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Original Article Open Access
Wenjing Ni, Jie Li, Xue Bai, Sisi Zhou, Xiangyu Wu, Leyao Jia, Zhuoru Jiang, Jiali Wu, Ming Li, Connie Wong, Chao Wu, Junping Shi, Mindie H. Nguyen
Published online July 20, 2026
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00596
Abstract
Randomized controlled trials (RCTs) have been conducted to evaluate treatment efficacy for metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated [...] Read more.

Randomized controlled trials (RCTs) have been conducted to evaluate treatment efficacy for metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis. This study aimed to compare the effectiveness and safety of 11 promising targets among adults with MASLD.

PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, Scopus, and Embase were searched from inception to November 20, 2024. The primary outcomes were fibrosis improvement ≥1 stage without worsening of steatohepatitis and steatohepatitis resolution without worsening of fibrosis. Additional outcomes included reductions in liver fat content, liver enzymes, metabolic profiles, and selected safety outcomes. The surface under the cumulative ranking curve (SUCRA) was used to rank efficacy.

Of 11,584 articles screened, 44 eligible RCTs (11,410 participants, 33 medications) were included. For fibrosis improvement, d-(R)-pioglitazone (SUCRA: 79.3) and fibroblast growth factor (FGF) 21 analogs (SUCRA: 71.9) ranked higher. For steatohepatitis resolution, glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic polypeptide (GIP) dual receptor agonists (RAs) (SUCRA: 91.7) ranked higher. Co-agonists of GLP-1/GIP/GCG and GLP-1/GCG receptors ranked higher for relative and absolute changes in liver fat content, respectively. For liver enzymes and glucose improvement, the combination of a GLP-1 RA and an acetyl-coenzyme A carboxylase inhibitor ranked higher. GLP-1 RAs, peroxisome proliferator-activated RAs, and FGF21 analogs showed favorable effects on lipid profile improvement.

Incretin-based co-agonists and FGF21 analogs showed favorable profiles across key endpoints, while d-(R)-pioglitazone and GLP-1/GIP dual RAs ranked higher for fibrosis improvement and steatohepatitis resolution, respectively. SUCRA rankings should be interpreted in conjunction with effect sizes, uncertainty, and available safety data.

Full article
Review Article Open Access
Zhaoyang Liu, Derong Yang, Irina V. Smirnova, Wen Liu
Published online June 30, 2026
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Future Integrative Medicine. doi:10.14218/FIM.2026.00012
Abstract
Non-motor symptoms of Parkinson’s disease, including sleep disturbance, cognitive impairment, depression, and anxiety, are common and often undertreated, yet their responsiveness [...] Read more.

Non-motor symptoms of Parkinson’s disease, including sleep disturbance, cognitive impairment, depression, and anxiety, are common and often undertreated, yet their responsiveness to mind-body exercises remains unclear. This scoping review evaluated the currently available evidence on the effects of Tai Chi and Qigong interventions on non-motor symptoms in patients with Parkinson’s disease.

We searched six databases (PubMed, Google Scholar, EMBASE, CINAHL, Web of Science, and PEDro) through February 28, 2026, for randomized controlled trials (RCTs). We included English-language RCTs that evaluated the effects of Qigong and Tai Chi interventions on non-motor outcomes in Parkinson’s disease and excluded non-RCTs, review articles, and protocol articles. We were predominantly interested in the following non-motor outcome measures: cognition, depression, anxiety, fatigue, and sleep quality.

This review identified 18 RCTs that met the inclusion criteria, including nine Tai Chi studies and nine Qigong studies. Most of the reviewed studies were of high quality according to the PEDro scale, but the small sample sizes limited our analysis to identifying trends in outcomes. A strong trend toward a beneficial effect was found for sleep quality and cognition, a moderate trend toward improvement was found in depression, anxiety and quality of life, and weak or unclear effects were found for other non-motor symptoms such as fatigue. Several studies also had high dropout rates.

Although these studies suggest that Tai Chi and Qigong may improve sleep quality and cognition, the evidence supporting their benefits in alleviating other non-motor symptoms is generally weak, primarily because of small sample sizes. The heterogeneity in methodologies across the reviewed studies and high dropout rates in some studies are significant limitations of previous RCTs.

Full article
Editorial Open Access
Lanjing Zhang
Published online June 11, 2026
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Future Integrative Medicine. doi:10.14218/FIM.2026.00011
Review Article Open Access
Zhi-Feng Wei, He Qin, Shui-Juan Lu, Ping Ruan, Ze-Chao Zhang, Min Zhu
Published online June 29, 2026
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Oncology Advances. doi:10.14218/OnA.2026.00004
Abstract
Cervical cancer is a major malignancy that threatens women’s health, and early screening is a core strategy for reducing its incidence and mortality. Multimodal fusion artificial [...] Read more.

Cervical cancer is a major malignancy that threatens women’s health, and early screening is a core strategy for reducing its incidence and mortality. Multimodal fusion artificial intelligence (AI) pathological diagnosis models integrate multidimensional data—including cytological images, colposcopic images, whole-slide histopathological images, clinical data, and molecular testing results—and may enhance the detection sensitivity, grading accuracy, and screening efficiency for early cervical cancer and precancerous lesions. However, traditional cervical cancer screening methods face limitations such as high subjectivity, reliance on single-source information, relatively low efficiency, and insufficient primary care resources. Furthermore, existing reviews mostly focus on single-modal AI models or specific technical aspects, lacking a comprehensive analysis of the full technical framework and clinical translation pathways of multimodal fusion models. This review aims to comprehensively present the development and application of multimodal fusion AI models in pathological diagnosis for early cervical cancer screening. Specifically, it comprehensively details the technical architecture, data modalities, and fusion strategies—including deep learning, attention mechanisms, and cross-modal alignment techniques—that enable the complementary representation of morphological, clinical, and molecular information. Additionally, the review integrates recent advances in clinical applications and evaluates current translational challenges, providing insights into clinical validation pathways to bridge technological innovation and practical healthcare delivery. In conclusion, with further technological refinement and clinical validation, multimodal fusion AI may become a useful tool for improving the precision and efficiency of cervical cancer screening and prevention, and may inform the standardized application and translational research of AI technology in this field.

Full article
Original Article Open Access
Yali Wan, Lingya Chen, Tian Deng, Wenfang Xie, Pei Wang, Ling Xu, Hongliang Zou, Hengtao Lu, Bing Li, Yuxin Zhan
Published online June 29, 2026
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Neurosurgical Subspecialties. doi:10.14218/NSSS.2026.00009
Abstract
Post-stroke dysphagia management research has primarily focused on screening, assessment, and intervention strategies, with limited objective indicators for evaluating nursing care [...] Read more.

Post-stroke dysphagia management research has primarily focused on screening, assessment, and intervention strategies, with limited objective indicators for evaluating nursing care quality. This study aimed to develop a dysphagia nursing quality evaluation index system for neurosurgical inpatients with stroke.

Using the “structure-process-outcome” three-dimensional quality model as the theoretical framework, a preliminary quality evaluation index system was constructed through literature analysis and group discussion. A two-round Delphi expert consultation was conducted among 25 purposively selected clinical experts from tertiary Class A hospitals, with inclusion criteria requiring a bachelor’s degree or higher, an intermediate professional title or above, and at least 10 years of clinical experience in stroke nursing or related fields. The analytic hierarchy process was used to determine indicator weights. Outcome measures included expert authority coefficients (Cr), Kendall’s W concordance coefficient, internal consistency reliability (Cronbach’s α), and the final indicator structure.

The Cr values were 0.87 and 0.88 across the two rounds. Kendall’s W concordance coefficient increased from 0.207 to 0.235 (P < 0.001), indicating statistically significant expert agreement. The final index system comprised 3 first-level indicators, 11 second-level indicators, and 44 third-level indicators, with all indicator definitions and weights determined. The overall Cronbach’s α was 0.86, indicating preliminary internal consistency.

This study developed a dysphagia nursing quality evaluation index system for neurosurgical inpatients with stroke using the three-dimensional quality model and the Delphi method. The system showed acceptable expert authority, statistically significant expert agreement, and preliminary internal consistency, suggesting potential applicability for nursing quality monitoring in neurosurgical wards and Neurosurgery Intensive Care Units. Further clinical validation is needed before routine implementation.

Full article
Review Article Open Access
Ankita Dhara, Silpa Gangopadhyay, Soumen Bhattacharjee
Published online August 10, 2026
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Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2026.00006
Abstract
Bioactive peptides encrypted within food proteins and released by enzymatic hydrolysis or gastrointestinal digestion represent potential functional ingredients. Amaranth is an underutilized [...] Read more.

Bioactive peptides encrypted within food proteins and released by enzymatic hydrolysis or gastrointestinal digestion represent potential functional ingredients. Amaranth is an underutilized pseudocereal with a balanced amino acid profile and a protein composition that may yield peptides with diverse biological activities. However, translation of amaranth-derived peptides remains limited by low or uncertain bioavailability, variable yields, extraction and purification challenges, incomplete sequence identification, insufficient genotype screening, limited understanding of structure-activity relationships, and scarce in vivo and clinical validation. This review summarizes current evidence on the production, characterization, and pharmacological potential of amaranth-derived bioactive peptides. Enzymatic hydrolysis, fermentation, gastrointestinal digestion, and protein engineering have generated peptide fractions or sequences with antioxidant, antimicrobial, angiotensin-converting enzyme-inhibitory, dipeptidyl peptidase IV-inhibitory, hypocholesterolemic, anti-inflammatory, antithrombotic, and anticancer activities, primarily in in silico, biochemical, cell-based, and animal models. Analytical workflows involving chromatographic separation, mass spectrometry, and bioinformatic prediction have improved peptide discovery, but results remain difficult to compare because processing conditions and activity assays are not standardized. Available evidence suggests that amaranth proteins are promising sources of multifunctional peptides; nevertheless, these findings do not yet establish clinical efficacy. Future work should optimize extraction and identification methods, clarify sequence-structure-activity relationships, evaluate stability and intestinal absorption, compare genotypes and non-seed tissues, and conduct well-designed in vivo studies, safety assessments, and clinical trials. Scalable processing and formulation strategies will also be required before amaranth-derived peptides can be developed as reliable functional food, nutraceutical, or pharmaceutical ingredients.

Full article
Original Article Open Access
Xiaotian Yang, Hai Li, Yan Huang, Guohong Deng, Beiling Li, Xianbo Wang, Zhongji Meng, Yubao Zheng, Yanhang Gao, Zhiping Qian, Feng Liu, Xiaobo Lu, Yu Shi, Jia Shang, Jing Liu, Hang Jia, Sumeng Li, Lining Guo, Xin Zheng
Published online August 3, 2026
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2026.00384
Abstract
Bacterial infection is a key cause of mortality in patients with acute-on-chronic liver failure (ACLF). In this study, we aimed to identify metabolite biomarkers and develop a novel [...] Read more.

Bacterial infection is a key cause of mortality in patients with acute-on-chronic liver failure (ACLF). In this study, we aimed to identify metabolite biomarkers and develop a novel machine learning model for early identification of bacterial infection in ACLF.

Based on a prospective multicenter cohort from 14 centers, 1,314 patients with acute-on-chronic liver disease were enrolled, including those with ACLF and non-ACLF. Plasma samples at admission were collected for metabolomics profiling. Patients were randomly divided into discovery (n = 921) and validation (n = 393) sets. Machine learning was used to develop diagnostic models. The win ratio method was employed to assess the risk stratification capability of the models.

Bacterial infection occurred in 198 of the 451 ACLF patients and 132 of the 863 non-ACLF patients. Infection altered the plasma metabolome, especially in lipid, amino acid, and xenobiotic metabolic pathways. Models for bacterial infection in ACLF (five metabolites) and non-ACLF (six metabolites) demonstrated superior discrimination in the discovery (AUCs: 0.881 and 0.935, respectively) and validation sets (AUCs: 0.835 and 0.889, respectively) compared with C-reactive protein, white blood cell count, procalcitonin, and the best composite clinical model. Metabolic risk stratification based on the models effectively predicted 90-day outcomes (all-cause death, organ failure, sepsis, new-onset acute decompensation, and systemic inflammatory response syndrome).

Our models based on novel metabolic biomarkers enable identification of patients at high risk of bacterial infection and support risk stratification of 90-day outcomes.

Full article
Original Article Open Access
Tianyang Guo, Hui Zhou, Lili Zhang, Rong Chen
Published online July 27, 2026
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2026.00013
Abstract
Observational studies indicate frequent associations between systemic lupus erythematosus (SLE) and various hematologic disorders, yet causal inferences are limited by confounding [...] Read more.

Observational studies indicate frequent associations between systemic lupus erythematosus (SLE) and various hematologic disorders, yet causal inferences are limited by confounding and reverse causality. We therefore applied a bidirectional Mendelian randomization (MR) design to assess potential genetic causal associations of SLE with specific hematologic conditions.

We used European-ancestry GWAS summary statistics for SLE (5,201 cases, 9,066 controls) and five hematologic outcomes (vitamin B12 deficiency anemia (B12DA), myelodysplastic syndrome (MDS), immune thrombocytopenia (ITP), agranulocytosis (AGC), iron deficiency anemia (IDA)) from FinnGen. The primary analysis used inverse-variance weighting, supplemented by MR-Egger and weighted median methods, with comprehensive sensitivity analyses, including heterogeneity tests, pleiotropy assessment, and leave-one-out analysis.

Bidirectional MR analysis revealed that genetically predicted SLE increased the risk of B12DA (odds ratio (OR) = 1.08, P < 0.001), and genetically predicted B12DA was associated with an increased risk of SLE (OR = 2.22, P = 1.6 × 10−29). The MDS → SLE association was nominally significant (P = 0.023) but did not survive Bonferroni correction (P < 0.005) and was inconsistent across MR methods. No significant genetic associations were found between SLE and ITP, AGC, or IDA in either direction (all P > 0.005).

This bidirectional MR study provides genetic evidence that SLE increases the risk of B12DA, whereas the reverse direction (B12DA → SLE) should be interpreted cautiously because it was based on only five instruments and was not supported by the Steiger directionality test. No robust genetic associations were found for ITP, AGC, IDA, or MDS. Clinically, monitoring B12DA in SLE patients may be warranted, although screening recommendations await prospective validation.

Full article
Opinion Open Access
Murat Kilic, Mehmet Akif Buyukbese
Published online July 21, 2026
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2026.00019
Review Article Open Access
Amancio Carnero
Published online July 29, 2026
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Gene Expression. doi:10.14218/GE.2026.00011
Abstract
High-throughput transcriptomic technologies have made differential gene expression analysis a cornerstone of cancer research by generating extensive lists of differentially expressed [...] Read more.

High-throughput transcriptomic technologies have made differential gene expression analysis a cornerstone of cancer research by generating extensive lists of differentially expressed genes across tumor types and conditions. However, such lists provide limited biological insight without functional and mechanistic interpretation. This review examines the transition from descriptive gene expression profiles to a mechanistic understanding of cancer biology. We discuss integrative approaches that place expression changes within signaling pathways, transcriptional regulatory networks, and protein–protein interaction networks, thereby helping to identify functional modules and candidate upstream regulators. We emphasize the context-dependent nature of gene expression, which is shaped by genetic alterations, epigenetic landscapes, microenvironmental signals, and cellular heterogeneity. We also examine methodological advances, including gene set enrichment analysis, network-based modeling, and integration of genomic, epigenomic, proteomic, metabolomic, and single-cell transcriptomic data. Case studies across cancer types illustrate how mechanistic analyses can reveal context-specific transcriptional programs associated with oncogenic signaling, tumor suppression, metabolic reprogramming, epithelial–mesenchymal transition, and tumor–immune interactions. We highlight potential translational applications, including candidate biomarker discovery, prioritization of druggable targets, rational design of combination therapies, and investigation of therapeutic resistance. Finally, we discuss current challenges and emerging technologies, such as spatial transcriptomics and clustered regularly interspaced short palindromic repeats (CRISPR)-based perturbation screens, that are advancing the field toward dynamic, systems-level models of tumor biology. Integrating computational analyses with experimental validation can help translate transcriptomic data into clinically relevant hypotheses for precision oncology and personalized cancer therapy.

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