Frontiers in Medicine最新文献

{"title":"Acute effect of whole-body vibration on hand grip strength, muscular activity, and upper limb function in young females with smartphone addiction: a randomized controlled trial.","authors":"Nesma M Allam, Ruyuf Abdullah Alkhaldi, Wadha Zaben Alshammari, Mohamed El-Dosoky Mohamed Salama, Sally Yussef Abed, Khalid M Ibraheem, Hasnaa Ali Ebrahim, Mohamed El-Sherbiny, Hadeel Essam Salem, Mohamed Mahmoud Abdelfattah Abdelrahman, Hadaya Mosaad Eladl","doi":"10.3389/fmed.2026.1800879","DOIUrl":"https://doi.org/10.3389/fmed.2026.1800879","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of whole-body vibration (WBV) on hand grip strength, muscular activity, and upper limb function in young females with smartphone addiction.</p><p><strong>Materials and methods: </strong>This is a single-blinded randomized controlled trial. 66 females aged 18-25 years with smartphone addiction were randomly distributed into two equal groups; WBV group: It received WBV with strengthening exercises, and Sham WBV group: that received Sham WBV plus strengthening exercises. All participants received two sessions per week for four consecutive weeks. The primary outcome was hand grip strength. Secondary outcomes included pinch strength, muscle activity, and upper limb function. Evaluation was performed at baseline and after 4 weeks.</p><p><strong>Results: </strong>Post-treatment, there were significantly greater improvement in all variables with more favor to WBV group (<i>p</i> < 0.001) compared to the Sham WBV group. Mean differences (95% CI) between both groups were 9.48 [7.07, 11.88] for hand grip strength, which is the primary outcome.</p><p><strong>Conclusion: </strong>WBV combined with hand strengthening exercises might have a positive effect in enhancing hand grip strength, pinch strength, muscle activity, and upper limb function among young females with smartphone addiction. WBV could be a valuable adjunct to traditional rehabilitation programs targeting musculoskeletal effects of smartphone overuse.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier: NCT06849687.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1800879"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution and economic evaluation of fecal incontinence management in United States intensive care units: from historical containment to automated diversion.","authors":"Deanna Vargo, Kristin Grimes, Kiara Tickoo","doi":"10.3389/fmed.2026.1761399","DOIUrl":"https://doi.org/10.3389/fmed.2026.1761399","url":null,"abstract":"<p><p>Fecal incontinence (FI) poses a significant clinical and economic challenge in the U.S. intensive care units (ICUs), affecting 9-40% of patients and contributing to billions of dollars in healthcare costs mainly towards complications such as incontinence-associated dermatitis (IAD), hospital-acquired pressure injuries (HAPI), and Clostridioides difficile infection (CDI). This review traces the evolution of FI management from rudimentary containment methods to the newest innovative Qoramatic Automated Stool Management (ASM) system with no balloon and zero radial pressure. We compared Qoramatic ASM to traditional absorbent pads and indwelling balloon catheters (IBCs) across four patients' subgroups Results demonstrate that Qoramatic ASM reduces per-patient care costs by 80-94.5% ($242-$1,344 vs. $1,215-$24,615 for pads/IBCs), decreases nursing time 91-96% (6-14 vs. 66-348 min/day), and nearly eliminates leakage and device-related injuries. ASM also reduces HAPI and CDI incidence, shortening hospital stays by up to 30%. Qoramatic's improved clinical outcomes, enhanced patient dignity, and reduced staff burden positioning it is a transformative solution for FI management in ICUs, warranting broader global adoption.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1761399"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-driven multi-omics integration of urinary organic acids and ions enables precision risk stratification for calcium oxalate nephrolithiasis.","authors":"Peizhi Zhang, Yang Liu, Boxing Su, Yingkun Xu, Zheng Xu, Tianxiang Zhang, Yuxian Wang, Jiangtao Yang, Yawei Liu, Jianxing Li","doi":"10.3389/fmed.2026.1808076","DOIUrl":"https://doi.org/10.3389/fmed.2026.1808076","url":null,"abstract":"<p><strong>Background: </strong>Calcium oxalate (CaOx) nephrolithiasis is closely associated with metabolic dysregulation, while current risk assessment based on 24-h urine analysis is time-consuming and inconvenient. This study aimed to develop a noninvasive predictive model for CaOx stones using morning urine organic acid and inorganic ion profiles combined with machine learning, and to identify metabolomic biomarkers related to CaOx stone formation.</p><p><strong>Methods: </strong>A total of 232 CaOx stone formers and 238 healthy controls were enrolled. Organic acids and inorganic ions in morning urine were quantified by gas chromatography-mass spectrometry and ion chromatography, respectively. Participants were randomly divided into training and testing sets (8:2). Diagnostic models were constructed using random forest, support vector machine, logistic regression, and extreme gradient boosting, with 10-fold cross-validation for optimization. Model performance was evaluated using AUC, accuracy, sensitivity, specificity, F1-score, and G-mean. Differential metabolite screening based on <i>p</i>-values and fold change, together with SHAP-based feature prioritization across multiple machine learning models, was integrated to identify candidate metabolites. The selected metabolites, together with BMI, were then incorporated into a multivariable logistic regression model to construct a nomogram.</p><p><strong>Results: </strong>No significant differences in age or sex were observed between groups, whereas BMI was higher in the CaOx group (<i>p</i> < 0.05). Twenty differential metabolites were identified (|log₂FC| > log₂ [1.5], p_adj < 0.05). SHAP analysis consistently highlighted seven metabolites across algorithms. Integration of differential and SHAP-based selection yielded five key metabolites, which, combined with BMI, produced a model with an AUC of 0.8439 (95% CI: 0.8071-0.8806), outperforming any single indicator.</p><p><strong>Conclusion: </strong>This study integrates morning urine organic acid and inorganic ion profiling with machine learning to establish a predictive model for CaOx nephrolithiasis. Five urinary metabolites were identified as potential biomarkers, providing a convenient tool for risk assessment and new insights into CaOx stone pathogenesis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1808076"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative research on technology-assisted physical activity and biological aging: a review of wearable sensors, tele-exercise platforms, and aging biomarkers.","authors":"Hongwei Zhang, Hongchao Zhang, Heming Chen, Junjie Liu","doi":"10.3389/fmed.2026.1778386","DOIUrl":"https://doi.org/10.3389/fmed.2026.1778386","url":null,"abstract":"<p><p>As global populations age rapidly, extending healthy lifespan has become a major public health priority. Physical exercise is widely recognized as a key strategy to slow functional decline and promote healthy aging, but its effectiveness and optimal prescription likely vary across individuals and should be evaluated using objective technologies and validated biomarkers. This review summarizes recent developments in technology-assisted physical activity and examines how wearable sensors, tele-exercise platforms, and digital health applications can improve adherence and enable individualized interventions for older adults. It also discusses how biological aging biomarkersons for oldepigenetic clocks, senescence-associated secretory phenotype (SASP) markers, and organ-specific plasma proteomicss, and organsto quantify exercise-related changes in biological aging and support mechanistic interpretation. This review discusses current translational challenges and future research directions, and proposes a biomarker-informed precision exercise anti-aging framework to support healthy aging through innovative technology-assisted physical activity interventions. Specifically, we ask: (i) which technology modalities and intervention components most effectively support sustained, individualized physical activity in older adults, and (ii) which validated biological aging biomarkers can serve as actionable endpoints to quantify geroprotective effects.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1778386"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flumazenil reversal of remimazolam-induced sedation: a narrative review of safety, pharmacokinetics, and clinical considerations.","authors":"Yukai Zhou, Wenzhi Wu, Yi Zhang, Yanhua Peng, Wencai Jiang, XianJie Zhang, Feng Ju, An Xie","doi":"10.3389/fmed.2026.1793528","DOIUrl":"https://doi.org/10.3389/fmed.2026.1793528","url":null,"abstract":"<p><strong>Introduction: </strong>Remimazolam, an ultra-short-acting benzodiazepine metabolized by carboxylesterase-1 (CES1), permits specific antagonism by flumazenil, enabling active reversal unavailable with propofol-based sedation. However, the safety profile of this reversal strategy-including re-sedation risk, seizure concerns, and special population considerations-remains incompletely characterized.</p><p><strong>Methods: </strong>This narrative review synthesizes evidence from randomized controlled trials, meta-analyses, pharmacokinetic-pharmacodynamic modeling studies, and pharmacogenomic research identified through comprehensive searches of PubMed, Embase, the Cochrane Library, and Google Scholar through February 2026 to evaluate the clinical utility and safety considerations of flumazenil reversal in remimazolam-based anesthesia.</p><p><strong>Results: </strong>Recent meta-analyses demonstrate that remimazolam-flumazenil accelerates emergence by approximately 4 min versus propofol with significant reductions in respiratory depression (RR 0.41; 95% CI 0.30-0.56) and hypotension (RR 0.25; 95% CI 0.12-0.52), though substantial heterogeneity (<i>I</i> ² = 96%) limits pooled estimate precision. Re-sedation occurs in 2-22% of cases depending on procedural duration and outcome definitions, with this variability primarily reflecting heterogeneous procedural settings and inconsistent outcome definitions rather than pharmacogenomic factors. The pharmacogenomics of CES1, particularly the G143E loss-of-function polymorphism, represents an emerging area that may influence remimazolam metabolism and reversal kinetics. Reconciliation of surgical database evidence with elevated pharmacovigilance signals from FAERS analysis suggests confounding by indication in emergency settings; however, the intrinsic neurophysiological risks of rapid GABA-A receptor de-occupation warrant continued vigilance. The Dextran 40 excipient in remimazolam besylate formulations is contraindicated in patients with severe dextran hypersensitivity, and clinicians should consider non-benzodiazepine etiologies when hemodynamic deterioration does not respond to flumazenil. In neonates, immature CES1 activity combined with reduced renal clearance creates theoretical risk of metabolite accumulation, contraindicating use outside research settings.</p><p><strong>Discussion: </strong>This review identifies critical evidence gaps-including the need for standardized re-sedation definitions, prospective validation of pharmacokinetic-pharmacodynamic models, and pediatric pharmacokinetic data-and provides evidence-based considerations for clinical practice while emphasizing the need for systematic review methodology and expert consensus to develop formal clinical guidelines.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1793528"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A sulfate-arsenical-ferruginous water affects apoptosis, oxidative stress and the gene expression of inflammatory mediators and of a panel of MicroRNA in IL-1β stimulated human osteoarthritic chondrocytes.","authors":"Antonella Fioravanti, Patrizia Manica, Iole Seccafico, Giulia Collodel, Elena Moretti, Serafino Carta, Sara Cheleschi","doi":"10.3389/fmed.2026.1800406","DOIUrl":"https://doi.org/10.3389/fmed.2026.1800406","url":null,"abstract":"<p><strong>Background: </strong>The beneficial effects of balneotherapy in osteoarthritis (OA) using the sulfate-arsenicalferruginous Levico water (LW) have been recognized by several clinical studies. However, the specific biological properties of LW are partially understood.</p><p><strong>Objective: </strong>The present study aimed at evaluating the ability of LW in the regulation of apoptosis, oxidative stress and of the gene expression of a panel of articular cartilage markers and MicroRNA (<i>miRNA</i>) in human osteoarthritic chondrocytes exposed to interleukin (<i>IL</i>)-<i>1</i>β.</p><p><strong>Methods: </strong>Chondrocytes were obtained from the femoral heads of patients with OA who underwent surgery for total hip prostheses. The cells were incubated for 24 h and 48 h with different concentrations of LW, alone or in combination with <i>IL-1</i>β (10 ng/ml). Apoptosis and mitochondrial superoxide anion production were detected by cytometry. Gene levels of antioxidant enzymes, B-cell lymphoma (<i>BCL)2</i>, cytokines [<i>IL-1</i>β<i>, IL-6</i>, tumor necrosis factor (<i>TNF</i>)-α], metalloproteinases (<i>MMPs</i>)1 and 13, type II collagen (<i>Col2a1</i>), <i>aggrecan</i>, and of a pattern of <i>miRNA</i> were evaluated by Quantitative Real-Time PCR analysis (PCR). The involvement of nuclear factor (<i>NF</i>)<i>-</i>κ<i>B</i> was investigated by PCR and immunofluorescence and by pre-incubation with a specific inhibitor (<i>BAY 117082, IKK</i>α<i>/</i>β).</p><p><strong>Results: </strong>LW at 50% or 25% concentration counteracted the negative effects of <i>IL-1</i>β on cell viability, apoptosis and mitochondrial superoxide anion production and on the gene expression of antioxidant enzymes, in a dose-dependent manner. The treatment of chondrocytes with 50% of LW significantly inhibited the gene expression of pro-inflammatory cytokines, <i>MMPs</i> and of <i>miR-34a</i> and <i>miR-181a</i>, while it upregulated <i>miR-140</i> in <i>IL-1</i>β stimulated cells. The pre-incubation with <i>BAY 11-7082, IKK</i>α<i>/</i>β reduced the damage induced by <i>IL-1</i>β, and, interestingly, potentiated the properties of LW.</p><p><strong>Conclusions: </strong>Our data demonstrated the ability of LW to regulate apoptosis, oxidative stress and gene expression of main factors implicated in OA pathogenesis through a possible modulation of <i>NF-</i>κ<i>B</i> signaling pathway. This study supports the use of balneotherapy with a sulfate-arsenical-ferruginous mineral water in the treatment of OA.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1800406"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic downregulation of MAPKAPK2 exacerbates oxidative stress-induced damage in vitiligo melanocyte cell line model.","authors":"Yishan Wang, Xiaoyong Zheng","doi":"10.3389/fmed.2026.1698091","DOIUrl":"https://doi.org/10.3389/fmed.2026.1698091","url":null,"abstract":"<p><strong>Background and objective: </strong>Vitiligo is an acquired depigmentation disorder caused by melanocyte dysfunction or loss. Oxidative stress is widely considered a key driver to its pathogenesis. Mitogen-activated protein kinase-activated protein kinase 2 (MAPKAPK2) is implicated in oxidative stress responses, although its role in vitiligo remains uncertain. This study intended to investigate whether epigenetic downregulation of MAPKAPK2 aggravates oxidative stress-induced damage in vitiligo melanocytes.</p><p><strong>Methods: </strong>Human melanocyte lines (PIG1 and PIG3V) were used to model normal and vitiligo conditions. The effects of oxidative stress, DNA demethylation (5-aza-DC), and MAPKAPK2 overexpression were assessed using qRT-PCR, Western blot, ELISA, comet assay, TUNEL, and CCK-8. Pharmacological inhibition of MK2 was employed to evaluate the functional requirement of MAPKAPK2 kinase activity, and key antioxidant pathways, including Nrf2 signaling, were investigated.</p><p><strong>Results: </strong>MAPKAPK2 expression was notably downregulated in PIG3V cells compared with PIG1 cells (<i>P</i> < <i>0.05</i>), and further reduced upon H₂O₂ exposure (<i>P</i> < <i>0.01</i>), suggesting stress-related suppression. Exposure to 5-aza-DC partially restored MAPKAPK2 expression (<i>P</i> < <i>0.01</i>), implicating DNA methylation in its silencing. Functional assays showed that MAPKAPK2 overexpression significantly alleviated H₂O₂-induced reductions in cell viability, increases in apoptosis, impaired melanogenesis, and oxidative damage (all <i>P</i> < <i>0.01</i>), while activating the Nrf2/HO-1 antioxidant pathway through suppression of KEAP1 expression and enhancement of Nrf2 nuclear translocation. Genetic knockdown, rescue, and pharmacological inhibition experiments further demonstrated that these cytoprotective effects under oxidative stress were dependent on MAPKAPK2 kinase activity.</p><p><strong>Conclusion: </strong>Epigenetic silencing of MAPKAPK2 aggravates oxidative damage in vitiligo melanocytes, potentially by attenuating Nrf2-associated antioxidant responses. These findings identify MAPKAPK2 as a functionally relevant and targetable factor in the oxidative pathology of vitiligo.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1698091"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative waiting time and no-show risk in day surgery: a large-scale cohort study.","authors":"Xiaoyan Wu, Qianyin Zhu, Meijuan Lan, Leiwen Tang, Huadi Yuan, Xiajuan Jiang, Li Liu, Dingjie Xin","doi":"10.3389/fmed.2026.1810536","DOIUrl":"https://doi.org/10.3389/fmed.2026.1810536","url":null,"abstract":"<p><strong>Background: </strong>No-shows in day surgery represent a global challenge that undermines healthcare efficiency, leading to substantial resource waste and increased operational costs. Preoperative waiting time is a key factor influencing patient attendance. This study investigated the association between preoperative waiting time and the risk of day-surgery no-shows.</p><p><strong>Methods: </strong>This retrospective cohort study included 79,516 day-surgery patients. Demographic characteristics, surgical information, and preoperative waiting time were extracted from the electronic medical record system. Patients were categorized into quartiles according to waiting time: Q1 (0-<3 days), Q2 (3-<6 days), Q3 (6-<11 days), and Q4 (≥11 days). Multivariable logistic regression and restricted cubic spline (RCS) analyses were performed to quantify the association between preoperative waiting time and no-show risk.</p><p><strong>Results: </strong>Among the 79,516 patients undergoing day surgery, 2,009 (2.53%) experienced no-show. The median waiting time was 6 (3-11) days. After adjusting for confounding factors, longer preoperative waiting was significantly associated with increased odds of no-shows(<i>p</i> < 0.001). RCS analysis revealed a nonlinear dose-response relationship (<i>p</i> for trend <0.001; <i>p</i> for nonlinearity <0.001). The no-show risk rose sharply when waiting time exceeded approximately 6 days.</p><p><strong>Conclusion: </strong>Our data showed a significant association between longer preoperative waiting time and an increased risk of no-show among day-surgery patients. This association became more apparent when the preoperative waiting time exceeded approximately 6 days. These findings provide preliminary quantitative evidence regarding the relationship between preoperative waiting time and no-show risk in day surgery.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1810536"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of risk factors and establishment of a predictive model for liver disease severity in metabolic dysfunction-associated fatty liver disease.","authors":"Ziyu Zhang, Yaqin Zhang, Xinxin Li, Weihua Cao, Wen Deng, Shiyu Wang, Xin Wei, Linmei Yao, Zixuan Gao, Shuojie Wang, Hongxiao Hao, Yuanjiao Gao, Xiaoxue Chen, Yao Xie, Minghui Li","doi":"10.3389/fmed.2026.1806275","DOIUrl":"https://doi.org/10.3389/fmed.2026.1806275","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors associated with liver disease severity in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and develop a risk prediction model.</p><p><strong>Methods: </strong>Clinical data were collected from MAFLD patients diagnosed via liver biopsy at the Second Department of Hepatology, Beijing Ditan Hospital, Capital Medical University, from January 2018 to December 2022. Patients were initially grouped by ALT levels to analyze its limitations in MAFLD diagnosis. Pathological reports were used to classify patients into non-significant (S/F/G < 2) and significant (S/F/G ≥ 2) groups based on fibrosis (S), inflammation (G), and steatosis (F) severity. Logistic regression identified independent risk factors for liver disease severity, and a predictive model was established. Model performance was validated using the area under the curve (AUC).</p><p><strong>Results: </strong>Significant differences were observed between ALT-normal and ALT-abnormal groups in AST, GGT, ALP, BMI, hyperlipidemia prevalence, age, and diabetes prevalence (<i>p</i> < 0.05). Univariate analysis revealed age, BMI, AST, ALB, ALP, TG, and high-calorie diet as significant variables (<i>p</i> < 0.05) across inflammation, steatosis, and fibrosis subgroups. When stratified by inflammation severity, multivariate analysis identified sex, age, BMI, ALB, and PcIII as independent predictors of significant inflammation in MAFLD. High BMI and hyperlipidemia were risk factors for MAFLD steatosis. When grouped by fibrosis severity, age, height, BMI, ALB, and PcIII emerged as independent predictors of pathologically significant fibrosis in MAFLD. Patients with G ≥ 2 and/or S ≥ 2 were classified as the significant pathology group, while others formed the non-significant group. A logistic regression model was constructed using regression coefficients and constants, <i>p</i> = 1/(1 + e^-Y), Y = -12.486 + 0.913 × Sex +0.442 × BMI + 0.04 × PcIII-0.085 × ALB. The area under the ROC curve was 0.833 (95% CI: 0.797-0.869), with a maximum Youden index of 0.456, corresponding to sensitivity and specificity of 67.3 and 83.3%, respectively.</p><p><strong>Conclusion: </strong>Sex, BMI, PcIII, and ALB are closely associated with MAFLD severity. The logistic regression model demonstrates potential clinical utility for predicting significant liver pathology.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1806275"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upadacitinib is effective in treating psoriasis combined with lichen planus: a case report.","authors":"Xingmo Li, Jinxu Qi, Liping Shi, Lijuan Liu, Xiaoyu Xie, Guoqiang Zhang, Qing Zhu","doi":"10.3389/fmed.2026.1771710","DOIUrl":"https://doi.org/10.3389/fmed.2026.1771710","url":null,"abstract":"<p><p>Psoriasis frequently coexists with other immune-mediated conditions such as arthritis, alopecia areata, vitiligo, and hidradenitis suppurativa, many of which remain challenging to manage. To date, there have been rarely reported cases of treating psoriasis combined with lichen planus. We report a case of coexisting psoriasis and lichen planus in a female patient. Despite initial efficacy with acitretin and topical mometasone, the patient self-discontinued treatment over safety concerns, prompting a relapse. Upadacitinib was subsequently initiated and yielded marked improvement within 3 months. By discussing the disease interplay and treatment rationale, this report seeks to inform clinical decision-making.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1771710"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}