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Original Article Open Access
Rafael Torres-Valadez, Luis R. Mejia-Godoy, Eloy A. Zepeda-Carrillo, Georgina Castillo Castañeda, Paola González-Ibarra, Daniel Maldonado Felix
Published online July 30, 2025
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2024.00010
Abstract
The COVID-19 pandemic profoundly impacted university students, presenting multifaceted challenges including the abrupt transition to virtual learning and significant disruptions [...] Read more.

The COVID-19 pandemic profoundly impacted university students, presenting multifaceted challenges including the abrupt transition to virtual learning and significant disruptions to emotional well-being and dietary habits. This study aimed to investigate the dietary and nutritional characteristics associated with academic stress among Mexican university students during the COVID-19 lockdown.

This cross-sectional study was conducted with a sample of 114 university students in Mexico. Participants completed a self-reported questionnaire assessing dietary patterns, nutritional intake, and academic stress levels. Informed consent was obtained from all participants prior to data collection.

Among study participants (n = 114), 57.8% experienced moderate academic stress, while 25.7% reported high academic stress during the COVID-19 lockdown. Notably, 13.5% of students demonstrated food cravings that were significantly associated with increased consumption of red and fatty meats (P = 0.030) and sausages (P = 0.017). A negative virtual education experience was associated with food cravings towards high-calorie and saturated-fat foods (P = 0.014), as well as elevated academic stress levels (P = 0.009). Furthermore, high academic stress levels were positively associated with food cravings (P = 0.020), particularly towards carbohydrate-rich foods (P = 0.037).

The COVID-19 lockdown substantially disrupted the dietary habits and nutritional status of university students, with academic stress serving as a significant mediating factor.

Full article
Review Article Open Access
Sana Rabeeah, Priyata Dutta, Ahmad Mahdi, Alejandra Vargas, Edward C. Oldfield, David A. Johnson
Published online December 30, 2025
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Journal of Translational Gastroenterology. doi:10.14218/JTG.2025.00042
Abstract
Micro- and nanoplastics (MNPs) are plastic particles smaller than 5 mm and 1 µm, respectively, and are emerging environmental pollutants with growing implications for human health. [...] Read more.

Micro- and nanoplastics (MNPs) are plastic particles smaller than 5 mm and 1 µm, respectively, and are emerging environmental pollutants with growing implications for human health. These particles stem from either ‘primary sources’, such as intentionally manufactured microbeads and industrial abrasives, or ‘secondary sources’, where larger plastic items break down into smaller fragments over time. Human exposure primarily occurs through ingestion and inhalation, with contaminated seafood and plastic-laden food packaging representing key routes of entry. Once ingested, MNPs can cross the intestinal barrier, accumulate in gastrointestinal (GI) tissues, and trigger biological responses. Mechanistic studies reveal that MNPs induce oxidative stress, DNA damage, chronic inflammation, and endocrine disruption, all of which are hallmarks of carcinogenic pathways. They also alter gut microbiota, potentially promoting dysbiosis and immune dysregulation. The GI tract is particularly vulnerable to these effects due to direct luminal mucosal contact and high epithelial turnover. Epidemiological data remain limited, but early evidence supports a plausible link between MNPs exposure and GI malignancies. Such findings are particularly concerning given the increasing global incidence and early age presentation of colorectal and esophageal cancers. Given that MNPs may represent a modifiable environmental risk factor in GI cancer prevention, public health strategies must prioritize reducing plastic exposure, promoting antioxidant-rich diets, and improving environmental monitoring. This review explores the potential carcinogenic effects of microplastics while also examining their emerging roles in cancer therapeutics. It highlights critical avenues for future investigation and underscores the importance of cross-disciplinary efforts to tackle this growing global health concern.

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Opinion Open Access
Uriel S. Bulow, Eric P. Grewal
Published online September 28, 2025
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2025.00014
Original Article Open Access
Ellen S. Wagner, Kaitlyn Oliphant, Mark D’Souza, Wilfredo Cruz-Ayala, Ruba K. Azzam, Bree Andrews, Erika C. Claud
Published online November 5, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00152
Abstract
Parenteral nutrition (PN)-associated cholestasis (PNAC) is frequently diagnosed in premature infants; however, not all PN-exposed infants develop PNAC. We propose that, in premature [...] Read more.

Parenteral nutrition (PN)-associated cholestasis (PNAC) is frequently diagnosed in premature infants; however, not all PN-exposed infants develop PNAC. We propose that, in premature infants receiving PN and varying amounts of enteral feeds, differences in the gut microbiome and fecal bile acid content are associated with PNAC development. This study aimed to examine the fecal microbiome and bile acid content of premature infants on PN to determine if there is a relationship with the development of PNAC.

Twenty-two preterm infants had serial bilirubin measurements and fecal samples collected during their neonatal intensive care unit admission. Fecal samples underwent 16S rRNA gene sequencing and bile acid analysis. Binomial regression, adjusting for postmenstrual age with feed amount as a moderator, was used to assess the impact of the fecal microbiome and bile acids on PNAC development.

Cholestatic patients (n = 11) had greater PN and antibiotic exposure (p = 0.020; p = 0.010) and longer neonatal intensive care unit stays (p = 0.0038) than non-cholestatic patients. Microbiome richness was higher in non-cholestatic infants (p < 2E-16), with no difference in β diversity (p = 1.0). Cholestatic infants had a significantly higher abundance of Proteobacteria and Fusobacteriota and a lower abundance of Bacteroidota (p < 2E-16). Akkermansia was abundant in all infants on low feeds; as feed volume increased, Akkermansia abundance significantly increased in non-cholestatic infants (p < 2E-16). Bile acid analysis demonstrated significantly lower deoxycholic acid concentrations in cholestatic infants (p < 2E-16). Metagenomic analysis revealed an increase in Proteobacteria requiring augmented stress responses in non-cholestatic infants.

This is the first study to directly explore the relationship between PNAC susceptibility, the microbiome, and fecal bile acids in preterm infants. The microbiome and bile acid patterns identified here may inform the development of targeted therapeutics for this vulnerable population.

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Original Article Open Access
Himat Ali Memon, Fazul Rahman, Abdul-Rehman Phull, Marvi Shaikh, Sadia Qamar Arain, Shamim Bhatti
Published online January 8, 2026
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00033
Abstract
Chronic diabetes mellitus is marked by hyperglycemia and metabolic dysfunction, increasing the risk of complications such as nephropathy. This study aimed to evaluate key biochemical [...] Read more.

Chronic diabetes mellitus is marked by hyperglycemia and metabolic dysfunction, increasing the risk of complications such as nephropathy. This study aimed to evaluate key biochemical parameters among participants with diabetic nephropathy (DNp), diabetes control (DC), nephropathy control (NC), and healthy control groups.

A prospective case-control study was conducted with 200 participants categorized into four groups: DNp, NC, DC, and healthy controls. Biochemical parameters, including glucose, glycated hemoglobin, waste metabolites, proteins, enzymes, electrolytes, and lipids, were analyzed using an Advia 1800 chemical system analyzer (Siemens, Germany) with standard kits.

Among the four investigated groups, the DNp group exhibited augmented fasting glucose (178.75 ± 61 mg/dL), glycated hemoglobin (8.13 ± 1.7%), creatinine (5.67 ± 1.8 mg/dL), and blood urea nitrogen (72.02 ± 22.8 mg/dL), indicating poor glycemic control and impaired kidney function. In contrast, the DC group showed elevated random glucose levels (280 ± 3.1 mg/dL). Elevated inflammatory markers (C-reactive protein, 6.35 ± 6.3 mg/L; lactate dehydrogenase, 1,216.43 ± 634 U/L) were observed in the NC group. Compared to the other groups, the DC group demonstrated augmented lipid profiles, including elevated triglycerides (230.67 ± 59 mg/dL), very low-density lipoprotein (48.5 ± 16.5 mg/dL), low-density lipoprotein (107.41 ± 16 mg/dL), and cholesterol (169 ± 19 mg/dL). Statistical analysis was performed using one-way analysis of variance followed by a t-test to investigate differences among groups at P < 0.05.

Altered biochemical variations were noted among groups. The DNp group showed renal dysfunction and poor glycemic control, the DC group had dyslipidemia and hyperglycemia, and the NC group showed elevated inflammatory markers. Early testing is indispensable for the timely diagnosis and management of diabetic complications.

Full article
Original Article Open Access
Swati Bhardwaj, Shenyu Wang, Yuxin Liu
Published online December 19, 2025
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2025.00013
Abstract
Endometrial polyp (EMP) is one of the most common diagnoses in the evaluation of women with abnormal uterine bleeding. Understanding the malignancy risk associated with EMPs and [...] Read more.

Endometrial polyp (EMP) is one of the most common diagnoses in the evaluation of women with abnormal uterine bleeding. Understanding the malignancy risk associated with EMPs and related risk factors is essential for guiding both pathology practice and clinical management. This study aimed to explore risk factors for malignancy in EMPs.

The pathology database was searched for women diagnosed with EMP between 2021 and 2022. Patient age, polyp size, background endometrium, recurrence, and (if applicable) cancer types were recorded. Immunohistochemistry (IHC) for p53 and p16 was performed on selected cases. Risk factors for malignancy were analyzed using Chi-square and analysis of variance tests.

Among the 740 EMP cases analyzed, 94% were benign, 2% were premalignant, and 4% were malignant. The median patient age was 54 years (range: 19–92). Minimal serous carcinoma (n = 14, 2%) was the most prevalent cancer. Among the 52 cases with p53 IHC, 38 were diagnosed as benign, supported by a wild-type p53 pattern, while 14 were diagnosed as serous carcinoma, supported by a mutant p53 pattern. Malignant polyps were found to be significantly associated with advanced age and malignant background endometrium (p < 0.001). Large size and recurrence were not identified as significant risk factors.

EMPs carry a low risk of malignancy, which is not significantly influenced by the polyp’s size or its recurrence. Our findings highlight the significantly elevated risk of malignancy in elderly patients and the importance of p53 IHC in improving diagnostic accuracy.

Full article
Review Article Open Access
Bani Bandana Ganguly, Nitin N. Kadam
Published online December 18, 2025
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Gene Expression. doi:10.14218/GE.2025.00051
Abstract
Full or partial trisomy of human chromosome 21 results in dysregulation of gene expression, leading to the manifestation of specific phenotypes described in individuals with Down [...] Read more.

Full or partial trisomy of human chromosome 21 results in dysregulation of gene expression, leading to the manifestation of specific phenotypes described in individuals with Down syndrome (DS). Defects in brain development, coupled with impairment in neurogenesis, are ultimately expressed as cognitive deficiency, Alzheimer disease (AD), and dementia. Amid the triplication of all human chromosome 21 (HSA21) genes, dual-specificity tyrosine phosphorylation-regulated kinase 1A (DYRK1A)-mediated neurogenesis and dendritic development have been attributed to the learning and memory deficits and cognitive impairment in the DS population. Upregulated DYRK1A perturbs the development and function of the brain, collectively affecting neurogenesis, synaptogenesis, synaptic transmission, and cell signaling pathways, which might disproportionately produce inhibitory neurotransmission and contribute to the cognitive phenotype. However, the lack of distinct gene-phenotype associations acts as a potential barrier to therapeutic improvement of cognitive performance and amelioration of AD-related neurodegeneration. The present review aims to summarize the neurogenetic consequences of triplicated DYRK1A in the DS population in relation to sexual dimorphism and expression of the Apolipoprotein Eε4 (APOE ε4) genotype. Notably, normalization of trisomic DYRK1A demonstrated improved synaptic plasticity, glutamatergic/GABAergic (excitatory/inhibitory) balance, and learning and memory in DS mouse models. Therapeutic approaches using inhibitors of DYRK1A, including catechins present in green tea extract and several other natural and synthetic agents, produced variable outcomes in cognitive improvement, depending on age and dose of administration. Mitigation of impairment in neurogenetic differentiation and cognitive performance might help control AD-related dementia and enhance quality of life. This review highlights the consequences of upregulated DYRK1A kinase on impairment of neurogenesis and cognitive deficits, and the therapeutic challenges associated with DYRK1A inhibitors for ameliorating dysregulated gene expression in DS models and human DS.

Full article
Review Article Open Access
Jie Yang, Qing Liu, Chao Sun
Published online October 28, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00383
Abstract
Myosteatosis is associated with poor outcomes in various liver diseases. However, standardized methods for assessing, defining, and diagnosing myosteatosis in the context of liver [...] Read more.

Myosteatosis is associated with poor outcomes in various liver diseases. However, standardized methods for assessing, defining, and diagnosing myosteatosis in the context of liver diseases remain unclear. Furthermore, the underlying mechanisms by which myosteatosis leads to pathophysiological progression and adverse health outcomes remain elusive. Therefore, in this review, we elaborate on the currently available measures, definitions, and diagnostic criteria of myosteatosis in the existing literature. We thoroughly clarify the recent evidence and data regarding the possible involvement of myosteatosis in the progression and deterioration of various liver diseases and resulting complications, including liver cirrhosis, chronic viral hepatitis, non-alcoholic/metabolic-associated fatty liver disease, primary sclerosing cholangitis, liver transplantation, and hepatocellular carcinoma. Additionally, it synthesizes insights from basic research on the pathogenesis of myosteatosis, which involves multifactorial mechanisms, including insulin resistance, mitochondrial dysfunction, and chronic inflammation. Finally, from an operational and pragmatic perspective, several regimens, including physical, nutritional, and pharmacological therapies, have been discussed as potential treatments for myosteatosis.

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Review Article Open Access
George Y. Wu
Published online February 4, 2026
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00090
Abstract
Congenital portosystemic shunts (CPSS) are rare vascular anomalies characterized by abnormal communication between the portal and systemic venous systems, resulting in partial or [...] Read more.

Congenital portosystemic shunts (CPSS) are rare vascular anomalies characterized by abnormal communication between the portal and systemic venous systems, resulting in partial or complete diversion of portal blood away from the liver. These shunts can give rise to a broad spectrum of clinical manifestations, including hyperammonemia (with or without encephalopathy), hepatopulmonary syndrome, and portopulmonary hypertension. Notably, these complications often occur in the absence of portal hypertension. Advances in diagnostic imaging, particularly Doppler ultrasound, computed tomographic angiography, and magnetic resonance imaging, have enhanced the early detection and classification of CPSS. Treatment approaches vary depending on shunt type and clinical severity and may include interventional closure via embolization or surgical ligation. Most persistent or symptomatic shunts require immediate intervention. Recent studies have also identified potential genetic and embryological mechanisms contributing to CPSS development, offering new insights into their pathogenesis. This review aims to summarize current knowledge on the epidemiology, pathophysiology, clinical presentation, diagnostic evaluation, and management of CPSS, and to highlight their consideration in patients with hepatic encephalopathy or unexplained liver disease.

Full article
Review Article Open Access
Richard Phillips, Yuk Ting Ma, Wasim Hanif, Tahir Shah, Shivan Sivakumar
Published online October 22, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00303
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most common chronic liver disease in the Western world, driven by obesity, insulin resistance, and systemic [...] Read more.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most common chronic liver disease in the Western world, driven by obesity, insulin resistance, and systemic inflammation. Its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), can culminate in cirrhosis and hepatocellular carcinoma (HCC). While lifestyle modification remains central to MASLD management, there is growing interest in pharmacological interventions, particularly nutrient-stimulated hormone-based therapies (NuSHs), such as GLP-1 receptor agonists. NuSHs exert metabolic and anti-inflammatory effects primarily via weight loss and improved insulin sensitivity. Emerging clinical data support their efficacy in resolving MASH without worsening fibrosis. However, benefits in cirrhotic patients are less evident, suggesting greater utility in early intervention. Observational studies and clinical trials suggest a reduction in liver-related morbidity with GLP-1 receptor agonist use, though fibrosis regression remains inconsistent. Preclinical models indicate that NuSHs may also reduce MASH-related HCC incidence and tumor burden, likely through systemic metabolic improvements rather than direct antineoplastic action. Observational human data following bariatric surgery reinforce this link, suggesting that weight loss itself plays a key preventive role. Herein, we propose that NuSHs are promising candidates for MASH-related HCC prevention. We provide mechanistic suggestions for how this may occur. Furthermore, incorporating NuSHs into the post-locoregional treatment pathway for HCC may delay the need for systemic anti-cancer therapies, improve immunotherapy synergy and transplant eligibility, and even slow disease progression through reversal of carcinogenic drivers. Future studies are needed to target oncological endpoints and clarify immunometabolic mechanisms to guide the integration of NuSHs into MASLD treatment algorithms.

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