Anti-Spike IgG antibodies as correlates of protection against SARS-CoV-2 infection in the pre-Omicron and Omicron era.

Anti-Spike IgG antibodies against SARS-CoV-2, which are elicited by vaccination and infection, are correlates of protection against infection with pre-Omicron variants. Whether this association can be generalized to infections with Omicron variants is unclear. We conducted a retrospective cohort study with 8457 blood donors in Tyrol, Austria, analyzing 15,340 anti-Spike IgG antibody measurements from March 2021 to December 2022 assessed by Abbott SARS-CoV-2 IgG II chemiluminescent microparticle immunoassay. Using a Bayesian joint model, we estimated antibody trajectories and adjusted hazard ratios for incident SARS-CoV-2 infection ascertained by self-report or seroconversion of anti-Nucleocapsid antibodies. At the time of their earliest available anti-Spike IgG antibody measurement (median November 23, 2021), participants had a median age of 46.0 years (IQR 32.8-55.2), with 45.3% being female, 41.3% having a prior SARS-CoV-2 infection, and 75.5% having received at least one dose of a COVID-19 vaccine. Among 6159 participants with endpoint data, 3700 incident SARS-CoV-2 infections with predominantly Omicron sublineages were recorded over a median of 8.8 months (IQR 5.7-12.4). The age- and sex-adjusted hazard ratio for SARS-CoV-2 associated with having twice the anti-Spike IgG antibody titer was 0.875 (95% credible interval 0.868-0.881) overall, 0.842 (0.827-0.856) during 2021, and 0.884 (0.877-0.891) during 2022 (all p < 0.001). The associations were similar in females and males (Pinteraction = 0.673) and across age (Pinteraction = 0.590). Higher anti-Spike IgG antibody titers were associated with reduced risk of incident SARS-CoV-2 infection across the entire observation period. While the magnitude of association was slightly weakened in the Omicron era, anti-Spike IgG antibody continues to be a suitable correlate of protection against newer SARS-CoV-2 variants.

Linked Care: A Harmonized Workflow for Medication Ordering, Prescription and Dispensing in Mobile Care Settings.

The growing demand for care amid changing demographics poses significant challenges exacerbated by decreasing healthcare professional availability. In Austria, the Linked Care project aims to address these challenges by developing an intersectoral, harmonized IT-supported workflow for medication ordering, prescription, and dispense in mobile care settings. A human centered design approach, with user-focused interviews and workshops was used to identify requirements and analyze the workflows. Activity diagrams were used represent workflows. The resulting harmonized workflow, developed through iterative collaboration with care organizations, integrates the LC platform into existing care software. To test and demonstrate the harmonized workflow, mockups were created and evaluated for usability, resulting in positive feedback and suggestions for enhancements. Current workflows revealed media breaches and inefficiencies, which the proposed harmonized workflow seeks to address. The paper concludes with implications for future developments, including the subsequent adoption of a HL7 FHIR Implementation Guide for Austria, based on the defined harmonized workflow, to streamline intersectoral communication and improve efficiency in mobile care settings.

Development of an Austrian HL7 Member FHIR IG Supporting Medication Ordering, Prescription and Dispense Processes.

The Austrian research project Linked Care explored digitalization in mobile care, focusing on streamlining the medication process to save nursing staff time. A FHIR R5-based workflow was developed to support medication ordering by nurses, prescriptions by practitioners, and dispensing by pharmacies. Key FHIR resources were profiled and published in an HL7 Austria Member Implementation Guide (IG). The IG includes specifications and technical details for implementation and was the first member-contributed IG approved by the HL7 Austria FHIR community in early 2024. These specifications are now being implemented and will be tested in late 2024.

Smart FOX - Enabling Citizen-Based Donation of EHR-Standardised Data for Clinical Research in Austria.

Access to healthcare data for secondary use in clinical research is often restricted due to privacy concerns or business interests, hindering comprehensive analysis across patient pathways. The Smart FOX project seeks to address this challenge by developing concepts, methods, and tools to facilitate citizen/patient-driven donations of health data for clinical research. Leveraging the groundwork, laid by the national Electronic Health Record implementation in Austria (called ELGA), Smart FOX aims to harness structured datasets from ELGA for research purposes through an opt-in approach. With funding secured from the Austrian Research Promotion Agency, the project embarks on innovative solutions encompassing governance frameworks, community engagement, and technical infrastructure. The Smart FOX consortium, comprising key stakeholders across various healthcare-associated domains, will evaluate these efforts through demonstrators focusing on clinical registries, patient-generated data, and recruitment services. The project targets to accompany the development of future data donation infrastructure while ultimately advancing clinical research efficiency and bolstering Austria's preparedness for the European Health Data Space. This paper presents the first systematic evaluation of the technical concept and proposal for the federated system architecture of the Austrian Health Data Donation Space, which is the socio-technical goal of Smart FOX.

Policies and opportunities for physical activity engagement in Austrian schools: a census survey.

Background: Compelling evidence suggests that schools' infrastructure and policy represent potential predictors of health and physical activity (PA) in children and adolescents. However, the translation of these findings into practice has not been examined. This study investigated the activity friendliness of Austrian schools. Methods: Using a census sampling method, principals of Austrian schools (n = 342) were invited to participate in an online survey assessing 1) the availability of PA facilities (e.g. playgrounds, sports courts, swimming halls) and 2) applied PA policies (e.g. cooperation with sports clubs and involvement in PA projects). Results: A total of 130 principals answered the survey which corresponds to a minimal response rate of 38%. While most schools (87.4%, n = 111) had a gymnastic hall, only one third (37%, n = 47) had access to a swimming hall. On average, the schools had 4.2 ± 2 PA facilities with significant variation between school types (i.e., high schools: 5 ± 2 vs. primary schools: 3.5 ± 2, p < 0.05). The most common facilities were meadow areas (89%, n = 113), sports fields (71.7%, n = 91), and playgrounds (64.6%, n = 82). Almost half of the schools were part of a PA project (e.g. "active break", 45%, n = 56) and offered extracurricular PA programs and courses (54%, n = 67), but only one in five (22%, n = 27) regularly conducted fitness tests. PA policies varied between school types (p < 0.05) but almost all principals (94%, n = 117) would welcome a stronger promotion of activity friendliness at their school. Conclusion: Schools are mostly activity-friendly regarding infrastructure although the limited possibilities for swimming lessons seem worrisome. PA promotion through projects, extracurricular PA offerings and fitness tests may be expanded.

Is something rotten in the state of Denmark? Cross-national evidence for widespread involvement but not systematic use of questionable research practices across all fields of research.

Questionable research practices (QRP) are believed to be widespread, but empirical assessments are generally restricted to a few types of practices. Furthermore, conceptual confusion is rife with use and prevalence of QRPs often being confused as the same quantity. We present the hitherto most comprehensive study examining QRPs across scholarly fields and knowledge production modes. We survey perception, use, prevalence and predictors of QRPs among 3,402 researchers in Denmark and 1,307 in the UK, USA, Croatia and Austria. Results reveal remarkably similar response patterns among Danish and international respondents (τ = 0.85). Self-reported use indicates whether respondents have used a QRP in recent publications. 9 out of 10 respondents admitted using at least one QRP. Median use is three out of nine QRP items. Self-reported prevalence reflects the frequency of use. On average, prevalence rates were roughly three times lower compared to self-reported use. Findings indicated that the perceived social acceptability of QRPs influenced self-report patterns. Results suggest that most researchers use different types of QRPs within a restricted time period. The prevalence estimates, however, do not suggest outright systematic use of specific QRPs. Perceived pressure was the strongest systemic predictor for prevalence. Conversely, more local attention to research cultures and academic age was negatively related to prevalence. Finally, the personality traits conscientiousness and, to a lesser degree, agreeableness were also inversely associated with self-reported prevalence. Findings suggest that explanations for engagement with QRPs are not only attributable to systemic factors, as hitherto suggested, but a complicated mixture of experience, systemic and individual factors, and motivated reasoning.

Shaping future practices: German-speaking medical and dental students' perceptions of artificial intelligence in healthcare.

BACKGROUND: The growing use of artificial intelligence (AI) in healthcare necessitates understanding the perspectives of future practitioners. This study investigated the perceptions of German-speaking medical and dental students regarding the role of artificial intelligence (AI) in their future practices. METHODS: A 28-item survey adapted from the AI in Healthcare Education Questionnaire (AIHEQ) and the Medical Student's Attitude Toward AI in Medicine (MSATAIM) scale was administered to students in Austria, Germany, and Switzerland from April to July 2023. Participants were recruited through targeted advertisements on Facebook and Instagram and were required to be proficient in German and enrolled in medical or dental programs. The data analysis included descriptive statistics, correlations, t tests, and thematic analysis of the open-ended responses. RESULTS: Of the 409 valid responses (mean age = 23.13 years), only 18.2% of the participants reported receiving formal training in AI. Significant positive correlations were found between self-reported tech-savviness and AI familiarity (r = 0.67) and between confidence in finding reliable AI information and positive attitudes toward AI (r = 0.72). While no significant difference in AI familiarity was found between medical and dental students, dental students exhibited slightly more positive attitudes toward the integration of AI into their future practices. CONCLUSION: This study underscores the need for comprehensive AI education in medical and dental curricula to address knowledge gaps and prepare future healthcare professionals for the ethical and effective integration of AI in practice.

"How long is life worth living for the horse?" A focus group study on how Austrian equine stakeholders assess quality of life for chronically ill or old horses.

BACKGROUND: Quality of life (QoL) provides a comprehensive concept underpinning veterinary decision-making that encompasses factors beyond physical health. It becomes particularly pertinent when seeking responsible choices for chronically ill or old horses that emphasise their well-being and a good QoL over the extension of life. How different stakeholders use the concept of QoL is highly relevant when considering the complexity of these decisions in real-life situations. METHODS: Seven focus group discussions (N = 39) were conducted to gain insights into how stakeholders assess and use equine QoL in veterinary care decisions for chronically ill and/or old horses. The discussions included horse owners (n = 17), equine veterinarians (n = 7), veterinary officers (n = 6), farriers (n = 4), and horse caregivers (n = 5). The combination of deductive and inductive qualitative content analysis of the group discussions focused on identifying both similarities and differences in the views of these groups regarding QoL for old and/or chronically ill horses. RESULTS: Findings show agreement about two issues: the importance of the individuality of the horse for assessing QoL and the relevance of QoL in making decisions about veterinary interventions. We identified differences between the groups with respect to three issues: the time required to assess QoL, stakeholders' contributions to QoL assessments, and challenges resulting from those contributions. While owners and caregivers of horses emphasised their knowledge of a horse and the relevance of the time they spend with their horse, the veterinarians in the study focused on the differences between their own QoL assessments and those of horse owners. In response to challenges regarding QoL assessments and decision-making, stakeholders described different strategies such as drawing comparisons to human experiences. CONCLUSIONS: Differences between stakeholders regarding equine QoL assessments contribute to challenges when making decisions about the care of chronically ill or old horses. The results of this study suggest that individual and collaborative reflection about a horse's QoL should be encouraged, for example by developing practicable QoL assessment tools that support relevant stakeholders in this process.

Undergraduates' workplace learning in health sciences education: psychometric properties of single-item measures.

BACKGROUND: Undergraduates' workplace learning is an important part of health sciences education. Educational psychology research considers many different aspects of self-regulated learning at the workplace, including cognition, motivation, emotions, and context. Multivariate longitudinal and diary studies in this field require fewer items than alternatives or even a single item per construct and can reveal the sub-processes of workplace learning and contribute to a better understanding of students' learning. Short instruments are necessary for application in workplace settings, especially stressful ones, to mitigate survey fatigue. The present study aimed to assess the psychometric properties of single items measuring various aspects of workplace learning. METHODS: Twenty-nine single items selected from the Workplace Learning Inventory in Health Sciences Education were analyzed for reliability, information reproduction, and relationships within the nomological network. The authors additionally analyzed four generally formulated single items' relationships with the full Workplace Learning Inventory scales and external criteria within the nomological network. Participants were 214 ninth- or tenth-semester veterinary medicine students in Austria and Germany who were learning at varied workplaces during the winter semester of 2021/2022. RESULTS: Of the 29 single items selected from existing scales, 27 showed sufficient reliability, but mixed results were obtained regarding validity. Although the items' relationships within the nomological network were similar to those of the full scales, information reproduction was insufficient for most items. The four general single items showed acceptable validity, but the reliability of these measures of states could not be assessed. CONCLUSIONS: This paper reported findings on the psychometric properties of single items for undergraduates' workplace learning in health science education. The findings are crucial for deciding whether to use scales versus single-item measures in future studies. By applying the findings, researchers can be more economical in their workplace learning data collection and can include more constructs.

Efficacy of Real-Time Feedback Exercise Therapy in Patients Following Total Hip Arthroplasty: Protocol for a Pilot Cluster-Randomized Controlled Trial.

BACKGROUND: Osteoarthritis of the hip joint is an increasing functional and health-related problem. The most common surgical treatment is hip replacement to reduce pain and improve function. Rehabilitation after total hip arthroplasty (THA) is not regulated in Austria and mostly depends on the patient's own initiative and possibilities. Functional deficits, such as valgus thrust of the leg, functional Trendelenburg gait, or Duchenne limp, are characteristic symptoms before and, due to the performance learning effect prior to surgery, also after the operation. Addressing these deficits is possible through neuromuscular-focused exercise therapy. The efficacy of such therapy relies significantly on the quality of performance, the frequency of exercise, and the duration of engagement. Enhancing sustainability is achievable through increased motivation and real-time feedback (RTF) on exercise execution facilitated by digital feedback systems. OBJECTIVE: This study will be performed to quantify the medium-term effectiveness of digital home exercise feedback systems on functional performance following THA. METHODS: A clinical trial with a cluster-randomized, 2-arm, parallel-group design with an 8-week intervention phase and subsequent follow-ups at 3 and 6 months postsurgery will be conducted. Feedback during exercising will be provided through a blended-care program, combining a supervised group exercise program with a self-developed digital feedback system for home exercise. In total, 70 patients will be recruited for baseline. The primary outcome parameters will be the frontal knee range of motion, pelvic obliquity, and lateral trunk lean. Secondary outcomes will be the sum scores of patient-reported outcomes and relevant kinematic, kinetic, and spatiotemporal parameters. RESULTS: The trial started in January 2024, and the first results are anticipated to be published by June 2025. RTF-supported home exercise is expected to improve exercise execution quality and therapeutic adherence compared to using paper instructions for excise guidance. CONCLUSIONS: The anticipated findings of this study aim to offer new insights into the effect of a blended-care program incorporating digital RTF on exercise therapy after unilateral THA, in addition to knowledge on the functional status 3 and 6 months postsurgery, for further improvement in the development of rehabilitation guidelines following THA. TRIAL REGISTRATION: ClinicalTrials.gov: NCT06161194; https://clinicaltrials.gov/study/NCT06161194. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/59755.

Effective grease separator management is the key to enhancing bioenergy recovery of fat, oil, and grease (FOG) and contributing to a circular bio-economy.

Management of fat, oil and grease (FOG) is crucial for the recovery of renewable resources and the protection of sewer systems. This study aims to identify the potential quantities and qualities of FOG that can be acquired through optimised grease separator (GS) management approaches in hotels and restaurants during seasonal tourism. A technical survey of 20 GS from hotels and restaurants in the federal state of Tyrol, Austria was conducted. The findings revealed that 55 % of the GS were in poor condition, often due to infrequent maintenance and limited operator's knowledge. The FOG layer quality and quantity was monitored over three years and physicochemical parameters including total residue, volatile solids, total organic carbon, lipid content, and biomethane yield, were analysed. An optimised management approach, which involved up to 4 GS emptying per season, revealed a significant increase in FOG quantity for the majority of the inspected establishments, with an overall doubling of the acquired FOG volume. Based on these results, the energy potential of GS is presented in three potential management scenarios. The energy recovered from GS increased by 246 %. This highlights the importance of proper GS management in the hospitality sector, which can play a critical role in promoting environmental sustainability and renewable energy production.

A retrospective analysis of the need for on-site emergency physician presence and mission characteristics of a rural ground-based emergency medical service.

BACKGROUND: This study aimed to address the challenges faced by rural emergency medical services in Europe, due to an increasing number of missions and limited human resources. The primary objective was to determine the necessity of having an on-site emergency physician (EP), while the secondary objectives included analyzing the characteristics of rural EP missions. METHODS: A retrospective study was conducted, examining rural EP missions carried out between January 1st, 2017, and December 2nd, 2021 in Burgenland, Austria. The need for physical presence of an EP was classified based on the National Advisory Committee for Aeronautics (NACA) score into three categories; category A: no need for an EP (NACA 1-3); category B: need for an EP (NACA 1-3 along with additional medical interventions beyond the capabilities of emergency medical technicians); and category C: definite need for an EP (NACA 4-7). Descriptive statistics were used for analysis. RESULTS: Out of 16,971 recorded missions, 15,591 were included in the study. Approximately 32.3% of missions fell into category A, indicating that an EP's physical presence was unnecessary. The diagnoses made by telecommunicators matched those of the EPs in only 52.8% of cases. CONCLUSION: The study suggests that about a third of EP missions carried out in rural areas might not have a solid medical rationale. This underscores the importance of developing an alternative care approach for these missions. Failing to address this could put additional pressure on already stretched EMS systems, risking their collapse.

Isolation and characterization of Leptospira licerasiae in Austrian swine - a first-time case report in Europe.

BACKGROUND: Leptospiraceae comprise a diverse family of spirochetal bacteria, of which many are involved in infectious diseases of animals and humans. Local leptospiral diversity in domestic animals is often poorly understood. Here we describe the incidental detection of Leptospira (L.) licerasiae in an Austrian pig. CASE PRESENTATION: During an experiment to characterize the pathogenesis of L. interrogans serovar Icterohaemorrhagiae in pigs, cultivation of a urine sample from a non-challenged contact pig resulted in growth of a spirochetal bacterium that tested negative for pathogenic Leptospira (LipL32 gene). PCR, Sanger sequencing and standard serotyping further confirmed that the recovered isolate was clearly different from the challenge strain L. interrogans serovar Icterohaemorrhagiae used in the animal experiment. Whole genome sequencing revealed that the isolate belongs to the species L. licerasiae, a tropical member of the Leptospiraceae, with no prior record of detection in Europe. CONCLUSIONS: This is the first report describing the occurrence of L. licerasiae in Europe. Since L. licerasiae is considered to have intermediate pathogenicity, it will be important to follow the geographical distribution of this species and its pathogenic and zoonotic potential in more detail.

Revisiting unstable disability and the fluctuations of frailty: a measurement burst approach.

BACKGROUND: It has been hypothesised that frailty is the root cause of clinically observed but rarely systematically measured unstable disability among older adults. In this study, we measure the extent of short-term disability fluctuations and estimate their association with frailty using intensive longitudinal data. METHODS: Repeated measurements of disability were collected under a measurement burst design in the FRequent health Assessment In Later life (FRAIL70+) study. A total of 426 community-dwelling older adults (70+) in Austria were interviewed about difficulties with basic, instrumental and mobility-related activities of daily living biweekly up to a total of 14 times in two measurement bursts (2891 and 2192 observations). Baseline frailty was assessed with both physical frailty (FP) and the frailty index (FI). Disability fluctuations were measured with the intra-individual interquartile range (iIQR) and estimated with a two-step generalised mixed regression procedure. RESULTS: Fewer participants were frail at baseline according to FP (11%) than FI (32%). Frail study participants reported not only more severe disability but also had more short-term disability fluctuations (iIQR = 1.0-1.5) compared with their robust counterparts (iIQR = 0). Regression models indicated that baseline frailty was associated with 2-3 times larger short-term disability fluctuations, which were also more prevalent among women, and increased with age and disability severity. CONCLUSION: Compared with those who were robust, frail older adults were characterised by not only more severe but also more unstable disability. Short-term disability fluctuations are closely tied to disability severity. Future studies should assess both stressors that may cause disability fluctuations among frail older adults as well as their potential consequences to inform frailty-centred care.

[Invasive ENT infections in immunocompetent schoolchildren in the winter half year 2022/23 : A case series]. / Invasive HNO-Infektionen bei immunkompetenten Schulkindern im Winterhalbjahr 2022/23 : Eine Fallserie.

We report a case series of severe complications following rhinosinusitis in the winter season 2022/2023 at the Franz-Lust Hospital for children and adolescents. Due to the severity of these complications in children with suspected complicated rhinosinusitis/orbital phlegmona, an immediate interdisciplinary approach is mandatory to prevent long-term sequelae. In addition, during this time period, we observed the unusual occurrrence of a number of invasive streptococcal infections in this age cohort.

Status quo of interprofessional education for midwifery and medical students in Germany, Austria, and Switzerland.

Objectives: The care of women and their families around childbirth requires effective interprofessional collaboration of the midwifery and medical profession. Given the academisation of midwifery, early interaction between students of midwifery and medicine is both necessary and feasible. As there is a lack of comprehensive data on interprofessional education (IPE) for midwifery and medical students at higher education institutions in Germany, Austria, and Switzerland (DACH region), the aim was to identify existing IPE activities, and their curricular determination. Methods: The exploratory study was conducted in the DACH region over three months (Dec. 2022-Feb. 2023). Higher education institutions offering midwifery science and/or medicine were invited to participate in a web-based survey. The questionnaire focused on the structure and curricular implementation of IPE courses, on cooperation, financial support and more. Results: A total of 58 out of 96 invited institutions (60%) participated in the survey, of which 34 (59%) offered IPE. Eighteen institutions (19%) offered 32 IPE courses for midwifery and medical students through cooperation within faculty (n=8) and between faculties (n=10). Notably, most of these IPE courses (60%) were integrated into the required curriculum of both study programmes. Most IPE courses were offered without financial support (71%). Conclusion: The current status quo highlighted the existence of numerous IPE offers for midwifery and medical students in the DACH region that warrant further curricular integration of proven and well-established best practice examples to further enhance these initiatives.

A Microbiology Analytics Tool to Evaluate the Burden of Antibiotic-Resistant Infections.

Leveraging the capabilities of a microbiological clinical analytics tool, this study delves into quantifying the public health impact of antibiotic-resistant bacteria. Focusing on eight predominant antibiotic-resistant bacteria, the study utilizes University Hospital Vienna's data to calculate the burden of antibiotic-resistant infections in disability-adjusted life years. The results highlight the potential of extended analytics tools in epidemiological research and underscore the pressing challenge of antimicrobial drug resistance.

Integrating AI-Generated Summaries of Medication Leaflets into a Mobile Application for Medication Management.

Effective medication management poses significant challenges, particularly when navigating multiple medications with intricate dosages and schedules. This paper presents a prototype mobile application to streamline information retrieval from dense medication leaflets. By utilizing automated information extraction based on large language models, the application seamlessly retrieves pertinent details from the Austrian medicinal product index upon scanning the medication package. This extracted information is organized and displayed within the app, ensuring clarity and accessibility for users. In addition to this core functionality, the application offers a suite of features tailored to facilitate effective medication management. By integrating comprehensive medication information with practical medication management tools, the application empowers users to navigate complex medication regimes with confidence and ease.