<?xml version="1.0" encoding="utf-8"?>
    <rss version="2.0">
      <channel xmlns:content="http://purl.org/rss/1.0/modules/content/">
        <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>
        <generator>Frontiers Feed Generator,version:1</generator>
        <pubDate>2026-05-14T15:58:10.931+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1794748</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1794748</link>
        <title><![CDATA[Magnetic resonance-guided focused ultrasound surgery for adenomyosis: current evidence and future directions]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Yang Li</author><author>Zhengguang Yang</author><author>Xunhua Xu</author>
        <description><![CDATA[Adenomyosis (AM) is a common gynecological disorder with high prevalence among women of childbearing age. Although hysterectomy is the definitive treatment, it is considered unsuitable for patients who wish to preserve fertility, creating an urgent need for effective, minimally invasive alternatives. Despite emerging evidence, no comprehensive synthesis comparing ablation techniques and guidance modalities specifically for AM currently exists. Currently used thermal ablation techniques include high-intensity focused ultrasound (HIFU), radiofrequency ablation, and percutaneous microwave ablation. Among these, HIFU has gained increasing attention as a non-invasive, uterus-sparing treatment option. Focused ultrasound procedures can be performed under ultrasound or magnetic resonance imaging (MRI) guidance. Magnetic resonance-guided focused ultrasound surgery (MRgFUS), leveraging the high resolution of MRI, enables more precise lesion targeting, real-time temperature monitoring, and immediate postoperative assessment. MRgFUS can effectively reduce lesion size and alleviate symptoms, while lesion-specific MRI features and radiomics models show predictive value for treatment outcomes. By integrating adjuvant hormonal therapies and advanced imaging evaluations, MRgFUS is expected to not only evolve into a more individualized and precise therapeutic strategy but also help establish standardized frameworks for patient selection and outcome prediction. This review summarizes recent advances in MRgFUS for the treatment of AM, focusing on its unique advantages, safety, and efficacy, and emphasizes the critical role of MRI-based imaging biomarkers in predicting therapeutic outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1786137</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1786137</link>
        <title><![CDATA[Oliceridine effectively attenuates fentanyl-induced cough during general anesthesia induction]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Clinical Trial</category>
        <author>Ru-Yi Xing</author><author>Wen-Yi Gong</author><author>Chen-Guang Li</author><author>Ilyar Mamtili</author><author>Shuang-Xiong Zhu</author><author>Wen-Jun Zhou</author><author>Bing-Xing Li</author><author>Jie Cao</author><author>Xiao-Fang Yue</author><author>Kun Fan</author>
        <description><![CDATA[ObjectiveFentanyl-induced cough (FIC) is a common adverse event during anesthesia induction with a high incidence and may result in serious clinical complications. Although our clinical observations suggest that oliceridine attenuates FIC, the available evidence remains limited. This study was designed to assess the prophylactic efficacy of oliceridine against FIC and to characterize its peri-induction safety profile.MethodsA total of 168 adult surgical patients with American Society of Anesthesiologists physical status I–III scheduled for general anesthesia were randomized to receive either oliceridine 2 mg (OF group) or normal saline (SF group) prior to fentanyl administration. The primary outcome was the incidence of cough within 1 min following fentanyl injection. Secondary outcomes included cough severity, vital sign changes, and the incidence of adverse events.ResultsNo patients in the OF group experienced FIC, compared to 58.33% in the SF group (p < 0.001). Cough severity in the SF group was classified as mild (17.86%), moderate (20.24%), and severe (20.24%). Vital signs did not show statistically significant changes from before to after oliceridine injection within each group, and no significant between-group differences were identified. The incidence of adverse events was low in both groups, with no significant between-group differences.ConclusionPretreatment with 2 mg oliceridine effectively reduces the incidence of FIC without increasing significant additional risks, providing a rationale and safe approach for anesthetic induction.Clinical trial registrationhttps://www.chictr.org.cn/showproj.html?proj=272947, identifier ChiCTR2500105221.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1796038</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1796038</link>
        <title><![CDATA[Stem cell-derived extracellular vesicles as immunomodulatory agents: targeting pathological crosstalk in systemic lupus erythematosus and multiple sclerosis]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Lifei Yao</author><author>Qiong Li</author><author>Wei Peng</author><author>Aimeng Sun</author><author>Shaofen Li</author><author>Mengting Zou</author><author>Xianyun Xu</author>
        <description><![CDATA[Systemic lupus erythematosus (SLE) and multiple sclerosis (MS) are chronic immune-mediated diseases characterized by overlapping clinical presentations and shared immunoregulatory pathways. Both conditions involve dysregulated immune cell activation, autoantibody production, cytokine imbalance, compromised blood-brain barrier (BBB), and mechanisms that establish self-perpetuating cycles that drive neuroinflammatory cascades, demyelination, and tissue injury. Stem cell-derived extracellular vesicles (SC-EVs) efficiently deliver and protect bioactive cargo, notably key immunoregulatory molecules including microRNAs (miRNAs) and proteins, from enzymatic degradation through their bilayer membrane structure, facilitating intercellular communication and immune modulation. Preclinical studies in animal models of SLE and experimental autoimmune encephalomyelitis (EAE, the standard MS model) have demonstrated that mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) modulate immune responses by suppressing pro-inflammatory mediators, enhancing anti-inflammatory signaling, promoting tissue repair, and conferring neuroprotection. Accumulating evidence suggests that the functional cargo of MSC-EVs targets key pathogenic processes in both diseases, including immune cell polarization, cytokine regulation, and tissue regeneration. This review examines the convergent immunomodulatory effects and mechanisms of SC-EVs in SLE and MS, highlighting their potential as cell-free immunotherapeutic agents for mitigating autoimmune-mediated damage. This review highlights the synergistic role of microRNA-146a-5p (miR-146a-5p) and microRNA-21-5p (miR-21-5p) in reprogramming immune responses and the context-dependent regulation of the hypoxia-inducible factor-1α (HIF-1α) axis in tissue repair.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1819067</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1819067</link>
        <title><![CDATA[Explainable machine learning identifies knee morphology thresholds for arthroscopic medial meniscus posterior root tear: a retrospective cohort study]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Minyuan Zhang</author><author>Fengyuan Guo</author><author>Yanlin Li</author><author>Jiali Zheng</author><author>Yang Yu</author><author>Miao Chen</author><author>Runze Li</author><author>Yatong Liao</author><author>Qianzeng Chen</author><author>Chuan He</author>
        <description><![CDATA[BackgroundMedial meniscus posterior root tear (MMPRT) is clinically important because disruption of posterior root function compromises hoop tension and load sharing, accelerating medial-compartment degeneration. Early or subtle posterior pathology may be underrecognized on MRI, highlighting the potential value of morphology-based risk awareness during MRI interpretation.MethodsWe retrospectively analyzed 608 patients who underwent arthroscopic surgery for knee joint injuries, including 281 patients with arthroscopically confirmed MMPRT and 327 controls without MMPRT. Demographic, clinical, and MRI-based morphologic parameters were compared in the training set. Variables identified from training-set comparisons and clinical/biomechanical relevance were used to develop 10 machine learning models, including CatBoost, Decision Tree, GBM, LightGBM, LASSO, Naive Bayes, Neural Network, Random Forest, Support Vector Machine, and XGBoost. Models were evaluated with 10-fold cross-validation and an independent testing set. Explainability was assessed using SHapley Additive exPlanations (SHAP), including global importance and dependence plots.ResultsTraining-set multivariable analysis identified older age, greater medial tibial slope (MTS), and deeper medial tibial plateau depth (MTPD) as independent factors associated with MMPRT. GBM achieved the highest AUC in the independent testing set and was selected for SHAP-based interpretation. SHAP analysis ranked age as the dominant contributor, followed by MTS and MTPD. Dependence plots suggested non-linear, threshold-like patterns in model contribution. Age showed an apparent transition from negative to positive SHAP contributions around midlife, MTS showed a threshold-like increase between approximately 6° and 8°, whereas MTPD shifted toward positive SHAP contributions around approximately 2.2–2.5 mm.ConclusionAge was the dominant model contributor, and MTS and MTPD were independently associated with MMPRT, exhibiting non-linear patterns in SHAP-based model interpretation. These findings may help raise suspicion for MMPRT in symptomatic patients undergoing MRI, particularly when age-related and tibial plateau morphologic risk patterns are present.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1834636</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1834636</link>
        <title><![CDATA[Effectiveness of AI-enhanced virtual patients for psychiatric interview training in health professions education: a meta-analysis]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Senay Kilincel</author><author>Furkan Bulut</author><author>Pelin Goksel</author><author>Mirac Baris Usta</author><author>Tuba Mutluer</author><author>Oguzhan Kilincel</author>
        <description><![CDATA[ObjectivesArtificial intelligence (AI)–enhanced virtual patient simulations are increasingly used in health professions education to improve clinical communication and diagnostic reasoning. However, the effectiveness of these technologies for psychiatric interview training has not been systematically quantified. This study aimed to systematically review and meta-analyze the existing literature evaluating the impact of AI-enhanced virtual patients on psychiatric interview performance, knowledge acquisition, and learner confidence in health professions education.Materials and methodsA systematic review and meta-analysis was conducted following the PRISMA 2020 guidelines. Electronic database searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar to identify relevant studies published between January 2000 and March 2026. Studies were included if they evaluated AI-enhanced virtual patient simulations for psychiatric interview training among medical students, psychiatry residents, clinicians, or other health professions trainees. Data extraction included study characteristics, participant populations, intervention types, and educational outcomes. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Quantitative synthesis was performed using random-effects meta-analysis models, and effect sizes were calculated as standardized mean differences (SMD) with 95% confidence intervals (CI) using R statistical software.ResultsA total of 560 records were identified through database searches and additional sources. After removal of duplicates and screening procedures, 10 studies met the inclusion criteria and were included in the final analysis. The studies involved approximately 450 participants, including medical students, psychiatry residents, clinicians, nursing students, and psychology trainees. AI-enhanced virtual patient interventions included conversational AI systems, virtual human simulations, large language model–based simulated patients, and AI–virtual reality training environments. The pooled analyses indicated improvements in psychiatric interview performance, knowledge acquisition, and learner confidence following AI-supported virtual patient training. Subgroup analysis demonstrated positive educational outcomes across both student and clinician populations. Risk-of-bias assessment revealed variable methodological quality across studies, with several pilot and non-randomized designs.ConclusionAI-enhanced virtual patient simulations appear to be effective educational tools for improving psychiatric interview training in health professions education. These technologies provide scalable and standardized simulation environments that support communication skill development, diagnostic reasoning, and learner confidence. Although the findings suggest promising educational benefits, further large-scale randomized controlled trials and standardized outcome assessments are needed to confirm the long-term educational impact of AI-supported virtual patient training in psychiatry.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1809667</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1809667</link>
        <title><![CDATA[From cultural competence to cross-cultural fluency: a framework for transnational medical education in an era of global health workforce mobility]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Hypothesis and Theory</category>
        <author>Changiz Mohiyeddini</author>
        <description><![CDATA[BackgroundAs medical education increasingly operates across national boundaries through institutional partnerships, offshore campuses, dual-degree programs, and digital learning platforms, the need for culturally responsive pedagogical frameworks has become urgent. Existing models of cross-cultural medical education were developed primarily for domestic settings and do not adequately address the complexities that arise when curricula, faculty, and learners simultaneously traverse multiple cultural, regulatory, and institutional contexts. This paper proposes a conceptual shift from cultural competence to cross-cultural fluency as a guiding principle for transnational medical education.Main bodyDrawing on established frameworks in cross-cultural medical education, global health workforce literature, and transnational education governance, we present a three-tier framework—the Transnational Cross-Cultural Fluency (TCCF) model—designed to address the unique challenges of medical education delivered across borders. The first tier addresses organizational and structural barriers inherent in cross-border educational partnerships, including divergent accreditation standards, regulatory misalignment, and institutional power asymmetries. The second tier focuses on pedagogical and clinical challenges arising from the multiplication of cultural contexts when faculty from one national setting teach students from another who will practice in a third. The third tier examines individual-level processes of professional identity formation, cultural self-reflection, and adaptation when learners and educators navigate multiple institutional cultures simultaneously. For each tier, we propose specific strategies encompassing curriculum design, faculty development, assessment innovation, and governance mechanisms. We critically examine how digital platforms and technology-enhanced learning can serve as both enablers and complicators of cross-cultural fluency in transnational settings. We further address ethical dimensions including epistemic justice, the risk of cultural hegemony in cross-border partnerships, and the imperative for bidirectional knowledge exchange.ConclusionThe TCCF model extends existing cultural competence frameworks by explicitly accounting for the multi-layered cultural transactions that characterize transnational medical education. Moving beyond competence—which implies a finite endpoint—toward fluency—which denotes ongoing adaptive capacity—provides a more appropriate conceptual foundation for preparing healthcare professionals to deliver equitable care across a globalized healthcare landscape. Implementation of this framework requires coordinated effort across partnering institutions, accreditation bodies, and policymakers to ensure that cross-border medical education promotes rather than undermines health equity.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1786209</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1786209</link>
        <title><![CDATA[Predicting poor response to anti-osteoporosis therapy: a machine learning model integrating clinical and novel biomarker data]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yannan Bi</author><author>Maolin Zhang</author><author>Weiqiong Zhang</author><author>Jiahong Li</author>
        <description><![CDATA[ObjectiveThis study was conducted to develop and validate a prediction model integrating clinical characteristics and novel biomarkers. The goal was to identify patients at high risk for a poor response to standard anti-osteoporosis therapy prior to treatment initiation, thereby supporting personalized therapeutic decision-making.MethodsA retrospective analysis was performed on 543 patients with primary osteoporosis admitted between January 2021 and December 2024. All patients received 12 months of standard treatment. Participants were randomly allocated to a training set (n = 380) and a validation set (n = 163) in a 7:3 ratio. In the training set, univariate analysis, Least Absolute Shrinkage and Selection Operator (LASSO) regression, and multivariate logistic regression were used to determine independent predictors. Three machine learning models—Random Forest (RF), Support Vector Machine (SVM), and K-Nearest Neighbors (KNN)—were then constructed. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) values were used to interpret the optimal model.ResultsBaseline characteristics were comparable between the training and validation sets (P > 0.05). Eight independent predictors of poor treatment response were identified: comorbid diabetes, history of fragility fracture, glucocorticoid use for ≥ 6 months, femoral neck bone mineral density T-score, and serum levels of osteocalcin, procollagen type I N-terminal propeptide, β-CrossLaps of type I collagen (β-CTX), and 25-Hydroxyvitamin D. Among the models, the RF algorithm demonstrated superior performance, with an AUC of 0.856 (95% CI: 0.808–0.905) in the training set and 0.825 (95% CI: 0.718–0.933) in the validation set. The model was well-calibrated, and DCA indicated a high net benefit. SHAP analysis confirmed serum β-CTX as the most significant predictive variable.ConclusionA predictive model integrating multi-dimensional factors was successfully developed and validated for assessing osteoporosis treatment efficacy. The RF-based model exhibited robust predictive performance and clinical utility. It shows potential for pre-therapeutic identification of high-risk patients, facilitating precision management in osteoporosis.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1840337</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1840337</link>
        <title><![CDATA[Biomechanical characteristics and therapeutic effects of Traditional Chinese Medicine manual therapy in adolescent idiopathic scoliosis: study protocol for a randomized controlled trial]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Mengying Rong</author><author>Shifang Fu</author><author>Longsheng Ren</author><author>Lei Bian</author><author>Zhenjie Yang</author><author>Qian Liu</author><author>Yuetong Li</author><author>Xiaoyu Zhi</author><author>Yu Wang</author><author>Yijia Liu</author><author>Yanguo Wang</author>
        <description><![CDATA[BackgroundAdolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that progresses with age, making effective early intervention crucial to avoid surgical treatment. Traditional Chinese Medicine (TCM) Manual therapy (MT) offers the advantage of relaxing muscles and correcting biomechanical imbalances, thereby assisting patients in performing postural correction exercises under proper biomechanical alignment. However, evidence supporting the use of TCMMT for AIS remains limited.ObjectiveThis study aims to elucidate the biomechanical changes in AIS patients by comparing with healthy individuals, and investigate the clinical efficacy and biomechanical mechanisms of combining TCMMT with Schroth method in the treatment of AIS.MethodsThis study is a randomized controlled trial. Sixty eligible AIS patients will be randomly allocated in a 1:1 ratio to either the experimental group (EG) or the control group. All patients will undergo Schroth method for 60 min, five times per week. The EG will additionally receive TCMMT for 20 min, three times per week. The treatment course will be 8 weeks. Furthermore, fifteen age-matched healthy volunteers will be included. The primary outcome measure is the Cobb angle assessed before and after treatment. Secondary outcome measures include plantar pressure and 3D gait parameters, surface electromyography and muscular temperature. Adverse events will be recorded throughout the trial. All patients randomly allocated in this study will be included in the intention-to-treat analysis.ConclusionThis study will provide multi-dimensional evidence for the efficacy of TCMMT as an adjunctive treatment for AIS, advance the development of manual therapy within the field of rehabilitation, and facilitate its application in clinical decision which making by both physicians and patients.Study protocol registrationhttp://itmctr.ccebtcm.org.cn, identifier ITMCTR2025002392.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1848131</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1848131</link>
        <title><![CDATA[Research on refractive power calculation formula of intraocular lens based on the principle of double thick lens imaging]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mengdi Yan</author><author>Juntao Zhang</author><author>Shiming Wang</author>
        <description><![CDATA[IntroductionThis study aimed to develop and validate a novel formula for calculating intraocular lens (IOL) refractive power based on Gaussian optics and thick-lens imaging.MethodsThis study was conducted at Ningbo Traditional Chinese Medicine Hospital between October 2021 and October 2023. A total of 54 patients (84 eyes) with age-related cataracts (ARC) undergoing phacoemulsification and IOL implantation were included. The effective lens position was defined as (ACD + W × preoperative LT), where ACD is the anterior chamber depth and LT is the lens thickness. A new IOL power calculation formula was derived using stepwise multiple linear regression, incorporating key ocular parameters including axial length (adjusted for central corneal thickness), keratometry, and the effective lens position. The performance of the new formula was compared with five established formulas: Barrett Universal II, Haigis, Hoffer Q, SRK/T, and Holladay I. For each formula, we compared the mean and median predicted error (PE), the mean and median absolute predicted error (APE), and the proportions of eyes with within ±0.25 D, ±0.50 D, and ±1.00 D.ResultsThe newly developed formula demonstrated excellent bias control, with a median prediction error of 0.060 D that was not statistically different from zero (p = 0.480). In contrast, the Barrett Universal II (0.450 D, p = 0.006), Hoffer Q (0.280 D, p = 0.024), and SRK/T (0.515 D, p = 0.0004) showed significant hyperopic shifts. The mean error of the new formula (0.071 D) was significantly lower than that of Barrett Universal II, Hoffer Q, and Holladay I formulas (all p < 0.01) and comparable to that of the Haigis formula (p = 0.226). Its accuracy (mean absolute error, 0.461 D) was comparable to that of all other formulas. The new formula achieved the highest proportion of eyes within ±0.25 D (43.3%), outperforming all other formulas.DiscussionThe proposed IOL calculation formula, which is based on a double-thick-lens imaging model, provides improved control of systematic bias and competitive predictive accuracy. This approach offers a promising framework for clinical applications of personal IOL power calculations.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1759313</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1759313</link>
        <title><![CDATA[Fulminant cerebral edema in the setting of acute dengue fever after mechanical thrombectomy in a patient with massive stroke and severe hypoalbuminemia: a case report]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Haiwen Huang</author><author>Ying Li</author><author>Yonglin Li</author><author>Zhihua Liu</author><author>Jiajing Hu</author>
        <description><![CDATA[BackgroundMalignant cerebral edema following mechanical thrombectomy for large vessel occlusion stroke carries high mortality. While reperfusion injury and metabolic factors are established contributors, the potential role of concurrent systemic inflammatory stressors remains underrecognized.Case presentationWe present the case of a 61-year-old male with a history of nephrotic syndrome and severe hypoalbuminemia (14.8 g/L), who developed an extensive left middle cerebral artery infarction. At approximately 20 h after onset, worsening neurological deficits (NIHSS 9 → 16) prompted mechanical thrombectomy. At 4 h postoperatively, the patient developed an abrupt high fever (39 °C), prompting immediate diagnostic reassessment, which confirmed acute dengue fever (NS1 antigen-positive) and concurrent bacterial pneumonia. Simultaneously, laboratory tests revealed a systemic inflammatory response, with procalcitonin (PCT) peaking at 1.18 ng/mL and markedly elevated interleukin-6 (IL-6). Within the following 20 h, cerebral edema progressed rapidly, with midline shift increasing from 4 mm to 11 mm, consistent with malignant cerebral edema and impending brain herniation. Despite aggressive medical management, the family declined further decompressive surgery and intensive treatment; the patient was discharged against medical advice, and death was confirmed on follow-up.ConclusionThis report suggests that the fulminant cerebral edema observed in this patient may have been related to blood–brain barrier (BBB) vulnerability following ischemia–reperfusion injury, together with superimposed systemic inflammatory stress and markedly reduced oncotic buffering capacity. Acute dengue infection may have acted as a systemic endothelial and inflammatory stressor during the post-reperfusion vulnerable period, rather than as an independent primary cause. Severe hypoalbuminemia may have represented a baseline physiological susceptibility condition that reduced tolerance to fluid shift once BBB integrity was compromised.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1789864</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1789864</link>
        <title><![CDATA[Differentiated effects of medical educational collaboration on primary care employment intention: a multi-group analysis based on competence types]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yang Rong</author>
        <description><![CDATA[This study aimed to investigate the differential associations between medical educational collaboration and primary care employment intention among medical students with distinct competence profiles, drawing upon Social Cognitive Career Theory (SCCT) as the theoretical framework. A cross-sectional survey was conducted among 398 clinical medicine students from three medical schools in Yunnan Province, China. Latent profile analysis was employed to classify participants into competence profiles based on self-assessed clinical reasoning, communication skills, and procedural skills. Multi-group structural equation modeling was performed to examine whether the SCCT-based pathways from medical educational collaboration to primary care employment intention varied across profiles. Three competence profiles were identified: Practice-Oriented (35.7%), Balanced (33.7%), and Reasoning-Oriented (30.6%). The overall structural model demonstrated acceptable fit, with career self-efficacy and outcome expectations serving as parallel and sequential mediators, with approximately 66% of the total association transmitted through indirect pathways. The multi-group analysis revealed significant pathway heterogeneity across profiles. For Practice-Oriented students, outcome expectations served as the dominant mediating pathway, while the association between career self-efficacy and primary care employment intention was non-significant. For Reasoning-Oriented students, career self-efficacy played a more critical mediating role, with the strongest association with primary care employment intention among the three profiles. The Balanced profile exhibited relatively equal contributions from both pathways. These findings provide empirical evidence suggesting that SCCT-based pathways may vary as a function of individual competence characteristics, contributing to the person-centered perspective in career development research. The results suggest that medical education institutions should implement differentiated career guidance interventions tailored to students’ competence profiles to strengthen the primary care workforce.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1829429</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1829429</link>
        <title><![CDATA[Infection incidence, timing, and predictors in newly diagnosed multiple myeloma: a real-world retrospective cohort study]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ozlem Candan</author><author>Narmin Naghizada</author><author>Tekin Tuncel</author><author>Beyza Melek Palaz</author><author>Mustafa Alperen Tunc</author><author>Derya Demirtas</author><author>Ahmet Mert Yanik</author><author>Arda Bayar</author><author>Secil Salim</author><author>Fatma Temiz</author><author>Ceren Uzunoglu Guren</author><author>Fatma Arıkan</author><author>Meral Ulukoylu Menguc</author><author>Asu Fergun Yilmaz</author><author>Isik Atagunduz</author><author>Zekaver Odabası</author><author>Tayfur Toptas</author><author>Ayse Tulin Tuglular</author>
        <description><![CDATA[BackgroundInfections are a leading cause of morbidity and mortality in multiple myeloma (MM), particularly during the induction phase. Identifying real-world infection patterns and predictors is crucial for guiding preventive strategies.MethodsThis retrospective cohort study included 161 newly diagnosed MM patients who received standard induction therapy at a single tertiary center between 2016 and 2024. Clinical, laboratory, and infection-related parameters were analyzed, with infection during the first 6 months defined as the primary outcome and 12-months analyses as secondary outcomes.ResultsInfections occurred in 50.9% of patients, with the highest incidence within the first 3 months (27.3%, p = 0.004). Pneumonia was the most common type (34.1%), and gram-negative bacteria, particularly Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa, were predominant. Antibiotic resistance to TMP-SMX and levofloxacin was observed in E. coli isolates. Multivariate analysis identified advanced ISS stage (OR: 3.83), diabetes mellitus (OR: 3.64), and chronic kidney disease (OR: 6.01) as independent predictors of infection (p < 0.05). Lymphocyte counts were significantly lower in febrile episodes (p = 0.040), suggesting a potential association with immune status, although this finding should be interpreted cautiously. Hospitalization was more common in patients with advanced ISS and kidney disease. No significant differences were found between induction regimens.ConclusionInfections pose a significant burden during the first year of MM treatment, particularly in high-risk patients during early induction. Readily available clinical parameters can aid in early risk stratification. These findings support a risk-adapted approach to infection prevention based on clinical risk factors, particularly during the early phase of treatment.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1824897</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1824897</link>
        <title><![CDATA[Stabilized adaptive states in microbiome–human integrated physiology: reframing health and chronic disease as symbiotic biological states]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>João Francisco Pollo Gaspary</author><author>Luis Felipe Dias Lopes</author><author>Fernanda Peron Gaspary</author><author>Eduarda Grando Lopes</author><author>Alfred Lee Edgar</author><author>Eduardo Poletti Camara</author><author>Antonio Geraldo Camara</author>
        <description><![CDATA[BackgroundModern medicine has achieved remarkable precision in identifying molecular mechanisms and developing targeted interventions. However, a persistent clinical paradox remains: many chronic conditions—including metabolic, autoimmune, neuropsychiatric, and oncological disorders—exhibit long-term stability, resistance to guideline-concordant treatment, and recurrent trajectories. Despite extensive mechanistic characterization, the organizational basis of this stability remains insufficiently explained.Conceptual gapIn acute contexts such as infection and environmental intoxication, organisms can remain internally coherent while temporarily prioritizing non-host biological demands. This state-based perspective, however, has rarely been extended to chronic disease. At the same time, microbiome research has demonstrated that human physiology operates within a multigenomic system, in which exogenous gene repertoires contribute substantial metabolic and signaling capacity. Epigenetic research further indicates that repeated ecological exposures can progressively stabilize adaptive biological states over time.Proposed frameworkWe propose a conceptual framework in which health and disease are interpreted as stabilized adaptive states emerging from hierarchical signal integration within a multigenomic human system. In this model, chronic pathology reflects coherent but constrained regulatory configurations, rather than simple dysregulation or isolated system failure. Central to this interpretation is membrane-level decisional architecture, which governs signal routing, threshold modulation, and downstream transcriptional responses across tissues.ImplicationsThis framework reorganizes existing evidence into a systems-level interpretation of chronic disease stability, providing a basis for generating testable hypotheses regarding state transitions, responsiveness to perturbation, and restoration of physiological flexibility. Rather than introducing new therapeutic doctrines, the model aims to clarify how biological systems stabilize over time and how such stabilization may be investigated within existing experimental paradigms.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261295889, CRD420261295889; https://www.crd.york.ac.uk/PROSPERO/view/CRD420261295945, CRD420261295945.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1713446</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1713446</link>
        <title><![CDATA[Associations of systemic immune-inflammation index and aggregate index of systemic inflammation with acute gouty arthritis in men: a cross-sectional study]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ziran Xiu</author><author>Zhengnan Gao</author><author>Lan Luo</author><author>Peiyang Yu</author>
        <description><![CDATA[ObjectiveThis study aims to evaluate the associations of complete blood cell count-derived inflammatory markers—including monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), Systemic Immune-Inflammation Index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI)—with acute gouty arthritis in males.MethodsA cross-sectional study was conducted in 380 males from the Department of Endocrinology and Department of Physical Examination, Central Hospital of Dalian University of Technology, between January 2022 and January 2024. Multivariable logistic regression models were used to investigate the independent associations between six inflammatory markers and acute gouty arthritis. Restricted cubic splines (RCS) were employed to model the dose–response relationships of inflammatory markers with acute gouty arthritis. Subgroup analyses were performed to identify susceptible populations. The diagnostic capabilities of the inflammatory markers were evaluated and compared using receiver operating characteristic (ROC) curves.ResultsA total of 380 male participants were included, with a mean age of 54 years. Among them, 108 participants had AGA, giving a prevalence of 28.4%. Significant associations with AGA were observed for monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), Systemic Immune-Inflammation Index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI). Further analysis using RCS revealed nonlinear dose–response relationships between SII and AGA (p-nonlinear = 0.001), as well as between AISI and AGA (p-nonlinear <0.001). Subgroup analysis showed that inflammatory markers (NLR, PLR, SII, SIRI, and AISI) were more effective in assessing AGA onset among men with fatty liver. ROC analysis indicated that when compared with other inflammatory markers (MLR, NLR, PLR, and SIRI), SII and AISI demonstrated superior diagnostic accuracy and discriminatory power in assessing the risk of AGA in men.ConclusionIn men, AGA is closely associated with inflammatory markers. In addition, compared with other inflammatory markers (MLR, NLR, PLR, and SIRI), SII and AISI may serve as more accurate indicators for the diagnosis of AGA.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1798434</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1798434</link>
        <title><![CDATA[Case Report: Basal ganglia brain abscess caused by Nocardia farcinica]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Feiwen Liu</author><author>Ke Yang</author><author>Mengna Wu</author><author>Pan Li</author><author>Lun Luo</author>
        <description><![CDATA[We report a rare case of Nocardia farcinica brain abscess in the basal ganglia, detailing its diagnosis, management, and rehabilitation. Diagnosing brain abscess based solely on clinical and imaging findings remains extremely challenging. Fortunately, metagenomic next-generation sequencing (mNGS) proved valuable in this case by rapidly identifying the pathogen, thereby facilitating targeted antibiotic therapy. This case highlights the importance of differentiating brain abscess from ischemic stroke and intracranial tumors. After completing a full course of anti-infective therapy and comprehensive rehabilitation, the patient achieved significant recovery in activities of daily living (ADL).]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1736755</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1736755</link>
        <title><![CDATA[Health Resorts as an integrated community healthcare model for fibromyalgia syndrome: a strategic SWOT analysis]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Gianluca Regazzo</author><author>Francesco Piccione</author><author>Aristide Roberto Gravina</author><author>Stefano Masiero</author>
        <description><![CDATA[BackgroundFibromyalgia syndrome (FMS) is a prevalent and disabling chronic pain condition associated with substantial socioeconomic burden and frequent dissatisfaction with conventional care. This supports the need for innovative community-based models. Health Resort facilities deliver multi-component, multidisciplinary programs (e.g., balneotherapy/aquatic exercise, structured exercise, education, and supportive environments) and may represent a promising setting for FMS management.MethodsThis study aims to systematically evaluate the strategic potential of Health Resorts as an integrated community healthcare model for FMS using a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis. Factors were identified and synthesized through a targeted narrative search of PubMed and a structured analysis of relevant national and international policy/guidance documents. A strategic analysis was also performed to formulate actionable recommendations by combining internal and external factors.ResultsStrengths included the ability to operationalize integrated biopsychosocial, patient-centered care within an immersive environment, and a potentially decentralized access model. Weaknesses included limited validation of standardized integrated protocols, heterogeneity across facilities, and suboptimal integration with public healthcare systems. Evidence for cost-effectiveness remains hypothesized pending dedicated economic evaluations.ConclusionHealth Resorts offer a promising paradigm for FMS management, shifting from fragmented treatment to an integrated, community-based approach. However, realizing this potential requires addressing critical weaknesses, particularly the need for a stronger evidence base, standardization of protocols, and improved integration with national health services.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1829122</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1829122</link>
        <title><![CDATA[Rare submucosal abscess following endoscopic mucosal resection for rectal polyps: a case report and literature review]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Guo-Li Cao</author><author>Ze-Ming Chen</author><author>Xiao-Dong Li</author><author>Xi-Qiu Yu</author>
        <description><![CDATA[Colonoscopy combined with polypectomy is a well-established strategy for the prevention of colorectal cancer, and endoscopic mucosal resection (EMR) serves as one of the primary therapeutic modalities for colorectal neoplastic lesions. While EMR is generally safe, severe complications may occasionally occur. Herein, we report a rare case of rectal submucosal abscess in a 74-year-old female patient who underwent EMR for rectal polyps. Initial endoscopic fenestration and drainage of the abscess failed to achieve a satisfactory therapeutic effect, and the patient ultimately underwent sigmoidostomy for further management. This case highlights the necessity of considering phlegmon or abscess formation in the differential diagnosis of patients presenting with unexplained acute abdomen after EMR for rectal lesions, especially in those with compromised immunity. Timely identification and intervention are crucial to avoid adverse clinical outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1830071</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1830071</link>
        <title><![CDATA[When behavior does not predict glycemic control in older adults with type 2 diabetes: evidence from Lao PDR]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Chanmaly Keomalavong</author><author>Ranee Wongkongdech</author>
        <description><![CDATA[BackgroundType 2 diabetes mellitus (T2DM) is increasing rapidly in low- and middle-income countries, including Lao People’s Democratic Republic (Lao PDR). Although behavioral self-management is widely considered essential in diabetes care, evidence linking psychosocial determinants to glycemic outcomes among older adults remains inconsistent.ObjectiveThis study examined the associations between diabetes-related knowledge, attitudes, self-care behaviors, and glycemic control among older adults with T2DM receiving tertiary hospital care in Lao PDR.MethodsA cross-sectional study was conducted among 88 adults aged ≥60 years with diagnosed T2DM attending the outpatient diabetes clinic at Setthathirath Hospital in Vientiane Capital. Structured interviews were used to assess diabetes knowledge, attitudes, and self-care practices. Glycemic control was defined as HbA1c < 7%. Pearson correlation and multivariable regression analyses were performed to examine associations between psychosocial factors and glycemic outcomes.ResultsA total of 19.3% of participants achieved glycemic control (HbA1c < 7%), with a mean HbA1c level of 9.03 ± 2.47%, indicating generally poor glycemic control. Diabetes knowledge levels were low, with 98.9% of participants classified as having low knowledge. Attitudes toward diabetes management were predominantly low (60.2%), while overall self-care behaviors were largely moderate (83.0%). Pearson correlation analysis showed no statistically significant associations between knowledge (r = −0.134, p = 0.213), attitudes (r = 0.108, p = 0.318), or self-care behaviors (r = 0.046, p = 0.671) and HbA1c levels. Multivariable regression analysis likewise identified no significant predictors of glycemic control.ConclusionDespite substantial psychosocial vulnerabilities, no statistically significant associations between psychosocial factors and glycemic control were observed in this sample. These findings may indicate a potential mismatch between psychosocial factors and glycemic outcomes; however, this interpretation should be approached with caution, given the study’s methodological limitations. Further research with larger samples and longitudinal designs is needed to better understand these relationships. This study contributes context-specific evidence from Lao PDR to the limited literature on psychosocial determinants of diabetes management in low- and middle-income countries.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1864422</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1864422</link>
        <title><![CDATA[Editorial: Transforming dementia caregiving through assistive technologies]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Quan Zhang</author><author>Yijin Wu</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fmed.2026.1735014</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fmed.2026.1735014</link>
        <title><![CDATA[Evaluating the diagnostic and prognostic utility of serum DLL1 in acute-on-chronic liver failure patients with bacterial infections]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Juanjun Huang</author><author>Zhi Wang</author><author>Wei Zhu</author><author>Jian Chen</author>
        <description><![CDATA[BackgroundThe diagnosis of bacterial infections (BIs) in patients with acute-on-chronic liver failure (ACLF) remains a formidable clinical challenge, directly impacting mortality rates. Current biomarkers are often confounded by the profound systemic inflammation inherent to ACLF itself. The objective of this study was to evaluate the diagnostic and prognostic utility of serum Delta-like ligand 1 (DLL1) in ACLF patients with BIs.MethodsThis retrospective diagnostic study utilized a pre-established, prospectively maintained ACLF cohort (n = 168). Serum DLL1 levels were measured with enzyme-linked immunosorbent assays, and diagnostic performance was assessed via receiver operating characteristic (ROC) curve analysis and multivariable regression.ResultsIn the ACLF cohort, serum DLL1 concentrations were significantly elevated in BI patients compared with their noninfected counterparts (p < 0.001). Multivariable regression revealed that DLL1 was an independent diagnostic predictor (adjusted OR = 1.982, 95% CI: 1.338–2.937). Moreover, the serum DLL1 level demonstrated substantial discriminative capacity (AUC = 0.815; 95% CI: 0.750–0.879), which improved when this variable was synergistically incorporated into a CRP-DLL1 dual-marker model (AUC = 0.852; p = 0.039 versus DLL1 alone). The stability of the combined model was further evaluated in subgroups with available procalcitonin (PCT) data. Decision curve analysis confirmed the clinical net benefit between probability thresholds from 10 to 70%. Crucially, the levels of DLL1 exhibited only marginal correlations with hepatic function parameters, indicating minimal confounding from liver inflammation, but failed to independently predict mortality in patients with ACLF and BI.ConclusionSerum DLL1 represents a robust and clinically deployable diagnostic biomarker for BI in patients with ACLF, and its performance is minimally affected by underlying hepatic dysfunction. The synergistic CRP-DLL1 dual-marker model demonstrated enhanced diagnostic discrimination, significantly outperforming the individual biomarkers. Notably, the DLL1 level was not an independent predictor of mortality in this population with concurrent infection.]]></description>
      </item>
      </channel>
    </rss>