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Background Physical activity (PA) has been associated with a reduced risk of severe COVID-19 outcomes. However, the relationship between cardiorespiratory fitness (CRF) and the risk of SARS-CoV-2 infection and COVID-19 hospitalization has not been thoroughly investigated. We aimed to investigate the association of estimated CRF (eCRF) and leisure-time PA (LTPA) with risk of SARS-CoV-2 infection and COVID-19 related hospitalization in a general population of Norwegian adults. Methods This cohort study included 48,821 adults participating in the population based Trøndelag Health Study (the HUNT Study). Individual data on pre-pandemic (2017–2019) eCRF and LTPA were linked to COVID-19 registries from February 2020 through September 2022. eCRF was categorized into sex-and-age specific quintiles based on V̇O 2peak (mL/kg/min) and LTPA was categorized based on metabolic equivalent hours per week (MET h/wk): inactive (0-3.5 MET h/wk), insufficiently active (> 3.5 to 7.5 MET h/wk), and sufficiently active (> 7.5 MET h/wk). Poisson regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association of eCRF and LTPA with SARS-CoV-2 infection and COVID-19 hospitalization. Results Age averaged 53.6 years (SD 16.8) and 53.9% were women. During 2.6 years of follow-up there were 5991 SARS-CoV-2 infections and 218 COVID-19 related hospitalizations. Fitness and LTPA categories did not associate with risk of infection. However, adults with the highest eCRF had significantly lower risk of hospitalization compared to adults with the lowest eCRF (IRR, 0.54, 95% CI, 0.34–0.86). Similarly, sufficiently active adults (> 7.5 MET h/wk) prior to the pandemic had significantly lower risk of being hospitalized compared to inactive adults (IRR, 0.60, 95% CI, 0.47–0.83). Conclusions Higher eCRF and LTPA were not associated with risk of SARS-CoV-2 infection. In contrast, adults with high eCRF and LTPA were associated with a lower risk of COVID-19 related hospitalization compared to adults with low fitness and inactive lifestyles.

Cognitive disorders span several diagnostic categories in psychiatry, but subjective cognitive complaints (SCC) remain underutilized in transdiagnostic assessments, particularly in Arab contexts. These difficulties can also be present in Affective disorder illnesses are assessed using neuropsychological tests. Self-assessments are useful for understanding difficulties from the user's perspective. The Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) is a rating scale designed to measure subjective cognitive complaints in persons with schizophrenia. This study explores the SSTIC-E, a culturally adapted tool, highlighting its cross-diagnostic relevance over simple psychometric validation. This cross-sectional study was conducted among 210 participants (126 patients, 84 controls) in the United Arab Emirates. Patients met ICD-10/DSM-5 criteria for schizophrenia spectrum disorders and affective disorders, in addition to other psychiatric disorders. The instruments included the SSTIC-E and the MoCA. Analysis focused on internal consistency, confirmatory factor analysis (CFA), and transdiagnostic comparisons. Patients reported higher SSTIC-E scores than controls (mean = 34.06 vs. 22.55, < 0.001). MoCA scores confirmed decreased objective performance in patients (mean = 22.71 vs. 27.19, < 0.001). The SSTIC-E has excellent reliability ( = 0.89). No significant differences were observed in SCCs between the schizophrenia and affective disorder groups. CFA analysis confirmed a one-factor model with residual item correlations (CFI = 0.91, RMSEA = 0.058). Women reported higher SCC; age had no effect. The SSTIC-E demonstrates utility beyond diagnostic silos, providing a valuable and culturally relevant instrument for transdiagnostic psychiatric assessment in Arabic-speaking populations. Schizophrenia exhibited slightly higher SCC compared to patients with affective disorders, with a lack of clear association between subjective and objective cognition. SCC is common across psychiatric diagnoses in the United Arab Emirates, supporting a dimensional model of cognitive dysfunction. SSTIC-E reveals insights into the lived experiences of patients not captured by objective tests. Cultural and gender influences underscore the necessity of context-specific approaches.

Background The United Arab Emirates reports one of the highest mortality rates due to non-communicable diseases, and insufficient physical activity is a major underlying cause. The workplace environment can be an important setting to promote physical activity and overall health. Methods We conducted a parallel, single-blinded, randomized controlled trial, enrolling adults (aged 18–59 years) from a semi-government telecommunications company with a waist circumference of ≥ 94 cm (≥ 90 cm for South and East Asians) for males and ≥ 80 cm for females. Eligible participants ( n  = 130) were randomly assigned (1:1) to the intervention group and delayed-intervention group (controls). The intervention group received two hours of weekly supervised exercises during working hours for 12 weeks. At the end of 12 weeks, the delayed-intervention group received two hours of weekly exercise for four weeks. The primary outcome was the change from baseline to week 12 in cardio-metabolic risk factors, including waist circumference, blood pressure, HDL cholesterol, triglycerides, and fasting glucose. The secondary outcome, assessed for the intervention group only, was the change in objectively measured physical activity from baseline to week 16. We used an intention-to-treat analytical approach. Results Mean age of participants at enrolment was 36.9 years, and 25% were female. A total of 105 (81%) completed the 12-week follow-up measurements. We found no statistically significant change between groups from baseline to the end of the 12-week for primary outcome. However, the within-group change in the intervention group at week 12 was statistically significant for fasting plasma glucose [− 3.6 mg/dL (95% CI, − 6.7 to − 0.42)], HDL cholesterol [2.6 mg/dL (1.1 to 4.0)], and waist circumference [− 4.8 cm (− 6.1 to − 3.5)]. For the secondary outcome, overall physical activity levels increased with a significant increase in the estimated weekly average of vigorous-intensity physical activity [12.5 min (4.1 to 21.0)] at four weeks post intervention. Conclusions We found no statistically significant difference between groups for primary outcomes. However, allocating time for exercise during working hours resulted in increased levels of physical activity and improved cardio-metabolic risk factors. Our study addresses a critical public health issue related to workers’ health in an office setting, highlighting the potential efficacy of implementing health-promoting strategies within the workplace environment to enhance employees’ health. Trial registration ClinicalTrials.gov NCT04403789.

To assess the predictive value of estimated cardiorespiratory fitness (eCRF) and evaluate the additional contribution of traditional risk factors in cardiovascular disease (CVD) mortality prediction. The study included healthy men (n=18,721) and women (n=19,759) aged 30 to 74 years. A nonexercise algorithm estimated cardiorespiratory fitness. Cox proportional hazards models evaluated the primary (CVD mortality) and secondary (all-cause, ischemic heart disease, and stroke mortality) end points. The added predictive value of traditional CVD risk factors was evaluated using the Harrell C statistic and net reclassification improvement. After a median follow-up of 16.3 years (range, 0.04-17.4 years), there were 3863 deaths, including 1133 deaths from CVD (734 men and 399 women). Low eCRF was a strong predictor of CVD and all-cause mortality after adjusting for established risk factors. The C statistics for eCRF and CVD mortality were 0.848 (95% CI, 0.836-0.861) and 0.878 (95% CI, 0.862-0.894) for men and women, respectively, increasing to 0.851 (95% CI, 0.839-0.863) and 0.881 (95% CI, 0.865-0.897), respectively, when adding clinical variables. By adding clinical variables to eCRF, the net reclassification improvement of CVD mortality was 0.014 (95% CI, −0.023 to 0.051) and 0.052 (95% CI, −0.023 to 0.127) in men and women, respectively. Low eCRF is independently associated with CVD and all-cause mortality. The inclusion of traditional clinical CVD risk factors added little to risk discrimination and did not improve the classification of risk beyond this simple eCRF measurement, which may be proposed as a practical and cost-effective first-line approach in primary prevention settings.

Background The representation of women in science, technology, engineering, and mathematics (STEM) is disproportionate to graduates from STEM fields. There is limited research addressing challenges facing women’s retention in STEM in the UAE. Methods A cross-sectional study using a validated questionnaire was conducted. A total of 165 participants were enrolled; 62% males and 35% females. Results More women believed there is gender inequality in STEM (47% versus 28%). 44% of female participants experienced gender inequality in their careers. Men were significantly less likely to experience gender inequality (OR=0.06, 95% CI=0.02-0.16). Women reported lack of organizational emphasis on diversity and inclusion for promotion to leadership (44% versus 60%). Thematic analysis of open-ended responses showed a number of dominant barriers, such as gender bias in hiring and promotion, career impact of motherhood and family responsibilities, and lack of institutional support and flexibility. Conclusion Data confirms gender-based preconceptions and biases in STEM fields. Institutional initiatives and policies to challenge stereotypes and promote gender equality are required. The governmental role is crucial in creating an inclusive environment for women scientists.

Cardiovascular disease (CVD) is the most common cause of death both globally and in the United Arab Emirates. Despite public health measures and health education, the rates of death from CVD remain stable. Barriers previously identified to lifestyle changes include cultural reasons, boredom, and lack of family support. The Emirates Heart Health Project (EHHP) seeks to support healthy lifestyle changes through a family-based intervention using a health coach and fitness tracker. The EHHP is a stepped-wedge cluster-randomized trial with each cluster comprised of members of an extended family. Eligible participants will be ≥ 18 years of age, with BMI ≥ 25, have Emirati citizenship and be able to give informed consent for study participation. The cluster will have 16 weekly teaching sessions in the participants' family home by a health coach who will review individual weight, diet and exercise (monitored by a wearable fitness tracker). The clusters will have pre-intervention assessments of their weight and CVD risk profile and enter the intervention in randomized order. Each cluster will have a post-intervention assessment of the same measures. The primary outcome is weight reduction from baseline. Secondary outcomes will include change in CVD risk factors such as systolic and diastolic blood pressure, hemoglobin A1c, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, waist circumference, and BMI. A mixed linear model will be used for analysis, where the parameters measured at the end of each 16-week episode will be the outcome values. These will be analyzed such that baseline values (measured just prior to the start of an episode) will be fixed covariables. Random effects are the family units. This trial has been registered with the NIH at clinicaltrials.gov (NCT04688684) and is being reported using the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) and TIDieR (Template for intervention description and replication) framework. Clinicaltrials.gov NCT04688684.

Telomeres are potential markers of mitotic cellular age and are associated with physical ageing process. Long-term endurance training and higher aerobic exercise capacity (VO(2max)) are associated with improved survival, and dynamic effects of exercise are evident with ageing. However, the association of telomere length with exercise training and VO(2max) has so far been inconsistent. Our aim was to assess whether muscle telomere length is associated with endurance exercise training and VO(2max) in younger and older people. Twenty men; 10 young (22-27 years) and 10 old (66-77 years), were studied in this cross-sectional study. Five out of 10 young adults and 5 out of 10 older were endurance athletes, while other halves were exercising at a medium level of activity. Mean telomere length was measured as telomere/single copy gene-ratio (T/S-ratio) using quantitative real time polymerase chain reaction. VO(2max) was measured directly running on a treadmill. Older endurance trained athletes had longer telomere length compared with older people with medium activity levels (T/S ratio 1.12±0.1 vs. 0.92±0.2, p = 0.04). Telomere length of young endurance trained athletes was not different than young non-athletes (1.47±0.2 vs. 1.33±0.1, p = 0.12). Overall, there was a positive association between T/S ratio and VO(2max) (r = 0.70, p = 0.001). Among endurance trained athletes, we found a strong correlation between VO(2max) and T/S ratio (r = 0.78, p = 0.02). However, corresponding association among non-athlete participants was relatively weak (r = 0.58, p = 0.09). Our data suggest that VO(2max) is positively associated with telomere length, and we found that long-term endurance exercise training may provide a protective effect on muscle telomere length in older people.

To assess the isolated and combined associations of leg and arm strength with adherence to current physical activity guidelines with all-cause and cause-specific mortality in healthy elderly women. This was a prospective cohort study of 2529 elderly women (72.6±4.8 years) from the Norwegian Healthy survey of Northern Trøndelag (second wave) (HUNT2) between August 15, 1995, and June 18, 1997, with a median of 15.6 years (interquartile range, 10.4-16.3 years) of follow-up. Chair-rise test and handgrip strength performances were assessed, and divided into tertiles. The hazard ratio (HR) of all-cause and cause-specific mortality by tertiles of handgrip strength and chair-rise test performance, and combined associations with physical activity were estimated by using Cox proportional hazard regression models. We observed independent associations of physical activity and the chair-rise test performance with all-cause and cardiovascular mortality, and between handgrip strength and all-cause mortality. Despite following physical activity guidelines, women with low muscle strength had increased risk of all-cause mortality (HR chair test, 1.37; 95% CI, 1.07-1.76; HR handgrip strength, 1.39; 95% CI, 1.05-1.85) and cardiovascular disease mortality (HR chair test, 1.57; 95% CI, 1.01-2.42). Slow chair-test performance was associated with all-cause (HR, 1.32; 95% CI, 1.16-1.51) and cardiovascular disease (HR, 1.41; 95% CI, 1.14-1.76) mortality. The association between handgrip strength and all-cause mortality was dose dependent (P value for trend <.01). Handgrip strength and chair-rise test performance predicted the risk of all-cause and CVD mortality independent of physical activity. Clinically feasible tests of skeletal muscle strength could increase the precision of prognosis, even in elderly women following current physical activity guidelines.

ObjectivesTo identify factors influencing the mortality risk in critically ill patients with COVID-19, and to develop a risk prediction score to be used at admission to intensive care unit (ICU).DesignA multicentre cohort study.Setting and participants1542 patients with COVID-19 admitted to ICUs in public hospitals of Abu Dhabi, United Arab Emirates between 1 March 2020 and 22 July 2020.Main outcomes and measuresThe primary outcome was time from ICU admission until death. We used competing risk regression models and Least Absolute Shrinkage and Selection Operator to identify the factors, and to construct a risk score. Predictive ability of the score was assessed by the area under the receiver operating characteristic curve (AUC), and the Brier score using 500 bootstraps replications.ResultsAmong patients admitted to ICU, 196 (12.7%) died, 1215 (78.8%) were discharged and 131 (8.5%) were right-censored. The cumulative mortality incidence was 14% (95% CI 12.17% to 15.82%). From 36 potential predictors, we identified seven factors associated with mortality, and included in the risk score: age (adjusted HR (AHR) 1.98; 95% CI 1.71 to 2.31), neutrophil percentage (AHR 1.71; 95% CI 1.27 to 2.31), lactate dehydrogenase (AHR 1.31; 95% CI 1.15 to 1.49), respiratory rate (AHR 1.31; 95% CI 1.15 to 1.49), creatinine (AHR 1.19; 95% CI 1.11 to 1.28), Glasgow Coma Scale (AHR 0.70; 95% CI 0.63 to 0.78) and oxygen saturation (SpO2) (AHR 0.82; 95% CI 0.74 to 0.91). The mean AUC was 88.1 (95% CI 85.6 to 91.6), and the Brier score was 8.11 (95% CI 6.74 to 9.60). We developed a freely available web-based risk calculator (https://icumortalityrisk.shinyapps.io/ICUrisk/).ConclusionIn critically ill patients with COVID-19, we identified factors associated with mortality, and developed a risk prediction tool that showed high predictive ability. This tool may have utility in clinical settings to guide decision-making, and may facilitate the identification of supportive therapies to improve outcomes.