A research team has developed a causal deep learning model to personalize corticosteroid therapy for intensive care unit patients with sepsis. Using data from patients across two major databases, the model accurately identified which patients would benefit, not benefit, or be harmed by treatment. Patients with severe metabolic acidosis and circulatory dysfunction showed the greatest survival benefit. This breakthrough could potentially optimize critical care decisions, reduce treatment risks, and improve survival rates in sepsis.

A new Genomic Psychiatry High-Priority Research Communication by Professor Yogesh Dwivedi and colleagues at the University of Alabama at Birmingham reports original, peer-reviewed findings demonstrating that long noncoding RNAs (lncRNAs) participate in stress-linked chromatin silencing during glucocorticoid receptor (GR) activation. Using an in vitro neuronal model, the team identified 79 significantly altered lncRNAs (44 upregulated, 35 downregulated; p < 0.05) following GR overexpression, with several physically interacting with the polycomb repressive complex 2 (PRC2) via EZH2 and the histone mark H3K27me3. These lncRNAs inversely correlated with nearby gene expression (R = –0.21, p < 0.005), repressing genes essential for synaptic communication and neuronal signaling. The discovery offers a mechanistic link between chronic stress exposure and long-lasting gene repression, suggesting that lncRNAs could serve as molecular signatures or intervention targets in major depressive disorder.

A comprehensive review published in Brain Medicine demonstrates that disruptions in gut microbiota composition are closely linked to sleep disturbances across multiple disorders, including insomnia, obstructive sleep apnea, circadian rhythm disorders, narcolepsy, and REM sleep behavior disorder. The gut microbiota influences sleep through metabolic pathways involving bile acids and short-chain fatty acids, neuronal pathways including the vagus nerve and hypothalamic-pituitary-adrenal axis, and immune system modulation. Alterations in the microbiota-gut-brain axis have been observed in sleep disorders and illnesses with comorbid sleep disturbances, including depression, anxiety, autism spectrum disorder, and Parkinson's disease. Microbiota-targeted interventions, including probiotics, prebiotics, synbiotics, and fecal microbiota transplantation, show promising results in clinical trials for improving sleep quality, presenting a novel strategy for developing therapeutic approaches to address sleep disorders and enhance overall brain health.