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Morbid obesity is a chronic condition characterized by metabolic disorders and low-grade chronic inflammation, both of which are closely linked to insulin resistance and adipokine dysregulation. In addition to its systemic effects, obesity also leads to structural and functional changes in the skin, supporting its role as an active metabolic and immunological organ. This study analyzed skin lesions occurring in individuals with morbid obesity and explored their potential relevance in the context of metabolic risk and treatment response rather than establishing clinically validated tools. The focus was on how excess adipose tissue affects the skin through metabolic, hormonal and mechanical mechanisms. Although this review focuses on morbid obesity, many of the included studies examine general obesity without separating its severity. Therefore, the findings may not fully reflect patients with BMI ≥ 40 kg/m2 and should be interpreted with caution. Three main areas were considered: the pathophysiological mechanisms underlying obesity-related skin lesions, selected dermatological manifestations as potential markers associated with metabolic risk, and changes in these manifestations during pharmacological, surgical, and lifestyle interventions. Available studies show that acanthosis nigricans and multiple acrochordons are consistently associated with insulin resistance, metabolic syndrome, and metabolic dysfunction-associated steatotic liver disease. An increase in BMI is also associated with impairment of the epidermal barrier, changes in the composition of skin lipids, and modifications of the skin microbiome, while biomechanical factors promote the development of chronic inflammation in the intertriginous areas. It has been shown that normalization of metabolic parameters achieved through GLP-1-based pharmacotherapy, bariatric surgery, or lifestyle changes can improve some skin manifestations, especially acanthosis nigricans. However, it should be emphasized that most available data are based on cross-sectional or observational studies, and validated composite dermatological indices are still unavailable. Skin changes in patients with morbid obesity often reflect underlying metabolic and hormonal disturbances. They may have potential as additional, non-invasive clinical clues, but they should not be treated as independent tools for risk assessment or treatment monitoring. At present, most evidence shows associations only, and it is unclear whether these findings add meaningful predictive value beyond standard metabolic markers. More prospective studies are needed to confirm their clinical usefulness and to define their role in assessing metabolic risk and monitoring treatment over time.

Acne vulgaris is highly prevalent among adolescents and carries significant psychosocial burdens. This study assessed the psychosocial impact of acne and identified factors contributing to reduced quality of life among Singaporean adolescents. A cross-sectional study was conducted between August 2023 and October 2025, recruiting patients aged 12-18&#x2009;years with acne vulgaris seen at KK Women's and Children's Hospital pediatric dermatology clinics. Patient-reported outcomes were measured using the Cardiff Acne Disability Index (CADI) and the Teenager's Quality of Life Index (TQoL). Acne severity was graded by physicians using the Global Evaluation Acne (GEA) scale. Among 100 participants, mean CADI and TQoL scores were 3.77 and 8.89, respectively. Self-perceived acne severity was the highest scoring CADI item but correlated poorly with physician-rated severity (r&#x2009;=&#x2009;0.334, p&#x2009;=&#x2009;0.001). The most affected TQoL domain was self-image. CADI and TQoL scores did not differ significantly by age, dermatological comorbidities, nodulocystic lesions, or scarring. Significantly worse scores (p&#x2009;<&#x2009;0.05) were associated with female sex, acne duration &#x2265;&#x2009;2&#x2009;years, and truncal involvement. A strong dose-response relationship with clinician-graded severity was evident, with scores rising from mild to moderate to severe acne (CADI: 2.85, 4.63, 6.29, p&#x2009;<&#x2009;0.001; TQoL: 6.36, 11.84, 12.71, p&#x2009;<&#x2009;0.001). Adolescents with acne experience self-image concerns that are poorly aligned with physician clinical assessment. Female sex, longer duration, truncal involvement, and greater clinical severity are key determinants of QoL impairment. These findings highlight the need for timely, effective treatment alongside proactive psychosocial screening to reduce emotional and social burden in high-risk groups.

Patient cycle time is a useful operational metric for assessing the clinical encounter pathway in primary healthcare settings. Prolonged cycle times may reflect delays within the consultation process and may affect patient experience and clinic flow. This study aims to evaluate patient cycle time at a large Family and Community Medical Centre in the Eastern Province of Saudi Arabia and to identify the demographic, clinical, and operational factors associated with variations in cycle time. A retrospective analytical chart review was conducted using electronic health record data for all visits to FCMC over a 1-year period in 2025 (n&#x2009;=&#x2009;52,611). Cycle time was defined as the duration from patient check-in to the closure of the physician encounter. Sociodemographic variables, visit characteristics, clinic type, seasonality, and diagnostic categories were analysed. Multivariable linear regression was performed to identify predictors of cycle time. The median cycle time was 20&#x2005;min (interquartile range: 20-21). Longer cycle times were significantly associated with visits to urgent care and chronic disease clinics, Saudi nationality, autumn visits, and acute diagnoses, including upper respiratory, gastrointestinal, musculoskeletal, neurological, and dermatological conditions. Shorter cycle times were observed for preventive care and diabetes-related visits. Increasing age was independently associated with shorter cycle time, while sex was not a significant predictor. Cycle time at this primary healthcare centre was relatively short compared with national and international benchmarks. However, it varied by clinic type, diagnosis, season, and patient characteristics. Targeted operational interventions focusing on urgent care services, seasonal demand, and acute presentations may help optimize the clinical consultation pathway.

Plants hold significant promise for dermatological applications. However, the potential for phytochemicals, particularly essential oils, to cause skin irritation or sensitization necessitates rigorous safety evaluation for products derived from medicinal plants. This Phase I study was therefore designed to investigate the safety profile of three novel herbal ointment formulations prepared from essential oils on the healthy human skin of volunteers. An open-label, randomized controlled Phase I trial was conducted with 30 healthy volunteers in Ethiopia. Participants were randomly assigned (10 each) to one of the three investigational herbal ointments in a 1:1:1 ratio. For each participant, placebo (vehicle), 2%, and 5% concentrations of the allocated investigational product were applied concurrently using an occlusive patch test, followed by a photo-patch test and a repeated open application test (ROAT). Participants were followed for 14 days to monitor for skin reactions and adverse events. The primary endpoint was the occurrence of serious adverse reactions (SAR) associated with investigational products. All 30 enrolled participants completed the study with full adherence to the required procedures as per the protocol. No serious adverse reaction related to the investigational herbal products (IHPs) were observed throughout the trial. A total of six non-serious adverse events were recorded among five study participants, none of which was assessed as related to the IHPs. Baseline and end-of-study laboratory parameters and vital signs remained stable, with no clinically significant abnormalities detected. All three investigational herbal ointment formulations demonstrated a favorable safety profile when applied to healthy human skin. These findings support further clinical development of the products and warrant subsequent studies to evaluate the long-term safety and efficacy for the intended dermatological application. Trial Registration: The trial was registered under the number PACTR202311887239866.

SERPINA12 is a member of the serpin superfamily that has been extensively studied in metabolic and inflammatory disorders. In recent years, increasing evidence has highlighted its emerging role in skin physiology and dermatological diseases. SERPINA12 is expressed in multiple skin cell types, including keratinocytes and dermal fibroblasts, where it participates in the regulation of inflammation, cellular proliferation, differentiation, and tissue homeostasis. Dysregulation of SERPINA12 has been implicated in several skin disorders. In psoriasis, altered SERPINA12 expression is associated with chronic inflammation, immune dysregulation, and abnormal keratinocyte proliferation, suggesting a potential modulatory role in psoriatic pathogenesis. Furthermore, emerging studies suggest a possible involvement of SERPINA12 in palmoplantar keratoderma, where it may contribute to aberrant keratinization and epidermal barrier dysfunction. This review summarizes current knowledge on the expression patterns, biological functions, and molecular mechanisms of SERPINA12 in the skin, with a particular focus on adipocytes, psoriasis, and palmoplantar keratoderma. Understanding the role of SERPINA12 in cutaneous biology may provide new insights into disease pathogenesis and identify potential therapeutic targets for skin disorders.

Snail mucus is increasingly investigated as a biologically compatible source of multifunctional biomolecules for pharmaceutical and dermatological use. However, the chemical profile and biological activities of mucus from the Moroccan endemic terrestrial snail Otala tingitana remain poorly characterized. In addition, the influence of heliciculture diet on the composition and functional properties of the mucus remains unclear. Here, O. tingitana was reared for 140 days under controlled conditions and fed a basal flour diet or the same diet supplemented with 3% Rosmarinus officinalis, Origanum compactum, or Thymus zygis subsp. zygis. Mucus from wild snails was included for comparison. Mucus samples were chemically profiled by GC-MS and evaluated for antibacterial activity, antioxidant capacity, wound-healing efficacy in mice, and histological anti-inflammatory effects, and evaluated semi-quantitatively based on the degree of inflammatory cell infiltration. GC-MS identified 13 compounds and demonstrated clear diet-dependent shifts in dominant components. All mucus samples exhibited broad-spectrum antibacterial activity against Staphylococcus aureus, Listeria monocytogenes, Escherichia coli, and Salmonella Typhimurium (inhibition zones 10.31-14.30 mm; MIC 120-240 &#xb5;g/mL), with predominantly bactericidal profiles (MBC/MIC < 4) and significantly enhanced activity in plant-supplemented groups (p < 0.05). Antioxidant performance improved markedly with medicinal-plant supplementation, reaching low IC50 values (best &#x2248; 1.18 mg/mL) compared with basal-diet mucus. In vivo, topical application accelerated wound closure, achieving complete healing in <21 days, versus 28 days in untreated controls. In addition, histological assessment showed faster resolution of inflammatory cell infiltration in treated groups. Collectively, these findings provide the first integrated evidence that O. tingitana mucus possesses antibacterial, antioxidant, wound-healing, and anti-inflammatory activities, and that heliciculture diet is a practical lever to optimize its bioactive profile. Further studies should prioritize standardized manufacturing, contaminant control, and safety/toxicology assessment before translational development.

Atopic dermatitis (AD) is a widespread dermatological condition, particularly affecting children globally. In spite of its high prevalence, comprehensive data on its burden and trends are limited. Using the Global Burden of Disease Study 2021 (GBD 2021) data from 204 countries and 21 regions (1990-2021), we analyzed AD prevalence, incidence, and disability-adjusted life years (DALYs), calculating age-standardized rates (ASRs) and estimated annual percentage changes (EAPCs). This study is designed to examine the temporal trends in the burden of AD across global, regional, and national levels. Globally, AD cases rose from 107.5 million (1990) to 129.0 million (2021). The high-income Asia Pacific region had instances of age-standardized prevalence (ASPR), age-standardized incidence rate (ASIR), and age-standardized DALYs, with Japan leading among 204 countries. High sociodemographic index (SDI) regions showed the highest ASPR, ASIR, and age-standardized DALYs, while medium and high SDI regions experienced the largest increases. Females exhibited higher ASRs than males. Age-specific prevalence and DALYs peaked in children aged 5-9 years, whereas incidence was the highest in those aged under 5 years. Projections based on 1990-2021 data suggest declining global trends in ASPR, ASIR, and age-standardized DALYs by 2050. Global AD prevalence and DALYs continue to rise, whereas ASPR and age-standardized DALYs are declining. High SDI regions exhibit the highest prevalence, yet low-income countries show increasing age-standardized DALYs, underscoring profound regional heterogeneity. Thus, the absolute burden of AD is escalating worldwide, while individual-level risk appears to be improving.

Skin cancer is a significant health issue in the entire world and there is a need to have diagnostic systems that are precise, enlargeable and privacy safeguarding. The heterogeneity of the institution and the issue of patient confidentiality frequently restrict the use of centralized deep learning in the medical imaging field because of data-sharing limitations and heterogeneity across different institutions. The solution is federation learning (FL), which allows joint training of models without transfer of unprocessed clinical data. In this work, it is suggested to implement a privacy-sensitive FL architecture in skin cancer classification on the basis of decentralized clinical environments. The framework has compared two aggregation topologies, centralized Federated Averaging (FedAvg) and a decentralized ring-based peer-to-peer strategy on five simulated non-IID clinical client data distributions. In order to capture the institutional heterogeneity, we constructed a heterogeneity sensitive client partitioning algorithm that is measured by KullbackLeibler divergence. The suggested framework was also compared to standard FL algorithms, such as FedProx and SCAFFOLD, and was evaluated at various non-IID levels of severity. The backbone architectures implemented were MobileNetV2 and VGG16 and tested on two benchmark data sets, which were ISIC and Skin Cancer: Malignant vs. Benign. It was reported that the performance is measured in several random seeds and has 95% confidence intervals, and the balance of privacy and utility is measured using the settings of differential privacy. MobileNetV2 with the ring-based FL topology was the best performing of all the considered configurations. This setting achieved an accuracy of 98.88% (95% CI: 97.92-99.84%) and F1-score of 98.80% which is significantly better than the centralized baseline (p < 0.01). In both datasets, MobileNetV2 has been able to achieve higher convergence rates, reduced communication overhead, and greater performance in terms of resistance to heterogeneous client distributions, compared to VGG16 in federation. The degradation of performance with increasing severity of non-IID was gradual, which validates that the planned framework is scalable and robust. The results show that federated learning is able to be as effective as or even more effective than centralized learning in skin cancer classification without sacrificing patient privacy. The MobileNetV2 performance is higher, implying that lightweight architectures are specifically suited in FL due to their effective gradient propagation and low communication cost. Altogether, the suggested framework will be a feasible and regulation-conformed solution of AI-aided dermatological diagnosis in distributed healthcare settings.

Comano thermal water (CTW) is a hypotonic, bicarbonate-calcium-magnesium mineral water traditionally used to manage chronic inflammatory and relapsing skin diseases. This review summarises and discusses the available clinical, experimental, and translational evidence on CTW, with a particular focus on dermatological indications. The physicochemical properties of CTW, along with the presence of a stable, non-pathogenic microbial community, are examined in relation to their potential biological activity. Clinical studies indicate that CTW-based balneotherapy, alone or in combination with narrowband Ultraviolet B (UVB) phototherapy, is associated with improvements in disease severity, symptom burden, and quality of life in patients with psoriasis and atopic dermatitis, and has a favourable safety and tolerability profile. Experimental data further suggest that CTW may exert anti-inflammatory and immunomodulatory effects, modulate keratinocyte function, support skin barrier restoration, and influence the cutaneous microenvironment, including microbiome-related pathways. The review also outlines emerging evidence for CTW in skin regeneration and in upper airway inflammatory conditions treated via inhalation-based approaches. Overall, this review suggests that CTW may serve as a biologically active therapeutic resource, warranting further investigation as a complementary approach within integrative management strategies for inflammatory and barrier-related conditions.

Multi-step skincare routines have become increasingly popular, particularly among adolescents and young adults, driven by social media exposure and commercial marketing. Although individual skincare ingredients have demonstrated efficacy for specific dermatological conditions, evidence supporting the routine use of elaborate multi-step regimens in otherwise healthy skin remains limited. Concerns have been raised regarding potential adverse effects and misinformation, especially among younger users. To explore dermatologists' perspectives on multi-step skincare routines, including perceived risks and benefits, observed complications, and the influence of social media. A cross-sectional digital survey was distributed to Dutch dermatologists and dermatology residents via the Dutch Society for Dermatology and Venereology. The questionnaire addressed attitudes toward skincare trends, observed dermatoses, implicated ingredients, recommended routine complexity, and perceived social media impact. Associations were analyzed using Fisher's Exact Test, Mann-Whitney U-test, and Spearman's rank correlation. A total of 168 respondents participated, including 146 board-certified dermatologists and 22 dermatology residents. Most respondents (91.6%) expressed concern about the popularity of multi-step skincare routines, and 88.1% reported regularly encountering skincare-related skin problems, most commonly irritant eczema, perioral dermatitis, allergic contact dermatitis, and acne exogenica. Retinoids, exfoliating acids, fragrances, and products marketed as natural were frequently mentioned in association with these complaints. Despite concerns, 79.8% acknowledged potential benefits, such as increased awareness of skin health and sun protection. Nearly all respondents identified daily sunscreen use as essential, whereas only 12.5% actively recommended multi-step routines. Social media was perceived as highly influential, with frequent reports of misinformation and delayed medical consultation. Dermatologists report substantial concern regarding complex skincare routines, particularly in relation to complications and misinformation among younger users. Although some benefits are recognized, professional recommendations emphasize simplicity and daily sun protection.

Astaxanthin (AST) is a carotenoid with powerful antioxidant and anti-inflammatory properties and increasing interest in dermatological and nutraceutical applications. In this study, AST-rich extracts were obtained from by-products of the blue crab Callinectes sapidus and chemically characterized using HPLC-DAD analysis. The antioxidant activity of the extracts was assessed through complementary spectrophotometric assays (DPPH and FRAP). Comparable AST contents were detected in the two extracts, with values of 1.269 &#xb1; 0.006 and 1.219 &#xb1; 0.015 mg/100 g dry weight for EtOH and IPrOH, respectively. However, the EtOH extract exhibited higher antioxidant activity, reaching 0.10 &#xb1; 0.01 mg Trolox equivalents (TE)/g in the DPPH assay and 0.27 &#xb1; 0.02 mg TE/g in the FRAP assay, compared with 0.08 &#xb1; 0.01 and 0.11 &#xb1; 0.03 mg TE/g for the IPrOH extract. The biological activity of AST extracts was further evaluated against the opportunistic pathogen Staphylococcus aureus and beneficial lactic acid bacteria. AST exhibited moderate antibacterial activity against S. aureus, with an MIC value of 50 &#x3bc;g/mL and inhibition zones up to 14 mm at 200 &#x3bc;g/disc, while promoting the proliferation of Lactobacillus plantarum, Lactobacillus casei, and Lactobacillus reuteri. These findings highlight the prospective valorization of blue crab by-products as a sustainable supply of antioxidant and microbiota-modulating compounds with possible applications in skin health and cosmetic formulations.

Scrub typhus, a zoonotic bacterial infection caused by the arthropod-borne, Gram-negative, obligate intracellular bacillus Orientia tsutsugamushi and transmitted by larval chiggers, is an underdiagnosed cause of acute undifferentiated febrile illness. Its clinical spectrum ranges from a self-limited denguelike illness to rapidly progressive multiorgan dysfunction driven by smallvessel vasculitis, including pneumonitis, acute kidney injury, hepatitis, encephalitis and circulatory shock. Early recognition is frequently missed because the characteristic eschar may be absent or easily overlooked in concealed or pigmented skin sites, and definitive diagnostics such as polymerase chain reaction (PCR) or indirect immunofluorescence assay (IFA) are often unavailable in resource-limited settings. Occupational and environmental exposures, particularly work in oil palm or rubber plantations and contact with forest- estate ecozones, remain key epidemiological clues that may be under-elicited in routine clinical practice. We report a case series of four patients with confirmed scrub typhus presenting to a hospital in Kluang district, Johor, Malaysia. All patients had acute fever and non-specific viral-like symptoms, including malaise, chills, headache and myalgia. Thrombocytopenia and acute kidney injury occurred in 50%, while 75% demonstrated transaminitis. Eschars were identified in all patients following comprehensive dermatological examination. Diagnosis was confirmed by PCR for O. tsutsugamushi DNA, a fourfold rise in IFA titres, or a single high-titre IgM or IgG in a compatible clinical syndrome. Three patients (75%) had clear domiciliary or occupational risk factors, including oil palm work or residence near secondary scrubland. One patient developed organ-threatening complications with acute kidney injury and severe hepatitis, illustrating the vasculitic end-organ involvement of severe scrub typhus. All patients achieved clinical defervescence and symptomatic improvement within 24-48 hours of doxycycline initiation, consistent with the characteristic brisk antimicrobial response. This series underscores the need for a low threshold of clinical suspicion and early empiric rickettsial coverage in undifferentiated febrile illness with relevant exposure in rural Malaysia and highlights the need for larger multicentre studies to define predictors of severity, guide triage and inform prevention in high-risk land-use settings.

Aloe vera has an extensive history in traditional folk medicine. There is a robust scientific literature on Aloe vera extracts and several prominent chemical constituents, covering chemical characterization, biological/chemoprotective effects, and mechanisms. This paper provides the first integrative assessment of Aloe vera-induced hormetic dose responses. Aloe vera extract-induced hormetic responses acted as an immunostimulant in multiple fish species, enhancing development/growth and reducing adverse effects from environmental stressors. Aloe vera extract-induced hormetic effects are prominent in dermatological studies, improving keratinocyte- and fibroblast-related wound-healing processes. Aloe vera extracts induced hormetic-based neuroprotective endpoints for epileptic seizures, pain, in Alzheimer's disease models, and for lifespan. This analysis includes the hormetic effects of specific chemical constituents of Aloe vera extracts (acemannan/aloin) on stem cells, cardiomyocytes, bone cells, and other cell types, and their mechanisms. These findings show that a complex range of Aloe vera extract mixtures/specific constituents induce hormetic dose responses. These findings also indicate that hormetic dose responses play a prominent role in mediating many biomedical and chemopreventive effects of Aloe vera extracts and their major chemical constituents. Recognition of these findings should assist in creating optimized hormetic-based study designs and improving biologically/mechanistically based interpretations of their dose-response findings with their clinical implications.

Ononis spinosa L. (Fabaceae), commonly known as spiny restharrow, is a widely distributed medicinal plant traditionally used in European and Middle Eastern phytotherapy, particularly for the management of urological and inflammatory conditions. Despite its long-standing ethnomedicinal relevance, comprehensive syntheses of its phytochemical profile and biological activities remain limited. This review aimed to summarize current evidence regarding the chemical constituents and pharmacological effects of O. spinosa. Four electronic databases (PubMed, Scopus, Web of Science, and SpringerLink) were searched for studies published between 1997 and 2024. The search yielded 308 records; after duplicate removal and eligibility screening, 34 studies met the inclusion criteria. The phytochemical profile of O. spinosa is characterized predominantly by isoflavonoids (e.g., ononin and other formononetin derivatives), triterpenes, phenolic acids, and additional polyphenolic compounds. Although the phytochemical profile of O. spinosa includes multiple classes of secondary metabolites, this review places particular emphasis on phenolic compounds, given their prevalence and well-documented biological activities. Experimental evidence indicates a broad spectrum of biological activities, including anti-inflammatory effects (associated with cPLA2&#x3b1; inhibition and cytokine modulation), antibacterial and antifungal activity, antioxidant capacity, wound-healing and dermatological benefits, as well as diuretic and anti-adhesive effects in urinary models. Additional reported properties include antiproliferative, anti-adipogenic, analgesic, and neurotrophic activities. Proposed mechanisms of action involve enzyme inhibition (e.g., Hyal-1 and COX-2), modulation of transient receptor potential (TRP) channels, redox regulation, and interference with microbial adhesion and inflammatory signaling pathways. Overall, O. spinosa contains bioactive compounds exhibiting a wide range of pharmacological activities supported by in vitro and in vivo studies. Among the investigated effects, anti-inflammatory, urological, and wound-healing activities appear to be the most promising targets for future research. These findings highlight its therapeutic potential while emphasizing the need for well-designed clinical studies to further validate its medicinal applications.

Photodynamic therapy (PDT) has emerged as a powerful minimally invasive modality for cancer treatment. However, its efficacy as a monotherapy is often limited by oxygen dependence and limited light penetration. Combining PDT with systemic anticancer drug therapies offers a promising strategy to achieve synergistic effects and overcome resistance. This review aims to provide a systematic analysis of the mechanisms and clinical potential of combining PDT with chemotherapy, targeted therapy, and immunotherapy, focusing on recent advancements and nanotechnology-based delivery systems. A comprehensive literature search was performed using PubMed and Scopus databases. The analysis focused on peer-reviewed studies published over the last 10 years addressing synergistic molecular pathways, co-delivery nanoplatforms, and clinical trial outcomes. The combination of PDT with chemotherapy enhances drug accumulation via vascular photosensitization and can overcome multi-drug resistance. Integration with immunotherapy, particularly immune checkpoint inhibitors and tumor vaccines, triggers immunogenic cell death (ICD), leading to systemic antitumor responses. Nanotechnology provides a versatile platform for the targeted co-delivery of photosensitizers and pharmacological agents, significantly reducing systemic toxicity. Combined PDT-drug regimens demonstrate superior therapeutic efficacy compared to monotherapies. Future clinical translation requires the standardization of dosimetry and the development of multifunctional nanomedicines to enable personalized treatment protocols.

Endophytic fungi can mediate salicylic acid (SA) and methyl jasmonate (MeJA)-related signaling in medicinal plants, thereby influencing metabolite synthesis, stress resistance, and growth development. Experimental groups comprised control, Trichoderma longibrachiatum inoculation (FG), FG&#x2009;+&#x2009;SA (FS), FG&#x2009;+&#x2009;MeJA (FM), FG&#x2009;+&#x2009;SA&#x2009;+&#x2009;MeJA (FSM), and corresponding inhibitor treatments (FSI, FMI, FSMI), with I indicating inhibitor application. Morphological traits, photosynthetic parameters, nitrogen metabolism enzyme activities, antioxidant defense indices, and signaling-related molecules in Codonopsis pilosula were measured at 15, 30, and 50&#x2009;days. Non-targeted metabolomic analysis was conducted to identify differential metabolites and enriched pathways. The results showed that the FSM treatment markedly promoted root development and biomass accumulation in C. pilosula, increased chlorophyll content and photosynthetic rate, and enhanced antioxidant capacity, as reflected by increased CAT and GR activities. Meanwhile, endogenous SA and JA levels were markedly altered, and nitric oxide (NO) levels exhibited treatment-dependent dynamics, suggesting that NO may participate in broader hormone-associated signaling responses during the Trichoderma-SA/MeJA interaction. Metabolomic analysis revealed that FSM notably regulated steroid and brassinolide biosynthesis pathways, with key metabolites such as 6-deoxotyphasterol upregulated and 4,4-dimethyl-5alpha-cholesta-8,14,24-trien-3beta-ol downregulated. Inhibitor treatments reduced enzyme activities, increased malondialdehyde accumulation, and suppressed growth and photosynthetic efficiency. Overall, the combined SA and MeJA treatment together with fungal inoculation was associated with the strongest promotion of growth and stress resistance in C. pilosula. This study reveals the metabolic reprogramming features of microbe-hormone interactions in medicinal plants and provides theoretical support for the quality cultivation of C. pilosula.

The photocatalytic activity of TiO2 can be increased by incorporating it into a composite with an electron-trapping co-catalyst. MXene can perform this task as an electron-conducting material. In addition to trapping electrons, it also affects the defects in TiO2 near the interface. To screen for the best photocatalytic performance, three types of composites were prepared: by physical mixing, chemical deposition, and ALD. During characterization, the structural, optical, and photoelectrochemical properties were determined. Photocatalytic activity was examined in suspension (phenol conversion) and on a layer (gas phase ethanol conversion). It was found that the composite containing the lowest proportion of cocatalyst (1 wt.%) had the highest photocatalytic activity. According to the results of photocatalytic activity measured in suspension, the physical mixtures were proven to be more effective than neat TiO2, with the composites converting approximately the total amount of phenol in ~40 min, while TiO2 required ~80-90 min to do so under the same conditions. Thus, the electron-trapping role of MXene is clearly demonstrated in suspension applications, which is also confirmed by other characterization methods (photoluminescence, photocurrent density). TiO2 performed best during ethanol conversion, as it has the highest ethanol adsorption capacity (33.41%). During ethanol conversion tests, the MXene electron-trapping property was most effectively demonstrated in composites formed using the ALD method.