Conference Proceedings Research Articles

Handheld echocardiography for the screening and diagnosis of rheumatic heart disease: a systematic review to inform WHO guidelines

Early detection and diagnosis of acute rheumatic fever and rheumatic heart disease are key to preventing progression, and echocardiography has an important diagnostic role. Standard echocardiography might not be feasible in high-prevalence regions due to its high cost, complexity, and time requirement. Handheld echocardiography might be an easy-to-use, low-cost alternative, but its performance in screening for and diagnosing acute rheumatic fever and rheumatic heart disease needs further investigation. In this systematic review and meta-analysis, we searched Embase, MEDLINE, LILACS, and Conference Proceedings Citation Index-Science up to Feb 9, 2024, for studies on the screening and diagnosis of acute rheumatic fever and rheumatic heart disease using handheld echocardiography (index test) or standard echocardiography or auscultation (reference tests) in high-prevalence areas. We included all studies with useable data in which the diagnostic performance of the index test was assessed against a reference test. Data on test accuracy in diagnosing rheumatic heart disease, acute rheumatic fever, or carditis with acute rheumatic fever (primary outcomes) were extracted from published articles or calculated, with authors contacted as necessary. Quality of evidence was appraised using GRADE and QUADAS-2 criteria. We summarised diagnostic accuracy statistics (including sensitivity and specificity) and estimated 95% CIs using a bivariate random-effects model (or univariate random-effects models for analyses including three or fewer studies). Area under the curve (AUC) was calculated from summary receiver operating characteristic curves. Heterogeneity was assessed by visual inspection of plots. This study was registered with PROSPERO (CRD42022344081). Out of 4868 records we identified 11 studies, and two additional reports, comprising 15 578 unique participants. Pooled data showed that handheld echocardiography had high sensitivity (0·87 [95% CI 0·76-0·93]), specificity (0·98 [0·71-1·00]), and overall high accuracy (AUC 0·94 [0·84-1·00]) for diagnosing rheumatic heart disease when compared with standard echocardiography (two studies; moderate certainty of evidence), with better performance for diagnosing definite compared with borderline rheumatic heart disease. High sensitivity (0·79 [0·73-0·84]), specificity (0·85 [0·80-0·89]), and overall accuracy (AUC 0·90 [0·85-0·94]) for screening rheumatic heart disease was observed when pooling data of handheld echocardiography versus standard echocardiography (seven studies; high certainty of evidence). Most studies had a low risk of bias overall. Some heterogeneity was observed for sensitivity and specificity across studies, possibly driven by differences in the prevalence and severity of rheumatic heart disease, and level of training or expertise of non-expert operators. Handheld echocardiography has a high accuracy and diagnostic performance when compared with standard echocardiography for diagnosing and screening of rheumatic heart disease in high-prevalence areas. World Health Organization. For the Chinese, French, Italian, Persian, Portuguese, Spanish and Urdu translations of the abstract see Supplementary Materials section.

Recent Advances in the Development of RET Inhibitors

Background: Rearranged during transfection (RET) is a receptor tyrosine kinase and a bona fide oncogene that drives various cancers. Oncogenic RET induces abnormal activation of RET kinase, causing tumorigenesis. RET can be abnormally activated through RET point mutations and RET fusions. Although RET kinase has been discovered in tumors more than 30 years ago, patients with RET-altered tumors gain limited benefits from multikinase inhibitors (MKIs). In 2020, pralsetinib and selpercatinib were approved by FDA for the treatment of RET-altered tumors. Objective: Recently reported RET inhibitors were reviewed to provide an overview of the development of novel RET inhibitors. Methods: Literatures, patents, and conference proceedings published in the past five years were collected. Only RET inhibitors with novel scaffolds or in vivo efficacy were discussed in this review. The enzymebased and cell-based activities, PK profiles, antitumor activities in vivo, and clinical efficacy of the selected RET inhibitors were described. Results: Great efforts have been spent on the development of RET inhibitors, leading to increased RETtargeted therapies. Due to high potency and specificity, pralsetinib and selpercatinib resulted in a >8- month improvement in overall survival, compared to MKIs. However, solvent-front mutants emerged and contributed to the acquired resistance to pralsetinib and selpercatinib. To overcome solvent front mutants, TPX-0046, TAS0953, and LOX-260 are investigated in early clinical studies. Conclusion: Zeteletinib, SYHA1815, TPX-0046, TAS0953, and LOX-260 are potential therapies for RET-altered cancers. In addition, macrocyclic inhibitors, allosteric inhibitors, and PROTACs are three promising strategies to address the potential drug resistance of RET.

Making a Better Logistic Regression Model Using Ensemble Learning

Abstract: Machine learning is a hot research topic in today's society and an important direction in the field of image classification research. Image classification is a supervised learning method used to classify images. There are many image classification algorithms that perform differently in different conditions. Paper focuses on improving the performance of image classification algorithms by using ensemble learning. Paper analyses the performance of logistic regression model and support vector machine model and then uses ensemble learning to increase the performance of logistic regression model. In the research work, both theoretical and empirical approaches were followed. For the theoretical approach a review of both secondary data as well as data based on results obtained by application on the tools is studied. Secondary data was acquired from the research articles, text books, journals, technical reports, published thesis, websites, e-journals, software tool manuals, conference proceedings and any other research articles published in the related domain. The empirical study was carried out on the set of experiments, using software tools. The results obtained from the experiments were analyzed for the finding of the research. The paper compares the results of three algorithms when tested on same dataset, in same environment and on same system. The final results of the research prove that ensemble techniques give best results and this type of learning is effective.

Managing global supply chain teams: human resource strategies for effective collaboration and performance

This study examines the role of human resource (HR) strategies in enhancing collaboration and performance within global supply chains, an area of increasing importance in the context of globalized business operations. The primary objective is to identify and analyze current trends in HR practices that contribute to effective global supply chain management, focusing on adaptability, technological integration, sustainability, and ethical practices. Employing a systematic literature review and content analysis as its methodology, the study draws on academic journals, conference proceedings, and industry reports from databases such as Scopus, Web of Science, and Google Scholar. Key findings reveal that adaptability and flexible work arrangements, supported by digital HR technologies, are essential for operational resilience and employee engagement. The integration of sustainability and ethical considerations into HR practices is identified as crucial for maintaining competitive advantage and ensuring regulatory compliance. Furthermore, the development of cultural intelligence and inclusive leadership within global teams is highlighted as vital for fostering effective collaboration across diverse cultural landscapes. The study concludes that strategic HR management plays a pivotal role in navigating the challenges and leveraging the opportunities within global supply chains. Recommendations for practitioners emphasize the importance of continuous learning, embracing digital transformation, and integrating sustainability into HR practices. The study also outlines areas for further research, including the impact of emerging technologies on HR practices and the long-term effects of sustainable HR strategies on organizational performance. This research contributes valuable insights into optimizing HR strategies to enhance global supply chain collaboration and performance.

China National Knowledge Infrastructure (CNKI) as a Resource for Nineteenth-Century Music Studies

As the largest and most comprehensive Chinese database in the world, China National Knowledge Infrastructure (CNKI: Zhong guo zhi shi ji chu she shi gong cheng 中国知识基础设施工程, also commonly known as Zhi wang 知网)1 is supervised by Tsinghua University and Tonfang Knowledge Network (TKN), a high-tech enterprise funded by Tsinghua University in 1997. It is supported by the Chinese Ministry of Education, the Publicity Department of the Communist Party of China, the Ministry of Science and Technology, the State Administration of the Press, Publication, Radio, Film and Television of the People's Republic of China and the State Planning Commission of the PRC. In December 1996, CNKI began providing CD-ROM and CAJ-CD for Chinese academic journals, and it was officially launched in 1999. This repository initially focused on Chinese academic journals and later expanded its coverage to PhD dissertations, masters’ theses, conference proceedings, yearbooks, books and patent documents. It is divided into three categories: ‘databases’, ‘specialized sources’, and ‘international sources’, including ProQuest and Taylor and Francis journal databases. Ten service centres are established across the world, including Beijing, North America, Japan, Korea, Taiwan and Hong Kong; users include universities, research institutions, government think tanks, industries, hospitals and public libraries.2 CNKI (or CIKRD) updates its information on a daily basis, and its current growth rate is approximately 350,000 new journal articles per month.

Utility of artificial intelligence in the diagnosis and management of keratoconus: a systematic review

IntroductionThe application of artificial intelligence (AI) systems in ophthalmology is rapidly expanding. Early detection and management of keratoconus is important for preventing disease progression and the need for corneal transplant. We review studies regarding the utility of AI in the diagnosis and management of keratoconus and other corneal ectasias.MethodsWe conducted a systematic search for relevant original, English-language research studies in the PubMed, Web of Science, Embase, and Cochrane databases from inception to October 31, 2023, using a combination of the following keywords: artificial intelligence, deep learning, machine learning, keratoconus, and corneal ectasia. Case reports, literature reviews, conference proceedings, and editorials were excluded. We extracted the following data from each eligible study: type of AI, input used for training, output, ground truth or reference, dataset size, availability of algorithm/model, availability of dataset, and major study findings.ResultsNinety-three original research studies were included in this review, with the date of publication ranging from 1994 to 2023. The majority of studies were regarding the use of AI in detecting keratoconus or subclinical keratoconus (n=61). Among studies regarding keratoconus diagnosis, the most common inputs were corneal topography, Scheimpflug-based corneal tomography, and anterior segment-optical coherence tomography. This review also summarized 16 original research studies regarding AI-based assessment of severity and clinical features, 7 studies regarding the prediction of disease progression, and 6 studies regarding the characterization of treatment response. There were only three studies regarding the use of AI in identifying susceptibility genes involved in the etiology and pathogenesis of keratoconus.DiscussionAlgorithms trained on Scheimpflug-based tomography seem promising tools for the early diagnosis of keratoconus that can be particularly applied in low-resource communities. Future studies could investigate the application of AI models trained on multimodal patient information for staging keratoconus severity and tracking disease progression.

National Public Health Dashboards: Protocol for a Scoping Review.

The COVID-19 pandemic highlighted the importance of robust public health data systems and the potential utility of data dashboards for ensuring access to critical public health data for diverse groups of stakeholders and decision makers. As dashboards are becoming ubiquitous, it is imperative to consider how they may be best integrated with public health data systems and the decision-making routines of diverse audiences. However, additional progress on the continued development, improvement, and sustainability of these tools requires the integration and synthesis of a largely fragmented scholarship regarding the purpose, design principles and features, successful implementation, and decision-making supports provided by effective public health data dashboards across diverse users and applications. This scoping review aims to provide a descriptive and thematic overview of national public health data dashboards including their purpose, intended audiences, health topics, design elements, impact, and underlying mechanisms of use and usefulness of these tools in decision-making processes. It seeks to identify gaps in the current literature on the topic and provide the first-of-its-kind systematic treatment of actionability as a critical design element of public health data dashboards. The scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The review considers English-language, peer-reviewed journal papers, conference proceedings, book chapters, and reports that describe the design, implementation, and evaluation of a public health dashboard published between 2000 and 2023. The search strategy covers scholarly databases (CINAHL, PubMed, Medline, and Web of Science) and gray literature sources and uses snowballing techniques. An iterative process of testing for and improving intercoder reliability was implemented to ensure that coders are properly trained to screen documents according to the inclusion criteria prior to beginning the full review of relevant papers. The search process initially identified 2544 documents, including papers located via databases, gray literature searching, and snowballing. Following the removal of duplicate documents (n=1416), nonrelevant items (n=839), and items classified as literature reviews and background information (n=73), 216 documents met the inclusion criteria: US case studies (n=90) and non-US case studies (n=126). Data extraction will focus on key variables, including public health data characteristics; dashboard design elements and functionalities; intended users, usability, logistics, and operation; and indicators of usefulness and impact reported. The scoping review will analyze the goals, design, use, usefulness, and impact of public health data dashboards. The review will also inform the continued development and improvement of these tools by analyzing and synthesizing current practices and lessons emerging from the literature on the topic and proposing a theory-grounded and evidence-informed framework for designing, implementing, and evaluating public health data dashboards. DERR1-10.2196/52843.

Building a Value-Based Workforce Through Islamic Work Value-Based Recruitment: A Conceptual Review

Building a Value-Based Workforce Through Islamic Work Value-Based Recruitment: A Conceptual Review

The Role of Artificial Intelligence (AI) in Developing English Language Skills in the Saudi EFL Context: An Analytical Study

This paper explores the role of Artificial Intelligence (AI) in language learning, examining its impact on language skills. The study synthesises research findings from diverse sources, including academic journals, conference proceedings, and scholarly books, to provide a comprehensive overview of the current state of AI integration in language learning. Key themes addressed include the effectiveness of AI-driven language learning platforms, the role of AI in learning experiences, the potential of AI technologies in language learning. Additionally, the paper discusses challenges and future directions in the field, offering insights for researchers, educators, and practitioners interested in harnessing the potential of AI to enhance language learning outcomes.

Are Archaeologists Talking About Looting? Reviewing Archaeological and Anthropological Conference Proceedings from 1899–2019

Are Archaeologists Talking About Looting? Reviewing Archaeological and Anthropological Conference Proceedings from 1899–2019

Cybersecurity’s Role in Environmental Protection and Sustainable Development: Bridging Technology and Sustainability Goals

This study investigates the pivotal role of cybersecurity in bolstering environmental protection and sustainable development, a critical yet underexplored nexus in contemporary research. Employing a systematic literature review and content analysis, the research scrutinizes peer-reviewed articles, conference proceedings, and industry reports from 2015 to 2023, sourced from databases such as IEEE Xplore, ScienceDirect, and Google Scholar. The methodology is anchored in a rigorous search strategy, leveraging keywords related to cybersecurity, sustainability, and communication technologies, and adheres to defined inclusion and exclusion criteria to ensure the relevance and quality of the literature reviewed. Key findings highlight cybersecurity as an indispensable enabler of sustainable development initiatives, safeguarding the technological infrastructure essential for environmental conservation efforts. The study identifies evolving cyber threats as a significant challenge, necessitating adaptive security measures that anticipate and mitigate potential vulnerabilities. Furthermore, it underscores the opportunities presented by advanced cybersecurity technologies, such as artificial intelligence and blockchain, in enhancing the security and efficiency of sustainable practices. Strategic recommendations emphasize the need for comprehensive cybersecurity frameworks, stakeholder collaboration, cybersecurity education, and alignment with regulatory standards to fortify the resilience of sustainability initiatives against cyber threats. The study concludes that integrating robust cybersecurity measures is paramount in the pursuit of sustainable development goals, calling for ongoing vigilance, innovation, and interdisciplinary collaboration to navigate the complex landscape of digital threats and opportunities. This research contributes valuable insights into the critical intersection of cybersecurity and sustainability, offering a foundation for future studies and strategic initiatives aimed at securing sustainable development in the digital age. Keywords: Cybersecurity, Sustainable Development, Environmental Protection, Advanced Security Technologies.

Is anyone listening? Evaluating the impact of decision systems and analytics research

ABSTRACT The decision support systems (DSS) area is an integral part of the Information Systems discipline. DSS’s main objective is to contribute to the common good by facilitating access to relevant information for improved decision-making. IFIP Working Group 8.3 Decision Support was established in 1981 as a community passionate about creating a body of knowledge on how to support better decision-making. The advances in addressing this mission were regularly presented at the bi-annual meetings of the IFIP WG8.3. Our aim in this paper is to analyse the impact of the research of the group through these conference proceedings. We use a ‘test of time’ as a starting point to identify the sample of papers that have been most noted and cited. Further analysis helps to clarify other parameters that define the impact of this research and allow us to propose strategies to inform more impactful research outcomes in the future.

Talent Management Practices in Higher Educational Institutions- A Bibliometric Analysis

Talent management practices are becoming crucial in educational institutions. These practices seek to discover and develop the talents and abilities of educators, staff members and students, ensuring that the institution can deliver quality education while remaining competitive. The study attempts to identify important topics, trends, and notable publications in this field. The analysis covers numerous sources during a pre-determined period (2018-2022), including books, conference proceedings, and scholarly journals. The Bibliometric analyses were conducted using data from the Scopus database (Total Scopus Data=55), VOSViewer, the Bibliometrics library, and the Biblioshiny platform of the RStudio® software. The results show that several themes like significant authors, publications, references, institutions, and nations’ information have emerged as essential elements of talent management in educational settings. We also analyse the geographic distribution, regional differences and possible research areas for cross-cultural comparisons. This study analyses the literature on these themes and contributes to our understanding of how to handle talent management in educational institutions.

Barriers and Challenges of Sustainable Logistics in Automobile Industry

Study Background and Objectives The automobile industry is a significant contributor to global environmental concerns. Vehicle production, transportation, and end-of-life management all have substantial environmental footprints. Sustainable logistics practices offer a path towards a greener future for industry. However, implementing these practices faces numerous challenges. This study aims to investigate the barriers and challenges hindering the adoption of sustainable logistics practices within the automobile industry. The specific objectives are: · To identify the key barriers faced by automobile manufacturers and their logistics partners in implementing sustainable practices. · To analyse the impact of these barriers on the environmental performance of the industry's logistics operations. · To develop recommendations for overcoming these barriers and promoting sustainable logistics practices within the automobile sector. Research Design This study employs a literature review methodology to analyze existing research on the barriers and challenges of sustainable logistics in the automobile industry. Relevant academic journals, conference proceedings, and industry reports are reviewed to identify key themes and insights. · Conduct a systematic and comprehensive review of relevant academic journals, industry reports, and government publications. · Utilize appropriate search engines and databases to identify relevant literature. · Analyse the collected data to identify key themes, trends, and research gaps. · Synthesize the findings to provide a comprehensive understanding of the barriers and challenges of sustainable logistics in the automobile industry. Major Findings The study reveals a growing consumer interest in the auto industry's commitment to sustainability. While price, performance, and safety remain significant purchase factors, a significant portion of consumers consider a car manufacturer's environmental practices when deciding. However, a knowledge gap exists, with many consumers lacking awareness of the environmental impact of traditional logistics practices. The research also highlights the importance of collaboration between car manufacturers, logistics companies, and policymakers in achieving significant progress towards sustainable practices. Standardized sustainability metrics and government incentives are seen as crucial factors for long-term success.

Perception and Attitude towards Disaster Preparedness among Library Professionals in University of Kerala and University of Calicut: An Investigative Study

Libraries stand as crucial pillars in moulding the future generations of society, playing a foundational role in the socioeconomic development of nations. Recognizing their significance, it becomes imperative to safeguard libraries for the prosperity of the upcoming generations. Central to this responsibility is the need for libraries to be well-equipped and prepared to face potential disasters. The article delves into the study of the perception and attitude of library professionals towards disaster preparedness at the University of Kerala and the University of Calicut. The objectives encompass assessing librarians’ perception levels, examining current disaster precautions, studying awareness about disaster management authorities, evaluating awareness of rules and laws, and determining the existence of structured training programs. To gather relevant literature, diverse resources such as Google Scholar, Emerald, ProQuest, ResearchGate, ScienceDirect, conference proceedings, dissertations and theses in Library and Information Science were consulted. The study utilised a closed-ended structured questionnaire aligned with the defined objectives to collect data. The gathered data underwent tabulation and analysis using Microsoft Excel 2013 and SPSS version 21. The findings of the study revealed that library professionals possess an awareness of disasters and the necessity for preparedness, yet there seems to be a gap in translating this knowledge into practical implementation. The conclusion drawn is a call to action, emphasising the need for libraries to execute disaster awareness and training programs for both staff and users. In a world where natural calamities and unforeseen events pose a constant threat, understanding how library professionals perceive and approach disaster preparedness becomes paramount. As custodians of academic treasures, their perspectives shape the resilience of these institutions against potential disruptions. The study, therefore, serves as a critical exploration into the preparedness landscape, providing insights that extend beyond the immediate scope of libraries to contribute to the broader discourse on disaster management in academic settings.

Innovation green technology in the age of cybersecurity: Balancing sustainability goals with security concerns

This study explores the critical intersection of cybersecurity measures and green technologies, aiming to assess their combined impact on sustainability goals and stakeholder implications. Employing a systematic literature review methodology, the research scrutinizes peer-reviewed journals, conference proceedings, and reports from reputable databases, focusing on publications from the year 2010 to 2024. The review identifies key themes, including the integration challenges and opportunities of cybersecurity within sustainable technologies, the evolving landscape of cybersecurity protocols, and the strategic implications for industry leaders, policymakers, and technologists. Key insights reveal the dual imperative of pursuing sustainability alongside security, highlighting the necessity of integrating robust cybersecurity measures without compromising the environmental benefits of green technologies. The study identifies significant challenges at this nexus, such as the rapid evolution of cyber threats and the complexity of embedding cybersecurity in green innovations. It also outlines opportunities for innovation and the development of a security-aware culture that supports environmental sustainability. Strategic recommendations are provided for stakeholders to navigate these complexities, emphasizing the importance of multidisciplinary approaches, continuous learning, and the development of policies that encourage the adoption of secure and sustainable technologies. The study concludes that fostering innovation in green technology requires a concerted effort to integrate cybersecurity measures effectively, underscoring the need for future research to expand the knowledge frontiers in this critical area. This research contributes to the ongoing dialogue on achieving environmental sustainability and technological resilience, offering a foundation for further exploration and action towards these dual objectives. Keywords: Cybersecurity, Green Technologies, Sustainable Technological, Stakeholder Security Concerns.

Evaluating the impact of educational technology on learning outcomes in the higher education sector: a systematic review

This systematic review evaluates the impact of educational technology on learning outcomes in the higher education sector. With the rapid integration of digital tools in educational settings, understanding their effectiveness has become crucial. The paper's objective is to synthesize existing research findings to assess how educational technologies influence learning outcomes. We employed a comprehensive search strategy across multiple databases, including peer-reviewed journals and conference proceedings, to collect studies published in the last decade. The inclusion criteria focused on empirical studies that measured the impact of technologies such as learning management systems, online simulations, and digital collaborative tools on student learning outcomes in higher education. Our methodology involved a rigorous screening process, quality assessment, and data extraction, followed by a thematic synthesis of the findings. The review included a total of 47 studies, which were analyzed to identify patterns, themes, and gaps in the current literature. Key findings suggest that educational technology, when effectively integrated into teaching and learning processes, can enhance student engagement, improve knowledge retention, and foster higher-order thinking skills. However, the impact varies significantly depending on the type of technology used, pedagogical approach, and context of implementation. The review also highlights the importance of faculty training and support in maximizing the potential benefits of educational technologies. Educational technology holds promise for improving learning outcomes in higher education, but its success is contingent upon thoughtful implementation, pedagogical alignment, and ongoing support for instructors. Future research should focus on longitudinal studies to better understand the long-term effects of educational technologies on learning outcomes. Keywords: Educational Technology, Learning Outcomes, Higher Education, Digital Divide, Accessibility, Equity, Blended Learning, Virtual Reality, Artificial Intelligence, Mobile Learning, Pedagogical Approaches, Professional Development, Strategic Integration.

Literature Review in Scientific Research: An Overview

The quality and success of academic work are closely linked to the literature review process. A literature review is essential to any scientific research study, which entails an in-depth analysis and synthesis of the existing literature and studies related to the research topic. The literature review process thoroughly searches various databases and sources to ensure the review is comprehensive and up to date. The primary objective of this article is to provide an overview of the literature review process in scientific research, its importance in research methodology, and its different types. It also aims to discuss the purpose of conducting a literature review in research, the methods involved, and the significance of having access to relevant literature. Additionally, it provides guidelines for early career researchers on how to conduct a comprehensive literature search. A literature search was conducted in major databases and supplemented by browsing journals and citations with relevant keywords. There are four main types of literature reviews: traditional or narrative, systematic, meta-analysis, and meta-synthesis. By conducting a literature review, researchers gain a deep understanding of the research landscape, identify potential biases and limitations, and contribute to developing knowledge in their field of study. Executing a literature search is fruitless unless researchers possess fundamental knowledge about it. Hence, collecting literature for the literature review is an indispensable step that requires a comprehensive search of various databases and sources, such as academic journals, books, conference proceedings, and other relevant publications. The present article provides vital information and literature search guidelines for early career researchers

Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients.

The risk of cytomegalovirus (CMV) infection in solid organ transplant recipients has resulted in the frequent use of prophylaxis to prevent the clinical syndrome associated with CMV infection. This is an update of a review first published in 2005 and updated in 2008 and 2013. To determine the benefits and harms of antiviral medications to prevent CMV disease and all-cause death in solid organ transplant recipients. We contacted the information specialist and searched the Cochrane Kidney and Transplant Register of Studies up to 5 February 2024 using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal, and ClinicalTrials.gov. We included randomised controlled trials (RCTs) and quasi-RCTs comparing antiviral medications with placebo or no treatment, comparing different antiviral medications or different regimens of the same antiviral medications for CMV prophylaxis in recipients of any solid organ transplant. Studies examining pre-emptive therapy for CMV infection are studied in a separate review and were excluded from this review. Two authors independently assessed study eligibility, risk of bias and extracted data. Summary estimates of effect were obtained using a random-effects model, and results were expressed as risk ratios (RR) and their 95% confidence intervals (CI) for dichotomous outcomes and mean difference (MD) and 95% CI for continuous outcomes. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. This 2024 update found four new studies, bringing the total number of included studies to 41 (5054 participants). The risk of bias was high or unclear across most studies, with a low risk of bias for sequence generation (12), allocation concealment (12), blinding (11) and selective outcome reporting (9) in fewer studies. There is high-certainty evidence that prophylaxis with aciclovir, ganciclovir or valaciclovir compared with placebo or no treatment is more effective in preventing CMV disease (19 studies: RR 0.42, 95% CI 0.34 to 0.52), all-cause death (17 studies: RR 0.63, 95% CI 0.43 to 0.92), and CMV infection (17 studies: RR 0.61, 95% CI 0.48 to 0.77). There is moderate-certainty evidence that prophylaxis probably reduces death from CMV disease (7 studies: RR 0.26, 95% CI 0.08 to 0.78). Prophylaxis reduces the risk of herpes simplex and herpes zoster disease, bacterial and protozoal infections but probably makes little to no difference to fungal infection, acute rejection or graft loss. No apparent differences in adverse events with aciclovir, ganciclovir or valaciclovir compared with placebo or no treatment were found. There is high certainty evidence that ganciclovir, when compared with aciclovir, is more effective in preventing CMV disease (7 studies: RR 0.37, 95% CI 0.23 to 0.60). There may be little to no difference in any outcome between valganciclovir and IV ganciclovir compared with oral ganciclovir (low certainty evidence). The efficacy and adverse effects of valganciclovir or ganciclovir were probably no different to valaciclovir in three studies (moderate certainty evidence). There is moderate certainty evidence that extended duration prophylaxis probably reduces the risk of CMV disease compared with three months of therapy (2 studies: RR 0.20, 95% CI 0.12 to 0.35), with probably little to no difference in rates of adverse events. Low certainty evidence suggests that 450 mg/day valganciclovir compared with 900 mg/day valganciclovir results in little to no difference in all-cause death, CMV infection, acute rejection, and graft loss (no information on adverse events). Maribavir may increase CMV infection compared with ganciclovir (1 study: RR 1.34, 95% CI: 1.10 to 1.65; moderate certainty evidence); however, little to no difference between the two treatments were found for CMV disease, all-cause death, acute rejection, and adverse events at six months (low certainty evidence). Prophylaxis with antiviral medications reduces CMV disease and CMV-associated death, compared with placebo or no treatment, in solid organ transplant recipients. These data support the continued routine use of antiviral prophylaxis in CMV-positive recipients and CMV-negative recipients of CMV-positive organ transplants.

Respiratory syncytial virus vaccination during pregnancy for improving infant outcomes.

Respiratory syncytial virus vaccination during pregnancy for improving infant outcomes.