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1
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"This evidence review addresses an important and evolving topic in gynecologic oncology and provides a useful overview of sentinel lymph node biopsy (SLNB) across cervical, endometrial, vulvar, and ovarian cancers. The discussion incorporates major studies including SENTICOL, SENTIX, FIRES, GROINS-V, SELLY, and SENTOV, and the summary table facilitates comparison of key evidence. The references are generally relevant and include recent publications.
As a review without patient recruitment or new experimental data, specific ethical approval and original biostatistical analysis are not applicable. However, the methodology of evidence identification could be described more clearly. Although PubMed was used, the search strategy, dates, eligibility criteria, and process for selecting studies are not provided, which limits reproducibility and raises the possibility of selection bias.
The conclusions are broadly consistent with the evidence presented, but some statements regarding SLNB as standard of care or its oncologic safety should be more carefully qualified according to cancer type, disease stage, patient selection, mapping technique, and maturity of survival evidence. The limitations of the review itself should also be explicitly acknowledged.
This is a clinically relevant and informative review with good educational value. Future updates would benefit from a more systematic literature-search methodology and incorporation of emerging prospective trial results and evolving international guidelines.
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Singh P. Sentinel lymph node biopsy in gynecologic cancers. World J Obstet Gynecol 2026; 15(2): 120261 [DOI: 10.5317/wjog.120261]
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2
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"This multicenter cross-sectional study addresses an important maternal and child health issue and provides useful evidence regarding breastfeeding techniques among primiparous mothers in Northeast Ethiopia. Ethical approval and informed consent are appropriately reported. The methodology is generally sound and reproducible, with systematic sampling, an adequate sample size, observational assessment of breastfeeding technique, and appropriate multivariable logistic regression. The tables and figures adequately present the main findings, and the references are generally relevant and reasonably current.
The principal limitation is the cross-sectional design, which permits identification of associations but not causal relationships. Therefore, terms such as “predictors” or “determinants” should be interpreted cautiously and preferably replaced by “associated factors.” The strong association between absence of breast problems and effective breastfeeding technique also requires cautious interpretation because the temporal relationship cannot be established. Facility-based recruitment from a limited geographic area, potential self-report and observer bias, and limited generalizability should also be recognized.
Overall, the article is scientifically credible and clinically relevant, with generally appropriate methods and statistical analysis. Future longitudinal or interventional studies would be valuable to determine whether structured breastfeeding education can causally improve breastfeeding technique and subsequent maternal and infant outcomes.
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Bogale M, Cherie N, Abeje G, Dagnew SB, Abate AW, Agidew MM. Breastfeeding techniques and associated factors among primiparous mothers: A multicenter health facility-based cross-sectional study in Northeast Ethiopia. World J Obstet Gynecol 2026; 15(2): 119451 [DOI: 10.5317/wjog.119451]
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3
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"This case report describes a rare and clinically important occurrence of ileosigmoid knotting with bowel gangrene and shock in a postpartum woman. The case has educational value because it highlights the diagnostic difficulty of acute abdominal conditions in the postpartum period and the importance of timely surgical intervention. The clinical course, operative findings, management, and follow-up are generally well documented, and written informed consent for publication is reported.
The major strength of the article is the direct operative confirmation of the diagnosis and the description of successful emergency surgical management. The figures, laboratory data, and discussion of previous literature support the clinical presentation. Formal biostatistical analysis is not applicable to a single case report.
Several issues, however, limit the scientific quality of the report. Most importantly, there appears to be an inconsistency in the classification of ileosigmoid knotting. Table 2 defines Type I as the ileum wrapping around the sigmoid colon and Type II as the sigmoid colon wrapping around the ileum, whereas the patient's condition is described as Type II despite the ileum reportedly twisting around the sigmoid colon. This should be clarified or corrected. In addition, the diagnosis of septic shock would be more convincing if supported by detailed objective parameters such as serum lactate, acid-base status, urine output, and evidence of organ dysfunction. The absence of CT imaging is appropriately explained by lack of availability but remains a diagnostic limitation.
The literature cited is generally relevant; however, because the article is presented as a case report and review of the literature, the method used to identify and select the reviewed literature could be described more clearly. The manuscript would also benefit from further language editing and more explicit acknowledgment of the limitations of drawing general conclusions from a single case.
Overall, the article provides a useful contribution concerning a rare postpartum surgical emergency, but greater consistency in disease classification, more precise documentation of shock, and cautious interpretation of conclusions would improve its scientific credibility. Future studies or case series should systematically document diagnostic, hemodynamic, operative, and outcome parameters to strengthen the evidence regarding ileosigmoid knotting in pregnancy and the postpartum period.
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Dereje WM, Zegeye ML, Wulolgn D, Tamene BA, Kassie MT. Ileosigmoid knotting causing gangrenous bowel obstruction in a postpartal mother presented with septic shock: A case report and review of literature. World J Obstet Gynecol 2026; 15(2): 118869 [DOI: 10.5317/wjog.118869]
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4
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"The article presents two interesting cases of patients with virus-related decompensated cirrhosis who were treated with TIPS and antiviral therapy and subsequently had favorable long-term outcomes. A major strength of the article is the more than 10-year follow-up period and the use of multiple assessment methods, including clinical, laboratory, hemodynamic, imaging, and histological parameters. The findings are particularly interesting, especially the normalization of portal pressure and the significant regression of liver fibrosis.
From a writing perspective, the article is well written, clear, and coherent, with a logical structure and appropriate medical terminology. The grammar and terminology are accurate, and the information is presented in a professional and easy-to-follow manner. Overall, I consider the article to be of good quality, addressing a relevant topic and presenting findings that deserve further investigation in larger studies.
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Tie J, Yuan XL, Niu J, Xu J, Shi YQ. Transjugular intrahepatic portosystemic shunt combined with viral suppression reverses decompensated cirrhosis: Two case reports. World J Gastroenterol 2026; 32(37): 120860 [DOI: 10.3748/wjg.120860]
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5
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"The conclusions are clinically relevant and highlight important dietary characteristics associated with glycemic control in patients with T2DM. However, the observed association between higher total energy intake and poor glycemic control should be interpreted cautiously, particularly given the cross-sectional nature of the analysis and the potential for reverse causality. The authors should further clarify the clinical implications of these findings and avoid overstating causality when discussing personalized dietary interventions."
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Tang YB, Du J, Zhou HP, Guo YM, Shen LS, Jiang XH, Huang S. Nutritional intake characteristics and glycemic control in patients with type 2 diabetes mellitus. World J Diabetes 2026; 17(9): 122163 [DOI: 10.4239/wjd.122163]
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6
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"The authors provide an interesting observation that elevated TNF-α levels may promote pancreatic islet β-cell apoptosis through the Bax/Bcl-2/caspase-3 pathway, with this process correlating with the severity of inflammation. However, the therapeutic implications of these findings remain insufficiently explored. The authors should further evaluate whether modulation of this pathway can attenuate β-cell apoptosis and improve glucose metabolism in acute pancreatitis-associated AGM.
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Qi FF, Zhang Y, Liu CQ, Chen HJ, Wang AF. Pancreatic injury and glucose metabolism dysfunction: The central role of inflammatory signaling and islet β-cell apoptosis. World J Diabetes 2026; 17(9): 117159 [DOI: 10.4239/wjd.117159]
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7
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"This is a methodologically sound, transparent, and clinically oriented retrospective cohort study that develops an interpretable machine-learning (ML) model for early (first-trimester) risk stratification of gestational diabetes mellitus (GDM). The authors compare eight ML algorithms under four class-imbalance handling strategies, report performance on an independent hold-out test set, and support interpretation with SHAP analysis and patient-level heatmaps. The study is well reported (STROBE statement), ethically complete, and internally consistent. Its principal contribution is the demonstration that routinely collected first-trimester clinical, ultrasound, and placental biomarkers can support a 'rule-out' (high negative predictive value, NPV 0.940) approach to GDM risk. The main limitations—single-center design, absence of external validation, heterogeneity of GDM diagnostic criteria, and test-set-based model selection—limit the generalizability and the strength of the causal/clinical claim. The study is a solid, incremental extension of the authors’ earlier logistic-regression work, but it does not deliver a new biological mechanism or a fully validated, practice-ready tool. Authors may add a head-to-head benchmark against a conventional multivariable logistic-regression model on the same cohort/features, and explicitly quantify the incremental AUC (ΔAUC), net reclassification improvement (NRI), and decision-curve net benefit over both no-screening and universal screening."
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Hung SM, Chen CP, Sun FJ, Chen YY, Wang LK, Chen CY. Early risk stratification of gestational diabetes using interpretable machine learning with first-trimester screening parameters. World J Diabetes 2026; 17(9): 123276 [DOI: 10.4239/wjd.123276]
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8
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"This paper evaluates the status of artificial intelligence (AI) implementation in the field of gastrointestinal endoscopy across six defined domains: evidence maturity, regulatory and healthcare system approval processes, clinical adoption status, potential for workflow integration (practicality), governance and monitoring, and generalizability. Computer-aided detection (CADe) for colonoscopy is classified as "Tier 1," while computer-aided diagnosis (CADx) for optical polyp characterization falls under "Tier 2." Also classified as "Tier 2" are second-observer systems for the upper gastrointestinal tract, AI-assisted procedural quality control systems, reading support tools for capsule endoscopy, and *Helicobacter pylori* infection prediction using endoscopic images. Cholangioscopy AI, therapeutic endoscopy assistance, and pancreatic lesion analysis using endoscopic ultrasound (EUS) are positioned at "Tier 3." The framework and checklist presented in this paper are noteworthy for enabling researchers designing trials, regulatory bodies evaluating submissions, and endoscopy departments deciding on implementation to apply these criteria in practice."
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Boppana SH, Chandrashekar A, Sunkesula V. From hype to clinical translation: A tiered, readiness-based framework for artificial intelligence in gastrointestinal endoscopy. Artif Intell Gastrointest Endosc 2026; 7(2): 121109 [DOI: 10.37126/aige.121109]
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9
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"Lee HY et al. presented an interesting case of an extensive multiple calcinosis in seronegative limited cutaneous scleroderma (CREST variant). The paper is written according to CARE criteria. The text is fluent and easy understandable. The figures are clearly visible and correctly marked. English is used according to scientific standards. Such unusual disease presentation is very important for everyday clinical practice. "
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Lee HY, Lee SK, Kim H, Kang SW. Extensive multiple calcinosis cutis in seronegative limited cutaneous scleroderma (CREST variant): A case report. World J Clin Cases 2026; 14(25): 123670 [DOI: 10.12998/wjcc.123670]
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10
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"The authors presented an interesting case of disseminated Cryptococcus infection (central nervous system and skin) in HIV-negative patient. The paper is written according to CARE criteria. The text is fluent and easy understandable. The figures are clearly visible and correctly marked. English is used according to scientific standards. Such unusual disease presentation is very important for everyday clinical practice. "
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Walia H, Mehta H, Rahi S, Singh I, McKee PH. Beyond the usual suspects - disseminated cryptococcosis presenting as molluscoid skin lesions: A case report. World J Clin Cases 2026; 14(25): 119033 [DOI: 10.12998/wjcc.119033]
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11
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"This is a nice, short review of the von Hippel-Lindau (VHL) protein by Kanno H and Nakahara K. Figure 1 summarizes the article content with impressive data. The authors concluded that VHL is a multifaceted regulator of neuronal differentiation and regeneration whose activity is heavily environment-dependent. Under normal oxygen conditions, VHL promotes neuronal development by suppressing JAK2/STAT and Notch signaling and activating proneural bHLH factors. In hypoxic settings, HIF-1α stabilization enhances glial differentiation and NSC survival and migration. The BC-box motif in VHL serves as a portable neural induction module, and the Daam2-VHL-Nedd4 axis promotes oligodendrocyte development and remyelination. Together, these pathways make VHL a promising target for regenerative therapeutics in neurodegenerative diseases, CNS injury, and demyelinating disorders."
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Kanno H, Nakahara K. Regenerative potential of von Hippel-Lindau tumor suppressor protein. World J Biol Chem 2026; 17(3): 119936 [DOI: 10.4331/wjbc.119936]
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12
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"The manuscript explains good scientific quality, novelty, innovation, and clinical significance.
It provides a timely and well-structured synthesis of the emerging gut–ocular axis, integrating immunological, metabolic, neuroimmune, and barrier mechanisms across several ocular diseases.
Its inclusion of a transparent literature-search methodology, an evidence hierarchy, clinical-trial findings, and translational research priorities strengthen its value.
The review appropriately recognizes that most mechanistic evidence comes from animal models, while human evidence is largely observational, heterogeneous, and vulnerable to dietary, geographic, medication-related, and methodological confounding.
Clinical evidence for probiotics, dietary interventions, and fecal microbiota transplantation remains sparse and is insufficient to guide routine ophthalmic practice.
Accordingly, therapeutic claims should remain cautious and emphasize biological plausibility rather than proven clinical efficacy.
Overall, the manuscript offers a useful and clinically relevant overview, provided that the gut–ocular axis is presented as an emerging hypothesis requiring validation through prospective studies and adequately powered randomized controlled trials."
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Paul RS, Samanta A. Gut-ocular axis: An emerging strategy to treat ocular diseases. World J Clin Cases 2026; 14(25): 124172 [DOI: 10.12998/wjcc.124172]
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13
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"The manuscript shown moderate scientific quality and significance.
Its use of a large national cohort and propensity-score matching provides value; however, its retrospective design, residual confounding, use of prescription records, and broad two-year outcome window limit causal interpretation.
The research topic has moderate novelty, while the study’s creativity and methodological innovation are limited because it applies established database and propensity-matching methods to a previously studied clinical association.
Overall, the conclusions are generally supported when interpreted cautiously, although further prospective research using clinically defined postoperative intervals, morphine-milligram equivalents, and actual medication use is warranted."
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Wu KA, Mai E, Warburton CS, Dhanjani S, Choudhury A, Docters F, Wong L, Prabhat A, Raza M, Maayan O, Song J, Shatkin M, Moucha CS, Hayden BL. Obesity and postoperative opioid utilization after total knee arthroplasty: A propensity-matched analysis. World J Clin Cases 2026; 14(25): 125054 [DOI: 10.12998/wjcc.125054]
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14
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"This review summarizes how gastric cancer spreads to the peritoneum by integrating key mechanisms such as genetic mutations, EMT activation, ECM remodeling, hypoxia-driven signaling, anoikis resistance, and immunosuppressive microenvironment interactions. It explains how tumor cells detach, survive, adhere, invade, proliferate, and induce angiogenesis within the peritoneal cavity, highlighting the coordinated roles of stromal cells, immune cells, and metabolic reprogramming. Overall, it provides a clear molecular framework that identifies promising biomarkers and therapeutic targets for improving early diagnosis and treatment of peritoneal metastasis."
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Yan HQ, Lai QQ, Huang MW, Wang TA, Wu LC, Qin YZ. Advances in molecular mechanism of gastric cancer peritoneal metastasis. World J Gastrointest Oncol 2026; 18(8): 121799 [DOI: 10.4251/wjgo.v18.i8.121799]
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15
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"This review explains the need for liquid biopsy in CRC screening, summarizes key circulating biomarkers and how they complement each other, and highlights that multi‑analyte panels can improve early detection accuracy despite challenges in standardization and validation. Liquid biopsy ultimately offers a pathway toward earlier and more precise CRC diagnosis."
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Bai XZ, Bao SCL, Zhang XQ, Yang ZN. Liquid biopsies in colorectal cancer screening and diagnosis. World J Gastrointest Oncol 2026; 18(8): 120332 [DOI: 10.4251/wjgo.120332]
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16
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"The study shows that MCM10 overexpression is strongly associated with aggressive HCC and poor prognosis. It provides consistent mechanistic evidence that MCM10 promotes tumor growth through cyclin D1–CDK4/6 activation across cell, animal, and patient samples. Overall, it highlights MCM10 combined with cyclin D1 as a meaningful biomarker pair for HCC progression."
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Chen YR, Wang G, He LJ, Ye HW, Wang LF, Zou DD, Wang MQ, Xie HW, Zhu SL, Wang XY. MCM10 promotes hepatocellular carcinoma progression through cyclin D1 regulation. World J Gastrointest Oncol 2026; 18(8): 119834 [DOI: 10.4251/wjgo.119834]
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17
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"The article clearly identifies a novel RHEB-CSF1R interaction as a driver of EMT in pancreatic cancer and supports this with coherent molecular, autophagy‑related, and functional evidence. It integrates in‑vitro and in‑vivo data to demonstrate mechanistic consistency across experimental models. Overall, the study provides a concise and compelling mechanistic framework that strengthens the biological relevance of targeting this pathway."
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Xing YR, Wang SF, Dai JJ, Xu XG, Mao WJ. Unlocking the metastatic switch: The RHEB-CSF1R complex ignites epithelial-mesenchymal transition in pancreatic cancer by autophagy. World J Gastrointest Oncol 2026; 18(8): 119680 [DOI: 10.4251/wjgo.v18.i8.119680]
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18
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"The case report clearly presents a rare CRC brain‑only metastasis with well‑documented imaging and pathology. It concisely describes coordinated multidisciplinary management across neurosurgery, oncology, and colorectal surgery. The discussion effectively contextualizes the case within existing literature, highlighting its clinical relevance. Overall, the report provides a clear and informative example of how early symptom recognition can guide timely multidisciplinary intervention."
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Xu JL, Ge ZW, Wu CW, Wang YH, Mao JD. Multidisciplinary care for colorectal cancer brain metastases with headache as initial symptom: A case report and literature review. World J Gastrointest Oncol 2026; 18(8): 119679 [DOI: 10.4251/wjgo.119679]
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19
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"This meta‑analysis is clearly structured, follows PRISMA standards, and uses high‑quality retrospective studies to synthesize evidence on NLR and malignant IPMN. The statistical method, including subgroup and leave‑one‑out sensitivity analyses, are rigorous and transparently reported. Overall, the article provides a coherent, well‑supported conclusion that elevated NLR is an adjunctive marker for malignant IPMN."
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Dong WW, Zhou LL, Yang DJ, Lu HM. Association between preoperative neutrophil-to-lymphocyte ratio and malignant intraductal papillary mucinous neoplasms: A systematic review and meta-analysis. World J Gastrointest Oncol 2026; 18(8): 119432 [DOI: 10.4251/wjgo.119432]
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20
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"The study clearly demonstrates that Streptococcus anginosus is most abundant in gastrointestinal tumors and rigorously links its load to inflammation, invasion depth, and tumor progression using both human samples and a controlled rat model. It integrates molecular, immunologic, and pathological data to show consistent pro‑tumorigenic effects, including elevated IL‑6/TNF‑α and increased immune‑cell infiltration. Overall, it provides strong, multi‑layered evidence that S. anginosus is a meaningful microbial driver and potential therapeutic target in gastric cancer."
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Huang DB, Chen BS, Wang AP, Hu XZ, Xu YJ. Polymerase chain reaction detection of Streptococcus anginosus in digestive diseases and its immunomodulation in rat gastric cancer model. World J Gastrointest Oncol 2026; 18(8): 119026 [DOI: 10.4251/wjgo.119026]
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21
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"The editorial clearly highlights how patient‑derived organoids overcome the limitations of traditional models and better preserve patient‑specific biology. It synthesizes recent mechanistic and translational findings into a coherent narrative that clarifies their relevance to gastric intestinal metaplasia. It also provides forward‑looking insight by emphasizing organoid‑based drug screening as a promising direction for future therapeutic development."
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Deng JY, Du HB, Zao XB. Patient-derived organoids: A new platform for mechanism research and drug development of gastric intestinal metaplasia. World J Gastrointest Oncol 2026; 18(8): 118750 [DOI: 10.4251/wjgo.v18.i8.118750]
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22
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"The study clearly states its clinical question, applies a structured comparative design with balanced baseline characteristics, and reports statistically consistent advantages of amlodipine without added toxicity. Safety outcomes are systematically presented using CTCAE criteria, and the authors transparently acknowledge methodological limitations. Overall, the article demonstrates clarity, methodological rigor, and responsible scientific reporting."
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Lou HC, Liu XH, Jin P, Wang JM, Liu B. Interaction between calcium channel blockers and capecitabine in colorectal cancer patients with hypertension. World J Gastrointest Oncol 2026; 18(8): 118698 [DOI: 10.4251/wjgo.118698]
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23
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"This is very interesting paper. While TIPS (Transjugular Intrahepatic Portosystemic Shunt) is dramatically effective in treating refractory ascites and esophageal varices caused by portal hypertension, a post-procedural decline in liver function—either temporary or long-term—is the more common outcome. However, under specific conditions or when complications are successfully managed, there are cases where the patient's overall condition and certain indicators of hepatic reserve appear to "improve." It is important to note that since the fundamental nature of TIPS is to bypass the liver, the procedure does not actually rejuvenate the hepatocytes themselves; rather, improvements in liver function markers and overall condition occur through the following mechanisms: Improvement in renal function and metabolism through the reduction or discontinuation of diuretics—Background: Cases involving the use of high-dose diuretics to control refractory ascites prior to the procedure, leading to dehydration, electrolyte imbalances, and impaired renal function (hepatorenal syndrome). Improvement: Once TIPS resolves the ascites, diuretic dosages can be significantly reduced or discontinued. This allows renal function to recover and improves systemic metabolic status, thereby indirectly reducing the burden on the liver and leading to improvements in blood test results (such as albumin levels). Recovery from liver failure by preventing gastrointestinal bleeding—Background: Cases where recurrent bleeding from esophageal or gastric varices causes chronic anemia and hypotension, resulting in insufficient oxygen supply to the liver and a marked decline in liver function. TIPS lowers portal pressure and completely controls bleeding, stabilizing oxygen supply to the liver. As anemia resolves, impaired hepatic reserve may recover to its baseline level. Dramatic improvement in nutritional status (amelioration of sarcopenia)—Background: Cases where abdominal distension due to massive ascites prevents adequate food intake, leading to severe malnutrition and loss of muscle mass (sarcopenia). Improvement: In such cases, the resolution of ascites enables increased food intake. Although the efficiency of amino acid metabolism decreases because a portion of portal blood flow bypasses the liver, there are cases where serum albumin levels rise and liver function (synthetic capacity) tends to improve over the long term due to increased total caloric and protein intake. I ask question for author. For which types of cases does TIPS yield favorable results?
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Tie J, Yuan XL, Niu J, Xu J, Shi YQ. Transjugular intrahepatic portosystemic shunt combined with viral suppression reverses decompensated cirrhosis: Two case reports. World J Gastroenterol 2026; 32(37): 120860 [DOI: 10.3748/wjg.120860]
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24
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"A really strange letter to the editor. This kind of article should not have any abstract nor separate conclusions. The references to histone metylation are nonsense. In all, the authors tried to do a soundful review and get a meaningless small review which does not get any interest for readers."
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Raikou VD, Gavriil S. Letter to the Editor: Finerenone and proteinuria in diabetic kidney disease. World J Nephrol 2026; 15(3): 121881 [PMID: 42625991 DOI: 10.5527/wjn.121881]
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25
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"This narrative review provides a comprehensive, well-structured, and clinically relevant overview of the imaging features of appendiceal mucinous epithelial neoplasms. The article successfully integrates pathological classification with the corresponding findings on ultrasound, CT, and MRI, offering a clear understanding of the role of imaging in diagnosis, characterization, staging, and assessment of peritoneal involvement.
The manuscript is clearly written and easy to follow. The figures are of good quality, informative, and appropriately selected to illustrate the main imaging patterns across the spectrum of appendiceal mucinous neoplasms. The tables are concise and practical, particularly the summary of differential diagnoses, which may be useful in routine clinical practice. The references are relevant and include recent literature in the field.
A particular strength of the review is its practical approach, combining morphological imaging features with clinically important aspects such as pseudomyxoma peritonei, assessment of disease burden, and the complementary roles of CT and MRI. The discussion of emerging applications of radiomics and artificial intelligence also adds a contemporary perspective and highlights promising directions for future research.
This is a valuable and educational review that provides a clear synthesis of current knowledge and may serve as a useful reference for radiologists, gastroenterologists, surgeons, and other clinicians involved in the multidisciplinary management of patients with appendiceal mucinous neoplasms.
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Morelli C, Villanova I, Lorusso G, Cozzi M, Greco S, Calbi R, Maggialetti N, Calabrese A. Imaging of appendiceal mucinous epithelial neoplasms: A narrative review. World J Gastroenterol 2026; 32(37): 120384 [DOI: 10.3748/wjg.120384]
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26
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"This study addresses a relevant and timely question regarding the potential of endocytoscopy to provide real-time optical assessment of histological inflammatory activity in ulcerative colitis. The development of a structured endocytoscopic scoring system, the use of blinded histopathological assessment, and the evaluation of interobserver agreement are important methodological strengths. The reported diagnostic performance of ECSS is encouraging, particularly for the more stringent definition of histological inactivity.
The findings should be considered in the context of the study design. The proposed ECSS cut-off was derived and evaluated in the same relatively small, single-center cohort of 72 patients, and further validation in independent populations would be useful. In addition, patients with Mayo endoscopic score 3 were not included and most patients had minimal or no endoscopic activity, which may inluence the applicability of the findings across the full spectrum of ulcerative colitis severity. The potential role of endocytoscopy in reducing the need for biopsies or in predicting the risk of clinical recurrence is particularly interesting, and represents an important area for further longitudinal investigation.
The manuscript is a scientifically interesting proof-of-concept study with promising results and potential clinical relevance. Its principal value lies in proposing a structured approach for real-time optical prediction of histological activity in ulcerative colitis. Larger prospective multicenter studies, external validation of the ECSS threshold, standardized image acquisition, and longitudinal outcome assessment would be valuable to further establish the clinical applicability of this approach.
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Li M, Lou XY, Liu ZC, Peng B, Huang Y, Guo Q. Endocytoscopy for histological evaluation of inflammation in ulcerative colitis. World J Gastroenterol 2026; 32(37): 119611 [DOI: 10.3748/wjg.119611]
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27
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"This is a well-designed single-center retrospective study which confirms the prognostic value of admission Pulse Pressure(PP) for early risk stratification in patients with TBI. The finding that PP 41-60 mmHg may represent an optimal hemodynamic window-warrants prospective validation. The admission PP might vary with different measurement method, and other markers such as the injury mode presented on CT scans, and the dynamic changes inclusive of the PP after initial resuscitation treatment in ER might be of better for the single admission PP measurement in this manuscript. "
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Ahmed K, El-Menyar A, Asim M, Al Jogol H, Taha I, Kanbar A, Younis B, Rizoli S, Al-Thani H. Prognostic utility of on-admission pulse pressure in hospitalized patients with traumatic brain injury. World J Crit Care Med 2026; 15(3): 115627 [DOI: 10.5492/wjccm.115627]
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28
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"This is a high-quality narrative review that innovatively reintegrates venous physiology into bedside hemodynamic assessment. The AVPG framework has some clinical teaching and practical value. The article is well-structured and well referenced. But the potential selection bias was inherent to narrative reviews, furthermore,the relationship between MAP-CVP as a surrogate and true organ-level perfusion gradients requires further elucidation."
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Kataria S, Vinjamuri S, Juneja D, Goel S. Venous dimension of shock: Integrating arterial inflow and venous back-pressure in hemodynamic assessment. World J Crit Care Med 2026; 15(3): 122632 [DOI: 10.5492/wjccm.122632]
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29
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"The decision of performing renal artery stenting for the treatment of atherosclerotic renal artery stenosis is very controversial in clinical grounds. This review offer important information about cummulated evidence in this field. A pitfall is that the design of the table is not friendly to read and too much information is included in the last row.
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Warfield AE, Morris CS, Bhave AD, Scriver GM, Massouh A, Kallen J, Solomon RT, Majdalany BS. Renal artery stenting for atherosclerotic renal artery stenosis: A review of contemporary data. World J Nephrol 2026; 15(3): 124524 [PMID: 42626292 DOI: 10.5527/wjn.124524]
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30
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"The authors have writen a very good mini review with clear objective and adequate evaluation of evidence. Conclusions are very clear. May be a figure would have improved the article. In the same way, a table comparing the different criteria suggested for diagnosing contrast associated acute kidney failure would had been helpful. "
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Trombara F, Cosentino N, Pontone G, Marenzi G. Renal replacement therapies in the prevention of contrast-induced acute kidney injury. World J Nephrol 2026; 15(3): 119548 [PMID: 42625961 DOI: 10.5527/wjn.v15.i3.119548]
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31
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"This manuscript is well-written and informative, offering adequate textual content and appropriate citation support. The content appears authentic and adequate, and the figures, tables, and references are sufficient and relevant to the topic(narrative mini-review). Nevertheless, several limitations should be addressed to improve the overall quality, as outlined below.
1. Title: The current title does not fully reflect the scope of the manuscript. While the title suggests a focused introduction to vascular complications, the content actually covers a broader range of topics, including diagnosis, treatment, and management of vascular complications in percutaneous biliary interventions. Revising the title to better align with the comprehensive nature of the content (narrative mini-review) is recommended.
2. Abstract: The phrase “for both benign or malignant biliary strictures” should be revised to “for both benign and malignant biliary strictures or obstruction” for greater accuracy and clarity.
3. Abstract and Vascular Complications section: The statement “reduced serum hemoglobin levels” is insufficiently specific. It should be expanded to “reduced hemoglobin levels, reduced blood volume, and/or hypotension” to more comprehensively describe the clinical manifestations."
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Acquafredda F, Vizzuso A, Grigoriadis S, Di Giovanni G, Renzulli M, Giampalma E, Paraskevopoulos I, Spiliopoulos S, Inchingolo R. Vascular complications in percutaneous biliary interventions. World J Radiol 2026; 18(8): 119018 [PMID: 42676980 DOI: 10.4329/wjr.119018]
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32
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"
Recent data support the view that the intestinal flora may, through its connection with the environment, host metabolism, and systemic health, be related to aging and age-related diseases. The intestinal flora influences metabolic reprogramming, immune regulation, and neuroinflammation through the gut-liver axis (a metabolic conduit) and the gut-brain axis (a neuroimmune communication pathway), with neuroinflammation acting as an integral hub. Dysbiosis, characterized by gut microbial imbalance and subsequent multisystem disorders, is a key mechanism underlying aging and the pathogenesis of related diseases. This comprehensive review highlights, among others, the potential of Traditional Chinese Medicine to regulate intestinal microflora. Classical theories of Traditional Chinese Medicine provide examples of how these interventions regulate microbiome function and contribute to host homeostasis, thereby addressing the systemic nature of aging.
The impact of environmental factors on microbiome aging represents a critical and cost-effective public health intervention. Applying polyomics, network pharmacology, and artificial intelligence technologies will accelerate the transition to clinical translation. By integrating traditional wisdom with modern scientific approaches, the development of precise, personalized microecological interventions may offer opportunities to address the challenges of an aging global population.
Current interventions include nutritional modulation, development of next-generation Probiotics and Prebiotics, use of Postbiotics, Fecal Microbiome Transplantation from young or healthy donors to older people, and drug repurposing.
Future Directions and perspectives include precision microbiome medicine with personalized gut mapping, engineered Live Biotherapeutic Products, multi-omics and artificial intelligence, and, finally, targeting gut-brain immune cells. For the latter, specialized gut immune cells (e.g., dendritic cells) can migrate directly to the brain and affect neuroinflammation. Developing therapies that "train" these cells in the gut to become anti-inflammatory before they travel to the central nervous system could be a radical therapeutic avenue. The future looks promising.
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Hou ZW, Zhang P, Chen C. Gut microbiota-multi-organ axis and neuroinflammatory network: A potential integrative hub in aging and age-related diseases. World J Gastroenterol 2026; 32(36): 119520 [DOI: 10.3748/wjg.119520]
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"This is an excellent review with an interest objective that have very good figures and a progresive development of facts that allowed a good understanding of this complex field. It could be really helpful for researchers and even for clinicians although, from a clinical point of view, currently there is no evidence of clinical helpfulness about microRNA for predicting or diagnosing diabetic nephropathy. "
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Sharma VK, Beg MMA, Singh S, Singh SK, Shrivastav D. SLC30A8 (ZnT8) at the crossroads of epigenetics and microRNA regulation in type 2 diabetes and nephropathy. World J Nephrol 2026; 15(3): 122565 [PMID: 42626274 DOI: 10.5527/wjn.122565]
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"The manuscript gives interesting results although it have some pitfalls. The beginning is a bit strange since it sounds like the start of a letter to the editor and the background is hard to understand since it signal an article that is not really related to the objective (even more, it is repeteadly referenced along the text). Conclusions are extremely long and not related to the article. "
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Mpisa S, Soldera J. From kidney to liver: Are sodium–glucose cotransporter-2 inhibitors emerging as metabolic disease modifiers? World J Nephrol 2026; 15(3): 121652 [PMID: 42626005 DOI: 10.5527/wjn.121652]
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"This is very interesting paper about the relationship between mental health and Inflammatory bowel diseases (IBDs), such as ulcerative colitis
and Crohn’s disease. These diseases are chronic immune-mediated diseases
that cause inflammation throughout the gastrointestinal
tract. Nearly 1 in 100 Americans are diagnosed IBD.
Although IBD is a gastrointestinal disease, it can have a
profound impact on a patient’s emotional health. Studies
have found a higher prevalence of psychiatric comorbidities,
such as anxiety and depression, among patients with IBD.
Compared with similar healthy individuals, patients with IBD
were found to have 3 to 5 times higher risk of developing
anxiety disorders and 2 to 4 times higher risk of developing
depression disorders in their lifetime. These psychiatric
comorbidities can have significant implications for IBD
patients, with evidence supporting an association between
psychiatric state and IBD disease course, such as patients
with more depressive symptoms presenting with greater in
flammation due to stressors. Depressive symptoms are also
associated with IBD relapse and shorter periods of remission
Studies have found a higher risk of comorbid anxiety and depression among patients with inflammatory bowel disease (IBD)
compared with healthy individuals. If left untreated, comorbid depression and anxiety in patients with IBD can lead to poorer health outcomes
and an increased healthcare utilization. The goal of this work was to develop a consensus statement to begin to address patient and provider
needs and responsibilities related to screening and treatment of depression and anxiety symptoms among patients with IBD. Mental healthcare and support for IBD patients is critical; the statements included in this article represent practical considerations
for IBD healthcare professionals in addressing key issues on provider awareness, knowledge and behaviors, screening and treatment resources,
and patient education.
patients with IBD may experience symptoms of anxiety and depression as the disease progresses. These symptoms can occur not only during active disease phases but also during periods of remission. The following approaches are considered effective for improving the mental health of IBD patients:
Importance of mental health care: Mental health care is crucial, as IBD patients often carry a heavier burden of stress and anxiety than is commonly realized.
Improving gut health: Restoring the balance of gut microbiota may help alleviate symptoms of depression.
Mindfulness: Evidence suggests that meditation and other mindfulness-based techniques can help relieve stress and anxiety in IBD patients.
I think that a combination of these methods is recommended for managing mental well-being in IBD patients. I agree to your paper.
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Gao X, Xiao P, Di JQ, Jiao Y, Liu Q. Beyond inflammation control: Rethinking fatigue as a multidimensional target in Crohn’s disease management. World J Gastroenterol 2026; 32(36): 118624 [DOI: 10.3748/wjg.118624]
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"It is a short but intensive review about Donor medicine. I cannot agree with the title: An emerging field in nephrology, since transplantation start by kidney living donors near eighty years ago. I do not support the final recommendation, there is no place for a medical especiality based only on the small number of this kind of donors, but the need for specific training on this issue is warranted.
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Abbasi MT, Prasad GVR. Donor medicine: An emerging field in nephrology. World J Nephrol 2026; 15(3): 121522 [PMID: 42626248 DOI: 10.5527/wjn.121522]
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"Although the sample is big and the data have some interest, the format of letter to editor make difficult to correctly assess the presented results. The discussion and conclusions are written in a telegraphic way that made it hard to understand. In fact, I think that it should had not been published."
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Feyissa GD. Letter to the Editor: Enhancing renin-angiotensin-aldosterone system inhibitors utilization through patiromer adherence - real-world insights for nephrology practice. World J Nephrol 2026; 15(3): 119286 [PMID: 42626019 DOI: 10.5527/wjn.119286]
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"The article addresses a clinically relevant and insufficiently clarified question, namely whether Clostridioides difficile colonization is associated with subsequent IBD activity. A major strength of the study is its prospective design, with the inclusion of patients in remission, which allows for longitudinal assessment of the development of IBD flares and evaluation of whether these are preceded by C. difficile colonization. Furthermore, the distinction between colonization and infection is an important aspect of the study. The authors define CDC as a positive culture and GDH test in the presence of a negative toxin test, whereas CDI requires both clinical criteria and a positive toxin test. Another strength is the repeated collection of stool samples from patients with IBD and the relatively long follow-up period of approximately 420 days, which increases the likelihood of identifying colonization and subsequent episodes of CDI. In addition, the inclusion of both clinical and biochemical parameters to assess IBD activity represents another methodological strength.
From a writing and presentation standpoint, the article is clearly and logically structured, the methods are described in sufficient detail to allow the study protocol to be understood and reproduced, and the findings are appropriately discussed in the context of the existing literature. The authors address both the clinical implications of their findings and the limitations of the study, which gives the manuscript a balanced and objective perspective.
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Morado-Aramburo O, Ochoa-Hein E, Pérez-Gutiérrez MT, Sánchez-Cruz MN, Bobadilla-del-Valle M, Yamamoto-Furusho JK, Ponce-de-Leon A, Sifuentes-Osornio J. Association between Clostridioides difficile colonization and inflammatory bowel disease activity in outpatients with remission. World J Gastroenterol 2026; 32(35): 118677 [DOI: 10.3748/wjg.118677]
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"Nanotechnology has evolved into a groundbreaking field, impacting everything from materials science to industrial applications. In medical science, nanomedicine using nanoparticles has led to the creation of new biomaterials suitable for diagnostic and therapeutic applications, particularly in CRC. Nanoscale delivery of anti-neoplastic drugs enables effective, precise administration of the correct doses to patients with CRC. Recent studies report on a variety of nano-biomaterials designed for controlled and targeted drug delivery to CRC, especially in immunotherapy, reprogramming the immunosuppressive tumor microenvironment and improving the effectiveness of immune checkpoint inhibitors. Most applications involving specialized "smart" nanoparticles for colorectal cancer are currently in the preclinical stage (laboratory and experimental animals) with promising results. Integrating Artificial Intelligence into nanomedicine accelerates the design of these platforms, bringing clinical trials in humans ever closer. As the authors point out, closer collaboration between different scientific disciplines and research groups is essential to integrate this technology into CRC treatment."
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Yang ZH, Huang QL, Luo L, Wu XX, Nie SW, Xu MM. Nanotechnology for drug delivery systems in colorectal cancer: Recent developments and future prospects. World J Gastroenterol 2026; 32(35): 121133 [DOI: 10.3748/wjg.121133]
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"This is a timely and relevant Letter to the Editor addressing an important aspect of antimicrobial stewardship in hospitalized patients with IBD. The distinction between antibiotic exposure prevalence and antibiotic consumption intensity is clinically meaningful, and the proposed shift toward indication-specific stewardship, de-escalation, and patient-level metrics such as days of therapy is appropriate and useful in clinical practice in the management of IBD patients. The manuscript is well structured, clearly and concise written, easy ro read, without spelling or grammar errors and provides a useful perspective on the findings of Zeng et al.
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Fiore M. Letter to the Editor: From antibiotic exposure to antibiotic intensity: Rethinking inpatient stewardship in inflammatory bowel disease. World J Gastroenterol 2026; 32(33): 118868 [DOI: 10.3748/wjg.118868]
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"In their interesting study, the authors utilized previous data showing that water temperature significantly affects gastrointestinal peristalsis. They found that low injected-water temperature during diagnostic endoscopic ultrasound with a mini-probe (mEUS) improves image quality, diagnostic accuracy, safety, and comfort during the examination compared with higher water temperatures. In more detail, cold water injection (6-10 °C) reduced gastrointestinal peristalsis and improved image quality of images. The authors concluded that cold-water injection enhances mEUS diagnostic and differential diagnostic value, especially for protuberant lesions, while helping select appropriate treatment strategies.
I believe that in the near future the technique should be applied more widely in specialized diagnostic centers. If these results are confirmed in other multicenter studies, then its application should be generalized. It is anticipated that mEUS using cold water would reduce the use of anticholinergic drugs and improve the diagnostic accuracy of mEUS, especially in cases of malignant tumors of the upper digestive tract.
"
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Mao XY, Ye MM, Yu XY, Liao JT, Hu Y, Guo M, Zeng B, Li J, Peng L, Hu WF, Liu H, Gong P, Long Y, Wang XY, Tian L. Cold water infusion enhances image quality in sedated miniprobe endoscopic ultrasonography: A prospective, multicenter, double-blind, randomized trial. World J Gastroenterol 2026; 32(34): 118510 [DOI: 10.3748/wjg.118510]
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"Endoscopic submucosal dissection (ESD) is considered the standard therapeutic approach for superficial esophageal carcinoma. Compared with surgery, ESD has advantages such as minimal trauma, rapid recovery, and fewer complications. However, owing to the narrowness of the esophagus, its thin wall, and the absence of a plasma layer, complications such as esophageal stenosis are prone to occur after the procedure. Previous studies have reported esophageal stenosis rates of 11%-20% following ESD. Lesions encompassing more than 3/4 of the circumferential area are among the high-risk factors for stenosis, with an incidence as high as 70% being observed. Moreover, complete circumferential lesion resection results in near-universal stricture formation (approximately 100% incidence) In clinical practice, body mass index (BMI) does not appear to affect the occurrence of postoperative esophageal ESD stenosis, nor does it comprehensively reflect patients' nutritional status. Sarcopenia is a progressive and generalized skeletal muscle disorder involving the accelerated loss of muscle mass and function (strength or performance). In recent years, this condition has evolved from simple muscle mass loss to a unique muscle disorder linked to the postoperative prognosis of various diseases. Sarcopenia (low muscle mass and strength) is an independent risk factor for esophageal stenosis (narrowing) after endoscopic submucosal dissection (ESD). Studies show that patients with sarcopenia have a significantly higher rate of post-ESD stricture (around 48%) compared to non-sarcopenic patients (about 22%). Poor tissue healing and lower systemic reserve drive this increased risk.Sarcopenia has been indicated to be related to the postoperative outcome of patients with various digestive tract diseases. However, no studies have investigated the association between sarcopenia and esophageal stenosis after endoscopic submucosal dissection (ESD). Patients with low skeletal muscle mass face a significantly higher rate of post-ESD stricture formation compared to non-sarcopenic patients, shifting focus toward holistic nutritional and functional pre-assessments. Please tell me the diagnostic criteria for sarcopenia. What percentage of the circumference was resected during the ESD, and how many months post-procedure did the stricture develop?
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Li WM, Liu B, Liu Q. Beyond local injury: Sarcopenia as a systemic host-related determinant of esophageal stenosis after endoscopic submucosal dissection. World J Gastroenterol 2026; 32(34): 118801 [DOI: 10.3748/wjg.118801]
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"1. Ethics
The study was approved by institutional review boards at four centers: Thomas Jefferson University, Johns Hopkins Medicine, National Cheng Kung University Hospital, and the University of Pennsylvania. It followed the Declaration of Helsinki and the Declaration of Istanbul. Written informed consent was obtained from all participants. Patients with a glomerular filtration rate below 30 ng/mL were excluded, as stated in the manuscript. The conflict-of-interest statement is complete. Four authors are shareholders of JBS Science Inc., and this is clearly disclosed.
2. Methods
The experimental design is reasonable and the procedures appear reproducible, but several details need attention.
2.1.Strengths
2.1.1. Urine was mixed with EDTA immediately after collection (final concentration 10–50 mmol/L) and stored at −80°C. Plasma was prepared by two-step centrifugation: 1300 × g for 20 min followed by 3000 × g for 10 min. These pre-analytical steps are described clearly.
2.1.2.DNA extraction followed a published method. Low-molecular-weight DNA (<1 kb) was size-selected with a 0.55× magnetic bead ratio.
2.1.3.UMI adapters were used for NGS library preparation, which should correct PCR errors. HBV genotyping and subgenotyping relied on 42 reference genomes.
2.2.Weaknesses
2.2.1.No tumor tissue mutational profile is available. As a result, the concordance between urine/plasma cfDNA and the tissue gold standard cannot be assessed.
2.2.2.The urine cfDNA isolation method may not recover fragments below 100 bp efficiently. Such short fragments are often enriched for tumor-derived variants. The authors acknowledge this limitation in the Discussion.
2.2.3. Plasma cfDNA was extracted with two different kits: Zymo Quick-cfDNA for Table 1, and a JBS in-house kit for the remaining samples. This inconsistency may introduce systematic bias.
2.2.4.Only four plasma samples were included in the HBV targeted NGS analysis. This small sample size limits the statistical power of the plasma-versus-urine trDNA fragment size comparison.
3. Results
The results appear credible. The main hypothesis is supported, but some conclusions rest on limited evidence.
3.1.Findings supported by the data
3.1.1.HBV transrenal DNA (trDNA) fragments were significantly shorter than human urine cfDNA and plasma HBV DNA (P < 0.001). Figures 2A–B support this finding.
3.1.2.In urine from HCC patients, the median HBV trDNA insert size was 100 bp. This was significantly shorter than in hepatitis (145 bp, P < 0.001) and cirrhosis (113 bp, P = 0.048). Figures 3A–D present these data clearly.
3.1.3.HCC-specific 5′ 4-mer end motifs, such as CCAA and GAGA, were 3–6 times more abundant in urine cfDNA from HCC patients than from non-HCC patients. No such difference was observed in plasma. This is one of the most novel findings in the study.
3.1.4.qPCR showed an overall urine–plasma mutation concordance of 78.3% (95% CI, 72.0–83.7%). Targeted NGS in HCC showed 97% concordance at the site level.
3.2.Findings with limited evidential support
3.2.1.Positive concordance was only 23.7% by qPCR and 17.7% by NGS. Urine and plasma therefore capture the same tumor mutations quite differently. The authors attribute this to “biological variation,” but without tissue controls it is impossible to determine which source is closer to the true mutation status.
3.2.2.The proposed link between HBV trDNA size differences and HCC—increased tumor cell death or a predominance of clonally expanded HBV DNA—lacks direct experimental evidence. It remains an interpretive hypothesis.
4. Figures and Tables
The figures and tables are well prepared and clearly annotated.
4.1. Figure 1 gives a clear overview of the study design.
4.2. Figures 2A–B compare fragment sizes among HBV trDNA, urine cfDNA, and plasma HBV DNA. The data are easy to follow.
4.3. Figures 3A–D show HBV DNA insert size distributions and statistical results by disease group.
4.4.Figures 4A–B compare the frequencies of the top 10 5′ 4-mer end motifs in plasma and urine.
4.5.Table 1 summarizes qPCR mutation concordance data for 101 HCC patients. The information density is reasonable.
One suggestion: the VAF correlation in Supplementary Figure 2 (Pearson’s r = 0.966) is mentioned only in the text. These key correlation data should be included in a main figure or table.
5. Biostatistics
The statistical methods are mostly appropriate, but there are several weaknesses.
5.1 Appropriate choices
5.1.1.Student’s t-tests and one-way ANOVA were used for fragment size comparisons. These are suitable for group comparisons.
5.1.2. Cohen’s κ (0.565) and overall percent agreement were used for concordance analysis. This is an appropriate approach.
5.1.3.Pearson’s r (0.966) was used to assess VAF correlation. That is reasonable for continuous variables.
5.2 Problems and limitations
5.2.1.In Table 1, TP53 positive concordance was 0.0% (0/10). There was no overlap between urine and plasma among TP53 mutation-positive samples. This extreme result may reflect small sample size or a methodological problem, but the authors do not discuss it.
5.2.2.No correction for multiple comparisons was described. It is unclear whether post-hoc tests after ANOVA used Bonferroni or another adjustment.
5.2.3.The reporting of 95% confidence intervals is incomplete. In Table 1, some intervals have a lower bound of 0.0%, which indicates very unstable estimates. These should be interpreted cautiously.
5.2.4.The HBV targeted NGS analysis included only four plasma samples. No statistical rationale is provided for this subgroup analysis.
6. References
The references are generally appropriate and cover important work in the field. However, there are a few self-citation and recency issues.
6.1.Strengths
6.1.1.The citations include key trDNA literature: Chan et al. (2008) on EBV trDNA, Su et al. (2004) on urine DNA, and Markus et al. (2021) and van der Pol et al. (2023) on urine cfDNA fragmentomics.
6.1.2 .Jiang et al. (2015) on plasma DNA length changes in HCC is cited. This is directly relevant to the core findings.
6.1.3.Mouliere et al. (2021) on urine cfDNA in glioma is cited, which shows cross-cancer awareness.
6.2.Issues requiring attention
6.2.1.The DOI for reference [20] points to a paper on digoxin metabolism (Schmoldt A, Biochem Pharmacol 1975). It is unrelated to urine DNA extraction. This is a clear citation error and should be corrected to the intended reference.
6.2.2.The authors’ previous work on urine HBV DNA [29] (Jain et al., BMC Gastroenterol 2018) and HCC urine DNA biomarkers [6–7] is cited multiple times. Some self-citation is present, but it remains within a reasonable range.
6.2.3.Few references from 2026 are included. Given the September 2026 publication date, the recency of citations is acceptable.
7. Language
The writing is clear and professional overall. It follows standard academic conventions.
7.1.Good points:
7.1.1. The Abstract, Introduction, Methods, Results, and Discussion are logically organized.
7.1.2.Technical terms such as “transrenal DNA,” “cell-free DNA,” and “variant allele frequency” are used accurately.
7.1.3. Figure legends and table notes are complete enough to be understood independently.
7.2.Minor points:
7.2.1. Some long sentences could be split to improve readability. One example is the first paragraph of the Discussion.
7.2.2.In the Methods, the phrase “Patients with glomerular filtration rates < 30 ng/mL” contains a unit error. GFR should be expressed in mL/min/1.73 m², not ng/mL.
8. Caveats or Drawbacks
The authors acknowledge several limitations in the Discussion. The following is a combined assessment.
8.1.Limitations already identified
8.1.1. No tissue control is available. The true-positive rate of urine/plasma cfDNA mutation detection cannot be verified. This is the largest methodological gap in the study.
8.1.2. Most patients have early-stage disease. With a 10 ng DNA input, detection sensitivity may be affected.
8.1.3. Recovery of fragments below 100 bp is insufficient. This may underestimate the true detection rate of tumor-derived variants.
8.1.4. Standardization across laboratories is lacking. Differences in DNA isolation and sequencing methods limit generalizability.
8.1.5. The sample size is limited: four plasma samples in HBV targeted NGS, and 15 paired samples in HCC targeted NGS.
8.2.Limitations not adequately discussed
8.2.1. The generalizability of HBV as a transrenal DNA marker is not addressed. HBV DNA is used as a liver-derived trDNA marker, but it is unclear whether the approach applies to HBV-negative HCC patients. These patients account for a substantial proportion of HCC.
8.2.2. Renal function is not fully controlled. Patients with GFR <30 were excluded, but the authors did not analyze whether trDNA detection rates vary with renal function. Glomerular filtration directly affects transrenal DNA excretion.
8.2.3. The discrepancy between qPCR and NGS results is not explained. qPCR showed 78.3% overall concordance, whereas NGS showed 97% site-level concordance. The difference may be due to different units of analysis. The authors do not discuss this.
9.Overall Assessment
This is a well-designed, data-rich exploratory study. It provides valuable preliminary evidence for urine cfDNA in HCC liquid biopsy. The fragmentomics analysis, especially the 5′ 4-mer end motif differences, is the most innovative contribution. However, the lack of tissue controls and gold-standard validation is a major weakness. The conclusions should be regarded as proof-of-concept. They need to be confirmed in larger cohorts that include tissue controls."
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Kim AK, Lin SY, Liu HN, Jain S, Gade TP, Shieh FS, Hamilton J, Hann HW, Chang TT, Goryunov D, Wang Z, Su YH. Urinary cell-free DNA as a noninvasive liquid biopsy for hepatocellular carcinoma. World J Gastroenterol 2026; 32(33): 118587 [DOI: 10.3748/wjg.118587]
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"The authors developed and implemented a preoperative artificial intelligence-based model that combines and integrates clinical variables with MRI-derived features to predict the need for neoadjuvant chemoradiotherapy in SNCs staged as cT1-2N0 rectal cancer. This model was shown to be effective in identifying patients with cT1-2N0 rectal cancer who require neoadjuvant chemoradiotherapy, thereby increasing the proportion of patients who will benefit from neoadjuvant chemotherapy. Compared with radiologist evaluation of the same data, this model demonstrated greater reliability and clear advantages in clinical decision-making. One can comment on the results of this study by noting the need to verify the findings by other centers treating rectal cancer, and by considering the possibility of their widespread adoption and application. I believe that the results of such studies should be carefully evaluated by competent scientific bodies, which will make the necessary recommendations and prompts for further study and practical application of these findings."
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Kang BY, Bai H, Ni K, Qiao YH, Li YL, Wang YQ, Wang Q, Zhu J, Li JP. Artificial intelligence-integrated multimodal data-assisted magnetic resonance imaging for neoadjuvant chemoradiotherapy decision-making in cT1-2N0 rectal cancer. World J Gastroenterol 2026; 32(33): 118584 [DOI: 10.3748/wjg.118584]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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Benea I, Fabbri N, Pesce A, Feo CV. Indocyanine green-guided laparoscopic completion cholecystectomy for stump syndrome: A case report. World J Clin Cases 2026; 14(23): 121732 [DOI: 10.12998/wjcc.121732]
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" The manuscript is written well. Its structure is appropriate for this type of article. Ethical approval form meets the requirements. Methods are appropriate and effective. Results are appropriate of methods and are authentic. Tables and biostatistics data are perfect. The references are adequate of topic. Language of article is satisfied."
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See KC. Performing medical thoracoscopy safely in the outpatient setting: A case report. World J Clin Cases 2026; 14(23): 121367 [DOI: 10.12998/wjcc.121367]
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"In this manuscript, authors stated ‘Has increased significantly’ which was a strong epidemiologic claim and needed supporting data and reference. They also wrote ‘Clinical significance of BMMs’. I think this statement was vague. More precise phrasing would be ‘To compare bone metabolic markers (BMMs) between patients with T2DM with and without OP and identify factors independently associated with OP’. In methods section, authors wrote ‘Using dual-energy X-ray absorptiometry as the gold standard’ which was also imprecise. DXA was the standard method for assessing bone mineral density and diagnosing osteoporosis, but ‘gold standard’ may depend on the diagnostic criteria used. Authors should state the specific diagnostic threshold and criteria. In presentation of the findings, authors wrote overloaded variables. It would be clearer to prioritize the clinically important findings; age, HbA1c, PTH, and β-CTX. The long list of nonsignificant variables added considerable clutter. They should be presented in tables. I also noted that authors used ‘OP comorbidity’ and ‘T2DM patients with comorbid OP’ terminology. I found them awkward. I recommend authors to prefer ‘osteoporosis in patients with T2DM’ or ‘coexisting osteoporosis’ phrases. Similarly, ‘risk determinants’ terminology implied causality. But, the study was observational. I recommend ‘independent factors associated with OP’ or ‘independent risk factors’ terms. In discussion and conclusion sections, authors stated that ‘PTH provides valuable guidance for OP diagnosis’ which overstated the findings presented in results section. An association didn’t establish diagnostic utility. Unless diagnostic performance was evaluated, authors should wrote that elevated PTH ‘may be associated with the presence of OP’. "
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Lu HL, Yu F, Zhou HF, Hu P, Gan SL. Clinical significance of bone metabolic markers in osteoporosis-complicated type 2 diabetes mellitus and risk determinants: A retrospective study. World J Diabetes 2026; 17(8): 123389 [DOI: 10.4239/wjd.123389]
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"In this manuscript, authors addressed an important clinical problem. They presented a potentially useful physiologic approach. The findings presented in results were promising, but several methodological and wording issues should be addressed. Authors wrote ‘fever, mania, inflammation and depression caused by the imbalance of water and electrolytes’ statement. This phrase was erratic because they were not standard DKA related symptoms collectively attributable to fluid/electrolyte imbalance, and ‘mania’ and ‘depression’ were particularly inappropriate. Authors should consider focusing on dehydration, hemodynamic instability, electrolyte disturbances, and cerebral complications. In methodology, authors described two stage design, which was confusing. They called the second stage ‘embedded, comprehensive review’ and then stated ’we systematically retrieved’ and ‘conducted a systematic review’ was really redundant. They should clearly distinguish the prospective proof of concept study from the systematic review. As primary outcome, authors reported net fluid balance at three time points as ‘the primary outcome’. This was somewhat awkward. They should specify whether this was a repeated measures outcome or whether one time point was pre-specified as primary. Moreover, I noted that in results section that absolute differences in fluid balance were difficult to interpret without the corresponding group values and confidence intervals. Authors wrote ‘-1246.8 mL’ and they should make clear that this was the between group difference. As a systematic review, authors added useful context. However, systematic review’s relationship to the intervention study should be clearer. Also, ‘externality validation and generalization’ was sound as nonstandard wording. They should use ‘to assess the generalizability of the findings and contextualize the available evidence’. "
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Bo Y, Li HJ, Han ZZ, Tian LJ, Chen YF. Non-invasive haemodynamic monitoring to individualise fluid resuscitation in adult diabetic ketoacidosis: A randomized controlled pilot trial. World J Diabetes 2026; 17(8): 121563 [DOI: 10.4239/wjd.121563]
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"Overall, I think the study was strong, logical, and included a clear study question. Statistics were appropriate and findings were clinically important. Authors used generalized additive models, two-piecewise regression, subgroup analyses, and sensitivity analyses in the work. These approaches provided a well support for the reported nonlinear associations. In methods, authors explained ‘nonlinearity’ meant was unnecessary for a scientific paper and could be removed. Authors also wrote ‘Missing glycated HGB (HbA1c) data’ which was incorrect terminology. HbA1c is glycated hemoglobin, not “glycated HGB.” Also, authors should clarify why HbA1c was missing and whether it was the only variable imputed. In results section, authors wrote ‘RBC and white blood cell (WBC) counts’ after mentioning HCT/HGB/RBC. They should consider separating the associations like ‘higher HCT, HGB, RBC count, and WBC count’. Moreover, if the inflection point was approximately 45 cm², I advise authors to report confidence intervals clearly. This would make the threshold estimate more informative. In discussion and conclusion sections, ‘sensitive indicators of visceral fat burden’ statement overstated the evidence presented in this work. Authors showed association, not diagnostic sensitivity or predictive validity in the current study. ‘Potential markers of visceral adiposity’ would be more defensible. "
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Rao ZC, Xu CY, Hua LY, Fang ZR, Zhu CY, Zhang YM. Visceral fat area and red-blood-cell-related indices in adults with type 2 diabetes: Cross-sectional evidence of nonlinear associations. World J Diabetes 2026; 17(8): 121923 [DOI: 10.4239/wjd.121923]
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"Overall, I think the paper was clear and written on a clinically relevant question. The results of the study were specific and quantitatively supported, especially the correlations of HbA1c. In my opinion, the wording ‘may contribute to glycemic regulation and the pathophysiology’ was stronger than warranted by a cross sectional, observational correlation analysis. Authors may consider writing ‘may be associated with’ instead of implying causality. In methods, the statement ‘Demographics and clinical characteristics were briefly evaluated’ was vague and slightly awkward. I recommend authors to write ‘Demographic and clinical characteristics were assessed’. In results, the number of elements reported was substantial. For brevity, I recommend authors to prioritize the most clinically relevant findings and avoid listing every association. They belong to the tables. Conclusion of the study was appropriate since authors acknowledged the need for longitudinal studies and healthy controls. "
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Abdelbaset-Ismail A, Hui X, Lin Q, Gu C, Xu J, Watson S, Cai L, Tan Y, Wintergerst KA. Serum elemental profiles and their associations with glycemic control in pediatric type 1 and type 2 diabetes. World J Diabetes 2026; 17(8): 122649 [DOI: 10.4239/wjd.122649]
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