Swiss School of Archaeology in Greece
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The changing epidemiology of invasive mold diseases in immunosuppressed patients: what, why, how?
No full textThe epidemiology of invasive mold diseases in immunocompromised hosts is evolving due to a combination of environmental and host-related factors.
Our goal is to characterize this changing epidemiology by exploring two key aspects: (a) the evolution of molds and (b) the expansion of the pool of immunocompromised hosts in the current era.
We searched PubMed and Google Scholar with the combination of the following keywords: "fungal epidemiology", "mold OR mould", "environment", "invasive fungal infection", "invasive mold infection", "Mucor*", "Aspergill*", "Fusari*", "Scedospor*", "antifungal resistance", "immunocompromised hosts". We also searched the reference lists of all relevant publications for additional references.
We describe the changing spectrum of invasive mold infections in the context of emerging antifungal resistance and the rapidly evolving landscape of immunocompromised patient populations.
Recognition of fungal adaptation to environmental changes and the spectrum of immunocompromised hosts is critical for timely diagnosis and management of invasive mold infections, health policy and research.
Copyright © 2025 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved
Symptom tracking for endometriosis: a systematic review protocol for mobile applications focused on content, inclusivity and features
No full textEndometriosis is a chronic gynaecological condition affecting 2%-10% of women worldwide, often leading to severe pain, organ dysfunction and infertility. Despite its prevalence, diagnosis is frequently delayed, and treatment options remain limited. Mobile health (mHealth) applications have gained popularity as tools for symptom tracking, yet concerns about their accessibility, evidence-based content and inclusivity persist. Ensuring that these digital tools are culturally relevant, user-friendly and available to diverse populations is crucial for improving patient care and engagement. This study aims to systematically review mobile applications designed for tracking endometriosis symptoms, with a focus on content quality, inclusivity and functionality. The objective is to identify gaps in existing apps and provide recommendations for developing more inclusive digital health solutions.
This study follows a systematic review methodology proposed by Gasteiger et al. The research process consists of seven steps, including defining research questions, identifying relevant applications, determining eligibility criteria, selecting and analysing apps and synthesising results. The apps will be sourced from the Apple App Store and Google Play Store via predefined search strategies. The evaluation criteria include content accuracy, usability, inclusivity, privacy protection and adherence to evidence-based medical guidelines. Data extraction focuses on app characteristics, including language availability, user accessibility, evidence-based symptom tracking and adherence to health equity principles. The Mobile App Rating Scale will be used to assess usability, functionality, aesthetics and information quality. The findings will be systematically compared to identify strengths, limitations and areas for improvement in existing applications.
This systematic review of applications offers an overview of available apps that can be downloaded in Switzerland. Furthermore, it will present a detailed analysis of those that are specifically geared towards symptom tracking and will evaluate the level of evidence-based content, inclusivity, data protection and quality. A key strength of this review is its multidisciplinary approach, which involves engaging experts in healthcare, digital technology, inclusivity and individuals with lived experiences with endometriosis.
Approval from an ethics committee is not required. Data and material will be available on request from the authors.
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group
Anti-CD74 autoantibodies in axial spondyloarthritis as biomarkers for activity and severity of disease but not for tumour necrosis factor inhibitor retention: data from the Swiss Clinical Quality Management in rheumatic diseases cohort.
No full textAnti-CD74 antibodies (Abs) have been proposed as a diagnostic biomarker in axial spondyloarthritis (axSpA). The aims of this study were to evaluate the association of these Abs with disease activity parameters in axSpA and to assess their predictive value for tumour necrosis factor inhibitor (TNFi) treatment effectiveness.
Patients diagnosed with axSpA in the Swiss Clinical Quality Management registry with available biosamples and a measurement of IgA anti-CD74 Abs were included in this cohort study. We used a cut-off of 15 U/ml to define anti-CD74 Abs elevation. Associations of important disease characteristics with anti-CD4 Abs elevation and anti-CD74 Abs levels were evaluated using logistic and linear regression, respectively. For patients with an available biosample before TNFi initiation, we evaluated drug retention and estimated the hazard ratio of treatment discontinuation depending on anti-CD74 Abs elevation.
Elevated IgA anti-CD74 Abs were found in 383/722 (53%) patients with axSpA and were significantly associated with older age, male sex, and elevated C-reactive protein (CRP). Among 310 patients starting TNFi treatment, no significant difference in drug retention was found between patients with and without elevated anti-CD74 Abs (HR 0.91, 95% CI 0.66 to 1.25). An increased Bath Ankylosing Spondylitis Disease Activity Index was found to be associated with a reduced TNFi retention whereas an elevated CRP was associated with a prolonged retention.
Although elevated IgA anti-CD74 Abs are associated with CRP elevation, we could not demonstrate an additional value of this biomarker for predicting response to treatment with TNFi beyond CRP measurement
miR-363-3p Mediates Maintenance and Tumorigenicity of Breast Cancer Stem Cells and Provides A Potential Diagnostic and Prognostic Sera-Exosome Biomarker of Early Breast Cancer
No full textPurpose: Despite great advances in breast cancer (BC) treatment, 20–30% of patients develop metastatic disease, eventually leading to death. Cancer stem cells (CSC) are key players in disease persistence and recurrence. However, methods for their detection and specific targeting are still lacking. MicroRNAs (miRNAs) are involved in the expression of many genes and biological processes. In this study, we aimed to identify miRNAs specific to BC stem cells (BCSC) that are resistant to treatment. Methods: By treating BCSC-enriched cells in vitro in mammospheres with chemotherapeutic agents, we selected miRNAs specific to resistant BCSCs. The most promising miRNA was then assessed in a mouse model and in clinical material from healthy women and patients treated with neoadjuvant chemotherapy. Results: In vitro enrichment of chemoresistant BCSC identified five-miRNA. miR-363-3p exhibited the highest expression in various BC cell lines and derived BCSC-enriched populations compared with non-tumorigenic cells. The inhibition of miR-363-3p decreased BCSC maintenance and tumorigenicity in vitro, whereas its overexpression increased mammosphere formation. Consistently, miR-363-3p downregulation decreased the growth and metastasis of human BC cells transplanted in mice. In human samples, miRNA-363-3p was overexpressed in cancer tissue before chemotherapy, whereas higher levels of miR363-3p in serum exosomes were correlated with better survival. Furthermore, a 7-exosomal miRNA (exomiRNA) signature, including miR-363-3p, enabled the discrimination of patients with BC from healthy women. Conclusion: In vitro, mouse and clinical models suggest that miR-363-3p and miRNA signatures act as biomarkers of the BCSC phenotype, providing a promising approach for BC detection, follow-up, and BCSC targeting
A New Prognostic Score Based on Cell-Mediated Immunity for Cytomegalovirus Infection After Transplantation
No full textThe interferon gamma (IFN-γ) enzyme-linked immunosorbent spot is a highly sensitive immune assay that enables the assessment of cytomegalovirus (CMV)-specific cell-mediated immunity (CMI) and can identify at-risk transplant patients of CMV infection; however, its clinical implementation remains elusive.
We developed a novel CMV-CMI risk-score based on the standardized T-SPOT.CMV assay against 2 CMV antigens (immediate-early protein 1 [IE-1] and 65 kDa phosphoprotein [pp65]), a biomarker predicting CMV infection, both high viral replication, and disease by performing a pooled analysis of 570 kidney transplants participating in different clinical trials and subsequently validating it in 146 consecutives solid organ transplants (SOT) in an interventional trial. By incorporating clinical variables into the CMV-CMI risk-score, we built an integrative prognostic system quantifying the risk of CMV infection (CMV-PrognosTIC score) using elastic net penalized regression analysis.
In the pooled derivation cohort, whereas specific IE-1/pp65-specific CMV-CMI frequencies independently correlated with high risk of CMV infection (areas under the curve [AUCs]: 0.694, P < 0.0001; 0.719, P < 0.0001, respectively), by combining both responses, 3 CMV-CMI risk-scores appeared, accurately discriminating low-risk (LR) from intermediate-risk (IR) and high-risk (HR) patients (98.7% negative predictive value [NPV], 97.2% sensitivity). Its prospective implementation guiding decision-making in an independent SOT cohort confirmed the very high NPV and sensitivity identifying LR patients. By integrating type of preventive therapy, patient age, and donor (D) and recipient (R) CMV-serostatus to the CMV-CMI risk-score, we generated a global risk-prognostic model showing accurate discrimination and calibration in both derivation (AUC: 0.807) and validation cohorts (AUC: 0.719).
We developed a robust CMV-PrognosTIC score to quantify the risk of CMV infection in SOT, which may be readily implemented in clinical transplantation to personalize CMV preventive therapies.
© 2025 International Society of Nephrology. Published by Elsevier Inc
Optimal Social Security Systems in the Context of Climate Change
No full textSocial security systems and their social insurance mechanisms have served as tools employed by governments to enhance societal well-being during significant socioeconomic transitions, such as industrialization or recovery from post-war economic declines. In these contexts, these systems have helped safeguard societies from potential vulnerabilities while simultaneously reinforcing collective efforts to enhance overall social well-being. Notably, these feedback effects have played a crucial role in shaping how social security can positively influence and transform socioeconomic trends during challenging periods. In line with these foundational purposes, this thesis examines the contemporary role of social security in light of the socioeconomic transition brought about by climate change. First, a comprehensive literature review has been conducted, highlighting the potential effects of climate change on social security through several key channels of risk transmission, including the cost of living, labor markets, financial markets, and health outcomes. In a second phase, this thesis contributes to climate economic modeling by proposing a social security module that endogenously interacts with an economic system affected by climate change. This model is then applied to develop scenario analyses that consider plausible global socioeconomic trajectories, as well as specific regional conditions. The findings from this research offer an alternative perspective on the effectiveness of funded versus pay-as-you-go financing systems for social security under climate change scenarios. By challenging existing views that overlook climate-related factors, this research lays the groundwork for a deeper examination of the optimality of social security systems in the context of climate change
