Search Results (2,101)

Background: Depression and anxiety disorders remain among the leading contributors to global disability and represent a major public health challenge. Although evidence-based psychotherapies are available, access to treatment remains limited due to structural, economic, geographical, and workforce-related barriers. Digital mental health interventions have emerged as scalable approaches to reducing this treatment gap, with artificial intelligence (AI)-guided cognitive behavioral therapy (CBT) representing a rapidly developing and clinically relevant extension of digital psychotherapy. Objective: This review aims to synthesize current evidence on digital and AI-guided CBT interventions for depression and anxiety, with a focus on clinical utility, scalability, mechanisms of change, safety considerations, and public health relevance. In addition, the review proposes a clinically oriented conceptual framework for understanding the role of AI-guided CBT within contemporary digital psychiatry. Methods: A focused narrative review was conducted using PubMed, Scopus, and Google Scholar databases, covering publications from 2010 to 2025. Relevant peer-reviewed studies, systematic reviews, meta-analyses, and conceptual papers addressing digital CBT, AI-assisted CBT, conversational agents, symptom monitoring, and digital mental health implementation were identified and analyzed qualitatively. Results: Existing evidence suggests that internet-delivered CBT, mobile applications, and AI-based conversational agents may reduce depressive and anxiety symptoms, particularly in individuals with mild to moderate conditions. However, the evidence base remains heterogeneous, with limitations including short follow-up periods, variability in intervention quality, reliance on self-reported outcomes, and insufficient data on long-term effectiveness, safety, and real-world implementation. Emerging concepts such as digital therapeutic alliance, continuous symptom monitoring, adaptive intervention delivery, and AI-driven personalization may represent key factors influencing engagement and clinical outcomes. Conclusions: AI-guided CBT represents a promising but still evolving component of modern mental health care. These technologies have the potential to improve accessibility, optimize resource allocation, and support stepped-care and hybrid models of treatment. Future research should prioritize rigorous clinical validation, long-term outcome evaluation, transparent safety protocols, ethical governance, and integration into real-world health systems. AI-guided CBT should not be understood as a replacement for clinicians, but as a complementary and scalable extension of evidence-based psychotherapy. Full article

The rapid emergence and dissemination of antimicrobial resistance (AMR) among bacterial pathogens, particularly the ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.), represents one of the most pressing global public health challenges, contributing to increased morbidity, mortality, and healthcare costs. The limited development of new antibiotic classes over the past two decades has intensified the search for structurally novel antimicrobial agents and adjuvants capable of overcoming multidrug resistance. Natural products continue to serve as an invaluable source of anti-infective drug leads owing to their remarkable structural diversity and broad spectrum of biological activities. Mangrove ecosystems, located at the interface of terrestrial and marine environments, harbor highly diverse microbial communities, including fungi that have evolved under extreme environmental conditions and produce a wide range of unique secondary metabolites. Beyond their ecological significance, mangrove-associated fungi have emerged as prolific producers of bioactive compounds with promising antibacterial activity against multidrug-resistant pathogens. This review comprehensively summarizes recent advances (2018–2026) in the discovery of antibacterial metabolites from mangrove-associated fungi active against ESKAPE pathogens, which discusses their structural diversity, reported antimicrobial activities, and emerging strategies for accelerating natural product discovery, including genome mining, metabolomics, OSMAC, adaptive laboratory evolution, and artificial intelligence-assisted approaches. A total of 139 chemically distinct metabolites (Compounds 1–139) isolated from mangrove-associated fungi are critically reviewed, highlighting their potential as promising leads for the development of next-generation antimicrobial agents against ESKAPE pathogens. Full article

Particulate matter (PM) pollution has become a major public health concern. Particularly, PM_0.3 in the air can cause significant damage to the human respiratory system. However, traditional air filtration materials, due to their limited protective functions, are facing challenges such as poor environmental adaptability, low transparency, and difficulties in balancing filtration efficiency with pressure drop. Inspired by the honeycomb structures and transparent dragonfly wings, this study successfully fabricated a bioinspired honeycomb-structured nanofibrous membranes (NFMs) using template-assisted electrospinning. By optimizing the mesh size of receiver, a directional distribution of the electric field was established on the receiver, promoting the simultaneous concentrated ordered stacking and sparse random orientation of fine-diameter nanofibers. This synergistic strategy of structural optimization and electric field modulation enables NFMs to achieve an optimal balance between filtration efficiency, pressure drop, environmental adaptability and transparency. Utilizing filtration mechanisms involving Brownian diffusion, electrostatic adsorption and physical interception, the honeycomb-structured NFMs achieved a filtration efficiency of over 98.51% for PM_0.3, with a pressure drop of only 34 Pa, whilst maintaining high transparency (85%) and high air permeability (130.8 mm/s). This bioinspired honeycomb-structured NFMs demonstrates broad application prospects in the field of air purification and offers novel insights for the development of multifunctional air filtration materials. Full article

Cocoa pod husk, a major agro-industrial by-product of cocoa processing, represents an underutilized source of phenolic compounds with potential functional applications. This study developed an integrated extraction process combining drying pretreatments with probe ultrasound-assisted extraction to enhance the recovery and bioactivity of cocoa pod husk extracts. Preliminary solvent screening identified aqueous ethanol (1:3, v/v) as the most suitable extraction solvent, and a solid-to-solvent ratio of 1:9 (w/v) was subsequently selected for further extraction experiments. Under these extraction conditions, the type of drying pretreatment (tray drying or vacuum microwave drying), ultrasonic amplitude, and extraction time influenced the total phenolic content, phenolic composition, and antioxidant activities (DPPH, ABTS, and FRAP) of cocoa pod husk extracts. The evaluated extracts exhibited antibacterial activity against Streptococcus mutans. Cellular assays were performed using two selected extracts: Cocoa-A (vacuum microwave-dried) and Cocoa-B (tray-dried), which were prepared with aqueous ethanol (1:3, v/v) at a solid-to-solvent ratio of 1:9 (w/v) under 75% ultrasonic amplitude for 15 min. These extracts contained total phenolic contents of 5.41 ± 0.14 and 5.01 ± 0.14 mg GAE/g dried cocoa pod husk for Cocoa-A and Cocoa-B, respectively. Both extracts showed low cytotoxicity together with reduced intracellular reactive oxygen species and suppression of lipopolysaccharide-induced inflammatory mediators, including nitric oxide, IL-6, and TNF-α. The tray-dried extract (Cocoa-B) exhibited greater anti-inflammatory activity than the vacuum microwave-dried extract (Cocoa-A), indicating that the drying pretreatment influenced the biological activity of the extracts. This difference may also be associated with variations in phenolic composition, although the contribution of individual phenolic compounds was not investigated in the present study. These findings improve the understanding of how drying pretreatment and probe ultrasound-assisted extraction parameters influence the recovery of bioactive compounds from cocoa pod husk and provide a scientific basis for the further development of cocoa pod husk-derived bioactive ingredients for functional food, nutraceutical, and oral health-related applications. Full article

Background: Sports training induces functional and structural adaptations that may influence body composition, particularly during adolescence when growth and maturation are still occurring. Although anthropometric characteristics have been extensively studied within individual sports, comparative analyses among different sport categories remain limited. The aim of this study was to compare body composition characteristics among athletes participating in individual, team, and combat sports within a Spanish Sports Technification Program. Methods: A total of 118 young athletes (62 males and 56 females) from the Valencian Sports Technification Centre participated in this cross-sectional study. Participants were classified into three sport categories: individual sports (athletics, swimming, and triathlon), team sports (handball and volleyball), and combat sports (karate and taekwondo). Anthropometric assessment was performed according to the International Society for the Advancement of Kinanthropometry (ISAK) protocol. Body composition variables, including fat mass, muscle mass, and bone mass, were estimated using established anthropometric equations. Statistical analyses were performed using non-parametric tests, with significance set at p < 0.05. Results: After adjustment for multiple comparisons, significant differences remained between sport categories for several body composition indicators. Athletes from the individual sport group showed a higher muscle mass percentage and lower body fat percentages estimated using the Withers, Faulkner, and Carter equations than those from the team sport group. Similarly, estimated body fat percentages were lower in the individual sport group than in the combat sport group across all three equations. Team sport athletes presented higher absolute fat and muscle mass than combat sport athletes. However, some differences identified in the initial analyses, including fat mass and bone mass percentage between the individual and team sport groups and muscle mass percentage between the team and combat sport groups, did not remain statistically significant after adjustment for multiple comparisons. Conclusions: Body composition characteristics differed among the groups of young athletes participating in the specific individual, team, and combat sports included in this study. Within this cohort, athletes from the individual sport group generally exhibited lower body fat levels than those from the team and combat sport groups, whereas differences were also observed in other anthropometric characteristics. These findings should be interpreted within the context of the specific sports included and should not be generalized to individual, team, or combat sports as a whole. The findings may assist coaches, sports scientists, and health professionals in the monitoring and development of young athletes participating in similar sports and development programs. Full article

Background: Dermal interstitial fluid (ISF) contains both plasma-derived biomarkers and biomarkers unique to ISF, making it a promising biofluid for painless, scalable, and decentralized liquid biopsy and continuous health monitoring. However, efficient ISF collection remains challenging due to the small accessible fluid volume in the dermis, slow physiological turnover, and stratum corneum. Methods: This review reframes dermal ISF sampling as a pressure gradient engineering problem using Darcy’s law. We examine how vacuum-assisted microneedle platforms can effectively drive ISF through the dermal extracellular matrix in a minimally invasive manner. We compare the two architectures: micropore-based and hollow microneedle approaches. Results: In the micropore approach, a vacuum chamber is placed over the transient micropores left by withdrawn microneedles, supporting off-device, multi-omic downstream analyses of the collected ISF. The hollow microneedle approach retains the microneedles in the skin and applies vacuum through internal lumens, allowing integration of the vacuum source, microneedles, and biosensors into a single wearable platform for in situ biomarker detection. Comparative studies across these architectures identify the vacuum seal between the device and the skin as the major engineering bottleneck shared by both architectures. Conclusions: Vacuum-assisted microneedle platforms provide a practical route for generating pressure gradient-driven ISF transport while preserving minimally invasive skin access. Future development should prioritize device–skin vacuum seal robustness, reproducible ISF recovery across users and skin sites, integrated vacuum sources, scalable fabrication, and usability in clinical or at-home settings. Full article

The increasing prevalence of presbyphagia and mild dysphagia among adults over 65 years (International Dysphagia Diet Standardisation Initiative, IDDSI, levels 4–6) has increased the demand for texture-modified foods that ensure safe swallowing while providing added health benefits. This study aimed to develop functional gummy-like systems containing grape pomace extracts obtained by ultrasound-assisted extraction using either a natural deep eutectic solvent (NaDES; choline chloride:citric acid, 1:1) or water, and to evaluate the effects of extraction medium and formulation composition on their physicochemical, textural, and bioactive properties. A simplex-centroid mixture design was used to assess the combined effects of gelatin (4–8%), low-methoxyl pectin (1–3%), and extract concentration (5–10%). NaDES-based formulations exhibited lower water activity and a more homogeneous moisture distribution than aqueous counterparts, indicating improved water structuring within the gel network. Intermediate gelatin–pectin ratios produced cohesive matrices with moderate firmness, consistent with IDDSI levels 5–6. Formulation F5 (6% gelatin, 1% pectin, 7.5% extract) showed the best overall performance, combining favorable textural properties with the highest total polyphenol content and antioxidant activity. These findings support the use of NaDES-extracted grape pomace for developing functional foods suitable for individuals with dysphagia. Full article

Drone-based chemical spraying in agriculture faces challenges related to operator health hazards, spray deposition, application efficiency, and environmental safety. Electrostatic charging system is a novel technology that minimizes off-target spraying losses and increases droplet deposition on the plant canopy. In electrostatic spraying, chemical consumption and application rates are reduced due to the uniform distribution and enhanced deposition of charged droplets on plant surfaces, thereby improving spraying efficacy. In this study, a drone-based air-assisted electrostatic sprayer was developed to investigate the effect of operational parameters that include forward speed, discharge rate, applied voltage (charged condition) and propeller speed on the droplet density (drops/cm²) in a cotton crop under laboratory conditions. The charge-to-mass ratio (CMR) of the developed air-assisted electrostatic nozzle was found in the range between 1.8–2.5 mC/kg. An Artificial Neural Network–Ant Colony Optimization (ANN–ACO) method was used to optimize the operational parameters for obtaining the highest charged droplet density on the plant canopy surfaces. Results showed that the charged droplet density was significantly affected by discharge rate (DR) and applied voltage (AV) followed by forward speed (FS) and was slightly influenced by the propeller speed (PS). Optimal performance was achieved at FS = 2.58 km/h, PS = 1204 rpm, DR = 558.45 mL/min and AV = 6.18 kV under the charged conditions. At these optimized parameters, an average charged droplet density of 185.83 ± 4.25 drops/cm² (mean ± SE) was achieved. For the uncharged conditions, the optimal performance was achieved at FS = 2.80 km/h, PS = 1065 rpm and DR = 556.75 mL/min, corresponding to an average droplet density of 108.49 ± 2.15 drops/cm². The integration of the ANN–ACO optimization algorithm with the drone-based air-assisted electrostatic spraying system can enhance precision chemical application on the cotton, improving efficiency and sustainability. Full article

Capsaicin is a bioactive substance with diverse health-promoting properties, but its intense pungency and irritant side effects limit oral application. This study developed a Pueraria lobata particle-based Pickering emulsion (PE) as an oral delivery platform for capsaicin. Modified Pueraria lobata particles (MP-ps) were prepared using a microwave-assisted enzymolysis technique (15% hydration, 252 J/g microwave energy and 8 h pullulanase hydrolysis). MP-ps exhibited surface cracks and pores, altered starch crystallinity, and enhanced water-holding capacity and swelling power. Compared with original Pueraria lobata particles, MP-ps avoided the burst release of puerarin in the upper gastrointestinal tract, dropping from approximately 54% to 20%. An optimized capsaicin-loading PE with excellent physical stability was obtained from 4% MP-ps and a 9:1 (v/v) water-to-corn oil ratio, exhibiting complete core–shell architecture and oil-phase sequestration of capsaicin in TEM images. Gastrointestinal transit analysis in male KM mice indicated that MP-p-based PE reduced the exposure of the encapsulated lipophilic substance in the stomach and small intestine and promoted its accumulation in the colon. Irritation assays in male KM mice and Sprague-Dawley rats further demonstrated that this effective encapsulation alleviated the gastrointestinal irritation of capsaicin and improved its palatability. This study provided a food-derived material and an easy-to-build PE platform for oral lipophilic/irritant substance delivery, with potential for future health-regulating applications. Full article

Pulsatile blood flow is a fundamental characteristic of cardiovascular physiology that regulates endothelial function, vascular homeostasis, microcirculatory integrity, and organ adaptation through complex mechanobiological pathways. The widespread use of continuous-flow left ventricular assist devices (CF-LVADs) has created a unique clinical model of chronic pulsatility deprivation, whereas heart transplantation restores physiological pulsatile hemodynamics. This review examines the molecular, cellular, and systemic consequences of these contrasting circulatory states. Evidence from experimental and clinical studies indicates that reduced pulsatility during CF-LVAD support is associated with impaired endothelial mechanotransduction, glycocalyx disruption, oxidative stress, inflammatory activation, angiogenic dysregulation, acquired von Willebrand syndrome, and microvascular remodeling. These alterations contribute to bleeding, thrombosis, neurological events, and progressive end-organ dysfunction. In contrast, restoration of pulsatile flow following heart transplantation promotes recovery of endothelial signaling, nitric oxide bioavailability, vascular responsiveness, and tissue perfusion, although persistent immune-mediated injury may limit complete vascular normalization. Emerging concepts involving Piezo1 signaling, YAP/TAZ mechanotransduction, extracellular vesicles, immunometabolism, and multi-omics profiling further support the role of pulsatility as a biological regulator rather than a simple hemodynamic consequence of cardiac contraction. Understanding pulsatility-dependent cardiovascular remodeling may facilitate the development of next-generation circulatory support technologies and novel therapeutic strategies to preserve vascular health. Full article

Obesity is a multifactorial condition that profoundly affects female reproductive health through endocrine, metabolic, and inflammatory mechanisms that disrupt the hypothalamic–pituitary–gonadal (HPG) axis. Women with obesity frequently develop menstrual irregularities, anovulation, amenorrhea, infertility, polycystic ovary syndrome (PCOS), impaired endometrial receptivity, and adverse pregnancy outcomes. Central obesity and insulin resistance contribute to hyperinsulinemia, reduced sex hormone-binding globulin (SHBG) levels, hyperandrogenism, altered gonadotropin secretion, and impaired folliculogenesis, while adipokines such as leptin and chronic inflammation further impair ovarian steroidogenesis and ovulatory function. Obesity-related oxidative stress and lipotoxicity also negatively affect oocyte quality, embryo development, implantation, and assisted reproductive technology outcomes, increasing the risk of gestational diabetes, preeclampsia, miscarriage, and preterm birth. This review evaluates the therapeutic potential of pharmacological weight-loss therapies in obesity-associated female reproductive dysfunction. A comprehensive literature review was conducted using various databases, focusing on anti-obesity pharmacotherapy on obesity, infertility and fertility in reproductive-aged women. Evidence suggests that several FDA-approved and off-label anti-obesity agents, including orlistat, liraglutide, semaglutide, phentermine/topiramate, bupropion/naltrexone, metformin, exenatide, and tirzepatide, may improve reproductive outcomes primarily indirectly through weight reduction and metabolic improvement. GLP-1 receptor agonists, particularly liraglutide, semaglutide, and exenatide, appear especially promising, demonstrating beneficial effects on insulin sensitivity, menstrual regularity, ovulation, androgen levels, and pregnancy rates in women with PCOS. Tirzepatide, a dual GLP-1/GIP receptor agonist, has shown potent weight-loss and metabolic effects with potential indirect fertility benefits. Metformin improves insulin sensitivity and is widely used in PCOS to regulate androgen levels and restore ovulation, although its effects on pregnancy and live birth rates remain controversial. However, evidence for several agents remains limited, and concerns persist regarding reproductive safety during pregnancy. Overall, anti-obesity pharmacotherapy may represent an important adjunctive strategy for improving reproductive and metabolic health in women with obesity, although larger randomized clinical trials are still required. Full article

Background: Virtual reality (VR) is increasingly being explored as a tool for upper limb (UL) assessment in adults with neurological disorders. This review synthesizes the available evidence on VR-based UL assessments by analyzing their psychometric properties and potential role in clinical and research settings. Methods: This systematic review followed the Guideline for reporting systematic reviews of outcome measurement instruments (PRISMA-COSMIN) and was prospectively registered in PROSPERO. Data extraction was independently performed by two reviewers, with disagreements resolved by consensus or a third reviewer. Psychometric evidence was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology, including risk of bias assessment, evaluation and synthesis of measurement properties, and evidence grading according to GRADE. Additionally, the clinical application context of each VR assessment was examined, and a strengths, weaknesses, opportunities and threats analysis was conducted to explore factors affecting implementation and future development in neurorehabilitation. Results: Twenty VR-based UL assessments were identified. VR-Box and Blocks Test represented the largest body of evidence and was the only assessment implemented across all immersion levels, with promising findings in both stroke and Parkinson’s disease populations (Grade B recommendation). Immersive Action Research Arm Test demonstrated the strongest psychometric profile among the stroke sample (Grade B recommendation). Additionally, the Virtual Occupational Therapy Assistant and SaeboVR^® incorporated the most ecologically valid tasks, reflecting activities closer to daily life performance. Test–retest reliability and construct validity were the most frequently evaluated measurement properties. Conclusions: VR-based assessments represent promising tools for UL assessment. However, despite most systems receiving a Grade B recommendation, the supporting evidence remained low or very low certainty due to methodological shortcomings and incomplete psychometric evaluation. Therefore, more rigorous and methodologically robust research is needed to strengthen the evidence supporting their implementation in clinical practice as a complementary tool for UL assessment. Full article

Psychoactive substance use is a significant public health issue. Developing effective preventive strategies to reduce its incidence requires a deep understanding of the motivations and risks underlying its development and maintenance. This study examines the associations between substance use risks, self-esteem, and body image perceptions within a Spanish sample (n = 174). Data were collected using standardized instruments (ASSIST v3.1, RSES, BSQ-8D, BIS) and an ad hoc questionnaire regarding aesthetic-related beliefs. Findings revealed that while alcohol (90.2%), tobacco (47.1%), and cannabis (29.3%) were the most prevalent substances used in the last three months, associated health risks were predominantly low. Significant negative correlations were identified between self-esteem and the risk of alcohol (ρ = −0.155) and sedative use (ρ = −0.221), as well as cocaine prevalence (ρ = −0.155). Gender differences emerged, with males exhibiting higher risks for cannabis and stimulants, while females reported greater body image concern. Approximately 38.5% of the sample had used substances for aesthetic purposes, primarily dietary supplements among men. Beliefs regarding the impact of consumption on physical appearance were predominantly negative. These results suggest that high self-esteem and negative aesthetic perceptions of substances are consistent with a potential protective role. Effective prevention strategies should incorporate body image and self-esteem as pillars of psychological resistance. Full article

Portable sensing systems are increasingly important in biological and chemical analyses because they can provide analytical information at the point of decision-making. While traditional laboratory methods remain crucial for reference measurements, regulatory validation, and high-precision quantification, portable systems emphasize rapid response, convenience, cost-effectiveness, robustness, and relevance to decision-making. This paper views portable sensing systems as integrated analytical platforms rather than isolated sensing elements. The paper discusses recognition elements, including enzymes, antibodies, nucleic acid probes, aptamers, molecularly imprinted polymers, nanomaterials, and hybrid recognition interfaces, as well as electrochemical, optical, mass-sensitive, thermal, field-effect, and hybrid sensing technologies. Furthermore, this paper reviews platform designs, including paper-based analytical devices, chip lab systems, smartphone-assisted sensors, wearable and flexible sensors, handheld instruments, and wireless sensor networks. It explores their applications in sample handling, calibration, data processing, and field deployment. Applications of this technology include point-of-care diagnostics, pathogen detection, wearable health monitoring, agriculture, veterinary medicine, environmental monitoring, food safety, industrial process control, forensic analysis, public safety, and occupational exposure assessment. The report focuses on sample acquisition, miniaturized preparation, reagent storage, matrix interference, calibration transfer, signal conditioning, machine learning, cloud platforms, analytical validation, and decision support. Furthermore, it identifies key obstacles to translating academic prototypes into industrial products, including reproducibility, stability, manufacturability, ease of use, cybersecurity, regulatory approval, and market acceptance. Future development requires fully integrated sample-to-result systems, multimodal sensing, artificial intelligence, sustainable single-use materials, self-powered devices, and system-level validation under real-world operating conditions. Full article

Black pepper (Piper nigrum Linn.), one of the world’s most economically important spice crops, is increasingly challenged by climate-related stresses, emerging pests and diseases, and declining soil health, all of which threaten its productivity and sustainability. While previous reviews have predominantly focused on black pepper genomic resources, breeding strategies, and disease management, the integration of multi-omics technologies, microbiome science, and artificial intelligence (AI) to enhance its stress resilience has received comparatively limited attention. This review synthesizes recent advances in the molecular mechanisms underlying black pepper responses to biotic and abiotic stresses, with emphasis on omics approaches (such as genomics and transcriptomics), as well as the roles of beneficial microbial communities in enhancing stress tolerance, nutrient acquisition, and disease suppression. We further discuss emerging microbiome-assisted strategies, including the development of beneficial microbial consortia and targeted manipulation of microbial functions, for enhancing black pepper resilience under changing environmental conditions. In addition, we explore how AI-driven analytical approaches can integrate complex multi-omics and microbiome datasets to unravel the complex molecular networks governing black pepper–microbe interactions under stress conditions and accelerate precision breeding. By integrating genomics, microbial ecology, and AI, this review presents a systems-level framework for understanding and improving stress resilience in black pepper. This interdisciplinary perspective highlights new opportunities to accelerate the development of climate-resilient cultivars and advance sustainable black pepper production. Full article