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.

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.

Challenges in the evaluation of suicide prevention measures and quality of suicide data in Germany, Austria, and Switzerland: findings from qualitative expert interviews.

BACKGROUND: Suicide prevention requires diverse, integrated, and evidence-based measures. Comprehensive evaluation of interventions and reliable suicide data are crucial for guiding policy-making and advancing suicide prevention efforts. This study aimed to analyze current issues and gaps in the evaluation of suicide prevention measures and the quality of suicide data in Germany, Austria, and Switzerland to derive specific recommendations for improvement. METHODS: Online, semi-structured interviews were conducted with 36 experts in suicide prevention from Germany, Austria, and Switzerland, covering insights from policy, science, and practice. The interviews took place between September 2022 and February 2023, were audio-recorded, transcribed verbatim, and analyzed using the Framework method. RESULTS: While solid evidence supports the effectiveness of some suicide prevention interventions, experts indicated that the evaluation of many other measures is weak. Conducting effectiveness studies in suicide prevention presents a range of methodological and practical challenges, including recruitment difficulties, choosing adequate outcome criteria, ethical considerations, and trade-offs in allocating resources to evaluation efforts. Many interviewees rated the quality of national suicide statistics in Germany, Austria, and Switzerland as comparatively high. However, they noted limitations in the scope, timeliness, and reliability of these data, prompting some regions to implement their own suicide monitoring systems. None of the three countries has national routine data on suicide attempts. CONCLUSION: While some challenges in evaluating suicide prevention measures are inevitable, others can potentially be mitigated. Evaluations could be enhanced by combining traditional and innovative research designs, including intermediate outcomes and factors concerning the implementation process, and employing participatory and transdisciplinary research to engage different stakeholders. Reliable suicide data are essential for identifying trends, supporting research, and designing targeted prevention measures. To improve the quality of suicide data, a standardized monitoring approach, including uniform definitions, trained professionals, and cross-sector agreement on leadership and financing, should be pursued. This study provides actionable recommendations and highlights existing good practice approaches, thereby supporting decision-makers and providing guidance for advancing suicide prevention on a broader scale.

"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.

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.

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.

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.

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.

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.

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.

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.

An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension - a comprehensive assessment of patient satisfaction.

BACKGROUND: Management of idiopathic intracranial hypertension (IIH) is complex requiring contributions from multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges. To meet those challenges, we established an interdisciplinary integrated outpatient clinic for IIH with a central coordination and a one-stop concept. Here, we aimed to evaluate effects of this one-stop concept on subjective patient satisfaction and economic outcome in patients with IIH. METHODS: In a retrospective cohort study, we compared the one-stop era with integrated care (IC, 1-JUL-2021 to 31-DEC-2022) to a reference group receiving standard care (SC, 1-JUL-2018 to 31-DEC-2019) regarding subjective patient satisfaction (assessed by the Vienna Patient Inventory). Multivariable binary linear regression models were used to adjust for confounders. RESULTS: Baseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female: 90.6% vs. 90.1%; mean age: 33.6 vs. 32.8 years, educational level: ≥9 years of education 60.0% vs. 59.3%; located in Vienna 75.3% vs. 76.5%). Compared to SC, management within IC concept was associated with statistically significantly higher subjective patient satisfaction (beta = 0.93; p < 0.001) with the strongest effects observed in satisfaction with treatment accessibility and availability (beta = 2.05; p < 0.001). Subgroup analyses of patients with migration background and language barrier consistently indicated stronger effects of IC in these groups. CONCLUSIONS: Interdisciplinary integrated management of IIH statistically significantly and clinically meaningfully improves patient satisfaction - particularly in socioeconomically underprivileged patient groups. Providing structured central coordination to facilitate and improve access to interdisciplinary management provides means to further improve outcome.

Compost amendment in urban gardens: elemental and isotopic analysis of soils and vegetable tissues.

Urban horticulture poses a sustainable form of food production, fosters community engagement and mitigates the impacts of climate change on cities. Yet, it can also be tied to health challenges related to soil contamination. This work builds on a previous study conducted on eleven urban gardens in the city of Vienna, Austria. Following the findings of elevated Pb levels in some soil and plant samples within that project, the present study investigates the elemental composition of soil and plants from two affected gardens 1 year after compost amendment. Inductively coupled plasma mass spectrometry (ICP-MS) analysis of skin, pulp and seeds of tomato fruits revealed minor variations in elemental composition which are unlikely to have an impact on food safety. In turn, a tendency of contaminant accumulation in root tips and leaves of radishes was found. Washing of lettuce led to a significant reduction in the contents of potentially toxic elements such as Be, Al, V, Ni, Ga and Tl, underscoring the significance of washing garden products before consumption. Furthermore, compost amendments led to promising results, with reduced Zn, Cd and Pb levels in radish bulbs. Pb isotope ratios in soil and spinach leaf samples taken in the previous study were assessed by multi-collector (MC-) ICP-MS to trace Pb uptake from soils into food. A direct linkage between the Pb isotopic signatures in soil and those in spinach leaves was observed, underscoring their effectiveness as tracers of Pb sources in the environment.

A One Health framework for exploring zoonotic interactions demonstrated through a case study.

The eco-epidemiology of zoonoses is often oversimplified to host-pathogen interactions while findings derived from global datasets are rarely directly transferable to smaller-scale contexts. Through a systematic literature search, we compiled a dataset of naturally occurring zoonotic interactions in Austria, spanning 1975-2022. We introduce the concept of zoonotic web to describe the complex relationships between zoonotic agents, their hosts, vectors, food, and environmental sources. The zoonotic web was explored through network analysis. After controlling for research effort, we demonstrate that, within the projected unipartite source-source network of zoonotic agent sharing, the most influential zoonotic sources are human, cattle, chicken, and some meat products. Analysis of the One Health 3-cliques (triangular sets of nodes representing human, animal, and environment) confirms the increased probability of zoonotic spillover at human-cattle and human-food interfaces. We characterise six communities of zoonotic agent sharing, which assembly patterns are likely driven by highly connected infectious agents in the zoonotic web, proximity to human, and anthropogenic activities. Additionally, we report a frequency of emerging zoonotic diseases in Austria of one every six years. Here, we present a flexible network-based approach that offers insights into zoonotic transmission chains, facilitating the development of locally-relevant One Health strategies against zoonoses.

Assessing the potential for gas supersaturation downstream of hydropower plants in Norway, Austria and Germany.

Hydroelectric power facilities can generate episodic total dissolved gas supersaturation (TDGS), which is harmful to aquatic life. We developed a decision tree-based risk assessment to identify the potential for TDGS at hydropower plants and conducted validation measurements at selected facilities. Applying the risk model to Norway's hydropower plants (n = 1696) identified 473 (28 %) high-risk plants characterized by secondary intakes and Francis or Kaplan turbines, which are prone to generating TDGS when air is entrained. More than half of them discharge directly to rivers (283, 17 % of total). Measurements at 11 high-risk plants showed that 8 of them exhibited biologically relevant TDGS (120 % to 229 %). In Austria and Germany, the analysis of hydropower plants was limited due to significant data constraints. Out of 153 hydropower plants in Austria, 80 % were categorized at moderate risk for TDGS. Two Austrian plants were monitored, revealing instances of TDGS in both (up to 125 %). In Germany, out of 403 hydropower plants, 265 (66 %) fell into the moderate risk, with none in the high-risk category. At a dam in the Rhine River, TDGS up to 118 % were observed. Given the uncertainty due to limited data access and the prevalence of run-of-river plants in Austria and Germany, there remains an unclarified risk of TDGS generation in these countries, especially at spillways of dams and below aerated turbines. The results indicate a previously overlooked potential for the generation of biologically harmful TDGS at hydropower installations. It is recommended to systematically screen for TDGS at hydropower installations through risk assessment, monitoring, and, where needed, the implementation of mitigation measures. This is increasingly critical considering the expanding global initiatives in hydropower and efforts to maintain the ecological status of freshwater ecosystems.

Attentional Biases and Nonsuicidal Self-Injury Urges in Adolescents.

Importance: Nonsuicidal self-injury (NSSI) is a significant clinical concern among adolescents. Exposure to NSSI-related content on social media platforms has been suspected to potentially act as a trigger for NSSI. Objective: To use free-viewing eye-tracking and dot-probe paradigms to examine attentional bias and psychophysiological responses to NSSI-related pictorial and textual stimuli in adolescents with and without a history of NSSI. Design, Setting, and Participants: From June 2022 to April 2023, adolescent participants in Vienna, Austria with and without a history of NSSI were exposed to NSSI-related stimuli in this nonrandomized controlled trial. Data were analyzed from December 2023 to January 2024. Exposure: Exposure to NSSI-related stimuli. Main Outcomes and Measures: During both tasks, subjective arousal, NSSI urges, and autonomic nervous system activity were assessed. Results: A total of 50 adolescents in 2 groups, 25 who engaged in NSSI (mean [SD] age 15.86 [1.14] years; 19 female participants [76%]) and 25 who did not (mean [SD] age 16.40 [1.71] years; 19 female participants [76%]) were included. Adolescents with a history of NSSI-but not those without a history of NSSI-showed a clear attentional bias toward NSSI-related images during eye-tracking, as indicated by increased initial fixations (500 ms stimulus presentation mean difference, 28.64%; 95% CI, 18.31%-38.98%; P < .001; 1000 ms stimulus presentation mean difference, 18.50%; 95% CI, 9.05%-27.95%; P < .001) and longer fixation durations (500 ms mean difference, 29.51 ms; 95% CI, 4.3-54.72 ms; P < .001; 1000 ms mean difference, 39.83 ms; 95% CI, 6.90-72.76 ms; P < .001), regardless of stimulus duration. This bias was associated with a heightened urge to engage in NSSI (d = 1.22; 95% CI, 0.69-1.73; P < .001), a trend not seen in adolescents without a history of NSSI. Similarly, in the dot-probe task, only the NSSI group showed an attentional bias toward NSSI images but not toward trauma images, emphasizing the specificity of their attentional bias. Physiological measures revealed no significant differences, suggesting that viewing NSSI images is not associated with increased autonomic arousal. Textual NSSI content did not provoke an attentional bias or heighten NSSI urges in either group. Conclusions and Relevance: In this nonrandomized controlled trial of 50 adolescents, results highlighted a specific attentional bias toward NSSI-related pictorial stimuli in adolescents with a history of NSSI, particularly a difficulty in disengaging from NSSI images. These findings contribute to understanding maladaptive information processing in NSSI and suggest implications for clinical management and cognitive models addressing NSSI triggers. Trial Registration: German Clinical Trials Register identifier: DRKS00025905.