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Frontiers In Endocrinology

May 13, 2026

Association of sleep variability and irregularity with gestational metabolic syndrome: a birth cohort study

Haiyan Gao
Libo Xu
Wenjuan Liu
Haibo Li
Bin Sun
Wei Li
Zhengqin Wu
Beihong Zheng
Yibing Zhu
May 13, 2026

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Objective: To investigate the associations of sleep variability and irregularity with the odds of gestational metabolic syndrome (GMS) and its components during

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Frontiers In Oncology

May 13, 2026

Baseline serum cortisol as a prognostic biomarker for immune checkpoint inhibitor therapy in advanced gastric cancer

Yufei Zhao
Zhanjun Guo
Jingjing Zhang
Zhidong Zhang
May 13, 2026

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Objective: To evaluate the prognostic value of baseline serum cortisol and ACTH levels in predicting immune checkpoint inhibitor (ICI) response in advanced gast

Baseline serum cortisol levels are significantly associated with immune checkpoint inhibitor efficacy in advanced gastric cancer patients.
High baseline cortisol correlates with poorer disease control rate, progression-free survival, and overall survival in advanced gastric cancer.
The study identified a cutoff of 193.95 nmol/L for baseline cortisol, with an AUC of 0.673 for overall survival prediction.
Multivariate analysis confirmed high baseline cortisol as an independent prognostic factor for poorer overall survival.
This research supports further exploration of stress hormone signaling to optimize immunotherapy in advanced gastric cancer.

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Frontiers In Endocrinology

May 13, 2026

Case Report: Twenty years of metreleptin therapy in congenital generalized lipodystrophy type 1: the longest reported follow-up to date

Elise Van der Borght
Bart Van der Schueren
Roman Vangoitsenhoven
David Cassiman
Baris Akinci
Rebecca J. Brown
Elif A. Oral
Ann Mertens
Pieter-Jan Martens
May 13, 2026

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Objective: To evaluate the long-term clinical outcomes, treatment adherence, immunogenicity, and pregnancies in two sisters with congenital generalized lipodyst

Congenital generalized lipodystrophy (CGL) is characterized by a near-complete absence of adipose tissue and severe metabolic dysfunction due to leptin deficiency.
Metreleptin is the only approved leptin replacement therapy for CGL, significantly improving metabolic outcomes and allowing discontinuation of insulin in treated patients.
The two sisters in the study experienced sustained metabolic enhancement, including normalized triglyceride levels and resumed menstrual cycles, enabling successful pregnancies.
Long-term treatment adherence diminished over time, with one sister developing anti-drug antibodies after 14 years, though without significant clinical impact.
The cases highlight the lasting benefits of metreleptin therapy while also emphasizing the challenges of maintaining adherence and managing antibody development.

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Frontiers In Neurology

May 13, 2026

Rehmannioside A alleviates neuroinflammation and cognitive impairments after traumatic brain injury by suppressing microglial activation via the MAPK/NF-κB pathway

Shiyu Zhou
Yiwan Fang
Haoxin Ji
Huazheng Yan
Jianxiong Gao
Hezuo Lü
May 13, 2026

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Objective: To assess the therapeutic efficacy of Rehmannioside A (REA) in traumatic brain injury (TBI) and clarify its underlying molecular mechanisms, highligh

Rehmannioside A (REA) reduces neuroinflammation and cognitive deficits after traumatic brain injury (TBI) by inhibiting microglial activation.
In a mouse model of TBI, REA improved neurological function and spatial memory while decreasing cerebral edema and neuronal degeneration.
REA therapy resulted in a dose-dependent reduction of pro-inflammatory cytokines in LPS-activated microglial cells.
The neuroprotective effects of REA are associated with decreased phosphorylation of p65 (NF-κB) and p38 (MAPK) in activated microglia.
The study supports REA as a potential therapeutic candidate for managing TBI and other neuroinflammatory disorders.

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Frontiers In Immunology

May 13, 2026

Comparative effectiveness of budesonide EC and telitacicept in proteinuria and eGFR trajectories in IgA nephropathy: a retrospective cohort study

Xingsheng Zuo
Yaqin Wang
Fangfang Ma
Xianyuan Zhu
Chenglong Zhao
May 13, 2026

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Objective: To compare the effectiveness of budesonide EC and telitacicept in lowering proteinuria and maintaining renal function in patients with IgA nephropath

IgA nephropathy (IgAN) is the most common primary glomerulonephritis, with significant global incidence variation, particularly high in East Asia.
This study compared the efficacy of budesonide EC and telitacicept in reducing proteinuria and maintaining eGFR in patients with IgAN.
Telitacicept showed a greater reduction in proteinuria, especially in patients with mild-to-moderate baseline proteinuria.
Budesonide EC was associated with a higher average eGFR during follow-up, but this significance diminished after propensity score matching.
The findings highlight the need for further prospective studies to validate the comparative effectiveness of these treatments in IgAN.

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Frontiers In Immunology

May 13, 2026

Divergent immune cascades activated by metabolic versus mechanical exercise intensity: revisiting cytokine heterogeneity in “moderate-intensity exercise”

Jia-wen Wang
Jian-Jun Xun
Li-Na Jian
May 13, 2026

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Objective: To address the variability in cytokine responses to moderate-intensity exercise by distinguishing between metabolic (aerobic) and mechanical (resista

Moderate-intensity exercise encompasses both aerobic and resistance training, which activate inflammatory pathways differently.
Aerobic exercise induces an anti-inflammatory response via IL-6, while resistance training triggers a damage-repair immune response.
Current meta-analyses often combine cytokine responses from diverse exercise modalities, leading to significant variability in findings.
The proposed dual-axis classification distinguishes between metabolic and mechanical exercise dimensions for better data interpretation.
Future research should utilize time-resolved inflammatory sampling and causal inference techniques to clarify exercise-induced cytokine responses.

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Frontiers In Neurology

May 13, 2026

Machine learning-based prediction of ischemic cardio-cerebrovascular events after endovascular or microsurgical treatment of unruptured intracranial aneurysms and risk stratification by the early post-treatment triglyceride-glucose index

Yingchao He
Shuheng Chen
Deshan Liu
Zheng Zheng
Yongkun Li
Yinzhou Wang
May 13, 2026

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The study aimed to predict ischemic cardio-cerebrovascular events (ICCEs) within 6 months post-treatment for unruptured intracranial aneurysms (UIAs).
A total of 1,954 patients with UIAs were analyzed, with 240 experiencing ICCEs, highlighting the significant risk following treatment interventions.
The CatBoost model demonstrated the highest predictive accuracy for ICCEs, achieving an accuracy of 0.875 and an AUROC of 0.945.
The early post-treatment triglyceride-glucose (TyG) index was identified as a significant predictor, with each 1-unit increase correlating to a 2.61-fold increased risk of ICCEs.
The findings suggest that the TyG index could serve as a practical metabolic indicator for personalized perioperative risk assessment in UIA patients.

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Frontiers In Endocrinology

May 13, 2026

Proteins at the intersection of circadian rhythms and metabolic dysfunction-associated steatotic liver disease: an 18-protein panel as a novel predictive biomarker set

Yiyi Wang
Qilong Zhai
Xuemei Lian
Lei Zhao
May 13, 2026

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Objective: To explore the relationship between circadian rhythm disruption and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and identify pot

Circadian rhythm disruption is linked to the rise of metabolic disorders, particularly Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).
Relative amplitude (RA) is a key measure of circadian rhythm disruption, showing lower values in individuals with MASLD compared to those without.
The study identified 18 candidate proteins as potential biomarkers for predicting RA-related MASLD, demonstrating strong predictive capabilities.
Machine learning models, including Random Forest and XGBoost, achieved high AUC values, indicating excellent predictive performance for RA-related MASLD.
An online predictive tool based on the 18-protein model has been developed to assess the risk of RA-related MASLD effectively.

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Frontiers In Immunology

May 13, 2026

Wnt signaling as a regulator of memory T cells: implications for CAR-T cell therapy

Tatiana Fourfouris
Ki Jun Lee
Samantha Hurwitz
Asher Ahdoot
Alexander Lee
Maiah Zarrabi
Michael Kahn
Yong-Mi Kim
May 13, 2026

Summary
Takeaways
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Objective: To explore the function of Wnt/β-catenin signaling in T cell maturation and memory formation, and its implications for enhancing CAR-T cell therapy b

CAR-T therapy shows high remission rates in hematologic malignancies but suffers from limited long-term effectiveness due to poor CAR-T cell persistence.
Wnt/β-catenin signaling, through TCF1 and LEF1, regulates memory programming essential for CAR-T cell longevity and positive patient outcomes.
Activation of the Wnt/β-catenin pathway promotes the development of CD8+ memory stem cells, enhancing their proliferative and recall capabilities.
Genetically modified CAR-T cells are influenced by the same mechanisms that govern memory development in endogenous T cells, linking basic biology to CAR-T engineering.
Wnt-targeted strategies have clinical potential to improve CAR-T cell memory phenotypes, persistence, and reduce exhaustion in cancer therapies.

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Frontiers In Immunology

May 13, 2026

Serum interleukin-6 as a neuroinflammatory biomarker across the spectrum of neurological disorders: a large-scale retrospective cohort study of 6,465 individuals

Lingjun Zhao
Zhaoming Tang
Chengliang Zhu
May 13, 2026

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Objective: To map serum IL-6 levels across 10 categories of neurological disorders, including traumatic brain injury, metabolic/toxic encephalopathy, and hemorr

Serum IL-6 levels significantly vary across 10 neurological disorders, with the highest levels in traumatic brain injury, metabolic/toxic encephalopathy, and hemorrhagic stroke.
Independent predictors of serum IL-6 levels include disease category, age with a U-shaped association, and male sex, all showing statistical significance.
IL-6 demonstrates strong diagnostic performance for distinguishing acute brain injuries from healthy individuals, with AUC values exceeding 0.9 for several conditions.
The diagnostic utility of IL-6 is limited for differentiating between various neurological diseases, particularly between traumatic brain injury and others.
A proposed clinical interpretation framework for serum IL-6 testing requires further validation in multi-center studies to confirm its utility in emergency settings.

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Frontiers In Hematology

May 13, 2026

Mechanisms of kinase inhibitor resistance in subtypes of cutaneous T-cell lymphomas

Julia A. Yescas
Christopher G. Bunick
Ayman Grada
Joan Guitart
Carlos A. Torres-Cabala
I. Caroline Le Poole
Xiaolong A. Zhou
May 13, 2026

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Cutaneous T-cell lymphomas (CTCLs) are aggressive skin-homing T-cell malignancies with limited curative treatment options.
Genomic studies reveal recurrent alterations in tyrosine kinase pathways in aggressive CTCL subtypes, particularly PCAETL and PCGDTL.
Tyrosine kinase inhibitors (TKIs) like ruxolitinib and pemigatinib show potential but often lead to transient responses and acquired resistance.
Resistance mechanisms include secondary kinase domain mutations and adverse events that hinder ongoing treatment efficacy.
Durable responses in CTCL may require molecular stratification, genomic monitoring, and combination therapy strategies.

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Frontiers In Medicine

May 13, 2026

Randomized controlled trial evaluating mixed reality technology for training scrub nurses in anterior cervical spine surgery

Wenqing Yang
Tingting Ma
May 13, 2026

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Objective: To evaluate the effectiveness of a Mixed Reality (MR) training module compared to standard training for scrub nurses in anterior cervical spine surge

A randomized controlled trial evaluated Mixed Reality training for scrub nurses in anterior cervical spine surgery against traditional methods.
The MR training group showed significantly higher scores in theoretical knowledge, practical performance, and emergency response assessments.
Participants in the MR group reported lower cognitive load and higher satisfaction compared to those receiving standard training.
Mixed Reality training effectively enhances learning outcomes by providing immersive, three-dimensional practice for scrub nurses.
This study highlights the potential of MR as a valuable tool for advancing surgical nursing education in complex procedures.

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Frontiers In Cardiovascular Medicine

May 13, 2026

Comparison of aortoiliac disease stenting patency using balloon-expandable, self-expanding, and covered stents

Ali A. Hasnie
Tonga Nfor
James O. Adefisoye
Kelly Magee
M. Fuad Jan
Mark W. Mewissen
Tanvir K. Bajwa
Babak Haddadian
May 13, 2026

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Objective: To investigate patency rates of balloon-expandable, self-expanding, and covered stents in patients with aortoiliac artery disease using a large inter

Peripheral arterial disease affects approximately 6.5 million individuals in the U.S., with a significant portion located in the iliac arteries.
The study analyzed 1,886 patients from the Vascular Quality Initiative database who underwent aortoiliac artery interventions between 2012 and 2017.
Balloon-expandable stents showed a higher one-year primary patency rate (98.4%) compared to self-expanding (97.1%) and covered stents (96.3%).
At three years, there was no significant difference in primary patency rates among the three stent types, indicating similar long-term outcomes.
Stent selection for aortoiliac interventions should consider factors like cost and lesion characteristics rather than relying solely on long-term patency.

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Frontiers In Ophthalmology

May 13, 2026

Peripheral retinal degenerations: multimodal imaging–guided risk stratification and clinical decision-making

Siniša Babović
Nemanja Maletin
Nikola Denda
May 13, 2026

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Objective: To provide an imaging-guided, risk-based framework for the evaluation and management of peripheral retinal degenerations (PRD), emphasizing the role

Peripheral retinal degenerations (PRD) range from benign atrophic changes to high-risk tractional lesions associated with retinal tears and detachment.
Posterior vitreous detachment (PVD) is a key factor linking PRD to retinal tears and rhegmatogenous retinal detachment, especially during acute symptoms.
Ultra-widefield imaging and swept-source OCT enhance visualization of peripheral retinal morphology, aiding in the differentiation of benign and unstable lesions.
Selective prophylactic laser photocoagulation is supported for symptomatic retinal tears and confirmed tractional instability, while asymptomatic low-risk PRD need no routine treatment.
Management of PRD should be individualized, utilizing multimodal imaging and clinical assessment to target interventions based on tractional instability and risk factors.

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Frontiers In Cardiovascular Medicine

May 13, 2026

Opioid overdose and cardiovascular disease-related mortality: a retrospective analysis using real-world data from the USA, 1999–2023

Mohamed Fawzi Hemida
Alyaa Ahmed Ibrahim
Maryam Saghir
Ahmed Elshahat
Mohammad Rayyan Faisal
Moaz Elsayed Abouelmagd
Zeyad Kholeif
Krish Patel
Noha Hammad
Pakeezah Tabasum
Eshal Saghir
Mohammed Hammad Jaber Amin
Ahmed Elmorsy Mohamed
Khaled Ali
Basel Abdelazeem
Mustafa Al-jarshawi
May 13, 2026

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Objective: To characterize long-term trends and disparities in mortality involving both opioid overdose and cardiovascular disease (CVD) from 1999 to 2023. Key

The study analyzed 112,430 deaths involving opioid overdose and cardiovascular disease (CVD) from 1999 to 2023 using CDC WONDER data.
Age-adjusted mortality rates for opioid overdose and CVD increased significantly, from 0.36 in 1999 to 4.08 in 2023, with an average annual percent change of 10.96.
Men exhibited higher mortality rates than women, with overall age-adjusted mortality rates of 2.51 for men compared to 0.99 for women.
Non-Hispanic Black individuals experienced the steepest increase in mortality rates, rising from 0.33 in 1999 to 6.48 in 2023.
Non-metropolitan areas had consistently higher mortality rates than metropolitan areas, highlighting significant regional disparities in opioid and CVD-related deaths.

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Frontiers In Cardiovascular Medicine

May 13, 2026

Construction of a regression model and post-procedure care strategy for predicting atrial fibrillation recurrence risk after radiofrequency ablation using combined P-wave electrocardiographic markers and serum

Dong Zhao
Yahong Chen
Hongwei Zhang
Lixia Yang
May 13, 2026

Summary
Takeaways
Quiz

Objective: To construct a risk prediction nomogram combining P-wave electrocardiographic indicators with serum BNP levels for predicting recurrence risk after r

A predictive nomogram was developed combining P-wave ECG markers and serum BNP levels to assess atrial fibrillation recurrence risk post-ablation.
The study involved 200 atrial fibrillation patients, with 62 experiencing recurrence and 138 remaining free of recurrence at the 3-month follow-up.
Significant differences in AF type, left atrial diameter, P-wave duration, and BNP levels were found between recurrence and non-recurrence groups.
Logistic regression identified AF type, left atrial diameter, P-wave parameters, and BNP as independent risk factors for recurrence after RFA.
The nomogram demonstrated high predictive accuracy with an AUC of 0.959, aiding in risk stratification and personalized follow-up care strategies.

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Frontiers In Surgery

May 13, 2026

Case Report: Partial resection of lingual ectopic thyroid using an electrohook under laryngoscopic guidance

Kepeng Li
Jinxiu Wang
May 13, 2026

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Objective: To present a case of lingual ectopic thyroid managed with an electrohook-assisted partial resection under laryngoscopic visualization, highlighting i

Lingual thyroid is a rare ectopic condition occurring in 1 in 100,000–300,000 individuals, often leading to symptoms like dysphagia and foreign body sensation.
A 56-year-old female with a 10-year history of dysphagia was diagnosed with lingual ectopic thyroid and hypothyroidism after imaging and lab tests.
The patient underwent a successful partial resection of the ectopic thyroid using an electrohook under laryngoscopic visualization, with minimal blood loss.
Postoperatively, the patient experienced complete symptom resolution, normalized thyroid function, and improved quality of life at the 3-month follow-up.
Electrohook-assisted resection is a cost-effective and safe alternative for managing symptomatic lingual ectopic thyroid, enhancing treatment accessibility.

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Frontiers In Digital Health

May 13, 2026

Recruitment strategies and participant motivations in a digital randomized controlled trial for the prevention of anxiety disorders: the prevANS study

Cristina García-Huércano
Sonia Conejo-Cerón
Alberto Rodríguez-Morejón
Carmela Martínez-Vispo
Natalia Sánchez-Aguadero
Olaya Tamayo-Morales
Patricia Moreno-Peral
May 13, 2026

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Objective: To evaluate the performance of different approaches to recruiting participants for the prevANS digital preventive intervention for anxiety and assess

The prevANS study aimed to evaluate recruitment strategies for a digital intervention targeting anxiety disorder prevention.
Over 26 months, 6,017 individuals initiated screening, resulting in a 17.5% enrollment conversion rate.
Social media and university dissemination were the most effective recruitment strategies, with word of mouth also significantly impacting enrollment.
Participants' motivations for enrolling included helping others, health-related issues, and personal benefits.
Tailoring recruitment strategies to the target population can enhance participant engagement in digital mental health trials.

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