Search Results (1,090)

Background: Farm-level antimicrobial stewardship in swine production requires indication-specific knowledge of treatment patterns and the herd-level features associated with them. Methods: We analyzed questionnaire-based data collected in 2015 from 13 Hungarian swine farms covering 15,725 sows and their progeny. The survey captured production indicators, pathogen occurrence, vaccination, resistance-testing practices, drug costs, and disease-group-specific antimicrobial use. As a separate, non-mergeable descriptive temporal comparator, we also considered independent digital farm-monitoring data from three large-scale swine herds from 2022 to 2024. Results: The most frequently reported pathogens were Mycoplasma hyopneumoniae (13/13 farms), Lawsonia intracellularis (12/13), Escherichia coli (12/13), swine influenza virus (11/13), and Streptococcus suis (10/13). S. suis ranked as the leading damaging pathogen on 69% of farms. Among farms with antibiotic cost data (9/13), antibiotics accounted for a mean of 31.8% of veterinary drug expenditures. Among farms with treatment-by-indication data (8/13), the highest relative frequency of reported treatment events was linked to porcine respiratory disease complex, where doxycycline represented 38% of reported PRDC treatment events. Colistin dominated E. coli-associated diarrhea control, whereas beta-lactams were central for S. suis-related disease. In the 2022–2024 comparator dataset, enteric and respiratory disorders and arthritis remained the main recorded health problems, but corrected antimicrobial use was markedly lower in the later dataset. Conclusions: Antimicrobial use showed clear disease-group-specific patterns, supporting syndrome-focused stewardship rather than generic reduction targets. Full article

Immune checkpoint inhibitors (ICIs) have substantially improved outcomes in advanced melanoma but are frequently linked to immune-related adverse events (irAEs). Vitiligo is a common cutaneous irAE and has been consistently associated with improved patient outcome, including prolonged progression-free and overall survival. It also represents significant visual stigma, particularly when the face is involved. Traditional treatment comprises topical steroids, calcineurin inhibitors, laser, and phototherapy which often have insufficient effects. Since 2023, the first approved drug for non-segmental vitiligo (NSV) with facial involvement, the topical Janus kinase inhibitor ruxolitinib, has been available. However, experience with its use in ICI-induced vitiligo remains limited. In this exploratory analysis, three patients who developed facial vitiligo following ICI therapy applied 1.5% ruxolitinib cream to affected facial areas twice daily. After six (two patients), and twelve months (one patient), extensive repigmentation was observed, quantified at 95.7%, 78.9%, and 99.1% using a novel semi-automatic tool. Quality-of-life questionnaires showed mean reductions of 57.6% (Vitiligo DLQI) and 68.2% (Vitiligo-specific Quality of Life) in disease burden. Treatment was associated with substantial repigmentation without observed side effects. Further evaluation in larger, prospective cohorts is warranted to better define treatment effects, clinical applicability, and long-term safety. Full article

Rift Valley fever (RVF) is a viral zoonosis endemic in Madagascar, threatening human and animal health as well as the economy. Trade-related livestock movements are a major factor in the spread of RVF virus. While previous RVF research in Madagascar has focused on farmers or general ecology, this study is the first to specifically target livestock traders, the primary drivers for long-distance viral spread, in the Alaotra Mangoro endemic hotspot. This study aimed to assess the level of knowledge, prevailing attitudes and current practices regarding RVF among people engaged in livestock trade in the Alaotra Mangoro region, as well as the factors associated with these KAPs. A descriptive and analytical cross-sectional survey was conducted among 406 livestock traders in five districts of the Alaotra Mangoro region, using a structured questionnaire. A multi-stage sampling approach was employed, utilising purposive selection of markets followed by snowball sampling to reach informal traders often missed by traditional surveys. Generalised linear mixed models were used to analyse factors associated with KAPs regarding RVF. Awareness of RVF was very low (only 18.5% respondents had heard of it), with significant regional disparities (0% in Anosibe An’Ala versus 51.6% in Moramanga). Veterinarians (15.5%), family (12.8%), radio (9.6%) and neighbours (9.6%) were the main sources of information. Understanding of symptoms and modes of transmission (particularly mosquito bites) was limited. Higher levels of education (OR = 181.6; 95% CI: 29.9–1123.7; p < 0.001) and older age (50–60 years) were associated with better knowledge. Proactive attitudes were scarce (21.4%), although more than half (53.4%) believed that RVF is a real disease. Perception of personal risk and the contribution of livestock trade to the spread of the disease was low. However, confidence in animal vaccination was relatively high (60.3%). Preventive practices were highly inadequate. The majority did not wear protective equipment when handling sick animals (94.6%) and rarely avoided touching aborted foetuses (12.6%). Less than half (48.3%) expressed a willingness to report sick or dead animals, and nearly half admitted to having sold or purchased sick livestock (49.5%). Cooking meat (95.1%) and using mosquito nets (74.1%) were the only well-established practices. More than half of respondents (57.9%) lived more than 5 km from veterinary services, and cost was the most frequently cited barrier to consultation. Participation in awareness campaigns was virtually non-existent (5.4%). Results revealed critical gaps in KAP that may contribute to the persistence of RVF. A “One Health” approach is imperative, integrating human, animal and environmental health. Full article

Background: Dry eye disease (DED) is a multifactorial disease. Numerous risk factors might cause DED, including indoor air pollution, such as incense. Incense (Bakhoor) is widely used in many cultures, including Saudi Arabia, although its smoke contains toxic chemicals that pose serious health hazards. This research investigates the link between the Schirmer II test and tear fluid proteins in DED patients. The study focuses on identifying the ocular examinations, hypothesizing that incense smoke, particularly from synthetic types, exacerbates DED. Methods: This pilot cross-sectional study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Participants were recruited from the Cornea and Ophthalmology Clinics. Eye assessments analyzed tear protein concentrations, including tear collection using Schirmer II test strips and tear break-up time (TBUT). The study included DED patients who used incense. Tear fluid from the Schirmer test of 20 randomly selected patients was used for protein analysis of total protein, lactoferrin, and Immunoglobulin E. Inclusion criteria were male and female subjects aged 18 years or older, diagnosed with DED, and using incense. The sample size was 55 participants, selected via convenience sampling. Subjective data were collected through questionnaires, as well as objective data from the tear test and the sample and analyzed with SPSS. Descriptive and inferential statistics were used, with statistical significance set at p-value < 0.05. Results: The Ocular Comfort Index (OCI) categories showed that 21.8% had no symptoms, 40.0% had low symptoms, 30.9% had moderate symptoms, and 7.3% reported high symptoms. TBUT values and Schirmer test scores decreased with increasing OCI severity, with no statistical significance. The mean (SD) of total protein in the right and left eyes for high OCI was 7.19 (1.39) and 7.42 (0.91), respectively, with no statistical significance. The immunoglobulin E levels in the right and left eyes for high OCI were 301.71 (55.97) and 301.71 (47.14), respectively, with no statistical significance. The mean (SD) of lactoferrin in the right and left eyes for high OCI was 163.77 (10.42) and 159.43 (1.68), respectively, with no statistical significance. Conclusions: The study findings demonstrate alignment in incense-using patients between subjective OCI symptom scores and objective clinical diagnostic measures. Specifically, higher OCI scores are associated with lower TBUT and Schirmer II test values, as well as changes in tear biomarkers such as IgE and lactoferrin. These findings emphasize the potential of using simple screening methods combined with bioanalytical markers for early detection of ocular surface disease. This highlights the potential health risks associated with incense exposure, particularly for individuals predisposed to DED. The urgency for further research to explore the long-term effects of incense on ocular health and to raise awareness about its potential impact on populations with high incense usage cannot be overstated. Full article

Adherence to the Mediterranean Diet (MD) is a cornerstone in managing Type 2 Diabetes Mellitus (T2DM), with patients’ Nutrition Literacy (NL) playing a potential role in their dietary choices. This cross-sectional study investigated the association between NL and MD adherence in 81 patients with T2DM from two Greek hospitals. Participants completed the NLS-GR questionnaire to assess NL and the 14-MEDAS for MD adherence, while socio-demographic and clinical data, including glycated haemoglobin (HbA1c), BMI, and disease duration, were obtained through researcher-conducted interviews and medical records. Median HbA1c was 6.9%, duration of T2DM was 13 years, and BMI 26.9 kg/m². A total of 71.6% had moderate MD adherence (median 14-MEDAS: 7), and 96.3% had adequate NL (median NLS-GR: 23). HbA1c showed a weak negative correlation (r = −0.238, p = 0.033) with the 14-MEDAS. Median duration of DM showed a low negative correlation with NL (NLS-GR: r = −0.323, p = 0.003). No statistically significant correlation was found between 14-MEDAS and NLS-GR (r = 0.032, p = 0.775). Although MD adherence was correlated with HbA1c, neither MD adherence nor nutrition literacy were independent predictors after adjustment for confounding factors. Further studies are needed to demonstrate the extent to which NL can influence adherence to a specific dietary pattern. Full article

Background: A physically active lifestyle is crucial for long-term cardiovascular health; however, access to supervised exercise programs for children and adolescents with congenital heart disease (CHD) remains limited. Although prior digital exercise interventions for this population have demonstrated safety and feasibility, adherence has often been low. Mobile health approaches integrating gamification may enhance motivation and engagement, particularly among young “digital natives.” FOOTLOOSE is an app-based home exercise program developed specifically for children and adolescents with CHD. This study aimed to evaluate user experience, usability, and perceived impact using a multimethod approach. Methods: Children and adolescents aged 10–18 years with simple, moderate, or complex CHD were recruited between July and December 2025 mainly during routine outpatient visits at the TUM Klinikum Deutsches Herzzentrum. Participants used the FOOTLOOSE app in their daily lives over a two-week period. Evaluation included semi-structured qualitative interviews and standardized questionnaires assessing physical activity self-efficacy, enjoyment of physical activity (PACES-S), user experience (UEQ), and health-related quality of life (KINDL^®). Interviews were conducted digitally, transcribed verbatim, and analyzed using qualitative content analysis according to Kuckartz until thematic saturation was reached. Results: A total of 22 participants (mean age 13.4 ± 2.3 years; 54.5% female) were included. Overall, the FOOTLOOSE app was perceived positively, with participants highlighting enjoyment, intuitive usability, and personalized workout creation. Participants contributed diverse and creative suggestions for further app development, particularly regarding more advanced gamification features (e.g., games or rankings). Most participants reported self-perceived increase in physical activity during the intervention period (n = 15). UEQ scores (mean ± SD) were as follows: attractiveness (1.3 ± 0.8), perspicuity (1.7 ± 1.1), efficiency (1.2 ± 0.9), dependability (1.4 ± 0.7), stimulation (1.0 ± 1.1), and novelty (0.6 ± 1.0). Conclusions: This study demonstrates the feasibility and user acceptance of a gamified, app-based home exercise program for children and adolescents with CHD. User-centered feedback highlights important directions for iterative refinement, particularly regarding age-appropriate and engaging gamification elements. These findings provide a foundation for future studies evaluating long-term engagement and effectiveness in larger samples. Full article

Newborn mass screening improves outcomes for inborn errors of metabolism (IEM); nonetheless, home-based dietary therapy imposes a substantial parental burden. In this study, we explored differences in parents’ health coping behaviors, assessed using the Coping Health Inventory for Parents (CHIP), based on the presence of dietary therapy, child age group, and diagnostic category. A 21-item, CHIP-based questionnaire was distributed via the JaSMIn registry to parents of children with IEM up to school age. Overall, 201 valid responses (56.1% response rate) were analyzed regarding the implementation and perceived usefulness of coping behaviors, stratified by child age, enrollment, diagnosis, and dietary therapy. Parents in the dietary-therapy group reported more coping behaviors than did those in the non-dietary-therapy group. Notably, parents of children aged 1–3 years (not yet in preschool) and those of children with organic acid metabolism disorders rated “daily home practice of treatments” as a highly useful coping behavior. Health-related coping behaviors among parents of children with IEM vary substantially according to child age and disease characteristics. Therefore, family support strategies should be tailored to specific developmental stages and treatment requirements. Full article

Objective: Systemic lupus erythematosus (SLE) is a complex autoimmune disease, and its diagnosis can cause considerable anxiety and uncertainty for those affected. This study aimed to investigate the effect of a one-day educational seminar on disease-specific knowledge among patients with SLE. Additionally, the influence on subjective needs, the cognitive and emotional impact of the disease, and health-related lifestyle were examined. Methods: Patients were randomly assigned in a 1:1 ratio to an intervention group or a waiting list control group. Both groups attended the seminar. Disease-specific knowledge was measured using a multiple-choice questionnaire. The primary objective was the change in knowledge after the intervention. Results: Thirty-nine participants were included in the analysis. The mean score difference between the waiting list control group and the intervention group was 3.4 points out of a maximum of 20 (95% CI 1.8 to 5) immediately after the seminar and 1.6 (95% CI −0.6 to 3.5) three months later. Pooled data from both groups showed an increase in SLE-specific knowledge from 13.7 points to 17.3 points. Three months later, SLE-specific knowledge remained above the initial value at 15.4 points. However, no influence on lifestyle was observed. Conclusion: A one-day seminar can increase disease-specific knowledge and reduce unmet informational needs but does not lead to lifestyle modifications. Full article

Background: Cost-utility analysis (CUA) is frequently used by reimbursement agencies and national advisory bodies to make informed decisions on whether or not to reimburse surgical interventions. Health state preferences (utilities) are a key component in valuing health outcomes in that they are used in calculating quality-adjusted life-years (QALY). Unfortunately, disease-specific HRQoL measures commonly lack the preference weights necessary to produce health-state utility values for use in CUA. A solution to this problem is to map a disease-specific quality-of-life measure to a generic preference-based measure. The aim of this study was to develop health-state utility values for cerebral palsy (CP) patients with scoliosis by mapping disease-specific quality-of-life scores (CPCHILD outcome questionnaire) to the Health Utility Index Mark 3 (HUI3) questionnaire. Methods: A prospective, multicentre CP scoliosis database was analysed identifying consecutive CP patients with ≥2 years follow-up who completed both the CPCHILD and HUI3 at enrolment, at 1-, and at 2 years follow-up. Ordinary least squared regression models were constructed to estimate HUI3 utility values from CPCHILD scores and clinical variables. The model was developed using enrolment data, while 1- and 2-years follow-up data were used for confirmatory analysis of the goodness of fit of the model (i.e., paired t test between observed and calculated HUI utility values). Results: A total of 232 patients were included, 91.9% were GMFCS IV and V, 87.9% underwent surgery during the study period, and the average magnitude of scoliosis deformity at enrolment was 81.93° ± 25.13°. A log-linear regression model was developed, including three predicting variables: CPCHILD total score (β = 0.016, p = 0.0001), communication (β = −0.436, p = 0.0001), and feeding ability (β = −0.289, p = 0.0001). The R² of the model was 0.578, and F 49.73 (p = 0.0001). The mean difference of means between observed HUI3 values and calculated HUI3 values at 1- and 2 years was −0.020 (p = 0.129) and 0.017 points (p = 0.187), respectively. Conclusions: Although the use of a preference-based HRQoL measure is the ideal method to generate health-state utility values, we demonstrate that HUI3 scores can be accurately predicted using the CPCHILD questionnaire. This mapping algorithm will be useful in estimating health-state utilities in clinical trials, and hence CUA, of CP patients undergoing scoliosis surgery to help better inform patients, care-givers, health-care providers, and decision makers of the economic burden of surgery in this patient population. Full article

Background/Aims: Glutamate is the primary excitatory neurotransmitter in the central nervous system, and elevated levels have been implicated in neurotoxicity. Corneal nerves are integral to ocular surface health and abnormalities can contribute to dry eye disease (DED). This study evaluates the relationship between serum glutamate levels, DED signs and symptoms, and corneal nerve parameters. Methods: A total of 124 veterans evaluated at the Miami Veterans Affairs Eye Clinic were included. Participants completed standardized questionnaires assessing ocular surface symptoms and pain, underwent comprehensive ocular surface examination and in vivo confocal microscopy, and provided blood samples for serum glutamate analysis. Results: Mean age was 55.67 ± 4.59 years; 90.3% were male, 55.6% White, and 35.5% Hispanic. Serum glutamate ranged from 0.26 to 3.16 µM/µL (mean 1.22 ± 0.57 µM/µL). Glutamate levels were not associated with DED symptoms as assessed by standardized questionnaires. Higher glutamate levels were linked with DED signs including reduced tear production (right eye: r = −0.05, p = 0.55; left eye: r = −0.25, p = 0.01) and increased corneal staining (right eye: r = 0.10, p = 0.29; left eye: r = 0.20, p = 0.03). Most notable were associations between elevated glutamate and corneal nerve health, including reduced corneal sensation (right eye: r = −0.20, p = 0.03; left eye: r = −0.18, p = 0.047) and decreased corneal nerve fiber width (r = −0.23, p = 0.01). Conclusions: Our findings support an association between systemic neurochemical status, specifically circulating glutamate, and ocular surface and corneal nerve health. Full article

Microplastics may pose health risks, particularly for chronic lung diseases. Clarifying the link between circulating microplastics and pulmonary disease is vital for shaping research and interventions. The objective of this study was to evaluate whether microplastics in peripheral blood are associated with COPD or IPF vs. no lung disease. In this pilot prospective case-control study, participants were grouped as control (n = 10), COPD (n = 9), or IPF (n = 10). Relevant comorbidities and exposures were obtained from records and questionnaires. All underwent standardized blood collection (PlasticTox©). Samples were analyzed for total microplastic concentration, stratified by size (<10 µm, 10–30 µm, 30–70 µm). The primary outcome was to show a difference in total microplastic burden between lung disease and controls. Secondary measures were to determine size-specific concentrations and associations with demographic variables and smoking history. Among 29 participants (median age 70 (IQR 64–80); 14 women (48.3%)), COPD/IPF groups had significantly higher total microplastic concentrations vs. controls (median 26.0 vs. 3.5 particles/100 µL; p < 0.01). Particle burdens <10 µm and 10–30 µm were particularly elevated (both p < 0.01). After adjusting for smoking, only the <10 µm fraction remained independently associated with lung disease (adjusted odds ratio 1.94 (95% CI, 1.23–7.04)). In this pilot exploratory study, individuals with COPD or IPF showed greater circulating microplastic levels than controls. These findings should be interpreted as hypothesis-generating, and larger analytically validated studies are needed to clarify directionality, causal mechanisms, contamination control, and the clinical relevance of circulating microplastic burden. Full article

Background/Objectives: Cardiovascular disease (CVD) is the leading cause of death in China. While obesity and dietary patterns are well-established factors, the independent association between overall dietary quality and CVD prevalence—specifically whether this link persists regardless of Body Mass Index (BMI)—requires further clarification. Furthermore, the behavioral and cognitive correlates that drive dietary quality, such as health literacy, remain insufficiently explored. This study evaluated the association of dietary quality with self-reported CVD among Chinese adults, independent of BMI, and identified the key behavioral and cognitive factors associated with dietary adherence in this population. Methods: This cross-sectional study surveyed 975 Chinese adults through anonymous questionnaires and collected self-reported data on CVD, BMI, dietary quality, and health literacy. One-way analysis of variance (ANOVA) and the chi-square test were used to compare the characteristics between groups, and multivariate Logistic regression was used to analyze the association between dietary quality and the odds of CVD, sequentially adjusting for variables such as BMI, physical activity. Results: Higher dietary quality was independently associated with lower odds of CVD (Model 3: OR = 0.879, 95% CI: 0.845–0.915, p < 0.001). Notably, this inverse association remained significant after adjusting for BMI, which itself showed no significant association with CVD prevalence in the multivariable model. Regarding population profiling, poor dietary quality was significantly related to regular smoking (p < 0.05), whereas age, gender, residence, employment status, and BMI showed no significant associations with dietary quality categories. Furthermore, health literacy (p < 0.05) and physical activity (p < 0.05) showed positive associations with superior dietary quality. Conclusions: Dietary quality is a significant independent factor inversely associated with CVD prevalence, regardless of obesity status. Suboptimal dietary habits cluster among smokers and individuals with lower health literacy and physical activity levels, showing a stronger association with cognitive and behavioral factors than with demographic or occupational characteristics. Interventions should prioritize enhancing health literacy and addressing the clustering of unhealthy behaviors to effectively address the cardiovascular burden in the Chinese population. Full article

Background: Adolescent obesity and depressive symptoms have increased concurrently, often presenting as co-occurrence. However, evidence on the timing of physical activity (e.g., weekday vs. weekend) and adherence to planetary health diets remains limited. This study examined these associations among adolescents in Zhejiang Province from 2022 to 2024. Methods: A total of 261,495 adolescents aged 11–18 years were included. Physical activity (PA) and dietary behaviors were assessed through the China Common Disease and Risk Factor Surveillance among Students questionnaire (reliability: Cronbach’s α = 0.84, validity: RMSEA = 0.07). The plant-based Planetary Health Diet Index (PHDI-green) adherence was defined as consuming at least one daily serving of both vegetables and fruits. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression (CES-D) scale, and co-occurrence was defined as the coexistence of obesity and depressive symptoms. Temporal trends were tested using χ² tests. Sex-stratified logistic regression, restricted cubic spline analyses, and population attributable fraction (PAF) analyses were applied. Results: From 2022 to 2024, obesity (p for trend = 0.013) and depressive symptoms (p for trend = 0.003) increased significantly, while co-occurrence remained stable (p for trend = 0.058). Boys had higher obesity and co-occurrence, whereas girls showed higher depressive symptoms (all p < 0.001). Higher weekly PA, greater weekend PA and PHDI-green adherence were associated with reduced odds of obesity in both sexes (all p < 0.001). Weekend PA showed stronger associations with depressive symptoms among girls, while PHDI-green showed stronger inverse associations in boys (p for sex difference < 0.001). PAF analyses suggested that low weekend PA accounted for substantial proportions of cases (girls: obesity 10.17%, depressive symptoms 31.30%, co-occurrence 35.64%). Joint adherence to adequate PA and PHDI-green conferred the lowest odds of co-occurrence (boys: OR = 0.40, 95% CI: 0.34–0.46; girls: OR = 0.33, 95% CI: 0.26–0.43). Conclusions: Adherence to the Planetary Health Diet may be particularly relevant for boys, whereas PA—especially weekend PA—may be more strongly associated with health outcomes among girls. These findings suggest the importance of sex-specific and time-targeted behavioral strategies for obesity, depressive symptoms, and their co-occurrence in adolescents. Full article

Background/Objectives: Facilities for persons with Alzheimer disease need to be adapted for them in terms of architecture and interior and exterior design, where the introduction of an artistic dimension is recommended. This raises the question of exploring the aesthetic preferences of the people concerned in order to optimise the design. We assessed whether individuals with Alzheimer’s disease can make aesthetic judgements, and if so, their nature and how stable they were over time. Methods: We compared the aesthetic preferences of 23 persons with Alzheimer’s disease matched to 23 controls. Preferences were collected using a Q-PEG questionnaire, which presents photographs of various artworks: paintings, sculptures, functional objects, and representation of living things: human, animal, and landscape, in various styles: figurative, stylized, abstract. This tool was created specifically by our team for this research; this is the first exploratory publication to use it. Results: We confirm the feasibility of collecting aesthetic judgements from individuals living with Alzheimer’s disease using the Q-PEG tool. The aesthetic judgements of both participant groups proved to be stable over time. Furthermore, the aesthetic judgements of individuals with Alzheimer’s disease did not differ from those of the controls, regardless of the style or type of artwork. These preferences are independent of the various cognitive functions assessed. Hypotheses about the Alzheimer-resistant nature of the cognitive register of aesthetic preferences are discussed. Conclusions: As they can express their artistic preferences, individuals living with Alzheimer’s disease should be consulted. These results provide insights for the design of facilities and therapeutic gardens based on evidence-based design (EBD) criteria. The integration of an artistic dimension in line with these preferences and in compliance with the general recommendations makes it possible to create adapted, specific spaces that are appreciated by all. Full article

Background: Generative artificial intelligence (GenAI) models are increasingly used for medical information retrieval, due to their accessibility and efficiency. However, the accuracy and readability of their responses, specifically for upper gastrointestinal cancers, remain inadequately evaluated. This gap highlights the need for rigorous assessment to ensure reliable patient education and clinical integration. Objective: This study aimed to assess the accuracy and readability of responses generated by four prominent GenAI models (Kimi, DeepSeek, ChatGPT, and Gemini) when addressing patient-focused questions related to esophageal and gastric cancers. Methods: Twenty-five standardized medical questions about esophageal and gastric cancer covering domains of disease definition, treatment and management were posed to each model. Responses were assessed by four oncologists for accuracy by a 5-point Likert scale and analyzed for readability using Flesch–Kincaid Reading Ease, Flesch–Kincaid Grade Level, and SMOG metrics. High-interest questions for patients were identified via questionnaires. Results: Comparing the accuracy of GenAI-generated responses, DeepSeek achieved the highest overall accuracy score and outperformed other models in questions about definitions and treatments, while ChatGPT excelled in management-related inquiries. In subgroup analysis, GenAI models exhibited higher accuracy in answering definition and management questions, which patients preferred to inquire, compared with questions about cancer therapies. The responses produced by all models required a reading capacity from 11th-grade to college level. Conclusions: This study revealed that in this comparative evaluation application of GenAI models, DeepSeek provides the most accurate responses for upper GI cancer inquiries about definition and treatment, while ChatGPT showed superiority in management-related questions. However, all models generate texts requiring advanced reading levels, highlighting a need for readability optimization without compromising accuracy. GenAI shows promise for patient education but requires rigorous validation for clinical integration. Full article