Search Results (117,686)

Background: Depression that is resistant to two or more adequate treatment trials—treatment-resistant depression (TRD)—is a prevalent clinical challenge. Although psychotherapies have been recommended by clinical guidelines as an alternative or adjunctive treatment strategy, the effectiveness of psychotherapy in individuals with TRD has not yet been evaluated through meta-analytic methods, primarily due to a limited number of trials. This highlights the necessity of personalized research targeting this specific population. This systematic review and meta-analysis aimed to summarize the evidence on psychotherapy in treating TRD. Methods: A systematic search was conducted following the Guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were included if they quantitatively examined the efficacy of psychotherapy on depression symptoms in individuals diagnosed with depression who had not responded to at least two prior treatments (i.e., pharmacotherapy and/or psychotherapy). Results: A total of 12 studies were included. The quality of evidence was evaluated as being globally moderate. When pooling all psychotherapies, a small-to-moderate, but significant, effect on depressive symptoms was observed compared to the control group (SMD = −0.49, CI = −0.63; −0.34). The observed effect remained unchanged after removing the outlier (SMD = −0.47, CI = −0.62; −0.32). When examining depressive symptoms by type of psychotherapy, Mindfulness-Based Cognitive Therapy (SMD = −0.51, CI = −0.76; −0.25), Cognitive Behavioral Therapy (SMD = −0.53, CI = −0.92; −0.14), and Cognitive Therapy (SMD = −0.51, CI = −1.01; −0.01) showed a moderately significant effect on depressive symptoms compared to the control group. Conclusions: Although this potentially represents the first meta-analysis in this area, the number of studies specifically addressing this complex population remains limited, and the existing literature is still in its early stages. Research focusing on TRD is notably sparse compared to the broader body of work on depression without treatment resistance. Consequently, it was not possible to conduct meta-analyses by type of psychotherapy across all treatment modalities and by type of control group. Due to several study limitations, there is currently limited evidence available about the effectiveness of psychotherapy for TRD, and further trials are needed. Beyond the treatments usually offered for depression, it is possible that TRD requires a personalized medicine approach. Full article

This research focuses on designing polymer membranes as biocompatible materials using home-built electrospinning equipment, offering alternative solutions for tissue regeneration applications. This technological development supports cell growth on biomaterial substrates, including hepatocellular carcinoma (Hep-G2) cells. This work researches the compatibility of polymer membranes (fiber mats) made of polyvinylidene difluoride (PVDF) for possible use in cellular engineering. A standard culture medium was employed to support the proliferation of Hep-G2 cells under controlled conditions (37 °C, 4.8% CO₂, and 100% relative humidity). Subsequently, after the incubation period, electrochemical impedance spectroscopy (EIS) assays were conducted in a physiological environment to characterize the electrical cellular response, providing insights into the biocompatibility of the material. Scanning electron microscopy (SEM) was employed to evaluate cell adhesion, morphology, and growth on the PVDF polymer membranes. The results suggest that PVDF polymer membranes can be successfully produced through electrospinning technology, resulting in the formation of a dipole structure, including the possible presence of a polar β-phase, contributing to piezoelectric activity. EIS measurements, based on R_ct and C_dl values, are indicators of ion charge transfer and strong electrical interactions at the membrane interface. These findings suggest a favorable environment for cell proliferation, thereby enhancing cellular interactions at the fiber interface within the electrolyte. SEM observations displayed a consistent distribution of fibers with a distinctive spherical agglomeration on the entire PVDF surface. Finally, integrating piezoelectric properties into cell culture systems provides new opportunities for investigating the influence of electrical interactions on cellular behavior through electrochemical techniques. Based on the experimental results, this electrospun polymer demonstrates great potential as a promising candidate for next-generation biomaterials, with a probable application in tissue regeneration. Full article

Antibody-mediated autoimmune diseases are common, can involve any organ system, and pose a large burden for patients and healthcare systems. Most antibody-mediated diseases are mediated by IgG antibodies. Selective targeting of pathogenic antibodies is an attractive treatment option which has already proven to be effective in antibody-positive generalized myasthenia gravis, maternal-fetal alloimmune cytopenias, and immune thrombocytopenic purpura. Warm autoimmune hemolytic anemia (wAIHA) is an autoimmune disorder mediated by pathogenic antibodies mainly of the IgG class with no approved therapy. Current treatment includes non-specific immunosuppression with corticosteroids, rituximab, and other immunosuppressive agents. With most therapies, time to response can be delayed and transfusions may be needed. Neonatal Fc receptor (FcRN) therapies provide rapid and sustained reduction of pathogenic IgG levels providing potential for fast, effective therapy in antibody-mediated autoimmune diseases including warm autoimmune hemolytic anemia. This review focuses on the emerging role of FcRn inhibition in autoimmune hematologic diseases, and their therapeutic potential in wAIHA. Full article

Among the numerous compounds released as a result of human activities, endocrine-disrupting chemicals (EDCs) have attracted particular attention due to their widespread detection in human biological samples and their accumulation across various ecosystems. While early research primarily focused on their effects on reproductive health, it is now evident that EDCs may impact neurodevelopment, altering the integrity of neural circuits essential for cognitive abilities, emotional regulation, and social behaviors. These compounds may elicit epigenetic modifications, such as DNA methylation and histone acetylation, that result in altered expression patterns, potentially affecting multiple generations and contribute to long-term behavioral phenotypes. The effects of EDCs may occur though both direct and indirect mechanisms, ultimately converging on neurodevelopmental vulnerability. In particular, the gut–brain axis has emerged as a critical interface targeted by EDCs. This bidirectional communication network integrates the nervous, immune, and endocrine systems. By altering the microbiota composition, modulating immune responses, and triggering epigenetic mechanisms, EDCs can act on multiple and interconnected pathways. In this context, elucidating the impact of EDCs on neurodevelopmental processes is crucial for advancing our understanding of their contribution to neurological and behavioral health risks. Full article

MXenes, a class of two-dimensional transition metal carbides and nitrides, emerged as a promising material for next-generation energy storage and corresponding applications due to their unique combination of high electrical conductivity, tunable surface chemistry, and lamellar structure. This review highlights recent advances in MXene-based composites, focusing on their integration into electrode architectures for the development of supercapacitors, batteries, and multifunctional devices, including triboelectric nanogenerators. It serves as a comprehensive overview of the multifunctional capabilities of MXene-based composites and their role in advancing efficient, flexible, and sustainable energy and sensing technologies, outlining how MXene-based systems are poised to redefine multifunctional energy platforms. Electrochemical performance optimization strategies are discussed by considering surface functionalization, interlayer engineering, scalable synthesis techniques, and integration with advanced electrolytes, with particular attention paid to the development of hybrid supercapacitors, triboelectric nanogenerators (TENGs), and wearable sensors. These applications are favored due to improved charge storage capability, mechanical properties, and the multifunctionality of MXenes. Despite these aspects, challenges related to long-term stability, sustainable large-scale production, and environmental degradation must still be addressed. Emerging approaches such as three-dimensional self-assembly and artificial intelligence-assisted design are identified as key challenges for overcoming these issues. Full article

Background/Objectives: Neuromodulation is under investigation as a possibly effective add-on therapy in Alzheimer’s disease (AD). While transcranial pulse stimulation (TPS) has shown positive short-term effects, long-term effects have not yet been fully explored. This study aims to evaluate the long-term feasibility, safety, and potential cognitive benefits of TPS over one year in patients with Alzheimer’s disease, focusing on domains such as memory, speech, orientation, visuo-construction, and depressive symptoms. Methods: We analyzed preliminary data from the first ten out of thirty-five patients enrolled in a prospective TPS study who completed one year of follow-up and were included in a dedicated long-term database. The protocol consisted of six initial TPS sessions over two weeks, followed by monthly booster sessions delivering 6000 pulses each for twelve months. Patients underwent regular neuropsychological assessments using the Alzheimer Disease Assessment Scale (ADAS), Mini-Mental Status Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Beck Depression Inventory (BDI-II). All adverse events (AEs) were documented and monitored throughout the study. Results: Adverse events occurred in less than 1% of stimulation sessions and mainly included mild focal pain or transient unpleasant sensations, as well as some systemic behavioral or vigilance changes, particularly in patients with underlying medical conditions, with some potentially related to the device’s stimulation as adverse device reactions (ADRs). Cognitive test results showed significant improvement after the initial stimulation cycle (ADAS total improved significantly after the first stimulation cycle (M_pre = 28.44, M_post = 18.56; p = 0.001, d = 0.80, 95% CI (0.36, 1.25)), with stable scores across all domains over one year. Improvements were most notable in memory, speech, and mood. Conclusions: TPS appears to be a generally safe and feasible add-on treatment for AD, although careful patient selection and monitoring are advised. While a considerable number of participants were lost to follow-up for various reasons, adverse events and lack of treatment effect were unlikely primary causes. A multifocal stimulation approach (F-TOP2) is proposed to enhance effects across more cognitive domains. Full article

The integration of artificial intelligence (AI), big data analytics, and blockchain technologies within the digital economy presents transformative opportunities for promoting low-carbon urban development. However, a systematic understanding of how these digital innovations influence urban carbon mitigation remains limited. This study addresses this gap by proposing two research questions (RQs): (1) What are the key success factors for artificial intelligence, big data, and blockchain in urban carbon emission reduction? (2) How do these technologies interact and support the transition to low-carbon cities? To answer these questions, the study employs a hybrid methodological framework combining the decision-making trial and evaluation laboratory (DEMATEL) and interpretive structural modeling (ISM) techniques. The data were collected through structured expert questionnaires, enabling the identification and hierarchical analysis of twelve critical success factors (CSFs). Grounded in sustainability transitions theory and institutional theory, the CSFs are categorized into three dimensions: (1) digital infrastructure and technological applications; (2) digital transformation of industry and economy; (3) sustainable urban governance. The results reveal that e-commerce and sustainable logistics, the adoption of the circular economy, and cross-sector collaboration are the most influential drivers of digital-enabled decarbonization, while foundational elements such as smart energy systems and digital infrastructure act as key enablers. The DEMATEL-ISM approach facilitates a system-level understanding of the causal relationships and strategic priorities among the CSFs, offering actionable insights for urban planners, policymakers, and stakeholders committed to sustainable digital transformation and carbon neutrality. Full article

Several chronic inflammatory processes are currently being studied in relation to other systems to better understand the regulation mechanisms and identify potential therapeutic targets. A significant body of evidence supports the role of the nervous system in regulating various immunological processes. This study investigates the relationship between pterygia and the sympathetic nervous system, focusing on their interaction in the inflammatory response and fibrogenic process. Sixteen surgical specimens of primary pterygia and four conjunctival tissue samples were examined, and their morphology was analyzed using hematoxylin–eosin and Masson’s trichrome stains. The gene expression of adrenergic receptors, as well as inflammatory and fibrogenic cytokines, was also assessed. Additionally, both adrenergic receptors and tyrosine hydroxylase were found to be localized within the tissues according to immunohistochemistry and immunofluorescence techniques. Increased expression of proinflammatory, fibrogenic, and adrenergic genes was observed in the pterygium compared to the healthy conjunctiva. Adrenergic receptors and tyrosine hydroxylase were localized in the basal region of the epithelium and within blood vessels, closely associated with immune cells. Neuroimmunomodulation plays a key role in the pathogenesis of pterygia by activating the sympathetic nervous system. At the intravascular level, norepinephrine promotes the migration of immune cells, thereby sustaining inflammation. Additionally, sympathetic nerve fibers located at the subepithelial level contribute to epithelial growth and the fibrosis associated with pterygia. Full article

This study focuses on developing a climate-flood model to investigate and interpret the relationship and impact of climate on runoff/flooding at a sub-regional scale using multiple linear regression (MLR) with 30 years of hydro-climatic data for the Cross River Basin, Nigeria. Data were obtained from Nigerian Meteorological Agency (NIMET) for the following climatic parameters: annual average rainfall, maximum and minimum temperatures, humidity, duration of sunlight (sunshine hours), evaporation, wind speed, soil temperature, cloud cover, solar radiation, and atmospheric pressure. These hydro-meteorological data were analysed and used as parameters input to the climate-flood model. Results from multiple regression analyses were used to develop climate-flood models for all the gauge stations in the basin. The findings suggest that at 95% confidence, the climate-flood model was effective in forecasting the annual runoff at all the stations. The findings also identified the climatic parameters that were responsible for 100% of the runoff variability in Calabar (R² = 1.000), 100% the runoff in Uyo (R² = 1.000), 98.8% of the runoff in Ogoja (R² = 0.988), and 99.9% of the runoff in Eket (R² = 0.999). Based on the model, rainfall depth is the only climate parameter that significantly predicts runoff at 95% confidence intervals in Calabar, while in Ogoja, rainfall depth, temperature, and evaporation significantly predict runoff. In Eket, rainfall depth, relative humidity, solar radiation, and soil temperatures are significant predictors of runoff. The model also reveals that rainfall depth and evaporation are significant predictors of runoff in Uyo. The outcome of the study suggests that climate change has impacted runoff and flooding within the Cross River Basin. Full article

Background: Emotional abuse is both prevalent and underrecognized particularly in culturally complex settings like India. Adolescents, being in a critical developmental phase, are especially vulnerable to the long-lasting psychological effects of emotional abuse. This qualitative literature review aims to synthesize findings from primary studies that explore the lived experiences of emotional abuse among Indian adolescents and identify emerging patterns across sociocultural contexts. Method: Electronic databases, including DOAJ, Google Scholar, ProQuest, JSTOR, Pubmed, PsycNet, and SCOPUS, were searched for peer-reviewed articles published in English up to March 2025. Inclusion criteria comprised qualitative or mixed-methods research focusing on emotional abuse among adolescents aged 12–20 in Indian contexts. The Critical Appraisal Skills Programme (CASP) was used for quality assessment. Results: Five major thematic domains were identified across the included studies: (1) Family as a primary site of emotional abuse; (2) Gendered experiences of abuse; (3) Cultural normalization and silence; (4) Psychological and emotional consequences; and (5) Coping and resilience among adolescents. These themes reflect shared experiences of emotional abuse shaped by cultural, familial, and gender-based expectations. Conclusions: This review highlights the urgent need for increased awareness and culturally sensitive interventions addressing emotional abuse in Indian adolescents. The findings suggest that parents, educators, and policymakers must recognize emotionally harmful behaviors and implement prevention-oriented strategies, particularly through non-violent communication and adolescent mental health support frameworks. Full article

To support carbon peaking and neutrality goals in the city transportation sector, this paper accounts for CO₂ emissions from the transport sector in Xuzhou City, North Jiangsu Province, from 1995 to 2023. This study explores the relationship between transport-related carbon emissions and economic growth, using the TAPIO decoupling index. Meanwhile, a carbon emission prediction model based on the STIRPAT framework is constructed, with scenario analysis applied to forecast future emissions. Results show three decoupling stages: the first, dominated by weak and expansive negative decoupling, reflects extensive economic growth; the second features weak decoupling with expansive coupling, indicating a more environmentally coordinated phase; the third transitions from expansive negative decoupling and weak decoupling to strong decoupling and expansive coupling, suggesting a shift in development patterns. Under the baseline, low-carbon, and enhanced low-carbon scenarios, by 2030, the CO₂ emissions of the transportation industry in Xuzhou will be 10,154,700 tons, 9,072,500 tons, and 8,835,000 tons, respectively, and the CO₂ emissions under the low-carbon scenario and the enhanced low-carbon scenario will be reduced by 10.66% and 13.00%, respectively. Based on these findings, the study proposes carbon reduction strategies for Xuzhou’s transport sector, focusing on policy regulation, energy use, and structural adjustments. Full article

Background: A high-fat diet has been shown to have an impact on metabolism resulting in changes in arterial wall thickness and degeneration of surviving neural cells of the hippocampus. The present review focuses on the various animal models used to induce high-fat diet conditions for studying obesity-induced atherosclerosis, along with the associated changes observed in surviving neural cells of the hippocampus. It also highlights the limitations of rodent models and discusses their implications for human research. Methods: The sources for the literature search were Scopus, PubMed, Medline and Google Scholar. Both animal and human studies published were considered and are cited. Results: High-fat-diet-induced vascular changes, mainly in the tunica media, has been shown to have more impact on medium-sized arteries and on the Cornu Ammonis three subregions and outer dentatae gyrus of the hippocampus. Conclusions: High-fat-diet-induced neurovascular changes have been studied radically in animal models, and more supporting studies representing preclinical research should be advanced to humans. Full article

This study dives into what drives people to use AR filters in the catering industry, focusing on the Hong Kong market. The main idea is to determine how “perceived value” shapes users’ intentions to engage with these filters. To do this, the research combines concepts from two popular models—the extended Technology Acceptance Model (TAM) and the Satisfaction–Loyalty Model (SLM)—to understand what influences perceived value. The survey data were then analyzed with Structural Equation Modeling (SEM) to see how perceived usefulness, enjoyment, satisfaction, and value connect to users’ intentions. The results showed that “perceived value” is a big deal—the main factor driving whether people want to use AR filters. Things like how useful or enjoyable the filters are and how satisfied users feel all play a role in shaping this perceived value. These findings are gold for marketing teams and AR developers, especially in the catering world. Combining TAM and the Satisfaction–Loyalty Model offers a fresh perspective on how AR technology influences consumer behavior. On top of that, it gives practical advice for businesses looking to make the most of AR filters in their marketing and customer experience strategies. Full article

This study aims to provide a comprehensive overview of psychological distress among medical students in Spain, a growing concern given the high prevalence rates of anxiety, depression, and burnout reported across multiple medical schools and universities. To assess the scope and key characteristics of this phenomenon, a thorough literature search was conducted in the PubMed, ProQuest, and Web of Science (WoS) databases. Studies published between 2010 and 2024 in peer-reviewed scientific journals, written in English or Spanish, and specifically focused on medical students enrolled in Spanish universities were considered for inclusion. A total of 14 studies were analysed. The findings indicate that psychological distress often emerges early in medical training and tends to intensify as students progress academically. Female medical students are consistently more affected, as most of the studies reviewed indicate that they exhibit higher levels of depressive symptoms, trait anxiety, and perceived stress. Some research also suggests greater levels of burnout among female students compared to their male peers. Key contributing factors include academic overload and dissatisfaction, sleep deprivation, and the use of maladaptive coping strategies. Although awareness of the issue is increasing, available evidence suggests that institutional responses remain limited, and that only a small number of universities have implemented structured mental health programmes. Overall, the results underscore the urgent need for institutional reforms in Spanish medical education to safeguard students’ mental wellbeing. Key priorities include revising curricula, implementing structured emotional support programmes, and ensuring accessible services—requiring coordinated, long-term commitment across academic, healthcare, and policy sectors. Future research should explore longitudinal trends and the effectiveness of targeted interventions. Full article

Previous reviews have examined specific facets of Geographic Information Systems (GIS) in transportation planning, such as transit-focused applications and open source geospatial tools. However, this study offers the first systematic, PRISMA-guided longitudinal evaluation of GIS integration in transportation planning, spanning thematic domains, data models, methodologies, and outcomes from 2004 to 2024. This study addresses this gap through a longitudinal analysis of GIS-based transportation research from 2004 to 2024, adhering to PRISMA guidelines. By conducting a mixed-methods analysis of 241 peer-reviewed articles, this study delineates major trends, such as increased emphasis on sustainability, equity, stakeholder involvement, and the incorporation of advanced technologies. Prominent domains include land use–transportation coordination, accessibility, artificial intelligence, real-time monitoring, and policy evaluation. Expanded data sources, such as real-time sensor feeds and 3D models, alongside sophisticated modeling techniques, enable evidence-based, multifaceted decision-making. However, challenges like data limitations, ethical concerns, and the need for specialized expertise persist, particularly in developing regions. Future geospatial innovations should prioritize the responsible adoption of emerging technologies, inclusive capacity building, and environmental justice to foster equitable and efficient transportation systems. This review highlights GIS’s evolution from a supplementary tool to a cornerstone of data-driven, sustainable urban mobility planning, offering insights for researchers, practitioners, and policymakers to advance transportation strategies that align with equity and sustainability goals. Full article