Laponite Composites: In Situ Films Forming as a Possible Healing Agent.

A healing material must have desirable characteristics such as maintaining a physiological environment, protective barrier-forming abilities, exudate absorption, easy handling, and non-toxicity. Laponite is a synthetic clay with properties such as swelling, physical crosslinking, rheological stability, and drug entrapment, making it an interesting alternative for developing new dressings. This study evaluated its performance in lecithin/gelatin composites (LGL) as well as with the addition of maltodextrin/sodium ascorbate mixture (LGL MAS). These materials were applied as nanoparticles, dispersed, and prepared by using the gelatin desolvation method-eventually being turned into films via the solvent-casting method. Both types of composites were also studied as dispersions and films. Dynamic Light Scattering (DLS) and rheological techniques were used to characterize the dispersions, while the films' mechanical properties and drug release were determined. Laponite in an amount of 8.8 mg developed the optimal composites, reducing the particulate size and avoiding the agglomeration by its physical crosslinker and amphoteric properties. On the films, it enhanced the swelling and provided stability below 50 °C. Moreover, the study of drug release in maltodextrin and sodium ascorbate from LGL MAS was fitted to first-order and Korsmeyer-Peppas models, respectively. The aforementioned systems represent an interesting, innovative, and promising alternative in the field of healing materials.

Accuracy of Eye and Hair Color Prediction in Mexican Mestizos from Monterrey City Based on ForenSeqTM DNA Signature Prep.

Forensic genomic systems allow simultaneously analyzing identity informative (iiSNPs), ancestry informative (aiSNPs), and phenotype informative (piSNPs) genetic markers. Among these kits, the ForenSeq DNA Signature prep (Verogen) analyzes identity STRs and SNPs as well as 24 piSNPs from the HIrisPlex system to predict the hair and eye color. We report herein these 24 piSNPs in 88 samples from Monterrey City (Northeast, Mexico) based on the ForenSeq DNA Signature prep. Phenotypes were predicted by genotype results with both Universal Analysis Software (UAS) and the web tool of the Erasmus Medical Center (EMC). We observed predominantly brown eyes (96.5%) and black hair (75%) phenotypes, whereas blue eyes, and blond and red hair were not observed. Both UAS and EMC showed high performance in eye color prediction (p ≥ 96.6%), but a lower accuracy was observed for hair color prediction. Overall, UAS hair color predictions showed better performance and robustness than those obtained with the EMC web tool (when hair shade is excluded). Although we employed a threshold (p > 70%), we suggest using the EMC enhanced approach to avoid the exclusion of a high number of samples. Finally, although our results are helpful to employ these genomic tools to predict eye color, caution is suggested for hair color prediction in Latin American (admixed) populations such as those studied herein, principally when no black color is predicted.

Systematic Review and Meta-Analysis: Recurrent Laryngeal Nerve Variants and Their Implication in Surgery and Neck Pathologies, Using the Anatomical Quality Assurance (AQUA) Checklist.

INTRODUCTION: The recurrent laryngeal nerve (RLN) is the structure responsible for sensory and motor innervation of the larynx, and it has been shown that its lesion due to a lack of surgical rigor led to alterations such as respiratory obstruction due to vocal cords paralysis and permanent phonation impairment. The objectives of this review were to know the variants of the RLN and its clinical relevance in the neck region. METHODS: This review considered specific scientific articles that were written in Spanish or English and published between 1960 and 2022. A systematic search was carried out in the electronic databases MEDLINE, WOS, CINAHL, SCOPUS, SCIELO, and Latin American and Caribbean Center for Information on Health Sciences to compile the available literature on the subject to be treated and was enrolled in PROSPERO. The included articles were studies that had a sample of RLN dissections or imaging, intervention group to look for RLN variants, or the comparison of the non-recurrent laryngeal nerve (NRLN) variants, and finally, its clinical correlations. Review articles and letters to the editor were excluded. All included articles were evaluated through quality assessment and risk of bias analysis using the methodological quality assurance tool for anatomical studies (AQUA). The extracted data in the meta-analysis were interpreted to calculate the prevalence of the RLN variants and their comparison and the relationship between the RLN and NRLN. The heterogeneity degree between included studies was assessed. RESULTS: The included studies that showed variants of the RLN included in this review were 41, a total of 29,218. For the statistical analysis of the prevalence of the RLN variant, a forest plot was performed with 15 studies that met the condition of having a prevalence of less than 100%. As a result, the prevalence was shown to be 12% (95% CI, SD 0.11 to 0.14). Limitations that were present in this review were the publication bias of the included studies, the probability of not having carried out the most sensitive and specific search, and finally, the authors' personal inclinations in selecting the articles. DISCUSSION: This meta-analysis can be considered based on an update of the prevalence of RLN variants, in addition to considering that the results show some clinical correlations such as intra-surgical complications and with some pathologies and aspects function of the vocal cords, which could be a guideline in management prior to surgery or of interest for the diagnostic.

The Landscape of Potential Small and Drug Substance Related Nitrosamines in Pharmaceuticals.

This article reports the outcome of an in silico analysis of more than 12,000 small molecule drugs and drug impurities, identifying the nitrosatable structures, assessing their potential to form nitrosamines under relevant conditions and the challenges to determine compound-specific AIs based on data available or read-across approaches for these nitrosamines and their acceptance by health authorities. Our data indicate that the presence of nitrosamines in pharmaceuticals is likely more prevalent than originally expected. In total, 40.4 % of the analyzed APIs and 29.6 % of the API impurities are potential nitrosamine precursors. Most structures identified through our workflow could form complex API-related nitrosamines, so-called nitrosamine drug substance related impurities (NDSRIs), although we also found structures that could release the well-known small and potent nitrosamines NDMA, NDEA, and others. Due to common structural motifs including secondary or tertiary amine moieties, whole essential drug classes such as beta blockers and ACE inhibitors are at risk. To avoid the risk of drug shortages or even the complete loss of therapeutic options, it will be essential that the well-established ICH M7 principles remain applicable for nitrosamines and that that the industry and regulatory authorities keep an open communication not only about the science but also to make sure there is a good balance between risk and benefit to patients.

Characterization of 58 STRs and 94 SNPs with the ForenSeq™ DNA signature prep kit in Mexican-Mestizos from the Monterrey city (Northeast, Mexico).

BACKGROUND: STR allele frequency databases from populations are necessary to take full advantage of the increased power of discrimination offered by massively parallel sequencing (MPS) platforms. MATERIAL AND METHODS: For this reason, we sequenced 58 STRs (aSTRs, X-STRs, and Y-STRs) and 94 identity informative SNPs (iiSNPs) on 105 Mestizo (admixed) individuals from Monterrey City (Northeast, Mexico), with the Primer Set-A of the ForenSeq™ DNA Signature Prep Kit. RESULTS: Most of the STR markers were in Hardy Weinberg equilibrium, with a few exceptions. We found 346 different length-based alleles for these 58 STRs; nevertheless, they became 528 alleles when the sequence was assessed. The combined power of discrimination from autosomal STRs (aSTRs) was -virtually- 100% in both length and sequence-based alleles, while the power of exclusion was 99.9999999976065 and 99.9999999999494%, respectively. Haplotypes based on X-STRs and Y-STRs showed 100% of discriminatory capacity. CONCLUSIONS: These results provide -for the first time- forensic genomic population data from Mexico necessary for interpretation in kinship and criminal analyses.

In Vitro Preformed Biofilms of Bacillus safensis Inhibit the Adhesion and Subsequent Development of Listeria monocytogenes on Stainless-Steel Surfaces.

Listeria monocytogenes continues to be one of the most important public health challenges for the meat sector. Many attempts have been made to establish the most efficient cleaning and disinfection protocols, but there is still the need for the sector to develop plans with different lines of action. In this regard, an interesting strategy could be based on the control of this type of foodborne pathogen through the resident microbiota naturally established on the surfaces. A potential inhibitor, Bacillus safensis, was found in a previous study that screened the interaction between the resident microbiota and L. monocytogenes in an Iberian pig processing plant. The aim of the present study was to evaluate the effect of preformed biofilms of Bacillus safensis on the adhesion and implantation of 22 strains of L. monocytogenes. Mature preformed B. safensis biofilms can inhibit adhesion and the biofilm formation of multiple L. monocytogenes strains, eliminating the pathogen by a currently unidentified mechanism. Due to the non-enterotoxigenic properties of B. safensis, its presence on certain meat industry surfaces should be favored and it could represent a new way to fight against the persistence of L. monocytogenes in accordance with other bacterial inhibitors and hygiene operations.

Listeria monocytogenes Biofilms in the Food Industry: Is the Current Hygiene Program Sufficient to Combat the Persistence of the Pathogen?

Biofilms contain microbial cells which are protected by a self-produced matrix and they firmly attach themselves to many different food industry surfaces. Due to this protection, microorganisms within biofilms are much more difficult to eradicate and therefore to control than suspended cells. A bacterium that tends to produce these structures and persist in food processing plants is Listeria monocytogenes. To this effect, many attempts have been made to develop control strategies to be applied in the food industry, although there seems to be no clear direction on how to manage the risk the bacteria poses. There is no standardized protocol that is applied equally to all food sectors, so the strategies for the control of this pathogen depend on the type of surface, the nature of the product, the conditions of the food industry environment, and indeed the budget. The food industry performs different preventive and corrective measures on possible L. monocytogenes-contaminated surfaces. However, a critical evaluation of the sanitization methods applied must be performed to discern whether the treatment can be effective in the long-term. This review will focus on currently used strategies to eliminate biofilms and control their formation in processing facilities in different food sectors (i.e., dairy, meat, fish, chilled vegetables, and ready-to-eat products). The technologies employed for their control will be exemplified and discussed with the objective of understanding how L. monocytogenes can be improved through food safety management systems.

Lesion Sterilization Tissue Repair (LSTR) Approach Of Non-Vital Primary Molars With A Chloramphenicol-Tetracycline-ZOE Antibiotic Paste: A Scoping Review.

The study aimed to perform a systematic scoping review with the need of exploring the actual clinical applications of the chloramphenicol-tetracycline-ZOE antibiotic paste (CTZ) as a lesion sterilization tissue repair (LSTR) therapy agent. Following a scoping framework suggested by Arksey and O'Malley, relevant articles (randomized controlled trials, literature reviews, observational studies, in vitro studies, and clinical case-series reports) published over the last 15 years (in English, Spanish, or Portuguese languages) were identified and retrieved from five internet databases: PubMed, Embase/Ovid, Cochrane Library, Google Scholar, and EBSCO. By title and abstract screening and after removing duplicates, 11 articles were finally included in the present scoping review: five randomized/non-randomized clinical trials, five in vitro studies, and one case-series report. According to the collected information, there were no differences between CTZ paste and conventional pulpectomy, antibiotic pastes, and intracanal filling materials, considering the clinical, radiographic, antimicrobial activity, and periapical tissue biocompatibility outcomes. CTZ has shown excellent rates of clinical success and good radiographic results, with adequate antimicrobial effects; however, its biocompatibility has been put into doubt. Contemporary pediatric dentists should carefully consider the CTZ paste as an alternative endodontic approach for pulpally involved primary molars, with the advantages of being simple and fast, and taking into account the limitations of instrumental pulpectomy such as the microbiological and morphological complexity of primary root canals.

From hazard analysis to risk control using rapid methods in microbiology: A practical approach for the food industry.

The prevention of foodborne diseases is one of the main objectives of health authorities. To this effect, analytical techniques to detect and/or quantify the microbiological contamination of foods prior to their release onto the market are required. Management and control of foodborne pathogens have generally been based on conventional detection methodologies, which are not only time-consuming and labor-intensive but also involve high consumable materials costs. However, this management perspective has changed over time given that the food industry requires efficient analytical methods that obtain rapid results. This review covers the historical context of traditional methods and their passage in time through to the latest developments in rapid methods and their implementation in the food sector. Improvements and limitations in the detection of the most relevant pathogens are discussed from a perspective applicable to the current situation in the food industry. Considering efforts that are being done and recent developments, rapid and accurate methods already used in the food industry will be also affordable and portable and offer connectivity in near future, which improves decision-making and safety throughout the food chain.

Antimicrobial Activity and Prevention of Bacterial Biofilm Formation of Silver and Zinc Oxide Nanoparticle-Containing Polyester Surfaces at Various Concentrations for Use.

Food contact surfaces are primary sources of bacterial contamination in food industry processes. With the objective of preventing bacterial adhesion and biofilm formation on surfaces, this study evaluated the antimicrobial activity of silver (Ag-NPs) and zinc oxide (ZnO-NPs) nanoparticle-containing polyester surfaces (concentration range from 400 ppm to 850 ppm) using two kinds of bacteria, Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli), and the prevention of bacterial biofilm formation using the pathogen Listeria monocytogenes. The results of antimicrobial efficacy (reductions ≥ 2 log CFU/cm2) showed that at a concentration of 850 ppm, ZnO-NPs were effective against only E. coli (2.07 log CFU/cm2). However, a concentration of 400 ppm of Ag-NPs was effective against E. coli (4.90 log CFU/cm2) and S. aureus (3.84 log CFU/cm2). Furthermore, a combined concentration of 850 ppm Ag-NPs and 400 ppm ZnO-NPs showed high antimicrobial efficacy against E. coli (5.80 log CFU/cm2) and S. aureus (4.11 log CFU/cm2). The results also showed a high correlation between concentration levels and the bacterial activity of Ag-ZnO-NPs (R2 = 0.97 for S. aureus, and R2 = 0.99 for E. coli). They also showed that unlike individual action, the joint action of Ag-NPs and ZnO-NPs has high antimicrobial efficacy for both types of microorganisms. Moreover, Ag-NPs prevent the biofilm formation of L. monocytogenes in humid conditions of growth at concentrations of 500 ppm. Additional studies under different conditions are needed to test the durability of nanoparticle containing polyester surfaces with antimicrobial properties to optimize their use.

Microscopic analysis and microstructural characterization of the organic and inorganic components of dairy fouling during the cleaning process.

This study evaluated the organic residues of milk fouling using fluorescence and confocal laser scanning microscopy. The inorganic content was analyzed with energy-dispersive X-ray spectroscopy, complemented with inductively coupled plasma optical emission spectrometry. These techniques were applied to evaluate milk fouling cleanliness using an alkaline product and an enzymatic formulation based on protease and amylase. The results showed that the efficiency of enzymatic cleaning was 87.1% when it was evaluated at 55°C for 30 min, and with a medium of pH 8.5. No difference was found from the efficacy in eliminating dairy fouling observed for the chemical cleaning (86.9%). The fluorescence microscopy proved useful for determining the organic solid components in the outer layer of the dairy fouling. The fouling spatial disposition in 3 dimensions, obtained by confocal laser scanning microscopy, showed that it was formed of 51.3% sugars, 9.3% fats, and 39.4% proteins, with the enzymatic cleaning of these compounds being homogeneous, compared with chemical cleaning. The protein and lipid contents were in the surface layer, whereas sugars were located in the innermost part that contributes to the Maillard reaction during fouling formation. After enzymatic cleaning, the reduction in the concentration of Ca and P was 71.61 and 74.67%, respectively, compared with fouling intact. Thus, enzymatic cleaning, without the accumulation of Na from chemical cleaning, leaves 1.5 times less mineral than chemical cleaning. Knowing the content and structure of fouling in the industry helps to formulate better products to achieve proper levels of cleanliness. Additionally, studying the cleaning residues helps to avoid problems of cross-contamination between batches or subsequent microbial growths (biofilms) on surfaces with residues.

Quantitative and Compositional Study of Monospecies Biofilms of Spoilage Microorganisms in the Meat Industry and Their Interaction in the Development of Multispecies Biofilms.

Food spoilage is a serious problem in the food industry, since it leads to significant economic losses. One of its main causes is the cross-contamination of food products from industrial surfaces. Three spoilage bacterial species which are highly present in meat and the gastrointestinal tract of chickens were selected: Pseudomonas fragi, Leuconostoc gasicomitatum, and Lactobacillus reuteri. The dual aim was to determine their ability to form monospecies biofilms and to examine how they interact when they coexist together. To do so, mature monospecies biofilms were produced statically for seven days at a temperature of 30 °C. L. gasicomitatum was also used to investigate the behavior of P. fragi and L. reuteri in the formation of multispecies biofilms. The structure and composition of the monospecies biofilms were evaluated by direct epifluorescence microscopy, and the multispecies biofilms were evaluated by plate counting. Both L. gasicomitatum and L. reuteri were able to form biofilms, with counts of approximately 7 Log CFU/cm2 and a defined structure. However, P. fragi obtained counts to the order of 4 Log CFU/cm2, which is significantly different from the previous species (P < 0.05), and it had no network of cell conglomerates. The content of the L. gasicomitatum and L. reuteri biofilm matrices were 70-80% protein, unlike P. fragi, which presented a higher polysaccharide content (P < 0.05). In the multispecies biofilms, the presence of P. fragi did not affect the growth of L. gasicomitatum, which remained at between 5.76 to 6.1 Log CFU/cm2. However, L. reuteri was able to displace L. gasicomitatum growth after 24 h of coexisting in a mixed biofilm, presenting differences in counts of approximately 2 Log CFU/cm2. The study of the biofilms constructed by food industry resident microbiota can help to understand the ecological relations that exist between species, characterize them, and propose strategies to eliminate them. The name of genes and species should be written in italic.

Comparison study of temperature and deformation changes in the femoral component of a novel ceramic-on-ceramic hip resurfacing bearing to a metal standard, using a cadaveric model.

Hip resurfacing is an attractive alternative to total hip replacement preserving bone and reducing dislocation risk. Recent metal-on-metal designs have caused failure due to metal wear debris. Ceramic implants may mitigate this risk. Temperature increase in periprosthetic bone during cementation can lead to osteonecrosis, while deformation of the component can affect joint lubrication and may increase wear through clamping. Both processes may lead to implant loosening. This study quantifies the temperature and deformation change in a novel ceramic hip resurfacing femoral component compared to a metal standard during cemented implantation in a fresh frozen cadaveric model. Study design and methods Eight femora were prepared from four fresh frozen cadavers. One surgeon experienced in hip resurfacing surgery (J.H.) prepared the femora by reaming. Four ceramic and four metal implants of equal and varying size were cemented in place. Bone and surface temperatures were taken using a probe in the periprosthetic bone and an infrared laser thermometer, respectively. Deformation was measured using a micrometre. Measurements were taken before implantation and every 5-min intervals up to 30 min. The average bone-temperature increment was lower for ceramic heads than for metal heads. Although this difference was not statistically significant, the average bone temperature incremental change in small sizes (42 and 46 mm) was higher than in the large sizes (48 and 50 mm). Most metal heads sustained bearing diameter change that was still near its peak value 30 min after implantation, whereas the ceramic heads suffered a lower diameter change and most of the samples recovered their original diameter 30 min after implantation. Both implants behave similarly, however, a lower temperature rise in bone was observed with ceramic heads. This may lower the risk for thermal damage on periprosthetic bone. The ceramic heads deformed less during surgical implantation. This was not significant.

Comparing the cup deformation following implantation of a novel ceramic-on-ceramic hip resurfacing bearing to a metal standard in a cadaveric model.

Hip resurfacing is an attractive alternative to total hip replacement preserving bone and reducing dislocation risk. Recent metal-on-metal designs have caused failure due to metal wear debris. Ceramic implants may mitigate this risk. Deformation of the acetabular cup can affect the lubrication, producing high friction torques between the femoral head and the cup that would increase wear and/or lead to cup loosening due to femoral head clamping. Our objective was to quantify the deformation of a novel monobloc ceramic hip resurfacing cup component compared to a metal standard, in a fresh frozen cadaveric model using a press-fit technique representative of standard surgical conditions. For this study eight acetabula were prepared from four fresh frozen cadavers. One surgeon with extensive experience in hip resurfacing surgery (J.H.) prepared the acetabulum by sequential reaming. The implants were then impacted into the acetabulum. Four ceramic and four metal implants were used of equal and varying size. Deformation was measured peri-implantation, and at 30 min, using an optical high-precision deformation sensor (GOM GmbH, Braunschweig, Germany). The maximum inscribed circle and the measurement of radial segment techniques were used. Deformation was greater in the metal implants (mean: 34-22mm) immediately after implantation. At 30 min after implantation, the deformation increased to 36mm in the metal and 26mm in the ceramic cup. Greater diameter changes were observed in larger cups. Metal and ceramic implants did not return to the initial diameter. We conclude the ceramic resurfacing acetabular implants undergo similar deformation to existing metal-on-metal implants. The deformation observed was significantly less in the ceramic component at 30 min on one measure. Less deformation may result in better surface conditions and wear characteristics. Deformation change did not resolve after 30 min for both implants.

Harnessing Noncovalent Interactions in Dual-Catalytic Enantioselective Heck-Matsuda Arylation.

The use of more than one catalyst in one-pot reaction conditions has become a rapidly evolving protocol in the development of asymmetric catalysis. The lack of molecular insights on the mechanism and enantioselectivity in dual-catalytic reactions motivated the present study focusing on an important catalytic asymmetric Heck-Matsuda cross-coupling. A comprehensive density functional theory (M06 and B3LYP-D3) investigation of the coupling between a spirocyclic cyclopentene and 4-fluorophenyl diazonium species under a dual-catalytic condition involving Pd2(dba)3 (dba = trans, trans-dibenzylideneacetone) and chiral 2,2'-binaphthyl diamine (BINAM)-derived phosphoric acids (BDPA, 2,2'-binaphthyl diamine-derived phosphoric acids) is presented. Among various mechanistic possibilities examined, the pathway with explicit inclusion of the base (in situ generated sodium bicarbonate/sodium biphosphate) is found to be energetically more preferred over the analogous base-free routes. The chiral phosphate generated by the action of sodium carbonate on BDPA is found to remain associated with the reaction site as a counterion. The initial oxidative addition of Pd(0) to the aryl diazonium bond gives rise to a Pd-aryl intermediate, which then goes through the enantiocontrolling migratory insertion to the cyclic alkene, leading to an arylated cycloalkene intermediate. Insights on how a series of noncovalent interactions, such as C-H···O, C-H···N, C-H···F, C-H···π, lp···π, O-H···π, and C-F···π, in the enantiocontrolling transition state (TS) render the migration of the Pd-aryl to the si prochiral face of the cyclic alkene more preferred over that to the re face are utilized for modulating the enantioselectivity. Aided by molecular insights on the enantiocontrolling transition states, we predicted improved enantioselectivity from 37% to 89% by changes in the N-aryl substituents of the catalyst. Subsequent experiments in our laboratory offered very good agreement with the predicted enantioselectivities.

Identifying the Employment Needs of People With Chronic Health Conditions in Europe.

OBJECTIVES: The main goal of this study was to compare the employment needs experienced by people with different chronic health conditions and in different welfare systems. METHODS: A total of 688 participants with six chronic health conditions were collected in nine countries representing four welfare systems in Europe (Continental, Mediterranean, Postcommunist, and Scandinavian). RESULTS: Raising awareness of what is to live with a chronic health condition in the workplace was the area perceived as more favorable. The types of employment needs were different across the social welfare systems but did not vary among the different chronic health conditions groups. CONCLUSION: Although diverse, there appear to be some common needs transversal to the working experience of people with chronic health problems. Actions to improve the employability of people with chronic health conditions should be tailored to each welfare system.

Views and Experiences of Persons with Chronic Diseases about Strategies that Aim to Integrate and Re-Integrate Them into Work: A Systematic Review of Qualitative Studies.

The effectiveness of strategies targeting professional integration and reintegration strongly depends on the experiences of participants. The aim of this systematic literature review is to synthesize European qualitative studies exploring views and experiences of persons with chronic conditions regarding strategies for integration and reintegration into work. The systematic search was conducted in Medline, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 24 studies published in English between January 2011 and April 2016 were included. Most studies were carried out in Nordic countries or in the UK, and most participants were persons with either mental or musculoskeletal disorders. Ten themes emerged: individual and holistic approach, clarity of strategy and processes, timing of rehabilitation processes, experience with professionals, at the workplace and with peer groups, changes in the understanding of health and work, active involvement in the process, competencies development and motivating aspects of work. Findings highlight, among others, the need to actively involve participants in the return to work process and to provide timely and clearly structured processes and interventions. This review provides stakeholders key information to develop, plan, implement and evaluate interventions to integrate and re-integrate persons with chronic conditions into work in Europe.

Furthering the Evidence of the Effectiveness of Employment Strategies for People with Mental Disorders in Europe: A Systematic Review.

(1) Purpose: This systematic review aims to assess the effectiveness of strategies used in the professional (re)integration of persons with mental disorders (MD) in European countries; (2) Methods: We conducted a search for scientific publications available in relevant electronic databases (Medline, PsycINFO, CDR-HTA, CDR-DARE, and Cochrane Library). The present study collected evidence on the effectiveness, from 2011 to 2016, of employment strategies for persons with MDs; (3) Results: A total of 18 studies were included, representing 5216 participants (aged 18⁻65, mean age of 38.5 years old) from 7 countries. Job access programs demonstrated effectiveness in four out of six studies. Return to work (RTW) interventions showed significant positive results in two studies, while four studies did not refer to effectiveness. There were inconsistent results in another four studies; (4) Conclusions: Our findings highlight the complexities of the implementation of employment strategies (job access and return to work). Job access strategies seem to improve employment outcomes. The effectiveness of return to work strategies remains unclear. The involvement and commitment of physicians, employment specialists, and employers, and employees capacity for self-care seem decisive for employment re-integration success. Further analyses are needed to assess the cost-effectiveness of these interventions and corroborate our results, with longer follow-ups.