Swiss School of Archaeology in Greece
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Post-traumatic stress disorder, trauma and parenting stress: an individual participant data meta-analysis
No full textBackground: Parental post-traumatic stress disorder (PTSD) symptoms are associated with heightened parenting stress, but it is unknown whether this relation depends on the timing (childhood or adulthood) and type of trauma (interpersonal or non-interpersonal). In survivors of childhood interpersonal trauma, PTSD and parenting stress may be more strongly intertwined.Objective: This study examined whether the relation between parental PTSD and parenting stress is moderated by childhood interpersonal trauma. Findings are supplemented with information on the process of performing an individual participant data meta-analysis (IPDMA) and lessons learned.Methods: Using one-stage IPDMA, data from published studies and unpublished datasets were synthesized and analysed using multilevel linear regression.Results: Twelve datasets were included (N = 1249: 92.5% female, M age = 32.8 years, 53.8% ethnic minority). Significant and positive main effects of PTSD and childhood interpersonal trauma on parenting stress were consistently found across studies. A moderating effect of childhood interpersonal trauma on the relation between PTSD and parenting stress was not found, but this finding may be impacted by limited data coverage. The proportion of individual-level variance in parenting stress explained by the model with main and interaction effects while controlling for education level was small to medium (R2 = .12, p = .003).Conclusion: This study is the first to investigate relations among parental childhood interpersonal trauma, PTSD, and parenting stress across studies using IPDMA methodology. Despite limitations in data coverage, its findings demonstrated that links among childhood interpersonal trauma, PTSD, and parenting stress were robust across populations and settings. This implies PTSD symptom reduction may be beneficial in reducing parenting stress, regardless of whether the parent experienced childhood interpersonal trauma. Additionally, lessons learned and suggestions for how IPDMA can bring the field of trauma and PTSD research forward are presented
Why gender and sex matter in infectious disease modelling: A conceptual framework.
No full textThe COVID-19 pandemic underscored the differential impact of infectious diseases across population groups, with gender and sex identified as important dimensions influencing transmission and health outcomes. Sex-related biological factors, such as differences in immune response and comorbidities, contribute to men's heightened severity risks, while gender norms and roles influence exposure patterns, adherence to prevention measures, and healthcare access, influencing women's higher reported infection rates in certain contexts. Despite widely observed gender/sex disparities, infectious disease models frequently overlook gender and sex as key dimensions, leading to gaps in understanding and potential blind spots in public health interventions. This paper develops a conceptual framework based on the Susceptible-Exposed-Infectious-Recovered/Deceased (SEIR/D) compartmental model to map pathways through which gender and sex may influence susceptibility, exposure, transmission, recovery, and mortality. Using a narrative review of modelling, epidemiological, and clinical studies, this framework identifies and characterises the main social and biological mechanisms on this matter-including gendered occupational exposure, differential adherence to preventive measures, and disparities in healthcare-seeking behaviour-alongside sex-based differences in immune response and disease severity. The framework also examines potential gender-related variations in epidemiological surveillance data, highlighting disparities in testing uptake and hospitalisation referrals that could influence model outputs. By synthesising these insights, this paper provides a theoretical foundation for integrating gender and sex into infectious disease models. It advocates for interdisciplinary collaboration between modellers, social scientists, and clinicians to advance gender- and sex-sensitive modelling approaches. Accounting for gender and sex can enhance predictive accuracy, inform intervention strategies, and promote health equity in pandemic response
Editorial: Management of congenital heart disease: challenges, implications, innovations and pitfalls.
No full text"Poétiques et pratiques de la forêt, entre dystopie, utopie et réalisme désenchanté: de Zamiatine à Darrieussecq et aux fictions sylvestres des années 2020"
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Diagnostic Accuracy of Ex Vivo Confocal Microscopy for Surgical Margin Assessment of High-Risk Nodular Basal Cell Carcinoma
No full textBackground: Accurate margin assessment during surgical treatment is essential to prevent recurrences of BCC. Mohs surgery or alternative peripheral and deep en-face margin assessment (PDEMA) based on conventional histopathology are considered the gold standard for excising high-risk BCC, as it allows stepwise and complete examination of peripheral and deep margins. However, it is labor-intensive and time-consuming. EVCM has emerged as a promising alternative, allowing rapid intraoperative evaluation of fresh excised tissue. Objective: To assess the diagnostic accuracy of EVCM in a PDEMA workflow of high-risk nodular BCCs. Methods: A retrospective monocentric study was conducted at the Lausanne University Hospital (CHUV) between March 2024 and May 2025. A total of 51 patients with histologically confirmed nodular BCCs considered as high-risk and thus addressed for EVCM-assisted excision were included, yielding 171 surgical margin samples. EVCM and conventional histology-based PDEMA analyses were compared. Results: EVCM achieved an overall sensitivity of 93.8% (95% CI: 71.7-98.9%) and specificity of 98.7% (95% CI: 95.2-99.7%) compared to conventional histology. The positive and negative predictive values were 88.2% (95% CI: 63.6-97.4%) and 99.4% (95% CI: 96.4-99.9%), respectively. Conclusion: EVCM demonstrates high diagnostic accuracy for the intraoperative PDEMA of high-risk, nodular BCC. Its integration in PDEMA surgical workflows may improve efficiency, although confirmatory studies are needed in broader clinical settings
Effectiveness and user experience of a virtual reality intervention in a cohort of patients with chronic musculoskeletal pain syndromes.
No full textChronic musculoskeletal pain (CMP) syndromes, including fibromyalgia, present diverse physical and psychological symptoms often resistant to pharmacological treatment. To retrospectively evaluate the effectiveness and user experience of Virtual Reality (VR) in reducing pain and anxiety in CMP patients and identify predictors of positive response. Data from 91 CMP patients in a 2-week interdisciplinary pain program were analyzed (78% met fibromyalgia criteria). Pain and anxiety were assessed using Numerical Rating Scales (NRS 0-10) before and after VR. Follow-up interviews were conducted after one month. An unsupervised machine learning model explored response patterns. VR led to a moderate but significant short-term reduction in anxiety and pain (median NRS -1.0, p < 0.001). A reduction of ≥3 NRS points occurred in 25% (anxiety) and 14% (pain). High baseline anxiety (NRS ≥ 7) correlated with greater pain reduction (median -2.0, p = 0.01). After one month, half of the patients reported sustained benefits. Catastrophizing and benzodiazepine use were linked to improved anxiety outcomes. Machine learning identified a most responsive cluster, characterized by patients with nociplastic pain, alexithymia, and anxiety. VR provided moderate short- and mid-term benefits for anxiety and pain in CMP patients, particularly in those with nociplastic pain and high baseline anxiety
Non-invasive imaging of individual histological carotid plaque characteristics: A diagnostic accuracy meta-analysis
No full textAccurately detecting carotid plaque characteristics is crucial for identifying high-risk patients due to risk of cerebrovascular events and complications during revascularizations. Diagnostic accuracy of individual and overall carotid plaque characteristics using computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US) compared to histology in patients with symptomatic/asymptomatic carotid plaques was aimed.
After prospective registration on PROSPERO (CRD42022329690), Medline Ovid, Embase, Cochrane Library, and Web of Science were searched without any limitations. QUADAS-2 tool was used to study quality assessment, GRADE framework to assess evidence certainty, and univariate/bivariate random-effect meta-analyses for data analysis.
Of 5960 studies screened, 107 were identified, resulting in 253 diagnostic accuracy comparisons of 16 plaque characteristics (28 CT, 120 MRI, and 105 US). CT detected intraplaque hemorrhage (IPH) and lipid-rich necrotic core (LRNC) with good accuracy (86 % [95 %CI 67-95] and 84 % [72-91], respectively) and exhibited very high accuracy for ulceration (92 % [87-95]; 76 % on MRI and 75 % on US) and calcification (90 % [58-98] vs. 89 % [87-91] on MRI). MRI identified LRNC and IPH with good accuracy (86 % [81-89] and 86 % [84-88], respectively), and differentiated between acute/subacute/old IPH (accuracy >87 %). US accurately detected ruptured fibrous cap (85 % [77-91]), comparable to MRI (85 % [79-90]), but demonstrated lower performance for other characteristics. Finally, CT detected overall carotid morphology with 89 % accuracy, followed by MRI (86 %; p = 0.374 to CT), and significantly lower by US (78 %; p < 0.001).
CT identified key plaque features, especially ulceration and calcification. MRI provided thorough plaque assessment by detecting all features and differentiating IPH age. For overall morphology, CT and MRI surpassed US accuracy.
Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved