BackgroundThis meta-analysis aimed to systematically evaluate the effects of exercise interventions on sleep quality in patients with depression and to explore the dose–response relationships of key intervention parameters.MethodsA comprehensive search was conducted in PubMed, Web of Science, Embase, Scopus, and the Cochrane Library to identify randomized controlled trials (RCTs). Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup and sensitivity analyses were performed to examine potential dose–response relationships.ResultsA total of 17 publications, including 19 randomized controlled trial comparisons and 1,457 participants, were included in this systematic review and meta-analysis. Pooled estimates indicated that exercise interventions significantly improved sleep quality [SMD = −0.37, 95% CI: −0.48 to −0.27]. Dose–response modeling suggested that exercise doses around 312.75 MET·min/week may be associated with greater improvements [Hedges’ g = −0.51, 95% CI: −0.71 to −0.31]. Subgroup analyses suggested that mind–body exercise [SMD = −0.49, 95% CI: −0.63 to −0.35], durations of 9–12 weeks [SMD = −0.49, 95% CI: −0.74 to −0.24], fewer than two sessions per week [SMD = −0.47, 95% CI: −0.65 to −0.29], and sessions longer than 90 minutes [SMD = −0.42, 95% CI: −0.66 to −0.18] may be associated with favorable changes.ConclusionsExercise interventions may improve sleep quality in individuals with depression, with potential benefits at low doses. These findings support individualized exercise prescriptions, but larger multicenter RCTs with long-term follow-up are needed to confirm the dose–response pattern and subgroup findings.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251105568, identifier PROSPERO (CRD420251105568).
Stigma and quality of life in hospitalized schizophrenia patient-family caregiver dyads in Northern China: an actor-partner interdependence model analysis
BackgroundSchizophrenia is a chronic and relapsing mental disorder that is consistently associated with a severely diminished quality of life (QoL) for patients. Existing research has predominantly focused on how the stigma experienced by patients with schizophrenia relates to their own QoL. However, stigma among family caregivers has received considerably less attention, and its potential association with patients’ QoL, in particular, remains underexplored. Therefore, this study aims to systematically analyze the dyadic associations of stigma—as experienced by both patients with schizophrenia and their family caregivers—with QoL, utilizing an actor-partner interdependence model (APIM). Through this framework, this study seeks to explore the interdependence of stigma between patients and their family caregivers and its correlational links to their quality of life.MethodsTwo hundred and sixty-four pairs of schizophrenic patients and their family caregivers were included, and the subjects’ stigma was measured using the Internalized Stigma of Mental Illness Scale and the Conjunctive Stigma Scale, respectively, and the quality of life was measured using the World Health Organization Quality of Life Measurement Short Form. The actor-partner effect of stigma on quality of life was explored by constructing an actor-partner reciprocity model.ResultsThe actor effect of stigma on quality of life was significant for people with schizophrenia and their family caregivers (β=-0.472, p < 0.001, β=-0.779, p < 0.001), and the partner effect of stigma on quality of life was significant for people with schizophrenia and their family caregivers (β=-0.128, p = 0.033, β=-0.419, p < 0.001).ConclusionIn future research and interventions aimed at improving the quality of life for people with schizophrenia and their caregivers, it is important to consider not only the individual’s own stigma, but also how the other person’s stigma is associated with one’s quality of life.
Post-intracerebral hemorrhage depression comorbid with obstructive sleep apnea and REM sleep behavior disorder: a case report and literature review
We report a 63-year-old male with post-cerebral hemorrhage depressive disorder. Previous adequate-dose, full-course antidepressant treatment yielded no significant improvement in depression, anxiety, or sleep disturbance. Detailed history taking and polysomnography (PSG) confirmed comorbid severe obstructive sleep apnea hypopnea syndrome (OSAHS) and rapid eye movement sleep behavior disorder (RBD). Without adjusting antidepressants, the patient first received continuous positive airway pressure (CPAP) for OSAHS, followed by individualized pharmacotherapy for RBD. With the improvement of sleep architecture and respiratory events, obvious remission of depressive and anxiety symptoms and substantial recovery of daytime function were observed. This case emphasizes the bidirectional relationship between sleep and mood disorders. For post-stroke depression (PSD) poorly responsive to antidepressants, active sleep evaluation, multidisciplinary collaboration, and targeted management of comorbid sleep disorders may be crucial to enhance therapeutic efficacy.
<![CDATA[AI may assist psychopharmacology by aiding suicide risk, digital phenotyping, and TRD care—while exposing EHR data limits and the need for smarter integration.]]>
Vitamins A and D Help Improve Lung Function in People with Asthma
Having higher levels of vitamins A and D in the body could help improve lung function in adults with asthma, suggests research led by Brigham and Women’s Hospital in Boston.
The study, published in the journal Thorax, also showed that higher vitamin A levels could also benefit lung health in children with asthma.
“Vitamins A and D are key regulators of gene expression involved in lung development and immune function…Both vitamins have complex roles in asthma and lung function,” write lead author Michael McGeachie, PhD, assistant professor at Brigham and Women’s Hospital, and colleagues.
“Vitamin A deficiency is more common in people with asthma and is linked to airway hyperresponsiveness. Moderate intake in childhood may improve lung function and reduce asthma risk, whereas excessive intake may increase adult-onset asthma risk. Vitamin D deficiency is associated with poorer lung function, increased exacerbations and worse disease control, although results are variable due to diet, age and sun exposure.”
In this study, the researchers evaluated data from two asthma study cohorts—the Genetic Epidemiology of Asthma in Costa Rica Study including 1,165 children with asthma and the adult Omic Determinants of Longitudinal Lung Function in Asthma cohort including 1,041 adults with the condition.
The researchers looked at both circulating vitamin A and D in both groups and also looked at links with epigenetic regulation.
In children, there were no significant links between lung function and vitamin D levels. Higher vitamin A levels were linked to better breathing capacity though. For each step up in vitamin A levels, the amount of air the children could blow out in the first second was about 2.5 percentage points higher, and the total amount of air they could breathe out was about 7.6 percentage points higher.
In the adults, one step up in vitamin A levels was linked to a 4.7 unit increase in the amount of air they could blow out in the first second and a 3.4 unit increase in the total amount of air they could breathe out. The effect of vitamin D levels in this group was smaller, but statistically significant, with lung function improvements between 0.16-0.18 units per step up in vitamin D levels.
The researchers also looked at DNA methylation and at several epigenetic clocks that estimate a person’s biological age from methylation patterns in the adult cohort. They found that adults with higher vitamin A and vitamin D levels had fewer methylation tags at key control sites in the IRF5 gene than those with lower levels and showed changes in small regulatory micro RNAs that respond to vitamin levels. These epigenetic changes were linked to better lung function and slower biological aging.
The epigenetic tests suggest that vitamins influence lung function and aging partly by producing these epigenetic changes, rather than only through a direct effect, according to the researchers.
“While future studies to replicate these findings in independent populations are needed to confirm the generalizability and robustness of these observations,” write Sze Man Tse, MD, and Geneviève Mailhot, PhD, of the CHU Sainte-Justine Research Center, Montreal, and the University of Montreal in an accompanying editorial in the same journal, “subsequent interventional studies examining the impact of vitamin supplementation on biological ageing and on IRF5 function will be particularly relevant.”
The post Vitamins A and D Help Improve Lung Function in People with Asthma appeared first on Inside Precision Medicine.
Cytiva Completes Doubling of Utah Site’s Liquid Media Production Capacity
Cytiva has completed an expansion of its Logan, UT, facility that effectively doubles its liquid media production capacity, a project designed to support supply chain continuity for customers relying on the company for their cell culture needs.
The company has completed its animal-derived component-free (ADCF) liquid media expansion facility (A1X), Pierre-Alain Ruffieux, Cytiva group executive, bioprocess, told GEN in an interview conducted from the company’s booth during the Biotechnology Innovation Organization (BIO) International Convention recently held in San Diego. He said the completion was celebrated with a ceremony on the site.
Cytiva detailed the expansion project in a May 12 post on its website: The ADCF liquid media expansion facility (A1X) has larger mixing tanks than the existing facility, supporting batch sizes from 700 L up to 13,000 L—compared with batch sizes of 100 L to 10,000 L supported by Cytiva’s existing facility.
Also, the A1X facility uses mixing tanks and liquid media transfer lines comprised of AL6XN and 316 L stainless steel. This differs from the existing facility equipment, which is comprised solely of 316 L stainless steel. AL6XN is a low-carbon, high-purity stainless-steel alloy that is more resistant to wear and corrosion than 316 L, representing an upgrade to the product contact layer versus the existing facility equipment.
The expanded site’s added liquid capacity comes from the addition of three manifold fill lines, three filling manifolds, six mixing tanks, six formulation booths, and a utility building to support large volume liquid media production. Housed in the utility building are a 45,000 L tank and process water system, a 55,000 L tank and water for injection system, a clean steam generator, and additional supporting utilities.
“In addition to the added capacity, Cytiva has updated several aspects of the manufacturing floor layout and equipment, improvements designed to shorten production cycle time, improve safety, and minimize product risk,” the company explained. “The updates also establish closed systems for cleaning and a controlled environment for the transport and handling of raw materials and finished goods.”
Previously, Cytiva completed expanding its dry powder and liquid media manufacturing capacity for large-volume customers and added high-speed bottle filling for smaller-volume users. The company also opened an expanded staging area for finished goods, as well as a new centralized 10,000-square-foot quality control lab to support increased manufacturing.
AI’s “two major impacts”
During a wide-ranging interview, Ruffieux discussed Cytiva’s approach to AI and several recent Cytiva announcements.
“We see two major impacts from AI on what we are doing,” Ruffieux explained. “The first one, and I always like to start with the customers because it’s really our focus: We see our customers accelerating and increasing the number of targets they are doing. AI is helping them to have more targets and in a faster time,” Ruffieux said. “It’s putting pressure on the CMC folks, and I think it’s where we play: They ask us to provide innovative solutions to go faster.”
Cytiva’s focus on AI is two-fold, he continued.
“One, we are developing intelligent equipment which is using AI to be easier for customers to use and which are more functional; that is one aspect. It’s also delivering more experience in a shorter time frame,” Ruffieux said. “It’s a kind of next level of DoE [design of experiments], but it’s also delivering a productivity aspect because the goal is to have equipment which requires either fewer people or fewer people with less specific knowledge of the equipment.”
Like a growing number of companies in and outside biopharma, Ruffieux said, Cytiva has fully embraced AI “to make our product better, to make the customer experience better, but also to improve our internal processes.”
“Faster and better”
“We see AI helping us to develop software, writing new software to go faster and better. AI is very powerful for reviewing documents and doing things,” he explained. “It’s amazing what we can do both in writing code, but also perhaps as importantly, as we validate the code and we test everything, the use of AI is allowing our people to work in a much more comprehensive way, in a much faster way.”
AI also adds a layer, he said, to the continuous improvement ethos that Cytiva and other Danaher-owned companies practice through the Danaher Business System (DBS). Since the mid-1980s, Danaher has carried out an ongoing company-wide Kaizen or continuous improvement effort based on lean manufacturing and anchored on DBS, a common culture and operating system focused on people, plans, processes, and performance.
“AI is an additional pillar to this system, really helping the company to be more efficient and to drive business,” Ruffieux said.
Cytiva’s customers, he continued, have not specifically asked about AI. So what are customers telling the company that they want?
“What customers want is Cytiva delivering solutions which help them to innovate, produce drugs, and accelerate these processes. And AI is one of the attributes, but they don’t have a specific task on AI,” Ruffieux replied. “In discussing with senior customers, people are interested in the outcome, not in the product itself. So it’s not AI for AI, it’s AI for a business outcome. And in life science, the business outcome is quality. It’s reliability. It’s speed. It’s customers asking, can we help them to be better?”
AMT designation
Last month, Cytiva hailed the FDA’s granting its Advanced Manufacturing Technology (AMT) designation to the company for its Elevecta
transient cell line for adeno-associated virus (AAV) manufacturing, one of the first gene therapy manufacturing technologies to receive the designation. Customers using the Elevecta transient cell line will benefit, according to Cytiva, from a clear, predictable regulatory and quality framework for gene therapy development.
Through its AMT designation, the FDA recognizes drug manufacturing technologies that it deems to have elevated the reliability, quality, and robustness of advanced therapeutics manufacturing. By enabling a streamlined Chemistry, Manufacturing, and Controls (CMC) review and frequent communication with the FDA, designees count on the AMT designation to help accelerate their manufacturing-related development timelines and create a meaningful advantage through faster time to market.
“This recognition by the FDA is giving confidence and trust for our customers: If they use this cell line to produce AAV, they know that the agency has seen the technical advantage and it’s confidence on the regulatory pathway,” Ruffieux said. “This recognition by that regulatory body is giving trust to the work of the company in helping customers develop drugs, which is really where we position ourselves as true partners.”
Elevecta is designed to significantly reduce the formation and encapsidation of host cell DNA (hcDNA).
“What is beautiful with that is, we get a reduction of 99% of the host cell DNA. You don’t have to worry any more about the host cell DNA which is coming with your product. Again, that is a huge advantage for the customer using that,” Ruffieux said. “This is the kind of innovation we are really proud to bring to our customers.”
Operating from hubs in Marlborough, MA, Amersham, U.K., Uppsala, Sweden, and Shanghai, Cytiva is a unit of Danaher that was re-launched in 2020 after Danaher spent $21.4 billion for the former biopharma business of GE Healthcare Life Sciences. Danaher oversees a global family of more than 20 operating companies focused on biotech and life sciences, as well as diagnostics, water quality, and product identification.
Bringing “the entire workflow”
Earlier this month, the company said that eight of its 2,000 L single-use Xcellerex bioreactors were among equipment contained in the new GMP-2 manufacturing facility inaugurated in Wuhan, China, by Chime Biologics, a decade-long customer that has used equipment made by Cytiva and its predecessor company.
“I want to put that in a larger context: At Cytiva, we really bring to the customers the entire workflow, which is really exciting for small to mid-sized customers. Coming to us, they really get a full facility that is working, really, from A−Z,” Ruffieux said. “It’s starting from an expansion of the cell line, to freezing the drug substance. It’s about a fully integrated solution that helps the customer to have that. And we have multiple facilities like that, that we are building every year for customers across the world.”
“We make significant investments to be able to supply our customers with what they need into different regions, in-region-for-region,” Ruffieux said.
In-region-for-region refers to Cytiva’s ongoing effort to satisfy customer demand for manufacturing tools and services usable within their regions of the world.
“This is really helping us and the customer to secure supply independent of any disruption,” he added. “Since COVID-19, we have seen multiple disruptions worldwide. And really, our original presence is giving confidence to customers that they will get what they need, independent of whatever crisis is happening across the world.”
Worldwide, the United States and European Union have championed “reshoring” efforts by drug developers and tools/technology providers across biopharma to manufacture more of their products within their regions rather than in China or elsewhere in Asia.
“When there is investment, it’s definitely always a tailwind,” Ruffieux said. “We welcome investment, and we are happy to support all customers to put up new facilities, and for the opportunity these facilities offer to position our equipment.”
The post Cytiva Completes Doubling of Utah Site’s Liquid Media Production Capacity appeared first on GEN – Genetic Engineering and Biotechnology News.
Claude Science is Anthropic’s newest flagship product
At an event for pharmaceutical executives, biotech founders, and researchers on Tuesday, Anthropic announced Claude Science, a major new product intended to support scientific research in the same way that Claude Code supports software engineering. Like Claude Code, Claude Science can autonomously carry out meaningful work when given concise, high-level instructions, and it has access to tools that make it particularly useful for research in computational biology and drug development. Along with launching and previewing Claude Science, which is now available to all paid Claude subscribers, Anthropic also announced that it will be using the product to pursue some of its own research into drugs for rare, neglected diseases.
This is not Anthropic’s first foray into AI for science. In October, the company released plug-ins that help Claude make use of scientific software and databases under the heading “Claude for Life Sciences.” But unlike this earlier release, Claude Science is a full-featured, standalone product. Anthropic’s decision to elevate Claude Science to the same rank as Claude Code and Claude Cowork indicates that the company is taking AI’s scientific applications very seriously—or at least wants to give the impression that it is.
“It represents how important this is to our mission that this is right up there with Claude Code and Claude Cowork as the next really significant product that we’re releasing,” says Eric Kauderer-Abrams, Anthropic’s head of life sciences. “Our mission is to develop AI that serves humanity’s long-term well-being, and we believe that by far the greatest opportunity to do that is in the life sciences.”
For the past decade, one company—Google DeepMind—has been at the vanguard of AI for science. CEO Demis Hassabis and researcher John Jumper won the Nobel Prize in chemistry for their work on the company’s AlphaFold model, and DeepMind has also made major contributions to meteorology, materials science, and a variety of other disciplines. But in the past several months, the fast-advancing frontier of AI progress seems to have left DeepMind in the dust. When it comes to coding, which has become the most lucrative use case for LLMs, DeepMind is stuck playing catch-up.
Anthropic is well positioned to take up DeepMind’s scientific mantle. Like Hassabis, Anthropic CEO Dario Amodei is a PhD scientist—unlike OpenAI CEO Sam Altman, who’s a businessman through and through. Many scientists are already avid users of tools such as Claude Code. These days, a lot of scientific research involves some amount of coding, but not all scientists are expert software engineers, and so tools like Claude Code can make a huge difference for their productivity. And the company has recently earned a major scientific vote of confidence: Earlier this month, Jumper announced that he is leaving DeepMind for Anthropic.
Since agents powered by LLMs, including Anthropic’s Opus model series, became capable of useful, independent work in late 2025, scientists have been seeing just how much they can do. In a blog post published on Anthropic’s website, the Harvard physicist Matthew Schwartz estimated, on the basis of his work with Claude Code and other Anthropic tools, that the company’s Opus 4.5 model is about as capable of executing scientific projects as a second-year graduate student.
According to Kauderer-Abrams, Claude Science isn’t intended to displace Claude Code and Claude Cowork in scientists’ workflows. Instead, it’s designed to build on what scientists already find useful about Anthropic’s products. For instance, it not only writes code but also helps scientists run their code on powerful computer clusters, which many many scientists need for their work but can be difficult to manage. And it prioritizes reproducibility, so that scientists can trace back the source of any figure or result and check it for accuracy and validity.
Though Claude Science could in principle assist with any area of scientific research, it seems designed and marketed as a tool for molecular and cellular biology, and for drug development in particular. It can interface with various tools used in genetics, chemistry, and protein biology, all of which could come in handy for researchers on the hunt for new drugs. During the Tuesday event, Alexander Tarashansky, who led the development of Claude Science, demonstrated how the system could autonomously identify new drug candidates for phenylketonuria, a rare genetic disease.
And Anthropic isn’t leaving all that work to the pharma companies and university labs that were represented at the event. Armed with Claude Science, it will be pursuing its own research into drug candidates for neglected diseases—both to help move science forward and to gain a clearer sense of how Claude Science works in the real world.
There are obvious humanitarian reasons to prioritize drug development when creating a general-purpose scientific research tool, and AI industry leaders often cite curing disease as a major potential upside of the technology. But it’s also notable that pharmaceutical companies have far deeper pockets than academic researchers. Anthropic says it’s set to see its first profitable quarter, and if major new contracts with pharmaceutical companies are forthcoming, they could help ensure it stays profitable as the tokenmaxxing craze dies down—something that’s ever more important as an IPO approaches later this year.
Stakeholder Experiences With the Pneumococcal Conjugate Vaccine Chatbot as a Complementary Capacity-Building Tool for Frontline Health Workers in India: Qualitative Study
<strong>Background:</strong> Pneumonia remains the leading cause of mortality in individuals aged 5 years or younger globally, with India bearing a disproportionately high burden. The introduction of the pneumococcal conjugate vaccine (PCV) in India necessitated innovative approaches to support frontline health workers (FLHWs), particularly in remote settings. To address this, a customizable WhatsApp-based PCV chatbot was developed as a complementary tool to traditional training and reference materials. <strong>Objective:</strong> This study aimed to document the opportunities, challenges, and mitigation measures encountered during the development and rollout of the PCV chatbot, and to explore its use and user experience as a capacity-building and support tool for FLHWs during new vaccine introduction. <strong>Methods:</strong> A qualitative study was conducted across 4 Indian states—Arunachal Pradesh, Delhi, Karnataka, and West Bengal—using purposive sampling at the district and block levels. Data collection involved key informant interviews with immunization officials and chatbot developers, and focus group discussions with auxiliary nurse midwives. A Likert scale–based tool captured quantitative feedback on user satisfaction. <strong>Results:</strong> Stakeholders appreciated the chatbot’s accessibility, familiarity (through WhatsApp), and multilingual functionality. Most auxiliary nurse midwives found it easy to use and rated responses highly for completeness and usefulness. The chatbot enabled immediate access to information, saving time and bridging gaps, especially when traditional training was delayed or unavailable in hard-to-reach areas. Challenges included occasional technical issues, limited content related to dropout and left-out scenarios, and difficulties in typing regional languages. Recommendations included implementing predictive text, expanding scenario coverage, and strengthening user-centered design and field testing. <strong>Conclusions:</strong> The PCV chatbot demonstrated acceptability and perceived value as an on-demand knowledge tool among FLHWs. Continuous user-driven refinement, expanded content, and enhanced usability are essential for its scalability and sustained use in vaccine introduction and capacity-building efforts.
Expedited Transition to Digital Delivery of Recovery Support Services Due to the COVID-19 Pandemic: Mixed Methods Needs Assessment
Background: Recovery support services (RSS) are an evidence-based approach to support recovery from substance use disorders, most often composed of peer-to-peer support, referrals to housing, job training, and other forms of prosocial engagement and activities. During the COVID-19 pandemic, RSS providers quickly converted in-person services to digital delivery to avoid disruption. It is unclear if this rapid conversion impacted the delivery of services or if this delivery model could enhance RSS reach and uptake more generally by extending the reach of RSS providers and offering an alternative delivery method and access point. Objective: The goal of this study was to identify how RSS providers in Texas adapted their services for digital delivery and to what extent, if at all, technology limitations (eg, lack of digital infrastructure) were present. Methods: We conducted an electronic survey of 85 RSS providers, assessing their current capacity and methods for the digital recovery support service (D-RSS), followed by semistructured online interviews with a subset of 20 respondents. Results: Most survey respondents (74/85, 87.1%) used D-RSS, though they used many dated technologies, devices, and platforms for service delivery. Many respondents indicated that they use Zoom (Zoom Video Communications) videoconferencing to communicate with participants; however, providers also indicated that they must use several different technology platforms to accomplish their service delivery goals. Four main themes emerged from the interviews: (1) the impact of the COVID-19 pandemic on RSS, (2) barriers and facilitators to technology-delivered D-RSS, (3) awareness and expectations regarding the use of D-RSS, and (4) training needs to deliver D-RSS. Conclusions: RSS organizations have access to technology for D-RSS; however, the technology is often outdated. Because the pandemic required a rapid and unexpected shift to D-RSS to maintain and potentially expand access during a public health emergency, providers desire guidance for training staff and participants on how to best use technology. A subset of providers endorsed the potential of a unified platform for D-RSS delivery, especially for data capture. Most barriers to D-RSS identified by our respondents may be addressable through the streamlined deployment of technology resources, rigorous training and onboarding programs in best practices for providers and participants, and tailored implementation strategies for varying local contexts.
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Knowledge Graphs Based on Meta-Analysis Papers Improve the Quality of Case Formulation: Mixed Methods Design
Background: Case formulation (CF) is a core skill for therapists; however, creating high-quality CFs requires considerable time. Objective: This study aims to demonstrate that providing a knowledge graph based on meta-analytic literature can enhance CF quality. Methods: Five groups were established, including 4 large language model groups and 1 human expert group, each generating 25 CFs based on 25 vignettes. The control group with Claude (Sonnet 3.7; Anthropic) produced 25 CFs. The personalization group served as the control group with additional personalization prompts. The knowledge graph group used a large language model that generated 25 CFs, which was provided with a meta-analysis knowledge graph. Further incorporation of additional personalization prompts then comprised the knowledge graph with personalization group. Finally, the expert group consisted of 25 CFs generated by a human expert. These 125 CFs in total were evaluated for general quality (ie, correctness, completeness, feasibility, and consistency) using a 7-point scale and 18 essential elements with binary scores (0 or 1) by another human expert. The CFs were also qualitatively analyzed. Results: The knowledge graph and knowledge graph with personalization groups scored significantly higher than the control group in terms of correctness, completeness, and feasibility. The expert group scored significantly higher on consistency than the machine-generated groups. Additionally, there was no significant difference in the feasibility scores among the knowledge graph, knowledge graph with personalization, and expert groups. The qualitative evaluation suggested that human CFs narrow the text to content that is easy for the client to read, whereas machine CFs are more likely to include expressions that are unnatural to the client. Conclusions: These results indicate that providing knowledge graphs to novice therapists increases the correctness, completeness, and feasibility of CF. Providing experienced therapists with knowledge graphs is suggested to improve the quality of their CF and mental health services.
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