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The Alpine region was shaped by repeated glaciations during the Quaternary, which led to the formation of overdeepened valleys and basins. These features today, hidden below the present-day land surface, host multiple stacked and nested glacial sequences and offer valuable insight into the environmental history and geomorphological evolution of the region. The project Drilling Overdeepened Alpine Valleys (DOVE) of the International Continental Scientific Drilling Program (ICDP) is dedicated to investigating such overdeepened structures around the Alps. Within DOVE, we here focus on the Tannwald Basin in southern Germany. Situated distally within the area formerly occupied by the Rhine Glacier piedmont lobe; it was shaped by multiple glaciations, yet it is located outside the Last Glacial Maximum (LGM) ice extent. Previous seismic imaging and the presence of interglacial pollen sequences indicate a multi-phase infill history. The complex sedimentary architecture observed in a newly drilled core allows for comparison with seismic data and lithological evidence from other sites. On the basis of a lithofacies model that introduces 17 lithotypes, we propose that the basin fill is composed of three lithostratigraphic units that reflect the glacial history of the basin. After the erosion of the Tannwald Basin, a cold-climate, stacked basin-infill sequence recorded sedimentation of two glacial advances, before it was covered by LGM outwash. The sedimentary record includes an extensive basal glacial shear zone with deformed bedrock and several overlying diamict horizons. Further upcore, deformation structures underscore the role of gravitational processes as well as profound glaciotectonics, deforming the sediment deep within the subsurface. While the sedimentary record indicates a rather rapid infill of the depression, further age constraints and detailed investigations of ice-contact sediments will clarify open questions regarding the temporal classification of the deposits.

The modern Alpine landscape and its foreland were strongly impacted by the numerous glacier advance and retreat cycles during the Middle-to-Late Pleistocene. Due to the overall erosive character of each glaciation cycle, however, direct traces of older glaciations tend to be poorly preserved within the formerly glaciated domains of the pan-Alpine area. Nevertheless, sediments of older glaciations may occur hidden under the modern surface in buried glacially overdeepened troughs that reach below the normal level of fluvial erosion (fluvial base level). These sedimentary archives, partly dating back to the Middle Pleistocene period, are of great scientific value for reconstructing the timing and extent of extensive Alpine glaciation, paleoclimate, and paleoenvironmental changes in the past and help to better understand ongoing and future changes in the pan-Alpine area. Therefore, the International Continental Scientific Drilling Program (ICDP) project DOVE (Drilling Overdeepened Alpine Valleys) targets several of these glacial overdeepened sedimentary basins to recover their sedimentary infills. In the frame of the DOVE project, a 252 m long drill core of unconsolidated Quaternary sediments was recovered in northern Switzerland from an over 300 m deep glacially overdeepened structure (“Basadingen Trough”) formed by the former Rhine Glacier lobe system. The recovered sedimentary succession was divided into three stratigraphic units on the basis of lithological and petrophysical characteristics. The lowest unit, deposited below the fluvial base level, consists of an over 200 m thick succession of glacial to (glacio)lacustrine sediments and contains remains of possibly two glaciation cycles. Overlying this lowermost succession, an ∼ 37 m thick fluvial-to-glaciofluvial gravel deposit occurs, which correlates to a locally outcropping Middle Pleistocene formation (“Buechberg Gravel Complex”). The sediment succession is capped by an ∼ 11 m thick diamictic succession interpreted as the subglacial till from the later extensive glaciation, including the regional glaciation during the Last Glacial Maximum. The recovered sediment succession thus supports the proposed multi-phase origin of trough formation and its infill.

Abstract The Deckenschotter is a fluvial to glaciofluvial gravel unit in northern Switzerland and southern Germany. The deposits are considered the oldest preserved glacial to interglacial Quaternary deposits in the northern Alpine foreland and are thus important geomorphological markers for landscape evolution. Nevertheless, the age of the deposits is only approximately known and subject to controversial debates. This study presents the results of an extensive palaeomagnetic investigation carried out on intercalated fine-grained sediments at 11 sites of the Höhere Deckenschotter (HDS) and at 5 sites of the Tiefere Deckenschotter (TDS). The HDS show reversed and normal magnetisations, indicating deposition > 0.773 Ma, while the TDS exhibit only normal directions. Age constraints for the different sites are discussed in the light of evidence from other studies. The study therefore clearly supports the efforts to determine the age of the Deckenschotter. As data from previous palaeomagnetic studies on the HDS and TDS have not been published or preserved, this is in fact the only data-based palaeomagnetic study available.

Background: SLN mapping has emerged as a standard of care in endometrial cancer due to its high sensitivity and significant reduction in morbidity. Although lymphovascular space invasion (LVSI) is a known risk factor for lymph node metastasis and recurrence, evidence on the reliability of SLN mapping in LVSI-positive patients is scarce. The aim of this study was to determine the impact of LVSI on the diagnostic performance of SLN mapping. Methods: This retrospective cohort study included patients with endometrial cancer who underwent primary surgical treatment at the Bern University Hospital, Switzerland, between 2012 and 2022. Results: LVSI was present in 22% of patients and was significantly associated with lymph node metastasis (p < 0.001) and recurrence (p < 0.001). In node-negative patients with only SLN mapping performed, LVSI was an independent predictor of recurrence during multivariable Cox regression analysis (p = 0.036). The negative predictive value of SLN mapping was 91.5% and was significantly lower in tumors with LVSI (75.0%) compared to LVSI-negative tumors (95.6%, p = 0.004). Conclusion: The presence of LVSI was significantly associated with worse oncological outcomes. LVSI was an independent predictor of recurrence in node-negative patients with only SLN mapping performed. Furthermore, the negative predictive value of SLN mapping was significantly lower in LVSI-positive tumors.

Abstract The modern, over 250-m-deep basin of Lake Constance represents the underfilled northern part of an over 400-m-deep, glacially overdeepened trough, which reaches well into the Alps at its southern end. The overdeepening was formed by repeated glacial advance-retreat cycles of the Rhine Glacier throughout the Middle to Late Pleistocene. A seismic survey of Lake Constance revealed a Quaternary sediment fill of more than 150 m thickness representing at least the last glacial cycle. The stratified sedimentary fill consists at the base of ice-contact deposits on top of the molasse bedrock, overlain by glaciolacustrine to lacustrine sediments. During the successful field test of a newly developed, mid-size coring system ("HIPERCORIG"), the longest core (HIBO19) ever taken in Lake Constance was retrieved with an overall length of 24 m. The sediments recovered consist of a nearly continuous succession of lacustrine silts and sands including more than 12 m of Late Glacial sediment at the base. 14 lithotypes were identified through petrophysical and geochemical analyses. In combination with a 14C- and OSL-based age-depth model, the core was divided into three main chronostratigraphic units. The basal age of ~ 13.7 ka BP dates the base of the succession back to the Bølling-Allerød interstadial, with overlying strata representing a complete and thick Younger-Dryas to Holocene succession. The sediments offer a high-resolution insight into the evolution of paleo-Lake Constance from a cold, postglacial to a more productive and warmer Holocene lake. The Late Glacial succession is dominated by massive, m-thick sand beds reflecting episodic sedimentation pulses. They are most likely linked to a subaquatic channel system originating in the river Seefelder Aach, which is, despite the Holocene drape, still apparent in today’s lake bathymetry. The overlying Holocene succession reveals a prominent, several cm-thick, double-turbiditic event layer representing the most distal impact of the Flimser Bergsturz, the largest known rockslide of the Alps that occurred over 100 km upstream the river Rhine at ~ 9.5 ka BP. Furthermore, lithologic variations in the Holocene succession document the varying sediment loads of the river Rhine and the endogenic production representing a multitude of environmental changes.

Abstract Background Low back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients’ multidimensional needs. Providing inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during weekends. Delays in therapeutic procedures may result in a prolonged length of hospital stay (LoS). The impact of delays on LoS might be strongest in patients reporting high levels of psychological distress. Therefore, this study investigates the influence of weekday of admission and distress on LoS of inpatients with LBP. Methods This retrospective cohort study was conducted between 1 February 2019 and 31 January 2020. In part 1, a negative binomial model was fitted to LoS with weekday of admission as a predictor. In part 2, the same model included weekday of admission, distress level, and their interaction as covariates. Planned contrast was used in part 1 to estimate the difference in log-expected LoS between group 1 (admissions Friday/Saturday) and the reference group (admissions Sunday-Thursday). In part 2, the same contrast was used to estimate the corresponding difference in (per-unit) distress trends. Results We identified 173 patients with LBP. The mean LoS was 7.8 days (SD = 5.59). Patients admitted on Friday (mean LoS = 10.3) and Saturday (LoS = 10.6) had longer stays, but not those admitted on Sunday (LoS = 7.1). Analysis of the weekday effect and planned contrast showed that admission on Friday or Saturday was associated with a significant increase in LoS (log ratio = 0.42, 95% CI = 0.21 to 0.63). A total of 101 patients (58%) returned questionnaires, and complete data on distress were available from 86 patients (49%). According to the negative binomial model for LoS and the planned contrast, the distress effect on LoS was significantly influenced (difference in slopes = 0.816, 95% CI = 0.03 to 1.60) by dichotomic weekdays of admission (Friday/Saturday vs. Sunday-Thursday). Conclusions Delays in interdisciplinary LBP management over the weekend may prolong LoS. This may particularly affect patients reporting high levels of distress. Our study provides a platform to further explore whether interdisciplinary LBP management addressing patients’ multidimensional needs reduces LoS in primary care hospitals.

Luminescence dating has become a pillar of the understanding of Pleistocene glacial advances in the northern foreland of the Swiss Alps. However, both quartz and feldspar from the region are equally challenging as dosimeters with anomalous fading and partial bleaching being some of the obstacles to overcome for the establishment of decisive chronologies. In this study, luminescence properties of coarse- and fine-grained quartz, feldspar, and polymineral fractions of eight samples from a palaeovalley, Rinikerfeld in northern Switzerland, are systematically assessed. Standard performance tests are conducted on all four fractions. Deconvolution of luminescence signals of the quartz fractions is implemented and shows the dominance of stable fast components. Reader-specific low preheat temperatures are investigated on the infrared stimulated luminescence (IRSL) signal of feldspar. Thermal stability of this signal is found for low preheats, and thermal quenching could be excluded for higher preheats. However, anomalous fading is observed in the feldspar and polymineral IRSL signals and two correction approaches are applied. For one approach, fading corrected coarse-grained feldspar ages are consistent with those derived from quartz. In general, coarse-grained quartz and feldspar, as well as the fine-grained polymineral fraction of one sample, are in chrono-stratigraphic agreement and present negligible evidence for partial bleaching. However, ages derived from fine-grained quartz are found to underestimate those of the coarse-grained quartz fractions. Hence, the impact of alpha efficiency and water content on the dose rate and thus the ages are assessed. A finite explanation for the observed discrepancies remains lacking, but this systematic investigation of different luminescence signals allows for the establishment of a chronology for the palaeovalley fill dating back to at least Marine Isotope Stage 6 (MIS 6).

Background: Fibromyalgia (FM) is a chronic primary pain condition, associated with widespread musculoskeletal pain, disturbed sleep, fatigue, cognitive dysfunction, and a range of comorbid conditions such as irritable bowel syndrome, and depression. Despite its high prevalence of 2% in the general population, FM continues to pose scientific and clinical challenges in definition, etiology, and day-to-day management. In terms of treatment, FM can be treated with selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs).Objective: Patients with FM and other chronic primary pain syndromes are known to experience substantial and clinically relevant placebo effects. An update of the placebo responses for various outcomes in the FM population and especially a discussion about clinical implications is therefore needed.Methods: We used data from a large data pool that includes randomized controlled trials (RCTs) examining within-placebo mean change scores of baseline vs. follow-up assessments in FM trials of SSRIs and SNRIs. The primary outcomes were pain, functional disability, and depression and using different scales. We assessed heterogeneity of included trials.Results: A total of 29 RCTs with N = 8,453 patients suffering from FM were included in our analysis. Within-placebo mean change scores of baseline vs. follow-up assessments were large for pain (mean change = 2.31, 95% CI: 0.42–4.21, p = 0.017), functional disability (mean change = 3.31, 95% CI: 2.37–4.26, p < 0.000), and depression (mean change = 1.55, 95% CI: 0.92–2.18, p < 0.000). Heterogeneity was found to be large for all outcomes.Impact: Our results provide preliminary evidence that placebo responses, which also consist of non-specific effects, might play a role in the treatment of FM. Furthermore, we highlight limitations of our analyses and make suggestions for future studies.