Balloon-occluded transarterial chemoembolization (B-TACE) has emerged as a significant advancement in the locoregional treatment of hepatocellular carcinoma. This technique utilizes a balloon microcatheter selectively placed in target hepatic arteries to occlude blood flow and enhance drug accumulation within tumors while minimizing systemic exposure. The feasibility, safety, and effectiveness of the balloon occlusion technique have been verified. Recent studies have demonstrated that B-TACE achieves superior tumor response rates and potentially improves survival outcomes compared with conventional transarterial chemoembolization (C-TACE) techniques, particularly in cases with complex tumor vasculature or C-TACE-refractory disease. However, determining which patients would benefit from B-TACE requires comprehensive assessment. It remains to be determined in clinical practice whether this technique increases the risk of liver function impairment or is associated with specific complications. Further research is needed to better understand the technical conditions required for its clinical application, prognostic factors, and how it can be combined with other interventional techniques. This review summarizes the current literature on B-TACE, focusing on its technical principles, clinical efficacy, safety profile, and evolving role within the contemporary treatment landscape for advanced hepatocellular carcinoma, including its integration with systemic therapies.

Biliary atresia (BA) is a severe pediatric cholangiopathy characterized by rapidly progressive liver fibrosis. This study aimed to characterize scar-associated macrophages and investigate the role of PLG–PLGRKT signaling in BA-associated fibrogenesis.

Single-cell RNA sequencing and spatial transcriptomics were applied to liver tissues from patients with BA and non-BA controls. Key findings were validated in an independent cohort using quantitative polymerase chain reaction and multiplex immunohistochemistry. The functional role of the PLGRKT pathway was further examined using primary human peripheral blood mononuclear cell-derived macrophages with small interfering RNA (siRNA)-mediated PLGRKT knockdown, together with co-culture systems involving LX-2 hepatic stellate cells and human liver organoids. In vivo therapeutic potential was evaluated in a murine bile duct ligation model of cholestatic liver fibrosis using macrophage-targeted Plgrkt–Trem2 antibody–siRNA conjugates.

In BA, scar-associated macrophages (SAMs) increased with fibrosis progression and co-localized with hepatic stellate cells in fibrotic areas. PLGRKT was upregulated in BA liver tissue and increased during monocyte-to-macrophage differentiation. In primary human macrophages, plasminogen induced a PLGRKT-dependent pro-fibrotic phenotype, and conditioned medium from these cells increased COL1A1 deposition in hepatic stellate cells and human liver organoids. In vivo, macrophage-targeted Plgrkt–Trem2 antibody–siRNA conjugates reduced SAM accumulation and attenuated bile duct ligation-induced liver fibrosis.

These findings support a role for SAMs and the PLGRKT–SAM axis in BA-associated liver fibrosis and suggest that PLGRKT warrants further investigation as a potential macrophage-directed anti-fibrotic target.

Metabolic dysfunction-associated steatotic liver disease affects roughly 38% of adults, yet approved agents do not correct the upstream redox-metabolic perturbations—a depressed nicotinamide adenine dinucleotide (NAD+/NADH) ratio, saturated lipid excess, and endoplasmic reticulum (ER) stress—that drive hepatocyte injury. Cytochrome b5 reductase 3 (CYB5R3) couples NADH oxidation to fatty acid desaturation, nuclear factor erythroid 2-related factor 2 (NRF2)-linked antioxidant and cholesterol-handling pathways, NAD+/sirtuin signaling, and ER-phagy, and is the sole electron input to mitochondrial amidoxime-reducing component 1 (mARC1). This review grades every link in the axis across the steatosis–cirrhosis–hepatocellular carcinoma spectrum, reporting effect estimates with sample sizes and test statistics alongside a study-level appraisal of clinical relevance. The common MTARC1 p.A165T variant protects against all-cause cirrhosis (odds ratio, 0.91; 95% CI, 0.89–0.94; P = 2.3 × 10−11; 12,361 cases, 790,095 controls), with lower hepatic fat, liver enzyme levels, and low-density lipoprotein cholesterol levels. Germline mARC1 deletion reduces picrosirius red fibrosis area by 24–50% depending on diet, without altering histological disease activity, whereas partial protein reduction confers no protection. Critically, therapeutic hepatocyte-directed knockdown loses its anti-fibrotic effect when started at higher disease burden and in the choline-deficient model: efficacy depends on the depth, compartment, and timing of inhibition. Deep, hepatocyte-restricted mARC1 inhibition by GalNAc-conjugated oligonucleotides—which also avoids a male-predominant cardiac liability—is therefore the most credible near-term strategy, only in pre-cirrhotic F2–F3 disease. CYB5R3 activation, and its combination with mARC1 inhibition, remain unproven, and no clinical trial of this axis has been reported. Falsifiable in vivo and pharmacodynamic biomarker roadmaps are proposed, together with the efficacy, delivery, and safety uncertainties specific to advanced cirrhosis and a non-invasive pharmacodynamic framework.

Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high recurrence rate and a substantial long-term surveillance burden. However, current detection and surveillance strategies rely largely on invasive cystoscopy and urine cytology, which are limited by patient discomfort, suboptimal adherence, and insufficient sensitivity, particularly for low-grade disease. This mini review examines the role of liquid biopsy in the detection, risk stratification, and surveillance of NMIBC. It summarizes current evidence on circulating tumor DNA, circulating tumor cells, exosomes and extracellular vesicles, urinary tumor DNA, and DNA methylation and protein biomarkers in blood or urine. For detection, urine-based molecular assays complement cystoscopy and cytology in the noninvasive assessment of patients with suspected bladder cancer. For risk stratification, molecular detection of residual disease and longitudinal biomarker changes help identify patients at increased risk of recurrence or progression. During surveillance, urine-based assays support earlier recurrence detection and, in selected settings, help reduce the frequency of cystoscopy. Overall, liquid biopsy is a promising minimally invasive complement to conventional NMIBC management although technical standardization and prospective clinical validation are required before routine implementation.

Machine-learning approaches that combine predictive performance with model interpretability may improve lung cancer status classification. This study aimed to develop and internally evaluate an Explainable Precision Screening Framework for lung cancer risk classification using demographic, behavioral, and symptom-based variables from a publicly available dataset.

This retrospective cross-sectional study analyzed a publicly available Kaggle dataset containing 309 records, including 270 labeled as lung cancer and 39 as non-cancer. Six models—logistic regression, support vector machine (SVM), random forest, LightGBM, XGBoost, and a stacking ensemble—were compared using a stratified hold-out test set and repeated stratified five-fold cross-validation. Performance was assessed using classification metrics with bootstrap 95% confidence intervals (CIs). A separate Shapley additive explanations (SHAP) analysis was applied to the standalone SVM model for exploratory feature attribution.

Across all models, accuracy ranged from 85% to 92% (ROC-AUC: 0.93–0.95). The stacking ensemble achieved 0.92 accuracy (95% CI: 0.85–0.98), 0.94 sensitivity (95% CI: 0.88–1.00), 0.75 specificity (95% CI: 0.40–1.00), 0.96 precision (95% CI: 0.89–1.00), 0.95 F1 score (95% CI: 0.91–0.99), and 0.95 ROC-AUC (95% CI: 0.89–0.99). Its PR-AUC was 0.993 (95% CI: 0.981–0.999), and its Brier score was 0.074 (95% CI: 0.037–0.121). SHAP analysis identified smoking, yellow fingers, coughing, chest pain, wheezing, shortness of breath, and age as the features contributing most strongly to its predictions.

Within this public retrospective dataset, the stacking ensemble was among the highest-performing models, whereas separate SHAP analysis of the standalone SVM model identified the features contributing most strongly to its predictions. Given the marked class imbalance, the absence of a reported clinical reference standard for the source labels, the framework requires independent validation in clinically verified multicenter cohorts before clinical use.

Anal canal melanoma (ACM) is a rare, aggressive malignancy with an ominous prognosis. However, its associated factors are largely unknown. Therefore, we investigated potential independent associations of sex and self-reported race with ACM and physiological anal canal pigmentation.

Two case-control cohorts from a single institution in Miami, Florida, were evaluated. The biopsy cohort comprised 117 sequential patients evaluated prospectively for melanocytic cells/pigment and anal intraepithelial neoplasia (AIN)/squamous intraepithelial lesion (SIL) in anal transitional zone biopsies between January 2021 and August 2022. The melanoma cohort consisted of 28 patients diagnosed with ACM between January 2003 and August 2021 and 116 of the patients in the pigmentation cohort. Multivariable logistic regression analysis was conducted to examine independent factor associations.

In the biopsy cohort, anal transitional melanocytic cells/pigment were identified in 48% (26/54) of Black patients compared to 17% (10/59) of White patients. Multivariable analysis demonstrated that White race was inversely associated with mucosal pigmentation (odds ratio (OR) = 0.19, 95% confidence interval (CI): 0.08–0.48, P < 0.001). Conversely, White race was associated with ACM (OR = 6.25, 95% CI: 2.07–18.81, P = 0.001). Male sex was also inversely associated with ACM (OR = 0.18, 95% CI: 0.07–0.47, P < 0.001). No significant correlations were observed between mucosal pigmentation and AIN/SIL or human immunodeficiency virus status.

Anal transitional zone pigmentation is more prevalent in self-reported Black individuals but is not associated with neoplastic squamous cell precursors. White (versus Black) individuals and female (versus male) individuals both have a significant association with ACM.

Celiac disease remains underdiagnosed despite an established diagnostic pathway, reflecting phenotypic heterogeneity, delayed recognition, and dependence on resource-intensive testing. This narrative review synthesizes evidence on artificial intelligence and phenomics in celiac disease (CD) across four operational layers: electronic health record phenotyping, Human Phenotype Ontology-based semantic encoding, machine-learning pre-screening from routine clinical data, and deep-learning-assisted histopathology. A targeted literature search of PubMed/MEDLINE, Embase, and Google Scholar covered publications from January 2010 through December 2025, using combinations of CD/coeliac disease with artificial intelligence, machine learning, deep learning, phenomics, Human Phenotype Ontology, computable phenotype, electronic health records, and natural language processing, supplemented by targeted searches and citation chaining. We present a curated minimum viable CD phenome and discuss clinical actionability, age-specific considerations, and current pediatric validation gaps. Selected models have demonstrated promising CD detection or pre-screening performance in specific datasets, but prospective, multicenter evidence with external validation remains insufficient to establish clinical utility. Artificial intelligence should augment expert clinical care rather than replace it.

Eosinophilic esophagitis (EoE) is characterized by esophageal dysfunction and ≥15 eosinophils/high-power field on biopsy. The specific clinicopathologic characteristics and therapeutic outcomes of patients with concurrent gastric Helicobacter pylori infection and EoE remain poorly defined. This observational cohort study reexamines this relationship and evaluates the clinicopathologic features and outcomes of patients with concurrent diseases.

We retrospectively reviewed esophageal and gastric biopsies obtained between January 1, 2022, and December 30, 2025. Patients with a first-time diagnosis of EoE and concurrent treatment-naive gastric H. pylori infection were identified and confirmed by morphology and immunohistochemistry. Patients with a history of prior H. pylori eradication therapy or eosinophilic gastrointestinal disease were excluded. Clinical, pathologic, and follow-up data were analyzed.

Among 5,443 patients undergoing concurrent esophageal and gastric biopsy evaluation, 197 (3.6%, 95% confidence interval [CI], 3.1–4.1%) met the diagnostic criteria for EoE, and 286 (5.3%, 95% CI, 4.7–5.9%) had gastric H. pylori infection. Twenty-eight patients with concurrent EoE and gastric H. pylori infection were initially identified, corresponding to an H. pylori prevalence of 14.2% (28/197) among patients with EoE. A significant association was identified between EoE and H. pylori infection (odds ratio, 3.20; 95% CI, 2.11–4.87; Fisher’s exact test, P < 0.001). After exclusion of 1 patient with eosinophilic gastrointestinal disease and 3 patients with prior H. pylori treatment, 24 patients met the study inclusion criteria for the subsequent clinicopathologic analysis. Among these 24 patients (M:F = 7:1; mean age, 29.5 years; range, 8–82 years), 8 (33%) were children. The most common presentations (n = 18, 75%) were abdominal pain in children and dysphagia in adults. Atopy was present in 7 (29%) patients. Histologically, 5 (21%) cases exhibited classic features, while 19 (79%) showed nonclassic features with lower eosinophil density and a more uniform distribution of eosinophils within the epithelium. Among 10 patients with follow-up, 3/10 (30%) achieved resolution of both H. pylori infection and EoE after H. pylori eradication therapy with or without steroids; 5/10 (50%) had persistent H. pylori infection and persistent or recurrent EoE; 2(20%) achieved H. pylori-negative status but had persistent EoE; and fungal infection developed in 2 of 4 patients (50%) treated with steroids.

H. pylori infection may be associated with a nonclassic pattern of EoE. Recognition of this pattern may have implications for diagnosis and management.

Bilateral above-knee amputation stump ulcers with poor arterial inflow, multidrug-resistant infection, and bone involvement are rare and difficult to manage. We report a 52-year-old man who developed nonhealing bilateral stump ulcers more than one month after emergency bilateral amputation for extensive aortoiliac and lower-extremity arterial thrombosis. On admission on January 6, 2026, the right stump wound measured approximately 16.0 × 13.0 cm, with exposed femoral bone, purulent medullary drainage, and necrotic tissue; the left measured 18.0 × 12.0 cm, with slough and persistent exudation. Wound culture yielded carbapenem-resistant Klebsiella pneumoniae, and right femoral bone pathology supported chronic necrotizing osteomyelitis. Because immediate revascularization was not feasible, we used a staged debridement strategy—repeated selective debridement preserving viable tissue, with negative pressure wound therapy (NPWT) as a bridge between operations—combined with delayed stump repair, culture-guided antimicrobial therapy, anticoagulation, analgesia, vascular protection, and nutritional support. NPWT was applied in seven cycles over approximately 54 days. The wounds achieved complete closure by discharge on March 16, 2026. At follow-up on March 30, 2026, there was no exudation, sinus tract, recurrent dehiscence, exposed bone, recurrent infection, or significant stump pain, although prosthetic fitting was not yet possible. This case suggests that NPWT combined with serial staged debridement may offer short-term salvage for selected complex infected amputation stumps when arterial inflow is poor and one-stage closure is unsafe; however, durability and generalizability remain uncertain.