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We aim to comprehensively identify typical life-spanning trajectories and critical events that impact patients' hospital utilization and mortality. We use a unique dataset containing 44 million records of almost all inpatient stays from 2003 to 2014 in Austria to investigate disease trajectories. We develop a new, multilayer disease network approach to quantitatively analyse how cooccurrences of two or more diagnoses form and evolve over the life course of patients. Nodes represent diagnoses in age groups of ten years; each age group makes up a layer of the comorbidity multilayer network. Inter-layer links encode a significant correlation between diagnoses (p $<$ 0.001, relative risk $>$ 1.5), while intra-layers links encode correlations between diagnoses across different age groups. We use an unsupervised clustering algorithm for detecting typical disease trajectories as overlapping clusters in the multilayer comorbidity network. We identify critical events in a patient's career as points where initially overlapping trajectories start to diverge towards different states. We identified 1,260 distinct disease trajectories (618 for females, 642 for males) that on average contain 9 (IQR 2-6) different diagnoses that cover over up to 70 years (mean 23 years). We found 70 pairs of diverging trajectories that share some diagnoses at younger ages but develop into markedly different groups of diagnoses at older ages. The disease trajectory framework can help us to identify critical events as specific combinations of risk factors that put patients at high risk for different diagnoses decades later. Our findings enable a data-driven integration of personalized life-course perspectives into clinical decision-making.

Many European countries face rising obesity rates among children, compounded by decreased opportunities for sports activities during the COVID-19 pandemic. Access to sports facilities depends on multiple factors, such as geographic location, proximity to population centers, budgetary constraints, and other socio-economic covariates. Here we show how an optimal allocation of government funds towards sports facilitators (e.g. sports clubs) can be achieved in a data-driven simulation model that maximizes children's access to sports facilities. We compile a dataset for all 1,854 football clubs in Austria, including estimates for their budget, geolocation, tally, and the age profile of their members. We find a characteristic sub-linear relationship between the number of active club members and the budget, which depends on the socio-economic conditions of the clubs' municipality. In the model, where we assume this relationship to be causal, we evaluate different funding strategies. We show that an optimization strategy where funds are distributed based on regional socio-economic characteristics and club budgets outperforms a naive approach by up to 117\% in attracting children to sports clubs for 5 million Euros of additional funding. Our results suggest that the impact of public funding strategies can be substantially increased by tailoring them to regional socio-economic characteristics in an evidence-based and individualized way.

Dependencies in the global food production network can lead to shortages in numerous regions, as demonstrated by the impacts of the Russia-Ukraine conflict on global food supplies. Here, we reveal the losses of $125$ food products after a localized shock to agricultural production in $192$ countries and territories using a multilayer network model of trade (direct) and conversion of food products (indirect), thereby quantifying $10^8$ shock transmissions. We find that a complete agricultural production loss in Ukraine has heterogeneous impacts on other countries, causing relative losses of up to $89\%$ in sunflower oil and $85\%$ in maize via direct effects, and up to $25\%$ in poultry meat via indirect impacts. Whilst previous studies often treated products in isolation and did not account for product conversion during production, our model studies the global propagation of local supply shocks along both production and trade relations, allowing comparison of different response strategies., Comment: 36 pages, 8 figures. Nat Food (2023)

Patients do not access physicians at random but rather via naturally emerging networks of patient flows between them. As retirements, mass quarantines and absence due to sickness during pandemics, or other shocks thin out these networks, the system might be pushed closer to a tipping point where it loses its ability to deliver care to the population. Here we propose a data-driven framework to quantify the regional resilience to such shocks of primary and secondary care in Austria via an agent-based model. For each region and medical specialty we construct detailed patient-sharing networks from administrative data and stress-test these networks by removing increasing numbers of physicians from the system. This allows us to measure regional resilience indicators describing how many physicians can be removed from a certain area before individual patients won't be treated anymore. We find that such tipping points do indeed exist and that regions and medical specialties differ substantially in their resilience. These systemic differences can be related to indicators for individual physicians by quantifying how much their hypothetical removal would stress the system (risk score) or how much of the stress from the removal of other physicians they would be able to absorb (benefit score). Our stress-testing framework could enable health authorities to rapidly identify bottlenecks in access to care as well as to inspect these naturally emerging physician networks and how potential absences would impact them., Comment: See also the dashboard under https://vis.csh.ac.at/care-network-resilience/