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Disparities in social determinants of health (SDOH) play a significant role in causing health inequities globally. The physical environment, including housing and workplace environment, can increase the prevalence and spread of fungal infections. A number of professions are associated with increased fungal infection risk and are associated with low pay, which may be linked to crowded and sub-optimal living conditions, exposure to fungal organisms, lack of access to quality health care, and risk for fungal infection. Those involved and displaced from areas of armed conflict have an increased risk of invasive fungal infections. Lastly, a number of fungal plant pathogens already threaten food security, which will become more problematic with global climate change. Taken together, disparities in SDOH are associated with increased risk for contracting fungal infections. More emphasis needs to be placed on systematic approaches to better understand the impact and reducing the health inequities associated with these disparities.

The article aims to outline the proposals for linking school effectiveness research and school improvement that are currently relevant in international discussion and to ask how they deal with the 'technology deficit' at the level of model improvement. We will first show the difference between school improvement and school effectiveness. Then, we outline areas showing basic problems associated with linking school effectiveness and school improvement. After that, we present a summary of two relevant models for linking school effectiveness research and school improvement--Comprehensive Framework of Effective School Improvement and Dynamic Model of Educational Effectiveness--and subject them to critical analysis. The result of the critical analysis is that the question arises whether a link between the two traditions leads to a complementation of their respective problems of observation rather than to a compensation of them. This, in particular, concerns the problem of causality, which gives rise to theoretical and methodological considerations in both fields of research.

Introduction: Pre-existent pools of coronavirus-specific or cross-reactive T cells were shown to shape the development of cellular and humoral immune responses after primary mRNA vaccination against SARS-CoV-2. However, the cellular determinants of responses to booster vaccination remain incompletely understood. Therefore, we phenotypically and functionally characterized spike antigen-specific T helper (Th) cells in healthy, immunocompetent individuals and correlated the results with cellular and humoral immune responses to BNT162b2 booster vaccination over a six-month period. Methods: Blood of 30 healthy healthcare workers was collected before, 1, 3, and 6 months after their 3rd BNT162b2 vaccination. Whole blood was stimulated with spike peptides and analyzed using flow cytometry, a 13-plex cytokine assay, and n Counter-based transcriptomics. Results: Spike-specific IgG levels at 1 month after booster vaccination correlated with pre-existing CD154+CD69+IFN-γ+CD4+ effector memory cells as well as spike-induced IL-2 and IL-17A secretion. Early post-booster (1-month) spike IgG levels (r=0.49), spike-induced IL‑2 (r=0.58), and spike-induced IFN‑γ release (r=0.43) correlated moderately with their respective long-term (6-month) responses. Sustained robust IgG responses were significantly associated with S-specific (CD69+±CD154+±IFN-γ+) Th-cell frequencies before booster vaccination (p=0.038), especially double/triple-positive type-1 Th cells. Furthermore, spike IgG levels, spike-induced IL‑2 release, and spike-induced IFN‑γ release after 6 months were significantly associated with increased IL‑2 & IL‑4, IP‑10 & MCP1, and IFN‑γ & IP‑10 levels at 1 month post-booster, respectively. On the transcriptional level, induction of pathways associated with both T-cell proliferation and antigen presentation was indicative of sustained spike-induced cytokine release and spike-specific IgG production 6 months post-booster. Using support vector machine models, pre-booster spike-specific T-cell frequencies and early post-booster cytokine responses predicted sustained (6-month) responses with F1 scores of 0.80-1.00.Discussion: In summary, spike-specific Th cells and T-cellular cytokine signatures present before BNT162b2 booster vaccination shape sustained adaptive cellular and humoral responses post-booster. Functional T-cell assays might facilitate early identification of potential non-responders. [ABSTRACT FROM AUTHOR]

Invasive aspergillosis causes significant morbidity and mortality in immunocompromised patients. Natural killer (NK) cells are pivotal for antifungal defense. Thus far, CD56 is the only known pathogen recognition receptor on NK cells triggering potent antifungal activity against Aspergillus fumigatus. However, the underlying cellular mechanisms and the fungal ligand of CD56 have remained unknown. Using purified cell wall components, biochemical treatments, and ger mutants with altered cell wall composition, we herein found that CD56 interacts with the A. fumigatus cell wall carbohydrate galactosaminogalactan (GAG). This interaction induced NK cell activation, degranulation, and secretion of immune-enhancing chemokines and cytotoxic effectors. Supernatants from GAG-stimulated NK cells elicited antifungal activity and enhanced antifungal effector responses of polymorphonuclear cells. In conclusion, we identified A. fumigatus GAG as a ligand of CD56 on human primary NK cells, stimulating potent antifungal effector responses and activating other immune cells. Author summary: The opportunistic mold pathogen Aspergillus (A.) fumigatus possesses significant health risk, particularly for immunocompromised individuals. This ubiquitous fungus found in soil and decaying organic matter, causes a range of partially life-threatening infections known as aspergillosis. Natural killer (NK) cells, part of the innate immunity, recognize A. fumigatus by pathogen-associated molecular patterns (PAMPs) via their pattern recognition receptors (PRRs), leading to the elimination of infected cells, including direct cytotoxicity and cytokine production. Previously, we identified the NK-cell receptor CD56 as a PRR that recognizes A. fumigatus and triggers potent antifungal activity. However, the A. fumigatus ligand of CD56 has remained unknown. Here, we used different approaches to identify the A. fumigatus ligand of CD56 on NK cells. We found that CD56 directly binds to cell wall galactosaminogalactan. Specifically, deacetylated galactosamine residues of GAG played a role in the interaction with CD56 and triggered strong NK-cell activation, along with potent release of cytotoxic effectors and immune-enhancing chemokines. We also found that GAG-primed NK-cell supernatants activate and enhance effector responses of polymorphonuclear cells. Our study provides new insights on the A. fumigatus-NK cell interplay by identifying GAG as an activating ligand of CD56 on human NK cells, stimulating potent antifungal effector responses. [ABSTRACT FROM AUTHOR]

Objectives Historically, patients with leukaemia and invasive fusariosis (IF) have experienced poor outcomes in the setting of persistent immunosuppression. Herein, we retrospectively reviewed the incidence, presentation and outcomes of IF that are scarcely studied in contemporary cohorts of leukaemia patients. Methods We identified adult leukaemia patients with proven or probable IF at MD Anderson Cancer Center during 2009–21. Independent risk factors for 42 day mortality after IF diagnosis were determined using a multivariable logistic regression model. Combined with historical data, the annual IF incidence density over the past 23 years was estimated using Poisson regression analysis. Results Among 140 leukaemia patients with IF (114 proven), 118 patients (84%) had relapsed/refractory leukaemia and 124 (89%) had neutropenia at IF diagnosis. One hundred patients (71%) had pulmonary IF, 88 (63%) had disseminated IF and 48 (34%) had fungaemia. Coinfections were common (55%). Eighty-nine patients (64%) had breakthrough IF to mould-active triazoles. Most patients (84%) received combination antifungal therapy. Neutrophil recovery [adjusted OR (aOR), 0.04; 95% CI, 0.01–0.14; P  < 0.0001], pulmonary IF (aOR, 3.28; 95% CI, 1.11–9.70; P  = 0.032) and high SOFA score (aOR, 1.91 per 1-point increase; 95% CI, 1.47–2.50; P  < 0.0001) were independent predictors of 42 day mortality outcomes. From 1998 to 2021, IF incidence density increased significantly at an annual ratio of 1.03 (95% CI, 1.01–1.06; P  = 0.04). Conclusions IF is predominantly seen in patients with relapsed/refractory leukaemia and increasingly seen as a breakthrough infection to mould-active triazoles. Despite frequent combination antifungal therapy, high mortality rates have persisted in patients with lasting neutropenia. [ABSTRACT FROM AUTHOR]

To achieve the ambitious climate goals, the transition from fossil fuels to renewable resources is crucial. Hydrogen plays a central role in this. The German government adopted the National Hydrogen Strategy in June 2020 and appointed the National Hydrogen Council. The Council consists of 26 high‐ranking experts from industry, science, and civil society. Its task is to advise and support the State Secretary's Committee for Hydrogen by making proposals and recommendations for action in the implementation and further development of the strategy. [ABSTRACT FROM AUTHOR]

Germline pathogenic variants (PVs) in the gene encoding the GATA2 transcription factor can result in profound reductions of monocytes, dendritic cells, natural killer cells and B cells. GATA2 PVs are associated with an increased risk of myeloid malignancies and a predisposition to nontuberculous mycobacterial and human papillomavirus infections. Additionally, invasive fungal infections (IFIs) have been reported in individuals with GATA2 PVs, even in the absence of myeloid malignancies. In this report, we present the case of a 40‐year‐old man with Emberger syndrome (GATA2 mutation, recently diagnosed acute myeloid leukaemia [AML] and history of lymphedema with hearing loss) who developed Mucorales sinusitis while receiving his first course of remission induction chemotherapy. Additionally, we review the literature on all published cases of proven IFIs in patients with GATA2 PVs. Clinicians should be aware that patients with GATA2 PVs could be vulnerable to opportunistic IFIs, even in the absence of AML and antineoplastic therapy. Furthermore, the distinctly unusual occurrence of mucormycosis during the first course of induction chemotherapy for AML in our patient indicates that patients with germline GATA2 PVs receiving induction chemotherapy for AML might be at high risk for early onset of IFIs due to aggressive, opportunistic moulds. [ABSTRACT FROM AUTHOR]

Purpose: In Germany up until now, there has been very little research on staff development in schools. The purpose of this paper is to comprehensively assess school-based staff development and to describe the interplay between different instruments of staff development (e.g. classroom observations, development discussions) at the school level. Design/methodology/approach: Considering that different constellations of organizational management tools may be differentially effective in different contexts (see Mintzberg, 1983/1992), an approach that takes a combination of different staff development instruments into account was chosen. Data were gathered from principals of primary and secondary schools in two federal states of Germany. Using regression, cluster analysis, and analysis of variance, the authors examined different instruments and patterns of staff development used in everyday school practice and determined how these affected the professional development of teachers. Findings: Five staff development patterns could be identified. With regard to the extent of professional development activities of teachers, these patterns have been proven to have a different impact. Furthermore, the use of the different staff development patterns seems to be heavily dependent on the type of school. Research limitations/implications: Further research would be needed that examines if the three most relevant staff development patterns identified in this study can also be proven to be effective with regard to somewhat "harder" criteria than the extent of professional development activities of teachers. Such criteria could be teachers' teaching skills or even student achievement. Originality/value: The current study is the first to examine staff development in German schools systematically. The results provide some good leads for further studies in this area.

This study uses a school-level longitudinal control-group design to examine how teachers and principals of inspected versus uninspected schools perceive school improvement at their schools. During the phasing in of school inspections in the states of Berlin and Brandenburg (Germany), both inspected and uninspected schools were surveyed with respect to school improvement activities over a 1-year period. The main finding is that principals' and teachers' perceptions of school quality were highly stable, irrespective of the introduction of school inspections. The results show school inspections had a comparatively low impact on the aspects of school quality measured here.