The Brief Symptom Inventory in the Swiss general population: Presentation of norm scores and predictors of psychological distress.

Psychological distress is an important and frequent health problem. The Brief Symptom Inventory (BSI) allows screening for psychological distress in clinical, general and research populations. We aimed to provide normative data for the BSI and the BSI-18 for the Swiss general population: We 1) present psychometric properties, 2) develop a Swiss T-standardization and validate it using a clinical sample, 3) describe psychological distress in the Swiss general population and the clinical sample, and 4) compare the means and T-standardized scores of the Swiss general population to different German norm populations. Using a cross-sectional study design, we invited a representative sample of the Swiss general population aged 18-75 years to the study. A sample of psychotherapy outpatients had competed the BSI before start of their therapy. We calculated scores for the nine scales of the BSI (three of them constitute the BSI-18), the T-standardization and the following BSI indices: Global Severity Index (GSI), Positive Symptom Total (PST), Positive Symptom Distress Index (PSDI), and Caseness (reaching T≥63 on the GSI or T≥63 on at least two of the scales). A total of 1238 general population participants completed the BSI (41.8% male; mean age 48.9 years). The BSI had good psychometric properties. The Swiss T-standardization showed good validity when applied in the clinical sample. Females reached a significantly higher GSI score than males (p<0.001). Older participants (p = 0.026), those with higher education (p <0.001), and those employed or retired (p<0.001) reached lower scores than participants aged 18-25 years, those with compulsory schooling, and unemployed participants, respectively. A total of 18.1% (CI: 16.0-20.5) participants of the general population and 75.2% (CI: 73.7-76.7) of the psychotherapy patients were considered cases with psychological distress. Our study presents detailed normative data for the BSI and the BSI-18 based on a representative sample of the Swiss general population. This information will be helpful for clinical applications and research in the Swiss and international context.

The use of diagnostic ultrasound by primary care physicians in Switzerland - a cross-sectional study.

BACKGROUND: Diagnostic ultrasound has become a bedside tool widely available to many primary care physicians (PCPs) in Europe. It is often used as point-of-care ultrasonography (POCUS) in this setting. In Switzerland, certain POCUS examinations are listed as learning objectives in existing ultrasound training programs (we defined these examinations as swissPOCUS = sPOCUS). Ultrasound performed by PCPs can lead to faster diagnostic workup and reduce referral to secondary care units. However, adequate training is crucial to guarantee high quality. To guide the development of ultrasound training programs for PCPs, this study explores the use of ultrasound in primary care in Switzerland. METHODS: This was a cross-sectional study. We invited PCPs from the Swiss practice-based research network "Sentinella" to collect data on the first 5 daily ultrasounds they ordered or performed themselves. Participating PCPs collected data for 3 months - divided into 4 groups to account for seasonal differences. RESULTS: Out of 188 PCPs invited, 81.9% provided data through an initial questionnaire. 46.8% provided data on 1616 ultrasounds. 56.5% of PCPs had access to ultrasound machines, while 29.8% had completed formal training. 77% of the reported ultrasounds were self-performed; 27% of the reported scans (35% of all self-performed scans) were performed by PCPs with incomplete or no formal training. The main areas of interest were the abdominal (57.9%) and the musculoskeletal (22%) region. 36.9% of reported examinations were sPOCUS exams. Among PCPs with access to US machines, the percentages of referred examinations were similar for sPOCUS (11.9%) and non-sPOCUS (11.3%) indications. However, some sPOCUS musculoskeletal ultrasounds were often referred (e.g. tendon/ligament/muscle injuries or cutaneous/subcutaneous tumour). CONCLUSION: Most Swiss PCPs had access to ultrasound equipment and performed a majority of both sPOCUS and non-sPOCUS scans themselves, often without or with incomplete training. This reflects the fact that POCUS was only recently introduced in Switzerland. There is a need for easily accessible POCUS training programs aimed at PCPs in Switzerland. Training courses for PCPs should focus on abdominal and musculoskeletal ultrasound, because these were the most common sites for scans, and because some sPOCUS musculoskeletal examinations showed a particularly high percentage of referral.

Women in Natural Sciences (WiNS) at ETH Zurich Celebrates its 10th Anniversary - A Retrospective and Outlook.

For this CHIMIA special issue on the United Nations Sustainable Development Goals (SDGs) and the coincidental 10th anniversary of the association of Women in Natural Sciences (WiNS) at ETH Zurich, there is no better opportunity to share what we have achieved in the last decade. WiNS was originally founded by female PhD students and PostDocs at the Department of Chemistry and Applied Biosciences (D-CHAB) and has expanded to include three additional departments at ETH Zurich. Join us in celebrating our anniversary, reflecting on what we and other associations with the same mission have done to promote gender equality and reduced inequalities for all. We invite you to reflect on what yet has to be done to enact a systemic change towards achieving equal opportunities for all, rather than simply accommodating the female perspective to Switzerland's predominantly masculine working culture.

Reflexivity and positionality applied to medical practice: a study on implicit gender bias with medical students in a Swiss university.

BACKGROUND: An array of evidence shows how the presence of implicit bias in clinical encounters can negatively impact provider-patient communication, quality of care and ultimately contribute to health inequities. Reflexive practice has been explored as an approach to identify and address implicit bias in healthcare providers, including medical students. At the Lausanne School of Medicine, a clinically integrated module was introduced in 2019 to raise students' awareness of gender bias in medical practice using a reflexivity and positionality approach. The purpose of this study is to describe the gender bias that were identified by medical students, analysing their types, places and modes of emergence during a clinical encounter. It further explores how positionality supported students' reflection on the way in which social position modulates their relationship to patients. METHODS: As part of the teaching activity, medical students individually reflected on gender bias in a specific clinical encounter by answering questions in their electronic portfolio. The questionnaire included a section on positionality. We qualitatively analysed the students' assignments (n=76), applying a thematic analysis framework. RESULTS: Medical students identified and described gender biases occurring at different moments of the clinical encounter (anamnesis (i.e. patient history), physical exam, differential diagnosis, final management). They causally associated these biases with wider social phenomena such as the gendered division of labour or stereotypes around sexuality and gender. Analysing students' reflections on how their position influenced their relationship with patients, we found that the suggested exercise revealed a major contradiction in the process of medical enculturation: the injunction to be neutral and objective erases the social and cultural context of patients and impedes an understanding of gender bias. CONCLUSION: Gender biases are present in the different steps of a clinical consultation and are rooted in broader gendered social representations. We further conclude that the tension between a quest for objectivity and the reality of social encounters should be made explicit to students, because it is constitutive of medical practice.

Environmental and geographical factors influencing the spread of SARS-CoV-2 over 2 years: a fine-scale spatiotemporal analysis.

Introduction: Since its emergence in late 2019, the SARS-CoV-2 virus has led to a global health crisis, affecting millions and reshaping societies and economies worldwide. Investigating the determinants of SARS-CoV-2 diffusion and their spatiotemporal dynamics at high spatial resolution is critical for public health and policymaking. Methods: This study analyses 194,682 georeferenced SARS-CoV-2 RT-PCR tests from March 2020 and April 2022 in the canton of Vaud, Switzerland. We characterized five distinct pandemic periods using metrics of spatial and temporal clustering like inverse Shannon entropy, the Hoover index, Lloyd's index of mean crowding, and the modified space-time DBSCAN algorithm. We assessed the demographic, socioeconomic, and environmental factors contributing to cluster persistence during each period using eXtreme Gradient Boosting (XGBoost) and SHapley Additive exPlanations (SHAP), to consider non-linear and spatial effects. Results: Our findings reveal important variations in the spatial and temporal clustering of cases. Notably, areas with flatter epidemics had higher total attack rate. Air pollution emerged as a factor showing a consistent positive association with higher cluster persistence, substantiated by both immission models and, to a lesser extent, tropospheric NO2 estimations. Factors including population density, testing rates, and geographical coordinates, also showed important positive associations with higher cluster persistence. The socioeconomic index showed no significant contribution to cluster persistence, suggesting its limited role in the observed dynamics, which warrants further research. Discussion: Overall, the determinants of cluster persistence remained across the study periods. These findings highlight the need for effective air quality management strategies to mitigate air pollution's adverse impacts on public health, particularly in the context of respiratory viral diseases like COVID-19.

[Solidarity : new paradigm for health data spaces?] / Solidarité : nouveau paradigme pour les espaces des données de santé ?

At the intersection of health promotion and health data sharing, a normative paradigm is emerging: solidarity. This principle became evident with the European Commission's proposal for the European Health Data Space in 2022, approved by the European Parliament in 2024, and Switzerland's DigiSanté project. This article examines health data spaces beyond traditional legal considerations, exploring the implications of increased reliance on solidarity. Highlighting public and private actors, it analyzes the use of health data for research, health surveillance, and profit. The article emphasizes the need for robust frameworks to balance data use for the common good and mitigate the risks of repression and exploitation.

À l'intersection entre promotion de la santé et partage de données de santé, un paradigme normatif émerge : celui de la solidarité. Ce principe s'est révélé avec la proposition de la Commission européenne pour l'espace européen des données de santé en 2022, approuvée par le Parlement européen en 2024, et le projet DigiSanté en Suisse. Cet article examine les espaces des données de santé au-delà des considérations juridiques traditionnelles, en explorant les implications d'un recours accru à la solidarité. En mettant en lumière les acteurs publics et privés, il analyse l'utilisation des données de santé à des fins de recherche, de surveillance sanitaire et de profit. L'article souligne la nécessité de cadres robustes pour équilibrer l'utilisation des données pour le bien commun et atténuer les risques de répression et d'exploitation.

[Colorectal cancer screening program in the canton of Vaud: raising awareness]. / Programme vaudois de dépistage du cancer colorectal : évolution de la sensibilisation.

After five years of deployment, the participation rate in the Vaud colorectal cancer (CRC) screening program remains below projected targets. It was found that the communication tools made available to the population did not provide explicit recommendations regarding how to participate. To this end, Unisanté led a project between 2022 and 2023 to increase awareness and widely disseminate tools specifically designed with the target population. The intention was to provide decision-support tools (I decide to participate) and guidance in the system (in what way) to improve participation by the population targeted by the Vaud CRC screening program. This project incorporated the principles of proportionate universalism, that is to say, adapting screening methods to the specific needs of population sub-groups, such as those in a disadvantaged socio-economic position with low or very low levels of health literacy.

À l'issue de cinq années de déploiement, le taux de participation de la population au programme vaudois de dépistage du cancer colorectal (CCR) s'est révélé en dessous des objectifs souhaités Afin de faciliter une décision de participation, un projet global a été conçu par Unisanté entre 2022 et 2023, dont la finalité était de déployer des actions spécifiques de sensibilisation et de mettre à disposition de la population cible des informations d'une très large accessibilité. L'intention était de disposer d'outils d'aide à la décision (je décide à participer) et d'orientation dans le dispositif (de quelle manière) permettant d'amplifier la participation de la population ciblée par le programme vaudois de dépistage du CCR. Ce projet a permis d'adapter la sensibilisation sur les modalités de dépistage aux populations avec un niveau de littératie en santé faible, voire très faible.

[Colorectal cancer in 45-49-year-olds: systematic or targeted screening?] / Cancer du côlon chez les 45-49 ans : dépistage systématique ou ciblé ?

Principles to guide and inform population-based screening decisions cover a wide range of aspects beyond the screening test. Colorectal cancer (CRC) meets these requirements for individuals at moderate risk aged 50 to 69. In Switzerland, screening using a biennial faecal occult blood test or colonoscopy every 10 years is reimbursed free of deductible in 12 programs covering 15 cantons. This article assesses the appropriateness of systematic screening from age 45 in the Swiss context. Prioritizing measures to raise awareness among healthcare professionals and high-risk subjects rather than lowering the age of eligibility would not only be more sensible but would also benefit to the population over 50 years old.

Les critères pour proposer un dépistage organisé couvrent de nombreuses dimensions, au-delà des caractéristiques du test de dépistage. Le cancer colorectal (CCR) répond à ces exigences pour les personnes à risque modéré de 50 à 69 ans. En Suisse, un dépistage par un test biennal de détection de sang occulte dans les selles ou par coloscopie tous les 10 ans est remboursé hors franchise dans 12 programmes couvrant 15 cantons. Cet article fait le point de la situation concernant l'adéquation d'un dépistage organisé du CCR dès 45 ans dans le contexte suisse. Prioriser des mesures de sensibilisation auprès des professionnel-le-s de santé et des sujets à haut risque de CCR serait non seulement plus judicieux que d'abaisser l'âge d'éligibilité au dépistage organisé mais bénéficierait aussi à la population de plus de 50 ans.

Characteristics and Activities of Nurses in Expanded Roles Employed in Swiss Nursing Homes: A Cross-Sectional Study.

BACKGROUND: As the number of nursing home residents with multiple healthcare needs grows, the demand for nursing expertise increases. The implementation of new care models involving nurses with expanded roles is crucial for ensuring quality care in nursing homes. OBJECTIVES: To investigate the characteristics and activities of nurses employed in nursing homes in expanded roles and the factors associated with variation in the activities performed. METHODS: This multicentre cross-sectional survey in Switzerland collected data from a convenience sample of 118 nursing homes between September 2018 and October 2019. From a subsample of 62 nursing homes, we analysed the characteristics and activities of 104 nurses in expanded roles. Associations between the activities performed and the educational background of the nurses in expanded roles, their direct supervisors' positions and the presence of physicians in the nursing homes were examined. RESULTS: Most Registered Nurses in expanded roles were diploma educated (48%), with fewer having a bachelor's (35%) or master's degree (17%). Overall, direct clinical practice and guidance and coaching activities were conducted monthly to weekly; consultation, evidence-based practice, collaboration and ethical decision-making activities were conducted monthly. We saw variations where a higher educational background was associated with more frequent evidence-based practice activities (z = 3.47, p < 0.001), and if direct supervisors were ward managers, nurses in expanded roles worked more frequently below their scope of practice (z = 4.10, p < 0.001). CONCLUSION: This is the first study to use Hamric's integrative Advanced Practice Nursing model to examine the activities of nurses in expanded roles in nursing homes. We found considerable variation in their activities, where nursing homes seem to adapt their roles to their educational background and the local context. IMPLICATIONS FOR PRACTICE: Our findings show the importance of clarifying role expectations for Registered Nurses in expanded roles, allowing them to practice at the top of the licence to meet residents' complex healthcare needs.

Impact of the Covid-19 pandemic on inpatient health care in Switzerland 2020-2021-A descriptive retrospective study using admission data of all Swiss hospitals.

BACKGROUND: As part of the Covid-19-restrictions in Switzerland, a federal ban on non-urgent examinations and treatments was applied to all hospitals during six weeks in spring 2020 ("spring lockdown"). The aim of this study was to comprehensively investigate the consequences of the Covid-19 pandemic on Swiss inpatient admissions based on data of all hospitals, focusing on selected procedures of different medical urgency. METHODS: The study includes all acute care inpatient cases (including Covid-19 cases, excluding cases in psychiatry and rehabilitation) according to the Swiss Medical Statistics of Hospitals. Besides the total number of admissions, subdivided by regions, hospital types and age groups, we focused on selected procedures representing different medical urgency: elective surgeries, cancer surgeries, and emergencies. Procedures were selected based on expert interviews. We compared the number of admissions during spring lockdown and for the whole years 2020 and 2021 in absolute numbers and in percentage changes to the corresponding periods in 2019 (baseline year). RESULTS: During spring lockdown, the number of admissions decreased by 47,156 (32.2%) without catch-up effect by the end of 2020 (-72,817 admissions/-5.8%). With procedure-specific decreases of up to 86%, the decline in admissions was largest for elective surgery, a decline that was only fully reversed in the case of a few procedures, such as joint arthroplasty. Strikingly, admissions due to emergencies also substantially decreased during spring lockdown (stroke -14%; acute myocardial infarction STEMI: -9%, NSTEMI: -26%). Results for the selected procedures in cancer surgery showed no consistent pattern. In 2021, admission numbers for most procedures reached or even exceeded those in 2019. CONCLUSIONS: The substantial reduction in admissions, particularly in elective procedures, may reflect the impact of the triage in favor of anticipated Covid-19-cases during spring lockdown. By the end of 2020, admissions were still at lower levels relative to the previous, pre-pandemic year. The numbers in 2021 reached the same levels as those in 2019, which suggests that the Covid-19 pandemic only temporarily impacted inpatient health care in Switzerland. Long-term consequences of the observed reduction in admissions for emergencies and cancer surgery need to be investigated at the individual level.

Evaluation of health care utilisation and mortality in medical hospitalisations with multimorbidity and kidney disease, according to frailty: a nationwide cohort study.

INTRODUCTION: The impact of impaired kidney function on healthcare use among medical hospitalisations with multimorbidity and frailty is incompletely understood. In this study, we assessed the prevalence of acute kidney injury (AKI) and chronic kidney disease (CKD) among multimorbid medical hospitalisations in Switzerland and explored the associations of kidney disease with in-hospital outcomes across different frailty strata. METHODS: This observational study analysed nationwide hospitalisation records from 1 January 2012 to 31 December 2020. We included adults (age ≥18 years) with underlying multimorbidity hospitalised in a medical ward. The study population consisted of hospitalisations with AKI, CKD or no kidney disease (reference group), and was stratified by three frailty levels (non-frail, pre-frail, frail). Main outcomes were in-hospital mortality, intensive care unit (ICU) treatment, length of stay (LOS) and all-cause 30-day readmission. We estimated multivariable adjusted odds ratios (OR) and changes in percentage of log-transformed continuous outcomes with 95% confidence intervals (CI). RESULTS: Among 2,651,501 medical hospitalisations with multimorbidity, 198,870 had a diagnosis of AKI (7.5%), 452,990 a diagnosis of CKD (17.1%) and 1,999,641 (75.4%) no kidney disease. For the reference group, the risk of in-hospital mortality was 4.4%, for the AKI group 14.4% (adjusted odds ratio [aOR] 2.56 [95% CI 2.52-2.61]) and for the CKD group 5.9% (aOR 0.98 [95% CI 0.96-0.99]), while prevalence of ICU treatment was, respectively, 10.5%, 21.8% (aOR 2.39 [95% CI 2.36-2.43]) and 9.3% (aOR 1.01 [95% CI 1.00-1.02]). Median LOS was 5 days (interquartile range [IQR] 2.0-9.0) in hospitalisations without kidney disease, 9 days (IQR 5.0-15.0) (adjusted change [%] 67.13% [95% CI 66.18-68.08%]) in those with AKI and 7 days (IQR 4.0-12.0) (adjusted change [%] 18.94% [95% CI 18.52-19.36%]) in those with CKD. The prevalence of 30-day readmission was, respectively, 13.3%, 13.7% (aOR 1.21 [95% CI 1.19-1.23]) and 14.8% (aOR 1.26 [95% CI 1.25-1.28]). In general, the frequency of adverse outcomes increased with the severity of frailty. CONCLUSION: In medical hospitalisations with multimorbidity, the presence of AKI or CKD was associated with substantial additional hospitalisations and healthcare utilisation across all frailty strata. This information is of major importance for cost estimates and should stimulate discussion on reimbursement.

Autism spectrum: parents' perspectives reflecting the different needs of different families.

BACKGROUND: Parents of children on the autism spectrum often face great challenges in the care of their child. Early support tailored to families' individual needs is therefore crucial for the development and quality of life of both children on the autism spectrum and their families. However, to date it is unclear whether the support available meets the parents' needs. STUDY AIM: To investigate how the system of care, support, and therapies for children on the autism spectrum is perceived by their parents. METHOD: A total of 57 parents of Swiss children on the autism spectrum participated in an online survey, and 20 of them participated in additional semi-structured interviews. RESULTS: We found that parents of children on the autism spectrum may face substantial challenges and that social support is essential. Two thirds of the participating parents reported a long and difficult diagnostic process as challenging, and 60% expressed their need for closer follow-up after diagnosis and more support. Only one third of the parents stated that they manage their everyday lives well, whereas 17.5% felt exhausted, and more than half of the parents responded that they felt challenged. One fifth indicated that they had poor family support, and half reported substantial financial challenges. At the same time, most families also emphasize how important their neurodivergent children are to the family`s life together. CONCLUSION: It is important that primary pediatricians not only initiate the diagnostic process, but also assess the different needs of the different family independent of the diagnosis and, if necessary, initiate adequate measures or guide parents to institutions in charge. Parents who do not actively express their individual needs should nevertheless be advised about support services, including financial counseling. The positive aspects mentioned by families can be emphasized and used as resources to improve their quality of life.

Using high-density SNP data to unravel the origin of the Franches-Montagnes horse breed.

BACKGROUND: The Franches-Montagnes (FM) is the last native horse breed of Switzerland, established at the end of the 19th century by cross-breeding local mares with Anglo-Norman stallions. We collected high-density SNP genotype data (Axiom™ 670 K Equine genotyping array) from 522 FM horses, including 44 old-type horses (OF), 514 European Warmblood horses (WB) from Sweden and Switzerland (including a stallion used for cross-breeding in 1990), 136 purebred Arabians (AR), 32 Shagya Arabians (SA), and 64 Thoroughbred (TB) horses, as introgressed WB stallions showed TB origin in their pedigrees. The aim of the study was to ascertain fine-scale population structures of the FM breed, including estimation of individual admixture levels and genomic inbreeding (FROH) by means of Runs of Homozygosity. RESULTS: To assess fine-scale population structures within the FM breed, we applied a three-step approach, which combined admixture, genetic contribution, and FROH of individuals into a high-resolution network visualization. Based on this approach, we were able to demonstrate that population substructures, as detected by model-based clustering, can be either associated with a different genetic origin or with the progeny of most influential sires. Within the FM breed, admixed horses explained most of the genetic variance of the current breeding population, while OF horses only accounted for a small proportion of the variance. Furthermore, we illustrated that FM horses showed high TB admixture levels and we identified inconsistencies in the origin of FM horses descending from the Arabian stallion Doktryner. With the exception of WB, FM horses were less inbred compared to the other breeds. However, the relatively few but long ROH segments suggested diversity loss in both FM subpopulations. Genes located in FM- and OF-specific ROH islands had known functions involved in conformation and behaviour, two traits that are highly valued by breeders. CONCLUSIONS: The FM remains the last native Swiss breed, clearly distinguishable from other historically introgressed breeds, but it suffered bottlenecks due to intensive selection of stallions, restrictive mating choices based on arbitrary definitions of pure breeding, and selection of rare coat colours. To preserve the genetic diversity of FM horses, future conservation managements strategies should involve a well-balanced selection of stallions (e.g., by integrating OF stallions in the FM breeding population) and avoid selection for rare coat colours.

Do Varroa destructor (Acari: Varroidae) mite flows between Apis mellifera (Hymenoptera: Apidae) colonies bias colony infestation evaluation for resistance selection?

Since the global invasion of the ectoparasitic mite Varroa destructor (Anderson and Trueman), selection of mite-resistant honey bee (Apis mellifera L.) colonies appears challenging and has to date not broadly reduced colony mortality. The low published estimated heritability values for mite infestation levels could explain the limited genetic progresses obtained so far. We hypothesize that intercolonial horizontal mite transmission could differentially affect the single colonies located in a given apiary and therefore invisibly bias colony infestation phenotypes. This bias may be lower in regions with lower colony density, providing suitable conditions to set up evaluation apiaries. To verify these hypotheses, we monitored mite infestation and reinvasion in experimental colonies, as well as infestation in neighboring colonies belonging to beekeepers in three areas with variable colony densities in the canton of Bern, Switzerland during three consecutive beekeeping seasons. Mite immigration fluctuated between apiaries and years and significantly contributed to colony infestation level. Depending on apiary and year, 17-48% of the mites present in the experimental colonies at the time of the summer oxalic acid final treatment potentially derived from mite immigration that had occurred since mid-spring. Mite immigration was not linked to local colony density or the infestation levels of beekeepers' colonies located within 2 km. Our results do not prove that apiaries for colony evaluation should necessarily be established in areas with low colony density. However, they highlight the high impact of beekeeping management practices on mite colony infestation levels.

Real-life experience of chronic hepatitis C treatment in Switzerland: a retrospective analysis.

BACKGROUND AND AIM: Direct-acting antivirals (DAAs) have revolutionised the management of chronic hepatitis C. We analysed the use of different generations of DAAs over time in Switzerland and investigated factors predictive of treatment failure. METHODS: This retrospective study was conducted within the framework of the Swiss Association for the Study of the Liver and the Swiss Hepatitis C Cohort Study; it included all patients with chronic hepatitis C treated with DAAs between January 2015 and December 2019 at eight Swiss referral centres. RESULTS: A total of 3088 patients were included; 57.3% were male, and the median age was 54 years. Liver cirrhosis was present in 23.9% of the cohort, 87.8% of whom were compensated. The overall sustained virological response (SVR) rate (defined as undetectable HCV RNA at week 12 after the first course of DAA-based treatment) was 96.2%, with an increase over time. The rate of treatment failure dropped from 8.3% in 2015 to 2.5% in 2019. Multivariable analysis revealed that female sex, the use of the latest generation of pangenotypic DAA regimens, Caucasian origin, and genotype (gt) 1 were associated with SVR, whereas the presence of active hepatocellular carcinoma (HCC), gt 3, and increasing liver stiffness were associated with treatment failure. Notably, the presence of active HCC during treatment increased the risk of DAA failure by a factor of almost thirteen. CONCLUSIONS: SVR rates increased over time, and the highest success rates were identified after the introduction of the latest generation of pangenotypic DAA regimens. Active HCC, gt 3 and increasing liver stiffness were associated with DAA failure.

The Swiss National MD-PhD Grants Programme: an analysis of the career trajectories of grant recipients between 1992 and 2021.

AIM OF THE STUDY: The aim of this study is to provide an analysis of the career trajectory of the recipients of a Swiss National MD-PhD grant thirty years after the creation of the Swiss interuniversity MD-PhD programme. METHODS: The study surveyed 277 recipients of a Swiss National MD-PhD grant using an online questionnaire in April 2022. There were twenty questions about participants' demographics, the duration of their MD-PhD training, their career trajectory, current position, research and clinical activity, the impact of the support on the recipients' careers, and their satisfaction with various aspects of the grant. RESULTS: The study showed that 141 out of the 277 grant recipients contacted returned the survey (51% response rate). The gender distribution of the participants was 33% women, 63% men, 4% unknown, which is almost the same as that of all grantees (35% women, 65% men). One hundred and fourteen (81%) respondents had completed their MD-PhD thesis and were graduates, while 27 (19%) were still MD-PhD students. The mean duration of the MD-PhD training was 4.27 years, with a slight upward trend over time. A large proportion of graduates, 81%, remained scientifically active after the grant, most of them in academic settings. Of the grantees who had completed their MD-PhD at least eight years before the survey, 55% had a paid research position with 40% combining research and clinical roles, and 15% doing research only. Seventy-six per cent remained clinically active, 54% occupied leadership positions, and 25% were professors. Most grantees believed that the grant had had a positive impact on their career trajectory. The main challenges included a delay in clinical training, a limited number of clinical positions with dedicated research time after the MD-PhD period, and sub-optimal recognition by hospital hierarchies. CONCLUSION: The data collected for this study confirm that the competitive Swiss National MD-PhD Grants Programme excels in supporting promising physician scientists who remain active in both research and clinical contexts in the long term. The individual grants are perceived as a distinction that acts as the basis for a successful career in academic medicine. Continued support and alternative funding sources, however, will be essential to ensure the programme's sustainability.

By suppressing its MD-PhD fellowship programme, the Swiss National Science Foundation reduces the attractiveness of the physician-scientist career path.

No abstract available.

The MD-PhD programme: a key investment for academic medical centres.

No abstract available.

Socioeconomic Status and Adherence to Preventive Measures During the COVID-19 Pandemic in Switzerland: A Population Based Digital Cohort Analysis.

Objectives: To assess the association between socioeconomic status (SES) and self-reported adherence to preventive measures in Switzerland during the COVID-19 pandemic. Methods: 4,299 participants from a digital cohort were followed between September 2020 and November 2021. Baseline equivalised disposable income and education were used as SES proxies. Adherence was assessed over time. We investigated the association between SES and adherence using multivariable mixed logistic regression, stratifying by age (below/above 65 years) and two periods (before/after June 2021, to account for changes in vaccine coverage and epidemiological situation). Results: Adherence was high across all SES strata before June 2021. After, participants with higher equivalised disposable income were less likely to adhere to preventive measures compared to participants in the first (low) quartile [second (Adj.OR, 95% CI) (0.56, 0.37-0.85), third (0.38, 0.23-0.64), fourth (0.60, 0.36-0.98)]. We observed similar results for education. Conclusion: No differences by SES were found during the period with high SARS-CoV-2 incidence rates and stringent measures. Following the broad availability of vaccines, lower incidence, and eased measures, differences by SES started to emerge. Our study highlights the need for contextual interpretation when assessing SES impact on adherence to preventive measures.