Tag: News Approved

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Senate health panel delays vote on CDC nominee

WASHINGTON — The Senate’s health panel delayed until next week a vote on Erica Schwartz to run the Centers for Disease Control and Prevention, after postponing a separate vote on Sean Kaufman for a key public health preparedness role.

The committee vote on Schwartz was pushed back because too few senators showed up. Sen. Lisa Murkowski (R-Alaska) is dealing with a family emergency, and at least one other lawmaker was also absent.

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<![CDATA[Top 2026 psychiatry conference takeaways: mixed-feature bipolar care, GLP-1 addiction trials, schizophrenia adherence, TD gaps, AI prodrome screening.]]>
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Vagus nerve–driven microbiota homeostasis: a promising integrative add-on therapy for neurodevelopmental disorders

Over the past two decades, the conceptualization of neurodevelopmental disorders (NDDs) has undergone a profound transformation, shifting from a primarily brain-centric framework toward a systems-level perspective that integrates peripheral physiological processes. Among these, the gut microbiota has emerged as a critical determinant of neurodevelopmental trajectories. Through its involvement in immune modulation, metabolic signaling, and neural communication, the microbiota–gut–brain axis (MGBA) exerts a pervasive influence on brain maturation and function. A growing body of evidence indicates that early-life disruptions of microbiota composition—commonly referred to as dysbiosis—are associated with an increased risk of NDDs, including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and epilepsy. These disruptions are frequently driven by environmental exposures such as antibiotic use, cesarean delivery, dietary patterns, and psychosocial stress. Despite the expanding recognition of these associations, current therapeutic strategies aimed at restoring microbiota balance, including probiotics and fecal microbiota transplantation, have yielded inconsistent and often transient results. In this context, Vagus Nerve Stimulation (VNS), particularly in its non-invasive forms (nVNS), has emerged as a promising approach capable of modulating environmental exposures through the host-centered regulatory mechanisms of the MGBA. By influencing autonomic tone, activating the cholinergic anti-inflammatory pathway, and modulating neurotransmitter systems, nVNS may restore microbiota homeostasis while simultaneously improving neurodevelopmental outcomes. This article provides a comprehensive and integrative review of the mechanistic, preclinical, and clinical evidence supporting the role of nVNS as a microbiota-modulating intervention. We further discuss its potential as a safe, cost-effective and promising therapeutic strategy for neurodevelopmental disorders, with a particular emphasis on pediatric populations.
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Catastrophic consequences of prolonged immobilization after intracerebral hemorrhage: a case report of crush syndrome combined with capillary leak syndrome

BackgroundSpontaneous intracerebral hemorrhage is a neurological emergency with high mortality and disability rates. Prolonged immobilization after stroke can trigger severe systemic complications. The simultaneous occurrence of crush syndrome and capillary leak syndrome in the setting of acute intracerebral hemorrhage is extremely rare and life-threatening, and no established treatment protocol exists.Case summaryA 64-year-old man with hypertension was found unconscious on his home floor. The estimated time from onset to discovery exceeded 24 h. He was diagnosed with left basal ganglia intracerebral hemorrhage of approximately 5.6 mL with intraventricular extension. On admission, he was comatose with a Glasgow Coma Scale score of 9. Systemic involvement was extensive: severe bilateral leg swelling with multiple tension bullae, acute kidney injury requiring continuous renal replacement therapy, severe rhabdomyolysis with a peak creatine kinase exceeding 50,000 U/L, hyperkalemia, with an initial arterial blood gas in the emergency department showing 6.9 mEq/L, elevated liver enzymes, and distributive shock. Admission central venous pressure was negative, strongly indicating severe hypovolemia. Chest CT already showed hypostatic pneumonia. The clinical presentation was consistent with crush syndrome from prolonged compression, which then led to secondary capillary leak syndrome. The patient underwent emergency neuroendoscopic hematoma evacuation and external ventricular drainage. Postoperatively, he developed atrial fibrillation and deep vein thrombosis. After 3 weeks of multidisciplinary intensive care, his liver and kidney function gradually improved, and the hypostatic pneumonia was controlled. He survived to discharge with a Glasgow Coma Scale score of 11, left limb muscle strength grade 3/5, and right limb muscle strength grade 0/5, and was transferred to a local hospital for continued rehabilitation. At 3-month follow-up, he was walking independently (mRS 2), with significant improvements in neurological function and quality of life.ConclusionThis case reveals a frequently overlooked but deadly clinical pathway: prolonged immobilization after intracerebral hemorrhage can lead to traumatic rhabdomyolysis, crush syndrome, and secondary capillary leak syndrome. A negative central venous pressure, a rare finding, provided supportive evidence of severe hypovolemia due to capillary leak syndrome. This clinical triad represents a unique high-risk condition that demands a shift in treatment philosophy from neurocentric care to systemic resuscitation.
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Delayed multiple hemorrhagic brain metastases from atrial myxoma: a case report and literature review

ObjectiveBrain metastases from atrial myxoma are rare central nervous system manifestations and may mimic hemorrhagic malignant metastases or vascular lesions. We report a delayed case after prior cardiac myxoma resection and summarize the available patient-level literature.MethodsWe retrospectively reviewed the clinical course, multimodal neuroimaging, surgical findings, histopathology, immunohistochemistry, vascular imaging, and follow-up of a woman in her early 70s. A literature review was performed using PubMed, Web of Science, Embase, and Google Scholar from inception to 19 June 2026 with search terms related to cardiac/atrial myxoma, brain/intracranial metastasis, brain metastases, implantation, and cerebral aneurysm. Cases with histologically confirmed intracranial parenchymal myxomatous lesions were included.ResultsThe patient presented with recurrent dizziness, gait instability, right-sided weakness, and incomplete homonymous hemianopia. Brain lesions were detected 5 months after surgical resection of a left atrial myxoma, and echocardiography showed no local recurrence of the cardiac tumor. Brain CT and MRI demonstrated multiple hemorrhagic enhancing lesions with perilesional edema involving the cerebellar vermis, left occipital lobe, and other cerebral and cerebellar regions. Preoperative CTA showed no suspicious intracranial aneurysm. Two representative symptomatic lesions were surgically removed because of diagnostic uncertainty and local mass effect, whereas the remaining multifocal hemorrhagic lesions were managed with close radiological surveillance. Histology showed spindle/stellate cells in abundant myxoid stroma, and immunohistochemistry was positive for calretinin and CD31 but negative for GFAP and desmin, supporting brain metastases from atrial myxoma. At 6-month follow-up, MRI showed no local recurrence and repeat CTA showed no suspicious aneurysm.ConclusionDelayed hemorrhagic brain metastases from atrial myxoma should be considered when patients with a history of cardiac myxoma develop new neurological symptoms and multiple hemorrhagic enhancing brain lesions. Diagnosis requires integration of clinical history, neuroimaging, vascular imaging, radiology-pathology correlation, and immunohistochemistry. Treatment and surveillance should be individualized because embolic stroke, myxomatous aneurysms, and parenchymal metastases may coexist and recurrence can occur after long latency.
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Intraocular pressure spikes after intravitreal injection and their impact on OCT angiography

PurposeTo evaluate whether acute intraocular pressure (IOP) elevation after intravitreal anti-VEGF injection affects superficial capillary plexus (SCP) perfusion metrics on optical coherence tomography angiography (OCTA).MethodsIn this prospective single-center study, adults scheduled for unilateral intravitreal anti-VEGF treatment for macular edema were enrolled. Assessments were performed pre-injection (T1), early post-injection (T2), and 10 min after T2 (T3). OCTA (CIRRUS HD-OCT 5000; AngioPlex Metrix v11.0) used 6 × 6 mm fovea-centered scans. SCP vessel density (VD) and perfusion density (PD) were quantified for central (1 mm), inner (3 mm), and full macular fields (ETDRS grid). IOP was measured at T1–T3. Scans with signal strength index (SSI) < 6 or relevant motion/segmentation artefacts were excluded. Spearman correlation and multivariable regression analysis assessed associations of VD/PD with IOP and SSI.ResultsOf 81 recruited subjects, 54 eyes (66.7%) finally met OCTA quality criteria at all timepoints and were analyzed. Mean IOP increased from 13.98 ± 3.09 mmHg (T1) to 31.15 ± 9.65 mmHg (T2; p < 0.0001) and decreased to 16.30 ± 4.60 mmHg at T3 (p = 0.6246 vs. T1). Full-field SCP VD and PD decreased from 15.07 ± 3.01 and 36.23 ± 7.60 (T1) to 13.76 ± 3.50 and 33.21 ± 9.08 (T2), and to 13.22 ± 2.99 and 31.73 ± 7.67 (T3). Between T1 and T2, no OCTA parameter changed significantly. At T3, all SCP parameters were significantly lower versus at T1 except for central VD (p = 0.1495) and central PD (p = 0.2894). SSI declined from 8.35 ± 1.39 (T1) to 7.72 ± 1.42 (T2; p = 0.0105) and 7.09 ± 1.38 (T3; p < 0.0001). Correlations between VD/PD and IOP were weak (rs ≤ 0.17), whereas correlations with SSI were moderate-to-strong (rs = 0.53–0.83).ConclusionIntravitreal anti-VEGF injection caused a marked acute IOP spike, but most SCP OCTA metrics did not change at T2. The decline in SCP metrics at T3 coincided with reduced SSI and correlated more strongly with image quality than with IOP, indicating that post-procedural OCTA image quality may influence measured perfusion metrics; however, in the absence of blood pressure measurements, a physiological contribution cannot be excluded.
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Sex-related molecular phenotypes in anxiety-depressive disorders: a machine learning analysis of routine blood biomarkers

BackgroundAnxiety disorders and depressive disorders are the most prevalent mental disorders worldwide. Their diagnosis has long relied on clinical symptom assessment, and objective blood−based biomarkers remain lacking. Sex is a critical risk factor for these disorders; however, sex−specific divergence in blood biochemical profiles has yet to be systematically characterized.MethodsThis retrospective study enrolled 778 patients diagnosed with anxiety−depressive state at China−Japan Friendship Hospital. Demographic data, complete blood count parameters, and blood biochemical parameters were collected. Following missing value processing and multiple imputation, Mann–Whitney U tests were applied to identify sex−differentially expressed biomarkers. A random forest classifier was constructed to evaluate the discriminative capacity of combined multi−marker panels, with model performance comprehensively assessed through receiver operating characteristic curve analysis, SHAP−based explainability analysis, and multi−classifier probability projection. Age−stratified analyses were performed with a threshold of 50 years to explore the potential modifying effect of age on sex differences.ResultsSeveral biomarkers exhibiting significant differences between males and females were identified (FDR < 0.05), among which creatinine, hemoglobin, hematocrit, red blood cell count, and uric acid demonstrated the largest effect sizes. The random forest model achieved an area under the receiver operating characteristic curve of 0.902 on the independent test set. Multi−classifier probability projection following hyperparameter tuning yielded a Silhouette coefficient of 0.464 in the two−dimensional space, with permutational multivariate analysis of variance confirming highly significant centroid differences between groups (p < 0.001). Age−stratified analysis using hemoglobin as an example revealed that levels in males were significantly higher than those in females across both age strata, with the magnitude of the sex difference attenuated in the ≥50−year group compared with the <50−year group.ConclusionsRobust sex−related signals are embedded in routine blood biochemical markers. Although complete separation is difficult to achieve under unsupervised dimensionality reduction, these signals can be efficiently integrated through ensemble learning algorithms. This study provides a molecular phenotypic basis related to sex in patients with anxiety−depressive state and underscores the importance of fully considering sex as a variable in clinical laboratory testing.
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Art therapy for depression: a systematic review and meta-analysis

IntroductionDepression is among the leading causes of disability globally. Therefore, exploring the various non-medical treatment options for this condition is particularly important. The aim of the review was to assess the effect of art therapy on depressive symptoms.MethodsThe foundation of this review is a pre-planned, explorative, secondary analysis of a previously published umbrella review, encompassing the databases Cochrane Library, Embase, MEDLINE, CINAHL, ERIC, American Psychological Association PsycArticles, American Psychological Association PsycInfo, PSYNDEX, the German Clinical Trials Register, and ClinicalTrials.gov. Included were all randomized trials with any patient population receiving active visual art therapy. The outcome was depressive symptoms measured by depression assessment instruments. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and conducted a bias assessment using a modified Cochrane risk of bias tool. Data was pooled using a random-effects model and visualized in forest plots. A pooled standardized mean difference (SMD) with hedges g was calculated to measure the reduction of depressive symptoms.ResultsOf 3,100 identified reports we included 26 studies. Of these, 19 studies with 997 patients were eligible for inclusion in the meta-analysis. Overall, we found a standardized mean difference of 0.53 (95% CI: 0.30 to 0.76) for depressive symptoms, favoring the intervention group. Main sources of variation were different types of control groups, methodological quality, and patient populations.ConclusionOur results suggest that art therapy is associated with improved depressive symptoms. Therefore, art therapy should be accessible as complementary treatment for patients suffering from depressive symptoms.
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A comparison between seven scales of neuropsychological assessments for cognitive impairment screening in Chinese older population: a cross-sectional study in Chongqing, China

BackgroundThe Clinical Dementia Rating Scale (CDR), the Ascertain Dementia 8 (AD8), the Mini-Cog, the Verbal Fluency Test (VFT), the Community Screener for Dementia (CSI-D), the Rey Auditory Verbal Learning Test (RAVLT), and the Activities of Daily Living Scale (ADL) represent seven commonly employed methods for community cognitive impairment screening in China that have garnered limited attention. This study aimed to assess the discriminatory power of these seven tests when administered concurrently in a single screening to detect cognitive impairment in the absence of a gold standard.MethodsWe conducted a cross-sectional survey among 1,506 elderly people aged 60 and above in the community. The cognitive and social functions of the elderly population were evaluated by using the Seven scales. The characteristics related to demographics and health were collected through questionnaire surveys, and the correlations and consistencies of the Seven scales with cognitive impairment were analyzed respectively. Multifactor logistic regression model was used to analyze the risk factors of cognitive impairment in each scale.ResultsThe positive screening proportions for the seven scales—CDR, ADL, AD8, CSI-D, Mini-Cog, VFT, and RAVLT—were 61.1%, 33.7%, 38.0%, 37.1%, 53.7%, 39.3%, and 52.9%, respectively. Agreement on cognitive impairment risk between each pair of scales was fair-to-moderate (Kappa: 0.32–0.645, all p < 0.001). Screening results differed significantly across the seven scales by age, educational, marital status, epilepsy, cerebral infarction, brain atrophy, and depression (all P < 0.001). Notably, Screen-positive proportions for cognitive impairment rose significantly with increasing age (p < 0.001); the ≥ 80-year-old group showed the highest proportions across scales. Conversely, higher educational attainment was associated with lower risk of screening positive for cognitive impairment (p < 0.001).ConclusionsOur study identified a relatively high screening positivity proportion for cognitive impairment in Chongqing, Age, Sex, Education, Marital status, Brain atrophy, Anxiety, and Depression are risk factors for screening positivity. The identified screening positivity for cognitive impairment varied across different neuropsychological assessment methods, indicating that assessment choice should be tailored to population characteristics rather than applying a one-size-fits-all approach. Selecting the appropriate tool can improve sensitivity and reduce missed diagnoses.