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In 2022, over 1,000,000 people from Ukraine fled to Germany, mostly women and children. The aim of this study was to determine health status and socio-demographic background of Ukrainian refugee minors in Germany and to compare that to German minors. In this study, Ukrainian refugees of all ages, who voluntarily made contact with the study centres via flyers or refugee shelters, were interviewed with the help of trained interpreters from 09-12/2022. We assessed data from minors and their families on socio-economic status, general health perception, current and pre-existing infectious and non-contagious diseases, and vaccination status. The data for the minors were collected by interviewing the accompanying adults. In addition, a physical examination and serological screening for infectious and vaccine-preventable diseases were performed. Overall, 392 minors and accompanying adults (358) were included. Minors' general and mental health were reported as "at least good" in 83% (316) and 80% (304), respectively. In 16% (63), infectious or other underlying diseases were recorded. Tuberculosis infections (7, 1.8%) and hepatitis C (2, 0.5%) were found through the serological tests. HIV could only be detected in one previously known case. Self-reported vaccinations against measles and varicella, for example, did not match serological findings (protection against measles 304; 84%; varicella 230; 64%)., Conclusion: Accompanying adults often rate the general health and well-being of Ukrainian refugee minors as rather poor. Frequently, self-reported vaccinations and preexisting diseases did not match serology results; therefore, Ukrainian refugee minors without formal vaccination certificate should be offered all recommended vaccinations and be generously screened for hepatitis B, C and HIV in addition to tuberculosis., What Is Known: • Infectious diseases (TB, hepatitis B/C, HIV) are more common among Ukrainian minors and vaccine hesitancy is more widespread than in many host countries and require appropriate medical care. • Displacement and war worsen medical care and have negative impact on mental health.., What Is New: • Although intrafamilial spread of infectious diseases was rare (in this cohort), perceived general health of Ukrainian minors is rather poor. • Semi-structured interviews-even with interpreters-are often insufficient to collect valid medical information., Competing Interests: Declarations. Ethics approval: Two different leading ethics committees evaluated the study protocol, the one of the Goethe University in Frankfurt for adult participants (reference number 2022–831) and of Ruhr University in Bochum for the paediatric cohort (“minors”) (registration number 22–7623). Subsequently, the study was approved by all local ethics committees of all study centres. The study was conducted in accordance with the Declaration of Helsinki. Consent to participate: Written informed consent was obtained from all participants included in the study or, in the case of minors, that of the legal guardian. All participants were informed about the publication of anonymized data. No personal data was published, so no separate declaration of consent was obtained for this. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Biomedical and lifestyle factors in Western populations have significantly shifted in recent decades, influencing public health and contributing to the increasing prevalence of non-communicable diseases (NCDs) that share inflammation as common pathology., Methods: We investigated the relationship between these factors and 11 NCDs in the cross-sectional FoCus cohort (n = 1220), using logistic regression models. Associations with age-at-disease-onset were specifically analyzed for type 2 diabetes (T2D, low-grade chronic inflammation) and inflammatory bowel disease (IBD, high-grade chronic inflammation) in disease-specific cohorts (FoCus-T2D, n = 514; IBD-KC, n = 1110). Important factors for disease risk were identified using Cox-PH-regression models and time-to-event analysis. We further explored the interaction between identified risk factors and gut microbiome composition using linear models., Results: Lifestyle factors were clearly linked to disease phenotypes, particularly in T2D and IBD. Still, some factors affected only the age-at-onset, but not disease prevalence. High-quality nutrition significantly delayed onset for both IBD and T2D (IBD: HR = 0.81 [0.66; 0.98]; T2D: HR = 0.45 [0.28; 0.72]). Smoking accelerated T2D onset (HR = 1.82 [1.25; 2.65]) but delayed onset in ulcerative colitis (UC: HR = 0.47 [0.28; 0.79]). Higher microbiota diversity delayed IBD onset (Shannon: HR = 0.58 [0.49; 0.71]) but had no effect on T2D. The abundance of specific microbial genera was strongly associated with various biomedical and lifestyle factors in T2D and IBD. In unaffected controls, these effects were smaller or reversed, potentially indicating a greater susceptibility of the gut microbiome to negative influences in T2D and IBD., Conclusions: The dual insights into age-at-disease-onset and gut microbiota composition in disease emphasize the role of certain biomedical and lifestyle factors, e.g., nutrition quality, in disease prevention and management. Understanding these relationships provides a foundation for developing targeted strategies to mitigate the impact of metabolic and inflammatory diseases through lifestyle modifications and gut health management., (© 2024. The Author(s).)

Background: Despite the high prevalence and major disability associated with fatigue and cognitive deficits after SARS-CoV-2 infection, little is known about long-term trajectories of these sequelae. We aimed to assess long-term trajectories of these conditions and to identify risk factors for non-recovery., Methods: We analyzed longitudinal data from the population-based COVIDOM/NAPKON-POP cohort in Germany. Participants with confirmed SARS-CoV-2 infection were assessed at least 6 months (baseline) and again at least 18 months (follow-up) after infection using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Scale (cutoff ≤ 30) and the Montreal Cognitive Assessment (MoCA, cutoff ≤ 25). Predictors of recovery from fatigue or cognitive deficits between assessments were identified through univariate and multivariable logistic regression models. The COVIDOM study is registered at the German registry for clinical studies (DRKS00023742) and at ClinicalTrials.gov (NCT04679584)., Findings: Between 15 November 2020 and 9 May 2023, a total of 3038 participants were assessed at baseline (median 9 months after infection) and 83% responded to invitations for follow-up (median 26 months after infection). At baseline, 21% (95% confidence interval (CI) [20%, 23%]) had fatigue and 23% (95% CI [22%, 25%]) had cognitive deficits according to cutoff scores on the FACIT-Fatigue or MoCA. Participants with clinically relevant fatigue (at baseline) showed significant improvement in fatigue scores at follow-up (Hedges' g [95% CI] = 0.73 [0.60, 0.87]) and 46% (95% CI [41%, 50%]) had recovered from fatigue. Participants with cognitive deficits showed a significant improvement in cognitive scores (g [95% CI] = 1.12 [0.90, 1.33]) and 57% (95% CI [50%, 64%]) had recovered from cognitive deficits. Patients with fatigue exhibiting a higher depressive symptom burden and/or headache at baseline were significantly less likely to recover. Significant risk factors for cognitive non-recovery were male sex, older age and <12 years of school education. Importantly, SARS-CoV-2 reinfection had no significant impact on recovery from fatigue or cognitive deficits., Interpretation: Fatigue and cognitive deficits are common sequelae after SARS-CoV-2 infection. These syndromes improved over time and about half of the patients recovered within two years. The identified risk factors for non-recovery from fatigue and cognitive deficits could play an important role in shaping targeted strategies for treatment and prevention., Funding: Funded by the German Federal Ministry of Education and Research (BMBF; grant number 01KX2121) and German Research Foundation (DFG) Excellence Cluster "Position Medicine in Information"., Competing Interests: TB has received grants from the German Center for Lung Research (DZL), consulting fees from AstraZeneca, GlaxoSmithKline, Pfizer, honoraria from AstraZeneca, GlaxoSmithKline, Novartis, Roche, Chiesi, Boeringer-Ingelheim, Merck, Pfizer, support for attending meetings and/or travel from Chiesi, AstraZeneca, and participated on a Data Safety Monitoring Board or Advisory Board for CoVit-2 (NCT04751604). JD has received grants from the BMBF and participated on a Data Safety Monitoring Board or Advisory Board for the Max-Planck-Institute of Psychiatry, served as a section speaker for DGPPN, as president and treasurer for the DGBP, and as a speaker for NUM. ME has received grants and consulting fees from Bayer and honoraria from Bayer, Pfizer, Amgen, GSK, and Novartis, participated on a Data Safety Monitoring Board or Advisory Board for BMS, Bayer, and Daiichi Sankyo, served on the board of directors for EAN. All of the above were paid to the institution (no personal fees). He is a member of the DGN, ISCBFM, AHA/ASA, ESO, WSO, DZHK (German Centre of Cardiovascular Research) and DZNE (German Center of Neurodegenerative Diseases) and has received PCSK9 inhibitors for mouse studies from Amgen. KGH has received consulting fees from Edwards Lifesciences, Premiere Research Bayer Healthcare, Amarin, Alexion, Daiichi Sankyo. AstraZeneca, and Portola, and honoraria from Bayer Healthcare, Pfizer, Daiichi Sankyo, Bristol-Myers-Squibb, Boehringer Ingelheim, AstraZeneca, Abbott, SUN Pharma, and Novartis. PUH has received grants from the German Ministry of Research and Education, European Union, German Parkinson Society, University Hospital Würzburg, German Heart Foundation, Federal Joint Committee (G-BA) within the Innovationfond, German Research Foundation, Bavarian State, German Cancer Aid, Charité—Universitätsmedizin Berlin (within Mondafis; supported by an unrestricted research grant to the Charité from Bayer), University Göttingen (within FIND-AF randomized; supported by an unrestricted research grant to the University Göttingen from Boehringer-Ingelheim), University Hospital Heidelberg (within RASUNOA-prime; supported by an unrestricted research grant to the University Hospital Heidelberg from Bayer, BMS, Boehringer-Ingelheim, Daiichi Sankyo). All of the above were paid to the respective institutions (no personal fees). He participated on a Data Safety Monitoring Board in publicly funded studies (by German Research Foundation, German Ministry of Research, Foundations). FAM has received funding as part of the UNION-CVD Clinician-Scientist Programme (project number 413657723) by the German Research Foundation. CN has received grants from Internal Medicine Department I, University Hospital Schleswig Holstein, Campus Kiel and honoraria from CAU Kiel. CF has received grants from Deutsche Forschungsgemeinschaft (DFG, German Research Foundation), Grant numbers FI 2309/1-1 (Heisenberg Program) FI 2309/2-1 and 327654276 (SFB 1315), and the German Ministry of Education and Research (BMBF), Grant numbers 01GM1908D, 01GM2208C, 13GW0566D, 01GM2102, 01EP2201., (© 2024 The Author(s).)

Plant lipids are important as alternative sources of carbon and energy when sugars or starch are limited. Here, we applied combined heat and darkness or extended darkness to a panel of ∼300 Arabidopsis (Arabidopsis thaliana) accessions to study lipid remodeling under carbon starvation. Natural allelic variation at 3-KETOACYL-COENZYME A SYNTHASE4 (KCS4), a gene encoding an enzyme involved in very long chain fatty acid (VLCFA) synthesis, underlies the differential accumulation of polyunsaturated triacylglycerols (puTAGs) under stress. Ectopic expression of KCS4 in yeast and plants proved that KCS4 is a functional enzyme localized in the endoplasmic reticulum with specificity for C22 and C24 saturated acyl-CoA. Allelic mutants and transient overexpression in planta revealed the differential role of KCS4 alleles in VLCFA synthesis and leaf wax coverage, puTAG accumulation, and biomass. Moreover, the region harboring KCS4 is under high selective pressure and allelic variation at KCS4 correlates with environmental parameters from the locales of Arabidopsis accessions. Our results provide evidence that KCS4 plays a decisive role in the subsequent fate of fatty acids released from chloroplast membrane lipids under carbon starvation. This work sheds light on both plant response mechanisms and the evolutionary events shaping the lipidome under carbon starvation., Competing Interests: Conflict of interest statement. None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of American Society of Plant Biologists.)