# Accessibility bug reports — nih.gov, week 2026-W35

18 issue type(s) from 3333 pages scanned. Generated 2026-08-28 by [vital-scans](https://github.com/mgifford/vital-core), following [accessibility bug-reporting best practices](https://mgifford.github.io/ACCESSIBILITY.md/examples/ACCESSIBILITY_BUG_REPORTING_BEST_PRACTICES.html).

> Automated checks find roughly a third of accessibility barriers. Fields marked "requires manual testing" cannot be observed by an automated scan and need a human with assistive technology.

---
## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-2e6c599b`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/research-in-context  
**XPath / selector:** `.thumbnail-teaser:nth-child(3) > .thumbnail-teaser__link.link--no-tag[typeof="schema:WebPage"] > .thumbnail-teaser__img > .field--name-field-thumbnail.field--type-entity-reference.field__item > .image-style-thumbnail-large[loading="lazy"][width="200"]`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `image-alt` ([reference](https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 2 instances; 1 of 3333 pages affected
  
**History:** first seen 2026-W29, last seen 2026-W35 (6 weeks)

### HTML snippet
```html
<img loading="lazy" src="/sites/default/files/styles/thumbnail_large/public/2025-11/20251125-preg-.jpg?itok=5bGanDtb" width="200" height="auto" class="image-style-thumbnail-large">
```

### Description
Images must have alternative text. Detected by axe-core rule image-alt on 1 of 3333 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/research-in-context.
2. Locate the element: .thumbnail-teaser:nth-child(3) > .thumbnail-teaser__link.link--no-tag[typeof="schema:WebPage"] > .thumbnail-teaser__img > .field--name-field-thumbnail.field--type-entity-reference.field__item > .image-style-thumbnail-large[loading="lazy"][width="200"]
3. Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-6cd33f8e`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/research-in-context  
**XPath / selector:** `<img loading="lazy" src="/sites/default/files/styles/thumbnail_large/public/2025-11/20251125-preg-.jpg?itok=5bGanDtb" width="200" height="auto">`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** Siteimprove Alfa — `sia-r2` ([reference](https://alfa.siteimprove.com/rules/sia-r2))  
**Severity:** Moderate  
**Frequency:** 2 instances; 1 of 3333 pages affected
  
**History:** first seen 2026-W29, last seen 2026-W35 (5 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 3333 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/research-in-context.
2. Locate the element: <img loading="lazy" src="/sites/default/files/styles/thumbnail_large/public/2025-11/20251125-preg-.jpg?itok=5bGanDtb" width="200" height="auto">
3. Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give every <img> an accessible name (alt text), or alt="" if purely decorative.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2

---

## <ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1)

**Bug ID:** `VS-e4065d4d`  
**Pattern ID:** `VS-a0bdbdf6`  
**URL:** https://nih.gov/news-events/nih-research-matters?page=84  
**XPath / selector:** `.usa-pagination__list`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `list` ([reference](https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 3333 pages affected
  
**History:** first seen 2026-W29, last seen 2026-W35 (7 weeks)

### HTML snippet
```html
<ul class="usa-pagination__list pager__items js-pager__items">
```

### Description
<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 1 of 3333 scanned pages (1 instances).

### Steps to reproduce
1. Open https://nih.gov/news-events/nih-research-matters?page=84.
2. Locate the element: .usa-pagination__list
3. Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://nih.gov/news-events/nih-research-matters?page=84

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI

---

## Element has required owned roles (WCAG 1.3.1)

**Bug ID:** `VS-30194558`  
**Pattern ID:** `VS-3c632d31`  
**URL:** https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems  
**XPath / selector:** `<h3>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r64` ([reference](https://alfa.siteimprove.com/rules/sia-r64))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (7 weeks)

### Description
Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 1 of 3333 scanned pages (1 instances).

### Steps to reproduce
1. Open https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems.
2. Locate the element: <h3>
3. Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64

---

## Links must be distinguishable without relying on color (WCAG 1.4.1)

**Bug ID:** `VS-4efc24ce`  
**Pattern ID:** `VS-8ade3360`  
**URL:** https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions  
**XPath / selector:** `p:nth-child(10) > a[href$="niddk.nih.gov/"][data-extlink=""][rel="noopener nofollow noreferrer"]`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** axe-core — `link-in-text-block` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 122 instances; 20 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (11 weeks)

### HTML snippet
```html
<a href="https://www.niddk.nih.gov/" class="ext" data-extlink="" target="_blank" rel="noopener nofollow noreferrer" title="(opens in a new window)">https://www.niddk.nih.gov</a>
```

### Description
Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 20 of 3333 scanned pages (122 instances).

### Steps to reproduce
1. Open https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions.
2. Locate the element: p:nth-child(10) > a[href$="niddk.nih.gov/"][data-extlink=""][rel="noopener nofollow noreferrer"]
3. Confirm the axe-core finding for rule link-in-text-block against WCAG 1.4.1 Use of Color.

### Impact
Affects Without color perception (4.5%), Limited vision (2.4%).
- **Without color perception** (4.5% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/engineered-phages-treat-drug-resistant-infection
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://www.nih.gov/news-events/nih-research-matters/some-brain-functions-may-improve-age
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/news-events/nih-research-matters/childhood-screen-detects-mental-health-risks
- https://www.nih.gov/nih-style-guide/autism
- https://nih.gov/about-nih/nih-almanac/katherine-l-bick-phd
- https://www.nih.gov/brain-initiative/research/neuroimaging-technologies-across-scales
- https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-aging-nia
- https://nih.gov/about-nih/nih-almanac/national-institute-environmental-health-sciences-niehs
- https://nih.gov/news-events/nih-research-matters?page=84
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders
- https://nih.gov/about-nih/nih-turning-discovery-into-health/healthy-mind/traumatic-brain-injury-tbi
- https://nih.gov/news-events/nih-research-matters/old-tb-vaccine-may-work-better-when-delivered-intravenously

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI

### Example pages
- https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection

---

## Link in text block is visually distinguishable without color (WCAG 1.4.1)

**Bug ID:** `VS-24fdb8ec`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `<a href="https://pubmed.ncbi.nlm.nih.gov/32640131/" class="ext" data-extlink="" target="_blank">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 22 instances; 8 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (9 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 8 of 3333 scanned pages (22 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: <a href="https://pubmed.ncbi.nlm.nih.gov/32640131/" class="ext" data-extlink="" target="_blank">
3. Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

### Impact
Affects Without color perception (4.5%), Limited vision (2.4%).
- **Without color perception** (4.5% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Make links visually distinguishable from surrounding text (not by color alone).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-8d96b32d`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `text: "Get the Latest Updates and FAQs"`  
**WCAG SC:** 1.4.6 — Contrast (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r66` ([reference](https://alfa.siteimprove.com/rules/sia-r66))  
**Severity:** Moderate  
**Frequency:** 435 instances; 8 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (9 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 8 of 3333 scanned pages (435 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: text: "Get the Latest Updates and FAQs"
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Increase text contrast to meet WCAG AAA (7:1).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)

**Bug ID:** `VS-6312a8d9`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `<p class="usa-banner__header-text">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r73` ([reference](https://alfa.siteimprove.com/rules/sia-r73))  
**Severity:** Moderate  
**Frequency:** 26 instances; 8 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (9 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 8 of 3333 scanned pages (26 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: <p class="usa-banner__header-text">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)

**Bug ID:** `VS-898f502d`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `<a class="usa-button" href="/web-modernization">`  
**WCAG SC:** 2.5.5 — Target Size (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r111` ([reference](https://alfa.siteimprove.com/rules/sia-r111))  
**Severity:** Moderate  
**Frequency:** 228 instances; 8 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (9 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 8 of 3333 scanned pages (228 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: <a class="usa-button" href="/web-modernization">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## All page content should be contained by landmarks (WCAG criterion undetermined)

**Bug ID:** `VS-36393994`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions  
**XPath / selector:** `.usa-alert`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 40 instances; 20 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (11 weeks)

### HTML snippet
```html
<div class="usa-alert">
```

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 20 of 3333 scanned pages (40 instances).

### Steps to reproduce
1. Open https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions.
2. Locate the element: .usa-alert
3. Confirm the axe-core finding for rule region.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/engineered-phages-treat-drug-resistant-infection
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://www.nih.gov/news-events/nih-research-matters/some-brain-functions-may-improve-age
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/news-events/nih-research-matters/childhood-screen-detects-mental-health-risks
- https://www.nih.gov/nih-style-guide/autism
- https://nih.gov/about-nih/nih-almanac/katherine-l-bick-phd
- https://www.nih.gov/brain-initiative/research/neuroimaging-technologies-across-scales
- https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-aging-nia
- https://nih.gov/about-nih/nih-almanac/national-institute-environmental-health-sciences-niehs
- https://nih.gov/news-events/nih-research-matters?page=84
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders
- https://nih.gov/about-nih/nih-turning-discovery-into-health/healthy-mind/traumatic-brain-injury-tbi
- https://nih.gov/news-events/nih-research-matters/old-tb-vaccine-may-work-better-when-delivered-intravenously

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI

### Example pages
- https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection

---

## Heading levels should only increase by one (WCAG criterion undetermined)

**Bug ID:** `VS-d0b1a01a`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions  
**XPath / selector:** `article > div > h3`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 14 instances; 14 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (9 weeks)

### HTML snippet
```html
<h3>Reference</h3>
```

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 14 of 3333 scanned pages (14 instances).

### Steps to reproduce
1. Open https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions.
2. Locate the element: article > div > h3
3. Confirm the axe-core finding for rule heading-order.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/engineered-phages-treat-drug-resistant-infection
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://www.nih.gov/news-events/nih-research-matters/some-brain-functions-may-improve-age
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/news-events/nih-research-matters/childhood-screen-detects-mental-health-risks
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders
- https://nih.gov/about-nih/nih-turning-discovery-into-health/healthy-mind/traumatic-brain-injury-tbi
- https://nih.gov/news-events/nih-research-matters/old-tb-vaccine-may-work-better-when-delivered-intravenously

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI

### Example pages
- https://nih.gov/news-events/news-releases/adults-prediabetes-lifestyle-intervention-lowered-risk-developing-multiple-chronic-conditions
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection

---

## Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)

**Bug ID:** `VS-070ba14d`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `#block-nih2-uswds-search`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 12 instances; 11 of 3333 pages affected
  
**History:** first seen 2026-W29, last seen 2026-W35 (7 weeks)

### HTML snippet
```html
<div class="search-block-form usa-form block block-search container-inline" data-drupal-selector="search-block-form" id="block-nih2-uswds-search" role="search">
```

### Description
Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 11 of 3333 scanned pages (12 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: #block-nih2-uswds-search
3. Confirm the axe-core finding for rule landmark-unique.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/engineered-phages-treat-drug-resistant-infection
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://www.nih.gov/news-events/nih-research-matters/some-brain-functions-may-improve-age
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/nih-research-matters/childhood-screen-detects-mental-health-risks
- https://nih.gov/news-events/nih-research-matters?page=84
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders
- https://nih.gov/news-events/nih-research-matters/old-tb-vaccine-may-work-better-when-delivered-intravenously

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. "Primary" and "Footer" navigation) so screen-reader users can tell them apart.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## Headings should not be empty (WCAG criterion undetermined)

**Bug ID:** `VS-a2074b15`  
**Pattern ID:** `VS-0066c67d`  
**URL:** https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems  
**XPath / selector:** `article > div > h3`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-heading` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 1 instances; 1 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (8 weeks)

### HTML snippet
```html
<h3></h3>
```

### Description
Headings should not be empty. Detected by axe-core rule empty-heading on 1 of 3333 scanned pages (1 instances).

### Steps to reproduce
1. Open https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems.
2. Locate the element: article > div > h3
3. Confirm the axe-core finding for rule empty-heading.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Remove empty headings or give them text. Don't use heading tags for spacing.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-91bc952b`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `<h3>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 8 instances; 8 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (8 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 8 of 3333 scanned pages (8 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: <h3>
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use headings in a logical, non-skipping order.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## aria attribute is permitted for element role (WCAG criterion undetermined)

**Bug ID:** `VS-91030030`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `@aria-label="Descripción de la agencia"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 16 instances; 8 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (9 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 8 of 3333 scanned pages (16 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: @aria-label="Descripción de la agencia"
3. Confirm the Siteimprove Alfa finding for rule sia-r18.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Only use ARIA states/properties that are allowed on this element/role.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## Form field label is visible (WCAG criterion undetermined)

**Bug ID:** `VS-e4e5537b`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r61` ([reference](https://alfa.siteimprove.com/rules/sia-r61))  
**Severity:** Moderate  
**Frequency:** 8 instances; 8 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (9 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 8 of 3333 scanned pages (8 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## Scrolling content can be accessed by keyboard (WCAG criterion undetermined)

**Bug ID:** `VS-172c3aec`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care  
**XPath / selector:** `text: "NIH Websites Are Changing"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 32 instances; 8 of 3333 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W35 (9 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 8 of 3333 scanned pages (32 instances).

### Steps to reproduce
1. Open https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care.
2. Locate the element: text: "NIH Websites Are Changing"
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context
- https://nih.gov/news-events/nih-research-matters/trends-us-methamphetamine-use-associated-deaths
- https://nih.gov/news-events/nih-research-matters/blood-tests-show-promise-early-alzheimers-diagnosis
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems
- https://nih.gov/institutes-nih/nih-office-director/olpa
- https://www.nih.gov/news-events/nih-research-matters/scientists-find-common-brain-network-substance-use-disorders

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57

### Example pages
- https://www.nih.gov/news-events/nih-research-matters/approach-prevent-fall-injuries-no-better-usual-care
- https://nih.gov/news-events/nih-research-matters/preventing-organ-transplant-rejection
- https://www.nih.gov/news-events/nih-research-matters/research-in-context

---

## Keyboard trap does not exist (WCAG criterion undetermined)

**Bug ID:** `VS-a0f2b2ca`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems  
**XPath / selector:** `<p class="nih-slogan">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r85` ([reference](https://alfa.siteimprove.com/rules/sia-r85))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 3333 pages affected
  
**History:** first seen 2026-W29, last seen 2026-W35 (7 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 1 of 3333 scanned pages (1 instances).

### Steps to reproduce
1. Open https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems.
2. Locate the element: <p class="nih-slogan">
3. Confirm the Siteimprove Alfa finding for rule sia-r85.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://nih.gov/news-events/news-releases/diuretic-therapy-extremely-preterm-infants-does-not-alleviate-respiratory-problems

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r85