Oral microbiota dysbiosis and altered salivary cortisol levels have been linked to depression and anxiety. Given that bacterial transmission can occur between spouses, this study aimed to investigate whether the transmission of oral microbiota between newlywed couples mediates symptoms of depression and anxiety.

Validated Persian versions of the Pittsburgh Sleep Quality Index, Beck Depression Inventory-II, and Beck Anxiety Inventory were administered to 1,740 couples who had been married for six months. The researchers compared 268 healthy control spouses with 268 affected cases in a cross-sectional study. Data were analyzed using appropriate statistical methods.

After six months, healthy spouses married to an insomniac with the depression-anxiety (DA) phenotype scored significantly higher on the Pittsburgh Sleep Quality Index, Beck Depression Inventory-II, and Beck Anxiety Inventory compared to their baseline scores. This indicates that their sleep quality, depression, and anxiety scores became more similar to those of their affected spouses. Additionally, the composition of their oral microbiota changed significantly, becoming increasingly similar to that of their spouses. Specifically, in couples where one partner had the DA phenotype, the oral microbiota of the healthy spouse mirrored that of the affected partner (p < 0.001). These microbial changes correlated with alterations in salivary cortisol levels as well as depression and anxiety scores. Linear discriminant analysis revealed that the relative abundances of Clostridia, Veillonella, Bacillus, and Lachnospiraceae were significantly higher in insomniacs with the DA phenotype compared to healthy controls (p < 0.001).

Oral microbiota transmission between individuals in close contact partially mediates symptoms of depression and anxiety.

Cancer is the leading cause of death globally, with nearly 20 million new cases and 9.7 million deaths in 2022. Due to its vague initial symptoms, cancer is often difficult to detect in its early stages. Liquid biopsy, a revolutionary approach in oncology, provides a minimally invasive, real-time method for cancer detection, monitoring, and characterization by examining circulating tumor components in body fluids. This review presents current technologies and clinical applications of liquid biopsy, focusing particularly on its value for early cancer diagnosis. Liquid biopsy enables molecular profiling of cancer for precision oncology by isolating circulating extracellular nucleic acids (cell-free DNA), circulating tumor DNA, and circulating tumor cells from blood and other body fluids. Cell-free DNA, which circulates freely in the blood, may or may not be tumor-derived, while circulating tumor DNA is specifically of tumor origin. Additionally, circulating tumor cells can be isolated from blood; these cells, shed from tumors into the bloodstream, typically survive only 1–2.5 h before immune clearance, though a small fraction can persist and metastasize to distant sites. Exosomes, small membrane-bound vesicles secreted by tumor cells, also carry molecular information about the tumor and have become a valuable source of biomarkers in liquid biopsy. Advances in detection technologies for these analytes have expanded the utility of liquid biopsy, facilitating the identification of somatic mutations and actionable genomic alterations in tumors. Finally, this review discusses the opportunities and challenges facing liquid biopsy and offers insights into its future development.

Non-invasive vagus nerve stimulation (nVNS), including transcutaneous cervical (tcVNS) and auricular (taVNS) modalities, has garnered increasing attention as a neuromodulatory therapy for various neurological and psychiatric disorders. This narrative review synthesizes findings from over 80 studies, including randomized controlled trials, meta-analyses, and observational research published up to March 2024, evaluating nVNS in epilepsy, depression, stroke rehabilitation, headache, Parkinson’s disease, and Alzheimer’s disease. Evidence suggests that taVNS can reduce seizure frequency and improve quality of life in epilepsy. In major depressive disorder, nVNS demonstrates antidepressant effects comparable to pharmacotherapy, though the optimal stimulation parameters remain unclear. For post-stroke motor rehabilitation, both tcVNS and closed-loop stimulation systems enhance neuroplasticity and motor recovery. In Parkinson’s and Alzheimer’s diseases, preliminary findings indicate possible modulation of neuroinflammatory pathways and cognitive-motor functions, although recent meta-analyses report mixed efficacy. Challenges include methodological heterogeneity, protocol variability, and difficulties in designing effective sham controls, all of which limit the generalizability of current findings. Mechanistic differences between tcVNS and taVNS remain inadequately characterized. Overall, nVNS appears to be a safe and accessible therapeutic approach with broad clinical potential, particularly for treatment-resistant or underserved populations. However, future research must prioritize standardized protocols, robust clinical endpoints, and adequately powered trials to define efficacy and optimize treatment strategies. A greater focus on long-term outcomes, biomarker-guided personalization, and clinical significance over statistical findings will be critical in translating nVNS into routine practice.

Erosive Esophagitis (EE) is the most common complication of gastroesophageal reflux disease. Patients with EE can be asymptomatic or present with severe symptoms such as dysphagia and gastrointestinal bleeding. Approximately 10-15% of patients with EE have refractory disease. Optimal management of EE requires understanding its pathophysiology, clinical presentation, and available evaluation and treatment modalities. While pharmacologic treatment of EE is often successful, procedural options such as surgery and endoscopic therapy may be necessary. This article presents an evidence-based and pragmatic approach to the management of EE, the most common complication of gastroesophageal reflux disease.

With the increasing use of artificial intelligence (AI) in diagnostics, AI algorithms have shown great potential in aiding diagnostics. As more of these algorithms are developed, there is overwhelming enthusiasm for implementing digital and artificial intelligence-based pathology (DAIP), but doubts and pitfalls are also emerging. However, few original or review articles address the limitations and practical aspects of implementing DAIP. In this review, we briefly examine the evidence related to the benefits and pitfalls of DAIP implementation and argue that DAIP is not suitable for every clinical laboratory.

We searched the PubMed database using the following keywords: “digital pathology,” “digital AI pathology,” and “AI pathology.”. Additionally, we incorporated personal experiences and manually searched related papers.

Ninety-two publications were found, of which 24 met the inclusion criteria. Many advantages of DAIP were discussed, including improved diagnostic accuracy and equity. However, several limitations of implementing DAIP exist, such as financial constraints, technical challenges, and legal/ethical concerns.

We found a generally favorable but cautious outlook for the implementation of DAIP in the pathology workflow. Many studies have reported promising outcomes in using AI for diagnosis and analysis; however, there are also several noteworthy limitations in implementing DAIP. Therefore, a balance between the benefits and pitfalls of DAIP must be thoroughly articulated and examined in light of the institution’s needs and goals before making the decision to implement DAIP. Approaches for mitigating machine learning biases were also proposed, and the adaptation and growth of the pathology profession were discussed in light of DAIP development and advances.

Hepatic encephalopathy (HE) is a brain disorder secondary to cirrhosis, characterized by cognitive deficits, psychiatric manifestations, and motor impairments. It is associated with frequent hospitalizations, high mortality rates, and poor quality of life in cirrhotic patients. Additionally, ammonia and inflammation are key contributors to the onset of HE. Rifaximin is minimally absorbed in the intestine and is considered a locally acting, semi-synthetic antibiotic with broad-spectrum antibacterial activity. The pharmacological effects of rifaximin include reducing plasma ammonia levels, decreasing proinflammatory cytokine levels, and modulating gut microbiota and their functions. Currently, both Chinese and EASL clinical practice guidelines recommend rifaximin (800–1,200 mg/d) as a first-line treatment for HE for up to six months. However, the efficacy and safety of long-term (≥six months) use of rifaximin for HE remain debated. This review aimed to analyze the long-term (≥six months) use and dose-effect relationships of rifaximin treatment for HE. Long-term, low-dose use of rifaximin (600–800 mg/d) may offer potential benefits in terms of efficacy, safety, and cost-effectiveness.

Chiari malformation type I (CMI) is a congenital neurological disorder characterized by the herniation of the cerebellar tonsils through the foramen magnum, which impairs cerebrospinal fluid circulation at the craniocervical junction. The primary hypothesis regarding its pathogenesis involves a mismatch between the posterior cranial fossa volume and the developing nervous tissue, leading to crowding and subsequent herniation. CMI presents a wide range of clinical manifestations, including cerebrospinal fluid-related symptoms, brainstem and cranial nerve compression, and spinal cord dysfunction, typically diagnosed through magnetic resonance imaging. The surgical treatment of adult CMI remains controversial due to its heterogeneous manifestations and the lack of standardized surgical protocols. Posterior fossa decompression (PFD), with or without duraplasty (hereinafter referred to as PFDD), remains the most common intervention. In this review, we focus on the following aspects to provide an overview of the current surgical strategies: 1. Surgical indications; 2. The extent of bony decompression in PFD; 3. Choosing between PFD, PFDD, and the dura-splitting technique; 4. Atlantoaxial fixation; 5. Techniques for intradural procedures; 6. Timing and approach for syrinx shunting. Additionally, emerging surgical innovations, such as endoscopic techniques, offer promising avenues for treatment.