Introduction. The increasing number of craniofacial and ocular injuries, especially those associated with combat and severe trauma, has made enucleation and subsequent cosmetic rehabilitation a significant problem in modern ophthalmology. Successful ocular prosthetics largely depend on the formation of a stable, mobile post-enucleation socket, which directly affects cosmetic appearance, functional outcomes, and psychological well-being. Despite the wide variety of orbital implants and surgical techniques available, achieving a long-term stable result remains a clinical challenge. Aim. To evaluate long-term functional outcomes of a post-enucleation functional stump created using an original surgical technique. Materials and methods. A clinical case of a patient who underwent enucleation of the right eye following severe ocular trauma was analyzed. A mobile supportive socket was formed using an original surgical technique involving a reduced-weight orbital implant made of preserved cartilage enclosed in donor dura mater. Extraocular muscles were sutured to the implant covering, followed by staged ocular prosthetics. Postoperative course, complications, prosthesis motility, and aesthetic outcomes were assessed during long-term follow-up. Results. Throughout the extended observation period, no complications requiring implant replacement or socket revision were observed. The conjunctival sac retained its shape and volume, eyelid position remained anatomically correct, and prosthesis motility was sufficient to ensure a satisfactory cosmetic appearance. Cosmetic, functional, and psychological effects of ocular prosthetics remained stable, contributing to the patient’s social adaptation and quality of life. Conclusions. The proposed method of forming a mobile supportive post-enucleation socket demonstrated favorable immediate and long-term outcomes. This technique ensures good biocompatibility, adequate prosthesis motility, and a lasting cosmetic effect, which is particularly relevant given the growing number of severe ocular injuries.

Objective: The objective of this research is to analyze the potential advantages of Indigo naturalis (IN) in periodontal wound healing via investigating its impact on human osteoblast (hOB) and human gingival fibroblast (hGF) cells.Methods: Doses of 5, 10, and 15 μg/mL IN extract were administered to hGF and hOB cells for 24 hours then viability of the cells was evaluated via MTT assay. The expression levels of axis inhibition protein 2 (AXIN2), bone morphogenetic protein 2 (BMP2) and type I collagen (COL1) were assessed in hOB cells using ELISA.Results: IN treatment did not demonstrate a significant difference on the viability of hOB and hGF cell lines (p> .05). IN extract showed antimicrobial and antifungal properties. The IN-treated hOB cells had significantly increased expressions of AXIN2, COL1 and BMP2 compared to the control group (p < .05, p < .05, and p < .05 respectively).Conclusion: IN may have positive impact on periodontal wound healing and bone repair as it increases the protein expression in hOB cells, possibly regulated via activation of the Wnt signaling pathway. However, further research is required to reveal the effects of IN under a range of varying concentrations and extended observation periods.

BackgroundChronic insomnia affects more than 30% of US adults, is more prevalent in women and older adults, and is strongly associated with poor mental and physical health outcomes. Poor sleep quality and intraindividual variability of sleep are recognized to be key characteristics of chronic insomnia, but longitudinal assessment of sleep is largely subjective, with no objective characterization of sleep patterns and intraindividual variability over extended periods. Objective, ecologically valid longitudinal sleep measurements are needed to help identify and manage insomnia in both clinical and population settings. Consumer sleep technologies offer a possible solution, but their clinical utility remains relatively unexplored.ObjectiveWe aimed to evaluate the utility of a contactless, radio frequency–based device by demonstrating its ability to objectively characterize sleep in individuals with insomnia over an extended observation period in a naturalistic home environment.MethodsEighty-three participants meeting criteria for chronic insomnia and 29 healthy good-sleeper controls underwent 8 consecutive weeks of home-based sleep monitoring using an objective, contactless, radio frequency–based sleep monitoring device. Sleep efficiency, sleep latency, intermittent wakefulness, time in bed, and total sleep time were objectively quantified as daily means and SDs.ResultsCompared to healthy controls, individuals with chronic insomnia exhibited reduced sleep efficiency, increased sleep latency, and increased intermittent wakefulness. They also demonstrated significantly higher night-to-night variability (SDs) in sleep efficiency, sleep latency, and intermittent wakefulness than good-sleeper controls (all P<.001).ConclusionsIn the longest known objective characterization of sleep among individuals with chronic insomnia, we show that a radio frequency–based, contactless sleep monitoring device deployed in the participants’ typical sleep environments accurately distinguished healthy good sleepers from those with insomnia. Importantly, we show that persistent night-to-night variability in objective sleep measures is a hallmark of chronic insomnia.

Long-term laboratory-based surveillance of TORCH seroprevalence: A nine-year analysis of 188,251 routine diagnostic tests.

Background Previous epistaxis studies report conflicting weather correlations, potentially reflecting year-to-year variation rather than geographic differences. Traditional combined analysis approaches may mask temporal correlation patterns, contributing to inconsistent research findings. Aims/Objectives To examine annual stability of weather-epistaxis correlations and establish methodology for multi-year studies accounting for temporal variation in environmental health relationships. Material and Methods Pilot study examining weather correlation stability using 2,201 epistaxis presentations from two UK hospitals (January 2023-December 2024). Weather parameters were analyzed separately for each year. Year-specific and combined analytical approaches were compared. Results Weather-epistaxis correlations demonstrated notable year-to-year differences, though none achieved statistical significance. Humidity showed complete directional reversal from positive correlation in 2023 (r= +0.1259) to negative in 2024 (r=−0.1058). Temperature correlations increased in magnitude from weak (r=−0.036) to stronger negative correlation (r=−0.379) and pressure correlations similarly increased (r=−0.080 to r=−0.399). Combined analysis masked this variation, showing weak non-significant correlations. Spring presentations increased 26% year-over-year suggesting potential allergic confounding. Conclusions Weather-epistaxis correlations show year-to-year differences that combined analyses may mask, despite lack of statistical significance. Future studies should consider extended observation periods spanning 5–10 years to distinguish relationships from temporal variation. Significance This study provides evidence that temporal variation may contribute to conflicting findings in epistaxis literature and establishes methodology for environmental health research.

This randomised clinical study assessed and compared the healing outcomes, both clinical and radiographic, of platelet-rich fibrin (PRF) and human amniotic membrane (HAM) scaffolds in regenerative endodontic therapy for necrotic mature permanent teeth with apical periodontitis. The study protocol was registered on the Clinical Trial Registry (CTRI/2023/12/060979). Thirty participants presenting with necrotic mature permanent teeth and apical lesions were assigned to either the PRF or HAM group (n=15 each) randomly. Follow-up evaluations were performed at baseline, 6 months, and 12 months, with clinical assessments and periapical radiographs conducted at all 3 time points, while cone-beam computed tomography (CBCT) imaging was obtained at baseline and at 12 months. Standardised regenerative endodontic procedures were performed by a single operator. Examiner calibration was completed prior to data collection to ensure consistency in measurements. At the 12-month follow-up, both groups demonstrated favourable clinical outcomes, with resolution of symptoms and radiographic evidence of periapical healing. The CBCT analysis revealed significant reductions in lesion volume for both PRF (65.26%) and HAM (64.75%) groups (P < .005), without a statistically significant difference between the groups. Periapical healing scores improved similarly in both groups. Sensibility tests revealed no return of pulp responsiveness in any case throughout the study period. Both PRF and HAM scaffolds supported periapical healing in necrotic mature permanent teeth. However, biological regeneration of the functional pulp-dentin complex could not be confirmed, indicating that periapical healing occurred without verified neurovascular re-establishment. The restricted sample size and limited follow-up duration suggest the need for further studies with larger populations and extended observation periods to substantiate these findings.

This study investigates the impact of environmental, social, and governance (ESG) performance on enterprise value in publicly listed companies in Indonesia. Using 69 firm-year observations with complete ESG scores from the Bloomberg Terminal from 2021 to 2023, panel data regression is employed for analysis, which incorporates Tobin's Q as the dependent variable, ESG scores as independent variables, and leverage, firm size, and return on equity as control variables. The results reveal that none of the ESG pillars environmental, social, or governance significantly affect enterprise value suggesting that ESG initiatives do not generate measurable financial benefits in the short run. These findings are consistent with time horizon theory, which suggests that ESG initiatives generate immediate costs while their value creation benefits materialize in the long run. The study presents empirical evidence that in the short-term context, ESG performance is not yet viewed as a value enhancing signal for investors in the Indonesian capital market, highlighting the need for further research over extended observation periods to capture long term sustainability impacts.

Background/Objectives: Wearable electrocardiogram (ECG) monitoring has become increasingly important in detecting atrial fibrillation (AF) and subclinical arrhythmias by addressing diagnostic gaps inherent to intermittent or asymptomatic presentations. In contemporary clinical practice, two major types of wearable ECG monitors—patch-type and lead-type—are widely used, each with distinct advantages and limitations. This study aims to compare these modalities and evaluate their respective strengths and constraints in real-world settings. Methods: We retrospectively analyzed 639 consecutive outpatients (mean age 61.7 ± 14.5 years; 56.7% male) who underwent wearable ECG monitoring between March 2022 and October 2023. Patients were stratified into patch-type (n = 466; 72.9%) and lead-type (n = 173; 27.1%) groups. Baseline characteristics were comparable. Indications, monitoring duration, arrhythmia detection, and noise rates were assessed. Results: Baseline characteristics did not differ significantly between the two groups. Lead-type monitoring was often prescribed for symptomatic patients (87.9% vs. 75.8%; p = 0.001), Symptomatic patients were older than asymptomatic patients (p = 0.040), whereas the proportion of males was higher in the asymptomatic group (p < 0.001). AF detection rates were comparable between the two groups (24.0% vs. 24.9%; p = 0.911). Patch-type monitoring achieved significantly longer recording duration (p < 0.001) and higher pause event detection (p = 0.004), but at the cost of increased noise burden (p < 0.001). Conclusions: Both patch-type and lead-type wearable ECGs are clinical applicable for arrhythmia surveillance in real-world practice. While AF detection rates were similar, the patch-type monitoring provided more extended observation periods and enhanced pause detection, though accompanied by a higher noise burden. These findings suggest that device selection should be individualized based on patient symptoms, monitoring goals, and tolerability. This study provides practical insights for optimizing wearable ECG use in routine practice.

Wearable technologies that analyse non-conventional biological matrices, such as interstitial fluid, sweat, tears or breath, have the potential to provide longitudinal biomarker data with minimal invasiveness. These data could provide insights into physiological and behavioural patterns, in particular outside medical care facilities. Despite the success of continuous glucose monitoring, the adoption of wearable sensors for managing endocrine and metabolic diseases remains limited. This Perspective highlights five key challenges and proposes solutions. First, understanding the physiology of longitudinal biomarker profiles is crucial for uncovering rhythmic patterns and physiological interrelations in the prediction of health trajectories. Second, technical barriers currently hinder the continuous monitoring of most clinically relevant biomarkers. Third, machine learning models often struggle with the complexity of dense biomarker datasets, which increases the risk of spurious correlations. Fourth, the diagnostic value of wearable sensor data requires validation through clinical studies, and predicting treatment outcomes necessitates diverse and large patient cohorts over extended observation periods in real-world settings. Finally, most wearable devices function as isolated solutions. Thus, they lack interoperability and integration into clinical pathways, and often fail to incorporate context and user input. Addressing these challenges will be key for advancing the role of wearable sensors in endocrine and metabolic care in future health-care settings.

We propose a novel gravitational wave detection mechanism based on the theoretical interaction between gravitational waves and crystal phonons in modified transition edge sensors (TES). This approach exploits the continuous gravitational wave emission from the Sun–Earth system to provide a predictable test source. The detection principle relies on gravitational wave-induced modulation of phonon populations in crystalline materials, particularly ionic crystals like NaCl, which could manifest as measurable shifts in the critical temperatures of superconducting detectors. We present detailed theoretical calculations for phonon–gravitational wave coupling mechanisms, including quadrupolar deformation, induced polarization effects, and parametric amplification. While the proposed interaction cross-sections are extraordinarily small, quantum coherent effects operating over extended observation periods might enable statistical detection of phonon population changes. This work represents highly speculative physics requiring unprecedented experimental sensitivity.

Fluorescent live-cell microscopy enables the study of cellular dynamics by imaging specific molecules, their interactions, and biochemical states in living samples. It is vital for biological research and drug screening. However, live-cell imaging must balance temporal resolution with cell viability due to photo-toxicity, often necessitating lower temporal resolution to extend observation periods. This reduction complicates the tracking of cells and detection of cell division events, limiting the study of dynamic cellular processes. We present an integrated methodology combining contrastive learning and graph-based techniques to improve cell division detection and tracking in video microscopy with low temporal resolution. Our approach uses contrastive learning models to generate robust cell representations that enhance both division detection and tracking accuracy. Specifically, we develop a weakly-supervised contrastive learning strategy leveraging time-based augmentations to build temporal cell representations. In addition, we propose a novel graph optimization method to identify cell tracks using these representations alongside observed division events. Evaluation on an in-house dataset and public benchmarks demonstrates significant performance gains across both native and reduced temporal resolutions. The proposed methodology improves adaptability to various temporal resolutions, enabling more precise and efficient analysis of live-cell microscopy data. This advancement supports extended observation periods necessary for drug screening and biological studies by preserving cell viability and normal homeostasis. Our approach facilitates deeper insights into cellular mechanisms and has the potential to enhance therapeutic research workflows.

Enterprise digital transformation initiatives consistently prioritize speed and scalability while inadvertently creating security vulnerabilities that propagate through automated delivery pipelines. Traditional DevOps practices accelerate software releases but frequently defer security validation until late deployment stages, generating costly remediation cycles and compliance risks, particularly acute in regulated sectors. This article addresses this fundamental disconnect by presenting a comprehensive framework that embeds DevSecOps principles directly within cloud-native modernization architectures. Through practical implementation across mission-critical healthcare applications migrating to containerized infrastructure, the article demonstrates how automated security scanning, policy enforcement, and continuous compliance monitoring can be orchestrated within declarative CI/CD workflows using GitOps methodologies and Kubernetes orchestration. The article integrates four architectural layers encompassing source control governance, continuous integration with embedded security testing, automated deployment with rollback capabilities, and runtime compliance monitoring. Field validation spanning multiple production systems over an extended observation period revealed substantial improvements in deployment velocity, vulnerability prevention, and operational reliability. Comparative analysis against conventional CI/CD implementations highlighted the framework's effectiveness in eliminating critical security defects while accelerating release cadence. Cultural factors emerged as critical success determinants, with cross-functional collaboration between security and development teams proving essential for sustained improvement. The article establishes that security-driven modernization transforms enterprise delivery from reactive compliance toward proactive assurance, offering regulated industries a reproducible blueprint for achieving secure agility in cloud-native environments.

Radiotherapy remains a critical pillar of cancer treatment worldwide. This study evaluates the in vitro efficacy of high-energy ionizing radiation, specifically 6 MV electrons and 12 MV X-rays, generated by a Varian Clinac iX linear accelerator (linac), on human HepG2 (liver) and AGS (gastric) cell lines. Cell samples (1 ml) were irradiated with doses ranging from 0.5 Gy to 4 Gy. Cell viability was assessed using the WST assay 4-5 hours post-irradiation. The measured survival rates were critically compared with those predicted using the established linear-quadratic (LQ) model. The results revealed significant and consistent discrepancies between the experimental measurements and the theoretical predictions for both cell lines. For HepG2 cells, the measured survival rate at 4 Gy was higher than the predicted rate. Interestingly, AGS cells irradiated with 12 MV X-rays exhibited minimal cytotoxicity, with a viability rate of 99.0% at 3 Gy versus a predicted rate of 73.6%. These findings suggest a discrepancy between theoretical predictions and the short-term biological responses observed under the shallow in vitro irradiation conditions employed in this study. While the present study was not designed to isolate the underlying mechanisms, the results imply that factors inherent to high-energy beam delivery in thin in vitro geometries, together with the early (four to five hour) post-irradiation assessment window, may have contributed to the limited cytotoxicity observed in both cell lines. Further studies employing extended observation periods or complementary assays would be valuable in clarifying the temporal progression of MV-beam-induced cellular effects. Keywords: Varian Clinac iX, high-energy radiation, HepG2, AGS, cell viability, WST assay, Monitor Unit (MU).

Hypertension, which affects more than 1.4 billion individuals globally, is a leading modifiable risk factor for cardiovascular morbidity and mortality. Vascular endothelial dysfunction and arterial stiffness are critical contributors to hypertension-related complications, yet effective adjunct therapies remain underexplored. Xinruikang, a patented kefir peptide product derived from fermented goat milk, has demonstrated antihypertensive and vascular protective properties in preclinical studies, although clinical evidence supporting its efficacy and safety in human populations is lacking. This study aimed to evaluate whether Xinruikang, as an adjunct to standard antihypertensive therapy, could improve blood pressure (BP) control and arterial elasticity in patients with mild-to-moderate hypertension. A 12-week, single-center, double-blind randomized controlled trial was conducted among 122 hypertensive patients (aged 40-75 yr) recruited from Shandong Province, China. Participants were randomized to receive either Xinruikang (2 g twice daily) or goat milk powder alongside their existing antihypertensive regimens. Primary outcomes included changes in systolic BP (SBP), diastolic BP (DBP), and pulse wave velocity (PWV), while secondary outcomes encompassed lipid profiles, liver/kidney function, and adverse events. Assessments were performed at baseline and wk 4, 8, and 12 using standardized protocols for BP measurement and arterial stiffness evaluation. Both groups exhibited significant reductions in SBP and DBP, yet Xinruikang demonstrated superior efficacy, achieving a mean SBP reduction of -22.91 mmHg compared with -12.36 mmHg in controls, and a DBP reduction of -12.91 mmHg versus -9.36 mmHg. Notably, Xinruikang significantly improved bilateral arterial stiffness, reducing left and right PWV by -140.55 cm/s and -178.33 cm/s, respectively. Safety profiles were comparable between groups, with no statistically significant differences in adverse events or biochemical markers. This study provides the first clinical evidence supporting Xinruikang's role as a safe and effective adjunct therapy for hypertension. However, limitations, such as the single-center design, short follow-up duration, and lack of mechanistic biomarkers, warrant further validation through larger multicenter trials with extended observation periods.

Abstract We investigated the shallow seismic velocity structure of San Miguel Volcano, El Salvador, using seismic ambient noise data recorded by a temporary broadband seismic network. Phase velocities were estimated using the spatial autocorrelation (SPAC) method, and group velocities were obtained through ambient noise interferometry. Although the array geometry was irregular, the extended observation period allowed reliable velocity estimation across a broad frequency range (0.2–3.0 Hz). A joint inversion of phase and group velocity dispersion curves yielded a one-dimensional shear-wave velocity (Vs) model, comprising four layers overlying a high-velocity half-space to a depth of approximately 3 km. To evaluate the applicability of the velocity model, we relocated volcano-tectonic earthquakes using P-wave arrival times. The resulting hypocenters showed tighter clustering along the San Miguel Fracture Zone than those estimated using a conventional regional model. These results highlight the influence of shallow structure on earthquake location and demonstrate the importance of site-specific velocity models in volcanic regions. This study presents the first Vs model for San Miguel Volcano and provides a geophysical basis for future high-resolution tomography and volcanic hazard assessment. Graphical Abstract

The aim of the study was to examine whether a multimodal cognitive training program conducted over six months among the female students of the Jagiellonian University of the Third Age would be associated with changes in life satisfaction and attentional functioning; and whether the observed differences in both variables would be correlated. The study had a quasi-experimental design, involving only one group subjected to the intervention. The group consisted of 16 participants aged 67 to 87 years (M = 70.4; SD = 4.2). The Satisfaction With Life Scale (SWLS) and the Attention and Perception Test (TUS) were used to test the hypotheses. The results showed that pre- and post-intervention differences in the study group were not statistically significant – no significant changes were observed in either life satisfaction or attention. Moreover, Pearson’s correlation analysis did not reveal any association between changes in the two variables. Despite the lack of expected effects, the findings provide valuable insights into the limitations of cognitive interventions in the older adult population and highlight the need for further studies using larger samples and extended observation periods.

Understanding user sentiment is essential for strengthening platform competitiveness in Southeast Asia's rapidly evolving e-commerce landscape. This study presents a comparative sentiment analysis of Indonesia's two leading e-commerce platforms, Shopee and Tokopedia, based on 6,336 tweets collected from Twitter (X) between 10 and 17 January 2024. A lexicon-based sentiment analysis, complemented by keyword analysis, was employed to classify user sentiments using a five-star scale, thereby capturing nuanced emotional expressions. The results indicate that 47% of Shopee-related tweets conveyed positive sentiment, whereas only 15.6% of Tokopedia-related tweets were positive. In contrast, Tokopedia demonstrated a significantly higher proportion of negative sentiment at 64.3%, indicating notable user dissatisfaction. Keyword analysis revealed that Shopee users focused on affordability, promotions, and product discovery, while Tokopedia discussions emphasized transactional reliability, peer-to-peer selling, and financial services. These findings suggest that Shopee should continue leveraging promotional strategies while addressing technical reliability to maintain user trust and loyalty. Meanwhile, Tokopedia must enhance logistical performance, strengthen seller accountability, and improve financial services governance to rebuild user confidence. This study contributes to the e-commerce and social media analytics literature by integrating sentiment intensity and thematic keyword analysis, offering actionable recommendations for enhancing user engagement in Indonesia's competitive digital marketplace. Future research should consider more extended observation periods and cross-platform analyses to capture evolving sentiment trends and inform strategic decision-making.

Introduction O-GlcNAcylation (O-GlcNAc) is a dynamic post-translational modification involved in numerous cellular processes, including the response to cell stress and survival. It is regulated by a unique enzyme pair: O-GlcNAc transferase, which adds the GlcNAc moiety, and O-GlcNAcase (OGA), which removes it. Pharmacological inhibition of OGA with agents such as NButGT increases intracellular O-GlcNAc levels. Previous results from our laboratory demonstrated its benefit in rats subjected to haemorrhagic shock. 1 This study aimed to assess whether NButGT administration influences haemodynamic parameters during the early phase of haemorrhagic shock in a large mammalian model. Materials and Methods Twenty female Large White pigs (mean age: 4 months) were subjected to a traumatic haemorrhagic shock protocol, comprising bilateral femoral fractures, large muscular contusions and passive exsanguination of 60% of the estimated total blood volume (ETBV) via a jugular catheter. Animals were randomised to receive intramuscular NButGT (10 mg/kg; n = 9) or placebo (n = 8) immediately after exsanguination and again at 90 minutes following the defined time point of 40% ETBV drainage (T0). A control whole blood group (n = 3) underwent retransfusion at T120 min. Continuous haemodynamic monitoring was performed using the PiCCO system. Blood samples were collected at defined intervals, and tissue samples were obtained post-mortem. All procedures concluded with euthanasia six hours after T0. Results NButGT administration led to an increase in O-GlcNAcylation levels in cardiac tissue compared to placebo. No statistically significant difference in overall premature mortality was observed between groups (3 animals for NButGT and placebo groups); however, among the three premature deaths in each group, the mean time to death was 2 h 20 min in control animals and 3 h 00 min in NButGT-treated animals (non-significant difference). Cardiac output was significantly higher in the NButGT group at T90 min (p&lt;0.05), and remained elevated at T120 min, although this did not reach statistical significance (figure 1). Arterial and venous lactate concentrations did not differ significantly between groups. Discussion The observed increase in cardiac O-GlcNAc levels following NButGT administration, together with the associated rise in cardiac output, suggests a beneficial effect of NButGT on cardiac function during the acute phase of haemorrhagic shock. The absence of a significant effect on lactate levels supports the hypothesis that enhanced vascular distribution improves tissue perfusion, thereby increasing the proportion of adequately vascularised tissue and facilitating more efficient lactate clearance from these regions into the venous circulation. Although survival was not a primary endpoint, the longer time to death observed among the three premature fatalities in the treated group may indicate a potential survival benefit, which warrants further investigation. Conclusion This study demonstrates that pharmacological enhancement of O-GlcNAcylation via NButGT improves cardiac output in a porcine model of the acute phase of traumatic haemorrhagic shock. The potential impact on short-term survival now merits further exploration. These findings, reported here for the first time in a large mammal, support continued investigation into inhibition of OGA as a potential adjunct therapy. Future studies should include extended observation periods and the assessment of tissue perfusion markers to better elucidate the therapeutic potential and underlying mechanisms. Inhibition of OGA is not intended to serve as a stand-alone treatment for haemorrhagic shock; however, it may represent a promising adjuvant strategy, capable of prolonging the survival window and allowing patients to reach definitive care in a medical facility. Abstract P04 Figure 1 Mean of cardiac output at each time (Picco monitoring). Error intervals: standard error. * : p-value &lt; 0,05 of unpaired unilateral Student’s t-test between NButGT and Placebo (alternative hypothesis NButGT &gt; Placebo). n =20 Reference Vergnaud A, Dupas T, Aillerie V, et al . Sodium potassium pump: a novel O-GlcNAc protein beneficial in hemorrhagic shock situation. Arch Cardiovasc Dis . 2024; 117 :S55. https://doi.org/10.1016/j.acvd.2023.10.100. Disclosure with Conflicts of Interest The authors have no conflicts of interest to declare. approval by sponsoring authority: French armed forces

This systematic review and meta-analysis evaluates the effectiveness of AI-driven tools, particularly conversational agents (CAs), in alleviating psychological distress and improving mental health outcomes. The focus is on their impact across diverse populations, including clinical, subclinical, and older adults. A comprehensive search was conducted in PubMed, Google Scholar, Elsevier, and Scopus using specific MeSH terms and keywords such as “Artificial Intelligence,” “Machine Learning,” “Natural Language Processing,” “Depression,” and “Anxiety.” The timeframe included studies published between January 2000 and July 2024. Inclusion criteria comprised peer-reviewed original research articles, cohort studies, and case reports focusing on AI tools for mental health. Systematic reviews, secondary sources, and non-English publications were excluded. Random-effects meta-analysis was conducted using standardized mean differences, with effect sizes synthesized in forest plots. Twenty studies were included in the qualitative synthesis and six in the quantitative meta-analysis. The analysis demonstrated that AI-based CAs significantly reduce anxiety (Cohen’s d = 0.62, p < 0.01) and depression (Cohen’s d = 0.74, p < 0.001), with higher effectiveness observed in multimodal CAs compared to text-only systems. However, the long-term impact remains inconsistent due to variability in follow-up durations and methodological heterogeneity. Some studies lacked extended observation periods or reported diminished effects over time, highlighting a need for sustained intervention research. AI-based CAs, especially when integrated into mobile platforms and using multimodal interfaces, provide scalable and engaging support for mental health. While short-term benefits are evident, future studies should address long-term efficacy, methodological consistency, and ethical concerns like privacy and algorithmic bias to strengthen the utility and trust in AI interventions for mental health.

ChatGPT as a decision-support tool for better self-monitoring of hearing.