Literature Review Research Articles

Determinants of adoption of virtual reality as a teaching aid in higher education: the mediating role of hedonic motivation

PurposeThe inclusion of technology in teaching–learning ensures better clarity and interactivity in the delivery of content, leading to enhanced student engagement. The present paper aims to identify the determinants of adopting virtual reality (VR) learning from the educators’ perspective. The mediating role of hedonic motivation for adopting VR is also explored.Design/methodology/approachThis quantitative research is conducted using a conceptual model with the help of a literature survey. A self-designed questionnaire was used to collect primary data. The respondents were teachers working at higher education institutes. A sample of 341 respondents were used and the data was analyzed using confirmatory factor analysis and structural equation modeling.FindingsResults demonstrate that digital competence and technology support are the factors affecting the perceived ease of use, which further affects the attitude and intention of adoption. The role of hedonic motivation is established as a mediator in attitude toward virtual reality and adoption intention.Originality/valueThe study is a valuable addition to the existing literature as it presents the conceptual model and explores the imperative role of hedonic motivation. This provides a unique aspect to this research. Educators and the management of higher education institutes can use the findings to make decisions and create policies regarding integrating VR in existing curricula.

The potential role of neoadjuvant treatment in thyroid cancers in the era of kinase inhibitors: a narrative review.

To analyse the literature on the potential role of kinase inhibitors (KI) as neoadjuvant treatment (NAT) in all thyroid cancers (TC). Online databases were systematically examined, including MEDLINE (via PubMed) Embase, ISI Web of Science, Google Scholar, and Scopus. As many papers were published before the classification of TC was revised, our search was conducted as follows: NAT in TC, NAT in papillary thyroid cancer (PTC), NAT in follicular thyroid cancer (FTC), NAT in anaplastic thyroid cancer (ATC), and NAT in medullary thyroid cancer (MTC). The search revealed 21 single case reports and three small series on NAT in TC. Overall, 32 cases were found: 24 follicular cell derived cancers (FCDC) of which nine were ATC, eight were MTC. We also found four major retrospective series, in two of which the cohort was divided and analysed into different groups according to the kind of treatment. In these four series, NAT was performed in in a total of 99 patients (32 FCDC, 60 ATC, and 7 MTC). While awaiting large-scale clinical trials, the literature highlights that NAT may be an option for locally advanced TC (and above all ATC) when surgery may be too destructive or when the tumour is inoperable. The use of NAT should be discussed with the patient. An R0 or at least an R1 should be the goal of NAT, and the molecular profile should be performed as rapidly as possible.

Integrating one health with indigenous knowledge for improving public wellbeing – a review

PurposeThe interconnection between humans and animal has raised the concept of one health (OH) framework. The framework works at local, regional, national and global level with the aim to improve public health. However, while covering the OH approach, the knowledge of indigenous communities has not been given much attention. Despite of the fact that indigenous communities are living closely to ecosystem, their exceptional knowledge on OH has not been utilised. The present study has reviewed different studies to explore the prominent role of indigenous knowledge between the relationship of OH framework and public wellbeing.Design/methodology/approachThe present study is a narrative review which has included different quantitative and qualitative studies conducted in the area of OH field in concern to public health and indigenous knowledge. The present study has included the literature which is published in English language from the year 2001–2024 conducted in developed and developing countries.FindingsOn the basis of prevailing literature in the area, the present study has framed a model to integrate the OH with indigenous knowledge to improve public health. The model explains the concept of public wellbeing which is deeply rooted in the knowledge of indigenous communities associated with animal and veterinary care, ecological aspect, culture, religion, language, healing and wellness, food and nutrition practices.Research limitations/implicationsAfter considering the literature prevailing in concern to OH, it has been determined that OH approach is more prominent in scientific environment and laboratory equipment. The discipline of OH requires an inclusion from the researchers of social sciences and various behavioural fields. The present study has offered different factors which may act as an entry point for researchers to explore the field. Further, the study has suggested validating a comprehensive model offered by present study in empirical manner to improve public health.Originality/valueThe present study has highlighted the relevance of indigenous knowledge for promoting OH principles in public wellbeing. Also, the study has offered a model which can be utilised by future researchers to explore the relationship between OH, indigenous knowledge and public wellbeing.

AI-ML based HealthCare Chatbot

In the realm of modern healthcare, the exigency for instantaneous, accurate, and personalized medical assistance remains a paramount concern, primarily due to infrastructural deficits and delayed medical interventions, especially in remote locales. The AI-ML-powered healthcare chatbot aspires to ameliorate this predicament by offering 24/7 medical support, ranging from symptom assessment to scheduling consultations and medication reminders, thereby fortifying healthcare accessibility. The focal point of this inquiry entails a meticulous exploration of the underlying factors contributing to delayed medical responses, analysing the causative elements, and investigating the contextual framework to comprehend when and how such exigencies materialize. A comprehensive literature survey will be undertaken to discern prevailing methodologies and state-of-the-art techniques employed for the detection and prevention of health-related complications through chatbot interventions, leveraging machine learning and natural language processing paradigms. Subsequently, a comparative analysis of these techniques will be conducted to delineate their respective efficacies, performance metrics, and limitations, facilitating the selection of the most optimal strategy for deployment in real-world scenarios. Ultimately, the inquiry will culminate in a decisive conclusion that encapsulates the key findings, underscores the transformative potential of AI-ML chatbots in healthcare delivery, and delineates actionable recommendations for future enhancements and scalability . Keywords—Healthcare Chatbot, Artificial Intelligence (AI), Machine learning (ML), Disease detection, Healthcare automation, Symptom Assessment

Overview of female healthcare providers’ outlooks on cervical cancer screening: a narrative review

BackgroundCervical cancer is the second most frequent gynecologic cancer. Uniquely, it is easily preventable and treatable cancer if identified early. The insights of healthcare providers about cervical cancer screening have a crucial role in prevention and treatment. However, there has been limited literature on the providers’ perspectives on cervical cancer screening.ObjectiveThis review narrated the female healthcare providers’ (FHCPs’) outlooks on cervical cancer screening in terms of risk perceptions, awareness, knowledge, attitude, practice, and possible barriers.MethodsA thorough literature search was conducted to identify studies conducted on female healthcare providers’ overview of the perceived risk of cervical cancer, cervical cancer screening awareness, knowledge, attitude, and practice, as well as barriers to cervical cancer screening. Databases such as PubMed, Medline, Embase, Virtual Health Library, and Google Scholar were used to search for articles.ResultsAccordingly, this review identified that female healthcare providers have a low perceived risk of the disease, poor awareness and knowledge, unfavorable attitudes, and low uptake of screening practices. Furthermore, this review highlights the obstacles to cervical cancer screening acceptance, such as service inaccessibility, a lack of training and education, and fear of the procedure and results.ConclusionThis narrative review described the variable distribution of the FHCPs’ perceived risk of acquiring cervical cancer (CC). Poor knowledge and screening practices were observed. Moreover, the barriers to cervical cancer screening uptake were described. Given that healthcare providers are on the frontlines (act as role models) in increasing the community’s cervical cancer screening uptake, we suggest concerned bodies increase screening access and implement staff training programs. In addition, further mixed studies should be considered to deeply understand the possible attributes ingrained in individual and social belief systems.

Traditional Maasai Dietary Practices and Their Inapplicability to Modern Carnivore Diets: A Narrative Review

Traditional Maasai Dietary Practices and Their Inapplicability to Modern Carnivore Diets: A Narrative Review

Does Dexamphetamine Cause Addiction? A Narrative Review

Dexamphetamine (DEX) is widely used in treatments, but concerns persist about its potential for addiction. This review aimed to assess the risks of DEX addiction by examining the existing literature. Originally planned as a systematic review, it was adjusted to a narrative review due to a lack of qualifying studies. A search of the literature on addiction to DEX was conducted on three databases including PubMed, Scopus, and Embase. Seven articles consisting of three reviews and four papers with original data were identified and reviewed. In total, four poorly documented cases of possible DEX addiction were found. The commonly cited papers on prescription DEX addiction did not hold up to scrutiny. Overall, the evidence that DEX is addictive is limited and inconclusive, highlighting the need for more rigorous research to clarify its true addiction risk.

Acute abdomen in the era of immune checkpoints inhibitors – what the surgeon needs to know: A narrative review

Immune checkpoint inhibitors (ICI) have been approved for the treatment of a variety of malignancies. Immune-related adverse events are rare and might affect a lot of different organs including the intestines. Enterocolitis is a common complication characterised by symptoms such as diarrhoea, abdominal pain, and vomiting. In rare circumstances, bowel perforation, obstruction, or even toxic megacolon might appear. The proper therapeutic management of these conditions is based on case reports or case series. Conservative management is the standard of care in the case of ileus, however, the safety of performing a bowel anastomosis has not been answered yet. This study aims to raise awareness among the medical community, and specifically surgeons, regarding the intestinal complications of ICI, as the uprising administration of these targeted therapies makes this knowledge necessary.

Beyond the classroom: The transformative experience of short rural immersion programs for health professional students: A narrative review.

Rural areas house nearly half the global population yet face a significant shortage of skilled health professionals, exacerbating health inequities. Short-term rural immersion programs offer a cost-effective approach to exposing health professional students to the unique challenges of rural healthcare. Transformative learning theory is well suited to examining how these programs foster critical reflection and perspective shifts in students. To explore the potentially transformative impact of short-term (<6 weeks) rural immersion programs on health professional students through the lens of transformative learning theory. This review synthesised findings from various studies on the impact of rural immersion programs. Comprehensive searches were conducted across multiple databases, identifying 17 studies published between 2001 and 2024. Data extraction and thematic synthesis were guided by Mezirow's transformative learning framework, identifying key patterns and insights through an iterative process. Rural immersion programs deepen students' understanding of the unique health needs of rural and remote communities. These experiences promote personal and professional growth, enhance critical thinking, problem-solving abilities, cultural competence and social accountability and foster a commitment to serving underserved populations. The collaborative role of the community, student cohort and academic staff in facilitating transformative learning is emphasised. Short-term rural immersion programs offer invaluable and transformative educational opportunities that extend beyond traditional learning environments.

The emerging field of ultrasound-guided nerve decompression surgery: a narrative review.

The development of high-frequency ultrasound technology has transformed musculoskeletal diagnostic practices, offering detailed, multi-plane visualization of superficial structures with remarkable precision and comfort. This non-invasive, pain-free modality is particularly suited for patients of all ages, including children. Ultrasound serves as a valuable adjunct to clinical evaluations by facilitating the identification of conditions such as tumours, tenosynovitis, fractures, and nerve entrapments. Portable ultrasound devices have further expanded its utility to clinical, surgical, and emergency settings. Dynamic assessments, such as nerve gliding and entrapment detection, benefit from its precision, enabling targeted therapeutic interventions with minimal risks. The integration of ultrasound into surgical techniques, termed ultrasonosurgery, allows for minimally invasive management of conditions like carpal tunnel syndrome and other nerve compressions. By leveraging high-resolution imaging, these procedures can be performed under local anaesthesia, minimizing traditional surgical complications. This innovative approach aligns with contemporary healthcare trends emphasizing wide-awake surgeries, office-based care, mini-invasive procedures, and technological advancements. Such practices not only streamline patient care but also reduce costs and improve outcomes.

Exploring cerebellar transcranial magnetic stimulation in post-stroke limb dysfunction rehabilitation: a narrative review

This review delves into the emerging field of cerebellar Transcranial Magnetic Stimulation (TMS) in the rehabilitation of limb dysfunction following a stroke. It synthesizes findings from randomized controlled trials and case studies, examining the efficacy, safety, and underlying mechanisms of cerebellar TMS. The review outlines advancements in TMS technologies, such as low-frequency repetitive TMS, intermittent Theta Burst Stimulation, and Cerebello-Motor Paired Associative Stimulation, and their integration with physiotherapy. The role of the cerebellum in motor control, the theoretical underpinnings of cerebellar stimulation on motor cortex excitability, and the indirect effects on cognition and motor learning are explored. Additionally, the review discusses current challenges, including coil types, safety, and optimal timing and modes of stimulation, and suggests future research directions. This comprehensive analysis highlights cerebellar TMS as a promising, though complex, approach in stroke rehabilitation, offering insights for its clinical optimization.

Advancing Health Equity in the Cardiovascular Device Life Cycle.

Despite advancements in diagnostics and therapeutics for cardiovascular disease, significant health disparities persist among patients from historically marginalized racial and ethnic groups, women, individuals who are socioeconomically under-resourced or underinsured, and those living in rural communities. While transcatheter interventions have revolutionized the treatment landscape in cardiology, populations bearing the greatest burden of disease continue to face inequitable access and poorer outcomes. A notable gap in the literature concerns the role of modern approaches to cardiovascular device innovation in shaping and perpetuating health disparities. Health equity has been declared one of the top strategic initiatives for 2022 to 2025 by the Food and Drug Administration Center for Devices and Radiological Health, underscoring the need for greater attention, dialogue, and targeted interventions in this space. This narrative review uses the cardiovascular device life cycle as a conceptual framework to enhance understanding and guide future efforts to mitigate disparities in the field of interventional cardiology. Drawing on illustrative examples from interventional cardiology, we examine current practices in cardiovascular device regulation and approval, clinical trial evaluation, adoption patterns, and postprocedural outcomes with the aim of uncovering potential mechanisms of disparities and identifying opportunities for targeted interventions.

Anemia and retinopathy of prematurity: A narrative review

ABSTRACTRetinopathy of prematurity (ROP) and anemia are often comorbid in preterm and low birth weight infants in the United States. However, the relationship between ROP and anemia in infants is unclear across prospective and retrospective studies due to confounding from other comorbidities of prematurity and variable study designs. Molecular mechanisms that may underlie this association include tissue hypoxia, oxidative stress, inflammation, and the timing of onset of anemia relative to the phase of ROP. Furthermore, maternal or neonatal disruptions in iron homeostasis, leading to either iron deficiency or accumulation, have been associated with ROP. Further studies, including randomized clinical trials, are needed to better elucidate the association between ROP and anemia, as well as the impact of the timing of the onset of anemia.

Oncolytic Viruses in Ovarian Cancer: Where Do We Stand? A Narrative Review

Ovarian cancer (OC) remains the most lethal gynecologic malignancy with limited effective treatment options. Oncolytic viruses (OVs) have emerged as a promising therapeutic approach for cancer treatment, capable of selectively infecting and lysing cancer cells while stimulating anti-tumor immune responses. Preclinical studies have demonstrated significant tumor regression and prolonged survival in OC models using various OVs, such as herpes simplex. Early-phase clinical trials have shown a favorable safety profile, though the impact on patient survival has been modest. Current research focuses on combining OVs with other treatments like immune checkpoint inhibitors to enhance their efficacy. We provide a comprehensive overview of the current understanding and future directions for utilizing OVs in the management of OC.

Victimization of Sexual and Gender Minorities: A Narrative Review of Prevalence Rates, Adverse Outcomes, Protective Factors, and Suggestions for Future Research

Victimization is a common but unfortunate reality, with sexual and gender minority (SGM) individuals at an increased risk of various forms of victimization compared with the heterosexual and cisgender counterparts. This disproportionate victimization of SGMs increases the likelihood that these individuals will experience adverse mental, physical, and educational outcomes. Some scholars have explored potential protective factors, specific to SGMs, that may be associated with a decreased risk of victimization and/or subsequent adverse outcomes. The present article provides readers with a narrative review of the relevant literature on these topics by examining prevalence rates of SGM victimization, common adverse consequences experienced by SGMs, and empirically examined protective factors for SGMs that show some evidence of effectiveness. The article ends with a discussion of suggestions for future research.

SLEEP, CIRCADIAN RHYTHMS, AND LUNG CANCER.

Lung cancer is the leading cause of cancer-related mortality worldwide, with the prevalence of the disease continually rising. Therefore, identifying disease-modifying risk factors is critical, with increasing recognition of the impact of sleep quality/sleep disorders. This narrative review summarizes the evidence on the role of five domains of sleep on lung cancer incidence and progression: (i) sleep quality/duration, (ii) sleep disordered breathing, (iii) circadian rhythm disturbances, (iv) sleep-related movement disorders and (v) personal, environmental and social factors that modulate each of these associations. Epidemiological evidence supports reduced sleep duration, increased sleep duration, poor sleep quality, insomnia, obstructive sleep apnea, evening chronotype, peripheral limb movements in sleep, and less robustly for night shift work and restless leg syndrome to be associated with increased risk of lung cancer development, with potential impacts on cancer survival outcomes. Proposed mechanisms underlying the biological plausibility of these epidemiological associations are also explored, with common theories relating to immune dysregulation, metabolic alterations, reductions in melatonin, sympathetic overactivation, increased reactive oxygen species, production of protumorigenic exosomes and inflammation. We also summarized potential treatments addressing impaired sleep quality/sleep disorders and their ability to attenuate the risk of lung cancer and cancer survival. While evidence on reversibility is inconsistent, there are trends toward positive outcomes. Future research should focus on clinical trials to confirm cause and effect relationships, large epidemiologic studies for incidence/prognosis, clarification on the relative efficacy of treatment modalities, and more in vivo animal models to establish the molecular mechanisms underlying these relationships.

Global parent perspectives on school food service internationally: A mixed papers narrative review.

The views of parents/caregivers about food programs in schools internationally is not well understood. This review aimed to synthesise what parents/caregivers identify as the key features of school food programs and their perspectives of these programs globally. A mixed papers review was undertaken with a systematic search (January 2024)and screening of three databases (Scopus, Web of Science, PubMed). Eligible studies captured parent/caregiver perspectives across all school food models. Study findings were extracted using Bayesian methods to translate quantitative findings into qualitative data. Data was deductively categorised to identify features of school food models, and separately themed to identify parent perspectives. Twenty-six eligible studies were identified from 11 countries. Fifteen features were identified, including cost, time, effort and convenience, child preferences, nutrition, policy and messaging, eating environment and food education. Parent perspective themes were: child is the priority, lunchbox procurement, preparation and provision is challenging, school-provided meals have strengths and limitations, and parents acknowledge they are central to feeding. An overarching theme was that compromises must be made to meet the needs of family members, when parents make decisions on school food. This review found that globally parents perceive benefits and challenges to school food programs, regardless of provision model, with a range of features that influence parent acceptability. Considering parent/caregiver perspectives when developing or changing school food provision models is likely to increase caregiver acceptability, supporting children to engage with health promotion efforts.

How to overcome barriers to care with digital health applications (DiGA)? Areview of the patient pathway for unipolar depression

Digital health applications (DiGA) can play an important role in the treatment of unipolar depression. In Germany, the demand is high, but less than 1% of patients use DiGA, indicating existing barriers to their use. This article provides an overview of access and usage barriers along the patient pathway and discusses possible solutions to improve the dissemination and use of digital therapies.Based on the National Care Guideline (NVL) Unipolar Depression (2022), apatient pathway with the phases of "decision," "access," and "usage" was developed. Using this structure, existing care barriers were identified based on current literature, and solutions were derived. The narrative review shows that various factors hinder the effective use of DiGA. In the decision phase, lack of knowledge about DiGA and lack of trust in their effectiveness are central challenges. In the access phase, data protection concerns and bureaucratic hurdles are significant barriers. During the usage phase, difficulties in application and low adherence lead to limited effectiveness.Several solutions are proposed to overcome these barriers. Comprehensive education about the effectiveness of digital therapies could strengthen trust in DiGA. Improvements in user-friendliness and greater involvement of healthcare providers could increase acceptance and adherence. Additionally, targeted training for professionals and patients could promote the use of DiGA. These insights are also relevant for other areas of digital therapies.

Faculty Development Interventions in Medical Education During the COVID-19 Pandemic: A Systematic Review

The onset of the COVID-19 pandemic in March 2020 began a series of disruptions that rapidly impacted medical education across the globe. This review collates current literature that relates to medical education faculties’ development interventions as a result of the pandemic, with an emphasis on the effectiveness and type of strategies for intervention, such as the usefulness of hybrid and digitalised education. The study used PRISMA guidelines when conducting the literature survey with specified inclusion and exclusion criteria across numerous academic databases. From this survey, 1158 articles were found. The EndNote programme was used to identify and remove duplicate pieces. From this, 479 abstracts were reviewed. A total of 36 articles were selected for their relevance; from this, 11 were deemed to have met the inclusion criteria to warrant full-text analysis. To identify bias risk in these 11 studies, the Newcastle–Ottawa Scale (NOS) was utilised. The study findings have two major themes: (1) information about faculty development interventions; and (2) the nature of articles written in the pandemic. From this, it was indicated that faculty development initiatives are useful for improving teachers’ competency and for enhancing teachers’ adoption of digitalised learning to ultimately bolster the resilience of their teaching. The findings also show that there is a strong need to have robust frameworks in place for faculty development, and that such frameworks must be followed in and beyond the pandemic period to improve the long-term incorporation of online learning into medical education.

Laparoscopic hiatal hernia augmentation following sleeve gastrectomy using a “mesh sling” tethered to ligamentum teres – Case report of a novel technique

Symptomatic hiatal hernia following sleeve gastrectomy is a well known and documented complication. The gold standard for its treatment is to perform a hiatal hernia repair combined with conversion of the sleeve to a gastric bypass. However, in some patients a gastric bypass may not be indicated or the patient may be unwilling for the conversion. In these situations, the ligamentum teres augmentation combined with hiatal hernia crural repair seems to be the most effective and popular, according to a literature survey. To avoid damaging the sleeve, the use of prosthetic materials to augment the hiatal repair is generally not recommended. In this case report, for a patient who presented with a hiatal hernia with severe reflux following a sleeve gastrectomy, we describe a novel technique where a sling composed of a strip of composite mesh was loosely placed around the gastroesophageal junction and tethered to a shortened ligamentum teres.