Systematic Review Research Articles

Systematic literature review on the holistic integration of e-learning in universities: Policy, human, financial, and technical perspectives

This systematic literature review (SLR) explores the integration of e-learning in universities, emphasizing a comprehensive approach that intertwines various mainstream perspectives. Despite numerous studies on e-learning implementation evaluation, few have holistically considered financial, human, technical, and policy factors. This review used PRISMA guidelines and sources from Scopus, Google Scholar, ERIC, SAGE, and ProQuest. Of 26 analyzed studies, seven core themes emerged: Policy, financial, technical, human, institutional factors, others, and an integrated perspective, further distilled into 13 sub-themes. Findings highlight the importance of an integrative framework for evaluating e-learning, underscoring the interplay between macro and institutional policies. Additionally, the authors recommend cross-national comparisons and data synthesis from stakeholders, including students, educators and directors, to fully grasp e-learning implementation dynamics. Distinctively, it adopts an integrated perspective, filling the research gap by emphasizing overlooked financial considerations and presenting a comprehensive view through an SLR. By drawing insights from human, finance, technical, and policy perspective, the study provides a multidimensional lens on e-learning. This forward-looking approach not only captures the current state of e-learning integration but also charts future research directions, establishing its originality and significance in higher education.

Medicine communication between Aboriginal and Torres Strait Islander peoples and health professionals: a scoping review protocol.

This scoping review will describe strategies to support communication between Aboriginal and Torres Strait Islander peoples and health professionals about medicines. Poor communication is a well-established risk factor contributing to adverse medicine events. Communication challenges are exacerbated for Aboriginal and Torres Strait Islander peoples due to their poorer health status, greater use of medicines, a first language that may not be English, cultural bias and systemic racism in health services, and lower health literacy resulting from ongoing colonization. A scoping review will assist in summarizing strategies to support the communication process. The review will consider studies describing strategies related to medicine communication between Aboriginal and Torres Strait Islander peoples and health professionals. The proposed review will follow the JBI methodology for scoping reviews. The review will include all published and unpublished literature in English since 2000, including qualitative, quantitative, and mixed methods study designs, systematic reviews, text and opinion pieces, and gray literature. Databases to be searched will include CINAHL, PsycINFO, Cochrane Library, MEDLINE, Web of Science, Scopus, Informit, Indigenous HealthInfoNet, ProQuest Dissertations and Theses, and Google Scholar. Two researchers will screen titles and abstracts independently and assess the full text of selected citations against inclusion criteria. Extracted data will be presented in narrative format accompanied by tables that reflect the objective of the review.

Reflective thinking in school: a systematic review

<span lang="EN-US">Everything around us changes rapidly and to adapt to these constantly changing conditions and to understand the meaning of our life in the society in which we live, we must reflectively and consciously think about our actions in each given scenario. A school is a miniature form of society where learners are exposed to situations where they need to find solutions for every problem faced. No faultless solution and conclusions can be arrived at without a carefully employed reflective thinking process. In this context, the present study reviewed 19 intervention studies on reflective thinking in schools published between 2010 and 2021 and presents a brief summary. Various theories on reflective thinking, approach of educationists on reflective thinking of students and the relation between reflective thinking and students’ academic performance, are extensively analyzed. The findings of the study reveal that there are a few generally accepted theories of reflective thinking; reflection is a useful learning strategy and reflective thinking is an essential characteristic of academic excellence. This study recommends future research with a wider scope to accommodate more theoretical perspectives and wide-ranging databases.</span>

Do statins decrease testosterone in men? Systematic review and meta-analysis.

Statins are one of the most prescribed classes of drugs worldwide to treat hypercholesterolemia and dyslipidemia. By lowering the level of cholesterol, the use of statin could cause a reduction in testosterone levels. The objective was to evaluate whether the continued use of statins in patients with hypercholesterolemia causes a deficiency in testosterone and other sex hormones. Systematic Review with Meta-analysis, performed in Embase, Medline and Cochrane databases, until May 2023; PROSPERO CRD42021270424protocol. Selection performed by two independent authors with subsequent conference in stages. Methodology based on PRISMA statement. There were selected comparative studies, prospective cohorts (CP), randomized clinical trials (RCT) and cross-sectional studies (CSS) with comparison of testosterone levels before and after statin administration and between groups. Bias analysis were evaluated with Cochrane Tool, The Newcastle-Ottawa Scale (NOS), and using the Assess the Quality of Cross-sectional studies (AXIS) tool. There were found on MedLine, Embase and Cochrane, after selected comparative studies, 10CP and 6RCT and 6CSS for the meta-analysis. In the Forrest plot with 6CSS, a correlation between patients with continuous use of statins and a reduction in total testosterone was evidenced with a statistically significant reduction of 55.02ng/dL (95%CI=[39.40,70.64],I²=91%,p<0.00001).In the analysis with 5RCT, a reduction in the mean total testosterone in patients who started continuous statin use was evidenced, with a statistical significance of 13.12ng/dL (95%CI=[1.16,25.08],I²=0%,p=0.03). Furthermore, the analysis of all prospective studies with 15 articles showed a statistically significant reduction in the mean total testosterone of 9.11 ng/dL (95%CI=[0.16,18.06],I²=37%,p=0.04). A reduction in total testosterone has been shown in most studies and in its accumulated analysis after statin use. However, this decrease was not enough to reach levels below normal. Statins use causes a decrease in total testosterone, not enough to cause a drop below the normal range and also determines increase in FSH levels. No differences were found in LH, Estradiol, SHBG and Free Testosterone analysis.

Postoperative antibiotic prophylaxis for percutaneous nephrolithotomy and risk of infection: a systematic review and meta-analysis.

The aim of this study is to perform a high-quality meta-analysis using only randomized controlled trials (RCT) to better define the role of postoperative antibiotics in patients undergoing percutaneous nephrolithotomy (PCNL). A literature search for RCTs in EMBASE, PubMed, and Web of Science up to May 2023 was conducted following the PICO framework: Population-adult patients who underwent PCNL; Intervention-postoperative antibiotic prophylaxis until nephrostomy tube withdrawal; Control-single dose of antibiotic during the induction of anesthesia; and Outcome-systemic inflammatory response syndrome (SIRS) or sepsis and fever after PCNL. The protocol was registered on the PROSPERO database (CRD42022361579). We calculated odds ratios (OR) and 95% confidence intervals (CI). A random-effects model was employed, and the alpha risk was defined as < 0.05. Seven articles, encompassing a total of 629 patients, were included in the analysis. The outcome of SIRS or sepsis was extracted from six of the included studies, while the outcome of postoperative fever was extracted from four studies. The analysis revealed no statistical association between the use of postoperative antibiotic prophylaxis until nephrostomy tube withdrawal and the occurrence of SIRS/sepsis (OR 1.236, 95% CI 0.731 - 2.089, p=0.429) or fever (OR 2.049, 95% CI 0.790 - 5.316, p=0.140). Our findings suggest that there is no benefit associated with the use of postoperative antibiotic prophylaxis until nephrostomy tube withdrawal in patients undergoing percutaneous nephrolithotomy (PCNL). We recommend that antibiotic prophylaxis should be administered only until the induction of anesthesia in PCNL.

AI ChatGPT and student engagement: Unraveling dimensions through PRISMA analysis for enhanced learning experiences

This PRISMA-based literature review aims to assess and analyze the measurement of student engagement dimensions within AI ChatGPT interactions. The central question is how to effectively evaluate these dimensions using established methods and leverage insights to enhance AI ChatGPT’s capacity to foster student engagement. The systematic review of PRISMA methodology identifies 16 relevant peer-reviewed research. All relevant and eligible research according to PRISMA methodology are analyzed to comprehend the intricacies of student engagement in AI ChatGPT interactions. The synthesis of these findings unveils the current state of knowledge on AI ChatGPT’s influence on student engagement and uncovers opportunities for future research. This review underscores AI ChatGPT’s potential as an educational tool, offering personalized experiences that bolster student engagement and learning outcomes. The systematic review established that, even though using ChatGPT has many advantages such as enhancing student engagement and academic involvement and supporting inquiry-based learning. However, there are some negative aspects such as lacking empathy and human emotions, limited contextual understanding, increased technology dependence and possibility of Inaccurate or Biased Information. In summary, this PRISMA-based review contributes to understanding the measurement of student engagement within AI ChatGPT. It identifies best practices, laying the foundation for further research and development. By optimizing AI ChatGPT’s effectiveness, educators and developers can craft more engaging and tailored learning experiences, ultimately enhancing educational outcomes.

Sessile serrated polyp detection rates after fecal immunochemical test or multitarget stool DNA test: Systematic review and meta-analysis.

Background and study aims Published studies report a higher adenoma detection rate (ADR) for FIT-DNA as compared with FIT. Data are less replete about the performance of stool-based tests for sessile serrated polyp (SSP) detection. We performed a meta-analysis to evaluate the performance of FIT and FIT-DNA testing for SSP detection rate (SSPDR) in patients undergoing colonoscopy for follow up of positive noninvasive tests. Methods A comprehensive literature search of multiple databases (until September 2022) was performed to identify studies reporting SSPDR in patients with positive FIT or FIT-DNA tests. The outcome was overall colonoscopy detection of any SSPs and advanced serrated polyps (ASP: SSP ≥ 10 mm and/or dysplasia). Results Included were 482,405 patients (52.4% females) with a mean age of 62.3 ± 4.4 years from 23 studies. The pooled SSPDR for all positive stool-based tests was 5.3% and higher for FIT-DNA (15.0%, 95% confidence interval [CI] 8.3-25.7) versus FIT (4.1%, 95% CI 3.0-5.6; P = 0.0002). The overall pooled ASP detection rate was 1.4% (95% CI 0.81-2.3) and higher for FIT-DNA (3.8 %, 95% CI 1.7-8.6) compared with FIT (0.71%, 95% CI 0.36-1.4; P <0.01). SSPDR with FIT-DNA was also significantly higher than FIT when the FIT cutoff was >10 ug/g and in FIT-positive patients in studies conducted in North America ( P <0.05). Conclusions FIT-DNA outperformed FIT in both SSP and ASP detection including FIT with a lower threshold cutoff of >10 ug/g. Further comparative studies are needed to assess the impact of our findings on colorectal cancer reduction.

Knee Confidence, Fear of Movement, and Psychological Readiness for Sport in Individuals With Knee Conditions: A Systematic Review and Meta-analysis.

OBJECTIVES: To (1) compare activity-related psychological factors between individuals with and without knee conditions, and (2) assess associations between these factors and objective measures of function in individuals with knee conditions. DESIGN: A priori registered systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE-Ovid, Embase-Ovid, Scopus-Elsevier, CINAHL-EBSCO, SPORTDiscus-EBSCO, and Cochrane Library were searched to May 27, 2022. STUDY SELECTION CRITERIA: We included peer-reviewed primary data studies (observational and experimental) of human participants with and without knee conditions reporting knee confidence, fear of movement/avoidance beliefs, and/or psychological readiness to return to sport (RTS) or reporting correlations between these factors and objective measures of function in knee conditions. DATA SYNTHESIS: Where possible, data were pooled by knee conditions, otherwise performed narrative syntheses. The Downs and Black checklist assessed the methodological quality of the included studies. RESULTS: Forty studies (3546 participants with knee conditions; 616 participants without knee conditions) were included. There was very low-certainty evidence of higher fear of movement in individuals with knee osteoarthritis (standardized mean difference [SMD], 0.46; 95% confidence interval [CI]: 0.41, 0.52), but not in individuals with patellofemoral pain (SMD, 0.66; 95% CI: -7.98, 9.29) when compared with those without knee conditions. There was very low-certainty evidence of no differences in psychological readiness to RTS after anterior cruciate ligament reconstruction (SMD, -1.14; 95% CI: -2.97, 0.70) compared to no knee condition, and negligible to weak positive correlations between psychological readiness to RTS and objective measures of function. CONCLUSION: There was very low-certainty evidence of higher fear of movement in individuals with knee osteoarthritis compared to those without, and very low-certainty evidence of no correlations between these factors and objective measures of function following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 2024;54(4):1-14. Epub 29 January 2024. doi:10.2519/jospt.2024.12070.

Efficacy, Safety, and Cost-effectiveness of Bezlotoxumab in Preventing Recurrent Clostridioides difficile Infection : Systematic Review and Meta-analysis.

Clostridioides difficile infection (CDI) remains a global health challenge. Bezlotoxumab (BEZ) is a monoclonal antibody against C. difficile toxin B. Two randomized controlled trials (RCTs), MODIFY I and II, confirmed BEZ efficacy in preventing recurrent Clostridioides difficile infection (rCDI). However, there are safety concerns about its use in patients with a history of congestive heart failure. Observational studies have since been conducted, and it is important to explore the consistency of BEZ efficacy, cost-effectiveness, and its safety utilizing these real-world data. We performed a systematic review and meta-analysis to pool the rate of rCDI in patients receiving BEZ and explore its efficacy and safety in preventing rCDI compared with control. We searched PubMed, EMBASE, Cochrane Library, and Google Scholar from inception through April 2023 for relevant RCTs or observational studies assessing BEZ in preventing rCDI. Single-arm studies describing experience with BEZ in preventing rCDI were also included for proportion meta-analysis. A proportion meta-analysis with a random-effects model was used to pool the rCDI rate with its corresponding 95% CI. In a meta-analysis of efficacy, we generated the relative risk (RR) to compare BEZ versus control in preventing rCDI. Thirteen studies including 2 RCTs and 11 observational studies totaling 2337 patients, of which 1472 received BEZ, were included in the analysis. Of the constituent studies, 5 (1734 patients) compared BEZ versus standard-of-care (SOC). Pooled rate of rCDI in patients receiving BEZ was 15.8% (95% CI: 14%-17.8%), and was 28.9% (95% CI: 24%-34.4%) in the SOC. BEZ significantly reduced rCDI risk compared with SOC [RR=0.57 (95% CI: 0.45-0.72, I2 =16%)]. There was no difference in the overall mortality or heart failure risk. Of the 9 included cost-effectiveness analyses, 8 demonstrated BEZ+SOC cost-effectiveness compared with SOC alone. Our meta-analysis comprising real-world data revealed lower rCDI in patients receiving BEZ and supported its efficacy and safety when added to SOC therapy. The results were consistent across various subgroups. Available cost-effectiveness analyses mostly support BEZ+SOC cost-effectiveness compared with SOC alone.

Effect of Intraperitoneal Instillation of Dexmedetomidine With Local Anesthetics in Laparoscopic Cholecystectomy: A Systematic Review and Meta-analysis of Randomized Trials.

Dexmedetomidine (DEX) can strengthen the analgesic effects of local anesthetics (LAs) when used as an adjuvant through intrathecal, perineural, and intraperitoneal routes. Many studies have used intraperitoneal instillation of DEX with LAs in laparoscopic cholecystectomy (LC) to relieve postoperative pain. We performed a systematic review and meta-analysis to synthesize evidence of the efficacy and safety of intraperitoneal instillation of DEX as an adjuvant of LAs in patients undergoing LC. A comprehensive literature search of the MEDLINE, PubMed, EMBASE, and Cochrane Library databases was performed to identify randomized controlled trials in which patients received intraperitoneal instillation of DEX combined with LAs during LC. A meta-analysis and sensitivity analysis of the results were conducted. We also performed a subgroup analysis to investigate the source of heterogeneity. The Egger test was used to check for publication bias. Eleven randomized controlled trials involving 890 patients were analyzed. We found that the addition of DEX to LAs significantly decreased pain scores at six postoperative time points (0.5, 1, 2, 4, 12, and 24 h) and significantly prolonged the time to the first analgesic request by patients. In addition, 24-hour postoperative analgesic consumption was decreased in the experimental group, and no significant difference in the incidence of nausea and vomiting was observed. Our findings indicate that intraperitoneal instillation of DEX with LAs can reduce postoperative pain and prolong the time to first request analgesia after LC.

The association of thromboembolic complications and the use of tranexamic acid during resection of intracranial meningiomas: systematic review and meta-analysis of randomized controlled trials.

Antifibrinolytics, such as tranexamic acid (TXA), have been shown to decrease intraoperative blood loss across multiple surgical disciplines. However, they carry the theoretical risk of thromboembolic events secondary to induced hypercoagulability. Therefore, the aim of this study was to systematically review the available literature and perform a meta-analysis on the use of TXA in meningioma resection to assess thromboembolic risks. The PubMed, Web of Science, and Google Scholar databases were reviewed for all randomized controlled trials presenting primary data on TXA use during resection of intracranial meningiomas. Data were gathered on operative duration, venous thromboembolic complications, deep venous thrombosis, use of allogeneic blood transfusion, estimated blood loss (EBL), and postoperative hemoglobin. Patients who received TXA were compared with controls who did not receive TXA intraoperatively using random-effects models. A total of 508 unique articles were identified, of which 493 underwent full-text review. Ultimately, 6 studies with 381 total patients (190 receiving TXA) were included in the final analysis. All 6 trials were randomized, blinded, and placebo controlled with a TXA administration rate of a 20-mg/kg load followed by a 1-mg/kg/hr infusion. All studies were performed in lower-middle-income countries. There were no reported instances of venous thromboembolism (VTE) in the TXA and non-TXA cohorts. Patients receiving TXA exhibited fewer allogeneic transfusions (21.5% vs 41.6% [OR 0.26, 95% CI 0.09-0.77], p = 0.02) and lower EBL (MD -282.48 mL [95% CI -367.77 to -197.20 mL], p < 0.001) compared with patients who did not receive TXA, and they also had lower rates of perioperative complications (10.7% vs 19.9% [OR 0.47, 95% CI 0.2-0.95], p = 0.04). Current literature suggests that TXA is not associated with increased risk for VTE when administered during resection of intracranial meningioma. TXA appears to decrease intraoperative blood loss and allogeneic transfusion requirements during meningioma resection and thus may improve the safety of surgical management of this pathology.

Sleep loss and emotion: A systematic review and meta-analysis of over 50 years of experimental research.

In a largely sleep-deprived society, quantifying the effects of sleep loss on emotion is critical for promoting psychological health. This preregistered systematic review and meta-analysis quantified the effects of various forms of sleep loss on multiple aspects of emotional experiences. Eligible studies used experimental reductions of sleep via total sleep deprivation, partial sleep restriction, or sleep fragmentation in healthy populations to examine effects on positive affect, negative affect, general mood disturbances, emotional reactivity, anxiety symptoms, and/or depressive symptoms. In total, 1,338 effect sizes across 154 studies were included (N = 5,717; participant age range = 7-79 years). Random effects models were conducted, and all forms of sleep loss resulted in reduced positive affect (standardized mean difference [SMD] = -0.27 to -1.14), increased anxiety symptoms (SMD = 0.57-0.63), and blunted arousal in response to emotional stimuli (SMD = -0.20 to -0.53). Findings for negative affect, reports of emotional valence in response to emotional stimuli, and depressive symptoms were mixed and depended on the type of sleep loss. Nonlinear effects for the amount of sleep loss as well as differences based on the stage of sleep restricted (i.e., rapid eye movement sleep or slow-wave sleep) were also detected. This study represents the most comprehensive quantitative synthesis of experimental sleep and emotion research to date and provides strong evidence that periods of extended wakefulness, shortened sleep duration, and/or nighttime awakenings adversely influence human emotional functioning. Findings provide an integrative foundation for future research on sleep and emotion and elucidate the precise ways that inadequate sleep may impact our daytime emotional lives. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Implementation of the Integrated Emergency Response System: Systematic Review

ABSTRACT The aim of this research is to highlight the urgency of the need for an Integrated Emergency Response System in overcoming the complexity of current global disasters and emergencies. With the need for rapid and coordinated responses, this research explores the global implementation of these systems. The focus includes integration of resources from various agencies and community participation while addressing challenges such as climate change. Given the need for a rapid and coordinated response, this research explores the application of this system globally. The focus includes integration of resources from various institutions and community participation while addressing challenges such as climate change. This research method is a systematic research that adopts the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) method. Research stages include: formulating background, objectives and research questions, as well as literature searches using related keywords in databases such as Google Scholar, PubMed, and ResearchGate. The sample consists of articles in accredited academic journals published between 2020-2023, with a focus on the Implementation of an Integrated Emergency Response System. The results of the analysis show the importance of preparation before a disaster occurs. Preparedness through health education, emergency planning, and community participation increases knowledge about emergency response. Active community involvement plays an important role in the success of an emergency management system. Factors such as resources, policies, technology, and interagency cooperation influence system implementation and response to disasters. Health system evaluation and education is an integrated strategy to improve disaster response and mitigation. Keywords: Integrated Emergency Response System, Emergency Response System and Implementation

Digital game-based learning in mathematics education at primary school level: A systematic literature review

In recent decades, digital game-based learning (DGBL) has become a trend among scholars and practitioners in many parts of the world. Therefore, there were some systematic literature reviews in the past few years conducted to identify the trends of DGBL research with diverse subjects and educational levels, however, there is a lack of review that focuses only on mathematics education at primary school levels. This study seeks to provide a comprehensive overview of DGBL research within the context of elementary mathematics learning. Using PRISMA (2020) flow diagram, this study identified 45 articles related to the topic during the period of 2006-2023. Papers were coded and analyzed by years, regions, elementary mathematics topics, research issues, outcomes, research approaches, research design, data collection tools, game genres, and gameplay mode. The results from this systematic review identified the trends in DGBL research related to elementary mathematics learning, highlighted gaps in existing literature, provided insights, and oriented future studies on the topic. The findings of the research reveal a pronounced interest among scholars in the content topics of elementary mathematics, highlighting the research issues that attract attention, the methodologies employed in studies, and the types of games and gaming modes frequently utilized for elementary school children. The article discusses the trends of DGBL within elementary mathematics education, offering in-depth analyses and identifying research gaps that could guide future directions.

Effectiveness of erector spinae plane block for rib fracture analgesia: a systematic review protocol.

This systematic review will investigate the effectiveness of the ultrasound-guided erector spinae plane block as an analgesic technique for patients with rib fractures compared with all other standard management techniques. Comparisons will be made with both nerve blocks (neuraxial techniques and peripheral nerve blocks) and systemic treatment (with patient-controlled analgesia and/or per required need analgesia for breakthrough pain). Erector spinae plane block is a well-established rescue analgesia option for patients with rib fractures. The use of ultrasound-guided erector spinae plane block in clinical practice has been largely based on observational data, with recent randomized controlled trials examining it against several other options for analgesic management. This review will compare the erector spinae against all other management techniques used in practice for rib fractures to determine whether this is the most effective analgesic technique. The review will include all randomized controlled and pseudo-randomized controlled trials examining ultrasound-guided erector spinae plane block for the analgesic management of traumatic rib fractures. All other study designs will be excluded. MEDLINE (PubMed), Embase (Ovid), CINAHL (EBSCOhost), the Cochrane Central Register of Controlled Trials, the Australian and New Zealand Clinical Trials Registry (ANZCTR), ClinicalTrials.gov, and the ISRCTN registry will be searched to identify all relevant ongoing clinical trials. Study selection, critical appraisal, and data extraction will be performed by 2 independent reviewers. Data will be extracted into software for statistical analysis (including meta-analysis where possible). PROSPERO CRD42023414849.

Correlates of Fundamental Motor Skills in the Early Years (0–4 Years): A Systematic Review

Aim: This systematic review aims to summarize evidence on correlates of fundamental motor skills in typically developing children aged 0–4 years. Methods: A literature search (PubMed, Embase, PsycINFO, and SPORTDiscus) was performed from 2000 till 23 May 2022. Inclusion criteria was cross-sectional and prospective studies examining associations between a potential correlate and fundamental motor skills in typically developing, apparently healthy children aged 0–4 years. Two independent reviewers performed screening and methodological quality assessment. Results: Eighty-three studies met eligibility criteria and were included. Thirteen studies were of high methodological quality. In children aged &lt;1 year, we found no evidence for family income, breastfeeding-related, sleep-related, home environment, and socioeconomic variables. In children aged 1–2 years, we found no evidence for sex, growth-related variables, singleton birth, and family income. In children aged 2–4 years, we found no evidence for screen behavior, toxicity, parental education, family income, socioeconomic variables, and maternal depression/anxiety and moderate evidence for a positive association with early childhood education and care setting type. For other examined correlates, we found insufficient evidence (inconsistent findings or only one study available). Conclusions: We found insufficient evidence for over half of examined potential correlates of fundamental motor skills. We recommend investing in better research methodologies and improved reporting.

Systematic Review Examining the Reporting of Race and Ethnicity in Sport-Related Concussion Studies.

Sport-related concussion (SRC) is an evolving public health concern among youth athletes. Despite emerging evidence that race and ethnicity are important factors in determining concussion outcomes, studies examining race and ethnicity are limited. We conducted a systematic review to (1) determine the prevalence of SRC studies in which participants' race or ethnicity is reported, (2) describe how race and ethnicity are used within each study, and (3) assess predictive factors for the reporting of race and ethnicity. PubMed, Embase, PsycINFO, and CINAHL databases. Study inclusion criteria were (1) primary and peer-reviewed research; (2) related to the diagnosis, treatment, or recovery of SRC; (3) involving school-aged athletes (ages 5 to 25); and (4) with 25 or more participants. The search was performed in March 2021 and included only studies published after March 2013. For each article, we looked at whether race and ethnicity were reported, and if so, which races or ethnicities were mentioned. For each race or ethnicity mentioned, we extracted the corresponding sample size and how they were used as variables in the study. Of 4583 studies screened, 854 articles met inclusion criteria. Of the included articles, 132 (15.5%) reported race, and 65 (7.6%) reported ethnicity, whereas 721 (84.4%) reported neither. When examining the demographic characteristics of the 132 studies that reported race, 69.8% of athletes were White. Additionally, 79.5% of these studies used race solely as a demographic descriptor as opposed to a main exposure or covariate of interest. Studies published more recently were more likely to report race. Further, studies in specific study or journal topics and specific geographic locations of the authors were more likely to report race. Reporting of race and ethnicity is limited in current SRC literature. Future authors should improve the reporting of race and ethnicity, diversify study samples by focusing on enrolling athletes from underrepresented groups, and consider the potential effect of race and ethnicity as social determinants of health on risk factors, recovery, and long-term sequelae after SRC.

705 Urgent or Emergent Endovascular Intervention for Neurological Deficits Post-carotid Endarterectomy: A Single-institutional Case Series and Systematic Review of the Literature

INTRODUCTION: Historically the management of acute neurological deficit following carotid endarterectomy (CEA) has been operative re-exploration; however, given the proliferation of endovascular techniques, and utilization of CT angiography, endovascular intervention is an alternative to redo-CEA. METHODS: All patients undergoing CEA in the Department of Neurosurgery at Rhode Island Hospital (Providence, RI) were reviewed. A systematic literature review was conducted in PubMed according to PRISMA guidelines to identify papers relevant to endovascular procedures addressing acute neurological deficits following CEA, which yielded 2499 unique articles. Review by 2 investigators revealed 12 relevant articles. RESULTS: Four patients from our institutional cohort met inclusion criteria. Among these, stenting was technically successful in 3 patients, 2 of which achieved near-full recovery. One patient underwent successful carotid stenting and ipsilateral M2 thrombectomy for tandem occlusion. Stent placement was unsuccessful in the remaining patient due to mechanical constriction. Articles obtained through the literature review revealed 57 further relevant cases. Of those with sufficiently complete data, 30/39 (76.9%) were male with an age range of 43 - 78 years old. Twenty-eight of 32 (87.5%) patients underwent CEA for symptomatic carotid stenosis. Post-CEA angiographic evaluation was most commonly conducted for routine completion imaging (21/57, 36.8%), non-specific stroke symptoms (15/57, 26.3%), and extremity weakness (7/57, 12.3%). Thrombotic stenosis (23/43, 53.4%) and arterial dissection (15/43, 34.9%) were the most common angiography findings. Two (3.5%) stent procedures were unsuccessful, and in the immediate postoperative period 8 patients (14.0%) had significant neurological deficits and only 3 deaths (5.3%) were reported. CONCLUSIONS: Endovascular intervention may be considered in situations where patients have neurological deficit after CEA. Direct comparison of outcomes in patients who have endovascular intervention vs. redo CEA may help identify the optimal management strategy.

Qualitative research in science education: A literature review of current publications

This study analyzed articles from the last four years regarding how science education research is framed and discussed as qualitative research. The research question that guided this study was: &lt;i&gt;To what extent do qualitative secondary science teaching research publications reflect high-quality practices found in mainstream methodological texts? &lt;/i&gt;The researchers utilized a systematic literature review methodology by (1) creating search terms based on the research question; (2) choosing relevant databases in which to search; (3) conducting the search and gathering articles; and (4) selecting articles based on inclusion criteria. The researchers chose “secondary education” and “science teaching” as search terms relevant to this study. Articles included in the review were peer-reviewed for credibility, available free online as full-text for accessibility, and available in English, which is the authors’ first language. The researchers conducted three levels of screening on the full collection of articles–title, abstract, then methods, to efficiently narrow the large sample of qualitative science education research articles to a manageable and characteristic selection. The findings include that few articles addressed science teaching and learning with deep qualitative engagement. Some articles claimed to use specific qualitative methodologies without adequately expressing aspects of those methodologies, which lend support to the credibility, transferability, dependability, or confirmability of the articles such as the researchers’ subjectivity or member-checking. Those studies that did are indeed diamonds in the ruff.

The incidence of information and communication technologies in early childhood classrooms: A systemic literature review

The importance of information and communication technology (ICT) in education has been increasingly acknowledged due to advancements in technology. Prior research has explored several perspectives on the “use of ICT in early childhood education (ECE) and has highlighted many obstacles to its implementation in the classroom setting”. The synthesis of these research does not lean towards a singular perspective or definitive result, so allowing for further investigation of the issue at a more profound level. This systematic literature review seeks to enhance the current body of knowledge on teachers’ attitudes toward the efficacy of using ICT in ECE classrooms. By using PRISMA procedures, a total of 12 studies were selected to investigate the perspectives of teachers about the use of ICT, the current methods employed, and the efficacy of teaching at ECE level. The study’s findings indicate that, in general, teachers exhibit a significant propensity toward the use of ICT in ECE. However, the implementation of ICT in classrooms is constrained by several factors.