Austrian Society of Cardiology

Abstract Background Research involving children and adolescents is often conducted solely by adults, even when youth are the target population. However, young people are experts in their own lives and should be actively involved in studies about them. In the “KoKo-Health” project, we applied a co-research approach with adolescents to develop a child- and adolescent-centered health literacy model. Methods The project employed a co-research approach with a youth advisory board and teams of young people aged 15-19. Workshops using interviews, photovoice, and focus groups were held in schools and youth organizations. Ten co-research teams also conducted peer-led projects, employing methods such as interviews, focus groups, and qualitative surveys to explore health literacy factors among peers aged 9-21. Adult researchers provided ethical oversight and methodological support. Reflection sessions with all stakeholders were conducted to capture key learnings from the process. Results Clear, respectful communication and flexibility were essential for meaningful youth participation. The co-research process had to be adapted to the daily lives and resources of the youth involved. Conducting research within existing institutional settings supported both practical organization and relationship-building between adult and youth researchers. Youth participants valued the openness of the process and appreciated being able to shape research questions and methods, as well as participating across all stages of the research. Conclusions Successful co-research with adolescents depends on transparent communication, adaptable processes, and authentic partnerships that grant youth real decision-making power. Ongoing reflection with all stakeholders is key to maintaining meaningful collaboration.

Palmitic acid-induced lipotoxicity contributes to the development of nonalcoholic fatty liver disease (NAFLD). Hesperetin has been reported to alleviate oxidative stress, inflammation, and cell death in NAFLD, while its potential to mitigate palmitic acid-induced lipotoxicity remains unexplored. This study investigates the protective effects of hesperetin on palmitic-acid-stimulated lipotoxicity and elucidates the underlying molecular mechanisms. Our results showed that hesperetin decreased palmitic acid-activated lipotoxicity through inhibition of the intrinsic apoptosis pathway and promotion of autophagic flux. Metabolomics analysis and stable-isotope-tracing data indicated that hesperetin treatment restored the aberrant tricarboxylic acid cycle caused by palmitic acid exposure, accompanied by a decrease in anaplerotic flux from glutamine to α-ketoglutarate. The reduction of α-ketoglutarate resulted in the inhibition of mTORC1 signaling, which in turn activated autophagy and limited apoptosis. Furthermore, hesperetin activated AMPK, which coordinated with mTORC1 to regulate autophagy. Additionally, hesperetin reinstated the activation of AKT and Nrf2, further protecting the cell against the deleterious effects of lipotoxicity. These data highlight the role of glutaminolysis as a survival mechanism for preventing lipotoxicity upon hesperetin treatment.

The purpose of this systematic review and meta-analysis (PROSPERO ID: CRD42021250467) was to evaluate the effects of exercise on low-trauma overall and major osteoporotic fractures (hip, spine, forearm, or humerus fractures) and to determine the corresponding effect of supervision of the exercise program. Our systematic search of six literature databases according to the PRISMA guideline was conducted from January 1, 2013 (ie, date of our last search) to May 22, 2021, and included controlled clinical exercise trials with (i) individuals aged ≥45 years, (ii) cohorts without therapies/diseases related to fractures, (iii) observation periods of ≥3 months, and (iv) the number of low-trauma fractures listed separately for the exercise (EG) and control (CG) groups. We included 20 intervention studies with 21 EGs and 20 CGs comprising a pooled number of participant-years of n= 11.836 in the EG and n= 11.275 in the CG. The mixed-effects conditional Poisson regression revealed significant effects of exercise on low-trauma overall incidence (rate) ratio (IR 0.67, 95% confidence interval [95% CI] 0.51-0.87) and major osteoporotic fractures IR (0.69, 95% CI 0.52-0.92). Heterogeneity between the trials was moderate for low-trauma overall (I2=40%) and negligible (I2 < 1%) for major osteoporotic fractures. Supervision of the exercise program plays a significant role in the reductions of overall and major osteoporotic fractures with IR about twice as favorable in the predominately supervised (IR 0.44; 95% CI 0.27-0.73 and 0.38; 0.19-0.76) versus the predominately non-supervised exercise trials (IR 0.83; 95% CI 0.60-1.14 and 0.82; 0.64-1.05). In summary, the present study provides evidence for the positive effect of exercise on low-trauma overall and major osteoporotic fractures in middle aged to older adults. Supervision of the exercise program is a crucial aspect in exercise programs on fracture reduction. Thus, home-based exercise protocols should increasingly implement online classes to ensure widely consistent supervision and monitoring of the exercise program. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Health-related quality of life represents an important aspect of the evaluation of medical treatment. Myocardial infarction (MI) is a major life event which impairs many aspects of daily life including health-related quality of life with physical, emotional, and social restrictions. The MacNew Heart Disease Health-related Quality of Life Questionnaire is designed to evaluate a patient's feelings about a range of issues and concerns [physical, emotional social] in patients who have survived an acute MI. The purpose of this study was to validate the German version of the MacNew. The self-administered MacNew and SF-36 were completed by 199 subjects (161 male, 38 female) with documented MI. Test-retest reliability, Cronbach's alpha, and convergent and discriminate validity coefficients were determined. Item response rates were > 92\% for the MacNew. Convergent validity wall the SF-36 scales ranged from r= 0.36 to 0.75 (p < .001). Discriminate validity, established with different grades of clinical severity, was high for all scales (ANOVA p < .01). Test-retest reliability [4 weeks] ranged between 0.72–0.87. Reliability using Cronbach's alpha ranged between 0.90 and 0.97. The high item response rate demonstrates the acceptance of the German version of the MacNew by patients with MI. Our results show that the MacNew is a valid, reliable, and sensitive instrument to measure health-related quality of life which can be recommended for use in German-speaking patients with MI.