Ludwig Boltzmann Institute for Age Research

Background Despite growing scientific evidence and health guidelines, the global health paradox persists, with rising lifestyle-related diseases and escalating healthcare costs exposing the inadequacy of current efforts. Objective Three multidisciplinary congresses were held to generate evidence-based conclusions aimed at addressing the global health paradox. Methods A total of 58 experts from 62 entities participated in the international research and knowledge-exchange panels. Experts reviewed the latest findings to develop practical strategies and identify key research and policy priorities, focusing on the Healthy Eating & Active Living (HEAL) approach. Results, conclusion, and relevance The expert consortium endorsed a 33 evidence-based consensual-statement policy roadmap for addressing global health challenges, emphasizing that the HEAL approach can significantly contribute to the “Prevention First” appeal and broad ethical, social, ecological, and economic advantages, and ultimately supporting policy change.

BackgroundThe two-period randomised crossover design can be advantageous over the parallel-group randomised controlled design with two study arms, yielding greater statistical power and requiring smaller sample sizes. However, a general assumption of the crossover design is that study participants return to their stable baseline state after the experimental treatment has been withdrawn, either immediately or following a wash-out period.Main bodyIn this article, we describe an alternative paradigm for the crossover design, which assumes that participants do not return to their baseline after the experimental treatment has discontinued—in other words, a paradigm under which a persistent carry-over effect is anticipated and even desired after intervention cessation. Such a paradigm is suitable, for example, when investigating behaviour change interventions that aim to establish long-lasting health behaviours through, for example, patient education or counselling. We present sample size calculations and statistical simulations to illustrate that under this alternative paradigm, the randomised crossover design can still maintain greater power than the parallel-group randomised controlled design. Statistical simulations show that, under realistic assumptions of partial or full carry-over, the crossover design can maintain equal or greater power than the parallel-group design, particularly when between-subject heterogeneity is non-negligible.ConclusionTrialists may consider this approach when the nature or intention of the experimental treatment is contrary to the assumption of return to baseline.

Abstract Artificial intelligence (AI) and machine learning (ML) are increasingly being applied in sports science to predict performance, assess injury risk, and support tactical decision-making. However, the opacity of many machine learning (ML) models has led to a growing interest in explainable AI (XAI) methods, which aim to make the decisions of "black box" algorithms more transparent and interpretable. The result of this is an increase in trust, facilitation of model validation, and enablement of more informed decision-making for practitioners and analysts. While XAI is well established in domains like healthcare or finance, its application in sports science remains fragmented and underexplored. This scoping review follows the PRISMA-Sc approach and systematically examines how XAI and interpretable ML techniques have been applied in the context of sports science. Between 2014 and June 2024, a total of 19 studies were identified through a multi-database search and analyzed in terms of sport type, ML model, XAI method, dependent variable, limitations, challenges and future research. The results reveal a clear dominance of SHapley Additive Explanations across multiple disciplines, while other tools such as Gradient-weighted Class Activation Mapping, Individual Conditional Expectation Plots, or domain-specific approaches are rarely used. Visual and rule-based explanation methods were largely absent. The findings highlight a lack of methodological diversity and limited validation of explanations with domain experts or practitioners. To increase real-world impact, future work should explore comparative evaluations of XAI techniques, domain-specific explanation frameworks, and user-centered approaches that align with the needs of coaches, athletes, and analysts.

Our objective was to investigate the effects of three hip flexion angles (0°, 45°, and 90°) and leg dominance on peak joint torque, angle at peak torque, and peak electromyographic activity (EMGA) of the adductor longus during bilateral eccentric hip adduction. Sixteen recreationally active participants completed bilateral eccentric contractions at each hip flexion angle using a custom-built dynamometer. The primary outcome measures were peak adduction torque, angle at peak torque, and EMGA of the adductor longus. A 3 × 2 repeated measures ANOVA was used to assess the effects of hip angle and leg dominance. Hip flexion angle had a significant main effect on peak torque (F(2, 30) = 15.75, p < 0.01), with peak torque significantly lower at 90° compared to 0° and 45°. No significant effects were observed for leg dominance or interaction. No significant main effects of hip flexion angle, leg dominance, or their interaction were observed on peak EMGA or peak torque angle. Eccentric hip adduction strength is reduced at 90° of flexion, likely due to mechanical disadvantage, while neural activation remains unchanged. These findings support the use of less flexed positions in eccentric training protocols for adductor strength development or injury prevention.

Abstract Polyploidization refers to the balanced increase in gene copy number and is a feature of specialized cells in different mammalian tissues, including the liver and the heart. During organogenesis, hepatocytes and cardiomyocytes undergo scheduled polyploidization events to increase their cellular or nuclear DNA content. This is thought to improve cellular output and enable for rapid genetic adaptation in response to stress. Yet, excessive increases in ploidy can also be disadvantageous and increase the risk of genome instability. Hence, a dedicated machinery, the PIDDosome multi-protein complex, has evolved to prevent exacerbated increases in DNA content. Using targeted mutagenesis in mice, we show that the PIDDosome controls hepatocyte ploidy in a cell-autonomous manner and that sequential and quantitative auto-processing of PIDD1 is key for accurate control of ploidy in postnatal development of liver and heart. Stoichiometric imbalances in bioactive PIDD1-fragments impair p53-dependent and independent cell cycle arrest responses during organogenesis, as well as caspase-2-dependent apoptosis caused by centrosome amplification. Strikingly, targeted mutagenesis of the caspase cleavage motif in the critical E3-ligase controlling p53 protein levels, Mdm2, impairs ploidy control in hepatocytes, but not in cardiomyocytes, indicative of the existence of alternative caspase-2 substrates that help to restrict ploidy in the heart.

Assisted suicide, also known as physician-assisted death, remains a contentious issue for healthcare providers, involving medical ethics, legal frameworks, and individual rights. This study aims to explore the attitudes, experiences, and training needs of nurses in Austria following the legalization of assisted suicide in 2022. Utilizing a cross-sectional online survey, both quantitative and qualitative data were collected from 280 palliative and hospice care nurses across all nine Austrian states. Approximately a quarter of nurses experienced a shift in their attitudes towards assisted suicide during the first year of its legalization. While a majority felt their wellbeing was unaffected, 14.5% reported a decline in mental health due to the new law. Despite both mandatory and optional training being provided by employers, 80.7% of nurses expressed a need for further education, particularly on legal and organizational aspects, practical case studies, and interdisciplinary communication. Qualitative analysis revealed diverse perspectives, with some nurses advocating for patient autonomy and empathetic support, while others preferred enhancing palliative care as an alternative to assisted suicide. Furthermore, nurses highlighted the necessity for a clear legal framework and collaborative decision-making processes. The study underscores the critical role of comprehensive palliative care and calls for more clarity around appropriate assisted suicide practices. Ongoing dialogue, enhanced training, and support for nurses to navigate both ethical and practical challenges posed by assisted suicide legislation is also needed. Future research should evaluate the effectiveness of these interventions and explore the long-term impacts of assisted suicide on patients, their families, and healthcare providers.

Multi-method approach including geophysics, coring, and (p)OSL profiling and dating, Merits of analysing all four dimensions of sediment archives, Dynamic landscape history accentuated by erosion and hillslope processes

Providing health care is a balancing act among human resources, financial pressures and system-intrinsic factors. Understanding the utilization behaviour of primary and secondary care facilities [general practitioners (GPs) vs. specialists, as well as in- and outpatient hospital care] is crucial for a country like Austria, which has free access to all levels of care. The aim of this study was to reassess access point consultations in relation to sociodemographic variables over time. The databases used for this cross-sectional analysis were the Austrian Health Interview Surveys 2006/07, 2014, and 2019, with sample sizes of 15 474, 15 770, and 15 461 persons, respectively. Analyses included patterns of utilization behaviour, multivariable logistic regression models, and diff-in-diff analyses highlighting differences between the observation periods. GP and secondary care consultations increased from 2014 to 2019. While there were fewer GP visits in 2014 than in 2006/07, GP consultation rates grew by 3.2% between 2014 and 2019. Secondary care utilization increased by 5.4%-8.2% between 2006/07 and 2019, with the highest growth in older and less-educated persons. Secondary-level utilization without prior GP visits decreased again in 2019 after peaking in 2014. Utilization of all access points increased over the entire observation period, especially regarding secondary-level care. Higher GP visit rates do not seem to result in a drop in secondary-level consultations. These results emphasize the coordinator role of primary care in ongoing structural health reforms in European countries, such as Austria.