Quality of life among Syrian refugees in Germany: a cross-sectional pilot study

Background: More than 10 million Syrians have left their homes and sought refuge in neighboring countries, including Europe, since the beginning of the Syrian conflict in March 2011, and immigration continues to this day. This cross-sectional study included Syrian refugees residing in and around Hannover, Germany. We investigated whether general socioeconomic factors (e.g. age, sex, housing, asylum duration) were predictive factors for the quality of life (QOL) of Syrian refugees in Germany. Methods: The QOL of Syrian refugees was assessed using the WHOQOL-BREF tool, a questionnaire assessing the QOL in four domains: Physical health, psychological, social relationships and environment. A total of 114 Syrian refugees, aged between 18 and 45 years, who obtained one of the following statuses, asylum, refugee protection or subsidiary protection, were included. The QOL domain and total scores of Syrian refugees in Germany were compared with a Western norm and Sub-Saharan population. Data were analyzed with the Spearman Rho correlation coefficient, Kruskal–Wallis and Mann–Whitney U test and multivariate linear regression. Results: More than 65% of the participants (62.3% male, 37.7% female) were between 18 and 29 years old, and 45% had lived in Germany for less than four years. The lowest QOL score was reported in the social relationship’s domain (60.5%), while the psychological score was lowest in participants aged 40–45 years (P = 0.011). The age was significantly negatively associated with physical health (P = 0.010), psychological (P <  0.001) and the total QOL (P = 0.005). Asylum duration was associated with the environment domain (P = 0.040), the short-time refugees were less satisfied than the longtime refugees, and with aspects of the psychological domain in Enjoying life and Concentration ability (P <  0.001 and P = 0.033, respectively), yet was not associated with total QOL or total domain scores. There were significant associations between housing and the psychological domain (P = 0.032) and housing and the social relationship domain (P <  0.001). The refugees who living in camps registered a lower score in psychological than residents of apartments and houses, and the single refugees had a higher score than those married and divorced (P = 0.032 and P = 0.035, respectively). Conclusions: The Syrian refugees participating in this study showed a low QOL score in the assessment of all domains compared to the normal population, especially regarding social relations and psychological; it was associated with socioeconomic factors, such as housing, asylum duration and marital status. This calls for urgent societal and political efforts to strengthen the social living conditions of Syrian refugees in Germany

Effects of Exercise Combined with a Healthy Diet or Calanus finmarchicus Oil Supplementation on Body Composition and Metabolic Markers : A Pilot Study

Aging is accompanied by a progressive decline in muscle mass and an increase in fat mass, which are detrimental changes associated with the development of health conditions such as type-2 diabetes mellitus or chronic low-grade inflammation. Although both exercise as well as nutritional interventions are known to be beneficial in counteracting those age-related changes, data to which extent untrained elderly people may benefit is still sparse. Therefore, a randomized, controlled, 12-week interventional trial was conducted in which 134 healthy untrained participants (96 women and 38 men, age 59.4 ± 5.6 years, body mass index (BMI) 28.4 ± 5.8 kg/m2) were allocated to one of four study groups: (1) control group with no intervention (CON); (2) 2×/week aerobic and resistance training only (EX); (3) exercise routine combined with dietary counseling in accordance with the guidelines of the German Nutrition Society (EXDC); (4) exercise routine combined with intake of 2 g/day oil from Calanus finmarchicus (EXCO). Body composition (bioelectrical impedance analysis), as well as markers of glucose metabolism and blood lipids, were analyzed at the beginning and the end of the study. The highest decreases in body fat were observed within the EXCO group (−1.70 ± 2.45 kg, p < 0.001), and the EXDC (−1.41 ± 2.13 kg, p = 0.008) group. Markers of glucose metabolism and blood lipids remained unchanged in all groups. Taken together results of this pilot study suggest that a combination of moderate exercise and intake of oil from Calanus finmarchicus or a healthy diet may promote fat loss in elderly untrained overweight participants

Effect of wheat bran derived prebiotic supplementation on gastrointestinal transit, gut microbiota, and metabolic health: a randomized controlled trial in healthy adults with a slow gut transit

Acute intake of the wheat bran extract Arabinoxylan-Oligosaccharide (AXOS) modulates the gut microbiota, improves stool characteristics and postprandial glycemia in healthy humans. Yet, little is known on how long-term AXOS intake influences gastrointestinal (GI) functioning, gut microbiota, and metabolic health. In this randomized, placebo-controlled, double-blind study, we evaluated the effects of AXOS intake on GI function and metabolic health in adults with slow GI transit without constipation. Forty-eight normoglycemic adults were included with whole-gut transit time (WGTT) of >35 h receiving either 15 g/day AXOS or placebo (maltodextrin) for 12-wks. The primary outcome was WGTT, and secondary outcomes included stool parameters, gut permeability, short-chain fatty acids (SCFA), microbiota composition, energy expenditure, substrate oxidation, glucose, insulin, lipids, gut hormones, and adipose tissue (AT) function. WGTT was unchanged, but stool consistency softened after AXOS. 12-wks of AXOS intake significantly changed the microbiota by increasing Bifidobacterium and decreasing microbial alpha-diversity. With a good classification accuracy, overall microbiota composition classified responders with decreased WGTT after AXOS. The incretin hormone Glucagon-like protein 1 was reduced after AXOS compared to placebo. Energy expenditure, plasma metabolites, AT parameters, SCFA, and gut permeability were unchanged. In conclusion, intake of wheat bran extract increases fecal Bifidobacterium and softens stool consistency without major effects on energy metabolism in healthy humans with a slow GI transit. We show that overall gut microbiota classified responders with decreased WGTT after AXOS highlighting that GI transit and change thereof were associated with gut microbiota independent of Bifidobacterium. NCT02491125.</p

HER2 and ESR1 mRNA expression levels and response to neoadjuvant trastuzumab plus chemotherapy in patients with primary breast cancer

Introduction: Recent data suggest that benefit from trastuzumab and chemotherapy might be related to expression of HER2 and estrogen receptor (ESR1). Therefore, we investigated HER2 and ESR1 mRNA levels in core biopsies of HER2-positive breast carcinomas from patients treated within the neoadjuvant GeparQuattro trial. Methods: HER2 levels were centrally analyzed by immunohistochemistry (IHC), silver in-situ hybridization (SISH) and qRT-PCR in 217 pretherapeutic formalin-fixed, paraffin-embedded (FFPE) core biopsies. All tumors had been HER2-positive by local pathology and had been treated with neoadjuvant trastuzumab/ chemotherapy in GeparQuattro. Results: Only 73% of the tumors (158 of 217) were centrally HER2-positive (cHER2-positive) by IHC/SISH, with cHER2-positive tumors showing a significantly higher pCR rate (46.8% vs. 20.3%, p<0.0005). HER2 status by qRT-PCR showed a concordance of 88.5% with the central IHC/SISH status, with a low pCR rate in those tumors that were HER2-negative by mRNA analysis (21.1% vs. 49.6%, p<0.0005). The level of HER2 mRNA expression was linked to response rate in ESR1-positive tumors, but not in ESR1-negative tumors. HER2 mRNA expression was significantly associated with pCR in the HER2-positive/ESR1-positive tumors (p=0.004), but not in HER2-positive/ESR1-negative tumors. Conclusions: Only patients with cHER2-positive tumors - irrespective of the method used - have an increased pCR rate with trastuzumab plus chemotherapy. In patients with cHER2-negative tumors the pCR rate is comparable to the pCR rate in the non-trastuzumab treated HER-negative population. Response to trastuzumab is correlated to HER2 mRNA levels only in ESR1-positive tumors. This study adds further evidence to the different biology of both subsets within the HER2-positive group

Development of central nervous system metastases as a first site of metastatic disease in breast cancer patients treated in the neoadjuvant trials GeparQuinto and GeparSixto

Background: The incidence of central nervous system (CNS) metastases in breast cancer patients is rising and has become a major clinical challenge. Only few data are published concerning risk factors for the development of CNS metastases as a first site of metastatic disease in breast cancer patients. Moreover, the incidence of CNS metastases after modern neoadjuvant treatment is not clear. Methods: We analyzed clinical factors associated with the occurrence of CNS metastases as the first site of metastatic disease in breast cancer patients after neoadjuvant treatment in the trials GeparQuinto and GeparSixto (n = 3160) where patients received targeted treatment in addition to taxane and anthracycline-based chemotherapy. Results: After a median follow-up of 61 months, 108 (3%) of a total of 3160 patients developed CNS metastases as the first site of recurrence and 411 (13%) patients had metastatic disease outside the CNS. Thirty-six patients (1%) developed both CNS metastases and other distant metastases as the first site of metastatic disease. Regarding subtypes of the primary tumor, 1% of luminal A-like (11/954), 2% of luminal B-like (7/381), 4% of HER2-positive (34/809), and 6% of triple-negative patients (56/1008) developed CNS metastases as the first site of metastatic disease. In multivariate analysis, risk factors for the development of CNS metastases were larger tumor size (cT3–4; HR 1.63, 95% CI 1.08–2.46, p = 0.021), node-positive disease (HR 2.57, 95% CI 1.64–4.04, p &lt; 0.001), no pCR after neoadjuvant chemotherapy (HR 2.29, 95% CI 1.32–3.97, p = 0.003), and HER2-positive (HR 3.80, 95% CI 1.89–7.64, p &lt; 0.001) or triple-negative subtype (HR 6.38, 95% CI 3.28–12.44, p &lt; 0.001). Conclusions: Especially patients with HER2-positive and triple-negative tumors are at risk of developing CNS metastases despite effective systemic treatment. A better understanding of the underlying mechanisms is required in order to develop potential preventive strategies

How EU Pressure Hampers Circular Migration between Niger and Libya

On 26 May 2015, under pressure from its European partners, the Nigerien government issued Law 36-2015, which forbids Nigeriens from transporting international migrants north from Agadez towards Libya or Algeria. While this law supposedly targets only international migrants, a closer look reveals its extended impact on circular migration and the local population. The implementation of Law 36-2015 has negatively affected the local economy in the Agadez region, as people who had once made a living from migration in the wider sense have faced sudden unemployment. In reaction to the law's implementation, drivers and migrants have developed a diverse range of strategies to circumvent new restrictions. As a result, migration to Libya and Algeria has become more expensive and more dangerous, since drivers are forced to use unofficial routes that include higher bribe payments to local security officials. Because routes have become more clandestine, dangerous, and expensive, the official number of Nigeriens migrating to Libya or Algeria has declined, leading to unintended consequences for their local communities for whom income from different forms of migration is part of an important resilience strategy to counter unemployment, poverty, and droughts. Given the law's sole and explicit focus on international migrants, international NGOs working in the region of Agadez have started to concentrate mostly on non-Nigerien migrants. This has fuelled dissatisfaction among the local population, with the potential for future violence. The European Union should stop using humanitarian aid as a bargaining chip to implement European externalisation policies. Rather than pursuing migration policies in sub-Saharan Africa that have evinced negative consequences for traditional and local forms of migration, policymakers should design policies that incorporate the knowledge, perspectives, and needs of both local actors and the affected local population - migrants and non-migrants alike

A (Bio-)Chemical Field-Effect Sensor with Macroporous Si as Substrate Material and a SiO2 / LPCVD-Si3N4 Double Layer as pH Transducer

Macroporous silicon has been etched from n-type Si, using a vertical etching cell where no rear side contact on the silicon wafer is necessary. The resulting macropores have been characterised by means of Scanning Electron Microscopy (SEM). After etching, SiO2 was thermally grown on the top of the porous silicon as an insulating layer and Si3N4 was deposited by means of Low Pressure Chemical Vapour Deposition (LPCVD) as transducer material to fabricate a capacitive pH sensor. In order to prepare porous biosensors, the enzyme penicillinase has been additionally immobilised inside the porous structure. Electrochemical measurements of the pH sensor and the biosensor with an Electrolyte/Insulator/Semiconductor (EIS) structure have been performed in the Capacitance/Voltage (C/V) and Constant capacitance (ConCap) mode

Associations between the Dietary Inflammatory Index, the Gut Microbiome, and Nutritional Status in Elderly Individuals (Abstract)

Diet can influence healthy aging through anti- or proinflammatory effects, partly by modulating the gut microbiome composition. This study investigated the relationships between the Dietary Inflammatory Index (DII), the gut microbiome, and nutritional status in elderly individuals. Methods: This cross-sectional analysis included 114 home-dwelling individuals aged over 70 years. The Energy-adjusted DII (E-DII) was calculated from 3-day food diaries, and blood samples were taken to measure micronutrient status, glucose, and lipid metabolism. Body composition was assessed using bioimpedance, and fecal gut microbiome composition was analyzed through 16S rRNA gene sequencing. The participants were categorized into maintaining an anti-inflammatory diet (AD) and a pro-inflammatory diet (PD) based on the median E-DII score. The associations of E-DII groups with blood markers and microbial diversity and composition were examined using the analysis of covariance, permutational analysis of variance, and multivariate linear models. Results: The AD (n = 57, 76 ± 3.83 years) and PD (n = 57, 75 ± 5.21 years) groups were similar in age but differed in sex distribution, with a higher proportion of females in the AD group (p = 0.02). When compared to the PD group and adjusted for sex, the AD group had a lower body mass index, fat mass, fasting insulin level, HOMA-IR (Homeostasis Model Assessment of Insulin Resistance), fasting triglycerides, and serum uric acid concentration (all p < 0.05), with higher concentrations of high-density lipoprotein, red-blood-cell folate (RBC), and Omega-3 index (all p < 0.05). While the microbial diversity and composition did not differ between the DII groups, folate concentrations were negatively associated with Agathobacter and positively associated with Bacteroides abundance (both q = 0.23). Lower uric acid concentrations were associated with a higher abundance of Bifidobacterium (q = 0.09) and lower abundance of Phocaeicola (q = 0.11). Discussion: The study suggests that following an anti-inflammatory diet is associated with improved nutritional status in the elderly. Dietary blood markers, rather than E-DII, were found to be associated with the gut microbiome, suggesting a potential link between the microbiome and changes in nutritional markers independent of diet. Further studies are needed to explore the causal relationship between dietary inflammatory potential, gut microbiome, and healthy aging

Association of diet, lifestyle, and chronotype with metabolic health in Ukrainian adults: a cross-sectional study

Abstract Morning chronotypes are associated with healthier metabolic profiles and lifestyles compared to evening chronotypes. However, limited research examined the relationship between chronotype, dietary intake, and metabolic health using accurate measures such as food records. This cross-sectional study aimed to investigate the association between chronotype, dietary intake, and metabolic health markers in a cohort of Ukrainian individuals. Chronotypes were determined using the Morningness-Eveningness Questionnaire (MEQ) in 110 healthy to obese individuals (30–75 years) without type 2 diabetes. Dietary intake was derived from weighed seven days food diaries, anthropometrics and blood markers of glucose and lipid metabolism were measured. Morning chronotypes were significantly older and exhibited distinct dietary patterns, including lower intake of fat and animal protein and higher intake of carbohydrates when compared to evening chronotypes (p < 0.01). Higher MEQ scores, reflecting a tendency toward a morning chronotype, were associated with lower BMI, waist circumference, fasting triglycerides, and glucose (p < 0.05). Further, being of morning chronotype predicted better overall metabolic health. These associations remained significant after adjusting for confounders. The findings suggest that morning chronotypes have a different dietary pattern characterized by a more balanced diet and favorable metabolic profile. Synchronizing daily routines with morning preferences could positively influence metabolic health