Artificial intelligence (AI) has demonstrated remarkable capabilities across diverse medical applications, potentially revolutionizing healthcare delivery systems. This systematic review and meta-analysis investigated the comparative effectiveness of generative artificial intelligence (GAI)-based teaching methodologies versus conventional pedagogical approaches on educational outcomes among medical students. We conducted a comprehensive literature search across multiple electronic databases, including PubMed, Cochrane Library, EMBASE, and Web of Science, encompassing studies published from January 2014 through January 2025. The review focused on randomized controlled trials (RCTs) that compared GAI-based teaching interventions with traditional instructional teaching methods in medical students. The meta-analysis incorporated 11 eligible RCTs, comprising 786 medical students. Pooled analysis revealed no statistically significant difference in knowledge acquisition scores between GAI-based and traditional teaching approaches (standardized mean difference [SMD] 0.27, 95% confidence interval [CI] -0.31 to 0.85; p = 0.36). However, subgroup analysis indicated enhanced knowledge performance in the GAI group specifically for extended learning periods (exceeding one week) and practice-oriented courses. GAI-based instruction demonstrated superior outcomes in practical skill development compared to conventional methods (SMD 0.63, 95% CI 0.10–1.16; p = 0.02). Students in the GAI group reported significantly higher satisfaction scores with their learning experience. While theoretical knowledge acquisition remains comparable between teaching modalities, the distinctive advantages of GAI-based approaches in practical skill development warrant their integration into medical curricula. Future research should focus on optimizing the integration of GAI-based teaching methods, standardizing implementation protocols, and evaluating long-term educational outcomes. This protocol was registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) with the registration number INPLASY202510006. Registered on 2 January 2025.

Background: Cognition disorders not only lead to adverse health consequences but also contribute to a range of socioeconomic challenges and diminished capacity for performing routine daily activities. In the digital era, understanding the impact of digital exclusion on cognitive function is crucial, especially in developing countries. Objective: This study aimed to evaluate the association between digital exclusion and cognitive function among elderly populations in developing countries. Methods: Using data from CHARLS (China Health and Retirement Longitudinal Study) from 2011 to 2020 and MHAS (Mexican Health & Aging Study) from 2012 to 2021, we defined digital exclusion as self-reported absence from the internet. Cognitive function was assessed through 5 tests: orientation, immediate verbal recall, delayed verbal recall, serial 7s, and figure recall. Cognitive function was assessed in 2 categories: worse cognition (a categorical variable that classifies cognition as either better or worse compared to the entire cohort population) and cognitive scores (a continuous variable representing raw cognitive scores across multiple follow-up waves). Logistic regression analyses and generalized estimating equation (GEE) analyses were used to examine the relationship between cognitive function and digital exclusion, adjusting for potential confounders, including demographics, lifestyle factors, history of chronic diseases, basic activities of daily living (BADL) disability, instrumental activities of daily living (IADL) disability, and basic cognitive abilities. Results: After excluding participants with probable cognitive impairment at baseline and those who did not have a complete cognitive assessment in any given year (ie, all tests in the cognitive assessment must be completed in any follow-up wave), a total of 24,065 participants in CHARLS (n=11,505, 47.81%) and MHAS (n=12,560, 52.19%) were included. Of these, 96.78% (n=11,135) participants in CHARLS and 70.02% (n=8795) in MHAS experienced digital exclusion. Adjusted logistic regression analyses revealed that individuals with digital exclusion were more likely to exhibit worse cognitive performance in both CHARLS (odds ratio [OR] 2.04, 95% CI 1.42-2.99; P<.001) and MHAS (OR 1.40, 95% CI 1.26-1.55; P<.001). Gender and age did not significantly modify the relationship between digital exclusion and worse cognition (intervention P>.05). The fully adjusted mean differences in global cognitive scores between the 2 groups were 0.98 (95% CI 0.70-1.28; P<.001) in CHARLS and 0.50 (95% CI 0.40-0.59; P<.001) in MHAS. Conclusions: A substantial proportion of older adults, particularly in China, remain excluded from internet access. Our study examined longitudinal changes in cognitive scores and performed cross-sectional comparisons using Z-score standardization. The findings suggest that digital exclusion is linked to an increased risk of cognitive decline among older adults in developing countries. Promoting internet access may help mitigate this risk and support better cognitive health in these populations.

CRISPR-Cas9 (clustered regularly interspaced short palindromic repeats-associated protein 9) has emerged as a transformative genome-editing tool with significant therapeutic potential for age-related diseases, including Alzheimer’s disease, Parkinson’s disease, cardiovascular disorders, and osteoporosis. This study presents a bibliometric analysis of CRISPR-Cas9 research in age-related diseases, identifying key contributors, major research hotspots, and critical technological advancements. While promising applications have been demonstrated in gene repair, functional regulation, and molecular interventions, significant barriers persist, including off-target effects, low delivery efficiency, and limited editing in non-dividing cells. Ethical concerns over germline editing and gaps in long-term safety data further complicate clinical translation. Future directions emphasize the development of high-precision Cas9 variants, homology-directed repair-independent tools, and efficient delivery systems, alongside the establishment of international regulatory frameworks and multicenter clinical trials. These efforts are essential to fully realize the potential of CRISPR-Cas9 in addressing the global health challenges of aging.

Background: Considering the significance of self-reported social participation in the context of depression, patterns of social engagement may influence the onset and progression of depressive disorders. This study aimed to elucidate the relationship between social behaviors and depressive symptoms. Methods: Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) over a nine-year span, we enrolled 9415 participants without depression in 2011 and monitored them for depressive symptoms until 2020. Baseline data included ten items related to social activities. We investigated the correlation between these social activity-related items, their major patterns, and the emergence of depressive symptoms, alongside varying depressive trajectories. Results: Individual analysis of social activity-related items demonstrated significant correlations with a decreased risk of developing new depressive symptoms and adverse depressive trajectories. Pattern analysis indicated that a higher level of engagement in activities such as frequent interactions with friends (odds ratio [OR] = 0.79, 95% confidence interval [CI] 0.70–0.89), participation in diverse societal activities (OR = 0.70, CI 0.62–0.80), and a combined pattern of internet use and friend interactions (OR = 0.60, CI 0.41–0.79) was associated with a lower risk of depression onset. Compared to individuals categorized in the societal isolation group, those with a higher adherence to these activity patterns exhibited a decreased risk of developing unfavorable depressive trajectories (ORs = 0.39 to 0.83). Conclusions: Patterns of social engagement, particularly frequent interactions with friends, participation in a variety of societal activities, and the combined use of the internet with friend interactions, were inversely related to the risk of depression onset and worsening depressive trajectories. These findings emphasize that promoting social participation activities can serve as practical intervention tools to prevent depression, providing a foundation for strengthening public health policies aimed at fostering social connectivity and reducing the burden of depressive disorders.

Rationale: Subcapsular liver hematoma (SLH) during pregnancy is a rare but potentially life-threatening complication, often associated with hypertensive disorders such as preeclampsia and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. Patient concerns: We report the case of a 37-year-old primipara who presented at 39 weeks of gestation with severe preeclampsia (blood pressure, 166/106 mm Hg; proteinuria, 2+). Notably, her prenatal course was marked by normal blood pressure and 3 negative urine protein tests. Diagnoses: The patient was diagnosed with incomplete HELLP syndrome and a ruptured SLH. This intraoperative diagnosis was confirmed by the identification of 800 mL of noncoagulated blood and a 4 × 2 cm left hepatic lobe subcapsular hematoma with semiactive bleeding. Interventions: Laparoscopic hematoma evacuation and hemostasis were successfully performed. Outcomes: The patient had a stable postoperative recovery. A systematic review of 99 cases from 71 studies was conducted, which documented HELLP syndrome in 78 cases, with maternal and fetal mortality rates of 13.1% and 33.3%, respectively. Notably, 88.8% of patients presented with pain, predominantly right upper quadrant (46%), whereas our case exhibited atypical left-sided pain. Lessons: This case, along with a literature review, underscores the importance of vigilance for SLH in hypertensive pregnancies, even in the absence of classic HELLP criteria, and advocates for prompt imaging, individualized treatment, and multidisciplinary coordination to optimize outcomes.

An abstract is unavailable. This article is available as a PDF only.