University of Innsbruck

The health status (HS) of children is influenced by a variety of factors, including physical fitness (PF) or social and environmental characteristics. We present a 4-year longitudinal study carried out with 263 primary school children. PF was assessed yearly using the German Motor Performance Test 6-18. Demographic data, leisure time behavior and socioeconomic factors were collected using questionnaires for children and parents. Based on parents' ratings in year 4, children were categorized as either "very good health status" (VGHS) or "good health status or below" (GHSB). Children with VGHS (73%) showed a larger improvement of global PF (p < 0.001), a significantly higher proportion of being/playing outside (p < 0.001), significantly lower proportions of overweight (p < 0.001), of media availability in the bedroom (p = 0.011) and of daily media consumption > 2 h (p = 0.033) compared to children with GHSB. Regarding socioeconomic factors, children with VGHS revealed significantly fewer parents with lower education (p = 0.002), lower physical activity levels (p = 0.030) 2 AIMS Public Health Volume 11, Issue 1, 1-18. and lower migration background (p < 0.001). Physical fitness (p = 0.019) and outdoors exercising (p = 0.050) were the only variables to provide significantly higher chances of perceiving one's own health as very good when tested within a complex model including all the variables studied in this work. Considering the little focus on PF in the current Austrian physical education curriculum and the favorable environmental features of the Tyrolean region, more emphasis should be given to promoting didactical and pedagogical approaches that allow schoolers to be active in the nature.

BACKGROUND The presence and clinical significance of hepatic tissue alterations as assessed by cardiac magnetic resonance imaging in patients with ST-segment–elevation myocardial infarction (STEMI), are unclear. This study aimed to investigate associations of hepatic T1 patterns with myocardial tissue damage and clinical outcomes in patients suffering from STEMI. METHODS We analyzed 485 patients with STEMI treated with percutaneous coronary intervention who were enrolled in the prospective magnetic resonance imaging in acute ST-elevation myocardial infarction study (MARINA STEMI). Myocardial function and left and right ventricular (RV) infarct characteristics were assessed by cardiac magnetic resonance within the first week after STEMI. Native hepatic T1 times and extracellular volume were evaluated from standard cardiac T1 maps at baseline and 4 months thereafter. RESULTS Median hepatic T1 times were 559 ms (interquartile range, 514–605) at baseline and decreased to 542 ms (interquartile range, 507–577) at 4 months ( P <0.001). Hepatic T1 times at baseline were independently associated with female sex (β 0.116; P =0.008), hyperlipidemia (β −0.116; P =0.008), and myocardial tissue damage (infarct size: β 0.178; P <0.001; microvascular obstruction: β 0.193; P <0.001; RV infarction: β 0.161; P <0.001). Determinants of hepatic T1 times at 4 months were female sex (β 0.123; P =0.002), multivessel disease (β 0.121; P =0.002), N-terminal pro–B-type natriuretic peptide (β 0.101; P =0.010), RV infarction (β 0.501; P <0.001), and RV end-systolic volume index (β 0.087; P =0.031). Patients without a decrease exhibited a higher frequency of major adverse cardiovascular events (13% versus 5%; P =0.003). Hepatic T1 times at baseline (hazard ratio, 1.87 [95% CI, 1.40–2.50]; P <0.001), 4 months (hazard ratio, 2.69 [95% CI, 2.15–3.36]; P <0.001), and hepatic extracellular volume at 4 months (hazard ratio, 1.59 [95% CI, 1.33–1.90]; P <0.001) were associated with major adverse cardiovascular events. After adjustment for univariable associates, only hepatic T1 times at 4 months were independently associated with adverse outcomes (hazard ratio, 2.86 [95% CI, 1.99–4.12]; P <0.001). CONCLUSIONS Hepatic tissue alterations determined by T1 mapping were associated with female sex, hyperlipidemia, multivessel disease, N-terminal pro–B-type natriuretic peptide, and left and RV myocardial tissue damage. These alterations can persist into the chronic phase after STEMI and indicate a worse clinical outcome. REGISTRATION URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04113356.

Background Unawareness or anosognosia of memory impairment is a common phenomenon in patients with Alzheimer's disease (AD). Different findings have been reported regarding its presentation, assessment procedure, and cognitive correlates. Objective To assess memory awareness of early AD patients predictively (before memory testing) and online (immediately after performing a memory test). Methods All participants were outpatients of a memory clinic. AD patients were compared with participants having mild cognitive impairment (MCI) and a group with normal cognitive aging (NC). We used a performance-based assessment procedure to measure self-perceived memory abilities. An anosognosia ratio was calculated by matching self-estimates with objective memory scores derived from the Consortium to Establish a Registry for Alzheimer's disease Neuropsychological battery. Results Memory anosognosia in terms of self-overestimation was found in almost half of the AD sample, only rarely in MCI, and was not present in NC. Most AD patients had both, a low prediction and also a deficient online accuracy of self-estimation. Memory overestimators were older, less educated, and had significantly poorer neuropsychological scores. A stepwise linear regression analysis showed that memory anosognosia was predicted by age, everyday functional abilities and neuropsychological variables, including executive and mnestic abilities. Conclusions Poor cognitive and memory functions combined with memory anosognosia are a hallmark of early AD. Further, mnemonic anosognosia as assessed by performance based measures separates AD patients already in the early disease stage from subjects with MCI or normal controls. Our findings highlight the importance of assessing memory self-appraisal in subjects attending a memory clinic, in addition to clinical and cognitive variables.

Decline in immune function with age has been studied extensively, but approaches to immune restoration have been hampered by the lack of simple methods of identifying individuals whose immune system is in decline. Our approach has been to identify individuals whose immune decline has led to a loss of control of common latent viral infections and their consequent reactivation. Viruses excreted in urine were detected and quantified and we believe this approach could provide a 'surrogate marker' for identifying immune compromised individuals. Here we report the detection of human herpes virus (HHV) 5, 6a, 6b and 7 in the urine of healthy individuals over a wide age range and their correlation with T cell receptor excision circle (TREC) data. The results did not show a clear correlation between TREC values and the detection of individual specific viruses or viral load values when measured singly. However, a correlation was found between low TREC values and the detection of several different human herpes viruses in the urine in males. We present evidence suggesting that for males, the detection of three or more different human herpes viruses in the urine could identify individuals with declining immune function as evidenced by their significantly lower TREC levels.

This study presents the mechanochemical synthesis of the two K2Ca(CO3)2 polymorphs, fairchildite and buetschliite, from CaCO3 and K2CO3 using a shaker mill. Unlike previous methods requiring high temperatures and prolonged heating, fairchildite, a high-temperature polymorph, is formed initially in all experiments, adhering to Ostwald's rule of stages. Notably, the transformation to the stable buetschliite phase can be achieved by varying milling parameters, particularly frequency and moisture content. The results suggest that pressure, rather than temperature, plays a significant role in this phase transition, with moisture further accelerating the transformation. These findings offer a new, efficient route for the synthesis of these polymorphs, highlighting the critical influence of milling conditions on the reaction pathway.

General anesthesia (GA) earlier than recommended (as first‐ or second‐line treatment) was recently described to improve status epilepticus (SE) outcome. We aimed to assess the impact of early GA on outcome in matched groups. Data from a multicenter, prospective cohort of 1179 SE episodes in 1049 adults were retrospectively analyzed. Incident SE episodes were categorized as “early anesthesia” (eGA; GA as first‐ or second‐line treatment) or “non‐early anesthesia” (neGA; GA after second‐line treatment or not at all). Using propensity score matching, eGA episodes were paired 1:4 with neGA episodes. We assessed survival, functional outcomes at discharge (good: modified Rankin Scale = 0–2 or no worsening), SE cessation rate, SE duration, and hospital stay. Among 1049 SE episodes, 55 (5.2%) received eGA, and 994 constituted the neGA group; 220 represented the matched controls. Patients receiving eGA were younger (median = 63, interquartile range [IQR] = 56–76 vs. median = 70, IQR = 54–80 years, p = .004), had deeper consciousness impairment (80% vs. 40% stuporous/comatose, p < .001), and had more severe SE forms (89% vs. 54% generalized convulsive SE/nonconvulsive SE in coma, p < .001). Mortality, functional outcome, SE cessation rate, and duration of SE and hospital stay were similar between the eGA group and matched controls. We conclude that early anesthesia for SE treatment did not influence prognosis.

Background and Aims Data on upadacitinib therapy in children with ulcerative colitis (UC) or unclassified inflammatory bowel disease (IBD-U) are scarce. We aimed to evaluate the effectiveness and safety of upadacitinib as an induction therapy in pediatric UC or IBD-U. Methods In this multicenter retrospective study, children treated with upadacitinib for induction of remission of active UC or IBD-U from 30 centers worldwide were enrolled. Demographic, clinical and laboratory data as well as adverse events (AEs) were recorded at week 8 post induction. Results One hundred children were included (90 UC and 10 IBD-U, median age 15.6 [interquartile range 13.3–17.1] years). Ninety-eight were previously treated with biologic therapies, and 76 were treated with ≥2 biologics. At the end of the 8-week induction period, clinical response, clinical remission, and corticosteroid-free clinical remission (CFR) were observed in 84%, 62%, and 56% of the children, respectively. Normal C-reactive protein and fecal calprotectin (FC) <150 mcg/g were achieved in 75% and 50%, respectively. Combined CFR and FC remission was observed in 18/46 (39%) children with available data at 8 weeks. AEs were recorded in 37 children, including one serious AE of an appendiceal neuroendocrine tumor. The most frequent AEs were hyperlipidemia (n=13), acne (n=12), and infections (n=10, five of whom with herpes viruses). Conclusion Upadacitinib is an effective induction therapy for refractory pediatric UC and IBD-U. Efficacy should be weighed against the potential risks of AEs.

The design of a compact electron source for mass spectrometry applications based on commercially available plug-and-play light sources and sturdy materials is presented, and its performance of photo-electron production is evaluated. We report quantum yields ranging between 1–2.5 × 10–5 for aluminum, 9 × 10–8–3 × 10–6 for stainless steel, 1– 2.2 × 10–6 for molybdenum, 6.3 × 10–7–5.1 × 10–6 for tantalum, and 1.4–2.1 × 10–6 for titanium, depending on the wavelength range of the irradiation source. In terms of quantum yield, the deuterium lamp provided better results compared to the two UV LEDs for all metals. However, due to their higher optical output power, the LEDs nevertheless yield a higher photoelectron current for all metals except for stainless steel. The measured photocurrents ranged from 1-2 nA for aluminum to 0.01 nA for Stainless Steel samples.

Objective To analyze long‐term clinical and biomarker features of anti‐contactin‐1 (CNTN1) autoimmune nodopathy (AN). Methods Patients with anti‐CNTN1 ⁺ autoimmune nodopathy detected in our laboratory from which clinical information was available were included. Clinical features and treatment response were retrospectively collected. Autoantibody, serum neurofilament light chain (sNfL), and serum CNTN1 levels (sCNTN1) were analyzed at baseline and follow up. Results A total of 31 patients were included. Patients presented with progressive sensory motor neuropathy (76.7%) with proximal (74.2%) and distal involvement (87.1%), ataxia (71.4%), and severe disability (median INCAT at nadir of 8). A total of 11 patients (35%) showed kidney involvement. Most patients (97%) received intravenous immunoglobulin, but only 1 achieved remission with intravenous immunoglobulin. A total of 22 patients (71%) received corticosteroids, and 3 of them (14%) did not need further treatments. Rituximab was effective in 21 of 22 patients (95.5%), with most of them (72%) receiving a single course. Four patients (12.9%) relapsed after a median follow up of 25 months after effective treatment (12–48 months). Anti‐CNTN1 titers correlated with clinical scales at sampling and were negative after treatment in all patients, but 1 (20/21). sNfL levels were significantly higher and sCNTN1 significantly lower in anti‐CNTN1 ⁺ patients than in healthy controls (sNfL: 135.9 pg/ml vs 7.48 pg/ml, sCNTN1: 25.03 pg/ml vs 22,186 pg/ml, p < 0.0001). Both sNfL and sCNTN1 returned to normal levels after successful treatment. Interpretation Patients with anti‐CNTN1 ⁺ autoimmune nodopathy have a characteristic clinical profile. Clinical and immunological relapses are infrequent after successful treatment, suggesting that continuous treatment is unnecessary. Anti‐CNTN1 antibodies, sNfL, and sCNTN1 levels are useful to monitor disease status in these patients. ANN NEUROL 2024

Aim To determine the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) among Western Austrian adolescents and its association with arterial stiffness as a marker of early vascular ageing. Methods In the cross-sectional Early Vascular Ageing in the YOUth study, liver fat content was assessed by controlled attenuation parameter (CAP) using signals acquired by FibroScan (Echosense, Paris, France) in 14- to 19-year-old Austrian adolescents. Arterial stiffness was determined by carotid-femoral pulse wave velocity (cfPWV) and cardiovascular risk factors by a face-to-face interview, physical examination, and fasting blood analyses. Linear regression models and one-way analysis of variance were performed to analyze the association between liver fat content, MASLD and cfPWV. Results A total of 1292 study participants (65.2% female) aged 17.2 ± 1.3 years were included. MASLD was detected in 62 (4.8%) adolescents. CAP value showed a significant association with cfPWV in the unadjusted model (p < 0.001) but lost its significant influence in the multivariable model after adjusting for sex, age and cardiovascular risk criteria (increased BMI or waist circumference, impaired glucose metabolism, elevated blood pressure, elevated plasma triglycerides, and decreased HDL cholesterol; p = 0.540). In the analysis of variance, a significant increase in cfPWV was observed in adolescents with any of the five cardiovascular risk criteria for MASLD (p < 0.001), but not with the additional presence of steatotic liver disease (p = 0.291). Conclusion In our adolescent cohort, liver fat content and MASLD were not found to be independent predictors for early vascular ageing. Nevertheless, the determination of liver fat content can be a useful tool to identify adolescents at high risk for cardiovascular disease and metabolic syndrome.

Dihydrogen bonding is a peculiar type of attractive interaction occurring between a partially positively charged hydrogen atom and a partially negatively charged hydrogen atom. Borazine represents a prototypical molecule exhibiting dihydrogen bonding in both gas phase, as well as in its crystalline form. For borazine assemblies on solid surfaces, a direct observation and characterization of dihydrogen bonding has remained elusive, possibly due to an intricate interplay of substrate‐molecule and intermolecular interactions. Here we present evidence of dihydrogen bonding occurring in borazine assemblies on a Au(111) surface. By means of low‐temperature scanning tunneling microscopy, we unveiled distinct configurations, exhibiting single and double dihydrogen bonding. Density functional theory calculations elucidate the interplay between substrate adsorption and intermolecular interactions to stabilize the formation of borazine dimers on Au(111), being the building blocks for the formation of larger assemblies.

Background In high-grade ovarian cancer (HGOC), determination of homologous recombination deficiency (HRD) status is commonly used in routine practice to predict response to platinum-based therapy or poly (ADP-ribose) polymerase inhibitors (PARPi). Here we tested the hypothesis that BRCA loss of function (LOF) due to epigenetic or genetic aberrations is a better predictor for the clinical outcome than HRD. One hundred thirty-one HGOC tissues were tested for BRCA DNA-methylation, BRCA mutations, HRD and BRCA1 mRNA expression, followed by a comprehensive survival analysis. Results BRCA1-methylation was detected in 11% of the tumors, exclusively in BRCA1-wild-type (wt) HGOCs. BRCA1-methylated tumors (BRCA1-meth) had HRD-scores similar to those of BRCA-mutated (mut) tumors, and higher compared to unmethylated-BRCA-wt tumors (BRCA-wt-unmeth; P < 0.001). Platinum-refractory or -resistant HGOCs at first recurrence were all BRCA-unmeth cancers. Only one of the BRCA-mut cancers had a platinum-resistant recurrence. Thus, 99% of relapses in cancers with epigenetic or genetic BRCA-alterations were platinum-sensitive. Multivariate analysis confirmed BRCA-LOF as an independent predictor of progression-free survival (PFS) and overall survival (OS), whereas HRD-status had no predictive value for PFS and OS. Patients with BRCA-wt-unmeth cancers had the worst outcome compared to patients with cancers harboring epigenetic or genetic BRCA-alterations (PFS: P = 0.007; OS: P = 0.022). Most importantly, the BRCA-wt-unmeth subfraction of HRD-positive HGOCs exhibited the same poor survival as the entire HRD-negative cohort. Conclusion In HGOC BRCA mutational status together with BRCA1-methylation exhibit the best predictive power for favorable clinical outcome and thus high sensitivity to platinum-based therapy, whereas BRCA-unrelated HRD positivity was not associated with improved platinum sensitivity.

Background Glioblastoma is the most frequent and aggressive brain cancer. It is a highly immunology-driven disease as up to a third of its mass is composed of immune cells. Apart from immunology, imaging is a major research frontier. The VASARI (Visually AcceSAble Rembrandt Images) MRI feature set is a system designed to enable consistent description of gliomas using a set of defined visual features and controlled vocabulary. Even though imaging and immunology are both indispensable for glioblastoma phenotyping, a comprehensive integration of these two disciplines has not been performed so far. Material and methods 76 patients from a previous glioblastoma immunotherapy clinical trial were retrospectively screened for the availability of peripheral blood immunology and tumor imaging data at baseline, i.e. at the start of the study. For 41 patients both were available. MRI were then analyzed via volumetry and VASARI morphometry. The resulting 27 imaging variables were linked with 67 peripheral blood immunology variables from flow cytometry and PCR and all potential relations were mapped. Results In an initial broad screening, 94 imaging-immunology associations were discovered. Notably, features of the contrast-enhancing margin like its thickness and its shape were positively correlated with various T cell species including activated cytotoxic CD8+ T cells and central memory CD8+ T cells. The T2-volume was correlated with CD56+CD16− natural killer cells, and the necrosis volume was correlated with immunopolarizing mRNAs in the blood (IFN-γ, GATA3, ROR-gt). After multiple testing correction, two imaging-immunology associations were confirmed as significant: a thick contrast-enhancing margin was correlated with lower regulatory T cell markers in the blood and invasion of deep white matter was correlated with less T helper 17 factors. Conclusion We here provide first evidence that imaging and peripheral blood immunology features can go hand in hand and that imaging variables can correlate with systemic immunophenotypes. Especially a thick contrast-enhancing margin seems to indicate a pro-inflammatory immune state. Via pioneering the integration of imaging and immunology, we not only advance basic glioblastoma science but we also open up novel avenues for research. In the future, e.g. patient stratification for therapy development could be based on imaging-guided immunophenotyping.

Introduction The effect of different anaesthetics on the incidence of postoperative delirium is still not entirely clear. Therefore, we will evaluate the effect of desflurane versus sevoflurane versus propofol for the maintenance of anaesthesia on the incidence of postoperative delirium in older adults undergoing moderate- to high-risk major non-cardiac surgery. We will further compare the incidences of delayed neurocognitive recovery, long-term postoperative neurocognitive disorder, postoperative nausea and vomiting between the groups. Methods and analysis In this multicentre, prospective, observer-blinded, randomised controlled clinical trial, we will include 1332 patients ≥65 years of age undergoing moderate- to high-risk major non-cardiac surgery lasting at least 2 hours. Patients will be randomly 1:1:1 assigned to receive desflurane, sevoflurane or propofol for anaesthesia. Maintenance of anaesthesia will be performed in a goal-directed manner using processed electroencephalography with an intraoperative goal of bispectral index 40–60. Our primary outcome will be the incidence of postoperative delirium within the first five postoperative days. Postoperative delirium will be assessed using the three-dimensional-confusion assessment method (3D-CAM) or CAM-intensive care unit (ICU) in the morning and evening of the first five postoperative days by blinded study personnel. The primary outcome, the incidence of postoperative delirium, will be compared between the three study groups using a χ ² test. Furthermore, a logistic regression model for the incidence of postoperative delirium will be performed, accounting for randomised groups as well as other predefined confounding factors. Ethics and dissemination This clinical trial has been approved by the ethics committee and the Federal Office for Safety in Healthcare as the competent authority for clinical trials in Austria. The results of this trial will be published in a peer-reviewed journal. Trial registration number ClinicalTrials.gov NCT05990790 .

While previous research on cabinet reshuffles has offered valuable distinctions in terms of their timing, other defining features of reshuffles have largely escaped comparative inquiry. This article seeks to develop a more complete comparative assessment of cabinet reshuffles in parliamentary systems that reaches beyond the ‘classic’ samples of Westminster democracies. We seek to distinguish different ‘types’ of cabinet reshuffles that account for several key features, namely: the mode, the scope, the key principal, and the party dimension of reshuffles. The usefulness and validity of this typology is demonstrated by a comparative assessment of cabinet reshuffles in four major West European parliamentary democracies. The conceptual distinctions and related empirical observations offered in this article should prove valuable in particular when it comes to gauging the likely political and policy effects of different types of cabinet reshuffles, and should, ultimately, provide the foundations of a theory of comparative cabinet reshuffles.

This special collection is devoted to cabinet reshuffles, which are understood as personnel-related changes within the lifetime of a cabinet. Scholars agree that cabinet reshuffles matter in many respects. To begin, they may shape intra-governmental relations, by either intensifying or helping solve cabinet conflicts. Further, they are important instruments for party leaders to promote or demote party representatives, with far-reaching possible consequences for the party and beyond. Last but not least, reshuffles may be used to increase governmental efficiency and often trigger policy change. The ever-increasing personalization of politics has fuelled the public interest in any ministerial personnel-related issues, and turned cabinet reshuffles into events of undisputed political and scholarly relevance. Despite the apparent importance and ubiquity of reshuffles, the international literature displays at least two major flaws: first, a lack of systematic comparison across countries and regimes and second, a strong notional and empirical bias towards Westminster democracies. This collection seeks to overcome these weaknesses and their limiting effects on the knowledge and understanding of key aspects of executive politics and executive–legislative relations. With that aim, it gathers novel comparative research on the different types, causes and effects of cabinet reshuffles in a variety of democratic and authoritarian systems. The theoretical approaches and empirical findings of the six articles featured mark a major contribution to the scholarship on political executives and executive elites in the contemporary world. This introductory piece offers a succinct historical overview of cabinet reshuffles in different contexts, and the study thereof