Medical Literature Research Articles

'Boy smell': transgender and nonbinary people's experiences of bodily smell.

Although smell is sometimes treated with little regard, it is invested with cultural meaning and conveys a great deal of information, including about gender, sexuality and identity. This article draws on interviews with 11 transgender and nonbinary people who have accessed gender affirming hormone therapy (GAHT), and focuses on how they understand and explain changes in how their own bodies smell. Although it is well documented that GAHT causes changes in skin oiliness, changes in smell are inconsistently documented, and within the medical literature are often commented on only in passing. Taking a discourse analytic approach, the article finds that participants noticed changes in their own smell during hormonal transition, that in many cases this change was understood as significant in some way, and that these changes could be experienced as affirming. Understandings of what changes in bodily smell meant were often derived relationally or socially, although participants' discussion of the experience frequently focused on their own embodiment. Smell seems to form part of a process of (re)identification with the physical self and gender affirmation that can be facilitated by GAHT.

Early Audiometric Intervention in Bacterial Meningitis: Cochlear Implantation in a 10-Week-Old Child.

Sensorineural hearing loss is a well-known complication of Streptococcus pneumoniae meningitis. Given the propensity for fibrosis and ossification of the cochlea in bacterial meningitis, implantation must be performed in a timely fashion because a delayed attempt at implantation can frustrate obtaining an optimal technical result or lead to an inability to implant. Obtaining optimal audiometric outcomes is reliant on early hearing screening in patients with streptococcal meningitis. In the absence of standardized protocols, audiometric testing is often overlooked or delayed in the workup and management of meningitis. Our institution implemented a meningitis protocol with a particular focus on timing of audiometric testing in patients with meningitis. We present a patient diagnosed with streptococcal meningitis in the first week of life. Early hearing screening allowed the diagnosis of profound unilateral sensorineural hearing loss and subsequent cochlear implantation at 10 weeks of age, the youngest described in the medical literature. Despite early implantation, there was cochlear fibrosis at the time of implantation. Fortunately, the majority of electrodes were implanted to achieve a serviceable hearing outcome. Serial magnetic resonance imaging scans were obtained because of her contralateral ventriculoperitoneal shunt that allowed unique visualization of the progression of cochlear fibrosis over time. This case demonstrates the importance of including audiometric testing in a standardized meningitis protocol to diagnose hearing loss in a timely and accurate way and to achieve optimal long-term hearing outcomes.

Racial Disparities in Sports Cardiology: A Review.

Racial disparities in cardiovascular health, including sudden cardiac death (SCD), exist among both the general and athlete populations. Among competitive athletes, disparities in health outcomes potentially influenced by social determinants of health (SDOH) and structural racism remain inadequately understood. This narrative review centers on race in sports cardiology, addressing racial disparities in SCD risk, false-positive cardiac screening rates among athletes, and the prevalence of left ventricular hypertrophy, and encourages a reexamination of race-based practices in sports cardiology, such as the interpretation of screening 12-lead electrocardiogram findings. Drawing from an array of sources, including epidemiological data and broader medical literature, this narrative review discusses racial disparities in sports cardiology and calls for a paradigm shift in approach that encompasses 3 key principles: race-conscious awareness, clinical inclusivity, and research-driven refinement of clinical practice. These proposed principles call for a shift away from race-based assumptions towards individualized, health-focused care in sports cardiology. This shift would include fostering awareness of sociopolitical constructs, diversifying the medical team workforce, and conducting diverse, evidence-based research to better understand disparities and address inequities in sports cardiology care. In sports cardiology, inadequate consideration of the impact of structural racism and SDOH on racial disparities in health outcomes among athletes has resulted in potential biases in current normative standards and in the clinical approach to the cardiovascular care of athletes. An evidence-based approach to successfully address disparities requires pivoting from outdated race-based practices to a race-conscious framework to better understand and improve health care outcomes for diverse athletic populations.

Recall Laterality and Bilaterality: Possible New Screening Mammography Quality Metrics

Purpose: Current screening mammography quality metrics are important and helpful, but do not address all quality concerns. An individual screening mammography reader may be systematically insensitive to findings present in the breast of one side, laterality bias, evidenced by left versus right difference in advised immediate recalls. Current metrics are not designed to detect laterality bias. Whether a reader exhibits laterality bias, or what an appropriate ratio/range of bilateral versus unilateral recalls should be, have never been discussed in medical literature. Methods: As a trainee quality project, five attending (‘consultant’ in Europe) radiologists’ screening mammography reports over 2 years at an academically affiliated, public hospital were tallied with regard to laterality of recommended recall, and with respect to unilateral versus bilateral recalls advised. The chi-square (χ²) statistic was applied to reports advising unilateral recall. Findings: No group laterality bias was discovered. One radiologist (the most experienced) evidenced a consistent laterality bias over 2 years (p=0.07) against left-breast findings. Of reports recommending recall, the radiologists’ single-year range for recall regarding both breasts was 10.2–23.3%; for both years combined, the individual radiologists ranged from 13.6–17.9%. The group, 2-year mean recommending bilateral recall was 16.5%. Conclusion: A radiologist may exhibit laterality bias, favoring detection of findings in one breast over the other, a concern never before considered. Audit to discern such bias leads simultaneously to assessment of bilateral recall bias. Possible causes of these biases are discussed, and research regarding them as possible quality metrics is encouraged.

Thyroid isthmus agenesis: An uncommon yet clinically relevant entity

The thyroid, a crucial endocrine gland composed of two lobes connected by isthmus tissue, rarely exhibits isthmus agenesis or hypoplasia, conditions scarcely documented in medical literature. This discussion centers on a 54-year-old female patient whose incidental discovery of isthmus agenesis occurred during surgery for a multinodular goiter. Identification of isthmus abnormalities prompts thorough consideration of potential associated anomalies, including hypoplasia, absence of a thyroid lobe and the presence of ectopic thyroid tissue. Increased awareness of potential isthmus agenesis or hypoplasia and associated thyroid anomalies among patients scheduled for thyroid surgery is essential for improving procedural safety and reducing the risk of complications related to surgery.

Evidence for Intermittent Theta Burst Transcranial Magnetic Stimulation for Dysphagia after Stroke: A Systematic Review and Meta-analysis.

Dysphagia is the most common serious complication after stroke, with an incidence of about 37-78%, which seriously affects the independence of patients in daily life and clinical recovery. Repetitive transcranial magnetic stimulation (rTMS), as a non-invasive neuromodulation technique, is an emerging option for post-stroke dysphagia. Theta burst stimulation (TBS) is a new mode of transcranial magnetic stimulation that simulates the frequency of pulses released in the hippocampus.Intermittent theta burst stimulation (iTBS) has been shown to increase cortical excitability and improve swallowing function in patients. Our study sought to summarize existing clinical randomized controlled trials to provide evidence-based medical evidence for the clinical use of iTBS. A computer search was conducted on 4 Chinese (Chinese Biomedical Literature Database, VIP Information Resource System, CNKI, and Wanfang Medical Science) and 4 English (including Cochrane Library, Embase, PubMed, Web of Science) databases to retrieve all randomized controlled trials in Chinese and English that explored the effects of Intermittent Theta Burst Stimulation for post-stroke dysphagia. The retrieval years are from database construction to 23 November 2023. The primary outcome measure was a change in Penetration/Aspiration Scale (PAS), Standardized Swallowing Assessment (SSA) and Functional Oral Intake Scale (FOIS), Secondary outcomes included Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), water-swallowing test (WST) etc. A meta-analysis by Standardized Mean Difference (SMD) and 95% confidence interval (CI) was performed with RevMan 5.3. we appraise risk of bias(RoB) of each study with the Cochrane RoB tool. Detailed instructions for using the Cochrane RoB tool are provided in the Cochrane Handbook for Systematic Reviews of Interventions (The Cochrane Handbook). Nine studies were obtained from eight databases after screening by inclusion and exclusion criteria, 567 patients from 9 studies were included in the meta-analysis, and one study was included in the qualitative analysis due to different control groups. Two of the nine studies had an unclear risk of bias, and four studies were at low risk. The results showed that iTBS significantly improved SSA, PAS, FOIS, and PAS scores in stroke patients compared to the control group(P < 0.05), and promoted swallowing function recovery. Our systematic review provides the first evidence of the efficacy of iTBS in improving dysphagia in stroke patients. However, the number of available studies limits the persuasiveness of the evidence and further validation by additional randomized controlled trials is needed.

A rare presentation of acute-onset chronic inflammatory demyelinating polyneuropathy with the detection of anti-GM3 and anti-sulfatides antibodies: a case report

ObjectivesChronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated neuropathy defined by clinical progression for more than 2 months. 16-20% of CIDP patients may present with rapidly progressive weakness that resembles GBS, known as acute-onset CIDP (A-CIDP). However, it is challenging to distinguish from GBS-TRF because of their similar clinical symptom and features. In this case review, we report a patient with A-CIDP with the detection of anti-GM3 and anti-sulfatides antibodies, which rarely have been in A-CIDP and may account for her progressive and recurrent symptoms.MethodsWe analyzed existing medical literature and described a clinical case of A-CIDP with antibodies positive.ResultsWe reported a 56-year-old female presented with bilateral lower extremity weakness and distal numbness. She experienced similar symptoms four times and responded well to the IVIg therapy. Lumbar puncture demonstrated albumin-cytologic dissociation and EDX examination revealed multiple peripheral nerve damage. After ruling out other demyelination diseases, a diagnosis of A-CIDP was made.DiscussionThe antiganglioside and anti-sulfatide antibodies are involved in CIDP pathogenesis and can help to distinguish A-CIDP and other variants. To prevent secondary damage, it is important to monitor relapse and remission symptoms along the treatment line. A rare case of A-CIDP is discussed concerning the detection of anti-GM3 and anti-sulfatides antibodies, thus making a retrospective comparison of antibodies in some literature to understand A-CIDP better.

A Case of a Penile Necrosis in a Patient with Simultaneous Fournier’s Gangrene and Priapism

Fournier's gangrene (FG) is a necrotizing fasciitis of the perineal and genital areas, characterized by severe complications and a high mortality rate. The occurrence of concurrent priapism is extremely rare and carries a very poor prognosis. We report the case of a 74-year-old male patient with no medical history who presented with FG of the scrotum and penis associated with simultaneous priapism. He received intravenous antibiotic therapy, cavernous aspiration, and surgical debridement. In the following days, the penis became completely necrotic. A total penectomy was performed with a perineal urethrostomy following complete wound closure. There are only a few documented cases in the medical literature of simultaneous Fournier's gangrene and priapism. Consequently, there is no established protocol for managing this rare occurrence. When gangrene extends to the penis, cavernous aspiration is not recommended as it tends to exacerbate penile necrosis in the majority of cases. However, early administration of broad-spectrum antibiotic therapy, surgical debridement, and urinary diversion are necessary to prevent necrosis and sepsis.

Asian Neonatal Network Collaboration (AsianNeo): a study protocol for international collaborative comparisons of health services and outcomes to improve quality of care for sick newborn infants in Asia – survey, cohort and quality improvement studies

IntroductionReducing neonatal deaths in premature infants in low- and middle-income countries is key to reducing global neonatal mortality. International neonatal networks, along with patient registries of premature infants, have contributed...

Reversible Increased Anxiety Following Left-Sided Stellate Ganglion Block to Treat Posttraumatic Stress Disorder: A Case Report.

Describe a 2-patient case report of a rare occurrence of significantly increased anxiety after a left-sided stellate ganglion block (SGB) and the subsequent improvement of that anxiety through a right-sided SGB. Right-sided SGB to treat post-traumatic stress disorder (PTSD) has over 23 supporting publications in the peer-reviewed medical literature, including level 1 evidence. A published case series of 285 patients showed that two-level SGB may improve anxiety-related symptoms in patients. However, a recently published study indicates that some patients only respond to a left-sided SGB. The patients had an ultrasound-guided right-sided SGB for the treatment of PTSD and experienced a reduction in anxiety symptoms based on Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) scores. Later, a left-sided SGB was performed. Clinically, the addition of a left-sided SGB is typically associated with further anxiety reduction, but in these 2 cases, the patients had a significant reversal of the improvements experienced after a right-sided SGB. Following this unusual response to a left-sided SGB, these patients were offered another right-sided SGB, after which, they experienced a significant and durable improvement in anxiety symptoms beyond the original baseline PCL-score. In rare cases and for unknown reasons, a left-sided SGB may result in acute worsening of anxiety symptoms, which can be addressed and significantly improved with the application of a subsequent right-sided SGB.

Non-Hereditary Obesity Type Networks and New Drug Targets: An In Silico Approach

Obesity, a chronic, preventable disease, has significant comorbidities that are associated with a great human and financial cost for society. The aim of the present work is to reconstruct the interactomes of non-hereditary obesity to highlight recent advances of its pathogenesis, and discover potential therapeutic targets. Obesity and biological-clock-related genes and/or gene products were extracted from the biomedical literature databases PubMed, GeneCards and OMIM. Their interactions were investigated using STRING v11.0 (a database of known and predicted physical and indirect associations among genes/proteins), and a high confidence interaction score of &gt;0.7 was set. We also applied virtual screening to discover natural compounds targeting obesity- and circadian-clock-associated proteins. Two updated and comprehensive interactomes, the (a) stress- and (b) inflammation-induced obesidomes involving 85 and 93 gene/gene products of known and/or predicted interactions with an average node degree of 9.41 and 10.8, respectively, were produced. Moreover, 15 of these were common between the two non-hereditary entities, namely, ADIPOQ, ADRB2/3, CCK, CRH, CXCL8, FOS, GCG, GNRH1, IGF1, INS, LEP, MC4R, NPY and POMC, while phelligridin E, a natural product, may function as a potent FOX1-DBD interaction blocker. Molecular networks may contribute to the understanding of the integrated regulation of energy balance/obesity pathogenesis and may associate chronopharmacology schemes with natural products.

Combined traditional Chinese medicine therapy for the treatment of infertility with polycystic ovary syndrome: A network meta-analysis of randomized controlled trials.

Polycystic ovary syndrome (PCOS) infertility has attracted great attention from researchers due to its high incidence. Numerous studies have shown that Chinese medicine is effective in treating this disease, but there is a wide variety of Chinese medicine therapies available, and there is a lack of comparative evaluation of the efficacy of various Chinese medicine combination therapies in the clinic, which requires further in-depth exploration. This study aims to evaluate the efficacy of a combined traditional Chinese medicine (TCM) therapy for the treatment of infertility with PCOS using network meta-analysis (NMA). In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0. This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate. The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.

Appraisal of AI-generated dermatology literature reviews.

Artificial intelligence (AI) tools have the potential to revolutionize many facets of medicine and medical sciences research. Numerous AI tools have been developed and are in continuous states of iterative improvement in their functionality. This study aimed to assess the performance of three AI tools: The Literature, Microsoft's Copilot and Google's Gemini in performing literature reviews on a range of dermatology topics. Each tool was asked to write a literature review on five topics. The topics chosen have recently had peer-reviewed systematic reviews published. The outputs of each took were graded on their evidence and analysis, conclusions and references on a 5-point Likert scale by three dermatologists who are working in clinical practice, have completed the UK dermatology postgraduate training examination and are partaking in continued professional development. Across all five topics chosen, the literature reviews written by Gemini scored the highest. The mean score for Gemini for each review was 10.53, significantly higher than the mean scores achieved by The Literature (7.73) and Copilot (7.4) (p < 0.001). This paper shows that AI-generated literature reviews can provide real-time summaries of medical literature across a range of dermatology topics, but limitations to their comprehensiveness and accuracy are apparent.

Towards discovery: an end-to-end system for uncovering novel biomedical relations.

Biomedical relation extraction is an ongoing challenge within the natural language processing community. Its application is important for understanding scientific biomedical literature, with many use cases, such as drug discovery, precision medicine, disease diagnosis, treatment optimization and biomedical knowledge graph construction. Therefore, the development of a tool capable of effectively addressing this task holds the potential to improve knowledge discovery by automating the extraction of relations from research manuscripts. The first track in the BioCreative VIII competition extended the scope of this challenge by introducing the detection of novel relations within the literature. This paper describes that our participation system initially focused on jointly extracting and classifying novel relations between biomedical entities. We then describe our subsequent advancement to an end-to-end model. Specifically, we enhanced our initial system by incorporating it into a cascading pipeline that includes a tagger and linker module. This integration enables the comprehensive extraction of relations and classification of their novelty directly from raw text. Our experiments yielded promising results, and our tagger module managed to attain state-of-the-art named entity recognition performance, with a micro F1-score of 90.24, while our end-to-end system achieved a competitive novelty F1-score of 24.59. The code to run our system is publicly available at https://github.com/ieeta-pt/BioNExt. Database URL: https://github.com/ieeta-pt/BioNExt.

Health technologies for tackling client absenteeism in primary and secondary care services.

Tackling client absenteeism in primary and secondary care settings is crucial to ensure the continuity of care for individuals, familiesand communities, as well as preventing waste of resources within healthcare systems. This article is an integrative review to identify advancements in health technologies that addressclient absenteeism in primary and secondary care. The databases Medical Literature and Retrieval System Online (MEDLINE/PubMed®), Scientific Electronic Library Onlineand Virtual Health Librarywere consulted. The inclusion criteria were as follows: full papers, published between 2013 and 2023, in English, Portugueseor Spanish. The descriptors used were the following: patients, mobile applications, health services management, absenteeismand primary care, and secondary care. Eleven articles published from 2014 to 2021 were included. Most articles were identified in the MEDLINE/PUBMED database, employed a randomized controlled trial methodology (36.36%), and were published between 2019 and 2021 (90.0%) in English (63.7%). The applications had managerial, assistiveand/or educational purposes. In addition to absenteeism control, these applications strived to promote client engagement with health services, increase health literacyand tackle structural barriers to care, such as language barriers. Efforts are needed to ensure that providers receive training to educate clients on the applications. Moreover, community-based participatory studies to ensure the feasibility of applications are warranted.

Zinc fever in a painter and varnisher: a case report

BackgroundZinc fever is well described in medical literature, particularly in workers after handling zinc-containing materials at high temperatures e.g., in the welding of hot-dip galvanized steel sheets. It is not known whether zinc fever also occurs at low temperatures.Case presentationWe present the case of a 33-year-old Caucasian atopic painter and varnisher with work-related dyspnea, sweating, as well as multiple occurrences of fever. He was sent to Institute for Prevention and Occupational medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA) for the evaluation of isocyanate asthma, but an inhalative challenge with hexamethylene diisocyanate was negative. Since symptoms were closely related to the use of zinc coatings at room temperature without adequate protective measures, the diagnosis of zinc fever was made. After exposure cessation the worker immediately became symptom-free. The work as painter and varnisher may be associated with various exposures to hazardous substances. Besides solvents, epoxy compounds and isocyanates, which can cause obstructive respiratory diseases; additionally, zinc-containing agents should be considered as health hazards.ConclusionsThis case demonstrates that zinc fever may occur also after application of zinc coatings by spray painting at low temperatures.

Congenital absence of the appendix in a 21-year-old male with clinical presentation of acute appendicitis: a diagnostic challenge at Prince Ali Military Hospital

Acute appendicitis is commonly associated with right lower quadrant abdominal pain and is a leading cause of emergent abdominal surgeries, carrying a significant morbidity risk. The rarity of anatomical deviations, such as appendix agenesis, complicates diagnosis and can exacerbate clinical outcomes due to diagnostic delays or mismanagement. We report the case of a 21-year-old male, who was surgically explored at prince Ali military hospital for suspected acute appendicitis based on clinical symptoms and an Alvarado score of 7. Despite strong clinical indications, imaging studies, including ultrasound and computed tomography, failed to visualize the appendix. Intraoperatively, appendix agenesis was confirmed, a finding seldom reported in medical literature. This case underscores the challenges of diagnosing congenital appendix absence and highlights the need for heightened awareness among clinicians to prevent unnecessary surgical interventions. Such awareness could potentially improve patient outcomes by sparing them from unnecessary surgical risks and complications.

Increasing Diversity, Equity, Inclusion, and Accessibility in Rare Disease Clinical Trials.

Diversity, equity, inclusion, and accessibility (DEIA) are foundational principles for clinical trials and medical research. In rare diseases clinical research, where numbers of participants are already challenged by rarity itself, maximizing inclusion is of particular importance to clinical trial success, as well as ensuring the generalizability and relevance of the trial results to the people affected by these diseases. In this article, we review the medical and gray literature and cite case examples to provide insights into how DEIA can be proactively integrated into rare diseases clinical research. Here, we particularly focus on genetic diversity. While the rare diseases DEIA literature is nascent, it is accelerating as many patient advocacy groups, professional societies, training and educational organizations, researcher groups, and funders are setting intentional strategies to attain DEIA goals moving forward, and to establish metrics to ensure continued improvement. Successful examples in underserved and underrepresented populations are available that can serve as case studies upon which rare diseases clinical research programs can be built. Rare diseases have historically been innovation drivers in basic, translational, and clinical research, and ultimately, all populations benefit from data diversity in rare diseases populations that deliver novel insights and approaches to how clinical research can be performed.

Intervention strategies for management of comorbid depression among individuals with hypertension: a scoping review protocol

IntroductionHypertension and depression often coexisted, leading to poor health outcome and significant challenges in healthcare management. Since no guidelines or consensus are available for health professionals to manage this comorbidity,...

Automation of systematic reviews of biomedical literature: a scoping review of studies indexed in PubMed.

The demand for high-quality systematic literature reviews (SRs) for evidence-based medical decision-making is growing. SRs are costly and require the scarce resource of highly skilled reviewers. Automation technology has been proposed to save workload and expedite the SR workflow. We aimed to provide a comprehensive overview of SR automation studies indexed in PubMed, focusing on the applicability of these technologies in real world practice. In November 2022, we extracted, combined, and ran an integrated PubMed search for SRs on SR automation. Full-text English peer-reviewed articles were included if they reported studies on SR automation methods (SSAM), or automated SRs (ASR). Bibliographic analyses and knowledge-discovery studies were excluded. Record screening was performed by single reviewers, and the selection of full text papers was performed in duplicate. We summarized the publication details, automated review stages, automation goals, applied tools, data sources, methods, results, and Google Scholar citations of SR automation studies. From 5321 records screened by title and abstract, we included 123 full text articles, of which 108 were SSAM and 15 ASR. Automation was applied for search (19/123, 15.4%), record screening (89/123, 72.4%), full-text selection (6/123, 4.9%), data extraction (13/123, 10.6%), risk of bias assessment (9/123, 7.3%), evidence synthesis (2/123, 1.6%), assessment of evidence quality (2/123, 1.6%), and reporting (2/123, 1.6%). Multiple SR stages were automated by 11 (8.9%) studies. The performance of automated record screening varied largely across SR topics. In published ASR, we found examples of automated search, record screening, full-text selection, and data extraction. In some ASRs, automation fully complemented manual reviews to increase sensitivity rather than to save workload. Reporting of automation details was often incomplete in ASRs. Automation techniques are being developed for all SR stages, but with limited real-world adoption. Most SR automation tools target single SR stages, with modest time savings for the entire SR process and varying sensitivity and specificity across studies. Therefore, the real-world benefits of SR automation remain uncertain. Standardizing the terminology, reporting, and metrics of study reports could enhance the adoption of SR automation techniques in real-world practice.