JGH Open最新文献

{"title":"Evaluating ChatGPT-5 for Detection of Barrett's Esophagus and Grading of Esophagitis: A Multiclass Endoscopic Image Analysis","authors":"Hamza R. Khan,&nbsp;Ibraheem Mirza,&nbsp;Owais M. Aftab,&nbsp;Yash Shah,&nbsp;Ahmed H. Al-Khazraji","doi":"10.1002/jgh3.70452","DOIUrl":"10.1002/jgh3.70452","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Gastroesophageal reflux disease can progress to reflux esophagitis and Barrett's esophagus (BE), making accurate endoscopic diagnosis important. Artificial intelligence tools like ChatGPT-5 may assist image interpretation, though data on newer large language models remains limited. This study evaluated ChatGPT-5 for BE detection and LA esophagitis severity classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Endoscopic images from the HyperKvasir dataset were analyzed, including BE, esophagitis A, esophagitis B–D, and normal Z-line images. Four standardized prompts were assessed: (1) BE versus normal, (2) esophagitis versus normal, (3) LA-grade severity (A vs. B–D), and (4) BE versus severe esophagitis. ChatGPT-5 was evaluated in auto mode. Two investigators analyzed 640 unique images, yielding 1280 evaluations. Sensitivity, specificity, positive/negative predictive values (PPV/NPV), F1 scores, and accuracy were calculated. In binary tasks, sensitivity was highest for severe esophagitis (B–D) (0.774). Binary accuracy was similar across tasks (~0.64), with the highest for severe esophagitis (0.655). In three-class analyses, severe esophagitis performed best (sensitivity 0.506, specificity 0.761, accuracy 0.438), with performance improving alongside disease severity. PPV trended higher for severe esophagitis compared with normal mucosa (<i>p</i> ~ 0.03), though significance was not retained after multiple-comparison correction. In the BE-severe esophagitis-normal comparison, severe esophagitis achieved the highest sensitivity (0.590), specificity (0.790), and accuracy (0.521). PPV trended higher for severe esophagitis versus normal mucosa (<i>p</i> ~ 0.05), though significance was not maintained after multiplicity adjustment. NPVs exceeded PPVs across all paradigms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ChatGPT-5 demonstrated moderate performance for esophageal image interpretation, performing best for severe esophagitis and worst for mild esophagitis/BE. Binary prompting outperformed multiclass formats, and the model functioned better as a rule-out tool.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal Involvement in Non–Eosinophilic Esophagitis Eosinophilic Gastrointestinal Diseases: Association With Esophageal Symptoms and Gastric Involvement","authors":"Yasuhiko Abe,&nbsp;Naoko Mizumoto,&nbsp;Yu Sasaki,&nbsp;Makoto Yagi,&nbsp;Yusuke Onozato,&nbsp;Yoshiyuki Ueno","doi":"10.1002/jgh3.70449","DOIUrl":"10.1002/jgh3.70449","url":null,"abstract":"&lt;p&gt;Eosinophilic gastrointestinal diseases (EGIDs) are chronic inflammatory disorders characterized by a T helper type 2 (Th2)–predominant immune response, eosinophilic infiltration of the gastrointestinal tract, and related gastrointestinal symptoms [&lt;span&gt;1&lt;/span&gt;]. EGIDs are broadly classified into eosinophilic esophagitis (EoE), which is confined to the esophagus, and non–EoE EGIDs, which can affect other segments of the gastrointestinal tract, including the stomach, small intestine, and colon.&lt;/p&gt;&lt;p&gt;Non–EoE EGIDs often involve multiple gastrointestinal segments through mechanisms that remain incompletely understood. Accordingly, site-based classifications—such as eosinophilic gastritis (EoG), eosinophilic duodenitis (EoD), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC)—have been proposed to better characterize the pathophysiology of disease [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Recent studies have reported that approximately 20%–40% of patients with non–EoE EGIDs exhibit esophageal involvement (EI) [&lt;span&gt;3-5&lt;/span&gt;]. Moreover, EI has been suggested to be associated with a greater disease burden, including more complex diagnoses, treatments, and prognoses [&lt;span&gt;4, 6&lt;/span&gt;]. However, the clinical significance and characteristics of EI in patients with non-EoE EGID remain unclear.&lt;/p&gt;&lt;p&gt;Therefore, this study aimed to evaluate the clinical and endoscopic characteristics associated with EI and to examine their relationship with involvement at other gastrointestinal sites in patients with non–EoE EGIDs.&lt;/p&gt;&lt;p&gt;We conducted a secondary analysis of patients from a previously reported multicenter study of gastric endoscopic findings in non–EoE EGIDs [&lt;span&gt;7&lt;/span&gt;]. The original cohort consisted of 64 patients diagnosed with non–EoE EGIDs according to the Japanese diagnostic criteria. Esophageal biopsies were performed in 29 patients. One patient was excluded because the esophageal eosinophil count was unavailable. Among the remaining 28 patients, those who fulfilled the Pesek histologic criteria for non–EoE EGIDs (stomach ≥ 30 eosinophils per high-power field [eos/HPF]; small intestine ≥ 50 eos/HPF; colon ≥ 60 eos/HPF) [&lt;span&gt;3&lt;/span&gt;] were included. A total of 22 patients met these criteria at one or more gastrointestinal sites and constituted the study population.&lt;/p&gt;&lt;p&gt;Biopsies from the stomach, duodenum, terminal ileum, and colon were obtained based on clinical indications during endoscopic evaluation; therefore, not all segments were assessed in every patient. Gastrointestinal involvement was defined based on available histological data, and patients without biopsy data for a given segment were classified as having no evidence of involvement.&lt;/p&gt;&lt;p&gt;EI was defined as ≥ 15 eos/HPF in esophageal biopsy specimens. Esophageal symptoms were defined as heartburn or dysphagia. Esophageal endoscopic findings were assessed using the EoE Endoscopic Reference Score (EREFS), analyzed as a total score (0–16) and separately for the proximal (0–8) and distal","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Unveiling Resmetirom: A Systematic Review and Meta-Analysis on Its Impact on Liver Function and Safety in Non-Alcoholic Steatohepatitis Treatment”","authors":"Rajeh Ruzayqat","doi":"10.1002/jgh3.70446","DOIUrl":"10.1002/jgh3.70446","url":null,"abstract":"<p>We read with interest the article by Hashim et al., which evaluated the effects of resmetirom in non-alcoholic steatohepatitis (NASH) through a systematic review and meta-analysis. The authors included three randomized controlled trials in the quantitative synthesis and presented multiple forest plots to summarize the findings [<span>1</span>].</p><p>According to Figure 1, the PRISMA flow diagram reports “Records after duplicates removed (<i>n</i> = 353).” However, the total number of identified records (321 from databases and 32 from other sources) already equals 353. This suggests that the reported number likely reflects records prior to deduplication rather than after. Accurate reporting of the study selection process is essential, and clarification of this discrepancy would improve transparency.</p><p>According to the data presented in the Table 1 (columns 4 and 5), the total number of participants sums to 1942 “Resmetirom: 322 (80 mg) 323 (100 mg), 327 (80 mg) 495 (100 mg), 84. Placebo: 32, 318, 41.” However, the Results section reports a total of 2234 participants “Total number of patients among the studies were 2234 including all the sub-groups.” This discrepancy does not appear to be clearly explained in the study, and no justification is provided for the difference between the reported totals. This raises concerns regarding the accuracy and consistency of sample size reporting.</p><p>In addition, the Results section reports a non-significant effect of resmetirom on AST levels “the AST levels (MD –3.60; 95% CI –7.44 to 0.24; <i>p</i> = 0.07) and GGT levels (MD –17.02; 95% CI –35.12 to 1.09; <i>p</i> = 0.07) also gave nonsignificant results”. Despite this, the Discussion describes a significant effect on AST “Our results show that Resmetirom play a significant role in LDL-C and AST levels compared with placebo.” This inconsistency between sections may affect the interpretation of the findings and should be explicitly addressed.</p><p>In this context, clarification regarding data reporting, sample size derivation, and outcome interpretation would improve the internal consistency and transparency of the study, ultimately strengthening the reliability of its conclusions.</p><p>The author declares no conflicts of interest.</p><p>Data sharing not applicable to this article as no datasets were generated or analysed during the current study.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Steroid Pulse Therapy on Early Treatment Response and Relapse in Type 1 Autoimmune Pancreatitis","authors":"Akihisa Adachi,&nbsp;Itaru Naitoh,&nbsp;Michihiro Yoshida,&nbsp;Yasuki Hori,&nbsp;Akihisa Kato,&nbsp;Kenta Kachi,&nbsp;Tadashi Toyohara,&nbsp;Kayoko Oda,&nbsp;Yusuke Kito,&nbsp;Kenji Urakabe,&nbsp;Toshitaka Mori,&nbsp;Hiromi Kataoka","doi":"10.1002/jgh3.70448","DOIUrl":"10.1002/jgh3.70448","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Despite the recommendation of steroid therapy for type 1 autoimmune pancreatitis (AIP), the value of steroid pulse therapy remains unclear. This study aimed to assess the efficacy and safety of steroid pulse therapy in patients with AIP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Of 121 patients with type 1 AIP who were identified, 116 with adequate follow-up data were included in the analysis. Patients were classified into four groups according to the initial treatment modality—pulse therapy alone (Pulse alone group), pulse therapy followed by oral steroid therapy (Pulse + PSL group), conventional oral steroid therapy (PSL group), and observation without treatment (Observation group)—and short- and long-term clinical response, relapse rates, and steroid-associated adverse events were compared across these groups. The numbers of patients in the Pulse alone, Pulse + PSL, PSL, and Observation groups were 12, 13, 68, and 23, respectively. After 2 weeks of steroid initiation, steroid pulse groups (Pulse alone and Pulse + PSL group) showed a significantly greater reduction in serum IgG4 levels than the PSL group (<i>p</i> = 0.048). Pulse + PSL was associated with a significantly lower relapse rate than PSL (log-rank test <i>p</i> = 0.02; multivariate Cox regression <i>p</i> = 0.048), with no differences in adverse events. Rates of relapse and adverse events did not differ significantly between the Pulse alone and Observation groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Steroid pulse therapy may serve as a useful therapeutic option when conducting a steroid trial and may help reduce relapse rate in the management of type 1 AIP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Real-World Evaluation of Tofacitinib's Effectiveness and Safety in Japan: Insights Into Optimal Timing for Dose Reduction","authors":"Yoriaki Komeda,&nbsp;Masashi Kono,&nbsp;Tomoyuki Nagai,&nbsp;Shunsuke Omoto,&nbsp;Mamoru Takenaka,&nbsp;Satoru Hagiwara,&nbsp;Naoko Tsuji,&nbsp;George Tribonias,&nbsp;Masatoshi Kudo","doi":"10.1002/jgh3.70447","DOIUrl":"10.1002/jgh3.70447","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Tofacitinib (TOF), an oral pan-Janus kinase (JAK) inhibitor, is a therapeutic option for moderate to severe ulcerative colitis (UC). While short-term efficacy has been reported, its long-term real-world outcomes—particularly in Asian populations—and optimal dose reduction timing are incompletely understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This single-center, retrospective study included 63 patients with UC treated with TOF between October 2018 and April 2025. Clinical outcomes—response, remission, steroid-free remission, and adverse events—were assessed at Weeks 26, 52, and 104. The impact of dose reduction (20–10 mg/day) was analyzed, focusing on endoscopic mucosal healing (Mayo endoscopic subscore 0–1). At Week 26, clinical response and remission rates were 63% and 53%, respectively; 43% of patients achieved steroid-free remission by Week 52, and 41% maintained it at Week 104. Early responders were associated with treatment efficacy in a lower partial Mayo score (OR = 1.724, 95% CI: 0.994–2.988, <i>p</i> = 0.052). Among 26 patients with dose reduction, relapse occurred in 5.6% with mucosal healing versus 62.5% without. Significant factors associated with relapse/exacerbation were TOF dose reduction based on clinical remission alone without endoscopic confirmation (<i>p</i> = 0.003, OR = 5.26) and disease duration (<i>p</i> = 0.019, OR = 0.86). Adverse events were infrequent and manageable, with no malignancies or deaths reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TOF demonstrated sustained effectiveness and safety in UC. Mucosal healing was strongly associated with successful dose de-escalation, representing a key treatment target. These findings support treat-to-target strategies incorporating endoscopic assessment to guide TOF dose reduction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13381722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom Overlap Stratifies Prokinetic Response in Functional Dyspepsia: A Real-World Multicenter Study of 1297 Chinese Patients","authors":"Dan Zhou,&nbsp;Tao Bai,&nbsp;Jie Chen,&nbsp;Doneke Wang,&nbsp;Jinsong Liu,&nbsp;Xiaohua Hou","doi":"10.1002/jgh3.70438","DOIUrl":"10.1002/jgh3.70438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Functional dyspepsia (FD) often overlaps with GERD-, IBS-, and FC-like symptoms, complicating treatment. This study evaluated overlap patterns and their association with cinitapride response in Chinese FD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter prospective observational study, 1297 Chinese FD patients meeting Rome IV criteria received cinitapride 1 mg three times daily for 4 weeks. Overlapping symptoms were classified as GERD-like, IBS-like, or FC-like. Patients were grouped by overlap complexity: no overlap, one overlapping symptom domain, or two overlapping symptom domains. Symptom improvement was defined as a ≥ 50% reduction in symptom score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 58.1% of patients had overlapping symptoms: 38.2% had one overlapping domain and 19.9% had two. GERD-like symptoms were the most common isolated overlap and were present in all two-domain overlap cases. IBS-like symptoms, mainly IBS-C-like, predominated among patients with two overlapping domains. Symptom burden increased with overlap complexity, peaking in the GERD-like + IBS-like group. FD-related improvement after cinitapride declined progressively from patients without overlap to those with one and two overlapping domains. After adjustment for demographic and clinical factors, greater overlap complexity remained associated with reduced odds of FD-related response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Symptom overlap is common in Chinese FD patients, especially GERD-like overlap. GERD+IBS overlap was linked to the greatest symptom burden and poorest observed response to cinitapride, suggesting that symptom-defined overlap phenotypes may support more individualized management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Clinical efficacy and safety of prokinetic agents as maintenance therapy for functional dyspepsia (FD): a real-world study: ChiCTR2100042166. https://www.chictr.org.cn/hvshowproject.html?id=84789&amp;v=1.0</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Association Between Cystic Fibrosis and Colorectal Neoplasia: A Matched Case–Control Study","authors":"Dazhong Huang,&nbsp;Douglas Tjandra,&nbsp;Ammar Majeed,&nbsp;Gregory Snell,&nbsp;Stuart K. Roberts,&nbsp;Gregor Brown,&nbsp;Alex Boussioutas,&nbsp;Peter Wark,&nbsp;Shara Ket","doi":"10.1002/jgh3.70440","DOIUrl":"10.1002/jgh3.70440","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cystic fibrosis (CF) is an autosomal recessive disorder that has been associated with increased risk of colorectal neoplasia and cancer (CRC). Current consensus statements recommend early screening and surveillance colonoscopies for CRC in CF, though high-quality data supporting this remains lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective case–control study in a statewide CF referral center, comparing patients with CF and matched controls who underwent elective colonoscopy between 2010 and 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and forty-five patients with CF were included and matched 1:1 to control cohort. Significantly higher number of patients in CF cohort had neoplastic lesions (51.8% vs. 24.1%, OR 3.41, 95%-CI 2.32–5.02, <i>p</i> &lt; 0.0001), advanced lesions (16.3% vs. 10.2%, OR 1.76, 95%-CI 1.03–2.99, <i>p</i> = 0.039), and CRC (4.9% vs. 0.8%, OR 6.26, 95%-CI 1.39–28.26, <i>p</i> = 0.017). CRC-free survival was significantly lower in CF (log-rank <i>p</i> = 0.007). Age and lung transplant recipients were predictors on multivariate analysis for colorectal neoplasia. Incidence of CRC in asymptomatic patients with CF at initial colonoscopy was 5.5% and mean age of diagnosis was 40.5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the increased association of CF with colorectal neoplasia and CRC, and the need for careful screening and surveillance via colonoscopy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Five Novel Anthropometric Indicators in Evaluating MASLD and Liver Fibrosis in MASLD: A Cross-Sectional Study","authors":"Huiya Huang,&nbsp;Yangni Lu,&nbsp;Tong Luo,&nbsp;Huabei Wu,&nbsp;Jinfeng Li,&nbsp;Tingting Tang,&nbsp;Xianli Xv,&nbsp;Jianlin Wu,&nbsp;Maowei Chen","doi":"10.1002/jgh3.70435","DOIUrl":"10.1002/jgh3.70435","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated fatty liver disease (MASLD) is the most prevalent chronic liver disease globally. Early screening is critical for preventing liver fibrosis (LF) and cirrhosis, but liver biopsy and imaging are costly and less accessible in primary care settings. Simple, economical anthropometric indicators are urgently needed for large-scale initial screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from NHANES 2017–2020, we applied logistic regression, generalized additive models, and ROC analysis to evaluate five novel anthropometric indices (BRI, LAP, WTI, WWI, and ABSI) for predicting MASLD and LF in individuals with MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All indices showed significant positive dose–response associations with MASLD risk (fully adjusted ORs: BRI, 1.86; LAP, 1.03; WTI, 5.31; WWI, 3.31; and ABSI, 2.13). BRI and LAP demonstrated the highest predictive performance for MASLD (AUC = 0.82). For LF among individuals with MASLD, BRI (AUC = 0.71) outperformed FIB-4 and APRI. Stratified analyses revealed sex-, age-, and BMI-related differences: WTI performed better in women; ABSI and BRI in men; WWI, ABSI, and BRI in younger adults; and BRI in lean individuals. Nonlinear associations with MASLD were observed for all indices, whereas only WWI showed a linear association with LF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BRI is independently associated with MASLD and LF in individuals with MASLD and demonstrates superior predictive performance and clinical net benefit compared with other noninvasive models. These findings support its potential use for the early identification of MASLD and LF risk in primary care settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Evidence: Critical Insights and Future Directions for Texture and Color Enhancement Imaging in Colorectal Neoplasia Detection","authors":"Anastasios Koulaouzidis,&nbsp;Wojciech Marlicz","doi":"10.1002/jgh3.70342","DOIUrl":"https://doi.org/10.1002/jgh3.70342","url":null,"abstract":"&lt;p&gt;We read with great interest the recent systematic review and meta-analysis by Judge et al. [&lt;span&gt;1&lt;/span&gt;] examining texture and color enhancement imaging (TXI) for colonic neoplasia detection. The authors provide an important synthesis of emerging evidence and suggest that TXI improves adenoma detection rate (ADR), polyp detection rate (PDR), and mean adenomas per patient (MAP) compared with white light imaging (WLI). The findings are encouraging, though several points merit further consideration before TXI can be regarded as a transformative advance in colorectal cancer (CRC) prevention.&lt;/p&gt;&lt;p&gt;Prior work, including a January 2025 published meta-analysis [&lt;span&gt;2&lt;/span&gt;] that reported clear benefits in ADR, had already begun to shape the field but omitted several important recent studies. The recently published, multicenter deTXIon randomized controlled trial (RCT) [&lt;span&gt;3&lt;/span&gt;], confirmed TXI's superiority for selected detection endpoints. Emerging data combining TXI with endocuff vision suggested additive benefits [&lt;span&gt;4&lt;/span&gt;]. A prospective crossover randomized trial (online ahead of print in August 2024), conducted between June 2022 and January 2023, found that TXI was associated with significant increases in PDR and ADR compared to WLI, especially in the right colon [&lt;span&gt;5&lt;/span&gt;]. Incorporating these studies would likely refine pooled estimates and reduce reliance on smaller early series. Therefore, the July 2024 search cutoff limits completeness, as the analyzed body of evidence remains modest; just four studies with a total of 5481 patients, only two of which were RCTs. The largest contribution by Toyoshima et al. included 3940 patients but incorporated routine dye-spray chromoendoscopy in both arms, a methodological choice that likely diluted the incremental effect of TXI [&lt;span&gt;3&lt;/span&gt;]. Judge et al.'s sub-analysis excluding this study, although not pre-specified, reduced statistical heterogeneity and revealed stronger effect sizes, with the reported absolute ADR improvement increasing from ~8% to ~14%. While illuminating, this post hoc approach warrants caution regarding potential bias. Differences in study design, scope, and methodology (e.g., Sakamoto's right-colon-only crossover) further complicate comparability and underscore the fragility of the evidence base.&lt;/p&gt;&lt;p&gt;Some apparent inconsistencies in reporting also warrant clarification. The results section states that proximal lesion detection was not significant (&lt;i&gt;p&lt;/i&gt; = 0.57; Section 3.2.3), which appears to contrast with the abstract and Figure 5, where a significant effect is reported (MD 0.21, 95% CI, 0.15–0.27, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Sessile serrated lesion (SSL) detection was significantly improved (RR 1.44; 95% CI, 1.02–2.02, &lt;i&gt;p&lt;/i&gt; ≤ 0.01; Section 3.2.3), though the analysis remains underpowered, with inclusion of only three studies, with incomplete subgroup data on lesion size and morphology and without harmonization of lesion definitions or size thresh","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148386334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenges of Performing Controlled Trials of Diet Therapies in Gastroenterology","authors":"Alice S. Day,&nbsp;Chu K. Yao,&nbsp;Alexander C. Ford,&nbsp;Gerald Holtmann,&nbsp;Emma P. Halmos","doi":"10.1002/jgh3.70439","DOIUrl":"https://doi.org/10.1002/jgh3.70439","url":null,"abstract":"<p>Dietary trials methodology in the field of translational gastrointestinal research is fraught with constraints, relating to cost, practicalities of executing dietary trials, and the particulars of manipulating foods that often cannot be overcome. As such, dietary interventions may be unfairly judged as low quality. However, dietary trials are commonly poorly designed, based principally on drug trial methodology, which is often not appropriate in the setting of food, has a very different composition, and is not delivered like pharmaceuticals. This risks accurate interpretation of data and a lack of translatability to clinic. Careful attention should be given to the design of dietary trials to ensure studies remain high quality and clinically relevant. This review summarizes the key factors necessary for consideration when executing a well-designed dietary trial for gastrointestinal conditions and examples of how they have been used and reported on. Key factors include modeling dietary composition to meet the research question, appraising pre-exposure diets and their impact on the study, interpretation and potential use of placebo and nocebo effects, and the use of sham diets. Finally, measuring and reporting on blinding and adherence, which is essential, as for all trials methodology.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 7","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}