Workplace health promotion interventions are effective in improving employee health. However, most interventions are temporary and cannot be sustained, and a comprehensive understanding of the factors that influence implementation is limited. Therefore, using the implementation framework, this scoping review aims to identify the barriers and facilitators influencing the implementation of workplace health promotion interventions for the prevention of non-communicable diseases.

We searched databases such as PubMed, Web of Science, and Scopus from January 1986 to August 2022 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Consistent with the Arksey and O'Malley framework, two independent reviewers reviewed the titles and abstracts for eligibility, followed by full-text screening using a data extraction form. Subsequently, a narrative summary of the barriers and facilitators identified from the included articles was synthesized and categorized into the Consolidated Framework for Implementation Research (CFIR). The identified barriers and facilitators were stratified according to the implementation outcomes.

Of the 38,384 articles identified, 610 articles were eligible for full-text screening, and 53 articles were included in the final analysis. Over 80% of the studies had applied a qualitative or mixed-methods approach, and the most common topics of intervention were reducing physical inactivity and promoting exercise (36%); moreover, 60% of the studies targeted interventions in medium- to large-sized organizations. Most factors were identified in the inner setting domain of the CFIR. The predominant facilitators were evidence strength and quality and leadership engagement, whereas structural characteristics, relative priority, and available resources were the most identified predominant barriers to the implementation of workplace health promotion interventions.

The barriers and facilitators identified in this study can be used to implement a process to develop a strategy that targets the identified determinants to improve workplace health promotion interventions and their implementation.

Sepsis-associated intestinal injury represents a critical pathological event contributing to multiple organ dysfunction, with its pathogenesis closely linked to excessive oxidative stress and hyperactivated endoplasmic reticulum stress. Current clinical interventions lack the capacity for precise modulation of the intestinal microenvironment, while existing nanozyme systems generally face challenges such as low oral delivery efficiency, insufficient stability, and uncertain biosafety. To address these limitations, we developed a novel oral nanozyme delivery system based on 2D V₂C MXene. Through surface modification with hydroxyethyl cellulose (HEC), we constructed a V₂C@HEC (CV) nanozyme with enhanced physiological stability and intestinal mucoadhesion. In both in vitro and in vivo studies, the CV nanozyme demonstrated significant reactive oxygen species (ROS)-scavenging capacity. Oral administration of CV effectively mitigated intestinal barrier damage and improved survival in a septic mouse model. Mechanistic investigations suggested that the protective effects of CV may be associated with ROS clearance and modulation of endoplasmic reticulum stress, with inhibition of the ATF6/CHOP signaling pathway potentially serving as one underlying mechanism for its cytoprotective function. In summary, this study not only presents a novel nanozyme material with favorable biocompatibility, excellent stability, and a defined antioxidant mechanism, but also provides an innovative materials-based strategy for the treatment of sepsis.

 Colporrhaphy is a surgical option for anterior or posterior compartment vaginal prolapse. Colporrhaphy has a high complication rate. Previous literature proved that individuals diagnosed with diabetes had higher rates of complications in other urological surgeries, especially in prosthesis or mesh insertion.

 This study aims to determine if HbA1c is associated with anterior or posterior colporrhaphy complications.

 The 2021 National Surgical Quality Surgical Improvement database was used for a retrospective review study of patients who had anterior or posterior colporrhaphy. The cohort was subdivided into those with HbA1c ≤6.4 and those with ≥6.5. In a 30-day composite, major and minor complications were analyzed. A multivariate logistic regression was then performed to predict complications.

 A total of 182 patients were included, with 46 (25.3%) in the ≥6.5 cohort and 136 (74.7%) in the ≤6.4 cohort. The ≥6.5 group was older (67.9 years vs. 64.1 years), whereas there was no noted difference in race, hypertension, or previous abdominal operations. The composite complication was higher in the ≥6.5 group at 21.7% (n = 10) compared to 10.3% (n = 14) in the ≤6.4 group. The most common complication was urinary tract infection (8.2%, n = 15). On adjusted analysis, the ≥6.5 group had higher odds of complication (OR 3.16, p = 0.05).

Diabetes should be considered a comorbidity in patients undergoing anterior or posterior colporrhaphy. Our study shows that there are three times the odds of complications in patients with higher HbA1c. Strict glycemic control should be implemented to decrease the risk.

Background Obesity and type 2 diabetes mellitus (T2DM) represent major and rapidly increasing public health burdens in Saudi Arabia. Metabolic (bariatric) surgery is an effective long-term intervention for obesity-related T2DM, while modern injectable pharmacotherapies, including glucagon-like peptide-1 receptor agonists, have become increasingly popular. However, public awareness and perceptions regarding these modalities remain insufficiently characterized in Saudi communities. Hence, this study aimed to assess public awareness, perceptions, misconceptions, and self-reported treatment preferences regarding metabolic (bariatric) surgery and injectable pharmacotherapies for obesity-related T2DM among adult residents of Jeddah, Saudi Arabia, using a perception-based cross-sectional survey. Methodology A community-based, descriptive, cross-sectional survey was conducted using an online, self-administered questionnaire distributed via social media platforms. The survey assessed sociodemographic characteristics, self-reported diabetes status, awareness and perceptions of obesity, metabolic (bariatric) surgery, and injectable pharmacotherapies, as well as stated treatment preferences. All outcomes reflect participant perceptions and were not intended to measure clinical knowledge or treatment effectiveness. Accordingly, type 2 diabetes status and related variables were self-reported and not verified through medical records. Descriptive statistics were used to summarize participant characteristics and awareness indicators. Chi-square tests were applied to explore exploratory associations between selected demographic variables and treatment preferences, with statistical significance set at a p-value <0.05. Results Participants demonstrated high awareness that obesity is a major modifiable risk factor for T2DM (74.6%). However, only 21.1% of participants recognized metabolic (bariatric) surgery as an effective metabolic intervention for diabetes improvement. Injectable therapies were preferred by 57.9% of participants, while 42.1% preferred surgical options. Misconceptions regarding indications, risks, and long-term outcomes were prevalent. Conclusions Although general awareness of obesity's metabolic impact was high, understanding of the therapeutic role of metabolic (bariatric) surgery for T2DM remained limited. Injectable therapies were more frequently preferred than surgical options; however, the present data do not allow definitive conclusions regarding the underlying drivers of these preferences. These findings highlight the need for structured public education initiatives to address misconceptions and improve metabolic literacy. The results reflect public perceptions rather than clinical decision-making or treatment effectiveness.

Emphysematous osteomyelitis is a rare condition caused by gas-producing bacteria in the bone and may be visualized by the presence of intraosseous gas on imaging. We report three cases of emphysematous osteomyelitis. The first case is an 80-year-old with acute myeloid leukemia with emphysematous osteomyelitis of the sacrum, right iliac bone, and multiple vertebrae and ribs. Blood cultures grew Enterococcus faecium and Clostridium spp. The second case is a 45-year-old man with diabetes mellitus with emphysematous osteomyelitis of the proximal left tibia with blood cultures positive for Proteus mirabilis and Clostridium perfringens. The final case is a 57-year-old male with diabetes mellitus who presents with emphysematous osteomyelitis of the left fifth metatarsal head. Wound cultures were positive for Klebsiella pneumoniae and Proteus mirabilis. Emphysematous osteomyelitis is associated with significant morbidity and mortality, and so an accurate and quick diagnosis is important for the radiologist to make.

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiometabolic complications, with attendant morbidity and mortality worldwide. Evidence suggests sex-linked disparities in cardiometabolic risks due to biological, social, behavioral, and socioeconomic determinants. However, sex-linked cardiometabolic risks among adults with T2DM in Kenya are poorly understood. This study examined sex differences in cardiometabolic risk factors among adults with T2DM attending Embu County Referral Hospital in Kenya.

This cross-sectional study included 136 adults with T2DM aged ≥18 years who were diagnosed at least six months earlier. Data were collected using a researcher-administered questionnaire. Physiological and anthropometric measurements, including body mass index (BMI), waist-hip ratio (WHR), blood pressure (BP), random blood glucose (RBG), and glycated haemoglobin (HbA1c), were measured. Data analysis involved descriptive and inferential statistics, including age-adjusted logistic regression analyses of cardiometabolic risks by sex. The p-value was set at ≤0.05.

Participants were predominantly female (69.9%), with a mean (±SD) age of 56.34 (±13.83) years. Females were more likely than males to have a prior hypertension diagnosis (73.33% vs. 26.67%; p < 0.001), be obese (88.9% vs. 11.1%; p = 0.003), have a higher waist circumference (93.6% vs. 6.4%; p < 0.001), and have a higher WHR (97.7% vs. 2.3%; p < 0.001). No significant sex differences were observed in RBG, HbA1c, or BP measurements. After age adjustment, sex was not independently associated with the cardiometabolic risks. Adults aged 50-65 years had significantly lower odds of high BMI compared with those aged <50 years (AOR = 0.35, 95% CI: 0.13-0.92; p = 0.033). Females showed a lower, but statistically nonsignificant, adjusted odds of poor glycemic control.

Notable sex differences in key sociodemographic characteristics and cardiometabolic markers were observed, though attenuated by age adjustment. These findings underscore the need for age- and sex-specific preventive and management strategies to improve cardiometabolic outcomes.

Latent autoimmune diabetes in adults (LADA) is an underrecognized form of autoimmune diabetes that is commonly misdiagnosed as type 2 diabetes mellitus (T2DM) because of its indolent progression and overlapping features with metabolic syndrome. We present a case of a 60-year-old woman with an initial diagnosis of T2DM who persistently had elevated hemoglobin A1c (HbA1c) despite optimal treatment and lifestyle modifications. After subsequent hospitalization and an episode of euglycemic diabetic ketoacidosis (DKA), further evaluation unmasked the diagnosis of LADA. This case emphasizes the need for a high index of suspicion for adults with poor glycemic control or unexplained DKA, as a timely diagnosis can significantly alter management and improve outcomes.

Diabetic patients receiving insulin therapy require frequent blood glucose monitoring. Recent advancements have enabled constant glucose monitoring using small sensors, such as continuous glucose monitoring (CGM) devices. Several studies have demonstrated improved HbA1c levels following CGM implementation. Glucose monitoring may influence dietary behaviors by providing real-time feedback and visualization of postprandial glucose excursions, which can enhance self-awareness and promote dietary modification. However, few studies have investigated its association with dietary behavioral changes. This study investigated the relationship between CGM implementation and changes in dietary behavior among insulin-using diabetic patients.

This study was a single-center prospective cohort study. Consecutive adult insulin-using diabetic participants were categorized into CGM and non-CGM groups based on participant intention. The primary outcome was changes in dietary behavior, defined as changes in the percentage of carbohydrates contributing to total caloric intake. Dietary intake was assessed twice at three-month intervals using the Brief-Type Self-Administered Diet History Questionnaire. A difference-in-differences analysis compared changes in carbohydrate intake percentages between the two groups.

A total of 42 participants were included. The mean age was 67 ± 13 years, and the median duration of diabetes was 11 (8.0-16.0) years. Thirty-one participants used CGM, whereas 11 did not. At baseline, the mean carbohydrate intake as a percentage of total calories was 51% in the CGM group and 52% in the non-CGM group. After three months, these values were 50% and 56%, respectively. However, difference-in-differences analysis revealed no significant difference between the groups (p = 0.295).  Conclusion: CGM implementation was not significantly associated with changes in dietary behavior among insulin-using patients with diabetes. These findings indicate that CGM alone is insufficient, necessitating complementary strategies to promote dietary behavioral modification in this population.

Fournier's gangrene (FG) is a rapidly progressive necrotizing infection involving the perineal and genital regions and is associated with significant morbidity and mortality. It is uncommon among adolescents and is typically linked to underlying comorbidities such as diabetes mellitus, immunosuppression, or trauma. We report a case of FG in a 19-year-old male with poorly controlled diabetes who required multiple surgical debridements. Wound cultures identified Actinomyces europaeus, an emerging but uncommon pathogen in necrotizing soft-tissue infections. Early initiation of broad-spectrum antimicrobial therapy combined with prompt surgical intervention was critical to disease control in this patient. This case underscores the need for heightened clinical suspicion in young patients with metabolic risk factors and highlights the importance of multidisciplinary management and strict glycemic control to improve clinical outcomes.

The expansion of the elderly population in China has been accompanied by an increase in the prevalence of diabetes among older adults. According to the National Bureau of Statistics, the total number of individuals aged 60 and over in China reached 310 million in 2024. Of these, approximately 78.9 million have been diagnosed with diabetes - with over 95% being classified as type 2 - while approximately 141 million have prediabetes. Approximately 90% of these patients present with multiple concurrent metabolic abnormalities, such as overweight/obesity, hypertension, dyslipidemia, and hyperuricemia, which increase the risk of cardiovascular and cerebrovascular disease and organ damage. Additionally, complications due to poor glycemic control are the main risk factors for healthy longevity. Diabetes prevention and treatment remain a priority within the Healthy China (2016-2030) initiative. In line with the main theme of the "Clinical Guidelines for the Prevention and Treatment of Type 2 Diabetes in the Elderly in China (2022 Edition)", we will continue to promote regular comprehensive patient assessments and the formulation/adjustment of personalized management goals to facilitate early diagnosis and intervention among the older population. These frameworks seek to refine diabetes education and self-management models, ensuring that patients can maintain quality of life, perform self-monitoring, adhere to pharmacological regimens, and seek medical treatment. Furthermore, prevention and treatment strategies advocate for the comprehensive management of comorbid metabolic abnormalities and the active and moderate treatment of complications, focusing on the patient's clinical baseline and balancing therapeutic targets to protect cardiac, cerebral, and renal functions, thereby optimizing outcomes. The updated 2026 Edition of the "Clinical Guidelines for the Prevention and Treatment of Type 2 Diabetes in the Elderly in China" incorporates supplemental guidelines and international and domestic research on geriatric diabetes generated over the past four years. This integration informs adjustments to hypoglycemic drug selection and promotes the implementation of standardized prevention, diagnosis, and clinical decision-making, aiming to continuously improve overall diabetes management in older adults.