Hilary M. Holets

The integration of artificial intelligence (AI) into psychiatric practice has accelerated rapidly, driven by advances in computational methods and the availability of diverse data sources. The present paper examines contemporary AI applications across diagnostic support, predictive analytics, therapeutic interventions, digital phenotyping, telepsychiatry integration, and ethical, legal, and social considerations. Foundations in machine learning, deep learning, and natural language processing are delineated alongside relevant data modalities, including structured clinical records, unstructured clinical notes, and multimodal signals. The roles of AI in symptom detection, neuroimaging pattern recognition, biomarker discovery, and differential diagnosis are evaluated. Predictive models for suicide risk, relapse, and treatment response are reviewed, with attention to personalization algorithms. Therapeutic tools, such as conversational agents, virtual reality, and gamified mobile applications, are discussed. Passive monitoring techniques, telepsychiatry workflows, and clinician dashboards are described. Ethical challenges, including data privacy, algorithmic bias, and regulatory frameworks, are considered. Implementation barriers and adoption factors are analyzed. Emerging trends, such as federated learning, multimodal fusion, explainable AI, and applications in low-resource settings, are explored. Implications for patient outcomes, health systems, and policy are synthesized, concluding with recommendations for future research and practice.

Obesity is a known risk factor for various cancers, influencing carcinogenesis through metabolic, hormonal, and inflammatory pathways. Excess adiposity leads to insulin resistance, chronic inflammation, and hormonal imbalances, all of which contribute to tumor development. Obesity increases the risk of cancers in the endocrine system (e.g., thyroid, pancreatic, adrenal) due to insulin resistance and altered hormone levels. In the reproductive system, it raises the risk of breast, ovarian, endometrial, and prostate cancers through hormone dysregulation and inflammation. Obesity is also linked to digestive system cancers, including esophageal, liver, and colorectal cancers, due to metabolic dysfunction and chronic inflammation. The role of obesity in lung cancer remains debated, but metabolic changes may influence tumor progression. Obesity contributes to hematologic cancers, such as leukemia, by altering immune function and promoting inflammation. Other systems show varying associations with obesity and cancer risk. Key mechanisms include metabolic dysregulation, chronic inflammation, epigenetic changes, and elevated insulin/IGF-1, which promote tumor growth. Early detection through imaging and biomarkers, along with lifestyle changes (e.g., diet, exercise) and pharmacologic treatments (e.g., metformin, GLP-1 agonists), can reduce cancer risk and improve outcomes. Personalized treatment for obese cancer patients requires adjustments in surgery, chemotherapy, radiotherapy, and immunotherapy. This review explores obesity’s association with cancers across body systems, overviews the mechanisms of obesity contributing to carcinogenesis, and summarizes clinical and public health implications, including screening, prevention, treatment, and policy interventions.

The underutilization of electrodiagnostic and electrotherapeutic tools has far-reaching consequences, impacting diagnostic accuracy, treatment outcomes, healthcare costs, and patient satisfaction. These issues are often rooted in inadequate training, insufficient physician awareness, and challenges in integrating complex technologies. Underuse compromises diagnostic precision, delays treatment, and limits the potential benefits of advanced therapies, leading to suboptimal management of a wide range of conditions. Additionally, the financial burden of underutilized equipment manifests through reduced facility return on investment, operational inefficiencies, and a decline in healthcare services’ overall quality and sustainability. Addressing this issue requires a multifaceted approach, emphasizing improved training, physician education, and seamless integration of technologies across specialties. Increased utilization can enhance patient outcomes, streamline operations, and ensure the financial viability of healthcare facilities. The purpose of this review is to highlight implications of underutilization while providing a detailed overview of available electrodiagnostic and electrotherapeutic tools across medical specialties, emphasizing the need for enhanced awareness, training, and integration to optimize their use in clinical practice.

The integration of gut microbiota research into the understanding and treatment of neurodevelopmental disorders has profound implications for both clinical practice and public health. The microbial community’s influence on neural development through mechanisms such as microbial metabolites, immune regulation, and gene expression underscores the complexity of neurodevelopmental disorders like autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). As research continues to unravel the intricate relationship between gut microbiota and brain function, innovative therapeutic interventions, including probiotics, prebiotics, and fecal microbiota transplantation, hold potential to improve symptoms and outcomes. However, the safety and long-term effectiveness of these therapies remain critical areas for future investigation. Advances in diagnostic tools and personalized medicine, which incorporate microbial biomarkers, offer exciting prospects for early detection and tailored treatments, ultimately improving the quality of life for individuals with neurodevelopmental disorders. Continued interdisciplinary collaboration is essential for translating these findings into practical solutions that address the underlying mechanisms of these complex disorders. This review highlights the critical role of gut microbiota in neurodevelopmental disorders, emphasizing the importance of microbial metabolites, immune regulation, and genetic interactions in shaping brain development.

Nonadherence to prescribed medications is a significant issue across many medical specialties and human conditions. Nonadherence affects individuals with chronic diseases like cardiovascular disease, diabetes, hypertension, psychiatric disorders, and respiratory conditions, as well as in more acute conditions. Nonadherence can lead to treatment delays or discontinuation, potentially impacting outcomes, but the challenge of medication adherence spans a wide variety of diseases and treatment settings. Factors influencing nonadherence are complex, including psychological, social, financial, and system-level barriers, which apply to numerous medical specialties. Historically, physicians often had to rely on suspicion and guesswork to identify nonadherence or factors contributing to reduced treatment efficacy and delayed or failed outcomes. This uncertainty often left physicians feeling limited in their ability to provide optimal care and effectively apply diagnostic strategies. Fortunately, today, there are various tools available across medical specialties that significantly reduce the uncertainty surrounding nonadherence and its contributing factors. These tools, while widely available, are sometimes underutilized or less well-known. The purpose of this paper is to serve as both a reminder and an introduction to these tools, encouraging healthcare providers to actively and practically employ them for more accurate patient and treatment assessment. This strategy ultimately supports physicians in their commitment to providing each patient with the best possible care and personalized support, as well as improving physician job satisfaction and reducing overall healthcare costs.

The review discusses the risks posed by conventional medical imaging methods, including radiation exposure, allergic reactions, and environmental contamination. It explores recent innovations, such as advanced modalities like photon-counting computed tomography (CT) scanners and ultra-high-field magnetic resonance imaging (MRI) systems, which provide high-resolution images with reduced radiation doses. Artificial intelligence (AI) further enhances the field by automating tasks, improving image analysis, and personalizing protocols, including real-time and predictive monitoring. Non-invasive techniques, such as elastography and photoacoustic imaging, are highlighted for minimizing reliance on ionizing radiation. AI-driven strategies also address environmental concerns through the use of biodegradable contrast agents and energy-efficient technologies. Economic assessments reveal the cost-effectiveness of imaging technologies and their impact on healthcare budgets while acknowledging persistent disparities in access. The review examines contrast agents and radiation: their long-term and broad-ranging adverse health impacts and how new imaging techniques aim to eliminate or mitigate these effects. It also considers how advancements in AI improve diagnostic accuracy and workflow efficiency. Also, the integration of imaging with genomics and telemedicine is discussed, alongside efforts to address economic and accessibility challenges and promote sustainable practices. Imaging technology and AI innovations are transforming diagnostic practices and addressing existing challenges, with ongoing innovation and collaboration essential for optimizing benefits for patients, medical staff, and the environment.

Detox diets, including intermittent fasting, ketogenic, Paleo, vegetarian, Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Whole30, are notable strategies for managing obesity and metabolic syndrome. This review evaluates these diets, highlighting their benefits and limitations. Intermittent fasting methods like 16/8 and 5:2 aid weight management and improve insulin sensitivity, while ketogenic diets induce rapid weight loss and enhance metabolic markers through ketosis. The Paleo diet supports weight loss and better blood glucose control by focusing on whole foods and avoiding processed items. Vegetarian and Mediterranean diets also aid weight management and metabolic health, with the former improving blood sugar control through high fiber and the latter offering anti-inflammatory benefits from healthy fats. The DASH diet reduces blood pressure and supports weight loss, and the Whole30 diet promotes weight loss and reduces inflammation by eliminating processed foods. Anti-inflammatory, plant-based, and vegan diets contribute to weight loss and metabolic health through high nutrient density and reduced processed food intake. Detox diets may offer temporary weight loss and metabolic benefits, but their restrictive nature often limits long-term sustainability and clinical feasibility. Effective use requires careful individualization and ongoing monitoring. Further research is needed to assess their long-term effects, safety, and impact on diverse populations. Advances in personalized nutrition could improve their effectiveness in managing obesity and metabolic syndrome. While promising, these diets require careful management to maximize benefits and minimize risks.

Late-onset psychiatric conditions, which emerge or are first diagnosed in older adulthood, present unique challenges. This review examines their prevalence, risk factors, and clinical presentations, providing a comprehensive overview of their impact on older adults. Late-onset psychiatric disorders, including schizophrenia, bipolar disorder, and major depressive disorder (MDD), are increasingly recognized as significant health concerns among older adults. Epidemiological trends show a rising incidence, influenced by an aging population and demographic changes. Variability in prevalence rates due to gender differences and aging-related factors highlights the need for tailored research and clinical approaches. Risk factors include genetic predispositions, environmental exposures, and lifestyle factors. Genetic research emphasizes hereditary components, while environmental and lifestyle influences, such as stress and social isolation, add complexity to the clinical picture. Comorbidities, common in older adults, further complicate diagnosis and treatment. Clinical presentations of late-onset psychiatric conditions often differ from early-onset forms, with symptoms that may overlap with age-related changes, making diagnosis challenging. Accurate evaluation is necessary to distinguish these conditions from cognitive and neurodegenerative disorders. Managing and treating these conditions effectively requires a comprehensive, individualized approach integrating pharmacological interventions, psychotherapy, and behavioral therapies tailored to older adults. Pharmacological treatment should consider changes in drug metabolism, sensitivity with age, and the risks of polypharmacy. Essential psychotherapies include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), with integrated care involving multidisciplinary teams to address both psychiatric and physical health. Neurologists and geriatricians are crucial in managing neurological manifestations and overall geriatric care. Addressing late-onset psychiatric conditions is critical given the growing old adult population. The rising prevalence emphasizes the need for ongoing research and innovation, focusing on early detection, refining diagnostic criteria, and exploring new therapeutic approaches to enhance care for older adults.

The placebo effect has notable implications for clinical practice and research, demonstrating its ability to enhance therapeutic outcomes through psychological and physiological mechanisms. Evidence shows that placebos can impact treatment responses by influencing patients’ expectations and mental states, with mechanisms including neurobiological changes such as endogenous opioid release and brain activity alterations. However, their use raises ethical concerns, especially regarding patient trust and autonomy. Psychological factors like belief, expectation, and mindset play a significant role in placebo efficacy, affecting mental and physical health outcomes. In clinical settings, integrating placebo effects requires careful management to enhance patient care without replacing evidence-based treatments. Ethical integration involves boosting placebo responses transparently and maintaining adherence to ethical standards to prevent misuse, such as non-disclosure or substituting proven therapies, which can damage trust and patient autonomy. Future research aims to refine placebo mechanisms, including genetic factors and biomarkers—to personalize medicine and improve therapeutic efficacy—and evaluate the long-term effects of placebo responses on patient care. Placebos are essential in drug development and approval. Placebo-controlled trials help differentiate between active drug effects and psychological influences. However, ethical concerns, especially about withholding effective treatments, remain. Guidelines by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) are crucial for upholding ethical standards in these trials. While the placebo effect offers valuable insights, its application must be managed with transparency and rigor to balance its benefits with high ethical standards in medical practice.

This review highlights the significant impact of SARS-CoV-2 on the hematological system, revealing complications such as thrombocytopenia, coagulopathy, venous thromboembolism (VTE), and hemolytic anemia, which contribute notably to morbidity and mortality, especially in critically ill patients. The underlying mechanisms involve direct viral effects, inflammation, cytokine storms, and hypercoagulability. The exacerbation of pre-existing hematological malignancies and the common occurrence of lymphopenia further illustrate the complex interaction between COVID-19 and the immune system. The review emphasizes the importance of early recognition and management of hematological complications for clinical practice. It discusses the necessity of monitoring biomarkers like D-dimer and platelet counts, utilizing imaging techniques for detecting thromboembolic events, and employing timely interventions with anticoagulants and immunomodulators. Tailoring treatment to individual patient needs and involving a multidisciplinary team are essential for improving outcomes, particularly in critically ill patients. The review also focuses on the need for ongoing research to understand the precise mechanisms of these complications, explore genetic and environmental factors, and assess the long-term outcomes of affected patients. It examines the impact of emerging SARS-CoV-2 variants and the importance of developing innovative therapeutic approaches, including personalized medicine and advanced therapies, to address the ongoing challenges in medical practice.