2026-04-02
Clare Rainey, Sonyia McFadden, Avneet Gill
Lung cancer is a leading cause of death internationally, with most cancers being diagnosed at an advanced stage. Initiatives, such as the Lung Cancer Policy Network promote best practice globally, such as development of screening programs, however, infrastructural issues such as staffing shortages may mean that changes to current practice may not be possible. Artificial intelligence (AI) has been proposed as a means to alleviate the pressure associated with additional imaging, triage and management. Principles of patient centered care should be adopted when considering any factor in healthcare. There is a dearth of literature on the patient and clinician perceptions of the impact of AI in the lung cancer pathway specifically, particularly in nations where this technology is being considered but not currently being utilized. This semi structured interview study recruited both patients and clinician volunteers who had responded to an initial survey on the same topic, resulting in seven members of the public and six clinicians. All participants reside in Northern Ireland, allowing for insight into a nation where AI had not yet been adopted in the lung cancer pathway. Interviews were coded and Braun and Clark’s recommendations for thematic analysis were followed, resulting in seven themes: 1. Person to person communication, 2. Use of AI in health – applications, 3. Validation, 4. Acceptability and variability of acceptance, 5. Education and training, 6. Patient consent AI in their care, 7. Workflow integration and infrastructural limitations. No themes were unique to either clinicians or public. Perception of the outlook for the future with AI in the lung cancer pathway was positive, and in many cased reported to be inevitable. Both clinicians and the members of the public highlighted the need for robust quality assurance to be in place. Opinions varied on the need for explicit patient consent to the use of AI in their pathway, with trust in the clinicians’ decision articulated by members of the public.
DOI: 10.3389/fmed.2026.17590412026-04-02
Jianming Zheng, Zihan Wang, Jinxian Zhang, Jianing Ying, Tao Chen, Quanyong Yi, Jiong Zhang
BackgroundThe eye and brain share developmental and regulatory vascular similarities, and 3D vascular segmentation from Optical Coherence Tomography Angiography (OCTA) and Magnetic Resonance Angiography (MRA) is essential for neuro-ophthalmic assessment. However, vascular trees exhibit extreme multi-scale morphology and are vulnerable to topology disruptions caused by OCTA artifacts (e.g., noise and discontinuities) and MRA anatomical variants (e.g., Circle of Willis incompleteness), which often lead to fragmented vessels and unstable segment-wise predictions.PurposeTo develop a unified 3D vascular segmentation framework that transfers and shares structural priors across OCTA and MRA, enabling accurate parsing under extreme scale imbalance and topology disruptions, and producing anatomically plausible predictions that remain robust to imaging artifacts in OCTA and Circle-of-Willis variants in MRA.MethodsWe propose GA-TAN, a Graph Aggregation and Topology-Aware Network for unified ocular–cerebral vascular segmentation. GA-TAN employs a variable-window hybrid CNN–Transformer backbone to adapt receptive fields across vessel scales, an Efficient Multi-Scale Attention (EMA) module to enhance volumetric spatial–channel interactions, and a Multi-Scale Graph Aggregation (MSGA) module to perform global topological reasoning and hierarchical feature fusion. A topology-aware training objective further supervises segment existence and connectivity to penalize structural discontinuities beyond pixel-wise losses. Experiments were conducted on Retina3D for binary 3D OCTA vessel segmentation and on TopCow for 13-class CoW artery segmentation from MRA.ResultsGA-TAN achieved the best overall performance on Retina3D, with a DSC of 0.684 and a clDice of 0.667, indicating improved overlap accuracy and centerline connectivity preservation. On TopCow, GA-TAN obtained a mean Dice of 0.814 across 13 arterial categories and produced more anatomically consistent segment-wise predictions, showing clear advantages on thin communicating and variant-related segments. Ablation studies further validated the complementary contributions of EMA, MSGA, and topology-aware supervision.ConclusionGA-TAN provides a unified and topology-aware solution for 3D vascular segmentation across OCTA and MRA. By integrating adaptive multi-scale modeling, graph-based global aggregation, and explicit topology supervision, the proposed framework improves both segmentation accuracy and vascular ontinuity, enhancing robustness to imaging artifacts and anatomical variants for ocular–cerebral vascular analysis.
DOI: 10.3389/fmed.2026.18121132026-04-02
Jingjing Yin, Sasa Liu, Na Zhao, Jun Guo, Jingyuan Wang, Wei Wei
ObjectiveThis study aimed to assess the clinical value of cytokeratin 19 fragment (CYFRA21-1) and its correlation with Krebs von den Lungen-6 (KL-6) in stratifying the severity of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).MethodsData were retrospectively collected from 178 patients with rheumatoid arthritis (RA) admitted to our hospital between November 2024 and September 2025. The classification of patients into subgroups was based on chest high-resolution computed tomography (HRCT) findings, with 82 without interstitial lung disease (ILD), 53 with mild ILD, and 43 with advanced ILD. Serum KL-6 levels were measured using a latex agglutination assay, and the levels of tumor markers were determined by chemiluminescent immunoassay.ResultsSerum CYFRA21-1 levels were significantly higher in both the RA-mild ILD and RA-advanced ILD groups compared with the RA-no ILD group (2.10 ng/mL vs. 1.90 ng/mL, q = 0.024; 3.70 ng/mL vs. 1.90 ng/mL, q < 0.001). Multivariate analysis demonstrated that CYFRA21-1 was an independent risk factor for RA-mild ILD [odds ratio (OR) = 1.711, 95% confidence interval (CI) = 1.160–2.523, p = 0.007] and RA-advanced ILD (OR = 4.819, 95% CI = 2.942–7.892, p < 0.001). KL-6 and CYFRA21-1 showed strong negative correlations with predicted forced vital capacity (FVC% pred), with correlation coefficients decreasing to −0.877 and −0.763 in the advanced ILD group, their positive correlation progressively increased with disease severity (r = 0.453–0.649). Furthermore, receiver operating characteristic (ROC) curve analysis indicated that CYFRA21-1 had diagnostic value for both RA-ILD (mild + advanced) and RA-advanced ILD. The area under the ROC curve (AUC) of CYFRA21-1 in RA-ILD was 0.73 (p < 0.001; sensitivity = 61.86%; specificity = 78.05%), while that in RA-advanced ILD was 0.88 (p < 0.001; sensitivity = 84.09%; specificity = 78.05%).ConclusionCYFRA21-1 exhibited graded expression and a positive correlation with KL-6, serving as a valuable serum biomarker for risk stratification and severity assessment in RA-ILD.
DOI: 10.3389/fmed.2026.17639282026-04-02
Yi Yao, Wenhong Zhang, Yunqian Chi, Zihan Zhang, Yunhe Wang, Wei Hao
BackgroundNeonatal bilirubin encephalopathy (kernicterus) results from toxic accumulation of unconjugated bilirubin in the brain, often leading to irreversible neurological damage. Docosahexaenoic acid (DHA), an omega-3 fatty acid with anti-inflammatory and antioxidant properties, may attenuate bilirubin-induced neuropathological alterations in neonates.ObjectivesThis study evaluated whether DHA mitigates neuropathological and molecular changes in a rodent model of bilirubin-induced encephalopathy via the CTBP1/miR-155-5p/KDM5A pathway and oxidative stress regulation.MethodsIn a cross-sectional experimental study, 48 neonatal Sprague-Dawley rats (7 days old) were allocated to Control, bilirubin encephalopathy (BE) and BE + DHA groups (n = 16 each). Bilirubin (120 mg/kg i.p.) was administered to induce encephalopathy. DHA (100 mg/kg by gavage) was given daily for 3 days. Physical status, neuro-behavior (righting reflex, negative geotaxis), biochemical markers (serum bilirubin, neuron-specific enolase [NSE], oxidative stress indices), and histopathology were assessed. Gene and protein expression of CTBP1, KDM5A and miR-155-5p were measured (RT-qPCR, Western blot).ResultsDHA improved neurobehavioral scores and was associated with a faster decline in serum bilirubin levels during the later observation period. Serum bilirubin peaked at ∼15 μmol/L at 24 h in BE and declined to 10 μmol/L by 72 h, whereas DHA accelerated clearance to ∼5 μmol/L at 72 h (control ∼5 μmol/L). Brain bilirubin and NSE were significantly elevated in BE and mitigated by DHA (each ∼60% reduction vs. BE, p < 0.01). DHA also reduced cortical apoptosis (TUNEL-positive cells ∼10% vs. 25% in BE, p < 0.01). Molecular analysis showed bilirubin-induced upregulation of miR-155-5p (∼3-fold) with downregulation of CTBP1 and KDM5A (∼50–60% of control); DHA partially restored CTBP1/KDM5A levels and lowered miR-155-5p (∼1.4-fold, p < 0.01 vs. BE). Markers of oxidative stress and ferroptosis were elevated in BE (e.g., malondialdehyde + 175%, p < 0.001) and blunted by DHA (+ 50% vs. control, p < 0.01).ConclusionDHA administration significantly attenuated bilirubin-induced neurotoxicity in neonatal rats. Neuroprotection by DHA was associated with changes in the CTBP1/miR-155-5p/KDM5A axis and reduced oxidative stress–related markers.
DOI: 10.3389/fmed.2026.16339472026-04-02
Xiaoni Zhou, Xiaohui Luo, Yuying Wu, Han Wang, Zhiyun Pan, Jun Wang, Xinhua Xiao, Zhi Yao
BackgroundThe infection rate of Aspergillus after non-tuberculous mycobacterial lung disease shows a persistent upward trend. While current treatment options for patients with complex pulmonary aspergillosis remains under investigation, the optimal treatment strategy remains under investigation.Case presentationA 66-years-old female was diagnosed with non-tuberculous mycobacterial lung disease complicated by a complex pulmonary aspergilloma involving the posterior segment of the right upper lobe and the dorsal segment of the right lower lobe. Due to scattered lesions and multiple underlying diseases, surgical resection could not be performed. Instead, based on oral low-dose voriconazole systemic antifungal therapy of 100 mg twice daily, four sessions of bronchoscopic lesion resection with biopsy forceps, and endobronchial instillation of liposomal amphotericin B 10 mg were selected. Finally, the aspergilloma disappeared, and the patient’s symptoms were relieved.ConclusionThis case report suggests that for patients with complex pulmonary aspergilloma and non-tuberculous mycobacterial lung infection who are ineligible for surgery and cannot tolerate high-dose systemic antifungal therapy, bronchoscopic lesion resection combined with endobronchial instillation therapy may represent a feasible treatment option with potential clinical benefits. It also serves as a reminder to remain vigilant for the occurrence of aspergillosis following non-tuberculous mycobacterial lung disease.
DOI: 10.3389/fmed.2026.17724742026-04-02
Alexa K. Dowdell, Thomas R. Ward, Lauren T. Hamilton, Roshanthi K. Weerasinghe, Erica Schnettler, Pratheesh Sathyan, Alison Roos, Josiah T. Wagner, John Welle, Ryan C. Meng, Alexandra Q. Bartlett, Carlo B. Bifulco, Brian D. Piening
IntroductionThe use of next-generation sequencing (NGS) in clinical investigations has enabled the identification of actionable biomarkers across tumor histologies, paving the way for the development of pan-tumor therapies. Gene fusions involving NTRK1, NTRK2, and NTRK3 (NTRK1/2/3) have emerged as rare yet clinically significant oncogenic drivers in a wide range of both pediatric and adult tumors due to high response rates to FDA-approved targeted therapies. Consequently, widespread testing for NTRK fusions is recommended across tumor types. However, data on NTRK fusions in cancer have predominantly been sourced from academic institutions and reference laboratories.MethodsIn this study, we investigated the frequency of NTRK fusions and co-occurring genomic alterations across solid tumor types in a large, real-world patient cohort that received DNA and RNA hybrid capture-based comprehensive genomic profiling (CGP) in the Providence community health system.ResultsAmong 15,128 adult patients, CGP identified 30 pathogenic NTRK1/2/3 fusions, corresponding to a clinically actionable prevalence of 0.2% across 12 solid tumor types. An additional 11 NTRK fusions were classified as variants of unknown significance, and 8 of the identified NTRK fusions in the cohort were novel. The number of distinct and novel fusion partners identified demonstrates the genomic diversity of NTRK fusions observed in routine clinical practice.DiscussionThese findings highlight the value of RNA-based NGS, particularly when used alongside DNA NGS, to provide a comprehensive assessment of NTRK fusions and co-occurring gene alterations. Implementation of combined DNA and RNA CGP in a community health system setting enables detection of both known and novel NTRK fusions and can inform clinical care of cancer patients.
DOI: 10.3389/fmed.2026.17643922026-04-02
Guangying Li, Baorui Zhang, Mingxing Wang, Yonglei Zhu, Sisi Wang, Aixin Liu, Tong Lai
BackgroundAs the global population ages, the incidence of acute ischemic stroke (AIS) among individuals aged 75 years and older is steadily increasing. Mechanical thrombectomy (MT) has become a standard treatment for AIS, with two commonly employed approaches: bridging thrombectomy (BT) and direct mechanical thrombectomy (DMT). However, the efficacy and safety of these strategies in elderly patients remain inconclusive.MethodsThis single-center retrospective study included AIS patients aged 75 years and older who underwent BT or DMT at Liuan City Hospital of Traditional Chinese Medicine, affiliated with Anhui University of Traditional Chinese Medicine, between December 2020 and August 2024. After propensity score matching (PSM), patients were compared in terms of neurological outcomes (NIHSS, mRS), inflammatory markers (CRP, NLR, SII, SIRI), and complication rates at 24 h, 7 days, and 90 days post-treatment. A predictive model for 90-day functional outcome was developed using univariate and multivariate regression analyses and evaluated for performance.ResultsA total of 87 patients were enrolled, and CRP levels on day 7 after treatment were significantly higher in the BT group than in the DMT group (P = 0.008). Multivariate analysis identified time to puncture, NIHSS at 24 h, and CRP at 7 days as independent predictors of 90-day poor functional outcome. Patients with a pre-puncture time >3.25 h had a 6.36-fold higher risk of poor prognosis than those with ≤ 3.25 h. For every 1 mg/L increase in C-reactive protein at 7 days postoperatively, the risk of poor prognosis increased by 2%, with a significant risk rise when the level exceeded 28.175 mg/L. Patients with a NIHSS score >14.5 at 24 h postoperatively had a 2.22-fold higher risk of poor prognosis than those with ≤ 14.5. The predictive model demonstrated high accuracy, with an area under the curve (AUC) of 0.93. And the risk value of 0.319 is the judgment point to distinguish high and low risk groups.ConclusionIn AIS patients aged 75 years and older, both BT and DMT yielded comparable short- and long-term neurological outcomes. Onset Puncture Time, Postoperative NIHSS at 24 h and CRP at 7 days were key prognostic factors. The developed model may serve as a reliable tool for individualized prognosis assessment and optimization of treatment strategies in elderly stroke patients.
DOI: 10.3389/fmed.2026.17035962026-04-02
Weitao Cao, Lineng Xie, Gang Xu, Zhaoxing Lu, YuDong Hu, Zhuxiang Zhao, Qing Li, Wei Ma, Wenhui Wang, Jun Zhao
ObjectiveAspiration pneumonia (AP) substantially increases mortality risk among elderly patients, necessitating prompt diagnostic recognition and prognostic stratification. However, standardized diagnostic criteria and prognostic markers remain elusive. This investigation seeks to quantify high-contribution clinical parameters for the diagnosis and evaluation of AP prognosis, elucidate nonlinear risk interactions, and establish a comprehensive risk stratification framework tailored for Chinese geriatric populations.MethodsThis retrospective cohort analysis (2017–2018) enrolled 295 patients with pneumonia (aged 65–98 years) from Guangzhou First People’s Hospital. The exposure variable was the diagnosis of AP, with the primary endpoints being 3-month mortality and recurrence rates. The adjustment variables encompassed demographic characteristics, comorbidities, biomarkers, and functional status. A dual-modeling approach was implemented: (1) multivariable multinomial logistic regression; (2) interpretable random forest algorithms incorporating SHAP/PDP analyses.ResultsConventional analytical approaches demonstrated significantly elevated 3-month mortality (17.3% vs. 5.9%) and recurrence rates (42.3% vs. 17.8%) in the AP cohort (both p 15 days and Barthel Index ≤2, along with nonlinear interaction effects between antibiotic duration and Barthel score; antibiotic duration was interpreted as a clinical-course marker rather than a causal factor. Additionally, prognostic quantitative markers for AP were established: albumin <30 g/L, with interactive effects between albumin levels and nutritional risk.ConclusionThis dual-framework methodology amalgamates epidemiological rigor with artificial intelligence interpretability, allowing AP identification and prognostic evaluation through routine clinical parameters. This approach establishes a foundation for dynamic risk stratification in AP patients and contributes to improved clinical outcomes.
DOI: 10.3389/fmed.2026.17353112026-04-02
Ye Zhao, Ming Bao, Wencui Niu
ObjectiveTo investigate the clinical efficacy and immunomodulatory effects of curcumin (Cur) combined with vedolizumab (VDZ) in patients with moderate-to-severe ulcerative colitis (UC).MethodsA prospective, multicenter, randomized controlled double-blind study was conducted. Patients with moderate-to-severe UC admitted between March 2021 and March 2024 were enrolled and randomly assigned to either the VDZ monotherapy group (76 cases) or the VDZ combined with Cur combination group (83 cases). The treatment period was 26 weeks. The primary outcome was the clinical remission rate at 26 weeks. Secondary outcomes included the remission rate at 14 weeks, the disease activity index (DAI), inflammatory and immune markers, and safety.ResultsThe combination group showed significantly higher clinical remission rates at both 26 and 14 weeks compared to the VDZ group (P 0.05), indicating comparable safety profiles. In the combination group, DAI exhibited a stronger positive correlation with Th17/Treg ratio, CRP, and fecal calprotectin, and a more pronounced negative correlation with IL-10 (P < 0.05). Subgroup analysis showed that both the VDZ group and the combination group had higher benefits in moderate UC compared to severe UC.ConclusionCurcumin as an combination group to VDZ significantly improves clinical remission rates, alleviates inflammatory and immune imbalances in patients with moderate-to-severe UC, without increasing safety risks, highlighting its important clinical translational value. This study provides new evidence for combination treatment strategies in UC.
DOI: 10.3389/fmed.2026.17890832026-04-01
Min Liu, Chaxiang Li, Haishuang Mei, Zhaohui Zhang, Guilan Ban, Tan Yayuan
RationaleAmniotic fluid embolism (AFE) is a rare and life-threatening obstetric emergency with an extremely high mortality rate. Pulmonary thromboembolism (PTE), a severe comorbidity of AFE in the puerperium, further exacerbates hemodynamic disturbance and multiple organ injury, posing great challenges to clinical diagnosis and targeted intervention. Relevant clinical diagnosis and treatment experience still need to be further supplemented and optimized.Patient concernsA 37-year-old advanced-age parturient with a history of hysteroscopic adhesiolysis suffered a sudden onset of AFE following forceps-assisted delivery, complicated with PE and severe multiple organ dysfunction. The patient developed acute respiratory failure, cardiogenic shock, and coagulopathy in a short period with critical clinical manifestations, requiring emergent intensive care intervention.DiagnosisAmniotic fluid embolism complicated with pulmonary embolism and multiple organ dysfunction syndrome (MODS).InterventionsA multidisciplinary team (MDT) formulated and implemented a comprehensive and individualized treatment regimen for the patient: invasive mechanical ventilation was administered for respiratory support; precise volume management guided by pulse indicator continuous cardiac output (PICCO) was adopted, combined with vasoactive agents and inotropic drugs for circulatory support; tranexamic acid (TXA) and component blood transfusion were given to correct coagulopathy, and risk-stratified anticoagulant therapy was promptly initiated after the recovery of coagulation function; standardized anti-infection therapy and preventive measures for thrombotic complications were implemented throughout the entire treatment course.OutcomesAfter 72 h of intensive care and dynamic treatment adjustment, the patient’s hemodynamic and respiratory status improved significantly and stabilized, and she was successfully weaned from mechanical ventilation. At the 30-day follow-up after discharge, the patient achieved complete recovery of organ function with no long-term sequelae or related complications.Lessons learnedThis case indicates that clinicians should maintain a high degree of vigilance for the possibility of complicated PE in AFE patients, especially those with high-risk factors such as advanced age and operative delivery. Early identification via standardized diagnostic tools, seamless collaboration of the MDT, precise organ function support based on real-time monitoring, and dynamic adjustment of the treatment regimen according to the patient’s condition are the core keys to improving the success rate of treatment and the prognosis of patients with AFE complicated with PTE.
DOI: 10.3389/fmed.2026.17953162026-04-01
Ning Yang, Jiancheng Mu, Feng Xu, Wanyue Guo, Chuhuan Sun, Bosen Peng, Junhan Xiang, Lixing Deng, Wei Fan
Dry eye disease (DED) is a multifactorial disorder of the lacrimal functional unit and ocular surface that leads to ocular discomfort, visual disturbance, and tear film instability. It affects a substantial proportion of the global population and is driven by a complex interplay of immune dysregulation, environmental stressors, and systemic factors. Accumulating evidence indicates that immune-mediated inflammation is central to DED pathogenesis and is closely intertwined with oxidative stress, autophagy imbalance, pyroptosis, apoptosis, ferroptosis, viral infection, and alterations in the ocular surface microbiota, ultimately disrupting ocular surface homeostasis. Despite the availability of multiple therapeutic options, current treatments often fail to achieve sustained symptom relief, largely due to short ocular residence time, limited bioavailability, and insufficient targeting of underlying inflammatory mechanisms. In recent years, innovative ophthalmic drug delivery systems–including nanoparticles, hydrogels, liposomes, microspheres, and emerging gene-based platforms–have been developed to enhance drug retention, improve ocular bioavailability, and enable controlled and targeted therapy. This review provides an updated and integrative overview of the immunopathological mechanisms underlying DED and critically summarizes recent advances in ophthalmic drug delivery technologies. By linking disease mechanisms with translational delivery strategies, we highlight how emerging delivery systems may overcome the limitations of conventional therapies and facilitate precision, long-acting, and patient-centered treatment for DED. These insights may inform future therapeutic development and guide the clinical translation of innovative treatment strategies for this increasingly prevalent ocular surface disease.
DOI: 10.3389/fmed.2026.17807332026-04-01
Guangping He, Jiali Liang, Ziyang Ding, Xinyu Qu, Junjun Qiu
IntroductionCervical cancer carcinogenesis often exhibits significant heterogeneity, and the molecular mechanisms underlying epithelial cell transformation are not fully understood.MethodsSingle-cell RNA sequencing was employed to compare the immune microenvironment of normal cervix and cervical cancer. Immunohistochemistry was applied to measure the expression of KDM5B in patient samples. qPCR and western blot were performed to detect the KDM5B expression and activation of IFN pathway in cell line. Co-immunoprecipitation (COIP), immunofluorescence (IF) and surface plasmon resonance (SPR) are employed to detect the binding between KDM5B and FOXG1. Flow cytometry was conducted to evaluate the immune infiltration of mice tumor.ResultsThis study reveals that malignant progression in cervical cancer is characterized by substantial DNA damage and marked upregulation of the histone demethylase KDM5B. We also identified a novel regulatory mechanism by which KDM5B recruits the transcriptional repressor FOXG1 to suppress the interferon signaling pathway, thereby promoting malignant behaviors and immune escape in cervical cancer. Targeting KDM5B could effectively enhance anti-tumor immunity.DiscussionThese findings provide crucial insights into the biological role of KDM5B in cervical cancer and highlight its potential as a promising therapeutic target for immunotherapy.
DOI: 10.3389/fmed.2026.17495362026-04-01
Caroline Jacobzone-Lévêque, Rieko Tsubouchi, Francisco Salazar, Haiping Zhang, Dimitre Dimitrov
Cutaneous atopy, which predominantly manifests as atopic dermatitis (AD), represents a significant global health concern due to its high prevalence and profound impact on patients’ quality of life. AD affects up to 20% of children and 10% of adults worldwide, with a rising incidence in both industrialized and developing regions. While genetic predisposition is a key determinant, most existing literature analyzes risk factors in isolation, limiting a comprehensive understanding of the disease. This article provides an integrative, regionally informed perspective on how environmental, cultural, genetic, and lifestyle factors may interact to shape the clinical expression of cutaneous atopy in diverse populations and regions. Drawing on published evidence and insights from an international expert panel, we highlight the complexity and multifactorial nature of the atopic environment, emphasizing the simultaneous disruption of the four key skin barriers—physical, chemical, immunological, and microbial—in AD. The article further addresses how regional differences in barrier function and the influence of urban versus rural living conditions can affect disease manifestation, underlining the need for personalized and holistic therapeutic strategies. This integrative perspective aims to offer healthcare professionals an updated framework for the management of AD, enabling more effective interventions tailored to the realities of diverse patient populations.
DOI: 10.3389/fmed.2026.17963372026-04-01
Ashwaq M. Al-Nazawi, Rana Alghamdi, Ali A. Al-Zahrani, Wafa Ali Hetany, Maseer Khan
BackgroundWest Nile virus (WNV), an emerging mosquito-borne flavivirus, is a growing global concern, particularly in tropical regions, where climatic conditions favor vector proliferation. Although often asymptomatic, less than 1% of cases develop severe neuroinvasive disease, primarily among the elderly or immunocompromised. Transfusion-transmitted WNV infections have been documented but remain underrecognized in the Middle East.MethodsThis study reports a case of a 4-year-old Saudi girl with Ewing’s sarcoma undergoing chemotherapy who developed WNV encephalitis following multiple blood transfusions from 30 healthy blood donors. The investigation was conducted at a tertiary hospital in Jeddah. Serological screening of 30 blood donors was performed to identify potential sources of infection.ResultsThe patient presented with febrile seizures, and MRI findings of bilateral thalamic and midbrain signal changes were consistent with viral encephalitis. WNV infection in the patient was confirmed by the polymerase chain reaction. The clinical picture correlated with reported cases of transfusion-associated WNV infection in immunocompromised hosts. Four of the 30 donor samples (13.3%) tested positive for anti-WNV antibodies, indicating prior exposure among donors and supporting transfusion as a plausible but unconfirmed transmission route, as retrospective molecular testing of implicated blood units was not available.ConclusionThis case underscores the need to consider the incorporation of nucleic acid testing (NAT) for WNV RNA into pretransfusion screening protocols, particularly for high-risk recipients and during peak transmission periods, to reduce the risk of transfusion-transmitted infection. The detection of anti-WNV antibodies among healthy donors highlights the silent viral circulation in the community. Strengthening national surveillance systems, enhancing vector control measures, and improving clinician awareness are vital to mitigate transfusion-related WNV transmission in endemic and emerging regions.
DOI: 10.3389/fmed.2026.17449892026-04-01
Yanyan Liang, Xi Lv, Jialin Niu, Shifeng Zhang, Pei Feng, Zhaohui Xiong, Ye Yang
ObjectiveTo characterize the clinical presentation of intraocular foreign body (IOFB) injury and evaluate the short-term visual acuity outcomes following 25-gauge pars plana vitrectomy (PPV), with identification of independent predictors of postoperative visual recovery.MethodsA retrospective study was conducted on 198 patients (198 eyes) diagnosed with IOFB who underwent 25G minimally invasive PPV at the Department of Ophthalmology, First Hospital of Hebei Medical University, between January 1, 2020, and December 31, 2024. Clinical characteristics of the IOFB, therapeutic efficacy of PPV, and best corrected visual acuity (BCVA) were analyzed to identify factors influencing postoperative visual acuity. Furthermore, receiver operating characteristic (ROC) curve analysis was performed to validate the predictive accuracy of the model for postoperative visual outcomes.ResultsAmong the 198 patients, most were young and middle-aged males residing in rural areas. Metal IOFB were the predominant type, accounting for 141 eyes (71.2%). The majority of these foreign bodies entered through Zone I (157 eyes, 79.3%), with a complete intraoperative removal rate (100%). Preoperatively, BCVA was ≥0.1 in 81 eyes and <0.1 in 117 eyes. Postoperatively, BCVA improved to ≥0.1 in 126 eyes, while it remained below 0.1 in 72 eyes. This improvement in BCVA after surgery was statistically significant (p < 0.001). Multivariate logistic regression analysis revealed that poor preoperative BCVA, macular involvement by the foreign body and coexisting endophthalmitis were independent risk factors for suboptimal postoperative visual outcomes. A composite predictive model integrating these three variables exhibited strong discriminatory performance, with an area under the AUC of 0.797 (95% confidence interval: 0.735–0.859), with a sensitivity of 94.4% and specificity of 55.6%, indicating high predictive accuracy.Conclusion25G minimally invasive PPV effectively improves visual acuity in the majority of patients with IOFB. Preoperative poor BCVA, macular impaction of foreign bodies and coexisting endophthalmitis are significant independent risk factors for short-term suboptimal postoperative visual outcomes.
DOI: 10.3389/fmed.2026.17467622026-04-01
Yao Wang, Meiqin Zhou, He Meng
BackgroundArtificial intelligence (AI) is rapidly transforming dental education by enhancing preclinical skill development, clinical diagnostic training, assessment processes, and content generation. Despite increasing interest, the scope and methodological characteristics of AI integration across dental curricula remain unclear. This review aimed to map current applications, benefits, and challenges associated with AI in dental education.MethodsFollowing the Arksey and O’Malley framework and PRISMA-ScR guidelines, a systematic search was conducted across major databases in December 2025. Seventeen empirical studies met the inclusion criteria. Data were charted using a structured extraction tool and synthesized descriptively. Studies were categorized into four thematic domains: preclinical training, clinical and diagnostic training, assessment and feedback systems, and AI-generated educational content. Methodological characteristics and commonly reported limitations (e.g., sample size, outcome type, comparator presence, and validation approach) were mapped descriptively to contextualize the evidence.ResultsAI demonstrated promising applications across domains, including improvements in procedural accuracy, diagnostic consistency, assessment workflows, and learning material generation. However, the evidence base was heterogeneous and frequently limited by small sample sizes, short evaluation periods, reliance on self-reported outcomes, and limited external validation. Key gaps included limited real-time procedural assessment and insufficient educator involvement in AI design.ConclusionAI offers substantial opportunities to enhance dental education but requires standardized definitions, stronger methodological rigor, ethical governance, and improved faculty readiness. Clinician-led, collaborative AI development will be critical to ensuring safe, pedagogically aligned integration.
DOI: 10.3389/fmed.2026.1775853