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Beneficial associations between plants and microbes play an important role in both natural and agricultural ecosystems. For example, associations between fungi of the genus Epichloë, and cool‐season grasses are known for their ability to increase resistance to insect pests, fungal pathogens and drought. However, little is known about the molecular changes induced by endophyte infection. To study the impact of endophyte infection, we compared the expression profiles, based on RNA sequencing, of perennial ryegrass infected with Epichloë festucae with noninfected plants. We show that infection causes dramatic changes in the expression of over one third of host genes. This is in stark contrast to mycorrhizal associations, where substantially fewer changes in host gene expression are observed, and is more similar to pathogenic interactions. We reveal that endophyte infection triggers reprogramming of host metabolism, favouring secondary metabolism at a cost to primary metabolism. Infection also induces changes in host development, particularly trichome formation and cell wall biogenesis. Importantly, this work sheds light on the mechanisms underlying enhanced resistance to drought and super‐infection by fungal pathogens provided by fungal endophyte infection. Finally, our study reveals that not all beneficial plant–microbe associations behave the same in terms of their effects on the host.

Background: Hearing and cognition decline with age. Hearing is now considered an independent risk factor for later cognitive impairment. Computerized cognitive auditory training is being discussed as a possible adjunctive therapy approach. Objectives: The aim of this exploratory study is to investigate how the success of a computer-based cognitive auditory training (CCAT) can be measured. For this purpose, the influence of a CCAT on different dimensions of hearing and cognition was determined. Materials and Methods: 23 subjects between 52 and 77 years old were recruited with normacusis to moderate hearing loss. They underwent 40 digital training lessons at home. Before, during, and after completion, concentration ability with the d2-R, memory (VLMT), subjective hearing impairment (HHI), hearing quality (SSQ12), listening effort in noise (ACALES), and speech understanding in noise (GÖSA) were measured. Results and Discussion: In this uncontrolled, non-randomized study, one of the main findings was that cognitive dimensions, namely processing speed, improved by 12.11 ± 16.40 points (p = 0.006), and concentration performance improved by 12.56 ± 13.50 points (p = 0.001), which were not directly trained in CCAT. Learning performance also improved slightly by 4.00 ± 7.00 (p = 0.019). Subjective hearing handicap significantly reduced by 10.70 ± 12.38 (p = 0.001). There were no significant changes in the SSQ-12 (p = 0.979). Hearing effort improved by 1.79 ± 2.13 dB SPL (p = 0.001), 1.75 ± 2.09 (p = 0.001), and 3.32 ± 3.27 dB (p < 0.001), respectively. Speech understanding in noise did not improve significantly. CCAT is likely to improve several dimensions of hearing and cognition. Controlled future studies are needed to investigate its efficacy.

Background Patient-reported outcome measures (PROMs) offer the potential for enhancing treatment quality and supporting patient-centered care. However, it remains uncertain how effectively these measures correlate with clinical outcomes. Methods This prospective observational cohort study included 107 adult patients undergoing elective thoracic surgery. PROMs assessing anxiety, depression, and pain perception were collected preoperatively and at 6–12 months postoperatively using the Hospital Anxiety and Depression Scale (HADS), the State–Trait Anxiety Inventory (STAI), the Pain Sensitivity Questionnaire (PSQ), and the Pain Catastrophizing Scale (PCS). Postoperative pain was assessed using the Numeric Rating Scale (NRS), and persistent pain at follow-up was defined as post-thoracotomy pain syndrome (PTPS). The primary endpoint was the longitudinal change in PROMs between preoperative assessment and follow-up. Secondary endpoints included subgroup analyses according to the type of surgical access (open and minimally-invasive), the type of locoregional anesthetic technique (epidural anesthesia, intercostal nerve block, local anesthetic infiltration), and the presence of acute and chronic postoperative pain (PTPS). Results Patients showed elevated scores at postoperative follow-up, with the exception of the HADS overall score, HADS-anxiety, and STAI, the latter of which demonstrated a significant decrease. No significant differences were found across subgroups based on procedure type, anesthesia method, or PTPS status, with the exception of a significant difference in HADS-depression scores in patients without PTPS. Conclusions A decline in physical and psychological well-being was observed 6 to 12 months post-surgery, reflected in increased levels of pain, depression, and anxiety. Our study did not find evidence of an association between the PROMs assessed and variations in surgical procedures, anesthesia methods, or the presence of acute and chronic pain in this cohort. Trial registration DRKS: DRKS00017798.

Purpose Despite improved treatment options, multiple myeloma (MM) remains an incurable disease. The aim of this study was to investigate the prognostic value of positron emission tomography/computed tomography (PET/CT) using 18 F-2’-deoxy-2’-fluorodeoxyglucose ([ 18 F]FDG) in MM patients shortly before and ~100 days after allogeneic hematopoietic cell transplantation (allo-HCT). Methods In this retrospective analysis, we evaluated [ 18 F]FDG-PET/CT-scans of 45 heavily pre-treated MM patients before and 27 patients after scheduled allo-HCT. All scans were qualitatively and semi-quantitatively assessed for the presence of active disease. Serological response was recorded according to International Myeloma Working Group (IMWG) criteria. Progression-free (PFS) and overall survival (OS) were correlated with different PET/CT-derived parameters, such as presence, number and maximum standardized uptake value (SUV max ) of focal myeloma lesions. The impact of extramedullary disease on patient outcome was also assessed. Results PET/CT negativity -prior to or following allo-HCT- was a favorable prognostic factor for progression-free and overall survival (both, PFS and OS: pre-HSCT p  < 0.001, post-HCT p  < 0.005). High FDG-uptake (SUV max  > 6.5) revealed a significantly shortened survival compared to patients with a lower SUV max (<6.5) (OS, 5.0 ± 1.1 m vs. not reached - longest 122.0 m; p  < 0.001). Moreover, our data prove that a higher number (>3) of focal lesions (pre-HCT: both PFS and OS: p  < 0.001; post-HCT PFS: p  < 0.001, OS: p  = 0.139) as well as the presence of extramedullary disease serve as adverse prognostic factors prior to and after allo-HCT. At response assessment after allo-HCT, [ 18 F]FDG-PET/CT had a complementary value in prognostication in addition to IMWG criteria alone. Conclusion [ 18 F]FDG-PET/CT before and shortly after allogeneic HCT is a powerful predictor for progression-free and overall survival in MM patients.

Periodontal therapy using antimicrobials that are topically applied requires slow or controlled release devices. The in vitro antimicrobial activity of biodegradable polymer formulations that contain a new minocycline lipid complex (P-MLC) was evaluated. The new P-MLC formulations that contained 11.5% minocycline were compared with pure minocycline or an existing commercial formulation, which included determination of minimal inhibitory concentration (MIC) values against two oral bacteria and activity on six-species periodontal biofilm. Moreover, the flow of gingival crevicular fluid (GCF) was modeled up to 42 days and the obtained eluates were tested both for MIC values and inhibiting biofilm formation. In general, MICs of the P-MLC formulations were slightly increased as compared with pure minocycline. Biofilm formation was clearly inhibited by all tested formulations containing minocycline with no clear difference between them. In 3.5 day old biofilms, all formulations with 250 µg/mL minocycline decreased bacterial counts by 3 log10 and metabolic activity with no difference to pure antimicrobials. Eluates of experimental formulations showed superiority in antimicrobial activity. Eluates of one experimental formulation (P503-MLC) still inhibited biofilm formation at 28 days, with a reduction by 1.87 log10 colony forming units (CFU) vs. the untreated control. The new experimental formulations can easily be instilled in periodontal pockets and represent alternatives in local antimicrobials, and thus warrant further testing.

Children and adolescents often do not meet the WHO´s physical activity (PA) recommendations. As many of them live in urban areas, these are important spaces for PA-promotion. Objective measures such as the Walkability Index are often used to assess urban spaces in terms of their PA friendliness. However, it is unclear whether such parameters can predict PA behavior of children and adolescents. This study examines the relationships between the Walkability Index and data of the intervention “Kreuz & Quer” (K&Q), promoting PA. K&Q collected data from 9,852 children and adolescents in urban neighborhoods. PA was measured through the number of interactions at K&Q checkpoints, reflecting participants’ actively performed visits to physical locations. PA acted as the dependent variable in a linear mixed models approach. Walkability served as a fixed factor and district, season of year and intervention day as random effects. Results indicate a significant positive association between a high Walkability Index and PA levels in children and adolescents. Some of the observed variance can be explained by the random effects. There is still unexplained variance, suggesting the need to consider additional influences to explain youth PA behavior. These may include qualitative explanations to provide a holistic picture. Subjective perspectives can help create environments that are structurally conducive to walking, thereby promoting PA.

Epichloë spp. often form mutualistic interactions with cool-season grasses, such as Lolium perenne . However, the molecular mechanisms underlying this interaction remain poorly understood. In this study, we employed reduced representation bisulfite sequencing method (epiGBS) to investigate the impact of the Epichloë sp. Lp TG-3 strain AR37 on the methylome of L. perenne across multiple grass generations and under drought stress conditions. Our results showed that the presence of the endophyte leads to a decrease in DNA methylation across genomic features, with differentially methylated regions primarily located in intergenic regions and CHH contexts. The presence of the endophyte was consistently associated with hypomethylation in plants across generations. This research sheds new light on the molecular mechanisms governing the mutualistic interaction between Epichloë sp. Lp TG-3 strain AR37 and L. perenne . It underscores the role of methylation changes associated with endophyte infection and suggests that the observed global DNA hypomethylation in L. perenne may be influenced by factors such as the duration of the endophyte-plant association and the accumulation of genetic and epigenetic changes over time.

During adaptation to host environments, many microorganisms alter their cell surface. One mechanism for doing so is variation in the number of amino acid repeats in cell surface proteins encoded by hypermutable DNA tandem repeats. In the yeast Candida albicans, an opportunistic human pathogen, the gene SSR1 encodes a GPI-anchored cell wall protein with a structural role. It contains two regions consisting of tandem repeats, almost exclusively encoding the amino acid pair Ser-Ala. As expected, the repeat regions make SSR1 highly mutable. New SSR1 alleles arose with a frequency of 1.11×10-4 per cell division in serially propagated cells. We also observed a large number (25) of SSR1 alleles with different repeat lengths in a survey of 131 isolates from a global strain collection. C. albicans is diploid, and combinations of these allele generated 41 different SSR1 genotypes. In both repeat regions, nonsynonymous mutations were largely restricted to one particular repeat unit. Two very similar allele combinations were largely restricted to one clade, clade 1. Each combination was present in ~30% of 49 infection-causing clade 1 strains, but one was rare (2%), the other absent in 46 infection-causing strains representing the remainder of the species (P < 0.00018 and 0.00004; Fisher's exact test). These results indicate that both repeat regions are under selection and that amino acid repeat length polymorphisms generate Ssr1 protein variants most suitable for specific genetic backgrounds. One of these two allele combinations was 5.51 times more frequent, the other 1.75 times less frequent in 49 clade 1 strains that caused disease than in 36 commensal clade 1 strains (P = 0.0105; Chi2 test). This indicates that insertion and deletion of repeats not only generates clade-optimized Ssr1p variants, but may also assist in short-term adaptation when C. albicans makes the transition from commensal to pathogen.

Purpose Radioguided sentinel lymph node biopsy (SLNB) is the standard of care in breast cancer and melanoma. Additional preoperative Single-photon emission computed tomography (SPECT/CT) for improved anatomical co-registration of the SLNs causes additional radiation exposure and is time-consuming and expensive. The aim of this prospective study was to evaluate a novel approach involving real-time fusion of freehand SPECT (fhSPECT) and ultrasound (US) for anatomical co-registration of SLNs. Methods From February 2015 to February 2016, 153 patients were included in this prospective study. All patients underwent lymphoscintigraphy according to practical guidelines and 151 (118 cases of breast cancer, 30 cutaneous malignancies, and three cases of vulvar cancer) of the 153 patients were additionally investigated with fhSPECT-US. FhSPECT connected to a hand-held gamma detector generates three-dimensional images of the radioactivity distribution in the scanned area. For co-registration and real-time fusion of fhSPECT and subsequently performed US, an infrared stereo tracking system was used. Results In all patients an SLN was found on lymphoscintigraphy, and the fhSPECT detected corresponding hotspots in all but one patient. In 72 % of patients and 73 % of lymph node basins, real-time anatomical co-registration with US was feasible. The rate of success in achieving good co-registration increased from 60 to 75 % after training by a radiologist specialized in breast imaging. A higher co-registration rate (78 %) was observed in patients with only one SLN than in those with two SLNs (68 %) or three or more SLNs (0 %). Conclusions Real-time fusion of fhSPECT and US for preoperative anatomical co-registration of SLNs is feasible. However, before this approach can completely replace preoperative lymphatic imaging, further technical developments are needed.

Background The mental health and well-being of school teachers is critical not only for their individual health but also for the quality and stability of educational systems. Numerous interventions have been developed to address teachers’ mental health challenges, yet their implementation in everyday school settings remains limited. Understanding implementation determinants, strategies, and outcomes is essential for improving sustainable implementation, intervention effectiveness and broader public health impact. This scoping review explored how implementation is addressed in studies evaluating mental health-promoting interventions for teachers. Methods Following Arksey and O’Malley’s (2005) and Levac et al.’s (2010) frameworks and PRISMA-ScR guidelines, we systematically searched Scopus and EBSCOhost up to April 2025. Studies were included if they evaluated an intervention targeting teachers’ mental health and reported at least one implementation aspect. Data extraction was guided by leading implementation science frameworks. Results Of 4,062 identified records, 16 met the inclusion criteria. Most studies were primarily effectiveness-focused and assessed early-stage implementation rather than long-term implementation or sustainment. Implementation outcomes such as acceptability and feasibility were frequently reported but rarely grounded in implementation frameworks. Implementation determinants appeared in most studies, predominantly as post hoc barriers, with few studies assessing them a priori to guide implementation planning. Implementation strategies were commonly described but seldom explicitly labeled as such. Most studies examined implementation and intervention outcomes separately, limiting insights into how implementation processes influenced effectiveness. Nevertheless, several insights emerged, including the relevance of training and educating stakeholders, tailoring interventions to context, and strengthening relational dynamics, all examples of implementation strategies, as well as the importance of considering intervention content and implementation jointly. Conclusion Although implementation determinants, strategies, and outcomes were reported in studies on teachers’ mental health interventions, reporting was often fragmented, unsystematic and rarely guided by established frameworks or terminology. Future research should adopt comprehensive, theory-informed approaches that link implementation and intervention content. From a public health perspective, aligning evidence-based interventions, addressing both organizational and individual levels, with context-sensitive implementation strategies is key to sustainably improving teachers’ mental health and strengthening schools as healthy, supportive environments.