Gastric cancer (GC) remains a global health burden. While international guidelines share consensus, variations exist in disputed issues. The 2025 Taiwan Consensus and Management Guidelines for Gastric Cancer had just been released. We compared the key recommendations with established international guidelines. A multidisciplinary taskforce addressed key questions and recommendations using modified Delphi method and evidence-based approaches. The comparative review aimed to elucidate similarities and differences among guidelines from Taiwan, Japan, South Korea, China, Europe, and the US. Guidelines converge on absolute endoscopic resection criteria for early GC but differ in extended indications and perioperative approaches for locally advanced disease. Heterogeneity exists in biomarker assessment protocols, cutoff thresholds, and companion diagnostics. For metastatic disease, consensus exists on anti-HER2, anti-VEGF, immunotherapy, and biomarker-driven strategies, though oligo-metastatic definitions and intraperitoneal chemotherapy indications remain controversial. Optimal GC management requires integrating global evidence with regional contexts. The comparative review addresses heterogeneity among international guidelines, which helps harmonize management strategies as therapeutic standards evolve.
Osteoporosis is a major and growing health concern in the Asia-Pacific region, y et it remains widely underdiagnosed and undertreated due to limited access to dual-energy X-ray absorptiometry (DXA) in many areas. Artificial intelligence (AI) offers new opportunities to improve osteoporosis screening and management, but unvalidated tools pose risks of inconsistent care. This consensus was developed to provide regionally harmonized guidance on the safe, effective, and equitable use of AI in osteoporosis care. Purpose The aim of this work was to establish expert consensus recommendations on the role of AI in osteoporosis screening and management in the Asia-Pacific region. Key objectives were to define appropriate applications of AI (e.g., imaging-based bone assessment and fracture risk prediction) and specify minimum standards for validation and reporting, addressing region-specific implementation challenges and ensuring that AI use aligns with clinical guidelines and ethical principles. Methods This consensus was developed through multidisciplinary collaboration among experts across the Asia-Pacific region. Each participant reviewed draft statements, contributed feedback during virtual meetings, and provided insights based on clinical experience and current evidence. Consensus was reached iteratively until full agreement was achieved for all statements. The process integrated global best practices and regional adaptations, drawing from peer-reviewed studies, international AI guidelines, and local fracture registry data. The final recommendations emphasize the validation, transparency, and ethical implementation of AI within regional healthcare systems, ensuring compatibility with local regulations. Ultimately, twelve consensus statements were established to guide the responsible use of AI for osteoporosis screening and management in the Asia-Pacific region. Results The panel produced 12 consensus statements covering the role of AI as an adjunct for opportunistic osteoporosis screening rather than a diagnostic tool, requirements for imaging quality and AI model transparency, standards for validation and performance reporting, integration of AI with clinical risk stratification, demonstration of clinical utility in real-world settings, adherence to data protection laws and ethical AI principles, training of clinicians in AI use, strategies for implementation and monitoring (including post-market surveillance and feedback loops), and recognition of technical, clinical, and equity limitations of AI. All 12 statements give extensive recommendations for using AI to improve osteoporosis management while ensuring patient safety, accuracy, and equity. Conclusion This first Asia-Pacific consensus on AI in osteoporosis concludes that AI, when appropriately validated and implemented, can help bridge the osteoporosis care gap by identifying high-risk patients who would otherwise remain undiagnosed, thus facilitating earlier intervention. It emphasizes that AI should complement-not replace-standard diagnostic methods and clinical judgment. The guidance emphasizes validation, transparency, and ethical oversight to facilitate early intervention while minimizing risks associated with unvalidated or premature AI adoption.
The impact of sustained virological response (SVR) on outcomes of patients with hepatocellular carcinoma (HCC) undergoing liver resection (LR) was assessed. This retrospective cohort study included 344 patients with hepatitis C virus (HCV)-related HCC who underwent LR. Patients were divided into three groups: preoperatively achieving SVR (pre-SVR); postoperatively achieving SVR (post-SVR); and not achieving SVR (non-SVR). 145 patients received direct-acting antivirals, 76 received interferon-based therapy, and 123 were untreated. 95 patients were pre-SVR, 87 were post-SVR, and 162 were non-SVR, including untreated patients. Five-year overall survival was 83
Bronchiectasis has traditionally been characterized as a neutrophil-driven disease, yet emerging evidence suggested inflammatory heterogeneities. The prognostic significance of elevated serum immunoglobulin E (IgE) in patients without peripheral eosinophilia remains unclear. We conducted a multicenter prospective cohort study between 2017 and 2020 across 16 institutions in Taiwan. Individuals with bronchiectasis but without allergic bronchopulmonary aspergillosis were included. Patients were stratified by baseline absolute eosinophil count (cutoff 300 /uL) and serum IgE level (≤ 100, 100–500, > 500 IU/mL). The primary endpoint was severe exacerbations resulting in hospitalization at one year. Secondary endpoints included all-cause mortality, distribution of sputum pathogen, imaging pattern, and lung function. A total of 579 individuals were enrolled. Nontuberculous mycobacteria (10.7
Klebsiella pneumoniae invasive syndrome (KPIS), often arising from pyogenic liver abscesses, is characterized by metastatic infections and thrombotic complications. Diabetes mellitus (DM) is the most important risk factor for KPIS, as hyperglycemia promotes resistance of hypervirulent K. pneumoniae ;(hvKp) strains to phagocytosis and impairs neutrophil function. Given the interplay between platelet activation, inflammation, and thrombosis, aspirin, a well-established antiplatelet agent, has been associated with reduced incidence and recurrence of pyogenic liver abscesses in cohort studies. Platelets interact with neutrophils to form platelet - neutrophil aggregates (PNAs), which may contribute to KPIS pathogenesis. This study examined platelet - neutrophil interactions under hyperglycemic conditions using in vitro assays and in vivo models of diabetic mice infected with hvKp. High glucose concentrations significantly increased platelet activation, PNA formation, and bacterial survival. Salicylic acid, the bioactive metabolite of aspirin, reduced platelet activation and bacterial burden but did not impede PNA formation. Aspirin pre-treatment improved survival, reduced organ abscesses, and preserved tissue integrity in diabetic mice infected with hvKp. These results highlight the relationship between hyperglycemia, platelet activation, and immune dysregulation in KPIS, and support aspirin as a potential adjunctive therapy to mitigate thromboinflammatory complications of hvKp infection.
