Eligibility Criteria For Review Research Articles

Self-directed learning versus traditional didactic learning in undergraduate medical education: a systemic review and meta-analysis

BackgroundSelf-Directed Learning (SDL) is a theory of andragogy in which adult learners take their own initiative to identify and tailor their individual learning process and outcomes. In undergraduate medical education, SDL aims to develop medical students into lifelong learners. This study aims to estimate the overall effectiveness of self-directed learning compared to traditional didactic learning (TDL).MethodsWe performed a systematic review and meta-analysis according to the PRISMA statement. A systematic search was used across PubMed, Scopus, Embase and Google Scholar to identify peer-reviewed articles spanning from January 1, 2014, to May 30, 2024. Key words used were “self-directed learning” AND “undergraduate medical education.” Forest plots were generated with the Open Meta-analyst Software, comparing SDL and TDL.ResultsA total of 2,955 titles and abstracts were screened for eligibility, of which 95 articles met the eligibility criteria for full-text review. Following a more detailed screening, 19 articles met the criteria for inclusion in the systematic review and 14 articles met the criteria for inclusion in the meta-analysis. The systematic review included 2,098 students while the meta-analysis included 1,792 students. The overall mean difference for all studies was 2.399, 95% CI [0.121–4.678], and I2 = 98.56%.ConclusionSelf-directed learning compared to traditional didactic learning is an effective learning strategy in medical undergraduate education and has the potential to aid in students’ learning and improve their cognitive performance. Moreover, SDL nurtures qualities such as autonomy, curiosity, and self-regulation, which are essential for success in the ever-evolving field of medicine.

Visual and Safety Outcomes of Refractive Correction Procedures Following Lens Removal for Residual Refractive Error: A Systematic Review and Meta-analysis.

To evaluate residual refractive errors after intraocular lens (IOL) extraction and the safety and effectiveness of refractive correction procedures. The eligibility criteria for this systematic review were patients who had undergone cataract or clear lens extraction and had experienced residual refractive error. All study designs were considered for inclusion and non-English publications, non-peer reviewed articles, books, and systematic reviews were excluded. A comprehensive electronic search strategy was employed on PubMed, Scopus, Web of Science, Cochrane, and Embase databases from January 1, 1950, to August 1, 2023. This review examined 55 articles with 2,223 eyes. Piggyback IOL and IOL exchange are highly effective in correcting both myopia and hyperopia, showing significant improvements in spherical and cylindrical errors. Among corneal-based procedures, laser in situ keratomileusis offers a strong balance, with substantial reductions in both spherical and cylindrical errors, along with a favorable safety profile. Small incision lenticule extraction improves uncorrected distance visual acuity (UDVA), particularly in hyperopic patients, whereas photorefractive keratectomy is effective for both UDVA and astigmatism correction, although it has less impact on corrected distance visual acuity (CDVA). Conductive keratoplasty is effective but has greater variability and a higher incidence of complications. Significant improvements in spherical equivalent were consistently observed after treatment across the different procedures. Both UDVA and CDVA demonstrated notable enhancements, suggesting an overall efficacy in improving visual function. Although complications were reported, they were generally low in incidence and varied across procedure types. [J Refract Surg. 2025;41(1):e73-e87.].

The effect of complementary foods on the colonic microbiota of weaning infants: a systematic review.

The transition from breastmilk to solid foods (weaning) is a decisive stage for the development of the colonic microbiota. However, little is known about how complementary foods influence the composition and function of the colonic microbiota in infants. This systematic review collected evidence of the effect of individual foods on the fecal microbiota of weaning infants (4-12 months old) using five databases: PubMed, CENTRAL, Scopus, Web of Science, and ScienceDirect. A total of 3625 records were examined, and seven randomized clinical trials met the review's eligibility criteria. Altogether, 983 participants were enrolled, and plant-based foods, meats, and dairy products were used as interventions. Wholegrain cereal increased the fecal abundance of the order Bacteroidales in the two included studies. Pureed beef increased the fecal abundances of the genus Bacteroides and the Clostridium XIVa group, as well as microbial richness in two of the three included studies. However, the conclusions of this review are limited by the small number of studies included. No conclusions could be drawn about the impact of complementary foods on fecal metabolites. Further clinical trials assessing the effect of dietary interventions on both fecal microbial composition and function are needed to fill this knowledge gap in infant nutrition.

Diagnostic challenges in calcitonin negative medullary thyroid carcinoma: a systematic review of 101 cases.

Calcitonin-negative medullary thyroid carcinoma (CNMTC), a rare form of MTC characterized by classic histopathology with normal serum calcitonin levels, presents a diagnostic challenge. This systematic review aims to summarize the clinical and pathological features of CNMTC and evaluate the utility of alternative biochemical markers. Eligibility criteria for this systematic review included patients with a confirmed histopathological diagnosis of medullary thyroid carcinoma (MTC), normal preoperative serum calcitonin levels, or negative immunohistochemical (IHC) stain for calcitonin. A comprehensive electronic search strategy was employed on PubMed, Scopus, and Embase databases from January 1st, 1950, to March 9th, 2023. This systematic review consists of 32 studies with 101 patients (66% females, 33% males) with a mean age of 52.2 years. All patients had a preoperative serum calcitonin level below the upper reference limit. Out of 101 patients, only seven underwent the Pentagastrin Stimulation Test (PST), only two patients had elevated calcitonin levels after stimulation. A total of 59 patients were tested for carcinoembryonic antigen (CEA) levels, and the majority tested normal (n=51, 86.4%). A total of 57 patients (61.2%) were found to have positive IHC staining on operative specimens for calcitonin. No recurrence was reported in the majority of cases, only 10 patients (9.9%) experienced recurrence. Despite the rarity of CNMTC, it is crucial to maintain a high level of suspicion when evaluating thyroid nodules. Total thyroidectomy with central neck dissection remains as the primary treatment. A multimarker approach may improve the sensitivity and specificity of CNMTC diagnosis and surveillance, particularly when calcitonin and CEA levels are inconclusive.

Prevalence of mental disorders among family members of individuals on the autism spectrum: systematic review and meta-analysis.

Parenting a child on the autism spectrum presents particular challenges that can lead to increased stress, anxiety, and depression among family members. Therefore, we aimed to investigate the prevalence of mental disorders in first-degree relatives of individuals on the autism spectrum. This article adheres to the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) guidelines, including studies indexed in PubMed/Medline, Embase, PsycINFO, Biblioteca Virtual em Saúde (BVS), and SciELO. Nineteen articles met eligibility criteria for the systematic review. Using a random-effects model (N = 93,876), we found a pooled prevalence of affective disorders of 13% in mothers of people on the autism spectrum (95% CI 7-21%; I2 = 99%, p < 0.01). Additionally, another random-effects model pointed out that first-degree relatives of people on the autism spectrum (N = 93,263) were more likely to present affective disorders than relatives of people with neurotypical development (N = 152,455) (pooled OR: 2.17; 95% CI 1.81-2.61). Careful assessment for mental disorders in parents and siblings of individuals on the autism spectrum is crucial to ensure appropriate treatment for these family members. This approach can also contribute to optimizing care for the individuals on the autism spectrum.

How does Levine's conservation model address the specific needs of postpartum women in relation to physical activity? : systematic review

Introduction. Levine's Conservation Model is a theory that focuses on energy conservation, structural integrity, personal and social integrity, and a holistic approach to care. This study aims to provide a framework for healthcare providers to support postpartum women in maintaining their health and well-being through physical activity. Methods. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. The data sources for this systematic review will include a comprehensive search of electronic databases such as PubMed, Scopus, and CINAHL, covering literature from their inception to the present date. Results. The PICO framework was used to define eligibility criteria for the systematic review. The results of the study indicate that the Levine Conservation Model effectively addresses the multifaceted needs of post-childbirth women by emphasizing energy conservation and structural integrity. The model's focus on structural integrity aids in the healing process and physical recovery after childbirth, addressing the unique physical challenges faced by post-natal women. Conclusion: The findings from the research highlight the significant benefits of using an integrative approach in post-partum care as encapsulated by the model. Keywords: Female, Pregnancy, Postpartum Period, Exercise, Health Personnel

Multidimensional challenges of internationalization among universities in Southeast Asia: A scoping review of empirical evidence

AbstractInternationalization plays a crucial role in building the international competitiveness and profile of a university. However, the process of internationalization can be very challenging. The understanding of these challenges is very crucial for internationalization implementation and improvement. This scoping review aimed to map the existing empirical evidence on the peculiar challenges of internationalization among universities in Southeast Asia. This scoping review was conducted based on Arksey and O’Malley's methodological framework and it was reported using the PRISMA‐ScR checklist. Ten research databases were systematically searched to retrieve all literature relevant to the review question. The retrieved articles were deduplicated and screened based on the review's eligibility criteria, and only the eligible articles were included in the review. Thereafter, relevant data were charted, collated, and summarized from the included literature and presented as results. A total of 34 articles were included in this review. Most of them were qualitative studies (26/34) and from studies conducted in Malaysia (21/34). The reported internationalization challenges in these articles were multidimensional and ranged from the individual to governmental level; however, the most reported challenges were the ones at the individual level which include issues related to adjustment/coping, trust, limited personal resources, family, and essential survival needs. There are numerous challenges facing the implementation of internationalization among universities in Southeast Asia. More efforts need to be placed at all levels to improve the status quo.

Clinical Factors on Dental Implant Fractures: A Systematic Review.

Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies included retrospective case-control, prospective cohort studies, and clinical trials. The initial search yielded 361 articles, of which 312 were excluded being these reviews, case reports, irrelevant, or written in languages other than English. This left 49 articles, with only 6 meeting the eligibility criteria for an in-depth review. These studies, all retrospective case-control, examine implant characteristics, patient demographics, surgical and prosthetic variables, biomechanical and functional factors, clinical and procedural variables, complications and maintenance issues. The risk of bias was assessed as low using the ROBINS-I tool. Key findings suggest a correlation between implant diameter and structural resistance, with wider implants demonstrating reduced fracture risk. Additionally, posterior regions, especially molars and premolars, exhibit higher susceptibility to IFs due to increased masticatory forces. Implant design and material may considerably influence fracture risk, with conical implants and screw-retained prostheses showing higher vulnerability. Biomechanical overload, particularly in patients with bruxism, emerges as a primary contributing factor to IFs. Prosthesis type significantly influences fracture incidence, with cantilever prostheses posing a higher risk due to increased stress. Peri-implant bone loss is strongly associated with IFs, emphasizing the need for meticulous preoperative assessments and individualized management strategies. Future research should prioritize larger and heterogeneous populations with long-term follow-up and standardized methodologies to enhance the generalizability and comparability of findings. Randomized controlled trials and biomechanical studies under controlled conditions are also essential to elucidate the complex interactions contributing to IFs and developing effective prevention strategies. Additionally, integrating patient-reported outcomes may offer a comprehensive understanding of the impact of IFs on quality of life.

Near real-time patient experience feedback with data relay to providers: a systematic review of its effectiveness.

Near Real-Time Feedback (NRTF) on the patient's experience with care, coupled with data relay to providers, can inform quality-of-care improvements, including at the point of care. The objective is to systematically review contemporary literature on the impact of the use of NRTF and data relay to providers on standardized patient experience measures. Six scientific databases and five specialty journals were searched supplemented by snowballing search strategies, according to the registered study protocol. Eligibility included studies in English (2015-2023) assessing the impact of NRTF and data relay on standardized patient-reported experience measures as a primary outcome. Eligibility and quality appraisals were performed by two independent reviewers. An expert former patient (Patient and Family Advisory Council and communication sciences background) helped interpret the results. Eight papers met review eligibility criteria, including three randomized controlled trials (RCTs) and one non-randomized study. Three of these studies involved in-person NRTF prior to data relay (patient-level data for immediate corrective action or aggregated and peer-compared) and led to significantly better results in all or some of the experience measures. In turn, a kiosk-based NRTF achieved no better experience results. The remaining studies were pre-post designs with mixed or neutral results and greater risks of bias. In-person NRTF on the patient experience followed by rapid data relay to their providers, either patient-level or provider-level as peer-compared, can improve the patient experience of care. Reviewed kiosk-based or self-reported approaches combined with data relay were not effective. Further research should determine which approach (e.g. who conducts the in-person NRTF) will provide better, more efficient improvements and under which circumstances.

Utilization of Social Media for the Prevention and Control of HIV/AIDS: A Scoping Review.

Social media has been used widely in public health for understanding health risks and intervening to improve health. However, the utilization of social media for HIV prevention and control interventions has not been clearly characterized. We conducted a scoping review on the utilization of social media for HIV prevention and control to identify gaps in the literature and highlight opportunities for future research and intervention. A comprehensive search of seven databases was performed: PubMed, Embase, CINAHL Complete (EBSCO), PsycInfo (EBSCO), Scopus, and WOS (Science Citation Index Expanded (SCI-EXPANDED). The Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used as a framework. A total of 790 articles were screened at the title and abstract level, and 78 were screened at the full-text level. Twenty-three articles met the eligibility criteria for review. We found that Facebook was still the most common social media service used to reach target populations. Lesbian, gay, bisexual and transgender (LGBT) individuals were the primary groups and were the most common targets of social media-based HIV prevention interventions. Outcomes of social media-based interventions, such as increased HIV testing, social networking and social support, condom use attitudes, behavioral skills, and research participation, were reported. Most social media-based interventions have emphasized HIV prevention, with fewer interventions focused on improving linkage to care and adherence to treatment among people living with HIV. Future studies may benefit from using social media for interventions to improve HIV-related outcomes in high-risk populations. This review highlights the potential and challenges of social media approaches for HIV/AIDS prevention and control.

Do cybersecurity threats and risks have an impact on the adoption of digital banking? A systematic literature review

PurposeThe purpose of the study is to identify cybersecurity threats that hinder the adoption of digital banking and provide sustainable strategies to combat cybersecurity risks in the banking industry.Design/methodology/approachSystematic literature review guidelines were used to conduct a quantitative synthesis of empirical evidence regarding the impact of cybersecurity threats and risks on the adoption of digital banking.FindingsA total of 84 studies were initially examined, and after applying the selection and eligibility criteria for this systematic review, 58 studies were included. These selected articles consistently identified identity theft, malware attacks, phishing and vishing as significant cybersecurity threats that hinder the adoption of digital banking.Originality/valueWith the country’s banking sector being new in this area, this study contributes to the scant literature on cyber security, which is mostly in need due to the myriad breaches that the industry has already suffered thus far.

E-cigarettes in Nigeria: A scoping review of evidence.

E-cigarettes will continue to be a public health issue in Nigeria. To curb the growing menace of the e-cigarette use in Nigeria through evidence-based approach, it is crucial to first map the empirical research landscape of e-cigarettes in Nigeria. No known study has mapped the existing empirical evidence and gaps concerning e-cigarettes in Nigeria; hence, this scoping review was conducted. This scoping review adopted the research design by Arksey and O'Malley. Four databases (PubMed, SCOPUS, CINAHL Complete, and APA PsycINFO) were searched to retrieve literature on e-cigarettes in Nigeria. With the aid of Rayyan web application, all retrieved literature were deduplicated and screened based on the review's eligibility criteria. Only those peer-reviewed journal papers meeting the inclusion criteria were included in the review. Relevant data from the included papers were charted, collated, and summarized. A total of six papers were included in this review. The reviewed papers reported a lifetime prevalence of e-cigarette use (or vaping) ranging from 5.8% to 19.8%, with a current e-cigarette use prevalence of 11.8%, among different population groups in Nigeria. The major determinants of e-cigarette use, as reported in these articles, include being a youth, having a health condition, severe anxiety, tobacco use, peer influence, and current alcohol use. Dry mouth and oral lesions (gingival inflammation and oral ulcers) were also identified to be the medical conditions associated with e-cigarette use in Nigeria. Lastly, one of the included papers identified a lack of clear regulation on e-cigarettes in Nigeria. There is an urgent need for more scientific investigations on the sociodemographic, economic, health, and regulatory landscape of e-cigarettes in Nigeria, as robust empirical evidence is needed for the effective planning, implementation, and evaluation of evidence-based policies and interventions on e-cigarettes control and regulation in Nigeria.

The cost-effectiveness of syphilis screening in pregnant women: a systematic literature review.

The cost-effectiveness study of syphilis screening in pregnant women has not been synthesized. This study aimed to synthesize the economic evidence on the cost-effectiveness of syphilis screening in pregnant women that might contribute to making recommendations on the future direction of syphilis screening approaches. We systematically searched MEDLINE, PubMed, and Web of Science databases for relevant studies published before 19 January 2023 and identified the cost-effectiveness analyses for syphilis screening in pregnant women. The methodological design quality was appraised by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist. In total, 17 literature met the eligibility criteria for a full review. Of the 17 studies, four evaluated interventions using different screening methods, seven assessed a combination of syphilis testing and treatment interventions, three focused on repeat screening intervention, and four evaluated the interventions that integrated syphilis and HIV testing. The most cost-effective strategy appeared to be rapid syphilis testing with high treatment rates in pregnant women who were positive. The cost-effectiveness of syphilis screening for pregnancy has been widely demonstrated. It is very essential to improve the compliance with maternal screening and the treatment rates for positive pregnant women while implementing screening.

Wheelchair outcome measurement instruments for children: a scoping review protocol

Purpose The proposed scoping review aims to explore and map wheelchair outcome measurement instruments for children in the literature. Method The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. The review question and eligibility criteria were developed using the PCC (population, concept, context) mnemonic as follows: (P) children manual or motorised wheelchair users (aged ≤ 18 years), (C) wheelchair outcome measurement instruments, (C) primary sources of literature. The search will be conducted in nine relevant electronic databases. including grey literature from Academic Google. Study screening, selection, and data extraction will be performed independently by two authors. A third reviewer will resolve discrepancies between the authors. General characteristics, population, feasibility, interpretability data will be extracted in accordance with the COSMIN methodology (Consensus-based Standards for the selection of health Measurement Instruments). This will encompass data pertaining to the measurement properties of the domains of reliability, validity and responsiveness. A descriptive analysis will be carried out, and the results will be classified into categories and presented in tables accompanied by a descriptive summary. Results The results can inform future research directions, clinical practice and the development of wheelchair outcome measurement instruments. Furthermore, it will help professionals in rehabilitation and wheelchair services to find the wheelchair outcome measurement instruments according to the target population and cultural context.

Interventions for Preventing and Resolving Bullying in Nursing: A Scoping Review.

Bullying in the workplace is a serious problem in nursing and has an impact on the well-being of teams, patients, and organisations. This study's aim is to map possible interventions designed to prevent or resolve bullying in nursing. A scoping review of primary research published in English and Italian between 2011 and 2021 was undertaken from four databases (Cochrane Collaboration, PubMed, CINAHL Complete, and PsycInfo). The data were analysed using Arksey and O'Malley's framework, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist was followed to report the study. Fourteen papers met the review eligibility criteria. The analysis revealed four main themes: educational interventions, cognitive rehearsal, team building, and nursing leaders' experiences. Interventions enabled nurses to recognise bullying and address it with assertive communication. Further research is needed to demonstrate these interventions' effectiveness and if they lead to a significant decrease in the short-/long-term frequency of these issues. This review increases the available knowledge and guides nurse leaders in choosing effective interventions. Eradicating this phenomenon from healthcare settings involves active engagement of nurses, regardless of their role, in addition to support from the nurse leaders, the organisations, and professional and health policies.

Aggressive behaviors in urban African American early adolescent girls: A systematic review of the literature

Increased media attention to youth violence perpetrated by early adolescent girls over the past two decades and increased arrests of girls has disproportionately impacted girls of color, specifically African American girls. Research on issues, policies, and programs for girls of color at heightened risk for aggression and violence perpetration has remained limited. We conducted a systematic review of studies published in English from January 1999 to December 2022 to better understand and identify the types of aggressive and violent behaviors in which African American early adolescent girls in urban locations engage as well as risk and protective factors associated with identified behaviors. In our systematic search of five databases, we captured 1,206 studies that were potentially relevant to our review. Removing duplicate studies and conducting title/abstract and full-text review resulted in the identification of 20 studies that met pre-specified review eligibility criteria. Synthesis of information that was systematically extracted from these 20 included studies revealed that in a little over two decades, few studies have examined aggressive and violent behaviors among early adolescent African American girls, although such research is critical to developing effective intervention and prevention strategies to support the healthy development of this group of young people.

Endometriosis on TikTok: Evaluating social media misinformation and the role of healthcare professionals

Introduction: TikTok is often the first source teens and young adult patients turn to for medical information, a short-form social media video application known to promote videos with inaccurate information. The primary goal of this study was to characterize popular endometriosis misinformation found on TikTok, with the secondary goal of describing attitudes surrounding endometriosis on TikTok so that physicians can be knowledgeable about the content available on the internet, and be prepared when patients talk about endometriosis misinformation. Methods: The top 100 videos under the three most popular endometriosis search terms were assessed for misinformation in four categories: incorrect causes, incorrect symptoms, incorrect treatment, and other incorrect information. Non-English, inaudible, duplicated, or irrelevant videos were excluded from analysis. Videos were analyzed until 100 valid videos were identified in each search term. Metadata was collected, including whether the video was created by a physician or non-physician and attitudes toward endometriosis. Chi squares, Fisher’s Exact Tests, and Mann–Whitney U tests were performed as appropriate. Results: Of total, 298 videos met the eligibility criteria for review. Fifty videos were created by individual physicians and 248 were created by non-physicians. Overall, out of 298 videos, 69 videos (23%) had incorrect or misleading information about causes, treatment, symptoms, or information about endometriosis. Only 1% of the analyzed videos discussed medication management other than COCPs. Nonphysician sources were associated with negative attitudes ( p &lt; 0.003). Nonphysician videos were more likely to contain misinformation in at least one category, compared to physician videos ( p &lt; 0.0008). Despite the greater volume of non-physician videos, those created by physicians were more likely to be shared. Misinformation from non-physician sources was associated with positive/neutral attitudes toward endometriosis and treatment ( p &lt; 0.00002). Discussion: This study reveals that TikTok hosts a high volume of endometriosis misinformation, especially about endometrosis treatments. Popular TikTok misinformation tends not to reflect traditional misconceptions, but rather modern misinformation trends of holistic health and “wellness.” Physicians should be prepared to have respectful discussions about endometriosis treatments found on TikTok without invalidating the emotions that led patients to seek information on the internet.

Effect of Exercise Programs on Physical Performance in Community-Dwelling Older Adults with and without Frailty: Systematic Review and Meta-Analysis.

The measurement of physical performance constitutes an indicator of the physical functional capacity of older adults with and without frailty. To present a synthesis of knowledge on the effect of exercise programs on physical performance in older adults with and without frailty in the community. A systematic review was carried out in accordance with the PRISMA-2020 criteria. The search for articles was made until 4 May 2023 in PubMed, Scopus, Web of Science, Cochrane Library, SciELO and LILACS. The outcome variable was physical performance, measured through the SPPB (Short Physical Performance Battery). The mean difference (MD) was estimated to evaluate the effect. We found 2483 studies, of which 12 met the eligibility criteria for the systematic review and 9 for the meta-analysis. The effect of exercise on SPPB scores was significantly higher in the exercise group compared to control in non-frail older adults with MD = 0.51 [95% CI, 0.05 to 0.96, p < 0.05]. Likewise, in older adults with frailty, the effect of exercise on the global SPPB score was significantly higher in the exercise group compared to the control with MD = 0.66 [95% CI, 0.09 to 1.24, p < 0.05]. Our findings suggest that exercise programs are effective in increasing and/or maintaining physical performance in older adults with and without frailty, whose effect is more evident in older adults with frailty, probably due to the greater margin of recovery of intrinsic capacity. This systematic review shows the differentiated effect of exercise training on physical performance in older adults with and without frailty. Scientific evidence reinforces the importance of implementing physical exercise programs in all older adults, including those who are frail. However, it is necessary to specify the types and doses (duration, frequency and intensity), for individualized groups, previously grouped according to the SPPB score.

Association between illegal drug use and cigarette smoking among Ethiopian students: A systematic review and meta-analysis.

Cigarette smoking is a persistent public health problem as it is a risk factor for many diseases. Previous studies on the role of illegal drug use in cigarette smoking have yielded disparate and inconclusive results, hindering the development of effective intervention strategies to address this issue. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of cigarette smoking and its associated factors, with a specific focus on the influence of illegal drug use among students in Ethiopia. We conducted a comprehensive search of international databases, including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google and Google Scholar. Grey literature was also identified from various university digital libraries. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. Due to the high heterogeneity among the included studies (I2 = 98.6%; p-value <0.001), we employed a random-effects model with a 95% confidence interval (CI) to estimate the pooled effect using STATA 14 software. The publication bias was assessed using a statistical Egger regression test. A total of 22 studies involving 18,144 students met the eligibility criteria for this systematic review and meta-analysis. The pooled prevalence of lifetime and current cigarette smoking among students in Ethiopia was 13.8% (95% CI: 9.90-17.82) and 9.61% (95% CI: 7.19-12.03), respectively. Students who used illegal drugs were twenty-three times more likely to smoke cigarettes compared to their counterparts (OR = 23.57, 95% CI: 10.87-51.1). Living in urban settings (OR = 2.9; 95% CI: 1.15-7.28) and the habit of alcohol consumption (OR = 4.79; 95% CI: 1.57-14.64) were also identified as factors associated with cigarette smoking. We found that more than one in eight students in Ethiopia have engaged in lifetime cigarette smoking. Notably, students who used illegal drugs exhibited a significantly higher likelihood of cigarette smoking. In light of these findings, it is imperative to implement comprehensive public health interventions that target illegal drug use, cigarette smoking, and alcohol consumption, with a particular emphasis on urban residents.

Comparing the Efficacy and Adverse Events of Available COVID-19 Vaccines Through Randomized Controlled Trials: Updated Systematic Review and Network Meta-analysis.

Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously. Study Design: A systematic review. Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score. In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88). Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.