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Sophisticated immune evasion strategies enable Helicobacter pylori (H. pylori) to colonize the gastric mucosa of approximately half of the world’s population. Persistent infection and the resulting chronic inflammation are a major cause of gastric cancer. To understand the intricate interplay between H. pylori and host immunity, spatial profiling was used to monitor immune cells in H. pylori infected gastric tissue. Dendritic cell (DC) and T cell phenotypes were further investigated in gastric organoid/immune cell co-cultures and mechanistic insights were acquired by proteomics of human DCs. Here, we show that ADP-heptose, a bacterial metabolite originally reported to act as a bona fide PAMP, reduces H. pylori-induced DC maturation and subsequent T cell responses. Mechanistically, we report that H. pylori uptake and subsequent DC activation by an ADP-heptose deficient H. pylori strain depends on TLR2. Moreover, ADP-heptose attenuates full-fledged activation of primary human DCs in the context of H. pylori infection by impairing type I IFN signaling. This study reveals that ADP-heptose mitigates host immunity during H. pylori infection.

Background There is a research gap in the survey of injuries and illnesses in the sport of luge.Objective To analyse the type, frequency and burden of injuries and illnesses that occurred over a preparation period and a competition period in elite luge athletes.Methods In total 40 elite luge athletes, who were all part of a national team and competed internationally, self-reported acute injuries, overuse injuries and illnesses weekly using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems.Results The most frequently stated health problems were illnesses with 41.9% (n=75), followed by acute injuries at 31.9% (n=57). Overuse injuries accounted for 24.0% (n=43). Illnesses represented the greatest burden with a median severity score of 60.0 (IQR: 23.63), followed by acute injuries with 42.0 (IQR: 26.83) and overuse injuries with 35.0 (IQR: 23.95). In the case of acute injuries, the anatomical regions most affected were the hand (n=8, 14.0 %), foot (n=8, 14.0 %), head (n=7, 12.3 %) and neck (n=6, 10.5 %). In the case of overuse injuries, the shoulder (n=9, 20.9 %) and lumbar spine (n=7, 16.3 %) were most frequently reported. Strains (n=15, 26.3 %) and contusions (n=14, 24.6 %) were the predominant types of acute injuries. Four concussions were recorded, with none of the athletes taking a break from normal training of more than 3 days. This stands in contrast to the current recommendations for the return to sport after concussion.Conclusion The results of this study represent the current incidence rates and health burden of acute and chronic injuries in this constantly evolving sport. 95% of all athletes reported at least one health problem during the observation period. These findings support the need for specific prevention programmes. The establishment of a concussion protocol should be considered.

Background/Objectives: Antibodies against the hepatitis B surface antigen (anti-HBs) are a marker of immunity against hepatitis B virus (HBV) infections. There is uncertainty about the anti-HBs seroprevalence in the general population of Austria. Methods: We conducted a cross-sectional analysis in blood donors from the Federal State of Tyrol in Austria (August–September 2023) to estimate anti-HBs seroprevalence and median antibody levels. Results: We enrolled 3935 blood donors (median age 47.6 years [25th–75th percentile: 33.3–56.6]; 40.7% female), who were hepatitis B surface antigen negative and had no detectable HBV-DNA. Overall seroprevalence was 51.4% (95% CI: 49.8–52.9%). Anti-HBs seropositivity decreased with higher age (p < 0.001), with 70.3% (66.1–74.3%) being seropositive among participants < 25 years of age and 30.2% (24.2–36.9%) in those aged ≥ 65 years. More females than males were seropositive (54.3% [51.8–56.7%] vs. 49.4% [47.4–51.4%]; p = 0.003). Seroprevalence was significantly higher in urban than in rural areas in participants aged 40 to p = 0.045) and ≥55 years (p = 0.001). Among 2022 seropositive participants, the overall median anti-HBs antibody level was 539.3 IU/L (25th–75th percentile: 116.3–5417.0). Furthermore, 5% of the participants had an anti-HBs antibody level between 10 and Conclusions: Anti-HBs seroprevalence in blood donors from Tyrol, Austria, was 51.4% between August and September 2023 and differed across age, sex, and residence area. Catch-up vaccination programs, especially targeting the elderly living in rural areas, are needed to close HBV immunity gaps.

Climate change will result in more intense and more frequent weather and climate events that will continue to cause fatalities, economic damages and other adverse societal impacts worldwide. To mitigate these consequences and to support better informed decisions and improved actions and responses, many National Meteorological and Hydrological Services (NMHSs) are discussing how to provide services on weather and climate impacts as part of their operational routines. The authors outline how a risk framework can support the development of these services by NMHSs. In addition to the hazard information, a risk perspective considers the propensity for a given hazard to inflict adverse consequences on society and environment, and attempts to quantify the uncertainties involved. The relevant strategic, methodological and technical steps are summarized and recommendations for the development of impact-related services are provided. Specifically, we propose that NMHSs adopt an integrated risk framework that incorporates a hazard-exposure-vulnerability model into operational services. Such a framework integrates all existing forecast and impact services, including the underlying impact models, and allows for flexible future extensions driven by the evolving collaboration with partners, stakeholders and users. Thereby, this paper attempts to unify existing work streams on impact-related services from different spatial and temporal scales (weather, climate) and disciplines (hydrology, meteorology, economics, social sciences) and to propose a harmonized approach that can create synergies within and across NMHSs to further develop and enhance risk-based services.

Nina Buchtele,1 Michael Schwameis,2 Dominik Roth,2 Franz Schwameis,3 Felix Kraft,4 Roman Ullrich,4 Jakob Mühlbacher,5 Roberta Laggner,6 Gunnar Gamper,7 Georg Semmler,8 Christian Schoergenhofer,9 Thomas Staudinger,1 Harald Herkner2 1Department of Medicine I, Intensive Care Unit 13i2, Medical University of Vienna, Vienna, Austria; 2Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria; 3Department of Anaesthesiology and Intensive Care Medicine, Landesklinikum Baden, Vienna, Austria; 4Department of Anaesthesia, Critical Care and Pain Medicine, Medical University of Vienna, Vienna, Austria; 5Department of General Surgery, Medical University of Vienna, Vienna, Austria; 6Department of Orthopaedics and Trauma-Surgery, Medical University of Vienna, Vienna, Austria; 7Department of Cardiology, Universitätsklinikum Sankt Pölten, Vienna, Austria; 8Department of Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria; 9Department of Clinical Pharmacology, Medical University of Vienna, Vienna, AustriaCorrespondence: Michael Schwameis, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria, Tel +43 1 40400 39560, Fax +43 1 40400 19650, Email michael.schwameis@meduniwien.ac.atObjective: To assess the applicability of evidence from landmark randomized controlled trials (RCTs) of vasopressor treatment in critically ill adults.Study Design and Setting: This prospective, multi-center cohort study was conducted at five medical and surgical intensive care units at three tertiary care centers. Consecutive cases of newly initiated vasopressor treatment were included. The primary end point was the proportion of patients (≥ 18 years) who met the eligibility criteria of 25 RCTs of vasopressor therapy in critically ill adults included in the most recent Cochrane review. Multilevel Poisson regression was used to estimate the eligibility proportions with 95% confidence intervals for each trial. Secondary end points included the eligibility criteria that contributed most to trial ineligibility, and the relationship between eligibility proportions and (i) the Pragmatic-Explanatory Continuum Indicator Summary-2 (PRECIS-2) score, and (ii) the recruitment-to-screening ratio of each RCT. The PRECIS-2 score was used to assess the degree of pragmatism of each trial.Results: Between January 1, 2017, and January 1, 2019, a total of 1189 cases of newly initiated vasopressor therapy were included. The median proportion of cases meeting eligibility criteria for all 25 RCTs ranged from 1.3% to 6.0%. The eligibility criteria contributing most to trial ineligibility were the exceedance of a specific norepinephrine dose, the presence of a particular shock type, and the drop below a particular blood pressure value. Eligibility proportions increased with the PRECIS-2 score but not with the recruitment-to-screening ratio of the trials.Conclusion: The applicability of evidence from available trials on vasopressor treatment in critically ill adults to patients receiving vasopressors in daily practice is limited. Applicability increases with the degree of study pragmatism but is not reflected in a high recruitment-to-screening ratio. Our findings may help researchers design vasopressor trials and promote standardized assessment and reporting of the degree of pragmatism achieved.Graphical Abstract: Keywords: real-world data, randomized controlled trials, critical illness, vasoconstrictor agents

BackgroundStrokes pose a particular challenge to the health care system. Although stroke-related mortality has declined in recent decades, the absolute number of new strokes (incidence), stroke deaths, and survivors of stroke has increased. With the increasing need of neurorehabilitation and the decreasing number of professionals, innovations are needed to ensure adequate care. Digital technologies are increasingly used to meet patients’ unfilled needs during their patient journey. Patients must adhere to unfamiliar digital technologies to engage in health interventions. Therefore, the acceptance of the benefits and burdens of digital technologies in health interventions is a key factor in implementing these innovations. ObjectiveThis study aims to describe the development of a discrete choice experiment (DCE) to weigh criteria that impact patient and public acceptance. Secondary study objectives are a benefit-burden assessment (estimation of the maximum acceptable burden of technical features and therapy-related characteristics for the patient or individual, eg, no human contact), overall comparison (assessment of the relative importance of attributes for comparing digital technologies), and adherence (identification of key attributes that influence patient adherence). The exploratory objectives include heterogeneity assessment and subgroup analysis. The methodological aims are to investigate the use of DCE. MethodsTo obtain information on the criteria impacting acceptance, a DCE will be conducted including 7 attributes based on formative qualitative research. Patients with stroke (experimental group) and the general population (control group) are surveyed. The final instrument includes 6 best-best choice tasks in partial design. The experimental design is a fractional-factorial efficient Bayesian design (D-error). A conditional logit regression model and mixed logistic regression models will be used for analysis. To consider the heterogeneity of subgroups, a latent class analysis and an analysis of heteroscedasticity will be performed. ResultsThe literature review, qualitative preliminary study, survey development, and pretesting were completed. Data collection and analysis will be completed in the last quarter of 2023. ConclusionsOur results will inform decision makers about patients’ and publics’ acceptance of digital technologies used in innovative interventions. The patient preference information will improve decisions regarding the development, adoption, and pricing of innovative interventions. The behavioral changes in the choice of digital intervention alternatives are observable and can therefore be statistically analyzed. They can be translated into preferences, which define the value. This study will investigate the influences on the acceptance of digital interventions and thus support decisions and future research. International Registered Report Identifier (IRRID)DERR1-10.2196/46056