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        <title>Frontiers in Medicine | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/medicine</link>
        <description>RSS Feed for Frontiers in Medicine | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-13T08:30:22.757+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1821762</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1821762</link>
        <title><![CDATA[A preclinical investigation into the potential associations of geraniin with ulcerative colitis alleviation through integrated multi-omics and in vivo analysis]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Chang Cheng</author><author>Wei Wang</author><author>Tingting Zheng</author><author>Xiangmin Shi</author><author>Chong Fu</author>
        <description><![CDATA[ObjectiveThis study aims to investigate the potential molecular mechanisms and alleviating effects of geraniin, a natural polyphenol compound, within a murine model of ulcerative colitis (UC), thereby providing preclinical insights that may inform future translational strategies.MethodsPotential targets of geraniin for UC were identified by screening databases such as the Comparative Toxicogenomics Database and SwissTargetPrediction. UC transcriptomic and single-cell data were sourced from GEO (GSE47908, GSE214695). Differential gene analysis used limma, co-expression modules via WGCNA, enrichment with ClusterProfiler for GO/KEGG, and immune cells via CIBERSORT. Single-cell analysis employed Seurat and AUCell to identify targeted subpopulations. In vivo, DSS-induced UC mice were grouped as control, model, and model + geraniin (30, 60 mg/kg). Effects were assessed by DAI, histopathology, Western blot, and immunofluorescence.ResultsGeraniin targeted 27 genes, which were integrated with 337 UC-related genes to construct a protein–protein interaction network. MCODE analysis identified a key subnetwork comprising 42 genes. GO and KEGG analyses suggested that the potential effects of geraniin may be linked to inflammatory pathways such as IL-17, TNF, and CXCR chemokine signaling. In the single-cell dataset GSE214695, AUCell scores indicated an enrichment of drug targets in macrophage and neutrophil clusters. In this murine model, in vivo experiments indicated that geraniin administration was associated with reduced DAI scores, improved colon length, and the alleviation of mucosal damage and inflammatory cell infiltration. Immunofluorescence analysis revealed that geraniin treatment was associated with a reduced presence of markers for M1 macrophages (F4/80+/CD86+), neutrophils, and NET formation (CitH3+/MPO+), while correlating with an increase in M2 macrophages markers (F4/80+/CD206+). Western blot analysis showed that geraniin treatment correlated with the downregulation of NOS2 and upregulation of PPARG expression, which may contribute to mitigating the inflammatory response observed in this model.ConclusionThese findings suggest that geraniin is associated with the alleviation of DSS-induced UC in mice, potentially through the modulation of phenotypic markers related to macrophages and neutrophils.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1793667</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1793667</link>
        <title><![CDATA[Case report and literature review of IgG4-related autoimmune pancreatitis secondary to pancreatic involvement of IgG4-related sclerosing disease]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Rongchun Xing</author><author>Dan Yu</author><author>Yan Li</author><author>Hang Zhou</author><author>Chongyuan Chen</author><author>Mingzheng Hu</author>
        <description><![CDATA[BackgroundWhen IgG4-related sclerosing disease (IgG4-RD) involves the pancreas, it frequently manifests as focal mass formation. These lesions clinically and radiographically closely mimic pancreatic ductal adenocarcinoma, often leading to unnecessary invasive interventions. Clarifying the diagnostic difficulties in differentiating focal mass-forming IgG4-RD from malignancies is of great significance for optimizing initial clinical assessment and management workflows.MethodsThis study reports the complete clinical course of a 70-year-old male patient who presented with a complaint of upper abdominal bloating, manifesting as a pancreatic head mass accompanied by a significant elevation of the tumor marker CA19-9 and biliary obstruction. Due to a high preoperative suspicion of malignancy and diagnostic challenges, the patient underwent a pancreaticoduodenectomy. Concurrently, this study conducted a systematic review and analysis of previous literature related to IgG4-RD presenting as focal pancreatic space-occupying lesions to explore the common diagnostic pathways and potential pitfalls in such cases.ResultsThe patient’s postoperative pathological and immunohistochemical examinations ultimately confirmed that the lesion was autoimmune pancreatitis secondary to IgG4-related sclerosing disease, with no malignant components identified. The literature review further indicated that, in the early stages of the disease when clear evidence of systemic involvement is lacking, the space-occupying effect on imaging often dominates the diagnostic pathway, obscuring its immune-mediated inflammatory nature.ConclusionFor patients with suspected pancreatic tumors, incorporating IgG4-RD into the routine differential diagnosis can serve as a beneficial relative reference clue. Provided that malignancy is strictly evaluated and excluded through methods such as endoscopic ultrasound-guided tissue biopsy, early recognition of the disease’s inflammatory characteristics combined with multidisciplinary assessment can facilitate the transition of treatment strategies from surgical resection to pharmacological management, thereby optimizing clinical decision-making and avoiding overtreatment.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1804663</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1804663</link>
        <title><![CDATA[Impact of tablet’s correlated color temperature on ocular and visual function in myopic children: a pilot study]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yunyun Chen</author><author>Lili Mei</author><author>Yanting Feng</author><author>Beilei Zhang</author><author>Changbiao Xu</author><author>Jian Jiang</author><author>Jingwei Zheng</author><author>Jinhua Bao</author><author>Jingjing Xu</author>
        <description><![CDATA[PurposeThis study aimed to determine whether a tablet’s correlated color temperature (CCT) setting affects ocular and visual function in myopic children.MethodsA total of 24 myopic children participated in this study. They were asked to watch a 30-min video at a distance of 33 cm on tablets with low (2800 K) and high CCT (8500 K) settings, in a random order on two different days. Near work-induced transient myopia (NITM), binocular vision function, tear break-up time (TBUT), and asthenopia questionnaire responses were evaluated before and immediately after the 30-min video-watching task.ResultsA significant interaction (CCT setting*examination time) (F = 6.01, p = 0.02) was observed for NITM, showing a trend toward an increase in the average initial NITM from pre- to post-video viewing when using the high-CCT tablet compared to the low-CCT tablet. No significant interaction was observed for the other visual function, TBUT, and asthenopia symptom scores (all p > 0.05), although the 30-min task using the tablet did result in a reduction in TBUT and an exacerbation of some asthenopia symptoms (p < 0.05).ConclusionThe 30-min tablet usage task decreased tear film stability and exacerbated some asthenopia symptoms but did not significantly affect other visual functions, regardless of the screen’s CCT setting. The use of a high-CCT (8500 K) tablet induced a slightly, but significantly, higher initial NITM compared to a low-CCT (2800 K) tablet; however, given the small magnitude of this difference, its clinical relevance still needs to be confirmed.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1833714</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1833714</link>
        <title><![CDATA[An esophageal-pleural fistula following transesophageal echocardiography-guided left atrial appendage closure: a case report]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Libin Qiu</author><author>Jinpeng Liu</author><author>Haijing Fan</author><author>Hongxia Hao</author>
        <description><![CDATA[Periprocedural complications of left atrial appendage occlusion (LAAC) are varied and potentially life-threatening. We report a rare case of an iatrogenic esophageal-pleural fistula following a TEE-guided LAAC procedure. A 77-year-old woman with atrial fibrillation and a contraindication to long-term anticoagulation underwent successful LAAC. Her post-operative course was complicated by a pneumothorax and persistent pleural effusion. The diagnosis of an esophageal-pleural fistula was established after analysis of the chest tube drainage revealed food particles. Given her age and active infection, a non-surgical, conservative management strategy was adopted, involving complete gut rest, broad-spectrum antibiotics, thoracic lavage, and enteral nutrition support. The fistula closed after 52 days of conservative management, confirmed by follow-up imaging. This case underscores that while TEE-related esophageal injury is exceedingly rare, it must be considered in cases of persistent post-procedural pleural effusion. Furthermore, it demonstrates that in selected high-risk patients, a conservative approach can be a viable management option. The decision to perform a pre-procedural upper GI evaluation remains complex, given the very low incidence of this complication.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1842868</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1842868</link>
        <title><![CDATA[Case Report: A case of intestinal occlusion caused by endometriosis]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Letong Li</author><author>Yi Dai</author>
        <description><![CDATA[BackgroundEndometriosis is a common gynecological condition, but intestinal involvement leading to bowel obstruction is rare, occurring in only 0.1–0.7% of cases. Diagnostic delay is frequent due to non-specific gastrointestinal symptoms.Case representationA 37-year-old woman presented to the emergency department with abdominal pain and recurrent intestinal obstruction for 10 days. Initial computed tomography (CT) at another hospital showed colonic obstruction, and thus she received gastric intubation, which provided no relief. At our hospital, she underwent emergency exploration surgery, which found suspicious deep infiltrating endometriosis (DIE). After being discharged from the hospital, she attended the outpatient departments of General Surgery and Gynecology alternately, and completed auxiliary examinations. A multidisciplinary team (MDT), including gynecologists, general surgeons, ultrasound specialists, and radiologists, thoroughly and collaboratively assessed the lesion. The gynecologist decided to attempt a diagnostic treatment with gonadotropin-releasing hormone agonist (GnRHa), which finally attributed her symptoms to endometriosis. Subsequent surgery and pathological examination confirmed bowel endometriosis. The patient is now on long-term medical therapy.ConclusionThis case highlights the diagnostic challenges of bowel endometriosis presenting as intestinal obstruction, and underscores the value of MDT and a diagnostic trial of GnRHa in achieving timely diagnosis and appropriate management.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1766951</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1766951</link>
        <title><![CDATA[New insights gained from a decade long multi-center retrospective study on the management strategy for heterotopic pregnancy: expectant management is worth considering in patients without vaginal bleeding]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xiaoyue Chen</author><author>Yifeng Liu</author><author>Shufeng Kang</author><author>Wenpei Shi</author><author>Jing Ouyang</author><author>Tao Su</author><author>Shuangdi Li</author>
        <description><![CDATA[BackgroundHeterotopic pregnancy (HP) is a rare but clinically challenging condition because treatment of the ectopic component must be balanced against preservation of the coexisting intrauterine pregnancy. The optimal management strategy remains controversial, particularly for clinically stable patients.MethodsThis multicenter retrospective cohort study included women diagnosed with heterotopic pregnancy over a 10-year period. Patients were managed either expectantly or surgically according to clinical presentation, hemodynamic status, serial transvaginal ultrasound findings, and physician judgment. Baseline characteristics, treatment details, and intrauterine pregnancy outcomes were compared between groups. Multivariable logistic regression and subgroup interaction analyses were performed to explore factors associated with live birth.ResultsA total of 159 women with heterotopic pregnancy were included, with a mean age of 31.9 ± 3.7 years. Overall, intrauterine pregnancy outcomes did not differ significantly between the operative and expectant management groups. However, patients selected for expectant management had more favorable baseline characteristics, including smaller ectopic masses, less pelvic fluid, higher hemoglobin levels, and absence of ectopic fetal cardiac activity. In subgroup analysis, among patients without vaginal bleeding, expectant management was associated with a higher live birth rate than surgical intervention (89.7% vs. 63.2%). Some subgroup estimates were accompanied by wide confidence intervals and should therefore be interpreted cautiously.ConclusionExpectant management may be considered in carefully selected, hemodynamically stable patients with heterotopic pregnancy, particularly in those without vaginal bleeding. However, because of the retrospective design and baseline differences between treatment groups, these findings should be interpreted as supporting a feasible alternative in selected patients rather than proving superiority over surgical intervention.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1812327</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1812327</link>
        <title><![CDATA[Neurobiological mechanisms of olfactory dysfunction: a ten-year bibliometric and visualization analysis]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Yuxin Zhu</author><author>Yutian Chen</author><author>Genki Izumoji</author><author>Siying Qu</author><author>Donghai Wu</author><author>Huiqin Chu</author><author>Yixiang Wang</author><author>Haiju Sun</author><author>Xiaoyu Li</author>
        <description><![CDATA[BackgroundOlfactory dysfunction (OD) has gained prominence in neurodegenerative diseases and COVID-19 sequelae in recent years. Its mechanisms have also attracted increasing research interest. However, there is currently a scarcity of bibliometric analyses in this field.MethodsArticles related to OD mechanisms were searched in the Web of Science Core Collection (WoSCC) and Scopus. Data merging and bibliometric analysis were conducted using CiteSpace, VOSviewer, Excel, Scimago Graphica, and the bibliometrix in R package. Simultaneously, PubMed was used to search and summarize interventional clinical trials in this field, and their protocols were tracked through trial registration information and ethical approval records.ResultsA total of 7,915 articles met the inclusion criteria in WoSCC and Scopus. Overall, the number of articles published annually on the mechanisms of OD is on the rise. The USA (2635 publications), University of California System (143 publications), and Thomas Hummel (174 publications) are the most productive country, institution, and author, respectively. Keyword analysis shows that “COVID-19,” “Parkinson’s disease,” “inflammation,” “odorant receptor,” and other related topics are hot topics and trends in research. PubMed retrieved and included 14 interventional clinical trials. These trials mainly focus on pharmacological interventions, non-pharmacological interventions, surgical interventions, and mechanistic studies.ConclusionMechanistic research on OD is advancing from macroscopic observations to precise molecular mechanisms. This review synthesizes evidence on how distinct etiologies, ranging from post-viral and inflammatory damage to neurodegeneration and metabolic imbalances, contribute to OD. Notably, the dysregulation of the inflammatory NF-κB, signal-transducing cAMP, and neuroregenerative Wnt/β-catenin pathways may collectively contribute to the development of OD. By integrating bibliometric trends with clinical trial evaluations, this study delineates a clear translational pipeline from mechanism exploration to clinical interventions.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1732176</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1732176</link>
        <title><![CDATA[Association between the Endothelial Activation and Stress Index and all-cause mortality in patients with chronic obstructive pulmonary disease]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yili He</author><author>Juntao Hu</author><author>Yang Li</author><author>Ling Huang</author><author>Wenyan Jiang</author><author>Zhiyi He</author>
        <description><![CDATA[BackgroundEndothelial Activation and Stress Index (EASIX) predicts outcome in diverse disorders; however, its independent association with short- to medium-term mortality in critically ill patients with chronic obstructive pulmonary disease (COPD) has not been examined.MethodsData were drawn from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and the Critical care datebase of Zigong Municipal Hospital, Sichuan, China. We identified consecutive COPD patients admitted between 2008 and 2019 in MIMIC-IV and between 2019 and 2020 in the Zigong cohort. EASIX was calculated from platelet count, creatinine, and lactate dehydrogenase measured within 24 h of ICU entry and log2-transformed. Multivariable Cox regression and restricted cubic splines assessed its relationship with 28-day and 90-day mortality after ICU admission; proportional hazards assumptions were verified. Subgroup analyses and interaction tests evaluated robustness. Discrimination was quantified by area under the receiver-operating-characteristic curve (AUROC).ResultsWe included 5,012 critically ill COPD patients from MIMIC-IV and 431 from the Zigong registry. In fully-adjusted models treating log2(EASIX) as a continuous variable, higher values were associated with increased 28- and 90-day mortality: MIMIC-IV: HR = 1.23 (95% CI: 1.17–1.28, p < 0.001) and HR = 1.18 (95% CI: 1.14–1.22, p < 0.001); Zigong: HR = 1.32 (95% CI: 1.17–1.50, p < 0.001) and HR = 1.32 (95% CI: 1.17–1.48, p < 0.001). After dividing log2(EASIX) into tertiles, we found that patients in the highest tertile faced significantly greater mortality than those in the lowest: in MIMIC-IV the 28-day hazard ratio was 1.66 (95% CI 1.39–1.98, p < 0.001) and the 90-day HR was 1.55 (1.33–1.80, p < 0.001), while in the Zigong cohort the corresponding estimates were 2.38 (1.41–4.00, p = 0.001) and 2.37 (1.47–3.81, p < 0.001). Log2(EASIX) showed a non-linear association with both 28- and 90-day mortality. In MIMIC-IV the inflection point lay at approximately 3.49; below this breakpoint the hazard ratio rose modestly (28-day HR = 1.168, 95% CI 1.100–1.239, p < 0.001; 90-day HR = 1.144, 1.088–1.202, p < 0.001), whereas above the breakpoint the risk increased sharply (28-day HR = 1.805, 1.367–2.383, p < 0.001; 90-day HR = 1.597, 1.219–2.092, p < 0.001). In the Zigong cohort the corresponding breakpoint was located between 3.42 and 3.70. Subgroups and interaction testing showed the log2(EASIX)–mortality link was stable. ROC analysis showed that log2(EASIX) predicts 28- and 90-day death with good accuracy, yielding AUROCs of 0.80 and 0.79 in MIMIC-IV and 0.83 and 0.83 in the Zigong cohort, respectively.ConclusionElevated log2(EASIX) independently predicts short- and medium-term mortality in critically ill patients with COPD.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1780240</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1780240</link>
        <title><![CDATA[Data-driven prediction of lipophilic drug solubility in supercritical CO2 using an adaptive ensemble learning architecture]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Arwa Sultan Alqahtani</author><author>Mahboubeh Pishnamazi</author>
        <description><![CDATA[IntroductionPredicting how lipophilic pharmaceuticals dissolve in supercritical carbon dioxide (SC-CO2) remains a central challenge for process development, largely because experimental measurements are time-consuming and traditional modeling approaches often fail to generalize across chemically diverse compounds.MethodsThis study examines the SC-CO2 solubility of four representative drugs Sirolimus, Tacrolimus, Rifampin, and Teriflunomide and introduces an adaptive computational framework designed to improve predictive power across varied molecular structures. The approach combines multiple boosting-based regressors within an ensemble scheme that incorporates a DST-inspired aggregation step and a weighted integration mechanism. Model hyperparameters are optimized using a bio- inspired Electric Eel Foraging strategy. Reliability of the final model was evaluated through repeated cross-validation, comparative statistical tests, and uncertainty estimation.Results and discussionThe resulting ensemble achieved high predictive accuracy (R2 = 0.99, RMSE = 0.089) with consistent performance across the investigated compounds. By integrating molecular descriptors, thermodynamic features, and process conditions within a unified ensemble framework, the approach provides a practical computational tool for supporting solubility estimation in SC-CO2 systems.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1815175</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1815175</link>
        <title><![CDATA[Mixed infection with Burkholderia cepacia and Cutibacterium acnes following subarachnoid hemorrhage surgery: a case report]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Lina Yao</author><author>Chenjie Zhou</author><author>Aixiang Wu</author><author>Ye Fu</author><author>Huajun Wang</author>
        <description><![CDATA[Intracranial mixed infection represents a rare and critical clinical scenario associated with high mortality and multi-organ failure, and its management remains extremely challenging. We report a 56-year-old female with chronic hepatitis B and intracranial hemorrhage, who developed a severe mixed infection with Burkholderia cepacia (Burkholderia cepacia) and Cutibacterium acnes (C. acnes). Notably, B. cepacia was isolated from blood and sputum specimens, whereas C. acnes was detected in cerebrospinal fluid. The patient experienced progressive systemic deterioration with high fever and multiple organ dysfunction. Multidisciplinary supportive care and targeted antimicrobial strategy achieved effective infection control and gradual recovery of hepatic and renal function. Nevertheless, irreversible neurological damage resulted in persistent coma, and the patient was discharged for palliative care 3 months later. This case highlights the therapeutic difficulties of severe mixed infections with intracranial involvement and provides clinical experience for the management of similar complex critical illnesses.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1816221</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1816221</link>
        <title><![CDATA[Interpretable machine learning to predict NOAF in ICU patients with CKD: validation in US and Chinese cohorts]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shujie Zhang</author><author>Na Ren</author><author>Qing Yin</author><author>Chao Yang</author><author>Lujing Nie</author><author>Jianan Zhao</author><author>Yuxiu Liu</author><author>Jing Huang</author><author>Yanbo Chen</author>
        <description><![CDATA[ObjectiveCritically ill patients with chronic kidney disease (CKD) are at high risk for New-Onset Atrial Fibrillation (NOAF), which significantly increases their risk of adverse events. Early detection of NOAF is crucial for prompt intervention and better outcomes. This study aims to develop and validate predictive models for the early identification and stratification of NOAF risk in this vulnerable population.MethodsWe developed and validated a predictive model using a cohort of 6,476 critically ill patients with CKD from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. After performing feature selection via least absolute shrinkage and selection operator (Lasso) logistic regression, we trained six machine learning (ML) models. These algorithms included: Random Forest, Gradient Boosting, eXtreme Gradient Boosting (XGBoost), Logistic Regression (LR), Multi-layer Perceptron (MLP), and Light Gradient Boosting Machine (LightGBM). The best-performing model was interpreted using SHAP to provide clinical insights. Its robustness and generalizability were confirmed through rigorous external validation on two distinct international cohorts: the US-based eICU-CRD (eICU Collaborative Research Database) (n = 12,509) and a Chinese ICU database from Weifang People’s Hospital (n = 880).ResultsUltimately, 12 predictive features were ultimately selected: age, SOFA score, minimum heart rate, congestive heart failure, average heart rate, minimum systolic blood pressure (SBP), mechanical ventilation use, minimum oxygen saturation (SpO2), average respiratory rate, minimum magnesium, SAPS II score, and maximum white blood cell (WBC) count. The Random Forest model demonstrated the best overall performance, achieving an area under the receiver operating characteristic curve (AUC) of 0.855 in internal validation. The model’s robustness was confirmed through external validation on two independent cohorts, yielding an AUC of 0.760 on the eICU-CRD and 0.740 on the Weifang People’s Hospital database. According to the SHAP analysis, age, average heart rate, minimum heart rate, SOFA score, and SAPS II were the top five most influential predictors for NOAF.ConclusionWe developed an interpretable machine learning model to predict NOAF in critically ill CKD patients, demonstrating strong generalizability through external validation on both a large US cohort (eICU-CRD) and a single-center Chinese cohort (Weifang People’s Hospital). SHAP analysis enhanced model interpretability.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1743905</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1743905</link>
        <title><![CDATA[Schisandra chinensis Fructus and its active metabolites for the treatment of metabolic dysfunction-associated steatotic liver disease]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Li Jun Wang</author><author>Ping Zhang</author><author>Gui Li Wang</author><author>Shu Cheng Chen</author><author>Wei You Cao</author><author>Ji Chun Han</author><author>Jian Guang Sun</author><author>Jian Chao Feng</author><author>Yang Zheng</author>
        <description><![CDATA[Schisandra chinensis Fructus (SCF) is a traditional Chinese herbal medicine with both medicinal and culinary uses. Its main active ingredients, including lignans, triterpenoids, volatile oils, and organic acids, have been utilized to treat liver diseases. SCF extract exhibits pharmacological activities such as protecting hepatocytes, reducing hepatic fat accumulation, alleviating insulin resistance, and mitigating oxidative stress, thus holding promising application prospects in alleviating metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of our review is to summarize and organize recent literature regarding the active metabolites and pharmacology of SCF, so as to clarify the pharmacological mechanism of this herbal medicine and provide a reference for the research, development, and utilization of SCF, its compound preparations, and related health foods. Literature selection was performed using relevant databases in traditional Chinese medicine and biomedical sciences, based on the ethnopharmacological uses (medicinal and culinary) of SCF. Studies investigating the roles and mechanisms of SCF’s active metabolites in alleviating MASLD were primarily chosen. SCF contains multiple active metabolites, among which lignans, triterpenoids, volatile oils, and organic acids play crucial roles in alleviating MASLD. These metabolites exert pharmacological effects by protecting hepatocytes from damage, regulating hepatic lipid metabolism, improving insulin sensitivity, and resisting oxidative stress, collectively contributing to the mitigation of MASLD. However, systematic exploration of the integrated mechanisms involving these metabolites remains necessary. The active metabolites of SCF possess diverse pharmacological activities in alleviating MASLD. Clarifying their underlying mechanisms is beneficial for promoting further research, development, and application of SCF in medicine and health foods, providing a solid basis for related drug development and functional food utilization.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1815780</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1815780</link>
        <title><![CDATA[Clinical characteristics and early admission predictors of in-hospital death in acute paraquat poisoning: a retrospective cohort study of 128 patients]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yuquan Chen</author><author>Meiwen Xie</author><author>Yifan Ye</author><author>Yuqiang Lin</author><author>Zhiqian Yang</author><author>Zhi Wang</author>
        <description><![CDATA[BackgroundAcute paraquat (PQ) poisoning is associated with high mortality and rapid multi-organ injury. Early risk stratification is particularly important when plasma or urine PQ concentrations are unavailable. This study aimed to characterize acute PQ poisoning and identify routinely available admission variables associated with in-hospital death.MethodsWe retrospectively enrolled 128 consecutive patients with acute PQ poisoning admitted to Guangzhou Twelfth People’s Hospital between January 2008 and December 2020. Patients were categorized as survivors (n = 46) or non-survivors (n = 82) according to in-hospital outcome. Continuous variables were analyzed using the Mann–Whitney U test and categorical variables using the chi-square test or Fisher’s exact test, as appropriate. Clinically relevant admission variables were screened for collinearity and entered into a backward stepwise binary logistic regression model in SPSS 25.0. ROC curves were generated in R, and AUCs with 95% confidence intervals were calculated.ResultsThe in-hospital mortality rate was 64.06%. Compared with survivors, non-survivors had significantly higher ingested dose, coagulation indices, inflammatory markers, liver injury markers, renal function indices, and myocardial injury markers (all p < 0.05). In multivariable analysis, ingested dose (OR = 1.016, 95% CI: 1.003–1.029, p = 0.015) and AST (OR = 1.027, 95% CI: 1.011–1.042, p = 0.001) were independently associated with in-hospital death. AST showed the best discrimination among single markers (AUC = 0.911, 95% CI: 0.855–0.958).ConclusionIngested dose and AST were independently associated with in-hospital death in acute PQ poisoning, and AST showed the best single-marker discriminative performance.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1791488</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1791488</link>
        <title><![CDATA[Evaluation of multimodal large language models for psoriasis diagnosis, severity grading, and treatment recommendations from clinical photographs: ChatGPT shows superior performance compared to other large language models]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mehdi Boostani</author><author>Paolo Gisondi</author><author>Francesco Bellinato</author><author>Tara Kiss</author><author>Christos C. Zouboulis</author><author>Drew Kuraitis</author><author>Noah Goldfarb</author><author>Nóra Nádudvari</author><author>Banu Farabi</author><author>Balazs Hodosi</author><author>Péter Holló</author><author>Norbert M. Wikonkal</author><author>Kende Lőrincz</author><author>András Banvölgyi</author><author>Gyorgy Paragh</author><author>Norbert Kiss</author>
        <description><![CDATA[IntroductionPsoriasis is common, but diagnosis and early severity assessment can be delayed because of variable presentation and overlap with mimicking dermatoses. Multimodal large language models (LLMs) may assist image-based triage.ObjectiveTo evaluate web-based multimodal LLMs for psoriasis identification, Physician Global Assessment (PGA) scoring, and treatment recommendation quality from clinical photographs.MethodsWe retrospectively analyzed 303 standardized photographs from 160 patients (Semmelweis University, May 2022–January 2025), including 163 psoriasis lesions and 140 mimickers. Reference diagnosis and PGA were assigned by two dermatologists with third-expert adjudication, treatment outputs were rated for appropriateness. ChatGPT-5, ChatGPT-4o, Gemini 2.5 Flash, and Claude Sonnet 4.5 received identical prompts for diagnosis and, when psoriasis was predicted, PGA and treatment; sessions were periodically reset.ResultsDiagnostic accuracy was highest for ChatGPT-5 (93.1%) and ChatGPT-4o (90.1%), followed by Claude (83.6%) and Gemini (61.5%). Among correctly identified psoriasis cases, PGA accuracy was 93.3% (ChatGPT-5), 92.9% (ChatGPT-4o), 82.7% (Gemini), and 78.1% (Claude). Appropriate treatment recommendations were most frequent for ChatGPT-5 (83.7%) and ChatGPT-4o (82.1%), then Claude (75.0%) and Gemini (53.2%); test–retest agreement favored the OpenAI models.ConclusionUnder standardized conditions, general-purpose multimodal LLMs, especially ChatGPT-5 and ChatGPT-4o, showed strong performance for psoriasis recognition and reasonable support for PGA scoring and treatment suggestions, supporting potential use by primary care physicians when dermatology specialist access is limited.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1798513</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1798513</link>
        <title><![CDATA[Current status of vision and refractive errors among children and adolescents in northeast Sichuan, China: a school-based cross-sectional study]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Zhe Li</author><author>Ximin Yin</author><author>Xinyi He</author><author>Wenchuan Liao</author><author>Yunchun Zou</author>
        <description><![CDATA[PurposeTo investigate the status of visual acuity and refractive errors among children and adolescents in northeastern Sichuan, providing a basis for targeted myopia prevention and control.MethodsIn 2024, a school-based vision screening program using a stratified cluster sampling framework was conducted among students from participating schools in 3 districts and 6 counties of Nanchong City. Visual acuity screening and non-cycloplegic autorefraction were performed using an electronic intelligent screening system with real-time data collection and strict quality control. Of the 61,012 students initially screened, 59,319 students with complete and analyzable data were included in the final analysis, corresponding to an effective screening rate of 97.23%. Detection rates and distribution characteristics of poor visual acuity and suspected myopia were analyzed, along with associated risk factors.ResultsThe prevalence of poor visual acuity and suspected myopia increased markedly with educational stage, reaching 90.81% and nearly 90%, respectively, in general senior high school students, accompanied by a parallel increase in myopia severity and high myopia proportion. Suspected myopia was more common among female students. Substantial regional disparities were observed, with the highest prevalence in Nanbu County (80.49%) and the lowest in Langzhong City (46.41%). Urban students had significantly higher myopia prevalence than township students. In addition, during the general senior high stage, students in ordinary schools showed significantly higher myopia prevalence than those in key schools. Regarding vision correction, eyeglasses were the predominant method. The rate of spectacle use increased with education level, though proper correction remained suboptimal. Additionally, astigmatism and anisometropia were prevalent among myopic students and increased with school grade. Hyperopia reserve declined progressively in lower-grade students. Multivariable logistic regression analysis showed that school grade, gender, regional type, and school level were independently associated with myopia.ConclusionsThis study reveals the epidemiological characteristics and influencing factors of visual acuity and refractive errors among children and adolescents in northeastern Sichuan, providing essential data and scientific evidence for the development of targeted myopia prevention strategies in the region.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1847050</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1847050</link>
        <title><![CDATA[Predictive model for in-hospital acute cerebral infarction in patients with acute gastrointestinal bleeding: a retrospective cohort study]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yiqian Liang</author><author>Ling Zhang</author><author>Zunling Chen</author><author>Lingfeng Ruan</author><author>Tao Zhang</author>
        <description><![CDATA[BackgroundAcute gastrointestinal bleeding (GIB) is a common emergency in gastroenterology and may be accompanied by blood loss, anemia, systemic inflammation, and hemodynamic instability. Because the brain has a high metabolic demand and depends on continuous perfusion and oxygen delivery, patients with GIB may be vulnerable to in-hospital acute cerebral infarction (ACI). However, whether GIB is associated with a higher incidence of in-hospital ACI in gastroenterology inpatients remains insufficiently studied, and clinically practical risk stratification tools are lacking.ObjectiveTo compare the incidence of in-hospital ACI between patients with and without GIB, identify factors associated with in-hospital ACI among patients with GIB, and develop a clinically applicable nomogram.MethodsA retrospective cohort study was conducted among gastroenterology inpatients at Nanchong Central Hospital between September 2020 and December 2025. Patients were classified as GIB or non-GIB. Propensity score matching (PSM) was used to compare in-hospital ACI incidence between groups. Among patients with GIB, candidate predictors were evaluated using univariable and multivariable logistic regression, and a nomogram was developed and internally validated. Sensitivity, alternative, and exploratory subgroup analyses were additionally performed.ResultsA total of 2,734 patients with suspected GIB and 10,763 patients without GIB were initially screened; after exclusion, 2,380 and 8,996 patients, respectively, were included. After 1:1 PSM, 2,380 matched pairs were analyzed. In-hospital ACI occurred more frequently in the GIB group than in the non-GIB group (7.8% vs. 5.2%, p < 0.001). Among patients with GIB, previous cerebral infarction history (OR 13.47, 95% CI 9.26–19.60), sepsis and infection (OR 2.43, 95% CI 1.71–3.44), cerebral hemorrhage (OR 3.48, 95% CI 1.17–10.33), anemia (OR 1.54, 95% CI 1.02–2.32), age (OR 1.05 per year, 95% CI 1.03–1.07), and length of hospital stay (OR 1.04 per day, 95% CI 1.02–1.07) were independently associated with in-hospital ACI. The nomogram demonstrated good discrimination (AUC 0.864, 95% CI 0.837–0.888) and calibration (MAE 0.008).ConclusionIn this single-center retrospective cohort, GIB was associated with a higher incidence of in-hospital ACI. A six-factor nomogram based on routinely available clinical variables showed good internal performance and may assist risk stratification, although external validation is needed before broader clinical use.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1835766</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1835766</link>
        <title><![CDATA[Early risk prediction model for intra-abdominal hypertension in adult ICU patients: a prospective cohort study]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yanrui Tan</author><author>Yujia Kou</author><author>Jiao Du</author><author>Yuqin Chen</author><author>Yi Ma</author><author>Hong Yu</author><author>Shasha Li</author><author>Chuanliang Pan</author>
        <description><![CDATA[ObjectiveTo identify independent risk factors for intra-abdominal hypertension (IAH) in adult intensive care unit (ICU) patients, develop a predictive nomogram, and perform internal validation.MethodsThis prospective cohort study enrolled 261 adult ICU patients from two tertiary hospitals in Sichuan Province, China, between August and December 2022, using convenience sampling. Patients with IAH at admission were excluded. A standardized questionnaire captured demographic, clinical, and laboratory data. Cox proportional hazards regression identified independent predictors of IAH within 1–6 days post-ICU admission. A nomogram was constructed and internally validated using Bootstrap resampling (1,000 iterations). Model performance was assessed by the concordance index (C-index), area under the time-dependent receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA).ResultsIntra-abdominal hypertension occurred in 198 patients (75.9%), with a median onset of 12 h (range: 12–72 h). Multivariable Cox analysis revealed six independent risk factors: pre-ICU surgery (HR = 1.524, 95%CI: 1.075–2.161), abdominal distension (HR = 2.082, 95%CI: 1.505–2.881), increased intra-abdominal contents (HR = 1.857, 95%CI: 1.343–2.567), intraperitoneal fluid accumulation (HR = 1.500, 95%CI: 1.074–2.095), shock (HR = 1.806, 95%CI: 1.218–2.677), and APACHE II score (HR = 1.047 per point, 95%CI: 1.016–1.078). The nomogram demonstrated excellent discrimination (C-index: 0.826; bootstrap-corrected: 0.826) and calibration. Time-dependent AUC at 12 h, 24 h, and 36 h were 0.836 (95% CI: 0.787–0.884), 0.932 (95% CI: 0.900–0.964), and 0.913 (95% CI: 0.877–0.950), respectively. DCA confirmed clinical utility across a range of threshold probabilities.ConclusionThis nomogram, based on six readily available clinical variables, enables early identification of ICU patients at high risk for IAH, facilitating targeted monitoring and preventive interventions.Relevance to clinical practiceThe model provides a simple bedside tool for risk stratification, guiding proactive intra-abdominal pressure monitoring and individualized care plans.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1794483</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1794483</link>
        <title><![CDATA[Case Report: A case of Rothmund–Thomson syndrome-like phenotype with an ANAPC1 variant of uncertain significance and observed hair improvement]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Chuhan Huang</author><author>Qingwu Liu</author><author>Dingquan Yang</author>
        <description><![CDATA[BackgroundRothmund–Thomson syndrome (RTS) is a rare autosomal recessive genodermatosis typically associated with mutations in the RECQL4 gene. However, some clinically diagnosed cases lack such variants, indicating genetic heterogeneity. ANAPC1, encoding a subunit of the anaphase-promoting complex (APC/C), has been implicated in RTS type 1, but its involvement in hair disorders remains unexplored.Case presentationWe report the case of a 29-year-old man who presented with lifelong sparse, fine scalp hair, bilateral malar erythema, soft fingernails, and dental anomalies (malocclusion with multiple caries). Routine laboratory tests were unremarkable except for reduced vitamins B1, B2, B6, and B9 (November 2024). Whole-exome sequencing (approximately 20,000 genes) identified a variant of uncertain significance in ANAPC1 (NM_022662.4:c.4907T>C, p.Val1636Ala); no reportable variants were found in ACMG-recommended secondary findings genes. Combination therapy (trazodone 50 mg qn, tanshinone capsules 1 g qid, isotretinoin 20 mg qod, topical halcinonide 10 mL mixed with minoxidil 60 mL 1 mL bid, and multivitamins 2 tablets tid) was initiated in November 2024. After 6 months, follow-up trichoscopy (May 2025) showed increased hair density and shaft thickness.ConclusionWe describe a patient with a Rothmund–Thomson syndrome-like phenotype who carried a heterozygous ANAPC1 variant of uncertain significance (VUS) and showed trichoscopic improvement after combination therapy. This singular observation hints at a possible phenotypic expansion associated with ANAPC1 but cannot establish a new genotype–phenotype correlation. The clinical improvement underscores that symptomatic management can be beneficial in complex genodermatoses, even in the absence of a definitive molecular diagnosis. The pathogenicity of the ANAPC1 VUS remains unconfirmed, necessitating functional validation and segregation studies in future research.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1772881</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1772881</link>
        <title><![CDATA[(Mis)trust among patients seeking unproven stem cell therapies: a qualitative analysis]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Omar Kawam</author><author>Sara Watson</author><author>Xuan Zhu</author><author>Shane Shapiro</author><author>Jon C. Tilburt</author><author>Zubin Master</author>
        <description><![CDATA[IntroductionThe unproven stem cell intervention (SCI) industry markets stem cell products to patients navigating chronic and serious conditions who seek alternative options when conventional treatments no longer offer relief or improvement. This market is often characterized by providers using deceptive advertising to misinform potential consumers to seek stem cells that have not been shown to be safe and/or effective through clinical studies.ObjectiveThis study examines how patients describe interpersonal and institutional trust in relation to their interest in and decisions about unproven SCIs among two distinct and divergent chronic disease patient groups: patients with little or no interest in unproven SCIs (low seekers) and those with high interest or have undertaken an unproven SCI (high seekers).MethodsA semi-structured interview guide was developed deductively and modified inductively based on the Unified Theory of Health Behavior. Qualitative interviews among 36 patients and carers were conduct and transcripts were analyzed using constant comparison based on the principles of grounded theory.ResultsTrust varies across social contexts as low seekers expressed strong reservations about the commercialization elements of the SCI industry placing greater confidence in conventional medicine. In contrast, high seekers questioned the advice of conventional providers and motives of medical regulators. Across both, personal relationships were commonly described as influential in how participants evaluated unproven SCIs.ConclusionThese findings suggest that communication efforts in clinical settings should account for the relational and emotional dimensions of trust. Interventions aimed at countering misleading information and promoting informed choices should engage trusted messengers and address the broader social and psychological contexts in which patients may seek unproven SCIs.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1823684</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1823684</link>
        <title><![CDATA[Interrelations of disease activity, health-related quality of life, and mental health in axial spondyloarthritis: the Rheuma-VOR cohort]]></title>
        <pubdate>2026-05-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Lina Judit Schiestl</author><author>Eva Wendt</author><author>Fabian Proft</author><author>Kirsten Hoeper</author><author>Torsten Witte</author><author>Gunter Assmann</author><author>Andreas Schwarting</author><author>Matthias Dreher</author>
        <description><![CDATA[BackgroundAxial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease characterized by pain and stiffness of the axial skeleton, peripheral manifestations like arthritis, dactylitis and enthesitis, extra-musculoskeletal manifestations, and reduced health-related quality of life (HRQoL). Depressive symptoms and fatigue are common, yet few studies have assessed these outcomes at diagnosis and during early treatment.ObjectiveTo evaluate mental health, fatigue, HRQoL, and their association with disease activity and functional status in patients with axSpA at diagnosis and after 1 year of rheumatologic care.MethodsRheuma-VOR is a multicenter, proof- of concept study in Germany implementing structured preselection and early referral for suspected axSpA. We included 238 patients with confirmed axSpA, of whom 76 completed a 12-month follow-up. Disease activity (BASDAI, ASDAS), functional status (BASFI, BASMI, FFbH), mental health (PHQ-9, WHO-5), fatigue (FACIT-F), and HRQoL (EQ-5D) were assessed at baseline and follow-up. Associations between disease activity, function, and patient-reported outcomes (PROs) were analyzed using correlation and multivariable regression.ResultsAt diagnosis, patients exhibited high disease activity (BASDAI 4.6 ± 2.0, ASDAS 2.6 ± 0.9) and substantial prevalence of depressive symptoms (PHQ-9 ≥ 10 in 36.5%) and fatigue (FACIT-F < 39 in 69.5%). One-year follow-up showed significant improvements in disease activity, functional impairment, HRQoL, mental well-being, and fatigue (all p < 0.05). Higher patient-reported disease activity (BASDAI) consistently predicted depressive symptoms and fatigue, whereas functional capacity (FFbH) was the strongest predictor of HRQoL. Physician-assessed disease activity (ASDAS) and functional impairment (BASFI) had smaller or time-limited effects.ConclusionIn axSpA, patient-reported disease activity and functional capacity are key determinants of mental health, HRQoL, and fatigue. Early diagnosis and initiation of guideline-concordant therapy are associated with improvements across physical and psychological domains, supporting systematic screening and interdisciplinary management strategies.]]></description>
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