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Introduction Approximately 30% of somatic hospital inpatients experience psychosocial distress, contributing to increased (re-)hospitalisation rates, treatment resistance, morbidity, and direct and indirect costs. However, such distress often remains unrecognised and unaddressed. We established ‘SomPsyNet’, a ‘stepped and collaborative care model’ (SCCM) for somatic hospital inpatients, aiming at alleviating this issue through early identification of distress and provision of appropriate care, providing problem-focused pathways and strengthening collaborative care. We report the protocol of the ‘SomPsyNet’ study, aiming to evaluate implementation and impact of the SCCM on distressed patients’ health-related quality of life. Secondary objectives include assessing efficacy of the screening procedures, influence of SCCM on other health outcomes and associated costs.Methods and analysis Our stepped wedge cluster randomised trial conducted at three tertiary hospitals comprises three conditions: treatment as usual (TAU) without screening for distress (phase 0), TAU with screening but without consequences (phase I, main comparator) and TAU with screening and psychosomatic-psychiatric consultations for those distressed (phase II). The time-of-transition between phases I and II was randomised. Sample size target is N=2200–2500 participants, with 6 month follow-up for distressed (anticipated n=640–700) and a subsample of non-distressed (anticipated n=200) patients. Primary outcome is mental health-related quality of life (SF-36 ‘Mental Health Component Summary score’); secondary outcomes include psychosocial distress, anxiety, depressive and somatic symptoms, symptom burden and distress, resilience, social support and qualitative of life, assessed by internationally accepted instruments, with good psychometric properties. Further, health claims data will be used to assess SCCM’s impact on direct and indirect costs.Ethics and dissemination SomPsyNet adheres to the Helsinki Declaration and is approved by the ‘Ethikkommission Nordwest- und Zentralschweiz’ (2019–01724). Findings will be published in peer-reviewed journals and communicated to participants, healthcare professionals and the public.Trial registration number Swiss National Clinical Trials Portal; ClinicalTrials.gov (NCT04269005, updated 19.09.2023).

Pandemic and endemic strains of Vibrio cholerae arise from toxigenic conversion by the CTXφ bacteriophage, a process by which CTXφ infects nontoxigenic strains of V. cholerae. CTXφ encodes the cholera toxin, an enterotoxin responsible for the watery diarrhea associated with cholera infections. Despite the critical role of CTXφ during infections, signals that affect CTXφ-driven toxigenic conversion or expression of the CTXφ-encoded cholera toxin remain poorly characterized, particularly in the context of the gut mucosa. Here, we identify mucin polymers as potent regulators of CTXφ-driven pathogenicity in V. cholerae. Our results indicate that mucin-associated O-glycans block toxigenic conversion by CTXφ and suppress the expression of CTXφ-related virulence factors, including the toxin co-regulated pilus and cholera toxin, by interfering with the TcpP/ToxR/ToxT virulence pathway. By synthesizing individual mucin glycan structures de novo, we identify the Core 2 motif as the critical structure governing this virulence attenuation. Overall, our results highlight a novel mechanism by which mucins and their associated O-glycan structures affect CTXφ-mediated evolution and pathogenicity of V. cholerae, underscoring the potential regulatory power housed within mucus.

The classical hypercontractive inequality for the noise operator on the discrete cube plays a crucial role in many of the fundamental results in the Analysis of Boolean functions, such as the Kahn-Kalai-Linial theorem, Friedgut's junta theorem and the invariance principle of Mossel, O'Donnell and Oleszkiewicz. In these results the cube is equipped with the uniform (1/2-biased) measure, but it is desirable, particularly for applications to the theory of sharp thresholds, to also obtain such results for general p-biased measures. However, simple examples show that when p is small there is no hypercontractive inequality that is strong enough for such applications. In this paper, we establish an effective hypercontractivity inequality for general p that applies to 'global functions', i.e. functions that are not significantly affected by a restriction of a small set of coordinates. This class of functions appears naturally, e.g. in Bourgain's sharp threshold theorem, which states that such functions exhibit a sharp threshold. We demonstrate the power of our tool by strengthening Bourgain's theorem, making progress on two conjectures of Kahn and Kalai (both these conjectures were open when we arXived this paper in 2019; one of them was solved in 2022; the other is still open), and proving a p-biased analogue of the seminal invariance principle of Mossel, O'Donnell, and Oleszkiewicz. In this 2023 version of our paper we will also survey many further applications of our results that have been obtained by various authors since we arXived the first version in 2019. [ABSTRACT FROM AUTHOR]

Determining the maximum size of a t$t$‐intersecting code in [m]n$[m]^n$ was a longstanding open problem of Frankl and Füredi, solved independently by Ahlswede and Khachatrian and by Frankl and Tokushige. We extend their result to the setting of forbidden intersections, by showing that for any m>2$m>2$ and n$n$ large compared with t$t$ (but not necessarily m$m$) that the same bound holds for codes with the weaker property of being (t−1)$(t-1)$‐avoiding, that is, having no two vectors that agree on exactly t−1$t-1$ coordinates. Our proof proceeds via a junta approximation result of independent interest, which we prove via a development of our recent theory of global hypercontractivity: we show that any (t−1)$(t-1)$‐avoiding code is approximately contained in a t$t$‐intersecting junta (a code where membership is determined by a constant number of coordinates). In particular, when t=1$t=1$, this gives an alternative proof of a recent result of Eberhard, Kahn, Narayanan and Spirkl that symmetric intersecting codes in [m]n$[m]^n$ have size o(mn)$o(m^n)$. [ABSTRACT FROM AUTHOR]

Dietary habits are a determining factor of the higher incidence and prevalence of chronic non-communicable diseases (NCDs). In the aim to find a possible preventive and intervention strategy, the Mediterranean diet (MedDiet) has been proposed as an effective approach. Within the MedDiet, moderate wine consumption with meals is a positive item in the MedDiet score; however, recent studies have reported a dose-response association between alcohol consumption and higher risk of a large number of NCDs. This review aimed to evaluate the association between NCDs and wine consumption in the framework of the MedDiet, with a simple review of 22 studies of the highest-level literature published over the last five years. We found that the information regarding the effects of wine in different health outcomes has not varied widely over the past five years, finding inconclusive results among the studies evaluated. Most of the literature agrees that light to moderate wine intake seems to have beneficial effects to some extent in NCDs, such as hypertension, cancer, dyslipidemia and dementia, but no definitive recommendations can be made on a specific dose intake that can benefit most diseases.

Myelodysplasia is a clonal disorder characterized by progressive cytopenias. Intravescial BCG is standard immunotherapy for superficial bladder cancer. We present a patient with transfusion-dependent myelodysplasia whose blood counts normalized during treatment with intravesical BCG for bladder cancer. After finishing treatment, the patient became transfusion dependent once more. We discuss possible mechanisms to explain this case report.