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Original Article Open Access
Reza Rastmanesh, Balachandar Vellingiri, Ciro Gargiulo Isacco, Abolfazl Sadeghinejad, Neil Daghnall
Published online April 30, 2025
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00013
Abstract
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 [...] Read more.

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.

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Review Article Open Access
Kashif Tousif, Muaz Ali, Shafaq Saleem, Ahmad Raza, Samar Imran, Muhammad Haroon, Furqan Anwar, Waqas Ahmed
Published online May 28, 2025
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00015
Abstract
Non-invasive vagus nerve stimulation (nVNS), including transcutaneous cervical (tcVNS) and auricular (taVNS) modalities, has garnered increasing attention as a neuromodulatory therapy [...] Read more.

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.

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Hot Topic Commentary Open Access
Maria Tampaki, Evangelos Cholongitas
Published online March 27, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00051
Mini Review Open Access
Yaxin Li, Keke Jin, Ying Han, Lingna Lv, Huiguo Ding
Published online May 13, 2025
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Journal of Translational Gastroenterology. doi:10.14218/JTG.2024.00048
Abstract
Hepatic encephalopathy (HE) is a brain disorder secondary to cirrhosis, characterized by cognitive deficits, psychiatric manifestations, and motor impairments. It is associated [...] Read more.

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.

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Mini Review Open Access
Gangadharan Thamizhoviya
Published online September 4, 2025
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Future Integrative Medicine. doi:10.14218/FIM.2025.00033
Abstract
Globally, the integration of traditional medicine and modern medicine has been recognized as a global health priority aimed at improving healthcare accessibility, cultural relevance, [...] Read more.

Globally, the integration of traditional medicine and modern medicine has been recognized as a global health priority aimed at improving healthcare accessibility, cultural relevance, and therapeutic effectiveness. This review systematically examines the global landscape of traditional medicine-modern medicine integration by analyzing policy developments, regulatory frameworks, and clinical implementation models across various regions, including Asia, Africa, Europe, and the USA. The scope of the review encompasses five key domains: (1) global policy initiatives, (2) regulatory and institutional frameworks, (3) clinical integration models, (4) impacts and outcomes of integrative practices, and (5) challenges and barriers to implementation. Based on peer-reviewed literature and official health policy documents published between 2000 and 2025, the present review investigates how countries have operationalized clinical integration models combining traditional and complementary medicine. Although interest in traditional and complementary medicine has grown worldwide, persistent challenges, such as limited scientific validation, lack of standardization, and professional resistance, continue to hinder progress. This review concludes that successful and sustainable integration requires evidence-based clinical approaches, inclusive regulatory reforms, and coordinated policy strategies. Countries such as China, India, and Brazil have made significant advances, offering valuable models for future implementation worldwide.

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Mini Review Open Access
Iris Z. Shen, Lanjing Zhang
Published online April 3, 2025
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2025.00007
Abstract
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, [...] Read more.

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.

DAIP is not suitable for every clinical laboratory, and a balance between its benefits (e.g., improved diagnostic accuracy) and pitfalls (e.g., substantial implementation costs and legal ambiguities) must be carefully weighed against an institution’s resources and goals before adoption. This review has inherent limitations, such as a restricted literature search to PubMed and English-language studies, which should be considered when interpreting the conclusions.

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Review Article Open Access
Zijian Zhao, Xinru Liu, Ruixiang Zhang, Ruoyu Ke, Shuhui Zhang, Yan Chen
Published online May 7, 2025
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Journal of Translational Gastroenterology. doi:10.14218/JTG.2024.00038
Abstract
Inflammatory bowel disease (IBD) is an idiopathic intestinal inflammatory condition affecting the ileum, colon, and rectum, including ulcerative colitis and Crohn’s disease. Clinical [...] Read more.

Inflammatory bowel disease (IBD) is an idiopathic intestinal inflammatory condition affecting the ileum, colon, and rectum, including ulcerative colitis and Crohn’s disease. Clinical symptoms include abdominal pain, diarrhea, and even bloody stools. The intestinal barrier is the first line of defense between the intestinal tract and the external environment, and maintaining its stability is essential for intestinal health. On one hand, it enables the digestion and absorption of water and nutrients; on the other, it plays a crucial role in reducing the absorption of toxins and the invasion of pathogens. Damage to the intestinal barrier has become one of the most important factors in the onset and progression of IBD. However, there is currently no literature that systematically reviews the mechanisms of the intestinal barrier in the pathogenesis of IBD and the factors influencing it. In this paper, we aimed to systematically elaborate on the role of the intestinal barrier in IBD through the perspectives of oxidative stress, intestinal flora, and cellular autophagy. Our goal was to explore the mechanisms of the intestinal barrier in IBD more deeply and to provide new insights for the diagnosis and treatment of IBD. This article will summarize the composition of the intestinal barrier, the factors affecting it, and strategies to protect it.

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Hot Topic Commentary Open Access
Bianca Thakkar, George Y. Wu
Published online April 11, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2024.00478
Review Article Open Access
You Deng, Tongtong Meng, Hong You, Jidong Jia, Yu Wang
Published online May 21, 2025
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00039
Abstract
China has made remarkable progress in controlling chronic hepatitis B virus (HBV) infection over the past three decades. The prevalence of hepatitis B surface antigen has declined [...] Read more.

China has made remarkable progress in controlling chronic hepatitis B virus (HBV) infection over the past three decades. The prevalence of hepatitis B surface antigen has declined from 9.72% in 1992 to 5.86% in 2020, with a striking reduction from 9.67% to 0.30% among children under five. Universal hepatitis B vaccination has been pivotal, preventing more than 40 million infections and seven million HBV-related deaths since 1992. Nevertheless, an estimated 75 million individuals are currently living with chronic HBV infection in China. Among them, only 59.78% are aware of their infection status, and about 30 million remain undiagnosed. Of those diagnosed, 38.25% (approximately 17 million) meet the criteria for antiviral treatment, yet only 17.33% (about three million) are receiving treatment. To accelerate progress toward the World Health Organization’s elimination targets, China has updated its clinical guidelines to expand treatment eligibility and improve diagnosis and treatment coverage. Moreover, Chinese pharmaceutical companies and academic institutions are actively engaged in developing novel therapies with promising efficacy, aiming to achieve a functional cure. China’s holistic approach, combining evidence-based public health interventions with active clinical management and innovative pharmaceutical development, provides valuable experience for global HBV elimination initiatives. This review aimed to summarize China's progress in HBV control, identify remaining gaps in diagnosis and treatment, and highlight strategic approaches, including public health interventions, clinical policy updates, and pharmaceutical innovation, toward achieving HBV elimination.

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Mini Review Open Access
Jieyun Yin
Published online June 30, 2025
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Journal of Translational Gastroenterology. doi:10.14218/JTG.2025.00024
Abstract
Imbalanced autonomic function has been reported in gastrointestinal (GI) disorders. The vagus nerve is a major component in the regulation of upper GI motility. Vagal nerve stimulation [...] Read more.

Imbalanced autonomic function has been reported in gastrointestinal (GI) disorders. The vagus nerve is a major component in the regulation of upper GI motility. Vagal nerve stimulation (VNS) has been shown to improve symptoms of various GI disorders by enhancing parasympathetic activity. This review aims to summarize the clinical efficacy of transcutaneous VNS for GI disorders, focusing on abdominal pain, other GI symptoms, and GI motility, and to discuss the mechanisms of action of transcutaneous VNS. Randomized clinical trials investigating transcutaneous VNS in several major GI disorders, including functional dyspepsia, gastroparesis, constipation, irritable bowel syndrome, and inflammatory bowel disease, were reviewed and discussed. The forms of transcutaneous VNS covered in this review include transcutaneous auricular VNS, transcutaneous cervical VNS, and percutaneous electrical nerve field stimulation. Transcutaneous VNS has been shown to relieve abdominal pain, improve GI symptoms, and accelerate GI motility by enhancing vagal activity in patients with various GI disorders. Transcutaneous VNS is an innovative, effective, and safe therapy for patients with GI disorders; however, large-scale clinical trials are necessary to establish optimal treatment modalities and efficacy.

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