Gastro hep advances最新文献

{"title":"Pediatric Inflammatory Bowel Disease Tissue Classification From Pathology Slide Images: Detecting Phenotypes Using Computer Vision","authors":"Chloe Martin-King PhD ,&nbsp;Ali Nael ,&nbsp;Louis Ehwerhemuepha ,&nbsp;Blake Calvo ,&nbsp;Quinn Gates ,&nbsp;Jamie Janchoi ,&nbsp;Elisa Ornelas ,&nbsp;Melissa Perez ,&nbsp;Andrea Venderby ,&nbsp;John Miklavcic ,&nbsp;Peter Chang ,&nbsp;Aaron Sassoon ,&nbsp;Brian Rubio ,&nbsp;Ghislaine Barragan ,&nbsp;Kenneth Grant","doi":"10.1016/j.gastha.2026.100899","DOIUrl":"10.1016/j.gastha.2026.100899","url":null,"abstract":"<div><h3>Background and Aims</h3><div>With the advent of computer vision algorithms, we hypothesize that histopathology images from endoscopic biopsies may be utilized for automated classification of histologic phenotypes, thus guiding Crohn’s disease and ulcerative colitis diagnosis and treatment. The aim of our study is to assess whether artificial intelligence can be used to improve pediatric inflammatory bowel disease outcomes by aiding pathologists with accurate detection of abnormal tissue sections.</div></div><div><h3>Methods</h3><div>Three two-dimensional (2D) convolutional neural networks with multiple instance learning were developed to classify histopathology tissue sections as normal vs abnormal and as containing active inflammation and/or chronic changes/architectural distortion.</div></div><div><h3>Results</h3><div>The abnormal vs normal classification model achieved an accuracy of 0.84, an area under the receiver operating characteristic curve (AUC-ROC) of 0.91, and an F1-score of 0.79. Precision, sensitivity, and specificity were 0.85, 0.74, and 0.91, respectively. The accuracy for predicting active inflammation was 0.85, AUC-ROC was 0.92, and F1-score was 0.78. The accuracy for predicting chronic changes/architectural distortion was 0.86, with an AUC-ROC of 0.93 and an F1-score of 0.76. All 3 models achieved a Matthews correlation coefficient of 0.67.</div></div><div><h3>Conclusion</h3><div>The findings resulting from this study are significant primarily because they indicate that there is a strong artificial intelligence–interpretable signal present in endoscopic whole slide imaging, even with the necessary, weakly supervised method of multiple instance learning.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 5","pages":"Article 100899"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147553600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Patterns, Perceptions, Barriers, and Costs in Patients With Chronic Idiopathic Constipation in the United States","authors":"Darren M. Brenner ,&nbsp;Baharak Moshiree ,&nbsp;Joanna de Courcy ,&nbsp;Neil Reynolds ,&nbsp;Teresa Taylor-Whiteley ,&nbsp;Jeanne Jiang ,&nbsp;Mei Lu ,&nbsp;Brian Terreri ,&nbsp;Eric D. Shah","doi":"10.1016/j.gastha.2026.100900","DOIUrl":"10.1016/j.gastha.2026.100900","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Limited real-world data are available on barriers to prescribing or recommending treatments for chronic idiopathic constipation (CIC), treatment experiences and expectations, and the financial impact of CIC from the perspectives of patients and health-care professionals (HCPs).</div></div><div><h3>Methods</h3><div>In this noninterventional, cross-sectional, retrospective survey in the United States (October 2022–June 2023), board-certified gastroenterologists, motility specialists, advanced practice providers, and primary care physicians each recruited up to 8 adults with HCP-diagnosed CIC and no previous CIC clinical trial enrollment. HCP and patient surveys, and case report forms (CRFs) captured demographics and treatment patterns, perceptions, barriers, and costs.</div></div><div><h3>Results</h3><div>Overall, 170 HCPs completed CRFs for 368 patients, of whom 230 completed the patient survey. Mean (standard deviation) patient age was 50.2 (16.5) years (CRF) and 49.7 (16.2) years (patient survey). HCPs would ideally recommend lifestyle/dietary modifications and over-the-counter treatments before prescription medications. Most HCPs rated increased quality of life (73.5%) and long-term efficacy (71.2%) as important when managing CIC, whereas most patients considered symptom relief (83.8%) and affordability (80.7%) as important. HCPs did not report substantial barriers to prescribing treatments, whereas patients reported difficulty getting an HCP appointment (36.3%) and a lack of awareness of CIC prescription medications (34.8%). Most HCPs and patients were satisfied with treatment options. The greatest patient expenses (30-day mean costs [$]) were seeing an HCP ($30.3) and prescription medication co-payments ($28.4).</div></div><div><h3>Conclusion</h3><div>Despite most patients feeling satisfied with CIC treatment options, education on the availability of prescription medication in the United States is needed. This limited awareness, the patient expense of HCP visits, and prescription medication co-payments may limit patient access to CIC therapies.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 4","pages":"Article 100900"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147540523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Serrated Polyposis Syndrome in a Large Health-Care System","authors":"Ayesha Javaid ,&nbsp;Yadana Khin ,&nbsp;Priyanka Kanth","doi":"10.1016/j.gastha.2026.100904","DOIUrl":"10.1016/j.gastha.2026.100904","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 4","pages":"Article 100904"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147540534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parasitic Persistence: The Diagnostic Challenge of Strongyloidiasis in a Nonendemic Setting","authors":"Alexander Siegel,&nbsp;Jennifer Gamache,&nbsp;Kyaw Min Tun,&nbsp;Wuttiporn Manatsathit","doi":"10.1016/j.gastha.2026.101014","DOIUrl":"10.1016/j.gastha.2026.101014","url":null,"abstract":"<div><div>Strongyloidiasis is a parasitic infection endemic to warm and moist climates, which is caused by the intestinal nematode <em>Strongyloides stercoralis</em>. In the United States, most cases are seen in immunocompromised patients residing in the Northeast and East South-Central regions and in travelers from endemic regions. While often underrecognized, <em>Strongyloides</em> infection should remain a key consideration in patients presenting with atypical gastrointestinal symptoms, with a relevant exposure history. We present a case of a 45-year-old male initially diagnosed with <em>Helicobacter pylori</em> whose symptoms persisted and was ultimately diagnosed with <em>Strongyloides</em> infection.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 8","pages":"Article 101014"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347518","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":"Direct Oral Anticoagulant Type and Dose in Atrial Fibrillation With Decompensated Cirrhosis: A Propensity-Matched Analysis","authors":"Julia Zanco,&nbsp;Aravinthan Vignarajah,&nbsp;Reza Arsanjani,&nbsp;Elizabeth J. Carey,&nbsp;Luis R. Scott,&nbsp;Dan Sorajja","doi":"10.1016/j.gastha.2026.100996","DOIUrl":"10.1016/j.gastha.2026.100996","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 8","pages":"Article 100996"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347608","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 Bowel in a Cocoon: Sclerosing Encapsulating Peritonitis","authors":"Budoor Alqinai,&nbsp;Guilherme Costa,&nbsp;Matthew Krafft","doi":"10.1016/j.gastha.2026.101020","DOIUrl":"10.1016/j.gastha.2026.101020","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 10","pages":"Article 101020"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478697","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":"Prospective Evaluation of Ustekinumab Dose Intensification in Inflammatory Bowel Diseases","authors":"Rahul S. Dalal,&nbsp;Heidy J. Cabral,&nbsp;Jessica R. Allegretti","doi":"10.1016/j.gastha.2026.101054","DOIUrl":"10.1016/j.gastha.2026.101054","url":null,"abstract":"<div><h3>Backgrounds and Aims</h3><div>Ustekinumab is an effective therapy for moderate-to-severe inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC). However, secondary loss of response to standard every-8-week maintenance dosing is common. Prospective data supporting dose intensification are limited. To prospectively evaluate the effectiveness and safety of ustekinumab dose intensification to every 4 weeks (q4w) or every 6 weeks (q6w) in patients with IBD experiencing secondary loss of response.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study of adults with CD or UC undergoing empiric ustekinumab dose intensification to q4w or q6w. Clinical disease activity was assessed using the Harvey-Bradshaw Index for CD and the Simple Clinical Colitis Activity Index for UC at baseline and following intensified maintenance dosing. The primary outcome was steroid-free clinical remission after the third intensified dose. Secondary outcomes included clinical response, biochemical response using fecal calprotectin, changes in serum ustekinumab concentrations, and adverse events.</div></div><div><h3>Results</h3><div>Nineteen patients (12 CD, 7 UC) were enrolled. After the third intensified dose, steroid-free clinical remission was achieved in 75.0% of CD and 71.4% of UC patients, while over 80% of patients achieved clinical response. Outcomes were similar between q4w and q6w regimens. Serum ustekinumab concentrations increased significantly following dose intensification, whereas biochemical response rates were modest. No new safety signals were observed, and no patients discontinued therapy due to adverse events.</div></div><div><h3>Conclusion</h3><div>Ustekinumab dose intensification to q4w or q6w was safe and associated with improved clinical outcomes in this prospective IBD cohort.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 10","pages":"Article 101054"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148742345","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":"Fiber-Dependent Microbiome Glycine Lipids Ameliorate Steatotic Liver Disease in Mice via Mitochondrial Enhancement","authors":"Liya Anto,&nbsp;Lidan Gao,&nbsp;Jaeeun Lee,&nbsp;Chelsea Garcia,&nbsp;Oliver Otoko,&nbsp;Emma Hickey,&nbsp;Neha Mishra,&nbsp;Siyun Kim,&nbsp;Sung Gi Noh,&nbsp;Mi-Bo Kim,&nbsp;Hyunju Kang,&nbsp;Saki Mihori,&nbsp;Saurav Ranjitkar,&nbsp;Alison B. Kohan,&nbsp;Young-Ki Park,&nbsp;Anthony A. Provatas,&nbsp;Clinton Mathias,&nbsp;Oh Sung Kwon,&nbsp;Robert B. Clark,&nbsp;Ji-Young Lee,&nbsp;Christopher N. Blesso","doi":"10.1016/j.gastha.2026.101064","DOIUrl":"10.1016/j.gastha.2026.101064","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Oral and gut <em>Bacteroidota</em> species produce bioactive glycine lipids (GL), including the core Lipid 342, serine-glycine Lipid 654 (L654), and complex Lipid 1256 (L1256) classes. These microbiome-derived molecules are emerging modulators of host metabolism, but their dietary regulation, systemic presence, and therapeutic potential in metabolic dysfunction–associated steatotic liver disease (MASLD) remain unclear.</div></div><div><h3>Methods</h3><div>Microbiome-derived GLs were quantified in murine systemic and portal blood, intestinal lymph, and in mouse and human liver using targeted mass spectrometry. Their biological effects were assessed in mouse and cell culture models of diet-induced liver disease following treatment with L654- and L1256-enriched lipid extracts.</div></div><div><h3>Results</h3><div>L654 and L1256 species were detected in mouse serum, portal plasma, intestinal lymph, and liver, as well as in human liver tissue. A Western-type high-fat diet lowered fecal and hepatic microbiome GLs, whereas fermentable fiber supplementation restored fecal levels (∼7-fold increase), with hepatic GL content showing an inverse association with liver triglycerides. In a 22-week diet-induced MASLD model, administration of L654- or L1256-enriched lipids for 8 weeks significantly reduced hepatic steatosis and histopathological progression. Treatments enhanced mitochondrial DNA content and metabolic function in liver and HepG2 cells. L1256 increased hepatic triggering receptor expressed on myeloid cells 2 expression, associated with lipid sensing and MASLD protection, while L654 modulated splenic cluster of differentiation 4⁺ (CD4⁺) effector memory T cells.</div></div><div><h3>Conclusion</h3><div>Microbiome-derived GLs are diet-sensitive molecules that protect against MASLD via mitochondrial enhancement, revealing a novel nutritional–microbial axis for liver disease intervention.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 10","pages":"Article 101064"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148742397","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":"Transjugular Intrahepatic Portosystemic Shunt (TIPS) Outcomes for Variceal Hemorrhage During and After COVID-19: Racial, Payer, and Income Disparities — A National Retrospective Cohort Study With Stratified Sensitivity Analyses","authors":"Nakul Ganju,&nbsp;Shubham Gupta,&nbsp;Sahak Hovsepian,&nbsp;Samay Shah,&nbsp;Shaunak Ganju,&nbsp;Farshad Aduli","doi":"10.1016/j.gastha.2026.101052","DOIUrl":"10.1016/j.gastha.2026.101052","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Transjugular intrahepatic portosystemic shunt (TIPS) reduces mortality in esophageal variceal hemorrhage. Whether the COVID-19 pandemic worsened existing disparities in outcomes among patients undergoing TIPS remains unclear. We aimed to characterize racial, payer-based, and income-based disparities in post-TIPS outcomes before and after the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Using the 2016–2022 National Inpatient Sample, we conducted a retrospective cohort analysis of 31,860 weighted hospitalizations of adults with cirrhosis and esophageal variceal hemorrhage who underwent TIPS. Admissions were stratified as pre-COVID (2016–2019) and post-COVID (2020–2022). Primary outcomes were in-hospital mortality, length of stay, and total hospital charges. Multivariable regression models with COVID-19 era interaction terms were constructed; pre- and post-COVID stratified models were performed as sensitivity analyses.</div></div><div><h3>Results</h3><div>In-hospital mortality increased from 7.8% to 9.4% post-COVID (<em>P</em> &lt; .001). Black patients had significantly higher mortality (adjusted odds ratio [AOR]: 1.67; 95% confidence interval: 1.27–2.19) that worsened in stratified analyses (pre-COVID AOR: 1.53 vs post-COVID AOR: 1.93). Self-pay mortality risk escalated markedly post-COVID (AOR: 2.12 pre-COVID vs 3.26 post-COVID, a 54% worsening). Black patient length of stay disparity nearly doubled post-COVID (+1.71 days pre-COVID vs +3.90 days post-COVID). Native American patients emerged as disproportionately affected post-COVID (mortality AOR: 2.39; 95% confidence interval: 1.76–3.25), a group nonsignificant in the pre-COVID era.</div></div><div><h3>Conclusion</h3><div>Structural inequities in post-TIPS outcomes persisted and worsened during the COVID-19 era, with race, payer status, and income independently predicting mortality across both eras. These findings have direct implications for equitable access to liver transplantation and underscore the need for policy reforms targeting postprocedural care coordination, insurance parity, and hospital-level accountability.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 10","pages":"Article 101052"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148742399","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":"Recurrent Esophageal Stricture Following Caustic Injury From a Concentrated Herbal Preparation in a Resource-Limited Setting","authors":"Audy Meutia Ariana ,&nbsp;Budi Widodo","doi":"10.1016/j.gastha.2025.100865","DOIUrl":"10.1016/j.gastha.2025.100865","url":null,"abstract":"<div><div>Caustic esophageal injury is a frequently overlooked health problem, despite its serious impact on patients’ quality of life. We report the case of a 24-year-old male from an island region of Indonesia who developed esophageal stricture after consuming a traditional herbal preparation with low potential of Hydrogen. Delayed endoscopy, due to limited facilities and financial constraints, further worsened the condition. The patient experienced recurrent dysphagia 6 months after dilation, necessitating conservative management with staged dilation and intralesional triamcinolone injection. This case highlights an unusual etiology, a multidimensional burden, and the need for effective therapeutic strategies and preventive health policies.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100865"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}