Search Results (396)

Background and Objectives: Depression is a leading cause of disability globally, with treatment challenges including limited access, stigma, and poor adherence. Gamification, which applies game elements such as points, levels, and storytelling into non-game contexts, offers a promising strategy to enhance engagement and augment traditional treatments. Our research is the first study designed to explore the implementation of gamification within the Malaysian context. The objective was to explore the feasibility of implementation of gamification as an adjunctive treatment for adults with depression. Materials and Methods: Focus group discussions were held with five mental health professionals and ten patients diagnosed with moderate depression. The qualitative component assessed perceptions of gamified interventions, while quantitative measures evaluated participants’ depressive and anxiety symptomatology. Results: Three key themes were identified: (1) understanding of gamification as a treatment option, (2) factors influencing its acceptance, and (3) characteristics of a practical and feasible intervention. Clinicians saw potential in gamification to boost motivation, support psychoeducation, and encourage self-paced learning, but they expressed concerns about possible addiction, stigma, and the complexity of gameplay for some patients. Patients spoke of gaming as a source of comfort, escapism, and social connection. Acceptance was shaped by engaging storylines, intuitive design, balanced difficulty, therapist guidance, and clear safety measures. Both groups agreed that gamification should be used in conjunction with standard treatments, be culturally sensitive, and be presented as a meaningful therapeutic approach rather than merely as entertainment. Conclusions: Gamification emerges as an acceptable and feasible supplementary approach for managing depression in Malaysia. Its success depends on culturally sensitive design, robust clinical oversight, and seamless integration with existing care pathways. Future studies should investigate long-term outcomes and establish guidelines for the safe and effective implementation of this approach. We recommend targeted investment into culturally adapted gamified tools, including training, policy development, and collaboration with key stakeholders to realistically implement gamification as a mental health intervention in Malaysia. Full article

Background: This study aimed to assess the impact of methacrylate-functionalized polyhedral oligomeric silsesquioxanes dispersed in nanosilica (MA/Ns-POSS) on the mechanical properties of light-curable dental resins and composites. The primary goal was to evaluate how different concentrations of MA/Ns-POSS (0.5–20 wt.%) affect the hardness, flexural strength, modulus, diametral tensile strength, polymerization shrinkage stress, and degree of conversion of these materials. Methods: A mixture of Bis-GMA, UDMA, TEGDMA, HEMA, and camphorquinone, with a tertiary amine as the photoinitiator, was used to create resin and composite samples, incorporating 45 wt.% silanized silica for the composites. Hardness (Vickers method, HV), flexural strength (FS), and flexural modulus (E_f) were assessed using three-point bending tests, while diametral tensile strength (DTS) polymerization shrinkage stresses (PSS), and degree of conversion (DC) analysis were analyzed for the composites. Results: The results showed that resins with 10 wt.% MA/Ns-POSS exhibited the highest E_f and FS values. Composite hardness peaked at 20 wt.% MA/Ns-POSS, while DTS increased up to 2.5 wt.% MA/Ns-POSS but declined at higher concentrations. PSS values decreased with increasing MA/Ns-POSS concentration, with the lowest values recorded at 15–20 wt.%. DC analysis also showed substantial improvement for 15–20 wt.% Conclusion: Incorporating MA/Ns-POSS improves the mechanical properties of both resins and composites, with 20 wt.% showing the best results. Further studies are needed to explore the influence of higher additive concentrations. Full article

Background and Objectives: Posterior chamber phakic implantable contact lenses (Phakic-ICL) are widely used for refractive correction due to their efficacy and safety, including minimal corneal endothelial cell loss. The Collamer-based EVO+ Visian implantable contact lens (ICL), manufactured from Collamer, which is a blend of collagen and hydroxyethyl methacrylate (HEMA), has demonstrated excellent long-term biocompatibility and optical clarity. Recently, hydrophilic acrylic Phakic-ICLs, such as the Implantable Phakic Contact Lens (IPCL), have been introduced. This study investigated the material differences among Phakic-ICLs and their interaction with fibronectin (FN), which has been reported to adhere to intraocular lens (IOL) surfaces following implantation. The aim was to compare Collamer, IPCL, and LENTIS lenses (used as control) in terms of FN distribution and cell adhesion using a small number of explanted Phakic-ICLs. Materials and Methods: Three lens types were analyzed: a Collamer Phakic-ICL (EVO+ Visian ICL), a hydrophilic acrylic IPCL, and a hydrophilic acrylic phakic-IOL (LENTIS). FN distribution and cell adhesion were evaluated across different regions of each lens. An in vitro FN-coating experiment was conducted to assess its effect on cell adhesion. Results: All lenses demonstrated minimal FN deposition and cellular adhesion in the central optical zone. A thin FN film was observed on the haptics of Collamer lenses, while FN adhesion was weaker or absent on IPCL and LENTIS surfaces. Following FN coating, Collamer lenses supported more uniform FN film formation; however, this did not significantly enhance cell adhesion. Conclusions: Collamer, which contains collagen, promotes FN film formation. Although FN film formation was enhanced, the low cell-adhesive properties of HEMA resulted in minimal cell adhesion even with FN presence. This characteristic may contribute to the long-term transparency and biocompatibility observed clinically. In contrast, hydrophilic acrylic materials used in IPCL and LENTIS demonstrated limited FN interaction. These material differences may influence extracellular matrix protein deposition and biocompatibility in clinical settings, warranting further investigation. Full article

Malignant cutaneous melanoma is among the most aggressive forms of skin cancer, characterized by high metastatic potential and frequent resistance to standard therapies. Hydroxytyrosol, a phenolic compound derived from extra virgin olive oil, has shown promising anticancer properties in various models, yet its effects in 3D melanoma systems remain poorly understood. In this study, we used paired 3D spheroid models of non-tumorigenic (HEMa) and melanoma (C32) to assess the therapeutic potential of hydroxytyrosol. To evaluate the anti-tumoral effect of hydroxytyrosol, we performed cytotoxicity, metastasis, invasiveness, cell cycle arrest, apoptotic, and proteomic assays. Hydroxytyrosol treatment significantly impaired spheroid growth, reduced cell viability, and induced cell cycle arrest and apoptosis in C32 spheroids, with minimal cytotoxicity observed in HEMa models. Proteomic profiling further demonstrated that hydroxytyrosol selectively downregulated a network of oncogenic proteins, including ERBB2, ERBB3, ERBB4, VEGFR-2, and WIF-1, along with suppression of downstream PI3K-Akt and MAPK/ERK signaling pathways. In conclusion, compared to dabrafenib, hydroxytyrosol exerted a broader range of molecular effects and was more selective toward tumor cells. These findings support the use of hydroxytyrosol as a multi-targeted agent capable of attenuating melanoma progression through suppression of kinase signaling and tumor-stromal interactions. Full article

Background and Objectives: Alcoholic hepatitis (AH) is a growing public health concern with its rising incidence and its contribution to nearly half of all cirrhosis-related deaths in the United States. In this systematic review, we aimed to comprehensively evaluate the current evidence and trials on the use of anti-interleukin-1 (anti-IL-1) drugs in patients with AH, assessing their efficacy and adverse events compared to routinely prescribed drugs like corticosteroids. Materials and Methods: A comprehensive literature search was conducted across five databases to identify randomized controlled trials (RCTs) evaluating the role of anti-IL-1 agents like canakinumab and anakinra among patients diagnosed with AH. Data was extracted and pooled in the form of mean and standard deviation for continuous variables and event and total for dichotomous variables. Results: Three RCTs were included for quantitative synthesis, encompassing 307 patients. Using canakinumab, 58% of patients showed improvement in histology. Prednisolone was associated with higher 90-day survival (90% vs. 70%; hazard ratio for death = 0.34, 95% CI 0.14–0.83, p = 0.018) and transplant-free survival. Overall, a higher incidence of acute kidney injury and new-onset cardiac disorders was noted in the anti-IL-1 arm when compared to placebo. Conclusions: This study concludes the lack of efficacy of anti-IL-1 agents in causing improvement in patient outcomes when compared to standard therapies. A higher incidence of adverse events was also noted in the anti-IL-1 arm. These results emphasize the need for future clinical trials to evaluate the use of anti-IL-1 agents in AH objectively. Full article

Anion exchange membranes (AEMs) are vital for electrochemical energy devices such as alkaline fuel cells and water electrolyzers, enabling the use of non-precious metal catalysts despite challenges from alkaline degradation. Hyperbranched polymers (hbPs) with their globular structure, high functional group density, and simple synthesis, offer a promising platform for enhancing transport and stability. In this study, multifunctional hbPs were synthesized from 4-vinylbenzyl chloride (VBC) and 2-hydroxyethyl methacrylate (HEMA) via atom transfer radical self-condensing vinyl polymerization (ATR-SCVP) and crosslinked into polyurethane-based AEMs. Characterization confirmed successful copolymerization and crosslinking, with excellent alkaline stability. Membranes crosslinked with higher molecular weight (MW) and VBC-richer hbPs (e.g., OH-hbP1-PU) exhibited high water uptake (75%) but low ion-exchange capacity (1.54 mmol/g) and conductivity (186 µS/cm), attributed to steric hindrance and insufficient ionic network connectivity. In contrast, OH-hbP2-PU exhibited optimal properties, with the highest OH⁻ conductivity (338 µS/cm) and IEC (2.64 mmol/g), highlighting a balanced structure for efficient ion transport. This work offers a tunable strategy for high-performance AEM development through tailored hbP architecture. Full article

Introduction: This study aimed to compare different scoring methods, such as phoneme, syllable, and word-based scoring, during word recognition in noise testing and their interaction with hearing loss severity. These scoring methods provided a structured framework for refining clinical audiological diagnosis by revealing underlying auditory processing at multiple linguistic levels. We highlight how scoring differences inform differential diagnosis and guide targeted audiological interventions. Methods: Pure tone audiometry and word-in-noise testing were conducted on 100 subjects with a wide range of hearing loss severity. Speech recognition was scored using phoneme, syllable, and word-based methods. All procedures were designed to reflect standard diagnostic protocols in clinical audiology. Discriminant function analysis examined how these scoring methods differentiate the degree of hearing loss. Results: Results showed that each method provides unique information about auditory processing. Phoneme-based scoring has pointed out basic auditory discrimination; syllable-based scoring can capture temporal and phonological processing, while word-based scoring reflects real-world listening conditions by incorporating contextual knowledge. These findings emphasize the diagnostic value of each scoring approach in clinical settings, aiding differential diagnosis and treatment planning. Conclusions: This study showed the effect of different scoring methods on hearing loss differentiation concerning severity. We recommend the integration of phoneme-based scoring into standard diagnostic batteries to enhance early detection and personalize rehabilitation strategies. Future research must involve studies about integration with other speech perception tests and applicability across different clinical settings. Full article

Dry age-related macular degeneration (AMD) is a leading cause of vision loss in individuals over 50, yet no approved therapies exist for early or intermediate stages of the disease. Oxidative stress is a central driver of retinal degeneration in AMD, and sodium iodate (NaIO₃)-induced injury serves as a well-characterized model of oxidative damage to the retinal pigment epithelium (RPE) and photoreceptors. BMI1, a poly-comb group protein involved in DNA repair, mitochondrial function, and cellular renewal, has emerged as a promising therapeutic target for retinal neuroprotection. We evaluated the efficacy of AAV-mediated BMI1 gene delivery in murine models using two administration routes: subretinal (SR) and suprachoroidal (SC). AAV5.BMI1 (1 × 10⁹ vg/eye) was delivered SR in Balb/c mice and evaluated at 4 and 15 weeks post-injection. AAV8.BMI1 (5 × 10⁹ or 1 × 10¹⁰ vg/eye) was administered SC in C57BL/6 mice and assessed at 4 weeks. Control groups received BSS or AAV8.stuffer. Following NaIO₃ exposure, retinal structure and function were analyzed by optical coherence tomography (OCT), electroretinography (ERG), histology, and molecular assays. SC delivery of AAV8.BMI1 achieved the highest levels of retinal BMI1 expression with no evidence of local or systemic toxicity. Treated eyes showed dose-dependent preservation of outer nuclear layer (ONL) thickness and significantly improved ERG responses indicating structural and functional protection. These findings support SC AAV.BMI1 gene therapy as a promising, minimally invasive, and translatable approach for early intervention in intermediate AMD. Full article

The release of synthetic dyes into the environment through industrial wastewater represents a significant environmental concern. In this study, a hydrophobic cryogel, Poly(2-hydroxyethyl methacrylate-N-methacryloyl-L-phenylalanine), was synthesized and employed for the efficient removal of methylene blue from aqueous solutions. The cryogel exhibited a surface area of 6.834 m²/g and a water retention capacity of 218.6%. Adsorption experiments conducted under various conditions revealed a high adsorption capacity of 1304.6 mg/g for MB. Thermodynamic analyses indicated that adsorption occurs spontaneously and follows a monolayer adsorption model. The adsorption capacity increased with temperature and ionic strength, confirming that hydrophobic forces predominantly drive the interaction. Reusability tests showed that the cryogel maintained its adsorption efficiency over five consecutive adsorption–desorption cycles, with a desorption efficiency of up to 98%. These findings demonstrate that Poly(HEMA-MAPA) cryogel is a practical, reusable, and eco-friendly adsorbent for removing methylene blue, a common textile dye pollutant, from water systems. Full article

To address the limitations of traditional endotoxin adsorbents, which exhibit poor endotoxin removal efficiency and low sample recovery when processing high-concentration samples, a novel cryogel, CG(HEMA-co-AM), based on acrylamide (AM) and hydroxyethyl methacrylate (HEMA) as the second monomer, was successfully designed and synthesized. After optimizing the epoxidation and polymyxin B (PMB) conjugation processes, leading to the successful preparation of the functionalized cryogel CG(HEMA-co-AM)@ECH@PMB, flow-through experiments showed that in Tris-HCl buffer at a flow rate of 6 mL/min, the endotoxin removal efficiency reached 99.82%, with a maximum adsorption capacity of 1408.38 EU/mg. In a complex protein system containing BSA, HSA, Hb, LYS, and OVA (each at 10 mg/mL), the maximum endotoxin removal efficiency was 99.62%. Further investigations revealed that pH and ionic strength critically influenced the regulation of hydrophobic and electrostatic interactions, thus significantly affecting the endotoxin adsorption efficiency. Additionally, weakly hydrophobic and basic lysozyme exhibited significantly higher recovery rates compared to strongly hydrophobic and acidic proteins such as BSA and OVA. This functionalized cryogel integrates a high adsorption capacity with excellent specificity and features a macroporous structure suitable for dynamic chromatographic separation. It offers a novel, reusable adsorbent material for endotoxin removal in protein preparation, biopharmaceutical production, and clinical blood purification applications. Full article

This study included deidentified antibiotic susceptibility results from outpatient urinary Escherichia coli isolates from Washington state which were tested at a large clinical laboratory during 2013–2019. Isolates were categorized as representing the first, second, third, or fourth-or-greater occurrence of infection in data from individual patients. We used logistic regression with the outcome of resistance, adjusting for year of antimicrobial susceptibility test, patient sex, patient age, and facility type. In cases of subsequent infection, we found a significant risk of resistance to levofloxacin, ciprofloxacin, ceftriaxone, trimethoprim-sulfa, nitrofurantoin, ampicillin, gentamicin, and amoxicillin-clavulanate. Our findings suggest that Escherichia coli isolates from recurrent urinary tract infections have a higher rate of resistance to most tested antibiotics than isolates from the first urinary tract infection in a given year. However, susceptibility frequencies did not differ significantly between antibiograms constructed using only the first occurrence in a patient and those constructed using all subsequent occurrences. These findings suggest that the traditional approach of including only the first occurrence of urinary Escherichia coli in a patient may underestimate levels of antibiotic resistance in a community. Such underestimation could negatively affect empiric therapeutic choices, health outcomes, and treatment costs. Full article

In Burkina Faso, increasing access to electricity requires the optimized management of energy consumption in buildings and the implementation of regional and national regulations. These regulations have been implemented to promote energy efficiency in the building sector. However, they do not yet seem to have produced the expected results. Conducting a study could help identify the shortcomings related to energy efficiency and guide future research toward sustainable solutions. To date, no such study has been carried out. Therefore, this research aims to analyze the causes of these shortcomings, understand the gaps in the literature, and identify prospects for implementing energy efficiency policy in buildings in Burkina Faso. The methodology consisted of systematically analyzing the scientific literature on current regulations and previous scientific studies on energy efficiency in Burkina Faso. A SWOT analysis of energy efficiency programs in buildings in Burkina Faso was then carried out, and recommendations were proposed. The results show that the obstacles to the emergence of a genuine energy efficiency program in buildings are the inadequacies of the texts and regulations in force, the lack of standards, and the focus of scientific studies on building materials to the detriment of residents’ consumption habits. This study, therefore, sets out guidelines for future research and policies, while providing recommendations for improving the energy efficiency of buildings in Burkina Faso. Full article

A soluble photosensitive polyamide ester precursor (BAFPAE) was synthesized through copolymerization of 2,2-bis [4-(4-aminophenoxy)phenyl]hexafluoropropane (HFBAPP) with 4,4′-(4,4′-isopropylidenediphenoxy)bis(phthalic anhydride) (BPADA). Hydroxyethyl methacrylate (HEMA) was incorporated as a photosensitive functional group, and a transparent photosensitive polyimide film was obtained by thermal curing of the precursor film. The effects of reaction temperature and varying HEMA equivalents on the mechanical properties of the film were systematically investigated. The results indicated that the formation of polyacrylate-polyimide interpenetrating polymer networks (IPNs) was pivotal in preserving the mechanical integrity of the material. The optimized BAF-x-y exhibited a toughness of 12.69 MJ m³, a Young’s modulus of 2.86 GPa, an elongation at break of 21.16%, and a tensile strength of 92.68 MPa. Full article

The development of lightweight construction is of crucial importance for the development of sustainable technologies and for the reduction in carbon dioxide emissions, especially in the automotive industry. This study aims to address the challenges associated with manufacturing plant fibre-based polymer composites. The investigation focused on two novel formulations of bio-based unsaturated polyester resins, assessing their viability as a matrix in plant fibre-reinforced composites within the context of automotive applications. The study addresses the challenges related to the preparation and processing of the system, leading to the necessity of diluting the resin with (hydroxymethyl)methacrylate (HEMA) to achieve an applicable viscosity. Two different flax fibre textiles, in the form of a short fibre mat and a woven fabric, were used as reinforcement. The composite panels were manufactured using the vacuum-assisted resin infusion (VARI) process. The most efficacious material combination, comprising Bcomp^® ampliTex™ 5040 and STRUKTOL^® POLYVERTEC^® 3831, with viscosity modified by 39% HEMA, exhibited a consistent fibre volume fraction of 40% and a glass transition temperature of 70 °C. In addition, the mechanical behaviour in the 0°-direction demonstrated tensile strength and modulus values of approximately 99 MPa and 9 GPa, respectively, accompanied by an elongation at break of 2%. The flexural modulus was found to be 7 GPa, and the flexural strength 94 MPa. Full article

mRNA vaccines have demonstrated considerable efficacy and safety against SARS-CoV-2, limiting the pandemic burden worldwide. The emergence of new variants of concern and the decline in neutralizing activity observed several weeks post-vaccination reinforced the call for repeated mRNA vaccination. We and others have shown that vaccine efficacy does not exclusively rely on antibody neutralizing activites; Fc-effector functions play an important role as well. However, it is well known that long-term exposure and repeated antigen stimulation elicit the IgG4 subclass of antibodies, which are inefficient at mediating Fc-effector functions. In this regard, recent studies highlighted concerns about IgG4 induction by mRNA vaccines. Here, we explored the impact of repeated mRNA vaccination on IgG4 induction and its impact on Fc-effector functions. We observed anti-Spike IgG4 elicitation after three doses of mRNA vaccine; the antibody levels further increased with additional doses. Vaccine-elicited IgG4 preferentially bound the ancestral D614G Spike. We also observed that Breakthrough Infection (BTI) after several doses of vaccine strongly increased IgG1 levels but had no impact on IgG4 levels, thereby improving Fc-effector functions. Finally, we observed that elderly donors vaccinated with Moderna mRNA vaccines elicited higher IgG4 levels and presented lower Fc-effector functions than donors vaccinated with the Pfizer mRNA vaccine. Altogether, our results highlight the importance of monitoring the IgG subclasses elicited by vaccination. Full article