To examine determinants of nurses' adoption of generative artificial intelligence outputs in clinical practice using a technology acceptance model and an integrated structural equation modelling framework.

Cross-sectional online survey.

Registered nurses in mainland China completed an anonymous questionnaire assessing perceived performance benefits, perceived ease of use, perceived information quality, perceived source credibility, social influence, facilitating conditions, adoption intention and adoption behaviour. Structural equation modelling was used to evaluate the measurement model and estimate a primary mediation model in which perceived performance benefits and perceived ease of use predicted adoption intention, and adoption intention predicted adoption behaviour. An integrated model added information quality, source credibility, social influence and facilitating conditions as additional determinants. Sensitivity analyses were conducted using an ordinal estimator to assess robustness.

The analytic sample comprised 330 nurses. In the primary model, higher perceived performance benefits and greater perceived ease of use were associated with stronger adoption intention, and stronger adoption intention was associated with higher self-reported adoption behaviour. The integrated model showed that perceived information quality contributed to adoption intention beyond core expectancy beliefs, while perceived source credibility showed a small direct association with adoption behaviour. Social influence demonstrated a modest association with adoption intention, whereas facilitating conditions showed weaker associations after accounting for other determinants. Model conclusions were consistent across estimation approaches.

Nurses' adoption of generative artificial intelligence outputs is shaped by perceived performance benefits, ease of use and perceived information quality, with adoption intention functioning as the proximal determinant of self-reported use. Implementation strategies should focus on demonstrable workflow gains, reducing interaction burden and strengthening governance and verification to support safe adoption.

Obesity is a systemic chronic disease associated with age-related skeletal muscle weakness, particularly in older adults. Chronic oral diseases share risk factors with critical non-communicable, chronic systemic diseases, including obesity. Poor oral health, increased fat mass, and muscle weakness are linked to adverse health outcomes and substantial economic burdens worldwide. This study developed predictive models of skeletal muscle strength (SMS) based on demographic characteristics, anthropometric and body composition measurements, blood biochemical examinations, and oral health parameters in obese adults.

This cross-sectional study was conducted between 2022 and 2024 and included 122 Brazilian obese adults (mean age: 41.1 ± 12.8 years; 66.4% female) who received care in primary public health services. Standard methods were used to obtain appendicular and overall anthropometric measurements. Fat, non-fat, and skeletal muscle mass were assessed with bioelectrical impedance method. Handgrip strength was measured with a hydraulic handheld dynamometer. Low SMS was defined as sex-specific HGS test values fell below the 25th percentile. Blood counts and circulating biochemical variables were measured using enzymatic, chromatographic, and mass spectrometric methods. The oral health exams evaluated dental and periodontal status. Multiple linear regression analysis was employed to identify the associations between SMS and independent variables.

Low SMS was identified in 35.2% of obese adults. The predictive model yielded an adjusted R-squared of 0.607 and a root mean square error of 5.182. Reduced SMS included female sex (β = -8.438; p < 0.001), lower height (β = 0.230; p = 0.010), higher body weight (β = -0.087; p = 0.022), lower estimated muscle mass (β = 0.140; p = 0.002), gingival bleeding (β = -3.881; p < 0.001), and greater tooth loss (β = -0.440; p < 0.001).

This study developed and validated a predictive model for low SMS in obese adults in a public healthcare setting, utilizing demographic characteristics, anthropometric measurements, body composition assessments, clinical parameters, blood biochemical examinations, and oral health parameters. Poor oral health, characterized by gingival bleeding and tooth loss findings, is associated with a higher risk of SMS in obese adults. Multiprofessional integrated care strategies may facilitate the early identification of muscle weakness in this population within public health care settings.

The human oral microbiome is a highly diverse ecosystem with important roles in oral and systemic health. Beyond dental caries and periodontitis, oral dysbiosis has been increasingly implicated in the development of multiple non-communicable diseases.

To systematically synthesize evidence on the mechanisms linking oral dysbiosis to systemic diseases and to summarize its diagnostic and therapeutic implications.

A systematic review was performed using major electronic databases. We screened 1,128 records and included 104 studies that met predefined eligibility criteria.

Evidence indicates that oral dysbiosis may influence systemic health through several mechanisms, including hematogenous dissemination of oral pathogens and virulence factors (e.g. lipopolysaccharide), chronic systemic inflammation, molecular mimicry in autoimmune disorders, and microbial metabolic byproducts. The reviewed studies support associations between oral microbiome alterations and atherosclerotic cardiovascular disease, type 2 diabetes, Alzheimer's disease, rheumatoid arthritis, and gastrointestinal cancers. The literature also highlights the promise of non-invasive oral microbiome-based biomarkers for early detection and disease monitoring. Emerging microbiome-modulating interventions, including probiotics, prebiotics, and bacteriophage therapy, show potential for restoring oral eubiosis and improving systemic outcomes.

Oral dysbiosis is an important regulator of systemic disease processes and a promising target for diagnosis, prevention, and therapy. Integrating oral health and oral microbiome assessment into broader disease management may improve outcomes, although methodological standardization and stronger causal evidence are still needed.

Gastric cancer (GC) is a leading cause of cancer-related deaths worldwide. Despite improvements in diagnostic techniques, GC is often diagnosed at advanced stages. MicroRNAs (miRNAs) have become recognized as important regulators in cancer development, influencing processes such as cell proliferation, migration, invasion, and apoptosis. This study examined the expression levels of two microRNAs, miR-548ac and miR-378j, in GC tissue.

Tumor and margin tissues were collected from 20 patients diagnosed with gastric adenocarcinoma, and control tissue samples were obtained from 20 healthy individuals. Total RNA was extracted, and cDNA synthesis was performed. Quantitative real-time polymerase chain reaction (qPCR) was used to assess the expression levels of miR-548ac and miR-378j, with miR-16 as the internal control. Statistical analysis was performed using REST software, with SPSS software used for further clinical correlation analysis.

The expression of miR-548ac was significantly upregulated in gastric tumor tissues compared with margin tissues and healthy samples (P=0.002). miR-378j expression, on the other hand, showed no significant difference between tumor and normal tissues (P=0.05). Statistical analysis revealed a borderline significant association between miR-548ac expression and tumor stage and grade, but found no significant correlation with lymph node or distant metastasis. Additionally, the miR-378j expression did not show significant correlations with any clinicopathological features.

miR-548ac is significantly upregulated in GC tissues and may serve as a potential biomarker for GC diagnosis and prognosis, particularly in more advanced stages. In contrast, miR-378j does not appear to have a strong association with GC and may not be helpful as a diagnostic marker.

To evaluate the associations of both baseline serological profiles and serological transitions of Helicobacter pylori infection patterns with the risk of precancerous gastric lesions (PGLs).

We analyzed data from 6208 participants in the FuSion cohort who underwent gastroscopy examination, with available H. pylori antibody and pepsinogen measurements at both baseline and follow-up. H. pylori status defined by IgG antibodies (Ab) and pepsinogens (PG), classified participants into four ABC groups. Multivariable logistic regression evaluated associations with PGLs across baseline and transition statuses. Trend tests were performed across the ABC groups and infection transition categories.

A significant increasing trend in the PGLs prevalence and severity was observed across the ABC groups (p for trend < 0.05). Analysis of infection transitions revealed graded risk increases for PGLs from consistently negative to remained positive groups. Interestingly, even participants who seroreverted remained at significantly elevated risks of atrophic gastritis (adjusted odds ratio [aOR] = 2.01, 95% CI: 1.67-2.43) and intestinal metaplasia (aOR = 1.72, 95% CI: 1.14-2.51) compared to the persistently negative participants. The sensitivity analyses excluding baseline PG-positive subjects yielded similar results.

Long-term exposure to H. pylori is associated with an increased risk of PGLs, and this risk may remain elevated even after seroreversion.

To examine the impact of baseline diabetes mellitus (DM) on longitudinal knee symptoms and disability in participants with knee osteoarthritis (OA).

This was a secondary analysis using publicly available data from a longitudinal study design (Osteoarthritis Initiative). Data from 4,796 participants (45-79 years of age) were obtained, and only participants with grade ≥2 in either knee, using the Kellgren and Lawrence grading at baseline, were included in the current analysis. Based on self-reported DM, the participants were categorized into two groups: knee OA and DM or knee OA only. Symptoms and disability were measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale and pain severity across 7- and 30-days at seven visits from baseline to 96 months of follow up.

A total of 2,486 participants were included and categorized into knee OA and DM (n = 221) and knee OA only (n = 2,265). The longitudinal analyses results (n = 2,483) showed that participants with knee OA and DM had significantly increased knee symptoms over time using the WOMAC total score [beta (B) = 3.20, p = 0.004], WOMAC pain subscale (B = 0.71, p = 0.003), WOMAC stiffness subscale (B = 0.22, p = 0.036), and WOMAC disability subscale (B = 2.26, p = 0.005) compared with participants with knee OA only. Knee OA and DM was not associated with increased knee pain severity over a 7-day period (B = 0.28, p = 0.10) and over a 30-day period (B = 0.20, p = 0.23) when compared to knee OA only.

This longitudinal cohort study provides evidence supporting the association between baseline DM and increased knee symptoms and disability among individuals with knee OA.

The prevalence of gestational diabetes mellitus (GDM) in Saudi Arabia is believed to affect 36% of all pregnant women. Many adverse outcomes affect the lives of the neonates of these mothers. Therefore, this study aims to assess the association between GDM and neonatal health outcomes in Jeddah City, Saudi Arabia.

A retrospective cohort design was used. Two hundred neonatal records were reviewed: 100 for neonates of mothers who had GDM and 100 without GDM for control. The two groups were compared in terms of neonatal outcomes.

The gestational age and the glycemic level of neonates of mothers without GDM were significantly higher than those with GDM (39± weeks vs. 37 weeks and 63± vs. 55 mg/dL, p ≤ 0.05). Neonates of mothers with GDM required cesarean section deliveries more than neonates of mothers without GDM (92% vs. 40%, p ≤ 0.05). Also, these neonates were more prone to develop respiratory distress syndrome and congenital anomalies than neonates of mothers without GDM (21% vs. 11% and 17% vs. 4%, p ≤ 0.05).

This study provides empirical evidence demonstrating the negative effect of GDM on neonatal health outcomes, mainly in terms of hypoglycemia, respiratory distress syndrome, and congenital anomalies. Therefore, it highlights the importance of adequate glycemic control by specifying proper treatment together with dietary intervention and exercise programs to improve outcomes. All authors have read and approved the final version of the manuscript. Corresponding author had full access to all the data in this study and takes complete responsibility for the integrity of the data and the accuracy of the data analysis.

 During pregnancy, a mother experiences a wide range of physiological as well as psychological changes. Maternal depression is one of the most common psychiatric disorders that occurs during pregnancy as well as after childbirth. If undiagnosed and untreated, it can lead to various maternal health issues, higher infant morbidity and mortality, and can also affect the growth, nutritional health, and cognitive, intellectual, and socioemotional development of the child. Women with diabetes during pregnancy are a high-risk group for developing mental health problems, and this has attracted worldwide attention. This study was therefore conducted to assess the relationship between gestational diabetes mellitus and antenatal depression and to identify factors associated with antenatal depression among the study participants.

 The study included 480 pregnant women, of whom 240 had gestational diabetes mellitus (GDM) and 240 did not. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure symptoms of depression in pregnant women attending routine antenatal care (ANC) visits. The scale was administered at 28 weeks of gestation and at the last antenatal visit prior to delivery. Descriptive statistics, logistic regression, and multiple regression analyses were performed to analyse the data.

 The final analysis was conducted on 467 study participants, of whom 232 pregnant women were diagnosed with GDM, whereas 235 pregnant women did not have GDM. The overall prevalence of significant depressive symptoms among the study participants was 11.6%. Thirty-seven (15.9%) pregnant women with GDM and 17 (7.2%) women without GDM had significant symptoms of antenatal depression (EPDS score ≥ 12). Pregnant women who exhibited significant symptoms of antenatal depression had a higher mean age (p = 0.039). Lower socioeconomic status (p = 0.038), limited social support (p = 0.046), and a sedentary lifestyle (p < 0.001) were associated with the presence of significant symptoms of antenatal depression.

 The results suggest that symptoms of depression are more common in women with gestational diabetes. Therefore, assessment and education regarding this condition during the antenatal period are important.

HELLP syndrome is a severe obstetric complication characterized by hemolysis, elevated liver enzymes, and low platelet count, typically occurring in the third trimester or postpartum period. One of its rare but life-threatening complications is subcapsular hepatic hematoma, which may rupture and cause catastrophic hemorrhage. We report the case of a 38-year-old woman with type 2 diabetes mellitus who developed severe right upper quadrant pain three days after a cesarean delivery complicated by eclampsia. Laboratory findings were consistent with HELLP syndrome. Abdominal ultrasound and contrast-enhanced computed tomography (CT) revealed a right subcapsular hepatic hematoma measuring 34 mm in thickness, associated with hepatic infarctions and moderate ascites. Given the high risk of rupture, urgent transarterial embolization was performed via selective catheterization of the right hepatic artery using 400-micron microparticles, achieving complete hemostasis while preserving hepatic perfusion. The patient remained stable and recovered uneventfully, with gradual resolution of the hematoma and normalization of laboratory parameters, thereby avoiding surgical intervention. This case highlights the importance of early recognition and prompt interventional management of hepatic complications in HELLP syndrome. Transarterial embolization offers a minimally invasive, effective, and organ-preserving alternative to surgery in selected hemodynamically stable patients, underscoring the value of multidisciplinary collaboration among obstetric, critical care, and interventional radiology teams to optimize maternal outcomes.

Despite the availability of newer antidiabetic medications, many patients with type 2 diabetes mellitus still do not achieve their glycemic targets and require insulin treatment. Research from a limited number of randomized controlled trials and observational studies suggests that Automated Insulin Delivery (AID) systems are safe and effective for treating individuals with type 2 diabetes. With the implementation of a hybrid insulin pump, an average reduction in HbA1c of 0.6 to 0.9 percentage points is achieved, along with an increase in Time in Glucose Range (70-180 mg/dL) (3.9-10.0 mmol/L) of 7 to 21 percentage points. This improvement corresponds to an additional 1.7 to 5.1 hours of euglycemia per day, without increasing the risk of hypoglycemia or diabetic ketoacidosis, and with a slight increase in body weight, potentially reflecting improved glycemic control. Concomitant treatment with GLP-1RA and/or SGLT-2 inhibitors has minimal effect on the magnitude of glycemic improvement achieved after switching to AID therapy, although evidence remains limited. Both the effectiveness and device-related adverse reactions are similar to those observed in patients with type 1 diabetes. Although individuals with type 2 diabetes who require insulin treatment are generally older and may be less familiar with technology, training in the necessary skills and adherence to AID use in real-world settings appear feasible. Treatment with AID may slightly improve quality of life and reduce diabetes-related stress.