Medicinal plants are an important source of bioactive compounds with a wide spectrum of practically useful properties. Various types of antioxidants synthesized in plants are the reasons for their application in medicine, phytotherapy, and aromatherapy. Therefore, reliable, simple, cost-effective, eco-friendly, and rapid methods for the evaluation of antioxidant properties of medicinal plants and products on their basis are required. Electrochemical methods based on electron transfer reactions are promising tools to solve this problem. Total antioxidant parameters and individual antioxidant quantification can be achieved using suitable electrochemical techniques. The analytical capabilities of constant-current coulometry, potentiometry, various types of voltammetry, and chrono methods in the evaluation of total antioxidant parameters of medicinal plants and plant-derived products are presented. The advantages and limitations of methods in comparison to each other and traditional spectroscopic methods are discussed. The possibility to use electrochemical detection of the antioxidants via reactions with oxidants or radicals (N- and O-centered) in solution, with stable radicals immobilized on the electrode surface, via oxidation of antioxidants on a suitable electrode, allows the study of various mechanisms of antioxidant actions occurring in living systems. Attention is also paid to the individual or simultaneous electrochemical determination of antioxidants in medicinal plants using chemically modified electrodes. Medicinal plants have been used in the treatment of various human diseases since ancient times. Their therapeutic effect is caused by the presence of a wide range of bioactive constituents with antibacterial, anti-inflammatory, antioxidant, anticarcinogenic, and antiviral properties ,2. NowadAntioxidants contained in medicinal plants are among the most actively studied constituents. The interest is caused by a diversity of antioxidants and a wide spectrum of biological activity including anti-inflammatory, anti-aging, anti-atherosclerosis, anticancer, etc. ,7. AntioPhenolic antioxidants and terpenes as well as ascorbic acid and tocopherols are the major antioxidants of medicinal plants. The group of phenolic antioxidants  is the most representative and contains more than 10,000 compounds to date . Terpene•) radical  concentration (M), cRed is K4[Fe(CN)6] concentration (M), E1 and E2 are potential measured before and after the addition of a test sample, respectively (V), and q is a dilution factor .TAC reflects the effective equivalent concentration of antioxidants interacted with ferricyanide ions and recalculated per 1 L of the sample (Equations (1) and (2)).Natural phenolics, ascorbic acid, and α-tocopherol undergo reactions with ferricyanide ions under experimental conditions ,90. The Other electrochemical approaches are based on the application of stable radicals as reactive species which can be added to the electrochemical cell or immobilized on the electrode surface or formed electrochemically by in situ technology.• is the most widely used stable radical for the characterization of antioxidant properties. It can also be applied under conditions of electrochemistry. DPPH• reduction currents are usually measured before and after the reaction with the sample antioxidants and the difference is used to calculate the TAC. Various electrochemical techniques can be applied.DPPH•-based TAC of Thai plant extracts 3+ adsorbed on the DNA layer [3)6]3+ in solution 3+ [3)6]3+ used as a redox probe for the gold electrode surface with self-assembled monolayers of hexanethiol are significantly increased after the reaction with hydroxyl radicals  Stapf, Psidium guajava L., Achyrocline satureoides (Lam.) DC., Matricaria chamomilla L., and Baccharis genistelloides Pers. from the Rio Grande do Sul state (Brazil) ) and antioxidants (AO) according to The determination is based on the electron transfer reaction between copper(II)-neocuproine complex (. . 117]. Tame peak . Accordi• confirm the accuracy of the data obtained by DPV and SWV and their applicability to the medicinal plants’ analysis.Taking into account the complex matrix of plant samples, the area under the voltammetric curves is a more suitable and reliable parameter than the peak current due to the integral nature of the voltammetric signal caused by several antioxidants with slightly different oxidation potentials. Natural phenolic antioxidants are the main contributors to the antioxidant properties of medicinal plant extracts. Therefore, voltammetric data provide an opportunity to measure total phenolic contents. However, the minor impact of other antioxidants such as ascorbic acid or tocopherols can not be fully excluded. Therefore, TAC or its variations are a more appropriate term. Positive correlations with the standard spectrophotometric assays of total phenolics and TAC towards DPPHRosmarinus officinalis L., Salvia officinalis L., Thymus vulgaris L., Origanum vulgaris L., Ocinum basilicum L., Mentha piperita, and Laurus nobilis L. have been studied. Antioxidant activity has been expressed in a Trolox equivalent that simplifies the comparison of the data obtained with those reported earlier. Another advantage is the rapidity of the analysis (60 determination h−1) making the method attractive for routine screening purposes.Amperometric detection of antioxidant oxidation in combination with flow-injection analysis is another approach to the evaluation of medicinal plants’ antioxidant properties . PrelimiChrono methods (chronoamperometry and chronocoulometry) did not receive enough attention in the investigation of medicinal plants and products on their basis, although it is simpler and easier in use and data interpretation compared to voltammetry. The preliminary voltammetric behavior of the plant sample is studied in order to make a choice of the potential at which the electrolysis is to be performed. One- and multi-step electrolysis allows the differentiation of various classes of antioxidants on the basis of their oxidation potentials.Valeriana officinalis L. and Schisandra chinensis (Turcz.) Baill.) also show peaks at 0.75–1.2 V  as well as a less tedious procedure compared to spectrophotometric methods and does not require additional reagents.A similar approach has been tested on commercial essential oils from 15 types of plants . EssentiAs was mentioned above, electrochemical methods are a good alternative to traditional methods such as chromatography and spectrophotometry in the evaluation of plants’ antioxidant parameters. Nevertheless, they also have advantages and disadvantages  to be ta4NClO4 in acetonitrile [Knowledge of the major class of antioxidants in medicinal plants allows electrochemical determination of total content. Such an approach is well-developed for application to food analysis. In the case of medicinal plants, limited data have been reported. A simple, rapid, and cheap method has been developed to determine total phenolic monoterpenes in particular isopropylmethylphenols (thymol and carvacrol) in essential oils of thyme and oregano using linear sweep voltammetry on GCE in 0.1 M Buonitrile . Being iCapsicum annuum L. tinctures using GCE modified with MWCNTs and electropolymerized gallic acid [2 nanoparticles [Capsicum annuum L. There are well-defined anodic peaks at 0.60–0.63 V in Britton–Robinson buffer pH 2.0 on both electrodes. Two electron oxidation occurs with the formation of the o-quinone moiety in the structure of capsaicinoids [2 nanoparticles [Another typical example is the determination of total capsaicinoids in lic acid , or GCE articles . Electroarticles  or cetylarticles . Furthericinoids ,131. Capicinoids . The linarticles  and spec3 which forms stable complexes with flavonoids such as quercetin and rutin. Complexation leads to changes in the flavonoids’ voltammetric behavior and the disappearance of their interference effect due to the anodic shift of the oxidation potentials. The simple addition of AlCl3 to the supporting electrolyte allows the elimination of the interference effect of other flavonoids. The practical applicability of the method has been shown in herbal medicines.An original approach to selective detection and determination of catechins (flavan-3-ols) in the presence of other flavonoids has been developed using DPV on GCE . VoltammThus, electrochemical methods can be used successfully for the estimation of total antioxidant parameters. In some cases, the first steps in phytochemical profiling based on the fingerprints approach can be achieved using DPV or SWV including solid-state electrochemistry based on the voltammetry of immobilized microparticles of plants or their extracts ,134,135.The creation of highly sensitive electrodes to the target antioxidant, which is a major and typical component of the medicinal plant. The determination should be performed by voltammetry after a significant dilution of the sample. In this case, other antioxidants will not give a sufficient response due to the low concentration, and the signal of the target antioxidant will be enough for quantification;Fabrication of highly selective electrodes allowing simultaneous determination of structurally related antioxidants.Determination of major individual antioxidants or several of them is another approach for the characterization of medicinal plants’ antioxidant properties. In this case, the major antioxidant content in the sample is considered as reflecting the antioxidant potential of the entire sample. Furthermore, this information is useful for the isolation of antioxidants that are further used in the production of pharmaceutical dosage forms and phytopharmaceuticals. A simultaneous determination of structurally related antioxidants is also required. Therefore, the selectivity of the target antioxidant response plays a crucial role since compounds of similar structure are usually presented in the sample. This problem has a great impact in relation to electrochemical methods and is one of the main limitations of their practical application in plant analysis. There are two strategies to solve this problem:irreversible adsorption of modifier on the electrode surface;chemical binding of modifier via various groups  with covalent bond formation;inclusion in the polymer film;addition in the volume of the carbon paste or composite material mechanically or using screen printing technology;formation of modifier layer using the sol-gel technology;drop casting or electrochemical formation of polymer or cavity-containing material capable to work on the guest–host principles .The combination of these two trends is desirable and has been realized through the development of chemically modified electrodes. The choice of a sufficient modifier can provide excellent sensitivity and selectivity of the target antioxidant determination. Electrode surface modification can be performed by the following methods :irreversVarious types of modifiers, in particular carbon nanomaterials, nanoparticles, and nanostructures of metal, metal oxide, sulfides, complexes and other compounds, metal-organic frameworks, ionic liquids, surfactants, and polymeric materials, have been shown to be effective electrode surface modifiers for antioxidants electroanalysis ,141,142.Flavonoids and phenolic acids are the most studied analytes, although ascorbic acid and eugenol are also of interest ,185,186.Various types of voltammetry have been used for quantification purposes. Most approaches are based on the application of pulse modes (DPV and SWV) due to the higher sensitivity compared to the linear sweep mode. Furthermore, adsorptive preconcentration at the open circuit potential ,178,179 Electrode fouling often occurs due to the complex composition of the plant sample that requires renewal of the electrode surface after each measurement ,173,185.2, ZrO2, Ta2O5, La2O3, etc.) provide a high surface area of the electrode and conductivity. Electropolymerized coverages of triphenylmethane dyes and gallic acid act as selective components giving a response to phenolic antioxidants due to the structural similarity [As one can see, the combination of several modifiers provides better analytical characteristics of antioxidants due to the synergetic effect of several modifiers. For example, carbon nanomaterials and electrochemically inert metal oxide nanoparticles . Furthermore, chemical synthesis is usually multi-stepped  and requires the application of many reagents (some of them are toxic) and special equipment a. From tAs one can see from Origanum vulgare, Origanum x applii, Thymus vulgaris)  . Two oxi vulgare A. One ofx applii B during vulgaris C, the cuTherefore, considering the results of Individual voltammetric quantification of isopropylmethylphenols (thymol and carvacrol) can be realized using chemometric treatment of electrochemical data. Successful selective determination of carvacrol in oregano essential oil has been achieved by a novel method using voltammetric second-order modeling based on multivariate curve resolution-alternating least-square . Second-• sensitive to light and water contents in solution. Furthermore, the modern trend in miniaturization of electrochemical equipment and the appearance of portable electrochemical analyzers operated by smartphones allow their application outside the laboratories that are useful for the operative control of plant material in place of their growth or storage.Electrochemical methods are a promising tool for the characterization of antioxidant properties of medicinal plants and products of their basis. The simplicity of equipment, rapidity of analytical procedures, low reagent consumption, reliable data, and good metrological and operation characteristics are important advantages over traditional methods such as spectroscopy and chromatography. Electrochemical methods have no limitations in the analysis of a colored sample that is typical for medicinal plants and their extracts. The use of oxidants as reagents or own oxidation of antioxidants at the electrode surface excludes the application of radical species such as DPPHCurrent developments in electroanalysis allow the measurement of total antioxidant parameters characterizing medicinal plant-based samples as a whole, taking into account possible synergetic and antagonistic effects. This is useful for the characterization and prediction of the biological activity of the samples. Voltammetric determination of specific classes of antioxidants  can be used for the characterization of medicinal plants depending on the stage, place, and conditions of growth, chemotype elucidation, as well as for the choice of most perspective plants for the isolation of these antioxidants and following the production of pharmaceutical on their basis. Selective electrochemical determination of individual antioxidants is a more complex task and can be solved by the application of chemically modified electrodes.Voltammetry is the most used electrochemical method due to the possibility to measure both the total and individual contents of antioxidants in medicinal plants. The possibility of electrode surface modification opens wide opportunities for the sensitivity and selectivity control of the antioxidant response in a complex matrix. On the other hand, constant-current coulometry and potentiometry are preferable for the total antioxidant parameters evaluation due to the wide range of antioxidants to be measured, simplicity of the protocols, high reproducibility of the data obtained, and rapidity in comparison to methods based on the electrooxidation of antioxidants on the electrode surface. Moreover, coulometry and potentiometry can be used for routine practice by specialists in pharmacognosy, pharmacy, biology, biochemistry, etc., as far as these methods do not require high skills in electrochemistry.To date, extracts with toxic solvents have often been studied to characterize the antioxidant constituents of the medicinal plant. Investigation of the medicinal plants’ dosage forms such as infusions, decoctions, tinctures, and essential oils has to be enlarged. Essential oils are almost out of the investigation, although of high interest;Unification of standard antioxidants used to express the total antioxidant parameters.Development of electrochemical methods for the determination of tocopherols and terpenes in medicinal plants and products on their basis. Total contents of tocopherols and tocotrienols or terpenes and their individual quantification are required;Enlargement of individual antioxidants studied. A limited range of natural phenolics are considered to date, whereas many other important for medicinal plants antioxidants and even classes of antioxidants are out of investigation;Application of flow systems including microfluidic chips that can significantly improve the operating characteristics of the systems and decrease electrode fouling and interference effects of co-existing components;Attention should be paid to the methods of electrochemical generation of reactive oxygen species and detection of their reaction to antioxidants;Creation of novel highly selective electrodes for the simultaneous determination of the antioxidants of the same class or group including isomers for the phytochemical profiling of the plant samples. Novel functional materials acting as electrode surface modifiers are required and can be predicted using molecular modeling and quantum chemical calculations with the following controlled synthesis.Further developments in the electrochemical evaluation of medicinal plants can be focused on the following aspects:In general, electrochemical methods are a good alternative to spectroscopy and chromatography. They have an excellent perspective in the characterization of the antioxidant properties of medicinal plants and products on their basis. The practical application of electrochemical protocols has to be expanded.


The stories of historic female scientists are inspiring. They show a deeply rooted passion for advancing our understanding of the natural world but also tenacity and perseverance in a male-dominated environment. The determination of these women to pursue their calling in the face of repudiation and hindering gender norms paved the way for modern-day female researchers.While barriers for women to enter research professions are lower now than they were in the past, retention and advancement of female researchers are still comparatively low. Accordingly, female leadership in science is a relatively recent phenomenon. Inclusive and supportive research ecosystems have thrived from the representation of women in advanced and leadership positions.We are pleased to present the inaugural Frontiers in Molecular Biosciences “Women in Glycoscience” Research Topic of articles. The series seeks to spotlight the work of female thought leaders who are shaping the field of glycoscience as well as that of female researchers in early stages of their careers. We proudly present this article Research Topic to inspire the next-generation of female scientists from diverse and deterrent backgrounds.per se is pervasive, leaving strong footprints on developments in diverse fields, such as disease mechanisms, biotherapeutics, material science, biomechanics, and sustainability. Working with sugars poses unique challenges for conventional probing, synthesis, and structure analysis techniques, yet leading female scientists continue to overcome persistent challenges with innovative approaches. The work of recent Nobel laureate Carolyn Bertozzi on imaging of cellular glycosylation, which ushered in a new field of bio-orthogonal click chemistry .The work by Nilsson et al. conducted a design of experiment (DoE) study of cellulose nanocrystal (CNC) films containing multiple plasticizers and developed empirical models to predict the mechanical and optical characteristics of the films. The developed modeling framework paves the way for commercial CNC film applications by enabling the prediction of film compositions that yield desired film properties.Szymanski reviews the field of microbial glycobiology using the foodborne pathogen Campylobacter jejuni as the model organism.Bacteria can synthesize a variety of glycan structures that cannot be found in eukaryotes. GC et al. summarize the oncogenic signaling pathways and targets affected by ST6Gal1.Aberrant protein glycosylation has been linked to various disease states. For example, the upregulation of the Golgi-sialyltransferase ST6Gal1  has been observed in many malignancies, and its activity impacts cancer hallmarks.


This study aimed to investigate the performance of zinc-coated brass wire in wire-cut electrical discharge machining (EDM) using an ultrasonic-assisted wire on tungsten carbide. The research focused on the effect of the wire electrode material on the material removal rate, surface roughness, and discharge waveform. Experimental results demonstrated that using ultrasonic vibration improved the material removal rate and reduced surface roughness compared to conventional wire-EDM. Cross-sectional SEM of the white layer and discharge waveform were investigated to explain the phenomena of ultrasonic vibration in the wire-cut EDM process. Wire Electrical Discharge Machining (WEDM) is a widely used process in the manufacturing industry for producing high-precision components in a variety of materials . One of The wire-cut EDM machine used for the study is the Mitsubishi Wire-Cut System model FA-Advance series. The experimental procedure began with the preparation of the workpiece and the setup of the WEDM machine with a zinc-coated brass wire and ultrasonic vibration. To better comprehend the relationship between the amplitude of ultrasonic vibration and WEDM performance, it is essential to measure the amplitude during the machining process. This comparison yields valuable insights into the performance differences between these two methods. When using the Wire-EDM machine, MRR is calculated by using the following equation:The scanning electron microscope (SEM) image of the surface integrity of USV-WEDM is investigated to show differences compared to that of traditional WEDM. Tungsten carbide is a highly sought-after material for its hardness and durability, but it is also known to be brittle, making it difficult to cut using traditional machining methods such as wire-cut electrical discharge machining (WEDM). The use of ultrasonic vibration in the WEDM process can cause the material to crack or break under the white layer due to several reasons. Firstly, high-frequency ultrasonic vibration generates surface stress on the tungsten carbide workpiece, which can lead to cracking or breakage. Secondly, the combination of ultrasonic vibration and electrical discharge in the WEDM process can generate high temperatures and rapid cooling cycles, leading to thermal shock on the surface of the tungsten carbide workpiece. Thirdly, tungsten carbide’s material properties, such as high hardness and low ductility, make it susceptible to breakage under high stress and high temperature conditions . FinallyThe surface integrity of wire surfaces was examined using a Scanning Electron Microscope (SEM). The surface appears granular with uneven dispersion of spheroid features for normal WEDM; and short discharges are evident in area A, potentially due to insufficient flow of dielectric fluid causing inhomogeneous temperature distribution ,18. On tTo understand the benefits of USV-EDM, it is important to perform a waveform analysis of the process. This involves measuring and comparing the electrical waveforms generated by USV-EDM and traditional EDM wire cutting processes. By assessing the waveform characteristics, critical information can be obtained regarding the performance of the process and potential areas for improvement. The application of ultrasonic vibrations to wire-cut electrical discharge machining (WEDM) has been demonstrated to have a significant impact on the material removal rate (MRR) and surface roughness (SR) of the workpiece. The use of ultrasonic vibration showed improved stability and increased MRR compared to a traditional WEDM. It was also noted that when the wire was vibrated, an effective discharge could be obtained more easily. The use of ultrasonic vibrations in WEDM has been shown to have a positive impact on machining performance, offering improved stability and better surface finish.The limitation of our study is that only under specific experimental conditions was a limited range of ultrasonic vibration parameters considered. While the experiment settings led to improved machining performance and surface finish, there may be other combinations of parameters that could lead to even better results. Lastly, future studies could also focus on the development of advanced control systems for USV-EDM, which could improve the precision and repeatability of the machining process. This could involve the integration of advanced sensors and control algorithms to enable real-time monitoring and adjustment of the machining parameters.


Nonspecific back pain (NSBP) contributes greatly to the overall burden of disease from musculoskeletal conditions. Digital therapeutics (DTx) aims to address the excess demand for movement and exercise therapy resulting from this spectrum of conditions. This study aims to investigate the differential therapeutic response of NSBP to different use profiles of a digital home exercise program. Methods: This study used a PSM model to comparatively assess the achievement of a clinically relevant pain improvement among patients who exhibit a high use (HU), intermediate use (IU), low use (LU), or sub-LU use profile. Sensitivity analyses with commonly accepted thresholds for clinically relevant improvements were conducted. Results: Higher use profiles show a higher probability of achieving a clinically relevant improvement of self-reported pain intensities. Additionally, the achievement of any higher use level is associated with a significant increase in the probability of achieving a clinically relevant improvement. Conclusion: To enable the optimal effectiveness of DTx home exercise programs, an HU use profile should be pursued. This finding is in line with earlier guidance for the achievement of optimal therapeutic benefit from conventional movement and exercise therapy and underscores the importance of a cross-disciplinary effort from patients, healthcare professionals and system stakeholders alike to maximize the therapeutic effect from DTx. Nonspecific musculoskeletal pain of the back is one of the leading drivers for burden of disease worldwide ,2. BeyonBeyond general therapeutic principles such as motivating patients to maintain an active lifestyle and providing condition-specific educational measures, the strongest therapeutic recommendation for the non-pharmacological management of nonspecific back pain consists of movement and exercise therapy, as outlined in international treatment guidelines ,4. MovemAs conventional movement and exercise therapy is typically administered by a qualified therapist , patientAdvances in the field of digital therapeutics (DTx) have opened up the opportunity to fill these capacity shortages with effective therapeutics that can be used independent of time and space and could therefore contribute to meeting the overall demand for care in the spectrum of conditions discussed above .Yet, as with all long-term therapies, therapeutic adherence  has a significant effect on the clinical effectiveness of any DTx . While tThe data included in this study were collected during the preliminary market approval phase of the DTx ViViRA as a DiGA in the German healthcare system between 20 October 2020 and 17 February 2022. As a DiGA, ViViRA is a medical device classified as risk class I under the Medical Device Directive (MDD) and is available to the entire patient population of the statutory health insurance (SHI) system upon prescription by a qualified healthcare professional. Once the DiGA is activated, it provides a guided home exercise program that undergoes a stepwise personalization for each patient to account for progress, symptom development and potential movement limitations. A prescription is valid for 90 days and grants daily access to the full spectrum of functions of the DiGA, which extends beyond the therapeutic elements  by providing educational content to improve the digital and health literacy of patients, as well as habit-building elements  to promote a physically active lifestyle. The recommended therapy consists of at least three routines per week with one routine consisting of four consecutive movement exercises. Patients are encouraged to complete all exercises of one routine in one session. All exercises and accompanying educational material are presented with text, video and audio guidance to enable unsupervised training. After the completion of every exercise, patients provide binary feedback on movement limitations and pain sensations, which drives the personalization of the exercise program. The progression algorithm maintains a sufficiently high training stimulus by increasing the intensity of the exercise  first, before the complexity of the exercise increases . Additionally, patients are prompted to report their current pain intensity on a verbal–numerical rating scale (VNRS) on a weekly basis, while the functional status  is assessed each month. The VNRS employed is an 11-point scale that extends from 0 to 10 in five categories  and is based on previous research for the assessment of non-malignant pain ,14. The Under the provision of article 4 of the DiGA regulation (DiGAV), the acquisition of performance and outcome data is allowed during the preliminary market approval phase once informed consent by the respective patient has been given. The regulation specifies that this consent can be obtained digitally. Patients received a prescription for ViViRA—and access to the digital movement and exercise therapy—at the sole discretion of a qualified healthcare professional once the respective patient was diagnosed with a nonspecific or degenerative back pain from the spectrum of medical conditions ViViRA has obtained market approval for . The manufacturer and the authors of this study, therefore, did not have any influence on the enrollment of patients. Hence, this analysis is based on real-world-use data. Ethics approval was obtained from the ethics committee of the University Medical Center, Freiburg on 5 April 2022 under the reference 22-1104-retro. The study was registered in the Deutsches Register Klinischer Studien (DRKS), a WHO-affiliated study registry, on 21 July 2022 under the reference DRKS00028920.Inclusion criteria were an age of ≥18 years, completion of at least one exercise and submission of any pain intensity of >0/10 on the VNRS at baseline and least one pain intensity after the baseline assessment. Access to the DiGA was provided only after (a) a prescription was issued by a qualified healthcare professional with consecutive approval by the respective SHI, or (b) after a patient approached their SHI independently and received approval on the basis of a prior confirmation of the diagnosis addressed.Use of the exercise program was stratified as either a high use , an intermediate use , or a low use  profile. Baseline demographics were compared between the use profiles . The outTo account for potential confounding through patient characteristics in the observational data, we employed a propensity score (PS) matching approach, which has been described elsewhere . In brien = 5 between exposed and unexposed in each stratum. Sampling with replacement was used. Primary results were adjusted for multiple testing using the Bonferroni method. All calculations were performed in Stata 17.We estimated a PS using a logistic model based on the baseline covariates of gender, concomitant physical therapy and/or pain medication at baseline, and the chronicity of the pain at baseline . As the The reporting in this article follows the adjustment of the STROBE guidelines for PS-based analyses proposed by Yao et al. , a reporIn total, 7628 patients who enrolled in the home exercise program for back pain between 20 October 2020 and 17 February 2022, completed at least one exercise and reported at least one pain score were included in this retrospective study. Owing to the automated data collection upon consent and activation of the DiGA, all potentially eligible patients could be included and analyzed. Overall, we see an overrepresentation of female patients in the sample . While tPrior to PS-matching, the probability of achieving a clinically relevant improvement in their pain intensity at the individual time of termination of use among patients with an HU profile is 39.2% . IU, LU Patients with HU consecutively have a 9% (95%-CI 6.7–11.5%) higher probability of achieving a clinically relevant reduction in their pain intensity in comparison to all other use profiles  . SimilarSensitivity analyses were conducted with other commonly accepted thresholds for clinically relevant benefits. Both sensitivity analyses supported the results above and showed a significantly higher probability of achieving the respective clinically relevant improvement once patients adhered to IU or HU use profiles. Similar to the primary analysis, no significantly higher probability of a clinically significant benefit could be detected when comparing the LU use intensity and the sporadic  use profile. Tabulated results of the sensitivity analyses can be found in The main result of this analysis supports the primary hypothesis that the achievement of a clinically relevant improvement in pain intensity is dependent upon the maintenance of sufficient therapeutic adherence . SpecifiFor conventional movement and exercise therapy, an association between a sufficiently high therapeutic intensity  and the therapeutic benefit has been well established ,22. As bLong-standing guidance from the World Health Organization (WHO) underscores that therapeutic adherence is “a primary determinant of the effectiveness of treatment, because poor adherence attenuates optimum clinical benefit” . This isBeyond these, however, the thorough exploration and consequent implementation of health system-related , socioeconomic , patient-related  and condition-related factors  is required to achieve the best possible benefit from DTx for both individual patients and the healthcare systems employing them.We see that the required collaborative approach towards facilitating the best possible therapeutic adherence has not yet been pursued in the German healthcare system. Specifically, the notion of suboptimal therapeutic adherence as a unidimensional indicator for poor quality of the respective DTx, as put forward by some system stakeholders, defies the existing body of evidence on adherence and prevents the thorough integration of the novel field of DTx into the existing healthcare infrastructure ,31. Yet,The study at hand aims to assess the effect of higher frequencies of use of the DiGA ViViRA on its therapeutic effectiveness in reducing nonspecific back pain. While this effect could be demonstrated and while the findings are in line with prior research in this field ,34,35, cThis work presents a PS-matched analysis of the effect of different use profiles on the achievement of a clinically relevant pain improvement in patients with nonspecific back pain. While a positive effect of relatively higher use profiles on nonspecific musculoskeletal conditions in general and nonspecific back pain in particular has been reported for conventional movement and exercise therapy before, our work indicates a similar effect for DTx and DiGA. To achieve sufficiently high use profiles—corresponding to a sufficient therapeutic adherence—among patients under care with a DTx, however, a multi-stakeholder effort is required. As it was proposed for conventional therapeutics in a hallmark paper of the WHO decades ago, further research should revisit the five dimensions of adherence in the light of DTx in order to maximize the individual and system-wide benefits of such novel therapies.


One of the main causes hampering predictability during the model identification and automated design of gene circuits in synthetic biology is the effect of molecular noise. Stochasticity may significantly impact the dynamics and function of gene circuits, specially in bacteria and yeast due to low mRNA copy numbers. Standard stochastic simulation methods are too computationally costly in realistic scenarios to be applied to optimization-based design or parameter estimation.In this work, we present IDESS (Identification and automated Design of Stochastic gene circuitS), a software toolbox for optimization-based design and model identification of gene regulatory circuits in the stochastic regime. This software incorporates an efficient approximation of the Chemical Master Equation as well as a stochastic simulation algorithm—both with GPU and CPU implementations—combined with global optimization algorithms capable of solving Mixed Integer Nonlinear Programming problems. The toolbox efficiently addresses two types of problems relevant in systems and synthetic biology: the automated design of stochastic synthetic gene circuits, and the parameter estimation for model identification of stochastic gene regulatory networks.https://doi.org/10.5281/zenodo.7788692.IDESS runs under the MATLAB environment and it is available under GPLv3 license at  E.coli, and most recently also in yeast S.cerevisiae), and it outputs the DNA sequence required to implement the logic circuit provided as an input. Within the second category, SYNBADm , a software toolbox for automated design and identification of biocircuits in the stochastic regime. IDESS is capable of simulating stochastic biocircuits very efficiently using GPU acceleration for simulation and global optimization. It includes CPU and GPU parallel implementations of the Stochastic Simulation Algorithm (SSA)  and the IDESS performs simulation, automated design and parameter identification of gene regulatory circuits combining efficient methods for simulation of stochastic gene regulatory networks with global optimization. The toolbox is implemented in MATLAB under WINDOWS environment. The main functionalities of the toolbox are summarized next.Simulation of stochastic gene regulatory circuits: IDESS implements the SSA  using MEIGO dPdtIDESS implements both the SSA algorithm, and the semi-Lagrangian method solving the PIDE model. It is important to note that, while the SSA algorithm provides realizations of the dynamics (time course trajectories), the PIDE model provides the whole probability distribution over time. Moreover, IDESS includes the optional use of GPU parallelization to run simultaneously a large number of SSA simulations or to greatly speed up the semi-Lagrangian algorithm for solving the PIDE model. It is also worth noting that, although the original formulation takes into account only intrinsic noise, extrinsic noise can be easily incorporated through the input function In a model calibration problem we start from a regulatory network with fixed topology, and estimate the parameters that maximize the probability of reproducing a given set of data. This probability is provided by the likelihood function. IDESS can perform model calibration from time course data, histogram time series or multidimensional displays . The parameters to be estimated include the unknown transcription, translation and degradation rate constants as well as cooperativities of the regulation. Parameters with known values are fixed. At each iteration of the optimization algorithm, the candidate vector of parameters is supplied to the simulation algorithm and the cost function is evaluated. The Kullback–Leibler divergence measures the distance between probability distributions .a priori. The design objective is encoded in a cost function that can take different forms depending on the desired behavior. Design objectives might include: (i) target dynamics (evolution of the probability distribution of the proteins over time), (ii) target stationary distribution, (iii) bimodal switches with given distance between modes or fixed probabilities of certain domains, (iv) capacity of adaptation upon external signals, and (v) oscillatory behavior with given metrics or optimal robustness against noise.The automated design problem consists of finding the circuit topology and parameters that lead to a target functionality defined The decision variables for the design include integer variables (topology) and real parameters . The user can fix the values of some of those parameters (if applicable to the specific design problem).IDESS includes as an illustrative example the design of a three-gene circuit with oscillatory behavior. In this case, the objective function is the second peak of the autocorrelation function of the protein stochastic dynamics, such that the biocircuit obtained as a result of the optimization has maximum robustness against molecular noise (


Carbon nanotubes (CNTs) are nanoscale tubes made of carbon atoms with unique mechanical, electrical, and thermal properties. They have a variety of promising applications in electronics, energy storage, and composite materials and are found as single-wall carbon nanotubes (SWCNTs) and double-wall carbon nanotubes (DWCNTs). Considering such alluring attributes of nanotubes, the motive of the presented flow model is to compare the thermal performance of magnetohydrodynamic (MHD) mono (SWCNTs)/Ethylene glycol) and hybrid (DWCNTs- SWCNTs/Ethylene glycol) nanofluids over a bidirectional stretching surface. The thermal efficiency of the proposed model is gauged while considering the effects of Cattaneo-Christov heat flux with prescribed heat flux (PHF) and prescribed surface temperature (PST). The flow is assisted by the anisotropic slip at the boundary of the surface. The system of partial differential equations (PDEs) is converted into a nonlinear ordinary differential system by the use of similarity transformations and handled using the bvp4c numerical technique. To depict the relationship between the profiles and the parameters, graphs, and tables are illustrated. The significant outcome revealed that the fluid temperature rises in the scenario of both PST and PHF cases. In addition, the heat transfer efficiency of the hybrid nanoliquid is far ahead of the nanofluid flow. The truthfulness of the envisioned model in the limiting scenario is also given. The salient conclusion revealed that nano coolant has an edge over water while discussing the rate of mass flux. The thermal performance of the CNTs-based liquid (water) in a flat heated pipe is studied by Arya et al.2 The important outcomes revealed that the heat transfer rate triggers the evaporating process. It is also witnessed that mass concentration also increases when the heat transfer coefficient is boosted. The assesment of the hybrid nanofluid on a cylinder and plane sheet considering the Yamada–Ota hybrid nanofluid model is deliberated numerically by Ramzan et al.3 using Keller box approximation. The highlighted outcome is that the flow velocity, as well as temperature, depict opposing behavior when influenced by a strong magnetic field. Farooq et al.4 computed the hybrid nanofluid flow comprising CNTs/ethylene glycol over an elongated surface supported by irreversibility analysis. Entropy generation for the flow velocity component is diminishing. The flow of the hybrid nanofluid containing combined effects of the ferro-oxide/CNTs nanomaterials and water between two parallel horizontally placed plates impacted by a magnetic field is numerically studied by Qureshi et al.5 The heat transfer rate of the upper plate is increasing for a thermal radiation value greater than zero. Nabi et al.6 analyzed numerically the nanofluid flow models comprising (SWCNTs-Water) and (MWCNTs-Water) through a micro-channel using the Finite Volume method. The outcomes disclosed that equal distribution of the fluid in the microchannel results in the highest heat transfer rate. Some recent explorations discussing the role of CNTs in nano/hybrid nanofluid flows may be found in10.Nanofluids are suspensions of nanoparticles in a base liquid. The nanoparticles can be made of metals, oxides, or other materials, and they can enhance the thermal conductivity and/or the heat capability of the fluid base. This makes nanofluids particularly useful for applications such as cooling and heating, where their enhanced heat transfer properties can improve system performance. The heat transfer rate of nanoliquids is greater compared to the same volume of base fluid (without nanoparticles) due to their augmented thermal conductivity and heat capacity. The insertion of nanoparticles, which provide additional thermal routes for heat transmission, improves heat transfer in nanofluids. The exact enhancement of heat transfer relies on several factors, such as the type and size of nanoparticles, the volume fraction of nanoparticles in the liquid, the thermal properties of the liquid and nanoparticles, and the flow conditions. Carbon nanotubes (CNTs) play a significant role in nanofluids due to their unique physical and thermal properties. CNTs are cylindrical structures made of graphene sheets, and they have high thermal conductivity, a high aspect ratio, and a large surface area. These properties make CNTs ideal for use as nanoparticles in nanofluids, where one can achieve the overall heat transfer performance of the fluid. In addition to their thermal properties, CNTs also have high mechanical strength, low density, and high electrical conductivity, which makes them useful for a variety of applications beyond heat transfer. The use of CNTs in nanofluids is still an active area of research, and further explorations are required to fully understand the function of CNT-based nanofluids and to optimize their use for specific applications. Chougule and Sahu11 numerically computed the non-Newtonian nanofluid three-dimensional flow influenced by a magnetic field and Cattaneo-Christov heat flux. Two different flow combinations namely Nanolubricant, and Propylene-Water mixture and Paraffin wax flow are considered. It is witnessed that nano lubricant flow depicts a escalating rate of heat transfer than the propylene-water mixture and Paraffin wax flow. The flow of hybrid nanofluid comprising silver-copper oxide/kerosene oil past a bi-directional stretched surface impacted by Cattaneo-Christov double diffusion and Hall current is studied by ZeinEldin et al.12 The outcome inferred that the boundary layer thickness is on the decline for large values of the Prandtl number. Shah et al.13 using the shooting technique deliberated the Prandtl-Eyring hybrid nanofluid flow with thermal radiative flux amalgamated with modified fourier law in a permeable media. The important results revealed that the liquid velocity substantially decelerates for the upsurging estimations of the permeable factor. The impact of the melting heat and Cattaneo-Christov heat flux on a Casson hybrid Ferrohydrodynamic nanofluid (Fe3O4–Ag/blood) flow over an elongated surface accompanying irreversibility analysis is analyzed by Jakeer et al.14 It is comprehended in this exploration that hybrid nanofluid temperature is decreased for the ferromagnetic parameter. Hayat et al.15 numerically computed the flow the hybrid nanoliquid flow in a channel due to Cattaneo-Christov heat flux in a Darcy-Forchheimer spongy medium. The upper plate is moving to and fro whereas the convective condition is implied on the lower one. Irreversibility assessment is also executed in this work. It is interpreted that the large estimations of the squeezing parameter influence the Entropy generation rate. Some more recent investigations depict the consequence of Cattaneo-Christov heat flux on varied geometries23.The Cattaneo-Christov heat flux is an extended form of the Fourier heat flux equation that considers the effects of heat conduction and thermal diffusion. It is a non-Fourier type heat transfer equation, which means that it provides a more accurate description of heat transfer in materials with high thermal diffusion rates, such as high-conductivity materials. The Cattaneo-Christov heat flux equation contributes a major role in the performance of the heat transfer in the nanoliquid flows. Nanofluids are suspensions of nanoparticles in a fluid, and their behavior is influenced by several factors, including the presence of nanoparticles, which can significantly affect the thermal conductivity and heat generation within the fluid. The Cattaneo-Christov heat flux equation takes thermal diffusion into account, which can be a significant issue in nanofluid flows. Furthermore, the Cattaneo-Christov heat flux equation can be used to analyse thermal instability in nanofluid flows, which can occur due to the enhance thermal conductivity of the nanoparticles and the fluid's thermal diffusion. This information can be utilized to improve the design of nanofluid-based cooling and energy generation systems. Studies have shown that the Cattaneo-Christov heat flux term can have a significant consequence on the heat transfer attributes of nanofluids, especially in laminar flow regimes. However, the applicability of the Cattaneo-Christov heat flux term in nanofluid flows is still a topic of ongoing research, as its effectiveness can be influenced by varied variables such as particle concentration, size and type, fluid properties, and flow conditions. Gowda et al.24 analytically discussed the flow of viscous fluid generated by the two-dimensional extended flat sheet. In this study, it is comprehended that for axisymmetric stretching (stretching in the same directions), the ratio of the stretching rate is equal to one. The study was corroborated by comparing it with Crane25 in a limiting case when the stretching ratio is zero. Later, Liu and Andersson26 investigated the bidirectional stretching sheet impact on the constant three-dimensional viscous fluid flow. The results revealed that fluid temperature declined for higher estimates of the stretching ratio parameter. Joshi et al.27 illustrated the hybrid nanofluid flow along the bidirectional spongy surface with the existence of heat generation. Ramzan and Yousaf28 explored the steady flow of viscoelastic nanoliquid over an extending surface. It is noticed that both the velocities exhibit opposing behavior when evaluated versus the stretching parameter. Interestingly, an anisotropic slip which is a directional-dependent slip can also be employed on bidirectional stretching surfaces. According to Wang29, anisotropic slip in fluid flow indicates that the slip factor varies with the flow direction. Amirsom et al.30 explored the three-dimensional flow of nanofluids over a bidirectional stretched sheet with an anisotropic slip and gyrotactic microorganisms. References33 are given about the bidirectional stretching surface in numerous scenarios.Boundary layer flows over extended surfaces attracted researchers owing to their wide-ranging applications like hot rolling, wire drawing, elastic sheets, crustal growing, etc. In the case of stretched surfaces, the role of effective cooling is vital in obtaining the refined end product. Wang34 investigated the effects of the PST and the PHF heating constraints on the unsteady flow of a Williamson nanofluid across an extendable surface embedded in a spongey medium. It is found that under both temperature conditions (PST/PHF), the heat transfer rate increases which may be useful in cooling procedures. Ahmad et al.35 numerically analyzed the flow of the hybrid nanoliquid with prescribed thermal conditions and thermal radiative heat flux using the Keller Box technique. It is determined that the liquid temperature is maximum for the thermal conditions. The flow of the Maxwell nanofluid flow with the impact of Arrhenius energy and prescribed temperature conditions over an extended bi-directional surface is studied by Faisal et al.36 It is witnessed that the liquid temperature is higher in the case of the prescribed heat flux than the prescribed surface temperature. Some more investigations featuring PST and PHF may also be seen in39.Prescribed surface temperature (PST) and prescribed heat flux (PHF) are two types of boundary conditions used in numerical simulations of heat transfer. In the condition of the prescribed surface temperature, the temperature at a specific surface is set to a particular value, which is kept constant throughout the simulation. The temperature at the boundary is identified as a boundary condition. Nevertheless, considering the case of prescribed heat flux, the heat transfer rate (heat flux) at a particular surface is set to a specific value. This type of boundary condition is used when the heat transfer rate is established or controlled, and it is required to establish the resulting temperature. Both PST and PHF temperatures can be used in numerous applications, such as electronics cooling, energy systems, and thermal insulation design. In the case of nanofluids, these boundary conditions are crucial for understanding the heat transfer characteristics of the fluid, including its thermal conductivity, convective heat transfer, and temperature distribution. By using these boundary conditions, researchers and engineers can develop more efficient heat transfer systems, improve energy efficiency, and optimize thermal management solutions in various applications. A plethora of publications may be quoted that highlight the importance of both types of boundary conditions. Chandel and Soodi.e., PST and PHF. The inimitability of the current model is strengthened with the inclusion of the Cattaneo-Christov heat flux to study the heat equation. The fundamental nonlinear partial differential equations (PDEs) that represent energy and momentum are converted into ODEs and numerically computed. Figures and tables are employed to determine the findings.The aforementioned cited studies revealed that studies focusing on the isothermal temperature may be found in bulk. But lesser attention is paid to the nanofluid flows with PST and PHF temperatures. This channel even becomes narrower when nanofluid flow over a bidirectional extended sheet is discussed. However, no attempt is made so far that deliberated the comparison of mono/hybrid nanofluids due to a bi-directionally stretched sheet with anisotropic slip and prescribed temperatures, Consider the laminar, steady, incompressible flows of mono and hybrid nanofluids due to a bidirectional extended sheet with anisotropic slip. The plate is placed in the mentclass2pt{minimmentclass2pt{minim35 nanofluid model, we have:Ethylene glycol and SWCNTs/DWCNTs are postulated to be in thermal equilibrium with no interference between them. Following these considerations and the Tiwari and Das20:With applicable boundary conditionsUnder the influence of preceding transformations, Eq.  is satisThe transformation of boundary conditions is as follows:Mono/hybrid nanofluids' effective dynamic viscosity is formulated as:Mono/hybrid nanofluids' effective density is expressed as:Mono/hybrid nanofluids' effective specific heat is articulated as:43 is considered and the estimates for For effective thermal conductivity of the Mono/hybrid nanofluid Yamada-Ota modelMono/hybrid nanofluid effective electrical conductivity is devised as:The physical attributes known as surface drag coefficients and Nusselt number are formulated as:Using similarity variables (6), we get:57. The “bvp4c” scheme, is used to compute the boundary value equations. The bvp4c technique is the finite difference approach. The modified ODEs (7)–(9) and their boundary constraints (10) are numerically investigated by employing the aforementioned method. Further, when the error involved reaches Nanofluid flows are numerically computed by different techniquesentclass1pt{minimaThis section presents a graphical analysis of numerous parameters versus velocity and temperature profiles with logical illustrations. In each figure, the comparison of mono and hybrid nanofluid is also provided. Furthermore, thermal profiles for both the prescribed surface temperatures are displayed separately. To depict the consequence of magnetic parameter mentclasspt{minimaConsidering the importance of engineering quantities, Tables Further, the Nusselt number is computed for both thermal conditions, i.e., (PST) in Table By enhancing the magnetic parameter both the primary and secondary profiles reduce. Whereas the temperature of the fluid enhances. This enhancement is more obvious for mono nanofluid (SWCNT/EG) instead of hybrid nanofluid (SWCNT-DWCNT/EG).Secondary and primary velocity distributions for both the nanofluids are reduced by enhancing the directional dependent slip coefficients.For PST and PHF scenario, the temperature distributions upsurges for large estimations of the thermal relaxation parameter. Compared to hybrid nanofluid (SWCNT-DWCNT/EG), this trend of enhancement is more obvious for mono nanofluid (SWCNT/EG).Under the PST and PHF scenarios, the estimations of the surface temperature with power indices has a significant consequence on the thermal boundary layer. The reduced boundary layer is noted more for the stretching of the sheet in For higher estimates of the stretching ratio factors the secondary velocity distributions enhances.Heat transfer rate is escalated for hybrid nanoliquid (SWCNT-DWCNT/EG) instead of mono nanofluid (SWCNT/EG), whereas surface drag coefficients are higher for mono nanofluid instead of hybrid nanofluid.Ethylene glycol (EG) is preferred due to its superior heat transfer and anti-freezing properties. It follows that a hybrid nanofluid (SWCNT-DWCNT/EG) with a heat flux boundary condition will be preferred because nano-coolant is more suited for radiators and other cooling systems than a mono nanofluid (SWCNT/EG).We have scrutinized the comparative analysis of mono and hybrid MHD nanofluid flows due to a bidirectional extending surface with modified Fourier law and anisotropic slip constraints. The process of heat transfer is analyzed with two thermal conditions that are applied to the surface: prescribe surface temperature and prescribe heat flux. In this work, two distinct nanoparticles, SWCNT and DWCNT, are inserted in the base fluid ethylene glycol. The bvp4c numerical scheme is applied to handle the boundary layer equations by first converting them to an ODE system of order one. The following are the most important observations from the current findings:In this study, hybrid nanofluid is used due to its advanced heat transfer properties as compared to mono nanofluid. Ethylene glycol (EG) is employed as a base liquid due to its superior heat transfer and anti-freezing properties. Further, Prescribed surface temperature and heat flux boundary constraints are utilized because, in the steelmaking industry, it is important to control the temperature and heating rates to achieve a good quality of the end products.The hybrid nanofluid flow can be considered in the spongy medium.The model can be evaluated by adopting a ternary hybrid nanofluid flow.Xue thermal conductivity model can be used for carbon nanotubes.Boundary conditions can be replaced by thermal jump and melting heat transfer.This research can be extended in the following directions:Slip coefficients value can be higher than one: The slip coefficient is a dimensionless quantity that connects the shear stress at the contact to the slip velocity between two fluid layers. A slip coefficient value larger than one shows that the slip velocity exceeds the velocity differential between the two fluids, which traditional models do not predict. The comments indicate that such big slip coefficient values are possible under certain conditions, challenging previous assumptions and opening up new research avenues.Magnetic field strength values can be less than zero: Magnetic field strength is a measure of the intensity of a magnetic field. Because magnetic fields are commonly assumed to be positive vector quantities, a negative magnetic field strength value may appear counterintuitive or impossible. The viewpoints demonstrate that such negative values may exist in some settings, calling into question previous assumptions and needing new theoretical or experimental approaches to comprehend.The commentaries point out two potential observations that may be unexpected or surprising based on prior knowledge or assumptions:


Biosensors are devices that quantify biologically significant information required for diverse applications, such as disease diagnosis, food safety, drug discovery and detection of environmental pollutants. Recent advancements in microfluidics, nanotechnology and electronics have led to the development of novel implantable and wearable biosensors for the expedient monitoring of diseases such as diabetes, glaucoma and cancer. Glaucoma is an ocular disease which ranks as the second leading cause for loss of vision. It is characterized by the increase in intraocular pressure (IOP) in human eyes, which results in irreversible blindness. Currently, the reduction of IOP is the only treatment used to manage glaucoma. However, the success rate of medicines used to treat glaucoma is quite minimal due to their curbed bioavailability and reduced therapeutic efficacy. The drugs must pass through various barriers to reach the intraocular space, which in turn serves as a major challenge in glaucoma treatment. Rapid progress has been observed in nano-drug delivery systems for the early diagnosis and prompt therapy of ocular diseases. This review gives a deep insight into the current advancements in the field of nanotechnology for detecting and treating glaucoma, as well as for the continuous monitoring of IOP. Various nanotechnology-based achievements, such as nanoparticle/nanofiber-based contact lenses and biosensors that can efficiently monitor IOP for the efficient detection of glaucoma, are also discussed. Visual sensing is one of the most crucial requirements in a human’s life. The eye plays a vital role in connecting human beings with the external world ,2. PropeBiosensors have gained considerable attention in the field of medicine due to the rising demand for point-of-care diagnostics . They plBiosensors have the ability to diagnose diseases at a preliminary stage and can monitor them continuously. Among the various devices, transducers worn or implanted into eyes have been improved and have had effective clinical applications, which is noteworthy as they have the capacity to directly monitor intraocular pressure (IOP) and humidity on the surface of eyes, and they also offer the option of recording lactic acid, glucose and cortisol levels ,23,24. TThe human eye  is globuThe iris is a pigmented tissue that is situated ahead of the lens and that has the ability to dilate or restrict with the help of specialized muscles, such as dilator and sphincter muscles. With the help of the sphincter muscles, the iris reduces the pupillary aperture under situations of excessive light in an effort to prevent the admission of too much light, as this would otherwise lead to the processing of a muddled blur. When an appropriate volume of light has entered the human eye via pupil, it comes in contact with the lens. The lens is constructed using proteins such as crystallin that are involved in refining the image from the cornea. The lens possesses a higher refraction index than the cornea, owing to its environment requirements. The index of refraction of the lens must be higher than the aqueous humor and vitreous humor for it to further focus the image and support the optical system . The retPeople can view objects that are nearby due to the accommodation process, which enables the human eye to change its optical power by altering the shape of the lens. The refractive power of the eye is dictated by the lens (15–20 diopters), the cornea (40 diopters) and the axial length of the eye (23.3 mm on average). Therefore, the human eye has a convergent refractive power of about 60 diopters. When the refractive power of the cornea, the axial length of the eye and the power of the lens balance out, rays are precisely focused on the retina and emmetropia (perfect vision) is attained . It is aSeveral ocular tissues are involved in the active functioning of the human eye. Loss of vision has a profound impact on a person’s capacity to preserve their independence and degrades their value of life. Visual impairment is caused by damage to the ocular tissues. Aging and retinal and optic nerve damage stand out as the primary causes of vision loss. The healthcare system is currently facing significant issues as a result of vision impairment . When coElderly people who have AMD may lose their central vision permanently . The mosCataracts are one of the primary reasons for eye blindness around the world, and are characterized by clouding and blinding one’s vision. The crystalline lens is vulnerable to numerous types of injuries, which can lead to protein misfolding and aggregation, and ultimately result in cataracts. A cataract—a clinical homologue of lens opacity—develops when the lens’ refractive index varies remarkably over the wavelength of transmitted light . The lenDiabetes or an uncontrolled blood sugar level serves as the major reason for the development of diabetic retinopathy (DR). DR damages retinal microvessels gradually and is characterized by microaneurysms, small intraretinal hemorrhages, capillary closures and hard exudates . This leKeratoconjunctivitis sicca, often referred to as dry eye, arises due to a deficit or the malfunctioning of the tear film. The corneal epithelium begins to pit and decreases the smoothness of the corneal surface. This leads to hazy or cloudy vision. There are two different forms of dry eye, namely, evaporative dry eye or aqueous tear-deficient dry eye. The causative reasons for dry eye are conjunctival scarring due to a deficiency in vitamin A, collagen vascular disorders or adverse effects due to drugs . Glaucoma  is a terIntraocular pressure (IOP) is an essential measurement that must be recorded during ophthalmic inspections, particularly in patients with ocular hypertension or glaucoma, and in individuals with a high-risk percentage of developing glaucoma ,52. IrreSome of the IOP measuring instruments are applanation tonometers, pneumatonometers, Perkins tonometers, dynamic contour tonometers, wireless implantable transducers, home tonometers and contact lens sensors  53]. Go. Go53]. Nanotechnology is the development and application of materials , machineIOP-lowering treatments are beneficial for most of the people with glaucoma since an elevated IOP is known to be a main risk factor for optic nerve injury. First-line glaucoma medication normally begins with eye drops that reduce IOP through one of two main mechanisms: increasing the aqueous humor outflow through the trabecular or uveoscleral pathways, or by suppressing aqueous humor production. When topical medicines are ineffective at reducing IOP, laser therapy or surgery may be performed. Brimonidine, brinzolamide, bimatoprost, carteolol, latanoprost, pilocarpine, timolol and travoprost are a few of the medications that have been studied as nanomedicine formulations for the treatment of glaucoma . Table 1Liao et al. fabricated pilocarpine-loaded gelatin MSNs with continuous-release characteristics for the intracameral pharmacotherapy of glaucoma. The prepared material was intracamerally injected into the anterior chamber to decrease the level of IOP. A fifty percentage pilocarpine release was observed for a period of thirty-six days. In vivo experiments proved the maintenance of intraocular pressure in eyes with ocular hypertension for a period of twenty-one days . A highly reliable and low-cost method to develop the graphene grating on contact lenses was first proposed and demonstrated by Tang et al., who carried out direct laser interference patterning of graphene film on commercial contact lenses using a Nd:YAG laser. During the fabrication process, two different features—film thickness and interference angle—were taken into consideration. The diffraction pattern of the graphene grating fabricated on the contact lens played a vital role in monitoring the normal functioning of the eye. Any change in the shape or bending of the contact lens can be recorded through the alterations in the diffraction pattern. The prepared graphene film on the contact lens proved to be flexible and conductive, and may serve as a suitable platform for designing a circuit for the construction of smart contact lenses .The conventional method of using eye drops for treating glaucoma has numerous disadvantages such as poor drug bioavailability owing to the quick clearance of the drops from the preocular space. Kim et al. prepared amino-functionalized mesoporous silica (AMS) particles and studied their role as delivering vehicles for the drug brimonidine. In total, 41.17 μg/mg of brimonidine was loaded inside the particles with a sustained drug release for up to eight hours. The presence of hydroxyl and amino groups made the prepared particles mucoadhesive, and hence, when applied topically onto the eyes of rabbits, the brimonidine–AMS particles were able to stay in the preocular space for up to twelve hours. The efficacy of the prepared brimonidine–AMS particles in reducing the intraocular pressure was analyzed using an in vivo model .The treatment of glaucoma involves multiple drugs, among which a combination of timolol maleate and brimonidine tartrate is commonly used to treat the disease. Timolol-maleate–brimonidine-tartrate-loaded liposomes were prepared using a thin-layer hydration method. Eight different formulations were prepared by Bigdeli et al. using the timolol-maleate–brimonidine-tartrate-loaded liposomes. Among the eight formulations, one formulation was used for in vivo experiments based upon the primary evaluations. The efficacy of the prepared formulation in reducing intraocular pressure was evaluated using an in vivo model, which demonstrated its potential application in the field of glaucoma treatment. The results showed that the formulation has potential therapeutic efficacy in lowering the IOP level and in helping the IOP level return to normal after ninety hours .Gagandeep et al. utilized an electrospinning method to fabricate nanofibers loaded with timolol maleate and dorzolamide hydrochloride for the efficient treatment of glaucoma. The nanofibers had a mucoadhesive property and were able to show sustained release of the drug for a period of up to twenty-four hours. In vivo experiments carried out by inserting the nanofiber patch into the cul-de-sac areas of glaucoma-induced rabbits showed a significant reduction in the IOP level when compared with conventional eye drops .Xu et al. fabricated a novel method where timolol and latanoprost were loaded inside a micelles-laden contact lens for treating glaucoma. The formulation was prepared by free-radical polymerization of a 2-hydroxyethyl methacrylate monomer. and the drugs timolol and latanoprost were loaded within mPEG-PLA micelles. The prepared formulation showed sustained drug release of timolol and latanoprost for a period of 144 h and 120 h, respectively, in a simulated tear fluid. When compared with eye drops, the formulation improved the mean residence time and bioavailability of both drugs. In vivo experiments using a rabbit model showed a reduction in IOP level for over 168 h. Thus, the prepared micelles-laden contact lens can be efficiently used to deliver two different drugs for a long time period for glaucoma treatment .Wang et al. designed dendrimer gel particles that possess the advantages of dendrimers, hydrogels and particles. Dendrimer gel particles were fabricated using an inverse emulsion technique in combination with the aza-Michael addition reaction method. Two different drugs, namely, brimonidine tartrate and timolol maleate, were loaded inside the dendrimer gel particles to study their drug-delivering efficacy. Non-toxicity, corneal permeability, degradability and drug release kinetics were also studied, which proved their efficacy in treating glaucoma .Sonntag et al. used gold nanoparticles and studied their role as delivering vehicles of antiglaucoma drugs. The optimum size for targeting the trabecular meshwork was studied using different-sized gold nanoparticles  that were either bare gold nanoparticles or those coated with hyaluronic acid. The colloidal stability, in vitro cellular uptake and ex vivo distribution in the anterior chamber of the eye was studied for bare and hyaluronic-acid-coated gold nanoparticles. The coating of hyaluronic acid avoided the aggregation of gold nanoparticles inside the trabecular meshwork even after applying them to the porcine eye. Nanoparticles that were 120 nm in size were seen to be accumulated at the higher concentration in the trabecular meshwork .Vandamme et al. studied the role of size, molecular weight, number of hydroxyls, and amine and carboxylate surface groups in different poly(amidoamine) dendrimers for the controlled release of drugs. A single dose of dendrimer solution was applied onto the eyes of albino rabbits to study the ocular tolerance and retention time of the poly(amidoamine) dendrimer formulations. Dendrimers with hydroxyl and carboxylic surface groups possessed a longer residence time. The remanence time was dependent upon the size and molecular weight of the poly(amidoamine) dendrimer solution . Maulvi et al. studied the role of gold nanoparticles in the uptake of the antiglaucoma drug timolol. The conventional soaking method which is widely used to load timolol did not affect the properties of the contact lens, but resulted in disadvantages such as poor drug loading and increased burst release of loaded drugs. Two different approaches were used: (i) gold nanoparticles were loaded into the timolol soaking solution and (ii) contact lenses were incorporated with gold nanoparticles. Further, the contact lenses were soaked in various concentrations of timolol (2 and 4 mg/mL). Optical transparency and swelling behavior were not affected due to the presence of gold nanoparticles. Both of these approaches did not show any significant improvement in the release behavior of timolol. In vivo experiments proved that there was a 2 mmHg average fall in IOP (72 h) in the groups treated with gold-nanoparticle-laden contact lenses, whereas soaked contact lenses without gold nanoparticles and conventional eye drops were measured to be 2 mmHg. A significant improvement in the deposition of drugs in the ciliary muscles and conjunctiva was observed with gold-nanoparticle-laden contact lenses, thereby proving their efficacy in treating glaucoma .Wu et al. proposed the loading of brinzolamide into liquid crystalline nanoparticles and studied their role in treating glaucoma. A modified emulsification technique was used for preparing the drug-loaded nanoparticles. When compared with the brinzolamide commercial product, brinzolamide-loaded liquid crystalline nanoparticles showed prolonged drug release. The ex vivo apparent permeability coefficient of brinzolamide loaded into liquid crystalline nanoparticles showed a 3.47-fold increase when compared with the brinzolamide commercial product. In vivo experiments proved that the brinzolamide-loaded liquid crystalline nanoparticles can serve as efficient delivering vehicles for treating glaucoma with improved ocular bioavailability and lower concentrations of drugs . Nguyen et al. prepared hollow poly (lactic acid) nanoparticles and studied the role of shell thickness in the sustained release of antiglaucoma drugs . PilocarAgaoglu et al. fabricated a microfluidic-based sensor that could convert minute strain changes into a large fluidic volume expansion that can be easily detected using the camera of smart mobile phones. The fabricated sensor had a detection limit of <0.06% for uniaxial strain and <0.004% for biaxial strain. Further, the sensor was embedded in a silicone contact lens and IOP-induced strain was measured in the physiological range in porcine eyes. The sensor can continuously operate for more than nineteen hours with the maximum life time of about seven months, which proves its role in ophthalmology . Kim et al. proposed a non-invasive method for the continuous monitoring of IOP using smart contact lenses integrated with transparent silver nanowires, IOP strain sensors and wireless circuits. The robust stability of the fabricated IOP sensors within the smart contact lens was analyzed in the presence of tears and with the eyelid blink model. In vivo experiments using a rabbit eye model proved the efficacy of the integrated wireless smart contact lens in the continuous monitoring of IOP, and thereby proved the method’s role in the management of glaucoma  55]..55].Xu et al. constructed a transparent, highly sensitive, biocompatible, graphene-based, non-invasive sensor for the continuous monitoring of IOP. The sensitivity and accuracy of the sensor was improved using a graphene Wheatstone bridge consisting of two strain gauges and two compensating resistors. When tested on a silicone eyeball, the voltage output was proportional to the IOP fluctuation, thereby proving its efficacy. A wireless system was designed for the sensor to monitor IOP using a mobile phone .Liu et al. developed a non-invasive method to continuously monitor IOP using a new strain gauge material based upon graphene nanowalls. The association between corneal strain, contact lens and IOP was determined using stimulation. A novel method was designed to transfer graphene nanowalls onto the contact lens with the use of a gold film for non-invasive monitoring of IOP. The device had an IOP detection sensitivity of 42,250 ppm/mmHg, which is higher than that of the IOP tonometer .Kim et al. fabricated a smart contact lens for monitoring IOP. A strain sensor was placed inside the lens which can perfectly monitor IOP. The contact lens also has the ability to transmit the IOP values using an antenna. The IOP values obtained using the smart contact lens were comparable with those measured using a tonometer, which proves their efficacy in monitoring IOP in diabetic individuals undergoing intraocular islet transplantation .Ye et al. fabricated a smart contact lens sensor that can be efficiently used for monitoring IOP and detecting matrix metalloproteinase-9 (MMP-9). Both of these biomarkers serve as important indicators for various ocular diseases, especially glaucoma. The contact lens sensor was able to continuously monitor higher levels of IOP by applying an antiopal structure that could detect changes in color without the aid of electronic systems. The sensor was able to quantify nanomolars of MMP-9 in real tear samples  83]. . 83]. Biosensors play a vital role in the field of point-of-care disease diagnostics . Until nGlaucoma is a term given to a group of ocular disorders that is characterized by impaired optic nerves, resulting in progressive loss of vision. The persistent rise in IOP is the main cause of the disease. Although there are multiple approaches available to monitor IOP, a novel non-invasive, transparent, highly sensitive, IOP biosensor is needed to overcome the drawbacks associated with current diagnostic procedures. Wearable and implantable biosensors fabricated using nanoparticles and integrated systems can be preferably be used due to their promising role in the continuous monitoring of IOP. Currently, few clinical trials have been carried out for the constant monitoring of IOP using implantable sensors. In the future, smart contact lenses with IOP sensors can serve as an efficient strategy to detect and treat glaucoma. However, they must be put into clinical practice for early diagnosis and timely treatment.


To assess the effectiveness of seasonal malaria chemoprevention (SMC) in reducing under-five malaria morbidity and mortalityUnder-five malaria data for confirmed episodes, deaths, and number of children dosed per cycle of SMC campaign were extracted from the District Health Information Management System (DHIMS-2) for 2018–2019. Data verification was done to compare extracted data with the source for completeness and consistency. Association between SMC and the main outcome variables  was computed from 2X2 tables and reported as rate ratios at a 95% confidence level.All seven (7) districts in Savannah Region, GhanaChildren under five yearsSulphadoxine-Pyrimethamine and Amodiaquine (SPAQ) prophylaxis given monthly, four times, durng the rainy season (July to October)SMC coverage per cycle and under-five malaria morbidity and mortality ratiosOver 370,000 dose packs of SPAQ were administered with an average cycle coverage of 93%. There was approximately 17% (p<0.01) and 67% (p=0.047) reduction in malaria-related morbidity and mortality, respectively, in the implementation year compared with the baseline. This translated into nearly 9,300 episodes of all forms of malaria and nine malaria-attributable deaths averted by the intervention.SMC (combined with existing control measures) wields prospects of accelerating the regional/national malaria elimination efforts if the implementation is optimised. Expansion of the intervention to other high-prevalence regions with seasonal variation in disease burden may be worthwhile.None declared Malaria is a life-threatening disease caused by parasites transmitted to humans through the bites of infected female Anopheles mosquitoes. In 2018, an estimated 228 million malaria cases were recorded globally, with over 400,000 deaths. Children under five years are the most vulnerable and account for 67% of the mortalities. Ninety-four per cent (94%) of cases and 93% of deaths were from Africa.1Malaria accounts for approximately 40% of outpatient attendance in Ghana, with children and pregnant women being the most vulnerable.2Like most West African countries, Ghana is classified to be in the control phase according to the global malaria elimination programme.5Achieving further control and setting the tone for elimination requires additional evidence-based interventions targeting the parasite in the host (human beings) or the vector (anopheles mosquito). Across the Sahel, most malaria illnesses and deaths occur during the rainy season, typically between July and October. Seasonal Malaria Chemoprevention (SMC) is a highly effective intervention to prevent malaria during this peak transmission period among children under five – the most at risk. The intervention, as recommended by World Health Organization (WHO), is safe, cost-effective, and feasible and can prevent up to 75 % of malaria cases in under-fives when used alongside other malaria interventions.6In 2015, the National Malaria Control Programme successfully piloted SMC in the Upper West Region of Ghana. The intervention contributed to approximately 42% reduction in malaria parasite prevalence in 2016.Savannah Region is one of the 16 regions in Ghana and was carved out of the Northern Region in 2019. It has the largest land surface area  administrative districts  and a to9Health-seeking behaviour varies by gender and age. Women  and caregivers seeking care for their children (under five years) often patronise NHIS-accredited health facilities. However, there is poor health-seeking behaviour among males : the majority resort to traditional medicine and only report to health facilities in the event of failure.8Agriculture is the major source of livelihood, with a considerable proportion being peasant farmers. Housing is mainly constructed with mud and roofed thatch, especially in rural areas. Most communities (>50%) are located more than 5 km from the nearest health facility.SMC involves administering four monthly courses of two antimalarial drugs, sulphadoxine-pyrimethamine (SP) and amodiaquine (AQ), to children 3–59 months, and it is delivered through a household-to-household approach. The objective of the intervention is to achieve and maintain therapeutic blood concentration of the antimalaria to reduce parasitemiaCommunity-based Surveillance Volunteers (CBSVs) and supervisors are trained before deployment to the field. CBSVs visit households, register children in the target group onto a mobile application called SMC in Children app (SiCapp), and administer the intervention (SPAQ).SiCapp is an android application developed by the National Malaria Control Programme to replace the paper-based campaign data management system. It has a volunteer interphase that enables registration, dosing, and logistics accountability as well as a supervisor interphase that facilitates in-process monitoring. Data collected on SiCapp include age of child, dose of SPAQ administered, and adverse drug reaction (ADR) among others. Field data is synchronised by volunteers and supervisors onto a central server for collation and analysis.Eligible children fall into two broad categories: 3–11 months and 12–59 months. Sick children and those with known allergies to SPAQ are excluded. A child is assessed and the appropriate dosage of anti-malaria is handed to a caregiver who administers the first dose (SPAQ) in the presence of the volunteer. The child is observed for a minimum of five minutes for ADR. The remaining two tablets of AQ are given to the caregiver to administer on the second and third days respectively. The volunteer follows up to observe and document drug administration as well as refer children with ADR to the nearest clinic for treatment at no cost to the caregivers.Each volunteer doses 20–40 children per day and dosing details are entered onto SiCapp. To ensure quality campaigns, monitoring and supervision are carried out at the community, sub-district, district and regional levels. Supervisors visit volunteers on the field to provide technical support as needed. Caregivers are also interviewed to evaluate the performance of volunteers as well as the acceptability of the intervention. Volunteers-supervisor meetings are held at the end of each day to account for logistics, resolve challenges, and sync data to a central server.Review meetings are organised at the end of each cycle to disseminate performance feedback and sharing of vital lessons. The SiCapp data is validated and entered onto the SMC summary return forms in District Health Information Management System (DHIMS-2) – a national health data platform.Analysis of routine data was conducted on under-five malaria data entered onto DHIMS-2 for 2018 and 2019 respectively.https://www.dhis2.org) developed from the district health information system (DHIS). It was first introduced in Ghana in the year 2007 and was primarily used for collecting and reporting health data. Data is collected at the health facility level using standard registers, collated onto summary forms and entered on the DHIMS-2 platform monthly or quarterly. The interphase is password protected and accessible to healthcare managers and health partners.Under-five malaria data for 2018–2019 was extracted from DHIMS-2. DHIMS-2 is free open-source software  morbidity forms, malaria score card, in-patient records and SMC summary return forms onto Microsoft Excel 14.0 spreadsheet for analysis. Although SMC is implemented from July to October, data for November and December were included due to possible “spill-over” effects of the intervention beyond October.Variables collected include the number of confirmed malaria episodes  malaria deaths; and the number of children dosed per cycle of SMC. Data verification was carried out to compare extracted data with the source for completeness and consistency.Ethical approval was sought from Kintampo Health Research Centre Institutional Ethics Committee (KHR-CIEC); study approval number: KHRCIEC/2021-02. Administrative permission was sought from the Regional Director of Health Service for Savannah Region and the respective Municipal/District Directors of Health Service. Informed consent was sought from the caregivers of the participants. Confidentiality and anonymity were ensured throughout the process. Soft and hard copies of data were kept on a password-protected computer and under lock and key respectively.Extracted data was exported into Epi Info statistical soft-ware  for analysis. The proportion of children dosed with SPAQ per cycle was calculated by dividing the number dosed by the population of children 3–59 months  and multiplied by 100% . The numAssociation between SMC and the main outcome variables  was computed from 2X2 tables and reported as a rate ratio at 95% confidence level.More than 95,000 episodes of malaria and 16 related deaths among children under five years were recorded during the study period . The majOn average, 93% of children (3–59 months) received the intervention per cycle and the average number of treatments per child was 3.7 dose packs.There was approximately 17%  and 67%  reduction in malaria-related morbidity and mortality respectively in the implementation period (2019) compared with the baseline (2018) . This trThe observed reduction in under-five malaria morbidity and mortality can largely be attributed to the implementation of SMC because it was the only additional malaria control tool introduced in the region in 2019. In addition, the regional health system remained stable regarding leadership and staff turnover; and there were no changes in the implementation of other malaria control interventions during the study period.The OPD attendance rate depends on health service utilisation and documentation of the same by health facilities. Variations could be real or apparent. The association between SMC and the outcome variables  could therefore be confounded by variations in health-seeking behaviour and data entry anomalies between the periods. However, this was mitigated through indirect standardisation: the number of cases and deaths that would have occurred in the implementation period (if it had the OPD attendance rate of the pre-implementation period) was calculated before computing the respective rate ratios . StandarThe reduction in the episodes of malaria during the intervention year is in tandem with the findings of other stud-ies.15The finding variations observed by different studies may lie in the design and the level of implementation and acceptability of other malaria control interventions prior to the introduction of SMC. As stated earlier, the malaria control interventions are complementary and in most sub-Saharan African countries mass distribution of long-lasting insecticide-treated nets (ITNs) is a basic public health intervention against the disease.17SMC campaigns are benchmarked against set targets to assess programme performance at the regional, district and sub-district: at least 90% of eligible children must be dosed per cycle and the average number of SPAQ dose packs received per child should not be less than three for the entire (four cycles) campaign.With follow-ups and advocacy, some refusals were over-turned but others remained adamant until subsequent cycles; having been convinced by the ‘testimonies' of care-givers who accepted the treatment. . The general drop in coverage for the fourth cycle was mainly due to volunteer exhaustion and overwhelming access challenges at the inception of the floods and overflow of rivers during the peak of the rainy season.Three districts  consistently achieved perfect coverage and even crossed the 100% mark for some of the cycles. The observation raises flag on adherence to SMC standard operation procedures and reliability of the population projections assigned to districts and regions. Dosing ineligible children (outside the target age); multiple data entries; application of underestimated population targets; and influx from adjoining communities may underly the observation. However, because the SMC campaign periods overlap in the five northern regions the latter may not be a significant contributor.The need to address gaps in the estimation of the target population and improve service data management would facilitate monitoring of programme performance and impact assessment. The engagement of satisfied caregivers as advocates may be explored to reduce hesitancy and refusals as well as contribute to sustaining the acceptability of the intervention. Lastly, expansion of the intervention to other high-prevalence regions with seasonal variation in disease burden may be worthwhile.A limitation of the study was that we are unable to ascertain whether children who developed malaria or died from it received SMC (and for how many months in the intervention year) due to the characteristics of the source data – aggregated data.Again, we utilized under-five malaria morbidity and mortality data (instead of 3–59 months) due to data separation challenges. This might not affect validity of the study because of low incidence of malaria and related mortality among children under three months.18Four cycles of SMC reduced the under-five malaria morbidity and mortality in the Savannah Region by 17% and 67% respectively during the first year of implementation. The intervention (combined with existing control measures) wields prospects of accelerating the regional/national malaria elimination efforts if the implementation is optimised.


Several pieces of evidence show that gut microbiota can impact psychiatric disorders. However, no mechanism behind the relationship has been identified. Host genetics and their diets have a significant impact on the gut microbiota. More advanced studies are needed to find the mechanism and develop new therapeutic strategies. Streptococcus, Lactobacillus, and Eggerthella and lower relative abundance of the butyrate-producing Faecalibacterium [Clostridium perfringens species for TR in anxiety and depression [Actynomyces and Porphyromonas genera for TR in schizophrenia [Proteobacteria, Tenericutes phyla, and family Peptostreptococcaceae for TR in major depressive disorder [In the last thirty years, there have been considerable advancements in the comprehension of the interplay between the biological environment of the gut and the central nervous system (CNS). This biological and functional connection has been first observed and described in scientific terms at the end of the 19th century, with seminal reports from a series of authors  producing bacterial genera while an increase in the pro-inflammatory genera in individuals with psychosis and schizophrenia, major depressive disorder, bipolar disorder, and anxiety . In all A major way of involvement of gut microbiome in psychiatric disorders is by regulating the host genetics. For several years a two-way interaction between the gut microbiota and host genetics was reported. The gut microbiota can impact the transcription factor binding which ultimately impacts the chromatin accessibility in the host’s body . StudiesAll the previous studies described earlier confirm the impacts of gut microbial alteration on the psychiatric disorder pathology in the host organisms. More in-depth studies are needed to identify the exact mechanism by which the gut microbiota affects the host’s mental health. Knowledge about the role of gut microbiota is important to develop new therapeutic strategies for psychiatric disorders. As the type of diet modulates the gut microbial population, changing dietary habits as well as consumption of probiotic supplements could be beneficial for psychiatric disease alleviation. Currently, most data about the effects of gut microbiota on psychiatric diseases are based on animal studies. Therefore, more clinical studies are required to find effective therapeutic strategies.