Search Results (399)

Background/Objective: Topical therapy remains a cornerstone in managing fungal infections due to the deep-seated nature of the pathogens and the persistence of the disease. Ketoconazole (KTZ) is a broad-spectrum antifungal agent, but its highly lipophilic nature presents considerable challenges in developing effective topical formulations. Additionally, oral KTZ has been subject to labeling restrictions and market withdrawal due to its association with severe hepatic adverse effects. This study was conducted to design, optimize, and evaluate KTZ-loaded nanolipid carriers (NLCs; KTZ-NLCs) as a delivery platform that could improve cutaneous bioavailability and enhance antifungal activity. Methods: The optimized KTZ-NLCs were further incorporated into a mucoadhesive system (KTZ-NLCs-C) through the inclusion of Carbopol^® 940 NF, aiming to improve the retention of the formulation on the skin surface. NLCs were characterized in terms of their physical appearance, particle size, polydispersity index, zeta potential, pH, viscosity, drug content, and entrapment efficiency. The optimized KTZ-NLC and KTZ-NLCs-C formulations were subsequently assessed for in vitro drug release, ex vivo skin permeation and deposition, as well as in vivo skin irritation. Results: In vitro release studies revealed that nanocarrier systems provided a sustained release of KTZ over 24 h. The ex vivo transdermal flux and permeability coefficient of KTZ from the lead KTZ-NLCs-C formulation were approximately 2.8-fold greater than those achieved with the marketed cream formulation. The in vivo skin irritation studies indicate that NLC-based formulations are suitable for topical applications. The lead formulation was stable for 90 days (the final time point evaluated) under refrigerated and room-temperature storage conditions. Conclusions: These findings suggest that the NLC-based system is a promising platform for the topical delivery of KTZ and has the potential to enhance the therapeutic outcomes for patients with superficial fungal infections. Full article

Background and Clinical Significance: “Hikikomori”—a state of prolonged social withdrawal affecting an estimated 2% of Japan’s working-age population—is frequently associated with underlying anxiety disorders, such as gaze phobia, and contributes to the socio-economic burden known as the “8050 problem,” in which aging parents support their socially isolated adult children. While Morita therapy is effective for such conditions, nursing support has historically lacked a systematic theoretical framework. This case report presents a novel nursing model analyzing the transformation process from toraware (mental preoccupation) toward mokuteki-hon-i (purpose-driven action). It proposes the ‘side-by-side’ nursing approach as a potentially important element in supporting patient autonomy in similar clinical settings. Case Presentation: A man in his 20s, diagnosed with gaze phobia and experiencing long-term withdrawal following traumatic bullying, was referred to our specialized short-care program. After initial preparation through structured psychoeducation regarding Morita therapy principles (toraware, sei-no-yokubo, mokuteki-hon-i), he participated in a 14-month Morita therapy-based short-care program combining individual and group interventions. Initially, the patient exhibited severe social avoidance and was trapped in a cycle of seishin-kogo-sayo (psychic interaction). Nurses applied ‘Strategic Inattention to Symptoms’ (shojo-fumon) and provided specific role suggestions, such as serving as a secretary in group discussions, to elicit his sei-no-yokubo (desire for life). Through the reframing of his anxiety as a constructive drive, the patient shifted to a purpose-driven stance. Outcomes showed improved self-adjustment skills in public spaces and successful social reintegration through sustained part-time employment. Conclusions: Nursing care characterized by ‘intentional non-intervention’—which involves waiting in a ‘side-by-side’ manner within a minimally structured environment—may contribute to fostering patient autonomy in similar clinical contexts. This ‘experience-oriented’ approach appeared to elicit inner strengths and support self-regulation in this case, warranting further investigation in multi-case designs. The relative contributions of individual nursing support and group therapeutic milieu cannot be disentangled in a single-case design. Full article

Background/Objectives: Several randomized controlled trials have found that dietary interventions promoting self-guided shifts away from ultra-processed foods (UPFs) and toward minimally processed, nutrient-dense foods may alleviate depressive symptoms. However, translating these interventions into scalable and sustainable real-world approaches remains a key challenge. Adopting a minimally processed dietary pattern requires sustained effort (e.g., meal planning, shopping, and preparation) within environments where UPFs are pervasive and convenient. These demands may be especially burdensome for individuals experiencing depressive symptoms. Consequently, interventions that rely heavily on individual effort may be difficult to maintain. Commercial meal delivery services may offer a structural solution by reducing logistical and cognitive barriers to dietary change, yet little is known about how individuals with depressive symptoms experience this approach. Methods: In a parent study, we conducted a randomized pilot study of a meal delivery service designed to provide minimally processed meals to adults with moderate to moderately severe depressive symptoms; here we report qualitative findings from post-intervention interviews with participants assigned to the meal delivery condition (n = 20). Results: Participants appreciated reductions in preparatory effort and mental load, which supported adherence. Dietary changes were also linked to improved mood through increased energy, mood stability, and more positive self-evaluation. However, social settings were a near-universal barrier, and acceptability depended on palatability, compatibility with personal preferences, and perceived autonomy. Several participants also described a temporal adjustment process (early cravings/withdrawal followed by adaptation). Conclusions: Overall, these findings suggest participant-informed priorities for future testing and refinement of scalable meal delivery interventions for depression, including personalization and choice, quality control, and support for social and withdrawal-related challenges. Full article

This study investigates the relationship between toxic workplace culture and voluntary employee turnover, undermining workforce sustainability in Ghana’s construction industry. While some previous research has found a relationship between a toxic working environment and employee withdrawal habits, few studies have investigated the psychological processes between the toxic work culture and employee turnover in Global South construction companies. Based on the theories of Conservation of Resources and Social Exchange, this research examines the possible mediating factors between the toxic work culture and employee turnover: employee burnout, psychological safety, and job dissatisfaction. Structured questionnaires were used to design a quantitative cross-sectional survey, which was administered to 174 construction workers in Ghana. The data were analysed using mediation regression models based on Ordinary Least Squares (OLS). The findings show that a hostile work environment and a lack of organisational support were the two highest dimensions of work culture assessed as negatively impacting employee burnout, psychological safety, and attrition intentions. Employee burnout was the only significant predictor for voluntary employee attrition (β = 0.3628, p < 0.001), and psychological safety had a significant protective effect (β = −0.1785, p = 0.016). Mediation accounted for 67.4% of the variance in attrition outcomes. This paper shows how a negative organisational climate can undermine the stability of human resources, psychological well-being, and the social dimension of sustainability in construction companies. The results indicate that organisational support, leadership accountability and psychologically safe working environments are important for increasing employee retention and long-term organisational resilience. Full article

The internal saboteur may be understood as a multidimensional configuration of maladaptive inner processes involving recurrent negative self-evaluation, distressing relational expectations, repetitive negative thinking, and self-undermining inner experiences. Within this framework, the present study aimed to develop and examine the psychometric properties of the Internal Saboteur Scale (ISS), a self-report measure designed to assess this construct. A sample of 328 Italian adults (women 71.6%; Mage = 37.37, SD = 14.88) completed the survey. Confirmatory factor analyses supported both an eight-factor correlational model and a theoretically meaningful higher-order model, in which the lower-order dimensions were grouped into four broader domains: Negative Relational Expectations (Expected Rejection; Expected Judgment), Self-Devaluation (Negative Self-Appraisal; Interpersonal Unworthiness), Rumination (Retrospective Rumination; Anticipatory Rumination), and Internal Destructiveness (Helplessness; Defensive Relational Withdrawal). Measurement invariance across gender was also supported. All dimensions showed satisfactory-to-good internal consistency. Furthermore, ISS scores were negatively associated with secure attachment, self-reassurance, and mentalizing and positively associated with insecure attachment, self-criticism, shame, and anger. Overall, the ISS appears to be a theoretically grounded and psychometrically promising instrument for the assessment of maladaptive inner dialogue and self-sabotaging internal processes. It may represent a useful tool for both research and clinical practice, particularly in supporting transdiagnostic assessment and case formulation. Full article

As cloud computing proliferates, outsourced data faces severe security threats, yet existing searchable encryption (SE) schemes rely on classical hardness assumptions, centralized trust authorities, and static access control, leaving critical gaps in quantum resistance, single-point-of-failure prevention, and dynamic permission management. To address these limitations, we propose BL-ABSE, a blockchain-enhanced, lattice-based attribute-based searchable encryption framework. BL-ABSE employs the Ring Learning With Errors (RLWE) problem as its security foundation and applies the Number Theoretic Transform (NTT) to reduce polynomial multiplication from $O\left(n^2\right)$ to $O(nlogn)$. To eliminate single-point trust risks, the framework further integrates a $(t,n)$ threshold key protocol across an edge-node consortium governed by Practical Byzantine Fault Tolerance (PBFT) consensus. A smart-contract-maintained on-chain revocation list enables permission withdrawal via a single blockchain transaction without re-encryption. Experimental evaluation demonstrates that commitment generation requires approximately 23 ms at $n=1024$, search latency scales linearly at roughly 29 µs per record, and revocation completes in approximately 2 s regardless of system scale. Formal security proofs under the quantum polynomial-time (QPT) adversary model reduce six security properties—index indistinguishability, query privacy, threshold key security, Byzantine fault tolerance, audit immutability, and revocation immediacy—to the hardness of RLWE and the Short Integer Solution (SIS) problems. To the best of our knowledge, BL-ABSE is the first framework to simultaneously achieve post-quantum security, attribute-based access control, decentralized key management, instant revocation, and immutable auditing within a single unified framework. We further conduct threshold parameter verification, end-to-end revocation latency decomposition, blockchain throughput stress testing, search-pattern leakage quantification, and communication/storage overhead analysis, providing a comprehensive evaluation of both performance and security trade-offs. We explicitly characterize the search-pattern leakage inherent in the deterministic commitment design as a correctness–privacy trade-off and discuss mitigation directions. Full article

Low-frequency (LF, ν ≤ 200 cm⁻¹) vibrational modes of crystalline organic semiconductors are of particular interest because they significantly affect charge transport in these materials. Herein, we study LF vibrations of [1]benzothieno[3,2-b][1]benzothiophene (BTBT) substituted by phenyls, (per)fluorophenyls or pyridyls using the synergy of Raman spectroscopy and (periodic) DFT calculations. The LF spectra for the compounds with electron-withdrawing (fluorine or nitrogen) atoms differ significantly in the band positions and intensities from those for diphenyl-substituted BTBT, whereas the high-frequency (HF, ν > 200 cm⁻¹) spectra are quite similar for all the compounds studied, excluding the perfluorophenyl-substituted BTBT. We found that Ph-BTBT-Ph counterparts containing one electron-withdrawing atom per aryl ring show significantly lower LF Raman intensity compared to the parent compound. The LF intensity decrease is attributed to the suppression of intermolecular motions by the stronger electrostatic interactions. The unexpected LF intensity increase for the perfluorophenyl-substituted BTBT can be ascribed to strong dynamic disorder induced by easier torsion of phenyls with respect to the BTBT core, which also results in the deterioration of the π-conjugation revealed in the HF Raman spectra. We anticipate that the established structure–property relationships will contribute to the rational design of crystalline organic semiconductors towards controlled dynamic disorder and high charge mobility. Full article

Cross-laminated timber (CLT), an engineered timber product with distinctive features, has significantly broadened the applicability of timber structures. The self-tapping screws (STSs) with excellent anchorage performance have become one of the primary connectors used in CLT structures. However, the long-term withdrawal resistance is susceptible to environmental factors such as temperature and humidity fluctuations, which may lead to reduced CLT density and corrosion-induced degradation of the steel components. These effects represent a critical life-cycle challenge to the structural integrity and safety of timber connections. This study aims to investigate the withdrawal resistance of STSs in CLT under material aging effects. To achieve this, a two-step experimental program was designed. First, the effects of two artificial accelerated aging methods (ASTM D1037 and improved version of ASTM D1037) on the withdrawal resistance of STSs in glued laminated timber (glulam) were compared to validate the feasibility of the improved protocol. This comparison was necessary to ensure that the improved protocol produces a degradation pattern without altering the failure mechanism. Subsequently, a series of CLT specimens with embedded STSs were subjected to 0, 3 and 6 aging cycles to investigate the withdrawal behavior including aging characterization, failure modes, load–displacement curves, withdrawal capacity, and stiffness. The results indicate that the failure mode of CLT joint with STSs under the improved aging scheme was the consistent pull-out of STSs, identical to that observed in the glulam, confirming mechanistic consistency. After three and six aging cycles, the normalized withdrawal capacity retention rates were 104.98% and 95.36%, respectively. The stiffness is more significantly affected by aging. The corresponding normalized stiffness retention rates were 85.60% and 80.94%, respectively. As the number of aging cycles increased, the occurrence of wood fiber tearing became more pronounced and the ratio of the corresponding load to the peak load decreased. Furthermore, ensuring adequate distance from the vertical glue layer was found to lead to greater long-term resilience and withdrawal capacity. Full article

The concept of water security emerged in the academic literature at the end of last century. While it became an increasingly popular term in water policy circles, it was also considered a contested concept. This manuscript aims to analyze the evolution of the water security concept by designing a timeline of this conceptual evolution, and discussing the implication of this evolution and the adoption of water security in water policies. The analysis of the conceptual evolution includes the decomposition of the water security concept in its main components or focuses, addressing the emphasis placed on human well-being and health and the necessary interventions on ecosystem and its functioning, the consequences for its long-term stability, the capability to preserve ecosystem services, and its close affiliation with an anthropocentric or an ecocentric view. The analysis shows that there is a hegemonic view of water security and this leads to an overvaluation of infrastructure as the way to guarantee water security, highlighting an anthropocentric view. This review presents the consequences of the choice for an anthropocentric view, and how this choice can favor fragmented views and facilitate distortion or emphasis in small parts of the water security concept that reinforces unsustainable water management, such as water withdrawals for economic purposes or investments in water infrastructure. Global Water Bankruptcy, declared by United Nations University in 2026, is the utmost consequence of having chosen an anthropocentric view, and they claim the need for a fresh start. It is concluded that it is time to advocate for a redefinition of the water security concept, amid calls for a paradigm shift. Full article

The rapid integration of artificial intelligence in higher education positively affects student satisfaction, engagement, and learning outcomes. However, students frequently report ethical unease, guilt, and concerns about dependency. The current literature offers a limited explanation for their coexistence, as both have been treated as parallel or independent outcomes. Hence, this review extends and integrates existing theories by reconceptualising cognitive and moral dissonance as a central psychological process that explains how student satisfaction with AI-mediated learning is produced, negotiated, and sustained. Following PRISMA 2020 guidelines, we adopted a two-layer explanatory review design, synthesising 40 Scopus-indexed studies (Layer 1 = 15 studies; Layer 2 = 25 studies) from 2016 to 2025. Layer 1 studies explicitly define dissonance-related explanatory mechanisms that influence satisfaction and continued AI use across contexts such as dissertation writing, programming education, and problem-based learning. Layer 2 encompasses satisfaction-based studies that report ethical or affective concerns in parallel without theorising their interaction. The findings suggest a recurring satisfaction–dissonance paradox, in which students often experience genuine or conditional satisfaction from performance gains while simultaneously managing their psychological discomfort through one or more regulation mechanisms. Further, persistent and escalated dissonance leads to withdrawal or full or partial adaptive behaviour. We propose these dynamics as a testable Dual-Process Satisfaction–Dissonance Framework (DPSDF), which includes five dissonance triggers, five regulation strategies, three feedback loops, and four behavioural outcomes. Further, five domain experts’ suggestions have been taken to provide specific practical implications. This framework extends understanding of AI-mediated learning and provides foundations for future theory and policy development in higher education. Full article

Across four decades of AI deployment, the same six human challenges (trust calibration, reliance behavior, cognitive engagement, skill retention, accountability, and transparency) recur, yet fragmentation across research communities obscures this continuity and limits knowledge transfer. Functionally similar phenomena are repeatedly relabeled (a jangle fallacy): what aviation researchers call “automation complacency,” decision scientists call “algorithm appreciation,” and LLM researchers describe as “over-reliance.” This systematic review synthesizes 152 papers spanning aviation, healthcare, manufacturing/supply chain, and cross-domain contexts across three AI technology generations: decision support systems, autonomous systems, and large language model (LLM) agents. We introduce the Collaboration Convergence Framework (CCF), a 6 × 3 matrix with solution-maturity indicators that maps each challenge across generations. The framework shows that Gen 3 designers can transfer decades of evidence from automation and decision support research (particularly reliance calibration, cognitive forcing, and skill maintenance) rather than rediscovering them. Cross-generational synthesis also isolates three Gen 3 phenomena without direct precedent in earlier generations: epistemia (attributing genuine knowledge to LLMs based on surface fluency), attribution ambiguity in co-creation, and motivational withdrawal. We distill twelve transferable design principles and propose ten research directions, prioritizing skill-retention interventions and accountability frameworks. These findings carry direct sustainability implications aligned with Industry 5.0: protecting workforce capability under increasing automation (SDG 8), reducing duplicated research effort through cross-generational knowledge reuse (SDG 9), and supporting responsible deployment by treating collaboration risks as predictable rather than novel (SDG 12). The CCF provides conceptual infrastructure for cumulative learning across AI generations and industries. Full article

We examined the limitations of observed course DFWI rates (% of D and F grades, withdrawals, and incompletes) as evaluation metrics, which obscure student characteristics, course design, instruction, structure, and latent factors, posing challenges in identifying courses that need improvement. An artificial neural network (ANN) was trained using student data to model risk, accounting for variations in student characteristics. The model’s predictions on test data were averaged at the course level, producing expected DFWI rates based on student composition. Courses with high observed DFWI rates and large deviations between observed and predicted DFWI rates (the GAP) were ranked and prioritized for review, as they may reflect aspects of course design, structure, or instructional practices warranting further qualitative evaluation. Our predictions are non-causal, and modeling calibration varies across subgroups; therefore, the original GAP rankings, robust to a post-hoc calibration check, are presented as risk-adjusted indicators for prioritizing courses for further review rather than as definitive causal measures of course quality. Rankings based on observed DFWI rates differ substantially from risk-adjusted GAP rankings, indicating that relying on observed DFWI rates alone may misidentify high-risk courses. Our methodology can assist educators and administrators in making fair resource allocation decisions and improving student outcomes. Full article

Background/Objective: The introduction of Ketoconazole (KZ, Nizoral^®) in 1977 by Janssen Pharmaceutica marked a significant milestone in medical mycology as the first broad-spectrum oral antifungal agent. However, KZ is a highly lipophilic compound, presenting significant challenges in the development of efficient topical formulations. Moreover, oral KZ has undergone labeling revisions and market withdrawal due to serious hepatic side effects. This study aimed to design, optimize, and evaluate KZ-loaded nanoemulsions (NEs; KZ-NEs) as a delivery platform that could improve skin bioavailability and antifungal activity. Methods: Optimized KZ-NEs were converted to a mucoadhesive formulation (KZ-NEC) by the addition of Carbopol^® 940 NF to enhance the adherence of the formulations to the skin surface. NEs were evaluated concerning physical appearance, globule size, polydispersity index, zeta potential, pH, viscosity, and drug content. Optimized KZ-NE and lead KZ-NEC formulations were further evaluated for in vitro release, ex vivo skin permeation and deposition, skin irritation, and in vivo studies. Results: In vitro release studies revealed that nanocarrier systems provided a sustained release of KZ over 24 h. The ex vivo permeability coefficients of KZ from the optimized KZ-NE and lead KZ-NEC formulations were approximately four- and three-fold greater than that achieved with the marketed cream formulation, respectively. In addition, the C_max of the lead KZ-NEC formulation (14.4 ± 1.1 μg/mL) was significantly higher (p < 0.05) compared with the marketed cream formulation (10.5 ± 0.5 μg/mL). Moreover, in vitro antifungal susceptibility testing showed that KZ demonstrated improved antifungal efficacy when incorporated into the KZ-NE and KZ-NEC formulations. Neither of the NE-based formulations caused any alterations in skin color or morphology during the 24 h visual observation period. Both NE-based formulations were stable for 90 days (the last time-point tested) at three different storage conditions. Conclusions: NE-based formulation could serve as an effective topical delivery platform for KZ and could improve therapeutic outcomes for patients with topical fungal infections. Full article

High-performance full-color displays and white lighting require stable and efficient red, green, and blue emitters; however, they are often limited by wide bandgaps, imbalanced carrier injection/transport, complex device structures, and high material costs. To address these challenges, we designed and synthesized a multifunctional deep-blue molecule (PPI-F-PO) integrating a phenanthroimidazole moiety, a 9,9-diphenylfluorene unit, and a phosphine oxide group. The twisted structure of fluorene, featuring a sp³-hybridized carbon, effectively suppresses conjugation extension and aggregation-caused quenching, whereas the electron-withdrawing phosphine oxide group enhances electron transport. Consequently, it exhibits good thermal stability, high solid-state photoluminescence quantum yield (58.8%), and high triplet energy (E_T = 2.54 eV). Non-doped blue OLEDs based on this emitter achieve a maximum external quantum efficiency (EQE) of 2.52% with deep-blue CIE coordinates of (0.16, 0.06). Moreover, using this material as a host, green and orange-red phosphorescent OLEDs exhibit maximum EQEs of 15.4% and 9.7%, respectively, along with low efficiency roll-off. This work demonstrates that a bipolar deep-blue emitter with high triplet energy can act both as a high-efficiency standalone emitter and as a universal host for lower-energy phosphors, thereby simplifying device architecture and reducing material costs for full-color OLEDs. Full article

Background: Despite considerable advances in contemporary pharmacotherapy for heart failure (HF), residual congestion continues to drive adverse outcomes in a substantial proportion of patients. Goreisan, a traditional Kampo herbal formulation, has seen growing clinical application as an adjunct for refractory fluid retention; yet the prognostic implications of sustaining versus withdrawing goreisan among patients on tolvaptan-based regimens have not been adequately characterized. Methods: We conducted a retrospective single-center observational analysis enrolling patients with HF who received goreisan alongside tolvaptan-incorporated medical therapy between April 2022 and November 2025. Enrolled patients were classified into a continuation group or a termination group based on their subsequent goreisan treatment course. The primary endpoint was defined as a composite of all-cause death and HF-related hospitalization requiring intravenous diuretic therapy. Results: Among 25 patients, 12 maintained goreisan throughout the observation period while 13 underwent treatment termination. Baseline clinical profiles were broadly similar across the two groups. The continuation group exhibited a significantly reduced cumulative incidence of the primary endpoint relative to the termination group (p = 0.036). Negative binomial regression revealed a markedly elevated event rate in the termination group (incidence rate ratio 9.27; 95% confidence interval 2.05–42.0; p = 0.004), with adverse events demonstrating a pronounced temporal clustering in the immediate post-discontinuation period. Conclusions: Among patients with HF and refractory congestion on tolvaptan-incorporated therapy, maintaining goreisan was associated with a trend toward fewer clinical events and longer periods of hemodynamic stability, whereas its withdrawal appeared to be followed by early adverse outcomes. Given the small sample size and observational design, no definitive conclusions can be drawn, and these findings should be regarded strictly as preliminary and hypothesis generating; prospective controlled studies with larger cohorts are needed before any clinical implications can be established. Full article