Due to occupational exposure, healthcare workers (HCWs) have a higher risk of Coronavirus Disease 2019(COVID-19) infection than the general population. Non-communicable diseases (NCDs) may increase the risk of COVID-19-related morbidity and mortality among HCWs, potentially reducing the available health workforce. We examined the association between NCDs and COVID-19 disease severity and mortality among infected HCWs.

This cohort study used data from the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) database. HCWs hospitalized between January 2020 and January 2023 due to clinically suspected or laboratory-confirmed COVID-19 were eligible for inclusion. Variables collected included demographic data, comorbidities, and hospitalization outcomes. Descriptive statistics were reported using mean/standard deviation (SD), median/interquartile range (IQR), or frequencies and proportions. For each NCD, the relative risk of death, adjusted for age and sex, was calculated using log-binomial regression as well as the population-attributable fraction.

There were 17,502 HCWs, 95.7% of whom had a confirmed COVID-19 diagnosis. The majority were female (66.5%) and the mean age (SD) was 49.8 (14.3) years. Roughly, half (51.42%) of HCWs had no comorbidities, 29.28% had one comorbidity, 14.68% had 2 comorbidities and <5% had ≥3 comorbidities. The most common comorbidities were diabetes mellitus (49.40%) and cardiovascular disease (36.90%). Approximately one-fifth of the HCWs had severe COVID-19 (16.95%) and 10.68% of the HCWs with COVID-19 died. Being ≥45 years old, male gender, smoking, obesity, and certain NCDs increased the risk of COVID-19 severity and mortality. Obesity and diabetes mellitus were the leading risk factors in terms of the population-attributable risk for COVID-19 severity (6.89%) and mortality (36.00%) respectively.

Many HCWs with COVID-19 had one or more NCDs. Obesity and diabetes mellitus increased COVID-19 severity and mortality risk. Reducing the prevalence of obesity and diabetes mellitus would yield the biggest reduction in COVID-19-related morbidity and mortality among HCWs.

Background Pregnancy is a critical period where maternal non-communicable diseases (NCDs) such as hypertensive disorders, gestational diabetes mellitus (GDM), and thyroid dysfunction significantly affect maternal and fetal outcomes. This study aimed to determine the prevalence and associated factors of these conditions among pregnant women in India. Methods A cross-sectional study was conducted among 300 pregnant women attending antenatal clinics at a tertiary care hospital. The participants were enrolled irrespective of gestational age. Known cases of pre-existing hypertension, diabetes, and thyroid disorders were excluded. Data were collected via structured questionnaires and clinical records, capturing demographics, obstetric history, lifestyle, diagnostic values, and the awareness of risk factors. Conditions were diagnosed based on standardized criteria (Diabetes in Pregnancy Study Group India {DIPSI} for GDM, blood pressure {BP} of ≥140/90 mmHg for hypertension, and trimester-specific thyroid-stimulating hormone {TSH} levels for thyroid dysfunction). Results The prevalence of GDM, hypertension, and thyroid dysfunction was 60 (20%), 48 (16%), and 36 (12%), respectively. GDM and hypertension were significantly more common in urban participants (p<0.05), and both were associated with higher body mass index (BMI). Thyroid dysfunction was frequently diagnosed in the first trimester (22, 61.1%). A significant upward trend in all three disorders was observed with increasing BMI. The awareness of risk factors was higher among educated women, correlating with earlier diagnosis. Conclusion This study highlights a substantial burden of NCDs among pregnant women, especially GDM and hypertension. Urbanization, obesity, and maternal age were key contributing factors. While structured screening and early antenatal registration are existing mandates, our findings underscore the need for targeted and scalable interventions beyond current protocols.

Behavioral science principles, including approaches such as gamification, commitment strategies, and nudges, are widely used in health promotion programs to prevent non-communicable diseases. These approaches are expected to influence behavior change regardless of health interest; however, their effectiveness remains unclear. This study evaluated the impact of a behavioral science-based health promotion program on body mass index (BMI) reduction across different levels of health interest.

This study evaluated the "Checkup Championship," a program that applies various behavioral science strategies to improve health checkup results for employees at Hakuhodo DY Group in Japan. Participants in the program in 2020 were compared with non-participants. Health interest was classified as low, middle, or high based on a single-question assessment. A linear regression model analyzed BMI changes between 2019 and 2020, using the inverse probability weighting of propensity scores to adjust for background differences between groups.

A total of 410 participants and 390 non-participants were included in the study. BMI reduction was greater among participants than non-participants (-0.36 kg/m² vs. -0.12 kg/m²). A significant BMI reduction was observed in the middle (average treatment effect [ATE]: -0.30 kg/m², 95 % confidence interval [CI]: -0.55, -0.06) and low health interest groups (ATE: -0.34 kg/m², 95 % CI: -0.61, -0.08); however, no clear BMI reduction was seen in the high health interest group.

The "Checkup Championship" demonstrated effectiveness, particularly among individuals with a lower health interest. Health programs incorporating diverse behavioral science strategies may help reduce health disparities.

This study aimed to estimate the prevalence of depression and anxiety and associated risk factors among non-communicable diseases (NCD) clinic attendees in rural Rwanda.

Cross-sectional.

44 health centres in three rural districts in Rwanda.

Adults aged 18 years and older with a clinical diagnosis of diabetes, hypertension and/or asthma, who were attending a follow-up appointment during the study period (n=595).

Primary outcome measures were depression (measured by Patient Health Questionnaire-9) and anxiety (measured by Generalised Anxiety Disorder-7). Explanatory measures included sociodemographic and behavioural risk factors associated with depression and anxiety.

Of 595 participants, 265 (44.5%) had depression (95% CI: 40.5% to 48.6%) and 202 (33.9%) had anxiety (95% CI: 30.1% to 37.9%). Comorbidity of depression and anxiety was found in 137 participants (23%). Participants with no formal education had significantly higher odds of reporting depression and anxiety compared with those with primary and secondary/higher education (adjusted OR (aOR)=2.08; 95% CI=1.27 to 3.33, p=0.004, aOR=5.00; 95% CI=1.12 to 25.00, p=0.035, respectively). In addition, participants who were unemployed were more likely to report depression and anxiety (aOR=3.03; 95% CI=1.62 to 5.67, p<0.001). Similarly, participants who had trauma in the past were more likely to report depression and anxiety than those who did not experience traumatic events in the past (aOR=1.67; 95% CI=1.09 to 2.56, p=0.019).

The overall prevalence of depression and anxiety was found to be significantly high among the study participants. The risk factors that were associated with depression and anxiety included level of education, district of residence, employment status and past trauma exposure. The findings emphasise the need for integrating mental health screening into NCD care, district-specific interventions, employment support services and trauma-focused care.

Selective RET inhibitors such as pralsetinib have become the standard of care for patients with RET fusion-positive non-small cell lung cancer (NSCLC). Serial analysis of circulating tumor DNA (ctDNA) has proven effective in monitoring disease control/progression and therapeutic response in NSCLC. In this prospective study, we analyzed longitudinal ctDNA profiles (at baseline, week 8, and at progression) in Chinese patients with advanced RET fusion-positive NSCLC treated with pralsetinib (NCT03037385), utilizing allele frequency-based, cfDNA quantity-normalized, and methylation-based metrics. Associations between ctDNA dynamics, tumor response, and genomic alterations were assessed. A total of 21 patients were enrolled. Baseline PIK3CA co-mutations were associated with inferior progression-free survival (PFS; 3.0 vs. 12.4 months, P < 0.001). Superior PFS was observed in patients with lower baseline ctDNA levels across all metrics: allele frequency-based (HR = 0.24; 95% confidence interval [CI], 0.07-0.80; P = 0.012), cfDNA quantity-normalized (HR = 0.20; 95% CI, 0.05-0.71; P = 0.006), and methylation-based (HR = 0.09; 95% CI, 0.01-0.85; P = 0.010). Early ctDNA clearance at the first radiographic assessment was also associated with prolonged PFS (median PFS not reached vs. 4.8 months; P = 0.002) and enhanced disease control (71.4% vs. 0%). Moreover, three distinct ctDNA dynamic profiles-clearance-rebound, reduction-rebound, and sustained clearance-were associated with different progression patterns (systemic progression, new extrathoracic lesions, new intracranial/intrathoracic lesions). No evidence of histologic transformation was identified at the time of progression. KRAS G12R and other non-canonical alterations emerged in ctDNA-rebound samples. Molecular progression preceded radiographic progression by a mean interval of 2.2 months. These findings suggest that ctDNA-based surveillance using multiple metrics, enables early forecasting of tumor response and progression in RET fusion-positive NSCLC. Early ctDNA clearance and dynamic profiles provide non-invasive biomarkers for early intervention, warranting further validation with ctDNA-guided strategies.

Post-discharge management of coronary artery disease (CAD) remains clinically challenging, with digital healthcare's efficacy underexplored. This study analyzed 16,797 CAD patients enrolled in the HeartMed Digital Management System (June 2018-September 2022), comparing outcomes between a digital management (DM, n = 4,713) and conventional management (CM, n = 12,084) cohort over 12 months. Cox models adjusted for confounders revealed significantly reduced all-cause mortality in the DM group (1.6% vs. 2.7%; HR 0.58, 95% CI 0.45-0.75, p < 0.001) and lower risks for major adverse cardiovascular events (MACCE: 6.4% vs. 9.2%; HR 0.67, 0.59-0.77, p < 0.001), cardiovascular death (HR 0.70, 0.51-0.95), myocardial infarction (HR 0.38, 0.29-0.50), recurrent angina (HR 0.75, 0.65-0.87), revascularization (HR 0.84, 0.71-0.99), and readmissions (HR 0.76, 0.68-0.84) (p < 0.05 for all). Digital healthcare demonstrates superior post-discharge optimization of CAD outcomes, significantly attenuating mortality and morbidity.

Severe asthma is frequently accompanied by comorbidities such as chronic rhinosinusitis, nasal polyps, allergies, and gastroesophageal reflux disease (GERD). With increasing age, non-communicable conditions such as cardiovascular diseases and multimorbidity become more prevalent. This study aimed to analyze the prevalence of comorbidities and their impact on asthma-related outcomes over a two-year period using data from the Swiss Severe Asthma Registry (SSAR).

We included 234 patients with baseline data and 2 years of follow-up visits from the SSAR. Patient's asthma control (ACT), quality of life (QoL), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), diffusing capacity of the lungs for carbon monoxide (DLCO) and fraction expiratory nitric oxide (FeNO) and their association to comorbidities were analyzed longitudinally using general estimation equations (GEEs) with log link function.

Over the study period, ACT and QoL scores significantly improved, and the frequency of exacerbations declined. The prevalence of the examined comorbidities remained stable. However, the presence of chronic obstructive pulmonary disease (COPD) was significantly associated with lower ACT scores, reduced QoL, and impaired pulmonary function (all p < 0.05). GERD was also linked to lower ACT and QoL (p < 0.05), while depression was associated with a significant decrease in DLCO (p < 0.05).

Our findings underscore the strong impact of comorbidities-particularly COPD, GERD, and depression-on asthma control, quality of life, and lung function in patients with severe asthma. These results highlight the need for integrated, multidisciplinary management strategies targeting comorbid conditions to improve overall asthma outcomes. Further research should explore these subgroups in more detail to guide personalized treatment approaches.

The MIR205 host gene (MIR205HG) has been reported to play important roles in various cancers. However, its role in the occurrence and development of lung cancer remains to be clarified. This study aimed to analyze the function and molecular mechanisms of MIR205HG in lung adenocarcinoma (LUAD).

The RNA sequencing (RNA-Seq) dataset was used to examine MIR205HG expression. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to analyze the expression of MIR205HG in LUAD tissues and adjacent tissues. It was also employed to examine the expression of MIR205HG in LUAD cell lines. Water-Soluble Tetrazolium 1 (WST-1), colony formation assay, transwell assay and flow cytometry assay were used to explore the function of MIR205HG in lung cancer cells. Immunofluorescence assay was applied to examine the formation of autophagosomes. Western blot assay was used to analyze the expression of autophagy-related proteins and ferroptosis-related protein.

MIR205HG was highly expressed in LUAD tissues compared to adjacent tissues. Knockdown of MIR205HG expression prevented cell growth, migration, and invasion, and promoted apoptosis in LUAD cells. Western blot results showed that autophagy-related proteins, AMPK, BECLIN-1, and LC3B, were increased, while p62, mTOR and the ferroptosis-related protein GPX4 were decreased after MIR205HG knockdown.

Knockdown of MIR205HG inhibits the development of LUAD through autophagy and ferroptosis pathways, suggesting that MIR205HG may be a potential target in the diagnosis and therapeutic treatment of LUAD.

Clostridioides difficile infection (CDI), along with the severity of the disease, is intimately tied to the production of bacterial toxins. The expression of toxins is governed by intricate mechanisms that respond to various intra- and intercellular stimuli. Recent genomic studies have identified an accessory gene regulator (agr) system in C. difficile, similar to that found in Staphylococcus aureus, playing a pivotal role in coordinating toxin synthesis. Nevertheless, the agr system of tcdA⁺B⁺ C. difficile clinical isolates, particularly in terms of phylogenetic analysis, phenotypic characteristics, and virulence expression, has not been extensively studied in Iranian isolates. This investigation aimed to characterize agr type and agrD sequences in tcdA⁺B⁺ clinical isolates obtained from Iranian diarrheal patients over a two-year period, utilizing specifically designed primer sets. Basal expression levels of virulence and regulatory factors, genotyping, sporulation efficiency, and motility were also examined. PCR analysis of 50 tcdA⁺B⁺ C. difficile isolates revealed universal presence of agr1, with 44 (88 %) isolates also possessing agr2. A notable number of isolates (n = 12, 24 %) exhibited a threonine (T) to lysine (K) substitution at position 47 (T47K) in the AgrD1 C-terminal charged region, predominantly associated with RT126/tcdC-A/toxinotype V genotype. The AgrD2 sequence remained conserved across 44 isolates, aligning with R20291 strain. The study uncovered significant variability in sporulation efficiency among isolates, with high efficiency correlating with tcdC-A genotype. Furthermore, 70 % of isolates demonstrated motility, with 58 % showing high motility in semi-solid brain heart infusion broth medium. Our findings highlight widespread prevalence of agr1 and the previously unrecognized T47K substitution within agr1, along with the distribution of two agr loci in tcdA⁺B⁺ C. difficile isolates. This study also provides novel phenotypic insights into tcdA⁺B⁺ C. difficile isolates from Iranian patients, paving the way for more comprehensive functional and clinical studies of agr loci.

Rehabilitation services are essential health services that should be made available to a population. Measuring effective coverage requires the assessment of whether a population's health services needs are met and whether they are met through quality interventions that produce the desired health gain. We propose a global indicator and corresponding questions to measure effective coverage of rehabilitation through population-based surveys.

An indicator to measure effective coverage of rehabilitation requires a clear definition of rehabilitation service need, utilization, and quality. These terms are defined for a tracer health condition with impact on functioning and for which rehabilitation services are beneficial. We selected chronic primary low back pain as the tracer health condition. Following technical input from experts early 2023, we drafted and cognitively tested a set of questions from August till November 2023 to provide key data points for calculating the number of people living with chronic primary low back pain who received rehabilitation services. To determine whether quality rehabilitation services have been delivered, the health gain or benefit can be measured using a valid functioning measure with a known Minimal Important Change value, i.e. a minimal improvement that is meaningful to the client. We selected the shorter version of World Health Organization Disability Assessment Schedule 2.0 to meet this criterion.

The proposed global indicator is defined as the proportion of adults with chronic primary LBP experiencing limitations in functioning that benefited from rehabilitation. There are eight corresponding questions to calculate the number of adults with chronic primary LBP experiencing limitations in functioning and utilizing rehabilitation services. The assessment of a benefit of received rehabilitation services is based on a change in functioning that is greater than the Minimal Important Change measured with World Health Organization Disability Assessment Schedule 2.0 12-item (simple scoring). The Minimal Important Change was set at 6 points following a secondary analysis of studies reporting on rehabilitation outcomes for people with chronic low back pain.

We propose a global tracer indicator for measuring effective coverage of rehabilitation at the population level that is captured through population-based surveys. This global indicator uses chronic primary low back pain as the tracer health condition and World Health Organization Disability Assessment Schedule 2.0 12-item to assess whether quality interventions have been provided that produce the desired health gain.

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.