Systematic Synthesis Research Articles

The antecedents and consequences of university brand: a systematic review

University brand is becoming a research topic that is increasingly of interest to researchers and university administrators because of its great role in the context of the strong development of higher education. This research aims to review and synthesize current studies on definitions, antecedents and consequences of university brand. The study applied a systematic synthesis method of 76 articles from reputable database sources in the period 2000-2023. The research findings indicate that the antecedents of university brand are divided into tangible group and intangible group with 08 factors including brand design, facilities and equipment, human resources, training programs, financial policies, communication activities, reputation and brand personality. Furthermore, from the standpoint of approaching university stakeholders, the consequences of university brand are highlighted in this study. Finally, the study points out some policy implications for institutions and suggests some future research directions.

Opportunistic Salpingectomy at the Time of General Surgery Procedures: A Systematic Review and Narrative Synthesis of Current Knowledge

Opportunistic salpingectomy (OS) for the primary prevention of ovarian cancer is performed by gynecologists. Advocates have suggested expanding its use to other surgical specialties. General surgeons are the other group to routinely perform intraperitoneal operations in women and could play a role in ovarian cancer prevention. Herein, we review the current evidence and perioperative factors requiring consideration prior to OS implementation in select general surgery cases. A systematic search was conducted for English-language studies evaluating OS during general surgery. The primary outcomes of this study were the feasibility and safety of OS during general surgery procedures. Secondary outcomes included pre-operative considerations (patient selection and the consent process), operative factors (technique and surgical specialty involvement), and post-operative factors (follow-up and management of operative complications). We evaluated 3977 studies, with 9 meeting the eligibility criteria. Few studies exist but preliminary evidence suggests relative safety, with no complication attributable to OS among 140 patients. Feasibility was reported in one study, which showed the capacity to perform OS in 98 out of 105 cholecystectomies (93.3%), while another study reported quick visualization of the fallopian tubes in >80% of cases. All patients in the included studies were undergoing elective procedures, including cholecystectomy, interval appendectomy, colorectal resection, bariatric surgery, and laparoscopic hernia repair. Studies only included patients ≥ 45 years old, and the mean age ranged from 49 to 67.5 years. Gynecologists were frequently involved during the consent and surgical procedures. OS represents a potential intervention to reduce the risk of ovarian cancer. Ongoing studies evaluating the general surgeon’s understanding; the consent process; the feasibility, operative outcomes, and risks of OS; and surgeon training are required prior to consideration.

Вопросы обеспечения благоприятных условий труда работников в мировой экономике

Labor process in the world occupies an essential place in the life of every person, since an employee spends a significant part of his time in the workplace within a certain production environment. Of course, the conditions of this environment have a great impact not only on human labour productivity, but also on fatigue, efficiency, health, and longevity. Formation of favorable working conditions is an ongoing process that is implemented in all organizations of the world's countries, regardless of their activities specifics. Its result should be creation of conditions that meet the requirements of safety and comfort, which will lead to a reduction in injuries, increased job satisfaction and the situation in which it is carried out, and increase of labour results quality. The purpose of the research is to study the initial conditions to ensure the performance of employees’ labour functions in the global economy based on the regulations and standards of the International Labor Organization. Research methods of the problem, such as a systematic approach, economic analysis, analysis and synthesis, comparisons, generalizations, and graphical method of analysis form the methodology of the problem study. As a result the assessment of the International Labour Organization activities on regulation and study of issues related to the working regime is given/ The problems related to working hours and their impact on people are considered and the analysis of key indicators of compliance with working conditions in our country and abroad is carried out. Conclusions are formulated on compliance with the work and rest regime of enterprises’ employees in the world countries.

Nicotine and Alcohol Use as Predictors of Recreational Cannabis Use in Adolescence: A Systematic Review and Narrative Synthesis

Background: The prevalence of recreational cannabis use among adolescents is a growing public health concern due to its link to short- and long-term adverse effects on adolescents’ wellbeing, physical health, mental health, and interpersonal behaviors. Method: Five databases were searched from inception to March 17, 2023, for exposure (nicotine product, alcohol) and outcome (recreational cannabis) in adolescents (persons aged 10–19 years). The studies were screened independently by two reviewers, and the quality of the studies was assessed with Newcastle Ottawa and AXIS tool. PRISMA guidelines were employed in this review. Result: Twenty-one (21) studies involving 2,778,406 adolescents were included in the appraisal and heterogeneity was found among these studies. Ascertainment bias was commonly detected in thirteen (13) of the included studies. Among the substances examined as potential exposures, nicotine-product use emerged as a significant factor associated with future cannabis use among adolescents, particularly in mid-adolescence and in places where recreational cannabis use has been legalized. Conclusion: Current evidence suggests an association between nicotine-product use and subsequent recreational cannabis use among adolescents. However, further research is needed to establish causality between exposure to nicotine substances and the use of recreational cannabis within this age demographic. Additionally, there is a need for the development of prevention programs and targeted policies that continuously inform and update this vulnerable sub-population about the risks associated with cannabis use for leisure.

Economic Evaluation of COVID-19 Immunization Strategies: A Systematic Review and Narrative Synthesis.

This study aimed to systematically assess global economic evaluation studies on COVID-19 vaccination, offer valuable insights for future economic evaluations, and assist policymakers in making evidence-based decisions regarding the implementation of COVID-19 vaccination. Searches were performed from January 2020 to September 2023 across seven English databases (PubMed, Web of Science, MEDLINE, EBSCO, KCL-Korean Journal Dataset, SciELO Citation Index, and Derwent Innovations Index) and three Chinese databases (Wanfang Data, China Science and Technology Journal, and CNKI). Rigorous inclusion and exclusion criteria were applied. Data were extracted from eligible studies usinga standardized data collection form, with the reporting quality of these studies assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022). Of the 40 studies included in the final review, the overall reporting quality was good, evidenced by a mean score of 22.6 (ranging from 10.5 to 28). Given the significant heterogeneity in fundamental aspects among the studies reviewed, a narrative synthesis was conducted. Most of these studies adopted a health system or societal perspective. They predominantly utilized a composite model, merging dynamic and static methods, within short to medium-term time horizons to simulate various vaccination strategies. The research strategies varied among studies, investigating different doses, dosages, brands, mechanisms, efficacies, vaccination coverage rates, deployment speeds, and priority target groups. Three pivotal parameters notably influenced the evaluation results: the vaccine's effectiveness, its cost, and the basic reproductive number (R0). Despite variations in model structures, baseline parameters, and assumptions utilized, all studies identified a general trend that COVID-19 vaccination is cost-effective compared to no vaccination or intervention. The current review confirmed that COVID-19 vaccination is a cost-effective alternative in preventing and controlling COVID-19. In addition, it highlights the profound impact of variables such as dose size, target population, vaccine efficacy, speed of vaccination, and diversity of vaccine brands and mechanisms on cost effectiveness, and also proposes practical and effective strategies for improving COVID-19 vaccination campaigns from the perspective of economic evaluation.

Interventions to suppress puberty in adolescents experiencing gender dysphoria or incongruence: a systematic review

BackgroundTreatment to suppress or lessen effects of puberty are outlined in clinical guidelines for adolescents experiencing gender dysphoria/incongruence. Robust evidence concerning risks and benefits is lacking and there is a...

Factors impeding physical activity in older hospitalised patients: A qualitative meta-synthesis.

Older hospitalised patients have low levels of physical activity and multiple impairing factors. To systematically evaluate the perceived barriers to physical activity among older patients during hospitalisation, and provide reference for future intervention programs. Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. An exhaustive exploration was conducted across the CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science from their inception until August, 2023 to identify qualitative research on obstacles to physical activity among older hospital patients. The quality of the literature was evaluated using the Joanna Briggs Institute's critical appraisal tool for qualitative research. Meta-synthesis method was used to integrate the results. In total, 8 literatures were included, 43 themes were extracted, and analogous research results were amalgamated to generate 10 categories and 3 syntheses: individual level, interpersonal influencing factors and hospital environment and resources level. Older inpatients are faced with multiple barriers to physical activity. Medical staff should pay attention to changes in physical activity during hospitalisation, identify barriers to physical activity in older inpatients and provide references for promoting physical activity programs for the older. This study is a meta-synthesis and does not require relevant contributions from patients or the public. Older patients are at low physical activity levels during hospitalisation. Older inpatients are faced with multiple barriers to physical activity. Factors of physical activity impairment in hospitalised older patients should be considered in the context of health status, psychological factors, motivation and social support. Disease-induced psychological fallout has a greater impact on physical activity in the older.

Drug repurposing as add-on treatment strategy for mania and bipolar depression: systematic synthesis and qualitative appraisal of the existing meta-analytic evidence

IntroductionIn the complex pathophysiology of bipolar disorder (BD), increasing evidence supports the involvement of neurobiological abnormalities beyond the classical ones, suggesting them as potential alternative therapeutic targets. Several drugs approved for different indications have thus been repurposed for the treatment of BD, all of them supported by a plausible biological rationale. Some recent reviews have provided an update on these possible additional treatment options for mania and bipolar depression, but no systematic synthesis and qualitative evaluation of meta-analytic findings has been made.ObjectivesTo provide a guidance on the available evidence on these treatments and their potential role in clinical practice, we conducted an umbrella review of meta-analyses of randomized placebo-controlled trials investigating drugs repurposed as add-on treatments for mania and bipolar depression.MethodsWe performed a systematic search and screening of the existing literature looking for the most up-to-date or comprehensive meta-analyses of randomized controlled trials (RCTs) on adults suffering from BD during an acute mood episode (mania or depression) which compared a repurposed drug and placebo as adjunctive treatments. We performed a critical appraisal according to “A MeaSurement Tool to Assess systematic Reviews” Version 2 (AMSTAR 2). We synthesized meta-analytic findings regarding efficacy, tolerability, and safety, also assessing the quality of evidence using the “Grading of Recommendations, Assessment, Development and Evaluations” (GRADE) approach.ResultsIn nine eligible meta-analyses investigating 12 drugs (four for mania and eight for bipolar depression) we observed a heterogeneous quality of reporting was according to AMSTAR 2.In mania, allopurinol (for symptoms reduction and remission at 4-8 weeks) and tamoxifen (for response and symptoms reduction at 4-6 weeks) showed higher efficacy than placebo, with evidence of low and very low quality, respectively.In bipolar depression, modafinil/armodafinil (for response, remission, and symptoms reduction at 6-8 weeks) and pramipexole (for response and symptoms reductionat 6 weeks) were superior to placebo, with low-quality evidence. Results on celecoxib and N-acetylcysteine were of low quality and limited to certain outcomes.ConclusionsOverall, the lack of evidence of high and moderate quality does not allow firm conclusions on the clinical utility of repurposed drugs as adjunctive treatments for mania and bipolar depression, limiting recommendations for their use in clinical practice. However, since some lines of evidence seem to hold some potential, and standard treatments for mania and bipolar depression remain not entirely satisfactory, the search for novel therapeutic targets and strategies for the management of BD warrants further research in the field.Disclosure of InterestNone Declared

Examining the Impacts of Human Resource Management HRM-Financial Management Alignment: A Qualitative Review of Accounting Literature

This qualitative research explores the implications of aligning Human Resource Management (HRM) practices with Financial Management objectives in organizations. The study aims to investigate the strategic significance of HRM-Financial Management alignment, its impact on organizational performance, and its implications for managerial practice. Through a comprehensive literature review, the research examines existing knowledge, theories, and empirical findings related to HRM-Financial Management alignment. The methodology involves systematic data collection, thematic analysis, and synthesis of literature from scholarly articles, books, and reports. Findings indicate a positive correlation between alignment and organizational outcomes, including financial performance, employee productivity, and innovation. The strategic integration of HRM and Financial Management functions fosters collaboration, communication, and innovation within organizations, enhancing their competitiveness and long-term sustainability. The study underscores the importance of prioritizing HRM-Financial Management alignment as a strategic imperative for organizational success in dynamic and competitive business environments.

Forestry impacts on stream flows and temperatures: A quantitative synthesis of paired catchment studies across the Pacific salmon range

Abstract Forestry is pervasive across temperate North America and may influence aquatic environmental conditions such as flows and temperatures, as well as important species such as Pacific salmon (Oncorhynchus spp.). While there have been many large‐scale forestry experiments using paired catchment designs, these studies have yet to be quantitatively synthesized. Thus, it remains unclear whether forestry impacts are consistent, context‐dependent or unpredictable. This study aims to quantitatively synthesize forestry impacts on streamflow and temperature, through a systematic review and synthesis of paired catchment studies across the range of Pacific salmon. Specifically, we investigated whether generalizable relationships exist between forestry intensity (percent watershed harvested) and impacts to streamflow and temperature. We also examined whether watershed features (climate, hydrology and lithology) and harvest method mediated forestry impacts. We extracted information from 35 unique paired‐catchments from California to Alaska. Forestry had strong impacts on peak and low flows and maximum summer water temperatures, but responses were quite variable. Across all catchments, forestry elevated peak flows ~20% (n = 31 catchments), reduced low flows ~25% (n = 13 catchments) and increased maximum summer temperatures ~15% (n = 35 catchments) on average. However, these impacts were variable and were not predictable based on forestry intensity, thus broader stressor–response relationships were not supported. Forestry impacts on peak flows and maximum summer temperatures varied spatially. Peak flow impacts increased with northward latitude and temperature impacts decreased with eastward longitude. However, the magnitude of impacts were unrelated to other watershed attributes, which included climate (precipitation and aridity), rain versus snow hydrology, elevation and bedrock lithology. Harvest method and riparian buffer presence also had no detected effects on forestry impacts across studies and statistical models explained a low proportion of variation overall. Collectively, our results indicate that forestry can have substantial impacts on key environmental conditions; however, the magnitude of impact was variable and could not be clearly linked to easily measured watershed characteristics. This implies that forestry impacts may not be broadly predictable. Probabilistic risk models based on distributions of potential impacts may therefore be more useful for watershed management in data‐poor situations.

Approaches and methods used to bring together Indigenous and Environmental science Knowledge in environmental research: A systematic map protocol

Abstract The bringing together of multiple knowledge sources, such as Indigenous knowledge (IK) and Environmental science Knowledge (ESK), is a topic of considerable interest and significance in environmental research. In the areas of resource management for example, the bringing together of IK and ESK datasets has raised considerable interest for its potential to increase understanding and provide insights into complex phenomena such as the effects of climate change and variability on wildlife health and distribution. The potential benefits that exist from merging these knowledge sources have been widely acknowledged. However, navigating the complex processes involved in knowledge linking continues to pose significant challenges. This systematic mapping protocol will guide the collection and analysis of literature to examine the approaches and methods used in published studies that aim to bring together Indigenous and Environmental science Knowledge in environmental research. The particular focus of this examination is placed on identification of the types of approaches and methods used to merge IK and ESK datasets at the stages of data analysis, results, and interpretation/discussion in the research process. Through a scoping exercise, a draft search string was developed based on a predetermined list of keywords. Consultation was held with a senior Indigenous scholar to advise on the keywords used and consideration for IK likely to be represented in the collected literature. The final search string will be applied to online bibliographic databases to collect studies published in peer‐reviewed journals. The final capture of the search will be screened in two stages: (1) at the level of title and abstract and (2) at full‐text. All studies included will be coded using a standardised coding template and a narrative synthesis approach will be used to identify patterns in the evidence, including knowledge gaps and clusters. Practical implication: The resulting systematic map, following the outlined procedures in this protocol and considering guidelines from the Collaboration for Environmental Evidence (CEE) and Reporting standards for Systematic Evidence Syntheses (ROSES), can serve to support and inform future research endeavours engaged in working towards the linking of IK and ESK, with practical implications for communities and policymakers.

Temporomandibular Joint (TMJ) Replacement Affects Quality of Life: A Systematic Review and Synthesis of Clinical Trials

This systematic review aims to determine the impact of temporomandibular joint (TMJ) replacement on health-related quality of life. The review was reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. An electronic search using the Bielefeld Academic Search Engine was performed to identify primary studies reported in English and published up until November 2023. Ten reports fulfilled the inclusion criteria and were assessed according to the Critical Appraisal Skills Programme (CASP): Qualitative Studies Checklist. The overall research value of the studies ranged from high (dominant) to moderate. The synthesis of the results concerning TMJ replacement in severe degenerative disease showed an improvement in (1) quality of life, (2) pain intensity, (3) mastication efficiency, and (4) mandibular mobility. One study presented favorable outcomes for patients suffering from ankylosis.

Integration Review of Project Based Learning in Biology Education: A Systematic Literature Synthesis of Education Levels, Biology Subdisciplines, Research Methodologies and Learning Competencies

Project-Based Learning (PjBL) has become an increasingly popular learning approach in many fields, including biology. The research conducted a systematic review of the literature on the implementation and effectiveness of PjBL in biology education, especially in the period 2019–2023. The study explores the use of PjBL in various subdisciplines of biology, education, and research methodologies, as well as integrating a variety of targeted learning and competence approaches. Colleges widely adopt PjBL, focusing on developing students' cognitive, affective, and psychomotor abilities. The study also highlights the various learning methods integrated into the pjBL, including laboratory experiments, field activities, and reflection. The findings confirm that PjBL is an effective educational strategy for improving student understanding of concepts, critical thinking skills, and learning motivation. This approach supports holistic and applied learning experiences, integrating theory with real practice, as well as developing skills essential to students in the 21st century. The study provides a comprehensive insight into the current trends and potential of PjBL in biology education, as well as recommending directions for future education research and practice.

The impact of media reporting of suicides on subsequent suicides in Asia: A systematic review

Introduction: This systematic review is aimed at (1) evaluating the association between media portrayals of suicides and subsequent copycat suicides or attempts among the general public in Asia, (2) understanding the factors associated with copycat suicides and (3) determining the positive impacts of the media reporting of suicides (e.g. increased help-seeking, coping). Method: A systematic review and narrative synthesis of English and Chinese articles from 8 electronic databases (i.e. PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, Ariti, China National Knowledge Infrastructure and OpenGrey) from January 2000 to May 2023 was conducted. Observational studies were included, and the data were analysed through narrative synthesis. The protocol was registered with PROSPERO (CRD42021281535). Results: Among the 32 studies included (n=29 for evidence synthesis) in the review, there is good-quality evidence to show that copycat suicides and suicide attempts increase after media reports of a suicide, regardless of country, celebrity status, study design, type of media, mode of suicide or follow-up period. Females, younger age groups and those sharing similar characteristics as the deceased in publicised suicides (age, gender) were more susceptible to negative impact. Reporting of the mode of death of the deceased increased suicides by the same method among the public. Conclusion: Media portrayals of suicide appear to have a negative impact on copycat suicides at the population level in Asia. Thus, in addition to tighter media control, healthcare systems, professional medical bodies and community outreach services should work collaboratively to promote early help-seeking in those with psychological distress.

School‐based anti‐bullying approaches for children and young people with special educational needs and disabilities: A systematic review and synthesis

AbstractMainstream anti‐bullying interventions can reduce primary school‐level victimisation by 15–16% and bullying perpetration by 19%–20% (Aggression and Violent Behavior, 2019; 45: 111–133). Less is known about anti‐bullying interventions for pupils with special educational needs and disabilities (SEND) even though they are at least 2–4 times more likely to be involved in bullying. This systematic review aimed to identify reported anti‐bullying approaches for pupils with SEND, what the evidence is for these approaches reducing bullying and which design factors are linked to a reduction in bullying. We searched 10 databases and four grey literature sources for articles that evaluated school‐based anti‐bullying strategies for children and young people aged 4–18 years with SEND. This review included 15 studies and used the Mixed Methods Appraisal Tool for quality and risk of bias. Ten reported a reduction in bullying involvement, but the evidence was variable. A further 27 articles formed a ‘suggested strategies’ review which synthesised articles without evaluations of interventions but that suggested anti‐bullying strategies for use with pupils with SEND. The main suggestion was encouraging social skills and networks. Interventions should be evaluated for feasibility, acceptability and effectiveness. High‐quality randomised controlled trials are required to build an evidence base to support pupils with SEND.

Alterations of the gut microbiota in patients with schizophrenia.

Schizophrenia is a complex psychiatric disorder, of which molecular pathogenesis remains largely unknown. Accumulating evidence suggest that gut microbiota may affect brain function via the complex gut-brain axis, which may be a potential contributor to schizophrenia. However, the alteration of gut microbiota showed high heterogeneity across different studies. Therefore, this study aims to identify the consistently altered gut microbial taxa associated with schizophrenia. We conducted a systematic search and synthesis of the up-to-date human gut microbiome studies on schizophrenia, and performed vote counting analyses to identify consistently changed microbiota. Further, we investigated the effects of potential confounders on the alteration of gut microbiota. We obtained 30 available clinical studies, and found that there was no strong evidence to support significant differences in α-diversity and β-diversity between schizophrenic patients and healthy controls. Among 428 differential gut microbial taxa collected from original studies, we found that 8 gut microbial taxa were consistently up-regulated in schizophrenic patients, including Proteobacteria, Gammaproteobacteria, Lactobacillaceae, Enterobacteriaceae, Lactobacillus, Succinivibrio, Prevotella and Acidaminococcus. While 5 taxa were consistently down-regulated in schizophrenia, including Fusicatenibacter, Faecalibacterium, Roseburia, Coprococcus and Anaerostipes. These findings suggested that gut microbial changes in patients with schizophrenia were characterized by the depletion of anti-inflammatory butyrate-producing genera, and the enrichment of certain opportunistic bacteria genera and probiotics. This study contributes to further understanding the role of gut microbiota in schizophrenia, and developing microbiota-based diagnosis and therapy for schizophrenia.

A systematic evidence synthesis of disability and inclusive pedagogy in initial teacher training in English as a Foreign Language

This systematic review considers recent evidence of the preparation of inclusive education implementation in the context of English as a Foreign Language (EFL) education across different countries. The study comprised of a comprehensive search of multiple databases which are accessible for scholars with visual impairments working with an open-source screen reader application: British Education Index, Education Source, ERIC subscription, Scopus, and Web of Science Core Collection. The searches generated 508 studies from January 1 2002, to December 31 2022,. 73 duplicated studies were removed, leaving 435 records to be screened for inclusion. 430 of these were rejected for not meeting the selection criteria, leaving five studies for inclusion. One additional relevant study from author's personal collection of references was also included in the review. The review discovered that the issue of disability and inclusive pedagogy in initial EFL teacher education scholarship is extremely under-studied. Only four relevant studies were conducted in the Global North, two in the Middle East, and none in the Global South, where an expanding population of pupils learning English are located. The findings of this study provide insights and recommendations for policy and practices of initial EFL teacher education.

Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis

BackgroundThe complexity and uncertainty around Persistent Physical Symptoms (PPS) make it difficult to diagnose and treat, particularly under time-constrained consultations and limited knowledge. Brief interventions that can be utilised in day-to-day practice are necessary to improve ways of managing PPS. This review aimed to establish (i) what training primary and secondary healthcare practitioners have undertaken to develop their clinical skills when working with PPS, (ii) what training techniques or theoretical models have been used within these interventions, and (iii) how effective was the training.MethodA systematic literature search was undertaken on eight databases to identify professional development interventions for healthcare practitioners working with PPS, were of any study design, and at a minimum were single measure studies (i.e., training outcome alone). Studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and narratively synthesised.ResultsDespite high methodological heterogeneity across the six included studies, they all aimed to improve healthcare practitioners’ communication skills through educational (theory, awareness, attitudes, assessment, treatment, and management of PPS) and experiential (role play) learning.ConclusionsThe review findings demonstrate that developing healthcare practitioners’ communicative behaviours led to increased confidence and self-efficacy when working with PPS, which facilitated improved consultations and improvements on some patient outcomes. Barriers to the uptake of training programmes and implementation into daily clinical practice are discussed, including the need for PPS to be formally implemented into undergraduate teaching and post-qualification continuous professional development.Trial registrationThis review was registered at PROSPERO [CRD42022315631] prior to the review starting.

AVANCES EN BIOMATERIALES METÁLICOS PARA IMPLANTES BIOMÉDICOS: UNA REVISIÓN INTEGRATIVA

Objective: The aim of this study is to investigate advancements in metallic biomaterials for biomedical implants, with the goal of enhancing patient safety and reducing mortality risks associated with medical procedures. Theoretical Framework: In this study, the theoretical framework draws upon concepts such as biocompatibility, advanced manufacturing techniques, and the role of artificial intelligence in improving implant performance and patient outcomes. These theories provide a solid foundation for understanding the context and significance of the research. Method: The methodology adopted for this research comprises an integrative literature review model. Specific steps included formulating a guiding question using the PICO/PIO/PEO strategy, establishing inclusion and exclusion criteria for studies, categorizing selected research, and analyzing and interpreting the results. Data collection involved selecting articles from reputable databases such as Web of Science, Springer Nature Librarian, and Wiley Online Library, using relevant keywords related to biomedical materials and human health. Results and Discussion: The results of the integrative literature review provide a systematic synthesis of research findings on metallic biomedical materials. These findings are contextualized within the theoretical framework, emphasizing the importance of continuous research efforts in developing safer and more effective materials for medical implants. The discussion highlights the implications of these findings for enhancing healthcare technologies and patient outcomes. Research Implications: The practical implications of this research include informing the development of safer and more effective materials for biomedical implants, thereby improving patient safety and quality of life. These implications extend to various sectors involved in healthcare technology and biomedical engineering. Originality/Value: This study contributes to the literature by synthesizing existing knowledge and providing valuable insights into the field of metallic biomaterials for medical applications.

Exploring Aesthetic Outcomes and Complications in Auricular Reconstruction Utilising Autologous Cartilage: A Systematic Review and Narrative Synthesis.

Auricular reconstruction remains a challenging procedure, requiring a high degree of manual dexterity and attention to detail in order to reconstruct the complex three-dimensional geometry of the ear successfully. Most techniques will rely on autologous cartilage for auricular framework fabrication, carrying a risk of donor and recipient site morbidity. The aim of this report is to investigate the complications and aesthetic outcomes associated with autologous cartilage harvest in auricular reconstruction. A systematic review protocol was registered with theInternational Prospective Register of Systematic Reviews (PROSPERO) and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies for four databases were developed. Studies were screened according to the inclusion and exclusion criteria by two independent reviewers. The literature search identified 7171 articles. Filtering for relevance and duplication reduced the number of articles to 52. A total of 12,215 patients underwent auricular reconstruction utilising autologous cartilage. Indications included 11,696 patients due to microtia, 334 patients due to burns or trauma, 70 patients due to constricted ears, and 115 patients due to prominent ears. The most commonly reported donor site complications included chest wall deformities (n = 159). The most commonly reported recipient site complications included hypertrophic or keloid scars (n = 279), haematoma (n = 155), tissue expander exposure (n = 111), cartilage or framework exposure (n = 122), and cartilage framework deformation or resorption (n = 50). Although a challenging procedure, auricular reconstruction utilising autologous cartilage is possible. Exceptional aesthetic results can be achieved when performed by a skilled surgeon on appropriately selected individuals. However, the potential risks and complications associated with the procedure should be discussed with the patient and family beforehand.