Swiss School of Archaeology in Greece
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Enteral autonomy and the role of abdominal surgery in a cohort of infants with gastroschisis
No full textAssess the influence of bowel injury and additional abdominal surgical procedures in infants with gastroschisis in relation to time to full enteral feeds (tFEF).
Retrospective cohort study of all patients with gastroschisis between January 2010 and December 2019. Patient demographics, type of abdominal wall closure, medical and operative notes, and tFEF were collected. Bowel injury was assessed by the Gastroschisis Prognostic Score (GPS). Patients were categorized according to tFEF outcomes: ≤60 days, >60-<90 days and ≥90 days.
205 patients with gastroschisis were identified with median tFEF of 26 (interquartile range 18-46) days. 173 (83 %) patients with simple gastroschisis required shorter tFEF compared to patients with complex gastroschisis (23 vs 50 days, p 90 days was non-progression of feeds, with no anatomical cause found at laparotomy. Stoma formation after abdominal closure was associated with largest increase in tFEF compared to stoma before abdominal closure and adhesiolysis alone.
Higher GPS and post-closure abdominal procedures were associated with significantly longer tFEF. Decision to perform additional abdominal procedures post-closure, particularly in gastroschisis patients with feed intolerance and no anatomical cause for concern, should be considered cautiously given the risk of increasing tFEF.
Copyright © 2025 Elsevier Inc. All rights reserved
Duration of antimicrobial treatment for uncomplicated streptococcal bacteraemia: Another example of shorter is better
No full textObjectives: Duration of treatment for uncomplicated streptococcal bacteraemia is unknown. The study aims to assess clinical outcomes of patients with uncomplicated streptococcal bacteraemia receiving a short course (5-10 days) of antimicrobial treatment compared to those receiving the traditional, longer duration (11-18 days).
Methods: This retrospective study was conducted at the Lausanne University Hospital, Switzerland and included episodes of uncomplicated streptococcal bacteraemia among adult patients from 2015 to 2023. Clinical failure was defined as mortality, recurrence of bacteraemia by the same streptococcal species and development in bone and joint infection within 120 days.
Results: During the study period, 336 episodes of uncomplicated streptococcal bacteraemia were included. The median duration of antimicrobial treatment was 10 days (interquartile range: 7-14); 184 (55%) and 152 (45%) episodes received a short (5-10 days) and long (11-18 days) duration of antimicrobial treatment, respectively. Forty-three (13%) episodes had clinical failure; 120-day mortality was 11% (36 episodes); recurrence of bacteraemia by the same streptococcal species was observed in 8 episodes (2%). No difference in clinical failure was observed between episodes receiving short and long courses of antimicrobial treatment (10% versus 16%; P 0.143). The Cox multivariable regression model found that a Charlson comorbidity index >4 (aHR 4.87, 95% CI 3.08-7.71), and septic shock (1.67, 1.04-2.67) were associated with clinical failure; a short course of antimicrobial treatment was not associated with clinical failure (0.90, 0.57-1.12).
Conclusions: This study has shown that a short duration of antimicrobial treatment for cases of streptococcal bacteraemia is effective and safe
Long COVID Services Between Medical Clinics and Healing Rituals: A Case Study in Switzerland
No full textThis chapter delves into clinical and experiential complexities of Long COVID, highlighting the challenges in diagnosis and treatment due to the diversity of symptoms and the lack of established clinical standards. It focuses on specialised Long COVID services in French-speaking Switzerland, which provide symptom management and patient support through on-site consultations, experimental therapies and virtual platforms. In response to therapeutic uncertainty, clinicians and patients are engaged in a trial-and-error approach that combines palliative pharmacotherapies, medical advice, activity management strategies, and even alternative therapies and lifestyle interventions. The chapter analyses this situation through the lens of healing rituals, which influence patients’ experiences, reshape their identities, impact on their social environments and help them to cope with their chronic condition but also force them to adapt to it
Design of a Mobile and Electromagnetic Emissions-Compliant Brain Positron Emission Tomography (PET) Scanner
No full textThis paper presents the development of two mobile brain Positron Emission Tomography (PET) scanners under the PETITION project, designed for Intensive Care Units (ICUs) and Proton Beam Therapy (PBT) applications. The ICU scanner facilitates bedside imaging for critically ill patients, while the PBT scanner enables undisturbed proton beam irradiation during imaging. Key aspects of the hardware design, including modular detectors and electromagnetic interference considerations, are discussed along with preliminary performance evaluations. Operational testing, employing a 22Na source and a hot-rod phantom, was conducted to determine the timing resolution (548 ps), energy resolution (11.4%) and a qualitative spatial resolution (around 2.2 mm). Our study presents findings on the ICU PET scanner's electromagnetic emissions measured in a controlled EMC testing facility, where all the emissions tests performed comply with the standard EN 60601-1-2 (radiated emissions 15 dB below regulatory limits in the frequency range of 30 MHz to 1 GHz)
Bipolar hemiarthroplasty for femoral neck fractures in elderly patients: a retrospective study of 1001 patients
No full textDisplaced intracapsular femoral neck fractures (FNF) are the most frequent surgical pathology in orthopedics. Controversy surrounds optimal treatment, with little consensus, particularly in the elderly multimorbid at risk population. For over a decade, our institution adopts a standardized protocol for FNF, utilizing cemented hip hemiarthroplasty (HA) via the posterior approach. This study evaluates the outcomes of this approach, contributing to the ongoing debate and potentially guiding future treatment strategies.
This retrospective study included patients (≥ 60 years) who underwent HA for FNF from January 1, 2008, to June 30, 2019, at a University Hospital. Our primary endpoint was revision surgery for HA (rHA) within four years after HA. Secondary endpoints included hip-related and unrelated complications.
Of 1001 patients, 40 (3.9%) underwent rHA. Indications were periprosthetic fractures (5; 0.5%), dislocation (15; 1.5%), suspected prosthetic joint infection (17; 1.7%), and acetabular erosion (3; 0.3%). Four-year mortality was 51%. Cox regression revealed age > 80 years (aHR 1.86, p < 0.001), ASA score III or IV (aHR 2.11, p < 0.001), and postoperative delirium (aHR 1.29, p < 0.05), as independent predictors of higher 4-year mortality. No difference was observed among patients with and without revision indication for ASA scores III or IV (64% vs. 64%; p = 0.912), surgery within 24 h (52% vs. 57%; p = 0.334), duration over 90 min (46% vs. 53%; p = 0.201), and surgery during the night shift (24% vs. 19%; p = 0.285). Board certification did not impact revision rates (39% vs. 39%; p = 1.000).
Cemented HA is a safe and reliable treatment option for FNF, delivering consistent outcomes in the elderly multimorbid population, with low rates of rHA (3.9%). The posterior surgical approach, even in patients with heightened dislocation risk, remains a viable option. Timing of surgery (night/day) does not significantly affect revision rates, which could have substantial implications for surgical planning and healthcare resource allocation
Heavy rainfall patterns and high streamflow dynamics in the southern Ecuadorian Andes
No full textEcuador’s southern tropical Andes are heavily impacted by intense tropical moisture, leading to flash floods and landslides. Here, we provide insights into the characteristics of the heavy rainfall triggering high streamflow in this area. High spatiotemporal resolution (500 m and 5 min) estimates from a high-elevation X-band weather radar (6 years, recording 1632 rainfall events) were analyzed for the small-scale rainfall properties, and a Lagrangian approach was employed to detect the moisture trajectories and sources. Employing a statistical model to analyze the rainfall space–time–intensity structures, rainfall was classified and characterized into three intense spatially clustered (convective) and one spatially homogenous (stratiform) rain types, which differ in their advection properties, intensities, and spatial structure. Tracking the rainfall trajectories, we found a predominant pathway for air masses to reach the study area, with the majority originating from the eastern flank of the Andes through the north Amazon basin (63.5%), followed by the high Andes Mountains (29%) and coastal plains (3.9%), whereas only a small proportion stems from the Pacific Ocean (3.6%). The major focal area from which air masses originate is only 250 km east of the study region. Analyzing high streamflow in the Tomebamba catchment, we estimated that convective rainfall types with a minimum duration of 2 h and intensity of 23 mm h−1 originating mostly from the Andes and the north Amazon basin can potentially trigger high runoff events, with peaks ranging between 100 and 200 m3 s−1. Rainfall characteristics and moisture sources are crucial for nearby catchments in tropical–temperate climates, aiding in weather forecasting and short-term flood warnings
Shaping international tax policies: bridging ideal principle-based solutions and effective reform amid political influences
No full textThis doctoral thesis explores how multinational enterprises’ profits are allocated among jurisdictions under international tax rules. It takes a theoretical approach, assessing core normative questions: what principles should guide the profit allocation, and how can they align with the realities of tax policy and politics? It compares the arm’s length principle with alternatives like the OECD’s Amount A, showing a potential shift in principles. The work highlights political constraints, the lack of universally shared principles, and the need for a more coherent framework for global tax governance. This thesis seeks to provide a foundation for future reforms of the international tax regime
"Exploitative or Empowering Tale?". Bella’s Journey Towards Self-Discovery and Female Emancipation in Yórgos Lánthimos’. Cinematic "Bildungsroman Poor Things" (2023).
No full textEnabling biological nitrogen fixation in agriculture: An eco-industrial perspective
No full textFood production, including cereal crops such as maize, rice, and wheat, and other products like oilseed, tubers, dairy, meat, fish and sugar, accounts for up to 50 % of global crop output and is projected to rise along with population and income growth. As industrial agriculture heavily relies on mineral fertilizers, for sustaining crop growth, the global fertilizer consumption is also projected to rise in the upcoming years. Nitrogen is the most critical nutrient for crops, so that N-based fertilizers are the most widely used worldwide. However, excessive N fertilization leads to remarkable environmental damage and economic losses annually. Enhancing nitrogen use efficiency (NUE) by aligning nitrogen supply with plant demand is crucial for more sustainable agriculture. Biological nitrogen fixation (BNF) presents a promising strategy to reduce synthetic N use. However, integrating BNF into industrial agriculture requires strategies that address both biological and technical challenges. This review discusses the limitations and feasibility of existing strategies to enable BNF in non-leguminous crops. Currently, issues such as consistency and scalability of microbial products, along with regulations, are amongst the main limitations to the adoption of BNF in agriculture. In addition, as the production of bioformulations has not been standardized yet, many products still lack reproducibility, stability and applicability. In this review, relevant factors contributing to the design of effective microbial formulations are discussed, and product design is proposed as alternative valuable strategy which – coupled with appropriate proof of agronomic efficacy – can enable BNF-based solutions as more sustainable fertilization practices. Therefore, the development of effective microbial formulations aiming at reducing N input, losses, and dependence on synthetic fertilizers, is described in the light of both industrial and ecological perspectives. The review remarks the potential of biofertilizers as tools to enable BNF in agriculture and how an eco-design can help developing more effective, stable and hence scalable products. On the other hand, beside the increasing market demand, the regulatory framework is still a major barrier, playing an important role in the identification and formulation of reliable protocols aimed at standardizing the production of microbial products for fertilizing purposes
