Search Results (11,041)

Conventional evaluations of indoor environmental quality (IEQ) in office spaces are typically disproportionately influenced by expert experience, often overlooking the cognitive gap between decision makers (experts) and users (employees). To quantify and explain this discrepancy, this study develops a comprehensive evaluation framework including 20 IEQ indicators, grounded in Maslow’s hierarchy of needs. Using the Shenzhen Science Park as a case study, evaluation data were collected from 13 experts and 432 employees. The Analytic Hierarchy Process (AHP) and the Kano model were applied to calculate expert weights and employees’ nonlinear sensitivities, respectively, followed by the construction of an optimization matrix via Importance–Performance Analysis (IPA). The results reveal a notable cognitive gap: experts prioritize foundational physical elements regarding spatial technology, whereas employees place greater emphasis on factors such as privacy protection and flexible layouts. Both groups concur that “noise interference” and “lack of privacy” are the primary shortcomings of open-plan offices. Prospective assessments indicate that embodied AI-enabled robots currently remain in a “early adoption phase,” with employees showing no functional dependency on them. This study confirms that merely improving building physical performance does not proportionally translate to increased employee satisfaction. Spatial optimization should adopt a human-centric approach, emphasizing acoustic control and the reconfiguration of privacy boundaries to enhance the scientific allocation of resources. Full article

Background: Dry Eye Disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and inflammation. Cyclosporine A, an immunomodulator, and Diquafosol sodium, a mucin secretagogue, represent two distinct therapeutic pathways. However, current evidence directly comparing their clinical efficacy is inconsistent. This meta-analysis aimed to compare treatment outcomes and efficacy between 0.05% Cyclosporine A and 3% Diquafosol sodium in patients with moderate-to-severe DED. Methods: In January 2026, we conducted a systematic search of PubMed, Scopus, Web of Science, and the Cochrane Library for randomized controlled trials directly comparing 0.05% Cyclosporine A to 3% Diquafosol sodium in adult patients with moderate-to-severe DED. For the meta-analysis, we used R 4.5.0 with R Studio 2024.12.1+563. Results: We included six RCTs with a total of 859 patients. No significant differences were found between Cyclosporine A and Diquafosol sodium in Tear Break-Up Time (TBUT) at 4, 8, or 12 weeks. Cyclosporine A showed a suggestive greater improvement in Schirmer test scores at 4 weeks (SMD = 0.35, 95% CI 0.07 to 0.63). A modest benefit in symptom scores favoring Diquafosol sodium was observed at 12 weeks (SMD = 0.23, 95% CI 0.06 to 0.41). Subgroup analysis suggested this symptomatic benefit may be more pronounced in patients with severe disease, although subgroup interaction tests were not statistically significant. There were no significant differences in corneal or conjunctival staining at any time point. The risk of adverse events did not differ significantly between treatments. Conclusions: Early improvement in tear production showed a potential benefit for Cyclosporine A, while longer-term symptomatic relief showed a potential benefit for Diquafosol sodium, with suggestive evidence in severe disease. However, these findings should be interpreted cautiously, given the methodological limitations and inconclusive TSA evidence for several outcomes. Future large-scale, standardized trials with extended follow-up are warranted to confirm these findings. Full article

Selenium (Se) is a beneficial element involved in plant growth, metabolism, stress adaptation, and crop quality improvement, but its effects are strongly influenced by chemical form, application dose, plant species, growth stage, and environmental conditions. To integrate mechanistic understanding with global research trends, this study combines a concise mini-review with a bibliometric analysis of Se research in plants from 2000 to 2025. The mini-review summarizes Se speciation and bioavailability in the soil–plant–microbe system, root uptake and long-distance transport, metabolic assimilation and detoxification, physiological regulation, stress tolerance, biofortification, and nano-Se applications. Bibliographic data were retrieved from the Web of Science Core Collection and analyzed using CiteSpace, VOSviewer, and Scimago Graphica. A total of 3451 valid publications were identified, showing a sustained increase in annual output, especially after 2018. The field has expanded from early studies on Se speciation, uptake, assimilation, and antioxidant responses toward broader themes involving crop biofortification, molecular regulation, stress physiology, foliar application, nano-Se applications, green synthesis, and phytoremediation. Overall, plant Se research has evolved into an interdisciplinary field linking mechanistic studies with safe agricultural application. Future work should emphasize standardized experimental frameworks, causal mechanism validation, precise biofortification, field-based evaluation, and safety assessment of emerging Se-based technologies. Full article

The demand for sustainable, high-performance biomaterials has driven intense research towards natural polysaccharide hydrogels. Accordingly, this study aimed to synthesize novel starch-based hydrogel materials, considering their inherent hydrogel-forming capabilities together with diverse potential applications (e.g., pharmaceuticals, medicine, and the cleaning application for the artifacts). To obtain hydrogels with enhanced mechanical and physico-chemical properties, starch was combined with other polymeric species (i.e., alginate, polyvinyl alcohol, and polyvinylpyrrolidone), and a gelling process was induced by using calcium cations or borate anions. Two distinct hydrogels (named S-Ca and S-SB, respectively) were prepared and characterized by a range of instrumental and experimental techniques. The assessed properties included water and solvent resistance, equilibrium water content, water-releasing capacity, morphology and microstructural features with their composition by SEM-EDS analysis, and mechanical properties (tensile strength, elasticity, Young’s modulus, and hardness). The results indicated that the investigated hydrogels exhibited suitable properties for a variety of applications, including surface cleaning processes in the field of cultural heritage conservation. For instance, they showed equilibrium water content (between 80 and 90%) comparable with other hydrogels commonly used as cleaning tools (e.g., agar and p(HEMA)/PVP) and quite low water-releasing capacity (between 10 and 17 mgcm⁻²). Moreover, the S-SB hydrogel displayed distinctly better tensile strength and elongation at break than hydrogel prepared in the presence of Ca²⁺ (S-Ca). Notably, S-SB experienced considerable elasticity improvement after freezing–thawing cycles, as indicated by a decrease in tensile strength (from 275 to 102 kPa) and an increase in elongation at break (from 121 to 275%). However, it should be noted that the hydrogel selection depends on the requirements of the target application, as different processes demand materials with distinct characteristics. Hence, both S-Ca and S-SB hydrogels were tested as cleaning tools for the removal of artificially aged acrylic coating (i.e., Paraloid B-72) from the surface of marble and wood specimens, respectively. The tests provided positive results, as aged coating was satisfactorily removed by applying the hydrogels loaded with a nanostructured emulsion (NSE). These novel starch-based hydrogels demonstrate significant potential as high-performance alternatives to conventional hydrogel systems currently used in conservation science as well as in other industrial applications. Full article

Background/Objectives: Metastatic triple-negative breast cancer (mTNBC) carries a poor prognosis and limited treatment options. Sacituzumab govitecan (SG), an anti-Trop-2 antibody–drug conjugate, has shown activity in this setting, but a quantitative synthesis integrating randomized and real-world evidence—particularly in underrepresented subgroups—was lacking. We aimed to summarize the comparative benefit of SG, which derives from a single randomized trial, and to assess whether trial-level efficacy is consistent with the activity observed in routine practice. Methods: Following PRISMA 2020, we searched PubMed/MEDLINE and Web of Science (January 2017–April 2026) for trials and observational cohorts of SG monotherapy in mTNBC. Comparative effects were taken from randomized data; single-arm efficacy (objective response rate [ORR], clinical benefit rate [CBR], median progression-free [PFS], and overall survival [OS]) was pooled using random-effects models. Risk of bias was assessed with RoB 2 and ROBINS-I. The review was registered in the Open Science Framework. Results: Nine studies (1242 patients; 980 SG-treated) were included: one randomized trial (ASCENT), two single-arm trials, and six real-world cohorts. In ASCENT, SG improved PFS (hazard ratio [HR] 0.41, 95% CI 0.33–0.63) and OS (HR 0.51, 0.42–0.64). Pooled ORR was 31.1% (28.0–34.4), and CBR was 42.2% (37.7–46.8), with the median PFS being 4.8 months (4.4–5.3) and OS being 11.0 months (9.3–13.0); trial-derived and real-world estimates were concordant. The benefit persisted in older patients (HR 0.25) and Black women (HR 0.44) but not in those with brain metastases (HR 0.68, 0.38–1.23). Conclusions: SG shows clinically meaningful activity in mTNBC that is broadly consistent between controlled trials and routine practice. Comparative superiority over chemotherapy rests on a single randomized trial (ASCENT); the pooled single-arm estimates describe activity and its consistency rather than a comparative effect. Full article

Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable driver of muscle deterioration in COPD. Nutritional deficits impair anabolic signaling, exacerbate proteolysis, worsen mitochondrial dysfunction, and contribute to frailty progression. Methods: This narrative review synthesizes evidence from PubMed, Embase, Scopus, and Web of Science up to 2025, integrating mechanistic, metabolic, nutritional, and biomarker-related pathways underlying muscle dysfunction in COPD. Studies examining inflammation, hypoxemia, oxidative stress, hormonal imbalance, nutrition, and emerging biomarkers were included. Results: COPD-related sarcopenia results from converging inflammatory (TNF-α, IL-6), catabolic (FOXO, UPS), metabolic, and vascular mechanisms, compounded by energy deficiency, protein insufficiency, and micronutrient deficits. Inadequate intake of protein, vitamin D, antioxidants, and omega-3 fatty acids increase anabolic resistance, enhance muscle catabolism, and worsen frailty. Nutritional interventions, particularly high-protein supplementation, leucine-enriched formulas, vitamin D repletion, omega-3 fatty acids, and multimodal nutrition–exercise programs, demonstrate benefits in muscle mass, strength, and physical performance. Biomarkers such as GDF-15, CAF22, and specific microRNAs reflect nutritional status and correlate with muscle health in COPD. Conclusions: Sarcopenia and frailty in COPD arise from a complex interplay of inflammatory, metabolic, nutritional, and lifestyle-related factors. Integrating nutritional assessment and targeted dietary interventions with exercise and pulmonary rehabilitation is essential to counteract anabolic resistance and improve functional outcomes. Advances in biomarker research may support earlier diagnosis and personalized nutrition-based therapeutic strategies. Full article

Microplastics (MPs; <5 mm) represent a growing environmental concern that increasingly challenges environmental monitoring, governance, and evidence-based decision-making. This review critically examines how current scientific understanding of microplastic sources, classification, occurrence, and environmental behavior can support environmental governance. MPs are classified as primary and secondary particles; however, persistent inconsistencies in size definitions, shape descriptors, and polymer identification limit the comparability of monitoring data and constrain the development of coherent regulatory frameworks. Evidence on the occurrence of MPs in surface waters and sediments highlights widespread contamination and pronounced spatial variability, raising challenges for risk assessment and policy harmonization across regions. Key transport pathways, including atmospheric deposition, terrestrial runoff, and riverine fluxes, are analyzed to illustrate how local emissions translate into large-scale environmental impacts. Rivers emerge as key components linking sources to receptors, offering relevant points for policy intervention and management measures. The review evaluates current policy responses to microplastic pollution, identifying significant gaps in standardized monitoring, data integration, and risk assessment approaches. It emphasizes the need for stronger alignment between scientific outputs and policy requirements, including the co-production of knowledge involving scientists, regulators, and stakeholders. By outlining pathways through which scientific evidence can inform regulatory design and environmental management, this study provides actionable insights for improving policy effectiveness. Advancing harmonized methodologies and integrating science into decision-making processes are essential steps toward mitigating microplastic pollution and supporting sustainable environmental governance. Full article

Agri-food by-products (BP) and BP-derived fractions are increasingly recognized as sources of functional and nutritional compounds (e.g., dietary fibers, proteins, waxes, phytosterols, phenolics, carotenoids) that can be upcycled into high-value food ingredients, to improve the sustainability of agri-food chains. This review provides a wide-ranging vision of the potential use of BP and BP-derived fractions in OG formulations, emphasizing the roles they can play (e.g., structuring agents, stabilizers, surfactants, physical scaffolds, fillers, sources of antioxidants), while offering mechanistic insights and science-based perspectives to support the rational design of tailor-made OGs for specific food applications. Particular attention is given to emerging areas including plant-based and hybrid products, and the valorization of insect BP and co-products. Finally, key gaps limiting BP-based OG design and application (e.g., effects on crystallization, interfacial phenomena, dispersion, scaffold/filler behavior, etc.) are identified and translated into a research roadmap and design guidelines for the formulation of tailor-made, scalable BP-based OGs. Full article

Modern prosthetic dentistry has been significantly reshaped by adhesive dentistry, CAD/CAM technologies, and advanced ceramic materials, leading to the development of minimally invasive all-ceramic restorative approaches. However, the longevity of the adhesive interface is fundamental to the long-term effectiveness of these restorations. With a focus on bond durability and clinical performance, this narrative review aims to evaluate modern adhesive strategies, tooth preparation requirements, and cementation techniques in all-ceramic minimally invasive restorations. Methods: A narrative review of the literature was performed using Google Scholar, Web of Science, and PubMed/MEDLINE databases. Publications from 2000 to 2026 were analysed. In vitro research, narrative reviews, and systematic reviews related to adhesive systems, resin cements, CAD/CAM materials, and minimally invasive prosthodontic principles were the core subjects of the research. Results: The findings indicate that material selection, surface conditioning techniques, and cementation methods have a significant impact on the clinical effectiveness of all-ceramic restorations. Retention and marginal sealing are greatly enhanced by resin-based adhesive systems. Nevertheless, hydrolytic degradation, procedure sensitivity, and substrate-related factors remain a challenge to the adhesive interface. Advances in CAD/CAM and ultra-conservative designs, like occlusal veneers and partial-coverage restorations, have increased treatment alternatives while ensuring acceptable functional and aesthetic results. Conclusions: Minimally invasive all-ceramic restorations represent a conservative and clinically effective treatment approach in modern prosthodontics. Their long-term performance is primarily dependent on adhesive interface stability and adherence to evidence-based clinical protocols. Continued developments in adhesive materials and ceramic systems are expected to improve bond durability and broaden clinical indications. Full article

Background: Obesity is a multifactorial metabolic disorder characterized by chronic low-grade inflammation, oxidative stress, mitochondrial dysfunction, lipotoxicity, dysregulated adipogenesis, and alterations in the gut microbiota, which collectively contribute to insulin resistance and cardiometabolic complications. In this context, dietary patterns rich in bioactive compounds have gained relevance as potential strategies to modulate these interconnected pathways. Objective: To assess the potential of the Milpa Diet (a sustainable, plant-dominant Mesoamerican eating pattern centered on the ancient three sisters’ polyculture of maize, beans, and squash, along with chili) as a culturally relevant, multi-axis functional dietary pattern, and to evaluate the molecular mechanisms underlying obesity-associated with metabolic dysfunction. Methods: A scoping review of preclinical and clinical studies was conducted using Medline via PubMed, Scopus, and Web of Science databases. The ChEMBL database was also used to identify chemical structures. The search focused on evidence related to inflammation, oxidative stress, adipogenesis, lipotoxicity, mitochondrial function, and gut microbiota modulation in the context of the main foods of the Milpa Diet, including maize, legumes, chili peppers, nopal, and quelites. Studies were selected based on peer-review status and their relevance to molecular, metabolic, and functional outcomes. Results: The current evidence shows that the core components of the Milpa Diet provide dietary fiber and a broad range of bioactive compounds, such as flavonoids, carotenoids, capsaicinoids, phenolic acids, pigments, and vitamins, which exhibit antioxidant and anti-inflammatory effects. These compounds have been associated with modulation of adipogenesis and lipotoxicity, preservation of mitochondrial function, and favorable regulation of gut microbiota composition and activity, collectively influencing metabolic pathways relevant to obesity. Conclusions: Overall, mechanistic and emerging clinical evidence suggests that the Milpa Diet represents a multi-axis nutritional strategy with potential to mitigate obesity-related metabolic dysfunction through coordinated effects on inflammation, oxidative stress, adipogenesis, lipotoxicity, mitochondrial function, and gut microbiota regulation. Although comprehensive clinical trials evaluating this dietary pattern as an integrated intervention remain limited, current evidence supports its relevance for future translational research, public health strategies, and the development of sustainable dietary models aimed at improving metabolic health. Full article

Background: Cardiac telemetry monitoring represents an important aspect of in-hospital patient safety in both telemetry and critical care settings. Despite technological advancements, telemetry effectiveness may be diminished due to systemic failures including operational processes, instructional policies, and human factors. Alarm fatigue, recognized by the Joint Commission as a leading contributor to serious patient harm, lies at the forefront of these failures. Objective: This narrative review utilized and synthesized sources indexed through PubMed, PubMed Central, MEDLINE, Web of Science, Google Scholar, Directory of Open Access Journals (DOAJ), and Scopus to illustrate the factors involved in hospital related monitoring failures. We purport that alarm fatigue and telemetry monitoring failures are the result of complex systemic failures comprising technological and human failures. Through this narrative, we propose an evidence-based framework known as the Safer Telemetry Architecture (STA) to pinpoint redundancies and promote closed-loop communication regarding alarm management. Conclusions: Monitored in-hospital environments represent a key area of preventable morbidity and mortality due to systemic design flaws. Our STA framework addresses such flaws via improvements in nurse-driven protocols, alarm routing, mandatory coverage standards for backup, and increased performance auditing. Systemic improvements via such a framework may represent an important institutional strategy for hospitals with cardiac monitoring, but requires further prospective validation. Managing redundancies in alerts and sounds, improving backup and nursing telemetry protocols, and promoting closed or continuous loops targeting alarm response times and telemetry utilization are key to effectively improving patient safety. Full article

Background and Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for type 2 diabetes and obesity treatment and may influence reward-related behaviors, including alcohol use. This study aimed to evaluate the effects of GLP-1RAs on alcohol consumption and related outcomes in adults with alcohol use or alcohol use disorder (AUD). Methods: A systematic review was conducted following PRISMA 2020 guidelines. PubMed and Web of Science were searched from inception to December 2025. Eligible studies included randomized controlled trials (RCTs), secondary analyses of RCTs, and observational studies reporting quantitative alcohol consumption outcomes. Data extraction and risk of bias assessment (RoB 2 and ROBINS-I) were performed independently by two reviewers. Results: Five studies (n = 49,892) were included, comprising three RCT-based analyses and one large cohort study. Semaglutide and dulaglutide were associated with modest reductions in alcohol consumption and craving in several studies, with statistically significant improvements in selected behavioral outcomes. In contrast, exenatide did not demonstrate significant effects in the overall AUD population, with signals limited to subgroups. The cohort study showed small but statistically significant reductions in AUDIT-C scores following GLP-1RA initiation. Objective measures (e.g., PEth, breath alcohol concentration) showed reductions in selected contexts but were reported in a few studies. Conclusions: GLP-1RAs may be associated with modest reductions in alcohol consumption, but evidence remains limited and heterogeneous. Larger, well-designed RCTs are needed to define their role in the management of AUD. Full article

Extended Reality (XR), including Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR), is increasingly used to support experiential learning in Initial Teacher Education (ITE). This systematic review aimed to examine how XR technologies are integrated into university-based ITE programmes and their reported educational outcomes. Following PRISMA 2020 guidelines, a multi-source search was conducted across major databases (e.g., Scopus, Web of Science) and the grey literature (last search: January 2026). Eligible studies included empirical research on XR in ITE published between 2016 and 2026; non-empirical and non-ITE studies were excluded. Risk of bias was assessed using established appraisal criteria, and results were synthesised using a narrative thematic approach. A total of 32 studies were included. Findings indicate that XR is primarily used for classroom management training, microteaching, and reflective practice. Across studies, immersive simulations were associated with improvements in teacher self-efficacy, classroom management skills, and reflective decision-making. However, accessibility and inclusion strategies remain underdeveloped, and evidence of transfer to real classroom practice is still limited. Overall, XR functions most effectively as a preparatory tool that complements practicum-based training. Full article

As generative AI expands the technical frontiers of prediction, measurement, and design, a growing tension has emerged between algorithmic fluency and institutional trust. This conceptual article offers a narrative synthesis of recent work in learning analytics, educational data science, human–AI interaction, and AI governance to propose stewardship as a necessary fourth paradigm of educational data science. Stewardship represents the professional, epistemic, and institutional work of governing judgment in an environment where analytic systems are increasingly generative and persuasive. Rather than treating stewardship as a general ethics checklist, the article positions it as the governance of epistemic and pedagogical authority: who determines what counts as evidence, interpretation, and educational action when AI systems help produce those judgments. The synthesis suggests that while GenAI can support bounded analytic tasks, evidence for systemic educational transformation remains limited and uneven. The field’s primary challenge is therefore not technical performance alone, but the governance of interpretation, validation, delegation, and action. By centering provenance, uncertainty, accountable oversight, learner agency, and institutional learning, stewardship provides an actionable framework for anchoring analytic innovation in responsible educational improvement. Full article

This study examines how the Internet of Things (IoT) acts as a key enabler of sustainability in industrial production systems within the Industry 4.0 paradigm, addressing the fragmented understanding of the mechanisms linking digital technologies to environmental, operational, and emerging human-centric outcomes. A systematic literature review was conducted following PRISMA 2020 guidelines using the Web of Science Core Collection. After applying explicit inclusion and exclusion criteria, 69 peer-reviewed studies published between 2016 and 2026 were analyzed through qualitative thematic synthesis and comparative analysis. The findings reveal that IoT functions as a foundational digital infrastructure enabling real-time monitoring, operational transparency, and data-driven decision-making in production environments. Four dominant application domains are identified: (i) energy and resource efficiency, (ii) production monitoring and control, (iii) predictive maintenance and asset management, and (iv) emerging human-centric production systems aligned with Industry 5.0. While IoT consistently improves operational reliability and resource efficiency, its contribution to the social dimension of sustainability remains comparatively underdeveloped. This study advances the existing literature by providing a mechanism-oriented synthesis that explains how IoT-enabled infrastructures generate sustainability outcomes across production systems. Furthermore, it establishes a conceptual bridge between Industry 4.0 digitalization and the transition toward human-centric and resilient manufacturing models associated with Industry 5.0. From a practical perspective, the results highlight that IoT adoption contributes to reducing energy consumption, optimizing resource utilization, and enhancing operational performance, while also supporting safer and more adaptive working environments. However, challenges related to data integration, workforce adaptation, and digital capability gaps persist, underscoring the need for inclusive and strategically aligned digital transformation processes. Full article