Blending public health and primary care together means building bridges between professionals – those who deal with the health and care of individuals and those who deal with the health of a population. At the organizational level, many factors facilitate the integration of these two areas among which  a clear mandate with a vision, identified goals, and the development of a collaborative culture. In French-speaking Switzerland, the integration of public health and general medicine into a common university dynamic was one of the driving forces behind the Alliance santé project that led to the creation of Unisanté in 2019. Elsewhere in the world, similar institutions already exist and sometimes take different forms. In this article, we will briefly present four of them in Wales, Scotland, Canada and the Netherlands.Gender bias in medicine negatively interfere with the medical care of both men and women, which can lead to risks for patients as well as health inequalities. Unisanté has launched a pilot project to integrate reflexivity by students at the Medical School of the University of Lausanne on the influence of gender in clinical practice, using an electronic portfolio. The clinical vignettes presented and discussed in this article illustrate this reflective work and the main biases and stereotypes encountered pain management, assessment of the psychosocial context, management of domestic violence, screening for chlamydia infection and discussion of a contraceptive method.The new federal Act on registration of oncological diseases requires since January 1st 2020 institutions and treating physicians to transmit regulated data on all Swiss cancer cases and some precancerous pathologies to the competent tumour registry, and to inform their patients about it. This legal basis is intended to enlarge cancer data collection and registration in a traceable, better standardized, more complete and rapid manner. These legal provisions are expected to improve the reliability and efficiency of the analysis of the data, which is crucial for the epidemiological surveillance of cancer in Switzerland, for the benefit of public health policy, clinical management and for the population.Consistent with the principles of evidence-based medicine, communicating clinical risks to patients and their families is an essential part of informed consent and decision-making. Communication of clinical risks can take place during and after consultations, orally or in writing, based on the latest available scientific data, when available. Numerous studies show that there are different degrees of innumeracy in the general population, meaning more or less significant difficulties mastering numbers in everyday situations. It is therefore imperative to communicate risks in a way that is adapted to the patients’ variable numeracy and health literacy levels. This article presents a synthesis of international research on risk communication, as well as recommendations for clinical practice.The NLST study in the United States showed, in 2011, that low-dose lung CT scans can reduce lung cancer mortality but was limited in its routine recommendation by 96% of false positive screening results. The European NELSON trial, published in 2020, confirmed a 24% decrease in lung cancer mortality and, by using lung nodule volume and volume doubling time, decreased false positive results to 56% of positive tests. The implementation of screening programs is now expected in Europe, including Switzerland. In anticipation, we have developed a decision aid to present patients with the benefits (decreased lung cancer mortality), risks (false positives and indeterminate results), and uncertainties (incidental findings) of lung cancer screening.Neuronal injury is a universal event that occurs in disease processes that affect both the central and peripheral nervous systems. A blood biomarker linked to neuronal injury would provide a critical measure to understand and treat neurologic diseases. #link# Neurofilament light chain (NfL), a cytoskeletal protein expressed only in neurons, has emerged as such a biomarker. With the ability to quantify neuronal damage in blood, NfL is being applied to a wide range of neurologic conditions to investigate and monitor disease including assessment of treatment efficacy. Blood NfL is not specific for one disease and its release can also be induced by physiological processes. Longitudinal studies in multiple sclerosis, traumatic brain injury, and stroke show accumulation of NfL over days followed by elevated levels over months. Therefore, it may be hard to determine with a single measurement when the peak of NfL is reached and when the levels are normalized. Nonetheless, measurement of blood NfL provides a new blood biomarker for neurologic diseases overcoming the invasiveness of CSF sampling that restricted NfL clinical application. In this review, we examine the use of blood NfL as a biologic test for neurologic disease.

Microbiology inhibitor (PI) is defined as a sleep disorder with no definite cause or inducement. Electroacupuncture, a treatment of inserting needles into specific points on the body surface and applying electrical stimulation, has been proved effective in treating PI with minimal adverse effects. However, the influence of gender difference on the clinical treatment efficacy of electroacupuncture for PI patients remains unclear. Therefore, we designed a clinical trial to compare the clinical treatment efficacy of electroacupuncture for PI patients with different genders. The research on the mechanism of electroacupuncture suggested it could modulate the sleep and wakefulness by activating or deactivating brain regions via a needling/tactile somatosensory specific stimulus. Therefore, we also designed a resting-state functional magnetic resonance imaging (rs-fMRI) study to detect the spontaneous brain activity of PI patients before and after the electroacupuncture treatment.

Thirty PI patients were recruited to cupuncture may be one of the factors affecting clinical treatment efficacy.

There is a gender-related difference in the clinical treatment efficacy of electroacupuncture for PI patients, and female patients may benefit more from electroacupuncture. Gender-related differences in the cerebral response to electroacupuncture may be one of the factors affecting clinical treatment efficacy.