Geneva College

While wastewater-based surveillance (WBS) has informed our understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza and respiratory syncytial virus (RSV) circulation in the community, its use in hospital settings remains limited. We aimed to use WBS to understand the dynamics between SARS-CoV-2, influenza (A/B) and RSV loads in the hospital wastewater and infections among patients in a geriatric hospital in Switzerland. We conducted a prospective WBS study which involved the collection of 24-h composite samples 7 days/week from the centralised hospital wastewater of the geriatric hospital. We measured SARS-CoV-2, influenza A/B and RSV RNA concentrations using digital reverse transcription polymerase chain reaction. Kendall's rank correlation (τ) and cross-correlation function were used to assess the correlation and lag time between the viral RNA loads and SARS-CoV-2, influenza A/B and RSV infections among hospitalised patients. Between 14th October 2024 and 19th April 2025, we collected 166 wastewater samples. The associations between wastewater loads and infections were significant and positive for SARS-CoV-2 (τ = 0.29, 95% confidence interval [CI]: 0.19-0.39, P < 0.01), influenza A (τ = 0.36, 95% CI: 0.25-0.44, P < 0.01) and RSV (τ = 0.48, 95% CI: 0.38-0.57, P < 0.01). In sensitivity analyses restricted to healthcare-associated infections, the associations between wastewater loads and infections among patients remained significant and positive for SARS-CoV-2 (τ = 0.32, 95% CI: 0.23-0.41, P < 0.01), influenza A (τ = 0.24, 95% CI: 0.12-0.34, P < 0.01) and RSV (τ = 0.37, 95% CI: 0.27-0.47, P < 0.01). Increases in wastewater viral load preceded increases in reported SARS-CoV-2 and influenza A healthcare-associated infections by approximately three and five days, respectively. WBS could be used as a complementary early warning system for the circulation of respiratory viruses in hospital settings.

Perioperative antibiotic prophylaxis is crucial in improving outcomes after colorectal surgery. Although guidelines in elective procedures are well established, evidence in emergency settings remains limited. This study evaluated the association between antibiotic timing before incision and 30-day mortality as well as surgical site infections (SSIs) in emergency colorectal surgery. This nationwide retrospective cohort study analyzed colorectal operations recorded in the Swiss National Infection Surveillance Program. Demographics, antibiotic regimens, and surgical characteristics of consecutive cases were compared between elective and emergency procedures. Independent predictors of 30-day mortality and SSIs were identified using multivariable logistic regression adjusted for patient and surgical factors. Timing of antibiotic administration was modeled using natural cubic splines to assess nonlinear effects. Among 63,945 patients, 16,939 (26.5%) underwent emergency procedures. In the fully adjusted model, antibiotic timing was significantly associated with 30-day mortality (p < 0.001) in both elective and emergency operations. A U-shaped pattern was observed, with the lowest predicted 30-day mortality when antibiotics were administered 48 minutes before incision in elective operations (mean 1.28%, 95% CI 1.15 to 1.40) and 51 minutes before incision in emergency procedures (mean 10.50%, 95% CI 9.71 to 11.20). In contrast, antibiotic timing was not significantly associated with SSIs (p = 0.229). In both elective and emergency colorectal operations, early or late administration of antibiotics relative to the incision was associated with increased 30-day mortality. The lowest risk occurred when antibiotics were administered approximately 50 minutes before incision. These findings support optimizing perioperative antibiotic timing to improve postoperative outcomes in emergency colorectal surgery.

Cervical cancer-related mortality remains high in Cameroon, yet data on high-risk human papillomavirus (HR-HPV) genotypes are sparse. This study characterized HR-HPV profiles and evaluated associations with cytomorphological abnormalities and clinical predictors. We enrolled 555 women (≥25 years) from four regions in Cameroon. Cervical samples underwent cytological evaluation and HR-HPV genotyping using polymerase chain reaction (PCR)-based assays (Abbott Laboratories, USA; Sacace Biotechnologies, Italy). Questionnaires were used to collect sociodemographic/clinical data, and associations with cytological abnormalities and clinical factors were assessed using multivariable logistic regression. HR-HPV prevalence was 26.5%, dominated by HPV16 (21.1%), HPV68 (19.4%), and HPV45 (14.3%). Multiple infections (38.8%) significantly increased risks for high-grade squamous intraepithelial lesions (HSIL; odds ratio [OR]=1.59, p=0.002) and squamous cell carcinoma (SCC; OR=2.81, p&lt;0.001). HPV16 showed the strongest association with SCC (OR=23.74, p&lt;0.001) while HPV45 (OR=2.91, p=0.039), HPV31 (OR=4.15, p=0.018), HPV33 (OR=5.47, p=0.039) and HPV52 (OR=6.60, p=0.023) showed significant associations with HSIL and SCC. Significant clinical predictors (p&lt;0.001) included age, parity, tobacco, and HIV-positive status. Our study confirms the diverse HR-HPV genotype profile in Cameroon, with notable frequencies of non-16/18 genotypes and multiple infections. These findings underscore the need for broader-spectrum vaccines and risk-based screening in Cameroon.

Health-related quality of life (HRQoL) has emerged as a central outcome in pediatric type 1 diabetes (T1D), reflecting not only metabolic control but also the lived experience of children, adolescents, and their families.As diabetes care increasingly incorporates continuous glucose monitoring and automated insulin delivery (AID) systems, it is often assumed that improved glycemic metrics will naturally translate into better quality of life.However, accumulating evidence suggests that this relationship is neither linear nor universal and is strongly shaped by age, gender, family dynamics, cultural context, and psychosocial burden. GENDER, AGE, AND PERSISTENT PSYCHOSOCIAL VULNERABILITYe gender differences observed align closely with European and global evidence documenting higher diabetes-related distress among females.Lithuanian registry data show greater emotional burden and lower confidence in self-care among adolescent and emerging adult females, independent of insulin delivery method. [2]Norwegian national data, in the age group 10-17 years, https://ispae-jped.com/

<h2>Abstract</h2><h3>Objectives</h3> We aimed to describe recent epidemiological trends of SARS-CoV-2, influenza virus (A/B), and respiratory syncytial virus (RSV) in the canton of Geneva, Switzerland, using data from the Sentinella network for primary care consultations, hospital-based surveillance at Geneva University Hospitals and municipal wastewater surveillance conducted by Eawag, the Swiss Federal Institute of Aquatic Science and Technology. <h3>Methods</h3> We described the temporal trends in weekly SARS-CoV-2, influenza virus (A/B), and RSV infections among primary care consultations, hospitalized patients and the mean normalized viral load per week for SARS-CoV-2, influenza virus (A/B), and RSV from wastewater samples between 1 July 2022 and 30 April 2025. We used Kendall's rank correlation (τ) to assess the correlation between the viral RNA loads in wastewater and SARS-CoV-2, influenza A, and RSV infections among hospitalized patients between 1 September 2024 and 30 April 2025. <h3>Results</h3> The period from September 2024 to April 2025 was the first extended winter season since the beginning of the COVID-19 pandemic, during which SARS-CoV-2 activity remained consistently lower than previous seasons across all surveillance systems. In contrast, influenza activity was higher than in recent prior winter seasons. There was a decrease in the number of RSV hospitalizations during the 2024–2025 winter season. The associations between wastewater loads and infections were significant and positive for SARS-CoV-2 (τ = 0.75; p <0.01), influenza A (τ = 0.80; p <0.01), and RSV (τ = 0.68; p <0.01). <h3>Conclusions</h3> Our findings contribute to understanding the evolving epidemiology of COVID-19 in relation to the two other respiratory viruses (influenza and RSV) across complementary surveillance systems.

Mevalonate kinase deficiency (MKD) is a rare monogenic autoinflammatory disorder characterized by recurrent fever episodes driven by dysregulated IL-1β secretion. Mutations in the MVK gene cause enzymatic defects resulting in a shortage of geranylgeranyl pyrophosphate, leading to a lowering of the threshold for pyrin inflammasome activation. A cellular model of MKD was established to discover novel inflammatory pathways contributing to disease pathogenesis, with a focus on IL-18 and IFN-γ signaling. Using CRISPR/Cas9 gene editing, we generated a THP1 monocyte cell line harboring homozygous MVK I268T mutations, a pathogenic variant observed in patients with MKD. Functional assays were conducted to assess inflammasome activation and cytokine responses after stimulation with the pyrin agonist etiocholanolone. Experiments using MKD patient-derived peripheral blood mononuclear cells were performed to validate in vitro findings. MVKI268T/I268T THP1 cells exhibited impaired isoprenoid biosynthesis, consistent with the metabolic defect observed in MKD. Activation of the pyrin inflammasome in MVKI268T/I268T THP1 cells induced robust secretion of IL-1β and IL-18, which was attenuated by supplementation with geranylgeranyl pyrophosphate. MKD peripheral blood mononuclear cells hypersecreted IL-18 in response to pyrin inflammasome activation, reflected by elevated IL-18 levels in plasma of MKD patients. Specifically, MKD T and natural killer cells were characterized by enhanced IL-18-driven IFN-γ production. Elevated IFN-γ and IL-18 binding protein levels in MKD plasma as well as transcriptomic data of MKD peripheral blood mononuclear cells further confirmed the presence of an IFN-γ signature in MKD. A pyrin inflammasome-driven IL-18/IFN-γ axis is a key signaling module of MKD-associated inflammation. This pathway may represent a novel target for therapeutic intervention in MKD.

Objectives To define stromal-immune cell crosstalk in cutaneous lupus erythematosus (CLE) using a data-driven approach.Methods We performed 3' scRNA-seq on lesional and non-lesional skin biopsies from patients with subacute cutaneous lupus (SCLE) and healthy volunteers (HV).Cell-cell communication was interrogated by combining LIANA+ consensus analysis with tensor-cell2cell (dimensionality reduction).We interpreted biological information from interactions using gene set enrichment (Reactome) and functional enrichment (PROGENy). ResultsWe analysed fibroblasts (FBs), monocytes, NK, and T cells from paired lesional and non-lesional samples from 3 patients and samples from 3 HV.We identified 8 cell-cell context aware factors, each representing a cell-cell communication

This study aimed to characterize the clinical spectrum and the bacteriological and microbiological etiology of pediatric primary subacute hematogenous osteomyelitis (PSAHO) and to evaluate a modern diagnostic approach for these infections. A single-center, 25-year retrospective review (2000-2025) of 107 consecutive cases of PSAHO was performed. Clinical presentation, traditional inflammatory markers, conventional cultures and nucleic acid amplification tests (NAATs) on blood, and bone and oropharyngeal samples were assessed. Most patients (73.8%) were <4 years. Fever was uncommon (15.9%), and inflammatory markers were frequently normal (white blood cell counts in 81.1%, C-reactive protein levels in 60.4%) and abnormal in 69.2% for erythrocyte sedimentation rates and in 53.8% for platelet count. Low diagnostic sensitivity of conventional blood (4.2%) and bone (25.7%) sample cultures has been reported. In contrast, a comprehensive NAAT-based approach identified or strongly suggested a pathogen in 44.9% of cases. Kingella kingae was the predominant pathogen in children under 4. Oropharyngeal PCR tests potentially identified the pathogen in another 20 cases, and its presence could be reasonably suspected in a further 68 (63.6%). MRI was essential for diagnosis, identifying all lesions, whereas the sensitivity of radiographs was low (<50%). All patients recovered completely, regardless of the management strategy. This study provides three critical advances for clinical practice: (1) PSAHO should be considered in a limping toddler even without fever or elevated inflammatory markers, and MRI is the imaging modality of choice; (2) NAATs are indispensable for etiologic diagnosis, revealing age-dependent pathogens; (3) Oropharyngeal PCR is a useful diagnostic adjunct.

BackgroundThe architecture of bone substitute scaffolds—particularly pore size and organization—plays a crucial role in orchestrating immune responses, osteogenesis and angiogenesis. Yet, the mechanisms linking scaffold design to the temporal dynamics of bone regeneration remain partially understood. To address this, we established a refined in vivo model that integrates histological, molecular, and immunological analyses from a single explant, enabling spatially resolved insight into the bone healing process and dynamics.MethodsUsing a dynamic rabbit calvarial model, we investigated 3D-printed calcium phosphate cement scaffolds designed with concomitant macroarchitectures of 250 μm and 500 µm pores within a single construct, allowing direct intra-animal comparison. The model recapitulated three vertically migrating zones of regeneration—regenerative, osteogenic, and granulation—captured at 2 and 4 weeks. Histomorphometric analyses quantified bone ingrowth, while laser microdissection enabled zone-specific transcriptomic profiling from paraffin-embedded sections previously used for (immuno-)histology. Gene expression was further validated by qPCR and complemented with immunohistochemical characterization of macrophage and neutrophil populations.ResultsHistological analysis revealed a consistent spatial organization of bone regeneration across conditions. After 4 weeks, scaffolds with 250 µm pores exhibited more homogeneous and advanced bone formation than those with 500 µm pores or particulate substitutes. Transcriptomic analysis identified 280–381 differentially expressed genes between microporous architectures, with over half being non-coding RNAs, suggesting an important role for post-transcriptional regulation. Enrichment analyses indicated modulation of pathways involved in immune activity, ossification, calcium signaling and autophagy. Immunohistochemistry confirmed similar inflammatory mechanisms across both macroarchitectures but revealed earlier M1-to-M2 macrophage transition and faster inflammatory resolution with the finest porous network.ConclusionThis integrative in vivo model provides a robust workflow for correlating structural, cellular, and molecular dimensions of bone regeneration within the same specimen. The findings show that scaffold macroarchitecture influences both the extent and timing of immune and osteogenic processes. While scaffolds with 250 μm and 500 µm pores supported regeneration, the finer design consistently promoted more advanced tissue formation and maturation. These results underscore the key role of scaffold design in modulating bone healing and highlight this model as a platform for studying structure–function relationships in bone tissue engineering.