Swiss School of Archaeology in Greece
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Sécurité des traitements de sevrage tabagique pendant la grossesse [Safety of smoking cessation treatments during pregnancy]
No full textAntiviral treatment in adult patients hospitalized for influenza: study protocol for a multi-center, randomized, placebo-controlled trial on the efficacy of baloxavir marboxil to reduce time to clinical improvement and the risk for severe complications (the INFLUENT trial)
No full textSeasonal influenza virus leads to more than half a million deaths each year worldwide. Due to its capacity to evolve, it is considered the most likely pathogen to cause a future pandemic. Antiviral treatment options are currently limited, with the most widely used drugs being neuraminidase inhibitors and the cap-dependent endonuclease inhibitor baloxavir marboxil. In adult hospitalized patients, due to the lack of placebo-controlled trials, current available evidence on antiviral treatment benefits is essentially based on observational studies. A placebo-controlled clinical trial is needed to fill this knowledge gap.
This is an investigator-initiated, randomized, triple-blind, placebo-controlled, superiority, multi-center trial to assess the clinical efficacy of single-dose baloxavir in decreasing time to clinical improvement in adult immunocompetent patients hospitalized with influenza. Patients (n = 484) with confirmed, severe infection (NEWS2 score ≥ 4) will be recruited over three influenza seasons in four large Swiss hospitals.
time to clinical improvement (in hours), calculated from treatment administration until NEWS2 score ≤ 2 maintained for 24 h or until hospital discharge, whichever comes first. The primary outcome is calculated in all patients independently of the duration of symptoms at treatment administration, as well as in participants treated early (<72 h) post onset of symptoms. The main secondary outcomes are the risk of serious influenza complications, length of hospitalization, and difference in viral load at D3 post-treatment administration.
This trial's results, whether positive or negative, will impact clinical guidance. If baloxavir's clinical benefit is demonstrated, a single-dose pill would be the easiest implementable treatment option in case of large seasonal outbreaks or a new influenza pandemic. If a clear treatment benefit is not shown, antiviral treatment administration in the hospitalized patient population could be reconsidered to prevent unnecessary medication, lower the risk of resistance development linked to treatment overuse, and ultimately save unnecessary treatment-related expenses.
ClinicalTrials.gov NCT06653569. Registered on October 22, 2024, https://clinicaltrials.gov/study/NCT06653569?term=NCT06653569&rank=1 .
© 2025. The Author(s)
Effectiveness of emotion-focused therapy: Main results of a practice-research network study.
No full textEmotion-Focused Therapy is one of the evidence-based psychotherapies for a range of psychological problems. While most evidence was gained from randomized controlled studies or process research at university settings, there is a need for more outcome research conducted within practitioner-researcher networks assessing the effectiveness of Emotion-Focused Therapy in private practice.
A total of N = 70 clients with a variety of psychiatric disorders have been included in the bi-national practitioner researcher network for Emotion-focused Therapy Switzerland-Germany. Symptom change was assessed using CORE-OM, BDI-II, IIP and WSAS. Therapist adherence was assessed by the self-reported version of the PCEPS. Pre-post-follow-up analyses were conducted using paired sample t-tests and hierarchical linear modeling.
Pre-post-assessment shows small to medium effect sizes for all outcome measures (except for interpersonal problems which did not change). Symptom reduction is maintained for CORE, BDI and WSAS, and increased for IIP at 3 and 6 months follow-up. Therapist adherence is good to excellent in this sample.
Emotion-Focused Therapy is effective in the real-world practice, as suggested by the small to moderate effect sizes. The smaller effects found in the current study as compared to randomized controlled trials are consistent with the literature and suggest that EFT remains moderately effective when applied in a naturalistic context
Les représentations (science-)fictionnelles de l'IA à l'écran
No full textA partir de quelques jalons du cinéma de science-fiction, l'article étudie quelques-uns des paradigmes qui ont régi la représentation de l'IA au cinéma, en mettant l'accent sur des récits technophobes qui mettent en scène les risques de la télésurveillance
Hypothalamic Astrocytes Exhibit Glycolytic Features Making Them Prone for Glucose Sensing
No full textIn the hypothalamus, detection of energy substrates such as glucose is essential to regulate food intake and peripheral energy homeostasis. Metabolic interactions between astrocytes and neurons via lactate exchange have been proposed as a hypothalamic glucose-sensing mechanism, but the molecular basis remains uncertain. Mouse hypothalamic astrocytes in vitro were found to exhibit a stronger glycolytic phenotype in basal conditions than cortical astrocytes. It was associated with higher protein expression levels of the Pyruvate Kinase Isoform M2 (Pkm2) and its more prominent nuclear localization. In parallel, hypothalamic astrocytes also expressed higher levels of the monocarboxylate transporter Slc16a3 (Mct4), which were dependent on Pkm2 expression. The stronger Mct4 expression in hypothalamic versus cortical astrocytes is an intrinsic characteristic, as it was also present after their direct isolation from adult mouse tissue. The high lactate release capacity of hypothalamic astrocytes was demonstrated to depend on the expression of Mct4, but not Mct1. Unlike cortical astrocytes, hypothalamic astrocytes in culture do not respond to glutamate with enhanced glycolysis, but instead, they modulate their lactate production according to glucose concentrations in an AMPK-dependent manner, an effect observed in both mouse and human hypothalamic astrocytes in vitro. Our study shows that hypothalamic and cortical astrocytes are geared to have distinct glycolytic responses to glucose and glutamate, respectively. These results reveal a metabolic specialization of astrocytes in order to fulfill distinct area-specific functions: glucose-sensing in the hypothalamus versus activity-dependent neuronal energetic supply in cortical regions.
© 2025 The Author(s). GLIA published by Wiley Periodicals LLC
Finerenone in patients with severe heart failure: The FINEARTS-HF trial
No full textWhile patients with severe heart failure (HF) were historically considered to have reduced left ventricular ejection fraction (LVEF), it is increasingly recognized that severe HF occurs across the full spectrum of LVEF. The aim of this study was to assess prevalence, cardiovascular (CV) outcome risk, and treatment response to the non-steroidal mineralocorticoid receptor antagonist finerenone among patients with severe HF in FINEARTS-HF.
Treatment effects of finerenone on the primary endpoint of total (first and recurrent) HF events and CV death were assessed by severe HF status, as defined by the adapted multiparametric ESC-HFA criteria including New York heart Association functional class III/IV, hospitalization for HF within the previous 12 months, and impairment of health status measured by Kansas City Cardiomyopathy Questionnaire total symptom score interaction = 0.98), with a greater absolute rate reduction in those with severe HF (5.9 per 100py) compared with those without severe HF (2.2 per 100py) in light of higher baseline risk. The proportion of patients who discontinued study treatment for any reason or experienced adverse events according to treatment assignment was similar regardless of severe HF status.
Among patients with mildly reduced or preserved LVEF, severe HF was associated with a heightened risk of CV events. Treatment with finerenone appeared safe and effective, regardless of HF severity.
© 2025 The Author(s). European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology
Association of part-time clinical work of hospitalists with efficiency and quality of care on medical wards: a retrospective study.
No full textPhysicians are increasingly interested in part-time employment. However, the impact of part-time work on efficiency and quality of care of inpatients is unknown.To investigate the association between part-time clinical work of hospitalists in General Internal Medicine (GIM) and resource utilisation and short-term patient outcomes.Retrospective study.GIM wards of 3 Swiss teaching hospitals.Each inpatient was categorised as having received care mainly (>50%) by part-time or full-time hospitalists. Part-time clinical work was defined as employment of <100% as a clinician. We included 3557 cases cared for mainly by part-time and 4973 by full-time physicians.Primary outcome was length of hospital stay, secondary outcomes included 30-day readmission, in-hospital mortality, hospitalisation cost and time to completion of the discharge letter. We assessed the association between both groups and outcomes using generalised estimating equations, clustering for individual patients and adjusting for patient and hospitalist characteristics.There was no statistically relevant difference in length of stay in cases cared for mainly by part-time (mean 7.3 days, 95% CI 7.1 to 7.6) compared with full-time hospitalists (mean 7.6 days, 95% CI 7.3 to 7.8; p=0.18). Time to completion of the discharge letter was longer in the part-time (mean 11.4 days, 95% CI 11.0 to 11.8) versus full-time group (mean 10.9 days, 95% CI 10.6 to 11.2, p=0.049). There was no statistically significant difference between groups for the other outcomes.We found no evidence that part-time clinical work of hospitalists negatively affects resource utilisation and short-term patient outcomes compared with full-time work.© 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
