Psychiatry Baselland

Functional gastrointestinal disorders (FGIDs) are common in childhood, but psychological correlates remain poorly understood. We compared emotional and behavioural functioning in children with FGIDs with somatic and healthy controls. Parents of children aged 2-12 years were recruited at the University Children's Hospital Basel (February 2024-February 2025). Children meeting Rome IV criteria formed the Functional Group; those with somatic gastrointestinal diseases and healthy peers served as Somatic and Healthy Controls. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and Patient Health Questionnaire (PHQ-4). Group differences were tested using non-parametric models and adjusted negative binomial regression. Data from 218 children were analysed (Functional n = 66, Somatic n = 62, Healthy n = 90). SDQ total difficulties were markedly higher in FGIDs than in both control groups (p < 0.001). Differences were most pronounced for emotional and hyperactivity problems. Using age-adjusted SDQ total difficulties cut-offs, elevated scores occurred in 45.5% of children with FGIDs, compared with 8.1% in somatic and 10.0% in healthy peers. Parental psychological distress and separation predicted higher difficulties. Emotional and behavioural difficulties in FGIDs exceed those observed in somatic gastrointestinal diseases, indicating a particularly high psychosocial burden. These findings highlight the relevance of psychological aspects within integrated paediatric gastroenterology care.

BackgroundCerebral venous sinus thrombosis (CVST) is an uncommon cerebrovascular condition, constituting less than 1% of all stroke cases, particularly affecting young adults. CVST typically presents with nonspecific symptoms, complicating timely diagnosis. Although anticoagulation remains the primary treatment, complicated cases may necessitate endovascular intervention. Reports of CVST presenting with multifaceted neurological and orthopedic complications in young patients without thrombophilic disorders are uncommon, underscoring the importance and educational value of documenting such cases.Case presentationWe report the case of an 18-year-old female without prior medical or migraine history who presented to the emergency department with a six-day history of persistent, progressive headache accompanied by nausea. Initial clinical evaluation revealed no neurological deficits, but symptoms and positional exacerbation warranted further investigation. Neuroimaging via contrast-enhanced CT demonstrated extensive thrombosis involving the superior sagittal sinus and bilateral cortical veins, accompanied by minimal parietal hemorrhage and edema. Endovascular thrombectomy was performed due to progressive neurological deterioration, achieving significant clot reduction and continuous venous recanalization. Despite treatment, the patient experienced persistent left-sided hemianopsia and subsequent focal seizures, managed effectively with anti-epileptic therapy. She also sustained an orthopedic injury; anteroinferior left shoulder dislocation, secondary to nocturnal seizure activity, requiring orthopedic intervention. Extensive thrombophilia screening was negative, with no identifiable hereditary factors. Follow-up imaging showed marked thrombus resolution, clinical symptoms improved significantly, and hemianopsia resolved completely after seven months.ConclusionsThis case illustrates the potential severity and complexity of CVST in healthy young patients. It underscores the importance of prompt diagnosis and multidisciplinary management, including consideration of endovascular thrombectomy in refractory or complicated cases. Further research is needed to elucidate the underlying mechanisms and optimize treatment strategies, particularly in young patients without identifiable thrombophilic disorders.

Background/Objectives: Formation of tight contacts between oral soft tissue and dental implants is a significant challenge in contemporary implantology. An essential role in this process is played by oral epithelial cells. In the present study, we investigated how titanium and zirconia surfaces with different roughness influence various parameters of oral epithelial cells in vitro. Methods: We used the human oral squamous carcinoma Ca9-22 cell line and cultured them on the following surfaces: machined smooth titanium (TiM) and zirconia (ZrM) surfaces, as well as sandblasted and acid-etched titanium moderately rough (SLA) and zirconia (ZLA) surfaces. Cell proliferation/viability was measured by CCK-8 assay, and cell morphology was analyzed by fluorescent microscopy. The gene expression of interleukin (IL)-8, intercellular adhesion molecule (ICAM)-1, E-cadherin, integrin (ITG)-α6, and ITG-β4 was measured by qPCR, and the content of IL-8 in conditioned media by ELISA. Results: At the initial culture phase, cell proliferation was promoted by rougher surfaces. Differences in cell attachment were observed between machined and moderately rough surfaces. Machined surfaces were associated with slightly higher IL-8 levels (p < 0.05). Furthermore, both ZLA and SLA surfaces promoted the expression of (ITG)-α, ITG-β4, and ICAM-1 in Ca9-22 cells (p < 0.05). Surface material had no impact on the investigated parameters. Conclusions: Under the limitations of this in vitro study, some properties of oral epithelial cells, particularly the immunological and barrier function, are moderately modified by roughness but not by material. Hence, the roughness of the implant surface might play a role in the quality of the peri-implant epithelium.

The application of patient-derived organoids (PDOs) in prostate cancer (PCa) research has been hampered by poor take rates and benign overgrowth. We highlight the limitations of existing culture conditions and identify extracellular matrix composition as a determinant of organoid outcome. Single-cell RNA sequencing reveals that Matrigel-free PDOs exhibit cellular heterogeneity, preserve patient-specific PCa cells with active androgen receptor signaling, and enrich in intermediate cells. In contrast, Matrigel fails to maintain primary PCa cells and produces in vitro basal-like features divergent from patient samples. Furthermore, we redefine cell-type signatures, identify biomarkers discriminating tumor versus other cell types, and show that expression of laminin-binding integrins is a hallmark of Matrigel-derived organoids. Finally, integrating previously published datasets with our data, we generate a prostate PDO single-cell atlas (PPScA), which captures a spectrum of cellular identities while revealing pathways altered in vitro. Our study provides methodological improvements for short-term culture and cellular biology insights.

549 Background: Breast cancer (BC) treatment selection is traditionally guided by clinical characteristics. However, as clinical characteristics cannot capture the complexity of a disease, genomic tools have been developed. Recent advances in artificial intelligence (AI) have allowed pathology imaging to be used to build more accurate and comprehensive prognostic/predictive models. In this study, we validated an AI test, powered by a pan-cancer histopathology foundation model, that integrates digital pathology images with clinical variables to predict breast cancer recurrence. Methods: The Ataraxis AI prognostic model (ATX) was developed using 4,659 stage I-III BC patients from 10 distinct cohorts. Ataraxis AI platform first extracts novel morphological features from digitized H&amp;E slides using a pre-trained AI foundation model. These morphological features are then integrated with common clinical characteristics, such as TNM staging, ER/PR/HER2 status, age at diagnosis, or lobular or ductal histology to generate a risk score between 0 and 1. We evaluated ATX on 3,502 patients from 5 external cohorts, including 858 patients with available Oncotype DX (ODX) scores. The primary endpoint of this study was disease-free interval (DFI), defined as the time until first recurrence, with deaths prior to recurrence censored. Results: Across 3,502 patients spanning five validation cohorts, ATX accurately predicted DFI with a C-index of 0.71 [0.68-0.75] and hazard ratio (HR) of 3.63 [3.02-4.37, p &lt; 0.01], computed for every 0.2 unit increase in the test score. Compared to ODX (n = 858), the ATX was more accurate, achieving a C-index of 0.67 [0.61-0.74] versus 0.61 [0.49-0.73]. Additionally, ATX added independent prognostic information to ODX in a multivariate analysis (HR: 3.11 [1.91-5.09, p &lt; 0.01]). ATX demonstrated robust accuracy in TNBC (n = 230, C-index: 0.71 [0.62-0.81], HR: 3.81 [2.35-6.17, p = 0.02]) and HER2+ (n = 353, C-index: 0.67 [0.55-0.80], HR: 2.22 [0.99-5.01, p = 0.05]) groups. Conclusions: (1) ATX is predictive of breast cancer recurrence, (2) ATX improves upon the accuracy of ODX, (3) ATX demonstrates robust performance in all main BC subtypes. ATX evaluated across 5 cohorts individually and pooled, for both Harrell’s C-index and hazard ratio. Cohort N C-index HR Karmanos 168 0.62 [0.49-0.75] 3.82 [1.33-10.98, p=0.01] Basel 269 0.67 [0.58-0.77] 3.98 [1.92-8.25, p&lt;0.01] TCGA 911 0.70 [0.63-0.77] 3.0 [2.1-4.28, p&lt;0.01] Providence 1733 0.74 [0.7-0.79] 4.02 [3.09-5.23, p&lt;0.01] Chicago 421 0.70 [0.60-0.80] 3.25 [1.45-7.31, p&lt;0.01] Pooled 3502 0.71 [0.68-0.75] 3.63 [3.02-4.37, p&lt;0.01]

Abstract Background Lymph node metastases (LNM) have an important prognostic value in colorectal cancer (CRC) and staging intends to determine adjuvant treatment. Lymph node ratio, defined as the proportion of positive lymph nodes compared to the total amount of resected lymph nodes, seems to have an important prognostic impact while taking the quality of lymphadenectomy and number of resected lymph nodes into account compared to the conventional N-stage. Previous studies could demonstrate better prognostic predication of LNR compared to conventional N-stage. Aims We aimed to evaluate the prognostic impact of LNR on the outcome of patients with CRC. Methods This is a unicentre retrospective cohort study. We included all patients undergoing surgical resection for colorectal cancer between 2014 and 2022 in a specialised centre in Switzerland. We used predefined LNRs from previous publications in CRC. Survival rates according to N-stage and LNRs were analysed using uni- and multivariate Cox regression. Results 493 patients were included. The median number of resected lymph nodes was 28. 5-year overall survival (OS) was 94% in N0-stage (n=301/493). Patients with LNMs (n=192/493) had decreasing 5-year overall survival (72% with pN1 and 52% in pN2). LNR showed decreasing 5-year OS with increasing LNR (50% in LNR2, 36% in LNR3 and 30% in LNR4, p &amp;lt; 0.001). Additionally, disease free survival (DFS) showed the same dynamic with 50% 5-year DFS in LNR2-3 and 33% in LNR 4 (p = 0.002). While most of the N1-stage patients showed LNR1, 4/122 (3%) had LNR2-3 and therefore a poorer prognosis. Conclusion The predefined LNRs should be standardly used for risk stratification in CRC as they add to the prognostic value of the conventional N-stage. LNR allows to predict 5 year OS and DFS more precisely than conventional N-stage.

Postpartum depression (PPD) is a serious mental health problem that affects about 17% of mothers. The aims of the current study were to observe the associations between prenatal stress, self- and expert-rated PPD, and prepartal and postpartal hair cortisol and cortisone concentrations as proxies for altered hypothalamic-pituitary-adrenal axis activity (HPA-AA). A total of 129 mothers (mean age 33.1 years) completed the Edinburgh Postnatal Depression Scale 3 days (baseline) and 12 weeks (study end) postpartum. At the end of the study, participants reported on prepartum stressful life events, experts rated participants' symptoms of depression, and participants provided 6 cm of hair strands for analysis of hair glucosteroid levels 12 weeks before and 12 weeks after delivery. Prepartal stress was associated with higher scores for self- and expert-rated PPD and with lower hair cortisone concentrations as a proxy for less adaptive HPA-AA. Higher prepartal and postpartal hair cortisol/cortisone ratios (i.e., higher cortisol/lower cortisone concentrations) were associated with higher PPD symptom scores. Women with prepartal stress were at increased risk of experiencing PPD 12 weeks after delivery. Altered hair steroid levels (lower cortisone concentrations) as a proxy for altered HPA-AA further substantiated this association. Results suggest that 1) both prepartal stress and the suppression of HPA-AA appear to be involved in the development of PPD; 2) hair steroid analysis can be used to predict PPD; and 3) women with prepartal stressful life events may benefit from timely support and relief to decrease their risk of developing PPD.