Search Results (48,740)

Emerging adults who are students (EAS) face challenges balancing academic demands with early career development in a competitive labour market. Career and vocational interventions (CVIs) aim to support this transition by improving employability, academic outcomes, career self-efficacy, and mental health protective factors. This systematic review assesses the effectiveness of CVIs compared with standard approaches in improving employment-related outcomes for EAS, following Cochrane and PRISMA guidelines. Multiple databases were searched for studies published between 2018 and May 2025. Three independent reviewers screened abstracts and full texts in duplicate. Eligible studies were primary research evaluating CVIs for students aged 12–25 yrs and reporting employment-related outcomes. Thirty-one moderate- to low-quality studies examining middle school, high school, and university students were included from an initial 5765 records. CVIs were typically multi-component, combining training, school- or work-based learning, and additional supports. Overall, CVIs were associated with improved career readiness, academic outcomes, employment, resilience, and career adaptability. However, some studies reported lower employment rates and income for women and students with disabilities compared with men and peers without disabilities. These findings suggest that CVIs can support school-to-work transitions but underscore the need for tailored, integrated approaches, and higher-quality longitudinal research to guide policy and practice. Full article

Temporomandibular disorders (TMDs) are the prevalent causes of orofacial pain and dysfunction of the temporomandibular joint (TMJ) and masticatory muscles. Previous studies have revealed that proinflammatory cytokines play a key role in promoting inflammation, pain, and degeneration within the TMJ. In this context, the present systematic review synthesizes current evidence on various cytokines involved in the pathophysiology of TMDs and evaluates their associations with clinical signs and structural TMJ damage. A PRISMA-guided search (PROSPERO: CRD420251163290) was conducted in PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library to identify human-based, in vivo, and in vitro studies (January 2014 to September 2025) that assessed the roles of proinflammatory cytokines in TMDs. The following data were extracted from the identified studies: cytokine profiles, sampling methods, clinical outcomes, and TMJ structural changes. Study quality and risk of bias were systematically evaluated. A total of 15 studies (clinical, animal, and mechanistic) were included in the review. Tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and interleukin-17 (IL-17) consistently emerged as the major contributors to synovitis, cartilage degradation, nociceptive sensitization, and bone resorption. Human studies showed that high levels of TNF-α, IL-1β, and IL-6 and chemokines such as C-C motif chemokine ligand 2 (CCL2) and regulated on activation, normal T-cell expressed and secreted (RANTES) were associated with TMJ pain, restricted mandibular motion, crepitus, malocclusion, and erosive changes on imaging. An increased ratio of TNF to soluble TNF receptor in synovial fluid correlated with both pain and condylar damage, suggesting that loss of cytokine control contributes to progressive joint destruction. TMDs, particularly inflammatory and degenerative subtypes, are cytokine-driven pathologies rather than purely mechanical disorders. TNF-α, IL-1β, and IL-6 are the promising candidate biomarkers of local inflammation and structural joint pathology. Standardized longitudinal studies are required to validate cytokine-based diagnostics and develop anti-cytokine therapeutics. Full article

Background/Objectives: High-risk prostate cancer patients undergoing radical prostatectomy remain at significant risk of biochemical recurrence and metastasis. Immediate adjuvant external beam radiotherapy (EBRT) has been proposed to improve outcomes, but its role compared to observation remains debated due to potential toxicity and uncertain overall survival benefit. To evaluate the efficacy and safety of immediate adjuvant EBRT versus observation following radical prostatectomy in men with high-risk prostate cancer. Methods: A meta-analysis was conducted according to PRISMA guidelines. We sought to include both randomized controlled trials (RCTs) and observational studies published between 2005 and 2025; however, no observational studies meeting the predefined criteria were identified. Therefore, only RCTs comparing immediate adjuvant EBRT with observation in patients with adverse pathological features and undetectable postoperative PSA were included. Primary outcomes were biochemical recurrence-free survival (BCR-FS), metastasis-free survival (MFS), and overall survival (OS). Secondary outcomes included toxicity and quality of life (QoL). Data were pooled using Mantel–Haenszel and inverse variance methods, and heterogeneity was assessed with I² statistics. Results: Four RCTs (n = 1987) met the inclusion criteria. Adjuvant EBRT significantly improved progression-free survival (PFS) (HR = 0.38; 95% CI: 0.20–0.74; p = 0.004) and metastasis-free survival (HR = 0.70; 95% CI: 0.54–0.92; p = 0.01). However, OS benefit was not statistically significant (HR = 0.88; 95% CI: 0.59–1.32; p = 0.55). Heterogeneity was substantial for some outcomes (I² up to 71%). Adjuvant EBRT was associated with higher genitourinary and gastrointestinal toxicity compared to observation. Conclusions: Immediate adjuvant EBRT after radical prostatectomy improves PFS and MFS in high-risk prostate cancer but does not confer a clear OS advantage. Treatment decisions should be individualized, balancing disease-control benefits against toxicity risks. Observation with early salvage RT remains a reasonable alternative in selected patients. Full article

Background/Objectives: Hypertensive disorders of pregnancy (HDPs) affect approximately one in seven hospital deliveries in the United States and increase the risk of pregnancy-associated mortality. Home blood pressure monitoring (HBPM) for patients with HDPs has emerged as a model of care poised to improve ascertainment of blood pressure and triage of care during pregnancy and postpartum periods. However, the strength of evidence supporting HBPM approaches has been variable. This rapid review aimed to understand how HBPM approaches for pregnant and postpartum populations with HDPs have been evaluated in order to strengthen future research. Methods: Search criteria included peer-reviewed literature in English and French published during 2018–2024 that assessed HBPM approaches for pregnant and postpartum populations in high-income countries. A total of 370 records were screened and reviewed to identify 52 eligible articles. Key study characteristics, methodologies, and outcome measures were extracted. Identified outcome measures were mapped by outcome type (implementation, health service, and client) to assess gaps in evaluation of HBPM approaches. Results: A range of study designs were employed to evaluate HBPM approaches: experimental (17%), observational (52%), qualitative (10%), mixed method (10%), and economic (11%) designs. Over a third employed a comparison group, most of which compared HBPM approaches to usual antepartum or postpartum care. Only 11 studies reported on impact outcomes (long-term blood pressure control, adverse maternal and perinatal outcomes). Significant gaps were identified among the implementation outcomes examined. While patient engagement measures were common, assessment of provider adherence and engagement was limited. Hospital admissions and emergency department visits were often employed as proxies to measure HBPM effectiveness, efficiency, and safety. However, no studies adequately reported effectiveness measures for remote patient triage. Conclusions: Our results call for improved HBPM metrics to ensure patients are receiving high-quality care responsive to their clinical condition. Future studies on HBPM approaches should prioritize more transparent reporting on health actor engagement. A composite measure including both patient and provider adherence to monitoring and triage processes will provide stronger evidence on the effectiveness of HBPM for pregnant and postpartum patients and share impactful learning for health systems interested in adopting HBPM approaches. Full article

Introduction: Antipsychotic (AP) medications are widely prescribed beyond psychotic disorders, yet their long-term safety profile regarding breast cancer (BC) risk remains uncertain. Methods: We conducted a systematic review and meta-analysis of observational studies evaluating the association between AP exposure and incident BC. Eligible studies reported adjusted odds ratios (ORs) with 95% confidence intervals for any AP, prolactin-increasing antipsychotics (PIAPs), or prolactin-sparing antipsychotics (PSAPs). Study quality was assessed using the modified Newcastle-Ottawa Scale (mNOS), and certainty of evidence was graded with the GRADE framework. Random-effect models were used to pool effect estimates by exposure category, duration, and cumulative Defined Daily Dose (DDD). Results: Nine high-quality observational studies encompassing 108 effect estimates were included. Most studies achieved mNOS scores of 9, yet GRADE certainty ranged from very low to moderate, with the overall body of evidence graded as low certainty due primarily to residual confounding. Any AP exposure was associated with a modestly increased BC risk, particularly with long-term use: use for >5 years yielded pooled ORs around 1.5–1.6, while short-to-medium duration (1–5 years) showed smaller increases (pooled ORs in the range 1.2–1.3). For PIAPs, both longer duration (>5 years) and higher cumulative exposure (>1000–2000 DDDs) were consistently associated with ORs/HRs in the 1.3–1.6 range, suggesting a possible dose–response pattern. Histological analyses indicated stronger associations for ductal than lobular BC, and elevated risks were observed across age strata, including women aged <55 and ≥70 years. Discussion: This meta-analysis suggests that chronic exposure to prolactin-increasing antipsychotics is associated with a potentially clinically relevant increase in BC risk, whereas prolactin-sparing agents do not show a clear signal of harm. However, the certainty of this association is limited by inconsistently measured confounders and by the observational nature of the data. These findings support a cautious, individualized approach in which clinicians preferentially consider PSAPs when appropriate, discuss BC risk as part of shared decision-making, and integrate tailored screening strategies for women requiring long-term PIAP therapy. Further high-quality pharmacoepidemiologic studies with better confounder control and mechanistic integration are needed to refine risk estimates and inform preventive neuropsychopharmacology. Full article

This qualitative systematic review evaluates the potential of modular prefabricated OSB/plywood housing systems in low-technification, high-seismicity settings. These systems are promoted as low-carbon options for emerging contexts, and we assess how far the evidence supports that promise and under which conditions they can contribute to net-zero housing pathways. An adapted PRISMA 2020 workflow was applied to Scopus (TITLE-ABS, 2000–2025); 153 studies were synthesized in a table-first, coded matrix into axes for structural, digital fabrication, sustainability/circularity, and extrapolatable systems—supplemented by curated housing cases—with other EWPs used only for contrast. To address fragmentation and heterogeneity across domains, we developed a domain-based QA/QC instrument (STRUCTURAL, LCA, and FABRICATION) to judge whether studies provide minimally comparable evidence. Structural performance is relatively mature for certain patterns (calibrated FEM, cyclic tests, some 1:1 trials), whereas digital fabrication and LCA evidence remain partial: file-to-factory workflows rarely report verifiable QA/QC traceability, and most LCAs stop at A1–A3 with uneven treatment of A4, C/D, and biogenic carbon. Full convergence of adequate STRUCTURAL, LCA, and FABRICATION evidence within the same system type is rare, so both transferability to low-technification, seismic-prone settings and alignment with net-zero objectives must be characterized as conditional rather than established. The review identifies minimum multi-domain thresholds—technical robustness, whole-life LCA coverage, and verifiable QA/QC—as prerequisites for positioning modular OSB/plywood housing as a credible low-carbon pathway. These conclusions are limited by Scopus-only, English-language coverage and methodological heterogeneity, especially in the LCA. Full article

Oncology teams operate in highly demanding clinical environments marked by recurrent acute and chronic stressors that can impair optimal quality of care. Although the practice environment is known to influence team processes, the specific contribution of team resilience at work to team effectiveness remains insufficiently delineated in oncology. This cross-sectional study investigated whether team resilience at work mediates the associations between the teamwork practice environment and two core indicators of team effectiveness: team functioning and team cohesion. A total of 189 oncology team members in Québec (Canada) completed an e-questionnaire between February 2022 and June 2023. Structural equation modeling was conducted to assess an evidence-informed mediation model. The tested model revealed acceptable fit. Findings showed significant indirect effects consistent with a mediating role of team resilience at work in the relationships between the teamwork practice environment and team functioning and team cohesion. Some dimensions—resourcefulness, alignment, efforts to understand problems, wellness awareness and being proud to work in the team—loaded strongly on the resilience concept. These results highlight the relevance of reinforcing team resilience capacities to sustain high-quality care in oncology settings. Interventions aiming to enhance team effectiveness may benefit from explicitly integrating strategies designed to strengthen resilience-related dimensions within oncology teams. Full article

Climate change poses an escalating threat to global water resources, with semi-arid regions such as Morocco being particularly vulnerable due to high climatic variability and limited adaptive capacity. In these regions, including the Tassaoute watershed in central Morocco, data scarcity and uncertainties related to data availability and quality frequently hinder robust assessments of climate change impacts. Recent advances in data science and remote sensing offer promising alternatives to overcome these limitations. This study investigates the potential of the PERSIANN-CDR satellite-derived precipitation product for assessing climate change impacts on water resources. The capability of PERSIANN-CDR to reproduce observed precipitation patterns and associated hydrological responses is evaluated through a comparative analysis using observed precipitation data. Results indicate that PERSIANN-CDR generally underestimates peak precipitation events and total rainfall amounts compared to in situ observations. Runoff is simulated using two hydrological models: GR2M (Génie Rural 2 parameters Mensuel) and the Thornthwaite water balance method, both driven by observed meteorological data and PERSIANN-CDR precipitation. The future water availability was assessed using 5 climate models, under two scenarios: RCP4.5 and RCP8.5 for the periods 2030–2060 and 2061–2090. Results show a marked temperature increase of 2–3 °C across all models, accompanied by a general decline in precipitation ranging from −30% to −60% under RCP4.5 and −20% to −80% under RCP8.5. These climatic changes translate into substantial reductions in runoff, with stronger decreases projected under the high-emission scenario and during the dry season. Monthly analyses reveal pronounced seasonal contrasts, highlighting the increased sensitivity of low-flow periods to climate forcing. Overall, runoff is projected to decrease by 50–90%, with model and data-source differences highlighting the importance of multi-model and satellite-derived approaches in data-sparse regions. These results emphasize the utility of satellite precipitation datasets in guiding climate-adaptive water management strategies. Full article

Standard 16000-8 of the International Organization for Standardization (ISO 16000-8) specifies the assessment of ventilation performance using age-of-air concepts and tracer gas techniques. Since its publication in 2007, ventilation systems and assessment practices have evolved considerably, driven by increased use of mixed-mode and decentralized ventilation and advances in modeling and measurement technologies. This review examines how ISO 16000-8 can be modernized to harmonize with adjacent ventilation and indoor air quality standards while remaining applicable to contemporary systems and emerging approaches. A structured literature search of Web of Science and Google Scholar identified 76 studies (2007–2026) that engage with ISO 16000-8, age-of-air metrics, or tracer gas-based assessment. The literature was synthesized qualitatively using the framework of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), classifying studies into performance assessment, measurement–simulation convergence, and standardization discourse. The synthesis shows that while the conceptual foundations of ISO 16000-8 remain valid, assumptions of homogeneous mixing and steady-state conditions are often violated in real buildings, leading to inconsistent application of age-of-air indicators. Field and laboratory studies under point-source conditions demonstrate reduced ventilation effectiveness of 0.73–0.82 in classrooms and 0.5–1.4 in various indoor environments, instead of ≈1 for perfect mixing. Spatial heterogeneity is also observed in mixed-mode systems, with an efficiency around 0.5. In decentralized and façade-integrated systems, air exchange effectiveness deviates from theoretical expectations, indicating inhomogeneous air renewal and short-circuiting. Field measurements show configuration-dependent discrepancies in air exchange rates (e.g., carbon dioxide vs. perfluorocarbon tracer methods under varying door positions), while wind induces time-varying infiltration. Collectively, the literature demonstrates systematic violations of well-mixed and steady-state assumptions underpinning ISO 16000-8. Fragmentation between ventilation performance standards and indoor air quality regulation limits practical uptake. Emerging experimental, numerical, and data-driven methods complement ISO 16000-8, provided applicability domains and uncertainties are addressed. The review concludes that ISO 16000-8 should be modernized toward a harmonized, performance-based framework integrating diverse ventilation systems and assessment technologies. Full article

Building retrofit optimization has gained increasing attention as a pathway to improve energy performance and support sustainability. This review examines 162 studies and synthesizes simulation-based (SBMOO) and metamodel-based (MBMOO) multi-objective optimization techniques for building retrofit across climatic conditions. The review also analyzes passive, active, and combined retrofit strategies and evaluates how climatic context influences their suitability and performance. Passive strategies typically involve envelope- or material-related upgrades, whereas active strategies focus on building systems. Energy efficiency, comfort, cost-effectiveness, and environmental impact are identified as the major performance metrics for retrofit evaluation. Sustainability metric such as life cycle assessment (LCA) has yet to be used adequately to evaluate retrofit measures, while social objectives are also less explored. SBMOO provides robust optimization but can be computationally intensive, whereas MBMOO improves computational efficiency through surrogate modeling but depends strongly on dataset quality, sampling strategy, and surrogate model selection. In contrast to earlier reviews that usually emphasize either optimization techniques or retrofit measures independently, this study integrates optimization pathway comparison with climate-based analysis of retrofit strategies. The review also finds that most studies are highly case-specific, limiting transferability across climates, building types, and retrofit contexts. Therefore, this work proposes a synthesized framework to support structured selection of baseline modeling and optimization pathways for future retrofit studies. Overall, the review identifies current methodological trends, key research gaps, and future directions for more consistent and climate responsive retrofit decision-making. Full article

Background: Myasthenia gravis (MG) is a chronic autoimmune disorder characterized by fluctuating skeletal muscle weakness and fatigue, leading to reduced functional independence and impaired quality of life (QoL). Although exercise has historically been discouraged due to concerns about symptom exacerbation, emerging evidence suggest that structured exercise programs may be safe and beneficial in clinically stable patients. This systematic review critically evaluates current evidence on exercise and physical activity interventions in MG, focusing on effectiveness, safety, and impact on functional outcomes, fatigue, and QoL. Materials and Methods: A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, Web of Science, Google Scholar, Scopus and ScienceDirect for studies published between 2015 and 2025. Keywords included MG, physical activity, aerobic training, resistance training, and respiratory muscle training. Methodological quality was assessed using the Downs and Black checklist. Results: Eight controlled studies met the inclusion criteria, encompassing aerobic, resistance, combined, and respiratory muscle training interventions. Sample sizes ranged from small pilot studies to moderate-size randomized controlled trials. Overall, exercise interventions were well tolerated, with no evidence of sustained symptoms exacerbation. Aerobic and combined programs consistently improved functional capacity, muscle strength, and activities of daily living. Respiratory muscle training demonstrated improvements in pulmonary function and inspiratory muscle strength, although findings were more heterogeneous. Study quality ranged from poor to excellent, with common limitations including small sample size, short follow-up duration, and heterogeneity in exercise programs. Conclusions: Current evidence supports the safety and potential efficacy of individualized, symptom-guided exercise interventions in clinically stable MG. Regular physical activity exercise may reduce secondary deconditioning, improve functional outcomes, and enhance QoL. However, larger, high-quality randomized controlled trials with standardized programs and longer follow-up periods are required to strengthen clinical recommendations and clarify long-term effects. Full article

The growing global food demand has increased the use of chemical fertilizers, causing environmental issues. Previous studies have often assessed waste-derived fertilizers separately in terms of soil improvement or environmental impact, with limited integration of these aspects across different recycling processes. This study evaluated the effects on soil quality and the environmental impact of fertilizers produced with different percentages of food wastes and different recycling processes. The fertilizers investigated include vermicompost (VC, 70% wood sawdust + 30% food wastes), Compost 1 (C1, 50% wood sawdust + 50% food wastes), Compost 2 (C2, 10% straw + 90% food wastes), and sulfur–bentonite (SBC, 90% SB + 10% food wastes). Six months post-fertilization, vermicompost significantly improved soil properties, increasing soil organic matter from 3.01% to 4.70% (+56%) and total nitrogen from 0.15% to 0.22%, along with an increase in microbial biomass compared to the unfertilized control. Compost treatments also improved soil quality, although to a lesser extent. A Life Cycle Assessment (LCA) was performed across the entire life cycle of the fertilizers. Vermicompost showed the lowest environmental impact, with a global warming potential of 45 kg CO₂ eq ton⁻¹, compared to 93 and 100 kg CO₂ eq ton⁻¹ for C1 and C2, respectively, and 167 kg CO₂ eq ton⁻¹ for SBC. The results evidenced that vermicompost improved soil quality by increasing soil organic matter, total nitrogen, microbial biomass, and biological activity and that it emitted less CO₂ eq, SO₂ eq and PO₄³⁻ during the vermicomposting process, emphasizing its environmental sustainability. The two composts improved soil quality with a moderate environmental impact. SBC positively affected soil properties but with a strong negative environmental impact. From the benefit–cost perspective, the sustainable fertilizer ranking was VC > C2 > C1 > SBC. These findings underscore that these waste management processes represent a possible transition to sustainable fertilizers derived from waste materials to mitigate the environmental degradation associated with the production and use of conventional fertilizers. By adopting these practices, the agricultural sector can boost productivity while maintaining environmental sustainability standards. Full article