Accessibility

· 13 checks — Landmarks, headings, alt text, forms, and link quality rolled into one auditable list.

SCORE

GRADE

FIX

REVIEW

PASS

INFO

Checks

3 REVIEW 10 FIX

Landmark Structure

Action

3 landmarks

FIX

3 landmarks

No <main> landmark found

Screen reader users cannot quickly navigate to the primary content. Wrap your main content in <main>.

2 <nav> landmark(s) found

2 of 2 <nav> elements are unlabeled

Multiple navigations need aria-label to distinguish them for screen readers.

No banner (header) landmark

No contentinfo (footer) landmark

Skip navigation link is missing (WCAG 2.4.1)

Add a skip link as the first focusable element so keyboard users can bypass repeated navigation.

Page Structure — as a screen reader sees it

Screen reader users cannot quickly navigate to the primary content. Wrap your main content in <main>.

Why this matters

Without a <main> landmark, screen-reader users can't skip past the navigation to the page content — every page starts with re-reading the menu.

Learn more ▾

The <main> element marks the page's primary content area. Assistive tech offers a 'jump to main' shortcut — but only if <main> exists. Without it, every page navigation forces re-reading the header. Wrap your primary content in a single <main>.

Source: WAI-ARIA / WCAG 2.4.1

Multiple navigations need aria-label to distinguish them for screen readers.

Why this matters

Some <nav> elements lack aria-label — screen-reader users hear 'navigation' multiple times with no way to distinguish them.

Learn more ▾

When a page has multiple <nav> regions (primary, footer, breadcrumb), each needs aria-label or aria-labelledby. AT users navigate by landmark; identical 'navigation' announcements force them to enter each one to discover purpose.

Source: WAI-ARIA Authoring Practices

Add a skip link as the first focusable element so keyboard users can bypass repeated navigation.

Why this matters

Without a skip-nav link, keyboard users tab through every nav item before reaching content — every page, every visit.

Learn more ▾

WCAG 2.4.1 (Bypass Blocks) requires a mechanism to skip past repeated content. The standard implementation is a 'Skip to main content' link that's the first focusable element, visually hidden until focused. Three lines of HTML + four of CSS.

Source: WCAG 2.1 SC 2.4.1

Alt Text Quality

Action

36 of 69 images have issues

FIX

36 of 69 images have issues

36 image(s) missing alt attribute

Images without alt text are invisible to screen readers.

35 image-in-link without alt text

An image inside a link with no alt creates an empty link.

33 image(s) with good alt text

69 images 33 good alt text 36 missing

Issue	Count
missing	36 image(s)

Images without alt text are invisible to screen readers.

Why this matters

Each image without alt text is a WCAG 1.1.1 failure — invisible to screen-reader users, lost from Google Image Search.

Learn more ▾

WCAG 2.1 Level A requires text alternatives for non-decorative images. Empty alt='' is fine for decorative; meaningful images need descriptive text. Common fixes: CMS audit + bulk add, build-time linter (alt-text-required ESLint rule), CI gate on Lighthouse a11y score.

Source: WCAG 2.1 SC 1.1.1 / WebAIM Million Report

An image inside a link with no alt creates an empty link.

Why this matters

Image-only links with no alt create empty links — screen-reader users hear 'link' with no destination context.

Learn more ▾

An <a><img></a> with no img alt is the worst-case for accessibility: AT announces the link but can't describe where it goes. Either add alt to the image OR add aria-label to the link.

Source: WCAG 2.1 SC 2.4.4

Form Accessibility

Action

9 of 9 controls have issues

FIX

9 of 9 controls have issues

5 control(s) without accessible label

Form controls need a <label>, aria-label, or aria-labelledby for screen readers.

Got: <input type="image">; <input type="image" id="search-icon-offcanvas">; <input type="submit">; <input type="submit">; <textarea name="g-recaptcha-response" id="g-recaptcha-response-100000">

4 control(s) rely on placeholder only

Placeholder text disappears on focus and is not a reliable label.

Got: <input type="text" name="q" id="q">; <input type="text" name="q">; <input type="text" name="email_address">; <input type="text" name="email_address">

9 controls

0 labeled

4 placeholder only

5 unlabeled

Control	Type	Label	Method
#q	text	(Search the JCI)	placeholder only
q	text	(Search the JCI)	placeholder only
email_address	text	(Your email address)	placeholder only
email_address	text	(Your email address)	placeholder only
input	image	(none)	none
input	submit	(none)	none
#search-icon-offcanvas	image	(none)	none
input	submit	(none)	none
#g-recaptcha-response-100000	textarea	(none)	none

Form controls need a <label>, aria-label, or aria-labelledby for screen readers.

Why this matters

Form controls without labels — assistive tech announces 'edit text' with no context; users can't complete forms.

Source: WCAG 2.1 SC 3.3.2

Placeholder text disappears on focus and is not a reliable label.

Why this matters

Placeholder-only labels disappear when the user starts typing — they must remember what the field was for.

Learn more ▾

Placeholders are NOT labels. They vanish on input, fail color contrast checks (most are gray), and don't satisfy WCAG SC 3.3.2. Always use a real <label> alongside (or aria-labelledby).

Source: WCAG 2.1 SC 3.3.2 / Nielsen Norman

Link & Button Quality

Action

16 issue(s) across 656 links and 2 buttons

FIX

16 issue(s) across 656 links and 2 buttons

12 link(s) with no accessible text

Links without text are announced as raw URLs by screen readers.

Got: /; a.left-off-canvas-toggle (#200 on page); /; a.exit-off-canvas (#278 on page); a.in-page (#316 on page); a.in-page (#368 on page); a.in-page (#558 on page); a.in-page (#656 on page); a.in-page (#1742 on page); /twitter (+2 more)

4 link(s) with generic text

Generic link text like 'click here' doesn't describe the destination.

Got: /in-press-preview ("More"); /review_series ("More"); /tags/reviews ("More"); /videos/video_abstracts ("More")

30 image-only link(s) without alt text

Image-only links need alt text on the image (or aria-label on the link) so screen readers can announce them.

Got: a[href="https://www.jci.org/articles/view/199850/figure/1"]; a[href="https://www.jci.org/articles/view/205029/figure/1"]; a[href="https://www.jci.org/articles/view/205273/figure/1"]; a[href="https://www.jci.org/articles/view/205442/figure/1"]; a[href="https://www.jci.org/articles/view/206748/figure/1"]; a[href="https://www.jci.org/articles/view/201075/figure/1"]; a[href="https://www.jci.org/articles/view/202577/figure/1"]; a[href="https://www.jci.org/articles/view/189044/ga"]; a[href="https://www.jci.org/articles/view/191735/ga"]; a[href="https://www.jci.org/articles/view/193812/ga"] (+20 more)

610 link(s) with descriptive text

656 links

12 empty

4 generic text

0 new tab

0 empty buttons

Element	Text	Issue	Suggested Fix
/	(empty)	empty	Add link text or aria-label
	(empty)	empty	Add link text or aria-label
/	(empty)	empty	Add link text or aria-label
	(empty)	empty	Add link text or aria-label
	(empty)	empty	Add link text or aria-label
https://www.jci.org/articles/view/199850…	Innate immune activation and m…	img no alt	Add alt attribute to the image
	(empty)	empty	Add link text or aria-label
https://www.jci.org/articles/view/205029…	A high-fat, high-sugar diet ra…	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/205273…	Altered CBF responses associat…	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/205442…	Myeloid cell GSDME expression …	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/206748…	Expanding CH clones promote an…	img no alt	Add alt attribute to the image
	(empty)	empty	Add link text or aria-label
https://www.jci.org/articles/view/201075…	Sinus MCs are enriched in burn…	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/202577…	HIV reservoirs and immune para…	img no alt	Add alt attribute to the image
	(empty)	empty	Add link text or aria-label
https://www.jci.org/articles/view/189044…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/191735…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/193812…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/194139…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/194207…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/194721…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/195411…	PHD deficiency in skeletal mus…	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/196788…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/196819…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/197271…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/197503…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/197556…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/197812…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/197923…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/198076…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/198708…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/198730…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/198815…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/198835…	Clinical manifestations and hi…	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/199035…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/199725…	Hormonal response to HG. Bar h…	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/200062…	Graphical abstract	img no alt	Add alt attribute to the image
https://www.jci.org/articles/view/201762…	Graphical abstract	img no alt	Add alt attribute to the image
	(empty)	empty	Add link text or aria-label
/in-press-preview	More	generic text	Replace with descriptive text
Before: More Suggested: In Press Preview
/review_series	More	generic text	Replace with descriptive text
Before: More Suggested: Review Series
/tags/reviews	More	generic text	Replace with descriptive text
Before: More Suggested: Reviews
/videos/video_abstracts	More	generic text	Replace with descriptive text
Before: More Suggested: Video Abstracts
/twitter	(empty)	empty	Add link text or aria-label
/facebook	(empty)	empty	Add link text or aria-label
/rss	(empty)	empty	Add link text or aria-label

612 links and buttons have descriptive text

Links without text are announced as raw URLs by screen readers.

/; a.left-off-canvas-toggle (#200 on page); /; a.exit-off-canvas (#278 on page); a.in-page (#316 on page); a.in-page (#368 on page); a.in-page (#558 on page); a.in-page (#656 on page); a.in-page (#1742 on page); /twitter (+2 more)

Why this matters

Links with no accessible text (empty <a></a>, image-only no alt, icon-only no aria-label) are unidentifiable to screen readers.

Source: WCAG 2.1 SC 2.4.4

Generic link text like 'click here' doesn't describe the destination.

/in-press-preview ("More"); /review_series ("More"); /tags/reviews ("More"); /videos/video_abstracts ("More")

Why this matters

Generic anchor text ('click here', 'read more', 'learn more') tells screen readers and search engines nothing about the destination.

Learn more ▾

Out-of-context lists of links read by AT (one navigation pattern) become useless when every link says 'click here'. Use the destination's title or topic as anchor text. Doubles as SEO win — Google passes anchor-text relevance to the destination.

Source: WCAG 2.4.4 / Google Search Central

Image-only links need alt text on the image (or aria-label on the link) so screen readers can announce them.

a[href="https://www.jci.org/articles/view/199850/figure/1"]; a[href="https://www.jci.org/articles/view/205029/figure/1"]; a[href="https://www.jci.org/articles/view/205273/figure/1"]; a[href="https://www.jci.org/articles/view/205442/figure/1"]; a[href="https://www.jci.org/articles/view/206748/figure/1"]; a[href="https://www.jci.org/articles/view/201075/figure/1"]; a[href="https://www.jci.org/articles/view/202577/figure/1"]; a[href="https://www.jci.org/articles/view/189044/ga"]; a[href="https://www.jci.org/articles/view/191735/ga"]; a[href="https://www.jci.org/articles/view/193812/ga"] (+20 more)

Why this matters

Image-only links with no alt are unidentifiable to screen-reader users — link's destination is invisible.

Source: WCAG 2.1 SC 2.4.4

Favicon & Branding

Action

No icons detected

FIX

No icons detected

No favicon.ico at site root

Some older browsers, bookmark tools, and RSS readers look for /favicon.ico. Add one as a fallback.

No apple-touch-icon detected

iOS devices use this when users add your site to their home screen. Add <link rel='apple-touch-icon' sizes='180x180' href='/apple-touch-icon.png'>.

No favicon or icon links detected

Your site will show the browser's generic page icon in tabs, bookmarks, and home screens.

✗ favicon.ico Missing

✗ PNG Icons Missing

✗ Apple Touch Missing

✗ SVG Favicon Missing

✗ Manifest Icons Missing

✗ Multiple Sizes Missing

Web Manifest

Action

Not found

FIX

Not found

No web manifest found

No manifest at standard paths (/manifest.json, /site.webmanifest). A manifest is optional but enables PWA features like home screen installation and standalone display.

No web manifest found.

Dark Mode Support

Action

No dark mode signals

FIX

No dark mode signals

No dark mode signals detected

Consider adding CSS with @media (prefers-color-scheme: dark) and <meta name='color-scheme' content='light dark'>.

Detection limited to meta tags and inline styles

External CSS files may contain prefers-color-scheme rules not visible to this scan.

Dark ModeNo Dark Mode Detected

color-scheme meta Not set ✗Dark theme-color Not set ✗CSS indicators Not detected ✗

Detection limited to meta tags and inline styles.

Print Stylesheet

Action

No print styles

FIX

No print styles

No print-specific styles detected

When users print this page, they get the screen layout including navigation and non-essential elements. Add @media print rules to hide navigation and optimize layout for paper.

Print Stylesheet No Print Styles

Print stylesheet Not found ✗Inline @media print Not detected ✗

Navigation UX

Action

No navigation patterns

FIX

No navigation patterns

2 navigation landmark(s) detected

No breadcrumbs, search, or skip link detected

These navigation aids help users orient themselves and find content efficiently, especially on large sites.

Breadcrumbs

Skip Link

Labeled Navigation 2 <nav> element(s)

Hamburger Menu

Sticky Navigation Cannot reliably detect (CSS-based)

1 of 6 testable patterns navigation patterns detected. Limited navigation support. Consider adding breadcrumbs, search, and skip link.

Lighthouse Accessibility Audits

Action

Score 68/100 — 10 failing, 20 passed

FIX

Accessibility

These checks highlight opportunities to improve the accessibility of your web app. Automatic detection can only detect a subset of issues and does not guarantee the accessibility of your web app, so manual testing is also encouraged.

Contrast

Low-contrast text is difficult or impossible for many users to read. Learn how to provide sufficient color contrast.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
In-Press Preview `div.row > div.small-12 > a > span.label-in-press-preview`
In-Press Preview `div.row > div.small-12 > a > span.label-in-press-preview`
In-Press Preview `div.row > div.small-12 > a > span.label-in-press-preview`
In-Press Preview `div.row > div.small-12 > a > span.label-in-press-preview`
In-Press Preview `div.row > div.small-12 > a > span.label-in-press-preview`
form > div.row > div.small-12 > input.button `form > div.row > div.small-12 > input.button`
form > div.row > div.small-12 > input.button `form > div.row > div.small-12 > input.button`

Low-contrast text is difficult or impossible for many users to read. Link text that is discernible improves the experience for users with low vision. Learn how to make links distinguishable.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
Torres et al. `div.small-12 > div > p > a`
Text `div.small-12 > div.row > div.small-12 > a`
PDF `div.small-12 > div.row > div.small-12 > a`
Text `div.small-12 > div.row > div.small-12 > a`
PDF `div.small-12 > div.row > div.small-12 > a`

These are opportunities to improve the legibility of your content.

Tables and lists

When definition lists are not properly marked up, screen readers may produce confusing or inaccurate output. Learn how to structure definition lists correctly.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
Review Series Immune signaling and function in neurodegeneration Yvonne L. Lat… `div.small-12 > div.row > div.small-12 > dl.article-section`
Commentaries Diet’s rapid effects on the thyroid gland challenge unidirectiona… `div.small-12 > div.row > div.small-12 > dl.article-section`
Research Letters Sinus mast cell accumulation and persistence suggest a unique… `div.small-12 > div.row > div.small-12 > dl.article-section`
Research Articles Inhibiting LSD1 unlocks retinoid AP-1 programming to activat… `div.small-12 > div.row > div.small-12 > dl.article-section`
Corrigendum Corrigendum to Type 2 diabetes candidate genes, including PAX5, ca… `div.small-12 > div.row > div.small-12 > dl.article-section`

These are opportunities to improve the experience of reading tabular or list data using assistive technology, like a screen reader.

Names and labels

Informative elements should aim for short, descriptive alternate text. Decorative elements can be ignored with an empty alt attribute. Learn more about the `alt` attribute.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
section.middle > h1.title > a > img `section.middle > h1.title > a > img`
div.small-12 > div.row > div.large-3 > img.issue-cover `div.small-12 > div.row > div.large-3 > img.issue-cover`

When an image is being used as an `<input>` button, providing alternative text can help screen reader users understand the purpose of the button. Learn about input image alt text.

Why this matters

Informational: a Permissions-Policy directive showing feature -> allowed origins.

Source: MDN Permissions-Policy

Failing Elements
form > div#search-div-offcanvas > div.small-4 > input#search-icon-offcanvas `form > div#search-div-offcanvas > div.small-4 > input#search-icon-offcanvas`

Screen reader users rely on frame titles to describe the contents of frames. Learn more about frame titles.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
div.row > div.small-12 > div.flex-video > iframe `div.row > div.small-12 > div.flex-video > iframe`

Link text (and alternate text for images, when used as links) that is discernible, unique, and focusable improves the navigation experience for screen reader users. Learn how to make links accessible.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
nav#small-navbar > section.middle > h1.title > a `nav#small-navbar > section.middle > h1.title > a`

These are opportunities to improve the semantics of the controls in your application. This may enhance the experience for users of assistive technology, like a screen reader.

Navigation

Properly ordered headings that do not skip levels convey the semantic structure of the page, making it easier to navigate and understand when using assistive technologies. Learn more about heading order.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
Issue published April 15, 2026 Previous issue `div.small-12 > div.row > div.small-12 > h3.issue`
Go to section: `div.small-12 > div.row > div.large-9 > h5`

These are opportunities to improve keyboard navigation in your application.

Best practices

Touch targets with sufficient size and spacing help users who may have difficulty targeting small controls to activate the targets. Learn more about touch targets.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
Article has an altmetric score of 66 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 8 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 29 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 50 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 2 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 7 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 11 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 3 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 6 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 3 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 8 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 11 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 4 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 38 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 5 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 46 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 3 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 2 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 4 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 5 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 4 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 1 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 5 `div.row > div.small-12 > span.altmetric-embed > a`
Article has an altmetric score of 4 `div.row > div.small-12 > span.altmetric-embed > a`

One main landmark helps screen reader users navigate a web page. Learn more about landmarks.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
html.js `html.js`

These items highlight common accessibility best practices.

○Interactive controls are keyboard focusable

○Interactive elements indicate their purpose and state

○The page has a logical tab order

○Visual order on the page follows DOM order

○User focus is not accidentally trapped in a region

○The user's focus is directed to new content added to the page

○HTML5 landmark elements are used to improve navigation

○Offscreen content is hidden from assistive technology

○Custom controls have associated labels

○Custom controls have ARIA roles

●`[aria-*]` attributes match their roles

●`[aria-hidden="true"]` is not present on the document `<body>`

●`[role]`s have all required `[aria-*]` attributes

●`[role]` values are valid

●`[aria-*]` attributes have valid values

●`[aria-*]` attributes are valid and not misspelled

●Input buttons have discernible text.

●Form elements have associated labels

●`[user-scalable="no"]` is not used in the `<meta name="viewport">` element and the `[maximum-scale]` attribute is not less than 5.

●ARIA attributes are used as specified for the element's role

●Elements use only permitted ARIA attributes

●Definition list items are wrapped in `<dl>` elements

●Document has a `<title>` element

●`<html>` element has a `[lang]` attribute

●`<html>` element has a valid value for its `[lang]` attribute

●Lists contain only `<li>` elements and script supporting elements (`<script>` and `<template>`).

●List items (`<li>`) are contained within `<ul>`, `<ol>` or `<menu>` parent elements

●Deprecated ARIA roles were not used

●All heading elements contain content.

●Identical links have the same purpose.

○`[accesskey]` values are unique

○`button`, `link`, and `menuitem` elements have accessible names

○Elements with `role="dialog"` or `role="alertdialog"` have accessible names.

○`[aria-hidden="true"]` elements do not contain focusable descendents

○ARIA input fields have accessible names

○ARIA `meter` elements have accessible names

○ARIA `progressbar` elements have accessible names

○Elements with an ARIA `[role]` that require children to contain a specific `[role]` have all required children.

○`[role]`s are contained by their required parent element

○Elements with the `role=text` attribute do not have focusable descendents.

○ARIA toggle fields have accessible names

○ARIA `tooltip` elements have accessible names

○ARIA `treeitem` elements have accessible names

○Buttons have an accessible name

○The page contains a heading, skip link, or landmark region

○ARIA IDs are unique

○No form fields have multiple labels

○`<html>` element has an `[xml:lang]` attribute with the same base language as the `[lang]` attribute.

○The document does not use `<meta http-equiv="refresh">`

○`<object>` elements have alternate text

○Select elements have associated label elements.

○Skip links are focusable.

○No element has a `[tabindex]` value greater than 0

○Cells in a `<table>` element that use the `[headers]` attribute refer to table cells within the same table.

○`<th>` elements and elements with `[role="columnheader"/"rowheader"]` have data cells they describe.

○`[lang]` attributes have a valid value

○`<video>` elements contain a `<track>` element with `[kind="captions"]`

○Tables have different content in the summary attribute and `<caption>`.

○Uses ARIA roles only on compatible elements

○Image elements do not have `[alt]` attributes that are redundant text.

○Elements with visible text labels have matching accessible names.

○Tables use `<caption>` instead of cells with the `[colspan]` attribute to indicate a caption.

○`<td>` elements in a large `<table>` have one or more table headers.

Heading Hierarchy

Action

165 headings, 2 skip(s)

REVIEW

165 headings, 2 skip(s)

Single H1 present

Heading level skipped: H1 → H3 (missing H2)

Skipping heading levels breaks the document outline. Screen readers may interpret missing levels as structural errors.

Heading level skipped: H3 → H5 (missing H4)

Skipping heading levels breaks the document outline. Screen readers may interpret missing levels as structural errors.

1 empty heading(s)

Empty headings appear in the document outline but provide no information.

H5 Back
H5 Back
H5 Back
H5 Back
H1 (empty)
H3 Issue published April 15, 2026 Previous issue skipped
H5 Go to section: skipped
H4 On the cover: Neuronal ERAD links ER proteostasis to neurometabolic dysfunction
H5 Immune signaling and function in neurodegeneration
H4 Immune signaling and function in neurodegeneration
H5 Abstract
H5 Authors
H5 Diet’s rapid effects on the thyroid gland challenge unidirectional assumptions about hypothyroidism and energy balance
H4 Diet’s rapid effects on the thyroid gland challenge unidirectional assumptions about hypothyroidism and energy balance
H5 Abstract
H5 Authors
H5 Unconscious uncoupling: dysfunctional neurovascular responses to low glucose in type 1 diabetes and impaired hypoglycemia awareness
H4 Unconscious uncoupling: dysfunctional neurovascular responses to low glucose in type 1 diabetes and impaired hypoglycemia awareness
H5 Abstract
H5 Authors
H5 Gasdermin E: a missing link in muscle regeneration
H4 Gasdermin E: a missing link in muscle regeneration
H5 Abstract
H5 Authors
H5 Expanding clones, expanding aneurysms through macrophage-to-osteoclast differentiation
H4 Expanding clones, expanding aneurysms through macrophage-to-osteoclast differentiation
H5 Abstract
H5 Authors
H5 Sinus mast cell accumulation and persistence suggest a unique endotype in toxin exposure–associated chronic rhinosinusitis
H4 Sinus mast cell accumulation and persistence suggest a unique endotype in toxin exposure–associated chronic rhinosinusitis
H5 Abstract
H5 Authors
H5 Characterization of elite controllers with an undetectable intact HIV DNA reservoir
H4 Characterization of elite controllers with an undetectable intact HIV DNA reservoir
H5 Abstract
H5 Authors
H5 Inhibiting LSD1 unlocks retinoid AP-1 programming to activate epithelial immunity and skin tumor suppression
H4 Inhibiting LSD1 unlocks retinoid AP-1 programming to activate epithelial immunity and skin tumor suppression
H5 Abstract
H5 Authors
H5 Therapy-induced cholesterol biosynthesis drives lung cancer dormancy and drug resistance
H4 Therapy-induced cholesterol biosynthesis drives lung cancer dormancy and drug resistance
H5 Abstract
H5 Authors
H5 Postnatal Slc26a4 gene therapy improves hearing and structural integrity in a hereditary hearing loss model
H4 Postnatal Slc26a4 gene therapy improves hearing and structural integrity in a hereditary hearing loss model
H5 Abstract
H5 Authors
H5 Galectin-3 mediates lysosome-related inflammation within monocyte-derived macrophages in a mouse model of ischemic brain injury
H4 Galectin-3 mediates lysosome-related inflammation within monocyte-derived macrophages in a mouse model of ischemic brain injury
H5 Abstract
H5 Authors
H5 Overnutrition in mice impairs thyroid hormone biosynthesis and utilization, causing hypothyroidism, despite remarkable thyroidal adaptations
H4 Overnutrition in mice impairs thyroid hormone biosynthesis and utilization, causing hypothyroidism, despite remarkable thyroidal adaptations
H5 Abstract
H5 Authors
H5 Distinct neuronal alterations distinguish two subtypes of sporadic Creutzfeldt-Jakob disease with shared dysfunctional pathways
H4 Distinct neuronal alterations distinguish two subtypes of sporadic Creutzfeldt-Jakob disease with shared dysfunctional pathways
H5 Abstract
H5 Authors
H5 Distinct HIF1α and HIF2α functions control skeletal muscle metabolism and erythropoiesis
H4 Distinct HIF1α and HIF2α functions control skeletal muscle metabolism and erythropoiesis
H5 Abstract
H5 Authors
H5 Colonic Engyodontium fungus triggers neutrophil antimicrobial activity to suppress Lactobacillus johnsonii–derived glutamic acid–maintained Tregs
H4 Colonic Engyodontium fungus triggers neutrophil antimicrobial activity to suppress Lactobacillus johnsonii–derived glutamic acid–maintained Tregs
H5 Abstract
H5 Authors
H5 Neuronal SEL1L-HRD1 ER-associated degradation is essential for motor function and survival in mice
H4 Neuronal SEL1L-HRD1 ER-associated degradation is essential for motor function and survival in mice
H5 Abstract
H5 Authors
H5 Alternative splicing–triggered mRNA decay informs splice-switching targets for neurodevelopmental disorders
H4 Alternative splicing–triggered mRNA decay informs splice-switching targets for neurodevelopmental disorders
H5 Abstract
H5 Authors
H5 AAV-mediated gene therapy in a model of SLC13A5 citrate transporter disorder rescues epileptic and metabolic phenotypes
H4 AAV-mediated gene therapy in a model of SLC13A5 citrate transporter disorder rescues epileptic and metabolic phenotypes
H5 Abstract
H5 Authors
H5 Hepatic glutathione depletion ameliorates MASLD through selective protein oxidation and inhibition of lipogenesis
H4 Hepatic glutathione depletion ameliorates MASLD through selective protein oxidation and inhibition of lipogenesis
H5 Abstract
H5 Authors
H5 Peripheral vaccination-induced brain-resident memory CD8+ T cells durably protect mice against intracranial malignancy
H4 Peripheral vaccination-induced brain-resident memory CD8+ T cells durably protect mice against intracranial malignancy
H5 Abstract
H5 Authors
H5 RNA-binding protein LARP6 coordinates hepatic stellate cell activation and liver fibrosis
H4 RNA-binding protein LARP6 coordinates hepatic stellate cell activation and liver fibrosis
H5 Abstract
H5 Authors
H5 GSDME–IL-18 pyroptotic axis prevents myosteatosis by expanding tissue-resident macrophages to promote muscle regeneration
H4 GSDME–IL-18 pyroptotic axis prevents myosteatosis by expanding tissue-resident macrophages to promote muscle regeneration
H5 Abstract
H5 Authors
H5 Tet2-driven clonal hematopoiesis drives aortic aneurysm via macrophage-to-osteoclast–like differentiation
H4 Tet2-driven clonal hematopoiesis drives aortic aneurysm via macrophage-to-osteoclast–like differentiation
H5 Abstract
H5 Authors
H5 α4 Integrin blockade impairs CD8+ T cell neuroimmune surveillance following SIV infection
H4 α4 Integrin blockade impairs CD8+ T cell neuroimmune surveillance following SIV infection
H5 Abstract
H5 Authors
H5 Inflammation- and resolution-programmed myeloid circuits govern therapeutic resistance in epithelial and mesenchymal triple-negative breast cancer
H4 Inflammation- and resolution-programmed myeloid circuits govern therapeutic resistance in epithelial and mesenchymal triple-negative breast cancer
H5 Abstract
H5 Authors
H5 Biallelic GLTP mutations cause nonsyndromic epidermal differentiation disorder via disrupted epidermal glucosylceramide transport
H4 Biallelic GLTP mutations cause nonsyndromic epidermal differentiation disorder via disrupted epidermal glucosylceramide transport
H5 Abstract
H5 Authors
H5 Tumor cell–derived IFN spatially reprograms osteopontin-enriched macrophage niches to promote PARP inhibitor resistance
H4 Tumor cell–derived IFN spatially reprograms osteopontin-enriched macrophage niches to promote PARP inhibitor resistance
H5 Abstract
H5 Authors
H5 Disrupted neurovascular-endocrine coupling in type 1 diabetes with impaired awareness of hypoglycemia
H4 Disrupted neurovascular-endocrine coupling in type 1 diabetes with impaired awareness of hypoglycemia
H5 Abstract
H5 Authors
H5 CD38 expression by neonatal human naive CD4+ T cells shapes their distinct metabolic and tolerogenic properties
H4 CD38 expression by neonatal human naive CD4+ T cells shapes their distinct metabolic and tolerogenic properties
H5 Abstract
H5 Authors
H5 Carriage of rare APOB variants predisposes to severe steatotic liver disease and hepatocellular carcinoma
H4 Carriage of rare APOB variants predisposes to severe steatotic liver disease and hepatocellular carcinoma
H5 Abstract
H5 Authors
H5 Corrigendum to Type 2 diabetes candidate genes, including PAX5, cause impaired insulin secretion in human pancreatic islets
H4 Corrigendum to Type 2 diabetes candidate genes, including PAX5, cause impaired insulin secretion in human pancreatic islets
H5 Abstract
H5 Authors
H4 In-Press Preview - More
H5 Western diet induces iron-dependent enteric neurodegeneration via ferroptosis
H4 Western diet induces iron-dependent enteric neurodegeneration via ferroptosis
H5 Abstract
H5 Authors
H5 Pathogenic variants in BORCS5 Cause a Spectrum of Neurodevelopmental and Neurodegenerative Disorders with Lysosomal Dysfunction
H4 Pathogenic variants in BORCS5 Cause a Spectrum of Neurodevelopmental and Neurodegenerative Disorders with Lysosomal Dysfunction
H5 Abstract
H5 Authors
H5 Lipoprotein(a)-Associated Proteomic Signature Predicts Cardiovascular Disease in Young Adults
H4 Lipoprotein(a)-Associated Proteomic Signature Predicts Cardiovascular Disease in Young Adults
H5 Abstract
H5 Authors
H5 Therapeutic targeting of the eIF4E cap-binding domain reveals control of lineage fate in prostate cancer
H4 Therapeutic targeting of the eIF4E cap-binding domain reveals control of lineage fate in prostate cancer
H5 Abstract
H5 Authors
H5 Variants in human CD48 lead to impaired T-cell immunity and increased inflammation
H4 Variants in human CD48 lead to impaired T-cell immunity and increased inflammation
H5 Abstract
H5 Authors
H5 View more articles by topic:
H4 Sign up for email alerts
H4 Review Series - More
H5 Neurodegeneration
H4 Neurodegeneration
H5 Series edited by
H4 Latest Reviews - More
H5 The changing landscape of urothelial carcinoma: on the edge of a paradigm shift
H5 Molecular stress and neurovascular injury in the diabetic retina
H4 Latest Video Abstract - More
H5 Depletion of hepatic glutathione and selective protein oxidation and inhibition of lipogenesis
H4 Sign up for email alerts

Skipping heading levels breaks the document outline. Screen readers may interpret missing levels as structural errors.

Why this matters

Skipping heading levels breaks the document outline — screen-reader users lose track of section nesting.

Learn more ▾

Screen reader users navigate by jumping between headings (H1 → H2 → H3). Skipping (H1 → H3) breaks the sense of hierarchy. Use sequential levels even if you don't like the default styling — restyle with CSS instead. WCAG 1.3.1 (Info and Relationships) treats this as an A failure.

Source: WCAG 2.1 SC 1.3.1 / W3C WAI

Skipping heading levels breaks the document outline. Screen readers may interpret missing levels as structural errors.

Why this matters

Skipping heading levels breaks the document outline — screen-reader users lose track of section nesting.

Learn more ▾

Source: WCAG 2.1 SC 1.3.1 / W3C WAI

Empty headings appear in the document outline but provide no information.

Why this matters

Empty <hN> tags break the document outline — screen-reader users navigating by heading hit dead silence.

Source: WCAG 2.4.6

404 Error Page

HTTP 404, custom page

REVIEW

HTTP 404, custom page

Correct 404 status code returned

Got: HTTP 404

Custom styled 404 page

Navigation links present on 404 page

Homepage link present on 404 page

404 Page Quality ✓ Custom 404 Page

Status Code HTTP 404 ✓Page Title Page not found ✓Custom Styling ✓Navigation ✓Homepage Link ✓Search Form ✗

Color Contrast (Screenshot)

Action

20 text elements analyzed, 1 fail WCAG AA

REVIEW

Analyzes text contrast against the actual rendered page, including background images, gradients, and overlays that CSS-based tools cannot detect.

19 pass 1 fail WCAG AA 1 pass AA only

title JCI - Welcome

1.36:1

#000000

#071A69

needs 4.5:1 (normal text)

16px · top of page (header area)

Show all checked elements (20)

Element	Ratio	Required	FG	BG	Result
h3 Issue published Apri…	21.00:1	3.0:1	#000000	#FFFFFF	Pass
title JCI - Welcome	1.36:1	4.5:1	#000000	#071A69	Fail
div Go to	4.75:1	4.5:1	#000000	#6A76A5	Pass
a JCI Insight	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a About	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Editors	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Consulting Editors	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a For authors	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Publication ethics	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Publication alerts b…	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Advertising	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Job board	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Contact	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Clinical Research an…	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Current issue	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Past issues	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a By specialty	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Back	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a COVID-19	21.00:1	4.5:1	#000000	#FFFFFF	Pass
a Cardiology	21.00:1	4.5:1	#000000	#FFFFFF	Pass

Methodology: The top 20 text elements by font size were checked. Background color was sampled from the desktop screenshot using a 5-point pattern. WCAG 2.1 AA requires 4.5:1 for normal text and 3:1 for large text.

All checks on this page are automated. Results are estimates - run targeted manual reviews when the score affects a release decision.