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The desert ant Cataglyphis fortis inhabits the North African saltpans where it individually forages for dead arthropods. Homing ants rely mainly on path integration, i.e., the processing of directional information from a skylight compass and distance information from an odometer. Due to the far-reaching foraging runs, path integration is error-prone and guides the ants only to the vicinity of the nest, where the ants then use learned visual and olfactory cues to locate the inconspicuous nest entrance. The learning of odors associated with the nest entrance is well established. We furthermore know that foraging Cataglyphis use the food-derived necromone linoleic acid to pinpoint dead insects. Here we show that Cataglyphis in addition can learn the association of a given odor with food. After experiencing food crumbs that were spiked with an innately neutral odor, ants were strongly attracted by the same odor during their next foraging journey. We therefore explored the characteristics of the ants’ food-odor memory and identified pronounced differences from their memory for nest-associated odors. Nest odors are learned only after repeated learning trials and become ignored as soon as the ants do not experience them at the nest anymore. In contrast, ants learn food odors after a single experience, remember at least 14 consecutively learned food odors, and do so for the rest of their lives. As an ant experiences many food items during its lifetime, but only a single nest, differentially organized memories for both contexts might be adaptive.

Background Morbid Obesity (MO), defined by a Body Mass Index (BMI) > 40 kg/m 2 , is the most severe form of obesity. The risk of suffering from any chronic medical condition is almost twice as high in MO as compared to overweight. Despite obesity being one of the most serious contemporary public health concerns, there is a paucity of nutrient intake data in adults with MO. Nutritional assessments in morbidly obese adults are often based on individuals seeking weight loss surgery rather than focusing on the general community. Methods Using National Health and Nutrition Examination Surveys data (NHANES, 2007–2016), we estimated nutrient intakes in the general US population with MO, thereby focusing on a comparative assessment to the Dietary Guidelines for Americans (DGA, 2020–2025). Nutrient intakes were assessed in morbidly obese US adults with a BMI > 40 kg/m 2 , regardless of their intention to seek weight loss treatment and regardless of reporting special diets. Sex- and age-specific nutrient intake assessments were performed, with the aim to identify population subgroups that may warrant particular attention from a public health perspective. Results The study sample comprised 1,708 participants with MO. This may be extrapolated to represent 14,047,276 US Americans. MO was more prevalent in females as compared to males (65.60% vs 34.40%) and the sample’s average age was 46.25 years, with a tendency towards a lower mean age in higher BMI groups. The alignment with the DGA was poor across both sexes, and particularly with regard to the nutrients of public health concern (fiber, calcium), saturated fatty acid intake and the intakes of several fat-soluble vitamins. Fiber intake was found to be particularly low in females with MO. Total energy intake was not associated with BMI in participants with MO. Morbidly obese individuals frequently reported special diets, with up to 28% of the examined population disclosing at least one special diet. Conclusions Using a descriptive epidemiological approach, we identified numerous sociodemographic and nutritional factors associated with MO. The poor alignment with US national dietary guidelines warrants special considerations and dedicated public health nutrition efforts to combat the increasing obesity-related burden.

Background Crohn’s disease and irritable bowel syndrome may both cause abdominal pain and diarrhea. Irritable bowel syndrome not only is an important differential diagnosis for Crohn’s disease but also occurs in one out of three patients with Crohn’s disease in remission in parallel. If not adequately diagnosed and treated, additional functional symptoms such as fatigue and/or muscle pain may develop, indicating a more severe course. Case presentation A 64-year-old Caucasian male with long-standing, widely inactive Crohn’s disease presented with persistent diarrhea, bloating, abdominal pain, general fatigue, unexplained hip pain, and frequent shivering with cold extremities, which had worsened following a gastrointestinal infection and psychological stress. A plausible explanation of his symptoms, based on an understanding of mind–body interactions, the autonomic nervous system, and temperature regulation, combined with symptom relief, was associated with rapid and sustainable improvement. After 2.5 years of follow-up, the patient is almost symptom-free. Conclusions This case report exemplifies the interrelation between organic (Crohn’s disease) and functional diseases (irritable bowel syndrome, chronic fatigue syndrome, and somatoform pain). It further demonstrates that these connections may be overlooked in daily practice and that providing a plausible explanation in combination with symptom relief may be important for patients with functional syndromes.

Background Unfortified plant-based diets are devoid of vitamin B12, and supply low intakes of iodine, zinc, selenium, and calcium. To disentangle the complex interplay between nutritional adequacy and nutrient intakes from supplements and foods in plant-based diets, data from a Germany-based cross-sectional study examining the nutritional status of omnivores, lacto-ovo-vegetarians and vegans was re-analyzed. Special emphasis was put on potentially under-consumed nutrients in plant-based diets, including vitamin A and choline. Methods A novel tool focusing on under-consumed micronutrients was employed to shed a new light on nutrient supply and dietary exposure to critical nutrients in plant-based diets: The Total Nutrient Index (TNI). The TNI extends existing measures of diet quality by considering nutrient intake data from both foods and supplements. The TNI covers calcium, magnesium, potassium, choline and vitamins A, C, D, and E. The TNI was compared between omnivores, vegetarians and vegans, with a special focus on its micronutrient component scores and with regard to dietary supplement contributions. Results Data from 108 participants was analyzed. The vegan and the omnivorous diet resulted in similar TNI scores (73.70 ± 19.68 and 72.77 ± 17.88), whereas lacto-ovo-vegetarians scored lower (68.50 ± 17.10). The contribution of supplements to the TNI was higher in vegans and omnivores (median contribution: 12.50 (16.80) and 10.81 (18.23) score points, respectively) as compared to lacto-ovo-vegetarians (3.42 (12.50) score points). High micronutrient component score contributions to the TNI were found for vitamin D supplements (all dietary groups), vitamin C supplements (omnivores and vegans) and magnesium supplements (all groups). Conclusions Supplementation has a profound impact on nutrient supplies in individuals on a plant-based diet. This study reiterates the need to quantitatively assess nutrient intakes from supplements to assess diet quality of plant-based dietary patterns. We posit that defining diet-specific TNI scores is important for a precise evaluation of diet quality, whether in omnivore or in the spectrum of plant-based diets.

The COPD population will steadily increase due to continuous exposure to COPD risk factors and the aging demographics. Acupuncture, as a common modality in complementary medicine, has been widely applied in the treatment of COPD in recent years. However, systematic reviews of the efficacy of acupuncture-based traditional Chinese external treatment in COPD are relatively scarce and when considering the quality of randomized controlled trials evidence remains insufficient. To provide an updated systematic review and meta-analysis of the effectiveness of acupuncture-based treatment for COPD using the latest data and a rigorous evaluation system. Randomized controlled trials evaluating any form of acupuncture in COPD in a stable phase or acute exacerbation phase (AECOPD) were selected from Medline, Cochrane Library, Web of Science, Embase, CNKI, the Wanfang database, VIP, and SinoMed, encompassing a publication period from January 1st, 2000, to May 1st, 2025. The completeness of each study was evaluated according to the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines (STRICTA). A meta-analysis was conducted using Cochrane RevMan. A total of 1294 articles were retrieved from the selected database and 25 articles meeting the criteria were included. According to CONSORT, 8 studies rated as high quality, 16 studies as moderate quality, and 1 study as low quality. Due to the heterogeneity of outcome parameters and the limited number of AECOPD studies, meta-analysis could only be performed for COPD in the stable phase. In the meta-analysis, acupuncture-based treatments were significantly superior to controls in COPD in the primary outcome 6-minute walk distance (6MWD: p < 0.01) and the secondary outcomes Borg Scale (p < 0.05), forced expiratory volume in 1 s (FEV1: p < 0.01) and forced vital capacity (FVC: p < 0.05); no significant differences were found in the St. George's Respiratory Questionnaire (SGRQ) and the COPD Assessment Test (CAT). Acupuncture-based treatments significantly enhance the 6MWD, Borg Scale, FEV1 and FVC in COPD patients. The predominance of moderate quality studies indicates the ongoing need for improvement to ensure the credibility of data. •CONSORT/STRICTA analysis reveals quality variations in acupuncture COPD trials.•Meta-analysis shows acupuncture benefits COPD symptoms and quality of life.•Few trials reported blinding/reporting details, impacting risk of bias assessment.•Most frequently used acupoints were Feishu (BL13), Shenshu (BL23), Dingchuan (EX B1).

Background Whole food plant-based diets exert anti-inflammatory properties and have been associated with clinical improvements in patients with autoimmune disorders. The underlying mechanisms remain poorly understood and functional insights into nutrient-host physiology cross-talks are urgently warranted. The present study investigated the effects of an isocaloric 8-week vegan diet (VD) intervention on whole blood count parameters and lymphoid composition in comparison to a meat-rich diet (MD). Methods We conducted a two-arm, monocentric randomized-controlled trial with healthy adults who were randomly allocated to either a MD or a VD for 8 consecutive weeks. Foods of animal origin were not permitted on the VD, whereas participants in the MD group were asked to consume at least 150 g of meat per day. Results Fifty-seven participants completed the study. At week 8, significant between-group differences were found for the white blood cell count (median (interquartile range): 5.17 (1.62) *10 3 /µL in the VD group vs. 5.39 (1.92) *10 3 /µL in the MD group, p  = 0.029) and the lymphocyte count (1.80 ± 0.53 *10 3 /µL in the VD group vs. 2.06 (0.74) *10 3 /µL in the MD group, p  = 0.049). This difference was driven by an increase in lymphocytes in MD group participants over the course of the study. Median change scores in platelets differed between VD and MD participants (− 21 (− 31) *10 3 /µL in the VD group vs. − 1.21 ± 28.37 *10 3 /µL in the MD group, p  = 0.035) and so did the neutrophil change scores (− 0.17 (− 0.31) *10 3 /µL vs. 0.13 (0.50) *10 3 /µL, p  = 0.034). Mixed models for repeated measures with a time-diet interaction as a fixed effect suggested that changes in white blood cells were driven by the diet factor alone (contrast: − 0.50 (95% CI: − 0.99–(− 0.01)), p  = 0.046). Immunophenotyping results suggested significant between-group differences in CD3 + and CD8 + T-cells, and CD19 + B-cells after 8 weeks. CD19 + B-cells decreased significantly in the vegan group (214.77 ± 96.64 at baseline vs. 171.56 (102.73) cells/µL at week 8). Conclusions The present study suggests that a VD, in comparison to a MD, reduces the number of various immune cells even in healthy individuals. A VD may thus exert anti-inflammatory properties. Trial registration Registered at Deutsches Register Klinischer Studien: DRKS00031541.

Background Limitations of current therapy of depression highlight the need for an immediately available, easily implementable add-on treatment option with high acceptance from patients. Hyperthermic baths (HTB) are a form of balneotherapy with head-out-of-water-immersion in a hot pool or tub at 40 °C for 15–20 min. A prior study suggests that HTB added to usual depression care can have antidepressant effects. Method Single-site, open-label randomised controlled 8-week parallel-group pilot study at a university outpatient clinic. 45 medically stable outpatients with moderate depression as determined by the 17-item Hamilton Depression Rating Scale (HAM-D) score ≥ 18 and a score ≥ 2 on item 1 (Depressed Mood) were recruited. They were randomised to twice weekly HTB ( n  = 22) or a physical exercise program (PEP) of moderate intensity ( n  = 23). Primary outcome measure was the change in HAM-D total score from baseline (T0) to the 2-week time point (T1). Linear regression analyses, adjusted for baseline values, were performed to estimate intervention effects on an intention-to-treat (ITT) and per-protocol (PP) principle. Results Forty-five patients (HTB n  = 22; PEP n  = 23) were analyzed according to ITT (mean age = 48.4 years, SD = 11.3, mean HAM-D score = 21.7, SD = 3.2). Baseline-adjusted mean difference after 2 weeks was 4.3 points in the HAM-D score in favor of HTB ( p  < 0.001). Compliance with the intervention and follow-up was far better in the HTB group (2 vs 13 dropouts). Per protocol analysis only showed superiority of HTB as a trend ( p  = 0.068). There were no treatment-related serious adverse events. Main limitation: the number of dropouts in the PEP group (13 of 23) was higher than in other trials investigating exercise in depression. Due to the high number of dropouts the effect in the ITT-analysis may be overestimated. Conclusions HTB added to usual care may be a fast-acting, safe and easy accessible method leading to clinically relevant improvement in depression severity after 2 weeks; it is also suitable for persons who have problems performing exercise training. Trial registration German Clinical Trials Register (DRKS) with the registration number DRKS00011013 (registration date 2016-09-19) before onset of the study.

Background The purpose of this review was to identify the relationship between the gut microbiome and the development of postoperative complications like anastomotic leakage or a wound infection. Recent reviews focusing on underlying molecular biology suggested that postoperative complications might be influenced by the patients’ gut flora. Therefore, a review focusing on the available clinical data is needed. Methods In January 2017 a systematic search was carried out in Medline and WebOfScience to identify all clinical studies, which investigated postoperative complications after gastrointestinal surgery in relation to the microbiome of the gut. Results Of 337 results 10 studies were included into this analysis after checking for eligibility. In total, the studies comprised 677 patients. All studies reported a postoperative change of the gut flora. In five studies the amount of bacteria decreased to different degrees after surgery, but only one study found a significant reduction. Surgical procedures tended to result in an increase of potentially pathogenic bacteria and a decrease of Lactobacilli and Bifidobacteria. The rate of infectious complications was lower in patients treated with probiotics/symbiotics compared to control groups without a clear relation to the systemic inflammatory response. The treatment with synbiotics/probiotics in addition resulted in faster recovery of bowel movement and a lower rate of postoperative diarrhea and abdominal cramping. Conclusions There might be a relationship between the gut flora and the development of postoperative complications. Due to methodological shortcomings of the included studies and uncontrolled bias/confounding factors there remains a high level of uncertainty.

Background Nutrition education remains an underdeveloped component of medical training globally. This gap in knowledge can hinder physicians from effectively integrating nutrition into clinical practice, creating a significant barrier to supporting meaningful dietary changes in patients. We developed a culinary medicine elective for 3rd to 6th year medical students titled “Prospective Physicians For Fibre (PPFF)” to promote students’ knowledge about the importance of fibre and its benefits in health and disease. Methods The four-week fibre-focused, mixed-methods, short-term, culinary medicine elective PPFF was tested in a non-controlled pilot study. Students’ fibre intake and knowledge about fibre were compared in a pre-post design in n  = 47 participants. Results Participants had a median age of 24 years; females accounted for 72% of the sample. Mean fibre intake based on 2-day weighed food diaries increased from 29.52 ± 10.72 to 38.40 ± 12.14 g/d after the elective ( P  < .001). Prior to the elective, self-assessed fibre intake ranged from 5 to 1000 g/d, and was not correlated with food diary-based fibre intake. After the elective, self-assessed fibre intakes were more accurate and a strong correlation between self-assessed and actual fibre intake was observed (Spearman’s rho = 0.55, P  < .001). Students’ scoring in the PPFF survey improved significantly from 3.06 ± 1.66 to 7.70 ± 1.49 points ( P  < .001). The elective received very good ratings and increased students’ self-perceived competences in various domains, such as fibre intake assessment, nutrition counselling and cooking skills. Conclusions PPFF improves fibre intake and nutrition knowledge in a pilot cohort of German medical students and may equip students with essential skills and competencies for their future career.

Mistletoe lectins (ML) have cytotoxic and immunomodulating properties, and subcutaneously applied mistletoe products (MP) containing ML have approval for supportive cancer treatment. MP are also given off-label intravenously, but data about pharmacokinetics are widely lacking. Therefore, the aim of our phase I trial was to evaluate the pharmacokinetics and safety of intravenously applied natural ML. Initially, 12 healthy male volunteers were planned to receive a single infusion of 2000 mg Helixor® P. We had to terminate the study prematurely after the inclusion of eight subjects due to elevation of all subjects’ liver enzymes. ML was detected in all subjects after infusion. The mean half-life of serum ML was 7.02 ± 2.01 h. Mean alanine transaminase increased from 23 ± 6 to a maximum of 445 ± 260 U/L, and mean aspartate aminotransferase increased from 24 ± 3 to a maximum of 318 ± 33 U/L 72 h after infusion. Severity grading for drug-induced liver injury was mild. Participants did not suffer from any liver-specific symptoms and recovered completely. As a conclusion, the dose of 2000 mg Helixor® P caused transient liver injury in healthy subjects and should, therefore, not be used for initial patient treatment. Liver enzymes should be monitored in patients receiving intravenous treatment with Helixor® P.