state of exception within modern democracy. This paper will first present how Agamben grounds the state of exception to the concept of necessity, tracing the theory of necessity to its apparent European origin, in the writings of Gratian and Thomas Aquinas. Then, this paper will focus on divergent interpretations of necessity drawn from the halls of the Swiss Federal Palace, whilst discussing the fate of recent state of exceptions. These divergent interpretations of necessity, namely by Ernest Paul Graber and Robert Grimm, both historic members of the Swiss Federal Assembly, indicate how necessity may be interpreted in different ways. Finally, this paper will question the extent to which this parallel relationship, between the state of exception and the concept of necessity, may undermine a democratic rule of law legal order. [ABSTRACT FROM AUTHOR]

Purpose: The massive increase of infections with Group A Streptococcus (GAS) in 2022–2023 coincided in Switzerland with a change of the recommendations for the management of GAS pharyngitis. Therefore, the objective of the present study was to investigate whether the clinical manifestations and management before hospitalization for GAS infection differed in 2022–2023 compared with 2013–2022. Methods: Retrospective study of GAS infections requiring hospitalization in patients below 16 years. Preadmission illness (modified McIsaac score), oral antibiotic use, and outcome in 2022–2023 were compared with 2013–2022. Time series were compared with surveillance data for respiratory viruses. Results: In 2022–2023, the median modified McIsaac score was lower (2 [IQR 2–3] vs. 3 [IQR 2–4], p = < 0.0001) and the duration of preadmission illness was longer (4 days [3–7] vs. 3 [2–6], p = 0.004) than in 2013–2022. In both periods, withholding of preadmission oral antibiotics despite a modified McIsaac score ≥ 3 (12% vs. 18%, n.s.) or ≥ 4 (2.4% vs. 10.0%, p = 0.027) was rare. Respiratory disease, skeletal/muscle infection, and invasive GAS disease were significantly more frequent in 2022–2023, but there were no differences in clinical outcome. The time course of GAS cases in 2022–2023 coincided with the activity of influenza A/B. Conclusion: We found no evidence supporting the hypothesis that the 2022–2023 GAS outbreak was associated with a change in preadmission management possibly induced by the new recommendation for GAS pharyngitis. However, clinical manifestations before admission and comparative examination of time-series strongly suggest that viral co-circulation played an important role in this outbreak. [ABSTRACT FROM AUTHOR]

Purpose: Outpatient parenteral antimicrobial therapy (OPAT) is a standard for antimicrobial therapy internationally. With this prospective cohort study, we aimed to assess the impact of an OPAT service as part of antimicrobial stewardship (AMS) and evaluate the safety and efficiency of the program while illuminating the financial benefit for the hospital. Methods: Socio-demographic data, treatment regimen and outcomes were prospectively recorded for all patients assigned to the program of the OPAT unit of the University Hospital of Zurich between November 2018 and September 2022. Results: In total, we recorded 303 OPAT assignments of which 260 resulted in effective OPAT episodes. The 260 OPAT episodes were further optimized toward the choice of antimicrobial agent (n = 18) and length of therapy (n = 6). Moreover, OPAT resulted in alteration of patient assessment and care led by AMS strategies in 247 of 260 episodes (95%). While the bed days saved per year increased consistently with time, a total of 3934 in-hospital treatment days were saved amounting to a cost saving of 9,835,000 CHF over 47 months. Adverse events were recorded in 46 cases whilst only two of these have been the reason for readmission during OPAT treatment. Clinical cure was noted in 77% (199/260) and was negatively associated with Charlson Comorbidity Index (CCI; OR per 1 unit higher 0.85 (95% CI 0.78–0.93)). Conclusion: This study demonstrates the impact of an OPAT service in the framework of AMS as well as its benefits for the hospital whilst preserving safety and efficacy for the patient's parenteral antimicrobial treatment. [ABSTRACT FROM AUTHOR]

Purpose: The Covid-19 pandemic may have encouraged at-risk patients to get vaccinated against influenza for the first time. As previous vaccinations are known predictors for further vaccinations, knowledge about individual vaccination patterns, especially in first time vaccinated patients, is of great interest. The aim of this study was to determine influenza vaccination uptake rate (VUR), individual vaccination patterns and factors associated with vaccination uptake among at-risk patients. Methods: The study design was retrospective cross-sectional. Based on claims data, VUR was determined for four influenza seasons (2018/2019—2021/2022). In a cohort subgroup, with data available for all seasons, VUR, vaccination patterns and factors associated with uptake were determined. At-risk patients were people aged ≥ 65 and adult patients with chronic diseases. Results: We included n = 238,461 patients in the cross-sectional analysis. Overall VUR ranged between 21.8% (2018/2019) and 29.1% (2020/2021). Cohort subgroup consisted of n = 138,526 patients. Within the cohort, 56% were never vaccinated and 11% were vaccinated in all seasons. 14.3% of previously unvaccinated patients were vaccinated for the first time in the first pandemic season (2020/2021 season). The strongest predictor for vaccination was history of vaccinations in all previous seasons (OR 56.20, 95%CI 53.62–58.90, p < 0.001). Conclusion: Influenza VUR increased during the Covid-19 pandemic, but only a minority of previously eligible but unvaccinated at-risk patients were vaccinated for the first time in the first pandemic season. Previous vaccinations are predictors for subsequent vaccinations and health care professionals should actively address at-risk patients' vaccination history in order to recommend vaccination in future seasons. [ABSTRACT FROM AUTHOR]

Purpose: For primary and secondary liver tumors oncological resection remains a chance of cure. Augmentation of functional liver tissue may be necessary to preserve sufficient future liver remnant (FLR). Clinical decision-making on liver augmentation techniques and indications may differ internationally. Thus, this study aims to identify standards of liver augmentation in hepato-pancreatico-biliary (HPB) centers in Germany, Switzerland, and Austria. Methods: Using a web-based survey, 48 hospitals in Germany, Switzerland, and Austria were invited to report their surgical indication, standard procedures, and results of liver augmentation. Results: Forty (83.3%) of the hospitals invited participated. Most of the hospitals were certified liver centers (55%), performing complex surgeries such as liver transplantation (57.5%) and ALPPS (80%). The standard liver augmentation technique in all countries was portal vein embolization (PVE; 56%), followed by ALPPS (32.1%) in Germany or PVE with hepatic vein embolization (33.3%) in Switzerland and Austria. Standard procedure for liver augmentation did not correlate with certification as liver center, performance of liver transplantation or ALPPS. Surgical indication for PVE varied depending on tumor entity. Most hospitals rated the importance of PVE before resection of cholangiocarcinoma or colorectal metastases as high, while PVE for hepatocellular carcinoma was rated as low. Conclusion: The survey gives an overview of the clinical routine in HPB centers in Germany, Austria, and Switzerland. PVE seems to dominate as standard technique to increase the FLR. However, there is a variety in the main indication for liver augmentation. Further studies are necessary evaluating the differing PVE techniques for liver augmentation. [ABSTRACT FROM AUTHOR]

Background: Reliable assessment of fluid responsiveness with pulse pressure variation (PPV) depends on certain ventilation-related preconditions; however, some of these requirements are in contrast with recommendations for protective ventilation. Objective: The aim of this study was to evaluate the applicability of PPV in patients undergoing non-cardiac surgery by retrospectively analyzing intraoperative ventilation data. Material and methods: Intraoperative ventilation data from three large medical centers in Germany and Switzerland from January to December 2018 were extracted from electronic patient records and pseudonymized; 10,334 complete data sets were analyzed with respect to the ventilation parameters set as well as demographic and medical data. Results: In 6.3% of the 3398 included anesthesia records, patients were ventilated with mean tidal volumes (mTV) > 8 ml/kg predicted body weight (PBW). These would qualify for PPV-based hemodynamic assessment, but the majority were ventilated with lower mTVs. In patients who underwent abdominal surgery (75.5% of analyzed cases), mTVs > 8 ml/kg PBW were used in 5.5% of cases, which did not differ between laparoscopic (44.9%) and open (55.1%) approaches. Other obstacles to the use of PPV, such as elevated positive end-expiratory pressure (PEEP) or increased respiratory rate, were also identified. Of all the cases 6.0% were ventilated with a mTV of > 8 ml/kg PBW and a PEEP of 5–10 cmH2O and 0.3% were ventilated with a mTV > 8 ml/kg PBW and a PEEP of > 10 cmH2O. Conclusion: The data suggest that only few patients meet the currently defined TV (of > 8 ml/kg PBW) for assessment of fluid responsiveness using PPV during surgery. [ABSTRACT FROM AUTHOR]

Background: Anastomotic leakage (AL), a severe complication following colorectal surgery, arises from defects at the anastomosis site. This study evaluates the feasibility of predicting AL using machine learning (ML) algorithms based on preoperative data. Methods: We retrospectively analyzed data including 21 predictors from patients undergoing colorectal surgery with bowel anastomosis at four Swiss hospitals. Several ML algorithms were applied for binary classification into AL or non-AL groups, utilizing a five-fold cross-validation strategy with a 90% training and 10% validation split. Additionally, a holdout test set from an external hospital was employed to assess the models' robustness in external validation. Results: Among 1244 patients, 112 (9.0%) suffered from AL. The Random Forest model showed an AUC-ROC of 0.78 (SD: ± 0.01) on the internal test set, which significantly decreased to 0.60 (SD: ± 0.05) on the external holdout test set comprising 198 patients, including 7 (3.5%) with AL. Conversely, the Logistic Regression model demonstrated more consistent AUC-ROC values of 0.69 (SD: ± 0.01) on the internal set and 0.61 (SD: ± 0.05) on the external set. Accuracy measures for Random Forest were 0.82 (SD: ± 0.04) internally and 0.87 (SD: ± 0.08) externally, while Logistic Regression achieved accuracies of 0.81 (SD: ± 0.10) and 0.88 (SD: ± 0.15). F1 Scores for Random Forest moved from 0.58 (SD: ± 0.03) internally to 0.51 (SD: ± 0.03) externally, with Logistic Regression maintaining more stable scores of 0.53 (SD: ± 0.04) and 0.51 (SD: ± 0.02). Conclusion: In this pilot study, we evaluated ML-based prediction models for AL post-colorectal surgery and identified ten patient-related risk factors associated with AL. Highlighting the need for multicenter data, external validation, and larger sample sizes, our findings emphasize the potential of ML in enhancing surgical outcomes and inform future development of a web-based application for broader clinical use. [ABSTRACT FROM AUTHOR]

The Bedretto adit, in the Alps of Switzerland, was excavated in 1972–1982 as an auxiliary adit for the main Furka Base Tunnel. The adit is 5218 m long, being excavated mostly in the Rotondo Granite with drill and blast methods to create a horseshoe cross-section. Much of the tunnel has remained unlined and such long observation periods are seldom available since tunnels typically are lined shortly after construction and mines are often closed or backfilled. Previous research in 2004 characterized the depth of failure (DoF) around the adit and found on average a depth of 1.1 ± 0.03 m. A site investigation was carried out in 2017, aimed to measure the DoF through 3D light detection and ranging scanned sections again. The new 3D scans covered a longer section of the tunnel with each scan, up to 6 m in length, compared to the previous laser scans with a single circumferential pass. The results were compared with the data from 2004 and with empirical and numerical prediction curves for Excavation Damage Zone depths. The findings indicate that between 2004 and 2017, the measured DoF generally extended, on average, by 0.1 m, implying that failure has progressed with time. Furthermore, the analysis showed that the volume of failure from 2004 extended up to 1.9 m3/m, and this volume increased to 3.2 m3/m in 2017 on average. The VoF was used as a means to overcome the challenge of comparing past to present scan results, since the exact location of the 2004 measurements were not known. Significant variations in the measured DoF at sections of the adit near faults and below a glacier indicate that these external factors can significantly influence the rock mass behaviour. When comparing the DoF to empirical excavation damage zone prediction intervals, the level of damage at the Bedretto adit is comparable with the outer excavation damage zone. This is a region of isolated micro-cracking, and it conceptually suggests that the continued spalling in the Bedretto adit is the results of crack propagation from initial excavation induced damage that leads to interaction even after 41 years since excavation works ceased. [ABSTRACT FROM AUTHOR]

Education is a key determinant of wage development. The relationship between education and wages is particularly strong in countries with vocationally oriented educational systems and a clear distinction between general and vocational education, such as Germany and Switzerland. However, whether general and vocational education offer the same returns to education is an ongoing debate. Previous findings from international research are still inconclusive. Against this background and based on theoretical arguments from human capital and signalling theory and the task-specific learning-by-doing approach, our paper examines the long-term wage development of Swiss university and professional education degree holders from the time they obtain their tertiary degree until their late career. It asks how differences between the two groups in wage development may be explained. Our results, produced with regression decomposition methods, show that within the first 20 years after graduation, university degree holders experience steeper wage growth. An important reason for this difference is that university graduates move more often than vocational tertiary degree holders into well-paid labour market positions endowed with formal authority, management responsibility, and a large proportion of cognitive nonroutine tasks. [ABSTRACT FROM AUTHOR]

Background: The Swiss national union of residents and attendings (VSAO) has voiced its desire for a transition from the current 48 h work week to a 42 + 4 h work week, in which 42 h be focused on patient care with the remaining 4 h be dedicated solely to training purposes. This could potentially result in a significant decrease in surgical education time. The current study seeks to address the issues involved in its implementation as well as possible compensatory mechanisms. Methods: This mixed methods study seeks to clearly underline the challenges associated with the implementation of a 42 + 4 h work week. First, the major stakeholders were identified and analysed via umbrella review. Thereafter, a classic stakeholder analysis was performed. Via morphological matrix, possible models for the implementation of a 42 + 4 h work week were developed and evaluated. Finally, representatives from the identified stakeholder groups were interviewed and given the opportunity to provide feedback. Results: A total of 26 articles were identified by the literature search and were used to identify the major stakeholders and issues involved in the implementation of the desired work hour regulation. Overall, these showed conflicting results with regard to the effect decreased working hours would have on surgical training and patient outcomes. In the end, the morphological matrix produced three feasible and desirable models for the implementation of a 42 + 4 h work week. Each included compensatory mechanisms like auxiliary staff, reduction in administrative tasks, and a switch to EPAs. In their interviews, the stakeholders generally supported these solutions. Conclusion: Given the increasing emphasis on the importance of a positive work-life balance, it seems inevitable that the next few years will see the introduction of a 42 + 4 h work week in Switzerland. However, it is imperative that every effort be made to preserve the quality of training and patient care for the next generations. This will require the cooperation of all stakeholders in order to find workable solutions. [ABSTRACT FROM AUTHOR]

Background: Recent data shows a 139.9% global increase in aesthetic procedures since 2011, with a notable 190.5% rise in Germany. This study analyzes the current landscape of plastic surgery in German-speaking European countries, focusing on the range of procedures offered in plastic surgery practices in Germany, Austria and Switzerland. We aimed to provide an overview of the current trends and procedures of plastic surgery in the practice setting in Germany, Austria, and Switzerland. Methods: The information sampled from the websites of n = 511 plastic surgery practices (314 German, 113 Austrian, 84 Swiss) were analyzed with regards to general information, as well as procedures offered on the websites. A set of different procedures, belonging to each pillar of plastic surgery (i.e., Aesthetic, Reconstructive, Hand, Burn surgery) as well as non-surgical aesthetic procedures was analyzed. Results: Aesthetic surgical procedures were offered most often with 98.8% (506) of all websites analyzed, followed by Hand surgery at 29.7% (152), Reconstructive surgery at 27.8% (142) and Burn surgery at 5.7% (29). Reconstructive and Hand surgery were statistically significantly most commonly offered on Austrian plastic surgery websites, with p = 0.011 and p < 0.001, respectively. Among aesthetic surgical procedures, statistically significant regional differences were found for head and neck, body and breast procedures most commonly offered on Swiss plastic surgery with p = 0.041, p = 0.010 and p = 0.003, respectively, while the procedures of the intimate region were most commonly offered on German websites with p = 0.007. Conclusions: Plastic surgery websites in German-speaking European countries predominantly advertise aesthetic surgical procedures, with other domains of plastic surgery such as reconstructive, hand, and burn surgery being less prominent, suggesting an underrepresentation. Regional differences between the countries investigated are evident, underscoring the need for a more balanced approach in plastic surgery care in the practice setting. Level of Evidence: Not gradable [ABSTRACT FROM AUTHOR]

The progress in chemical analytics and understanding of pesticide dynamics in surface waters allows establishing robust data on compounds with frequent exceedances of quality standards. The current chemical, temporal, and spatial coverage of the pesticide monitoring campaigns differs strongly between European countries. A questionnaire revealed differences in monitoring strategies in seven selected European countries; Nordic countries prioritize temporal coverage, while others focus on spatial coverage. Chemical coverage has increased, especially for non-polar classes like synthetic pyrethroids. Sweden combines monitoring data with agricultural practices for derived quantities, while the Netherlands emphasizes spatial coverage to trace contamination sources. None of the EU member states currently has established a process for linking chemical surface water monitoring data with regulatory risk assessment, while Switzerland has recently established a legally defined feedback loop. Due to their design and objectives, most strategies do not capture concentration peaks, especially 2-week composite samples, but also grab samples. Nevertheless, for substances that appear problematic in many data sets, the need for action is evident even without harmonization of monitoring programs. Harmonization would be beneficial, however, for cross-national assessment including risk reduction measures. [ABSTRACT FROM AUTHOR]

The Allalin gabbro of the Zermatt-Saas meta-ophiolite consists of variably metamorphosed Mg- to Fe-Ti-gabbros, troctolites, and anorthosites, which are crosscut by basaltic dykes. Field relationships of the various rock types and petrographic studies together with bulk rock and mineral chemical composition data allow the reconstruction of the complete geological history of the Allalin gabbro. With increasing magmatic differentiation, the incompatible element content in clinopyroxene increases (e.g., REEs and Zr by a factor of 5), whereas the Mg# decreases (from 86.4 to 74.6) as do the compatible element contents (e.g., Cr and Ni by factors of 3.5 and 5, respectively). Exhumation to shallower depths led to subsolidus ductile deformation and cooling of the gabbro followed by the intrusion of fine-grained basaltic dykes, which display chilled margins. Bulk rock data of these dykes reveal strong similarities in fluid-immobile trace element patterns to tholeiitic pillow basalts of the Zermatt-Saas and nearby meta-ophiolites. The recalculated REE patterns of the melt in equilibrium with igneous clinopyroxene is very similar to the REE patterns of the mafic dykes, indicating a cogenetic origin of pillow basalts, dykes, and gabbros. Together with the previously determined Jurassic intrusion age of the gabbro, our observations demonstrate that the Allalin gabbro intruded as a tholeiitic magma in a slow spreading MOR environment of the Piemonte-Ligurian ocean of the Alpine Tethys. Subduction of the Allalin gabbro resulted in different eclogitization extents of the Mg-gabbros as a function of variable hydration degrees. Metagabbros with low extents of hydration record incomplete eclogitization; the magmatic mineralogy (olivine + clinopyroxene + plagioclase) is preserved together with disequilibrium textures in the form of reaction coronae surrounding mineral boundaries. Metagabbros with high extents of hydration are completely eclogitized and display pseudomorphic replacement textures of magmatic minerals by eclogite-facies mineral assemblages, which required significant major to trace element transport across mineral domains. The locally variable extents of hydration took place near the sea floor, as recorded by the presence of Cl-apatite (6.28 wt% Cl), and an increase in B concentrations of minerals pseudomorphically replacing olivine (e.g., chlorite with 0.20–0.31 µg/g B and omphacite with 0.22–0.25 µg/g B) compared to magmatic olivine (0.12–0.16 µg/g B). Moreover, the chemical zonation pattern of metamorphic garnet coronae is different in completely eclogitized gabbros and gabbros with relic igneous minerals, in agreement with a main hydration event prior to subduction. The Allalin gabbro therefore represents a classical example of an oceanic gabbro formed in a slow spreading setting in the mid Jurassic that experienced heterogeneous hydration near the sea floor. Paleogene subduction of the gabbro to 70–80 km depth produced variably equilibrated gabbroic eclogites. In eclogite-facies Mg-gabbros, the water-rich minerals chlorite, talc, and chloritoid pseudomorphing magmatic olivine remained stable to these depths, revealing the potential relevance of hydrated Mg-gabbros as a fluid source at subarc depths in subduction zones. [ABSTRACT FROM AUTHOR]

Cornaux/Les Sauges (Switzerland, Late Iron Age) revealed remnants of a wooden bridge, artifacts, and human and animal skeletal remains. The relationship between the collapsed structure and the skeletal material, whether it indicates a potential accident or cultural practices, remains elusive. We evaluate the most plausible scenario for Cornaux based on osteological, taphonomic, isotopic, and paleogenomic analysis of the recovered individuals. The latter amount to at least 20 individuals, mostly adult males. Perimortem lesions include only blunt force traumas. Radiocarbon data fall between the 3rd and 1st c. BCE, although in some cases predating available dendrochronological estimates from the bridge. Isotopic data highlight five to eight nonlocals. No close genetic relatedness links the analyzed skeletons. Paleogenomic results, the first for Iron Age Switzerland, point to a genetic affinity with other Central and Western European Iron Age groups. The type of skeletal lesions supports an accidental event as the more plausible explanation. Radiocarbon data and the demographic structure of the sample may suggest a sequence of different events possibly including executions and/or sacrifices. Isotopic and paleogenomic data, while not favoring one scenario over the other, do support earlier interpretations of the last centuries BCE in Europe as a dynamic period from a biocultural perspective. [ABSTRACT FROM AUTHOR]

A new species (Marcopoloichthys mirigioliensis) of the stem teleosteomorph genus Marcopoloichthys is described from the lower Besano Formation (late Anisian at Monte San Giorgio, southern Switzerland), making this new species distinct from Marcopoloichthys furreri from the Prosanto Formation (early Ladinian at Ducanfurgga, southeastern Switzerland). Marcopoloichthys mirigioliensis n. sp. is smaller (ca. 32 mm standard length) than M. furreri (ca. 40 mm standard length), and in addition, the two species have some important differences in the caudal endoskeleton and fin, e.g., number of epaxial and hypaxial basal fulcra, uroneural structure, size of hypurals, and presence versus absence of urodermals. Marcopoloichthys mirigioliensis n. sp. is the smallest member of Marcopoloichthyidae which is currently known from at least five species living in the Triassic of China (one species), Italy (two and others that remain undescribed), and Switzerland and according to current information, with its ca. 32 mm standard length is candidate to be considered a miniature fish. Additionally, this size makes it the smallest known stem teleost. As in other marcopoloichthyids, the buccal and suspensorium anatomy of M. mirigiolensis n. sp. corresponds to that of suction-feeder fishes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the effect of training with a personal, portable laparoscopic endo-trainer (PLET) on residents' laparoscopic skills. Methods: The study took place at a tertiary-care academic university hospital in Switzerland. All participants were randomized to either a home- or hospital-based PLET training group, and surgical skill performance was assessed using five laparoscopic exercises. 24 surgical residents, 13 females and 11 males, were enrolled at any training stage. Nine residents completed the assessments. Endpoints consisted of subjective and objective assessment ratings as well as exercise time and qualitative data up to 12 weeks. The primary outcome was the difference in exercise time and secondary outcomes included performance scores as well as qualitative data. Results: The hospital-based training group performed exercises number 1, 3 and 4 faster at 12 weeks than at baseline (p =.003, < 0.001 and 0.024). Surgical skill performance was not statistically significantly different in any of the endpoints between the hospital- and home-based training groups at 12 weeks. Both the subjective and objective assessment ratings significantly improved in the hospital-based training group between baseline and 12 weeks (p =.006 and 0.003, respectively). There was no statistically significant improvement in exercise time as well as subjective and objective assessment ratings over time in the home-based training group. The qualitative data suggested that participants who were randomized to the hospital-based training group wished to have the PLET at home and vice versa. Several participants across groups lacked motivation because of their workload or time constraints, though most believed the COVID-19 pandemic had no influence on their motivation or the time they had for training. Conclusion: The PLET enhances laparoscopic surgical skills over time in a hospital-based training setting. In order to understand and optimize motivational factors, further research is needed. Trial registration: This trial was retrospectively registered on clinicaltrials.gov (NCT06301230). [ABSTRACT FROM AUTHOR]

This study aimed to examine whether acute myocardial infarction (AMI) patients in Switzerland return to work and identify factors associated therewith. Data of 4315 working-age AMI patients enrolled in the Swiss AMIS Plus registry between 01/2006 and 09/2021 with 1-year follow-up and self-reported work status were analyzed. Patient characteristics were compared between those who did not reduce their work hours, those who reduced, and those who were no longer working 1 year after AMI. Multinomial logistic regression was used to analyze independent predictors of working ability. Of the patients, 3204 (74.3%) did not reduce their work hours, 592 (13.7%) reduced and 519 (12.0%) were no longer working 1 year after AMI. Women were more likely to reduce or stop working. Patients who did not reduce were more frequently young and male. Multinomial logistic regression showed that work reduction was associated with female sex and a Killip class > 2 at admission whereas stopping work was associated with female sex and comorbidities. A high rate of AMI patients in Switzerland (88%) return to work 1 year after AMI. Approximately 1 in 8 did not return to work and approximately 1 in 7 reduced their work hours. Important factors associated with reducing or no longer working after AMI were female sex, older age and a higher proportion of comorbidities. [ABSTRACT FROM AUTHOR]

Background: For high-risk patients receiving right-sided colectomy, stoma formation is a safety strategy. Options are anastomosis with loop ileostomy, end ileostomy, or split stoma. The aim is to compare the outcome of these three options. Methods: This retrospective cohort study included all patients who underwent right sided colectomy and stoma formation between January 2008 and December 2021 at two tertial referral centers in Switzerland. The primary outcome was the stoma associated complication rate within one year. Results: A total of 116 patients were included. A total of 20 patients (17%) underwent primary anastomosis with loop ileostomy (PA group), 29 (25%) received an end ileostomy (ES group) and 67 (58%) received a split stoma (SS group). Stoma associated complication rate was 43% (n = 21) in PA and in ES group and 50% (n = 34) in SS group (n.s.). A total of 30% (n = 6) of patients in PA group needed reoperations, whereas 59% (n = 17) in ES and 58% (n = 39) in SS group had reoperations (P = 0.07). Wound infections occurred in 15% (n = 3) in PA, in 10% (n = 3) in ES, and in 30% (n = 20) in SS group (P = 0.08). A total of 13 patients (65%) in PA, 7 (24%) in ES, and 29 (43%) in SS group achieved stoma closure (P = 0.02). A total of 5 patients (38%) in PA group, 2 (15%) in ES, and 22 patients (67%) in SS group had a stoma-associated rehospitalization (P < 0.01). Conclusion: Primary anastomosis and loop ileostomy may be an option for selected patients. Patients with end ileostomies have fewer stoma-related readmissions than those with a split stoma, but they have a lower rate of stoma closure. Clinical trial registration: Trial not registered. [ABSTRACT FROM AUTHOR]