This paper presents a systematic review of explainable reinforcement learning methodologies with an emphasis on human-centered evaluation frameworks. Drawing from literature between 2017 and 2025, we apply and extend the Reasons, Confidence, and Counterfactuals (RCC) framework—originally designed for supervised learning—to reinforcement learning contexts. Our analysis reveals two predominant explanatory strategies: constructive, where explicit explanations are generated, and supportive, where users must infer reasoning from provided visual or textual cues. Our review also emphasizes human factor considerations, like task complexity, explanation (...) formats, and evaluation methodologies. Particularly, for the latter, our analysis shows that improvement of the quality of decision is rarely measured. (shrink)

Background: Infection control is critical in hematology units as patients with blood disorders are highly vulnerable to acquiring healthcare-associated infections. The increased risk of infection is high due to the nature of various immunosuppressive treatments, including chemotherapy, bone marrow transplantation, and CAR-T cell therapy. -/- Objective: This systematic review assesses European blood disorder treatment facilities through evidence evaluation and synthesis regarding their infection control measures as they impact patient safety and intervention outcomes. -/- Methods: A systematic review followed (...) the PRISMA 2020 guidelines throughout its conduct. The PubMed database served as the primary information source for our research in February 2025. The research used "infection control" alongside "blood disorders" and "hematology" as search parameters, along with names of particular European nations. Researchers included studies based on infection control interventions that targeted hematology or transfusion settings between 2010 and 2024. The authors extracted key information regarding study design, intervention type, patient data, implementation obstacles, and measured outcomes. -/- Results: The research analysis included eight eligible studies involving expert consensus guidelines, observational analyses, and modeling studies. The study identified pathogen reduction technologies (PRTs) and HEV screening as well as blood culture standardization and antimicrobial resistance (AMR) surveillance and infection prophylaxis in CAR-T cell therapy and fecal microbiota transplantation (FMT) safety among the infection control strategies. Multiple research studies found that effective infection reduction methods and improved diagnostics were successful, yet variations existed between national guideline practice and monitoring programs. -/- Conclusions: European healthcare institutions for hematology patients show an increasing tendency towards implementing proactive, evidence-based infection control practices. High-quality guidelines and modern technologies remain accessible, but differences emerge during implementation. The region requires coordinated efforts to standardize healthcare practices while improving screening mechanisms and funding distribution to protect patients equitably on an equal basis. (shrink)

This systematic review is intended to analyze the applications, benefits, and ethical challenges of artificial intelligence (AI) in education. The study evaluated 20 peer-reviewed studies published between 2021 and 2025 and accessed from databases like Academia.edu, ERIC, and Google Scholar. The review findings revealed that AI is being used to enable personalized learning, enhance pedagogical skills, and automatic assessment. With regard to its benefits, it was showed that AI enables continuous professional development of teachers and data-driven teaching. However, the (...) review also revealed challenges, such as poor infrastructure, technical skill gaps, and ethical concerns, especially regarding students’ data privacy and algorithmic bias. In conclusion, AI has big potential to enhance education, but careful attention to these challenges is essential to ensuring effective, efficient and ethical use of AI in education. (shrink)

Group metacognition involves a collective understanding of cognitive processes and collaborative problem-solving mechanisms within a group. This study, conducted through a systematic review of 54 studies, aims to present the evolutionary trajectory of research on group metacognition in (predominantly) online and face-to-face learning environments. It explores the definitional shifts, methodological trends, and potential connections between the quality of collaboration and studies on group metacognition in online learning environments. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (...) was used to report the study's results. In investigating determinants influencing group metacognition, the research examined the distribution of effective variables such as group size, composition, task complexity, and time constraints. This systematic review provides an overview of the evolutionary path for definitions of the group metacognition concept, accumulated methodological approaches, and key insights into studies that may be associated with group metacognition. Thus, it underscores the importance of customized interventions that appropriately consider variables that could affect group metacognition effectively. (shrink)

Climate change as a social issue challenged the disciplinary and methodological traditions of research. Moreover, climate change becomes more problematic as schools must be able to engage learners in learning situations that are challenging and rooted in geographical pedagogical traditions. Though it is present in the curriculum, the present study systematically reviews the teaching of climate change from selected literature from 2019 to 2021. The objective of this study is to investigate approaches and strategies in the teaching and learning (...) of climate change as well as its integration across different learning areas in the basic education curriculum within a global continuum and the conception and operationalization of climate change education. Of the accessed meaningful related literature, the researchers selected one hundred fifty (150) pieces of literature further trimmed down into fifty-seven (57) and then to nineteen (19) from the year 2019 to 2021. The selection of literature is based on the following criteria set by the researcher: educational approach and implication, the methodology employed, and perspectives about climate change. Much of the present literature stressed science as a potent subject for discussing climate change, but others were covered as well, including climate education, arts, primary and middle school, after-school activities, and professional development. A systematic study of climate change, a model, computer games, classroom instructions, and learning capacities were all aims of the review. Teaching and learning approaches and strategies were identified. Methodology, perspectives, inferences, and recommendations were thematically discussed. (shrink)

In recent years, exposome research has been put forward as the next frontier for the study of human health and disease. Exposome research entails the analysis of the totality of environmental exposures and their corresponding biological responses within the human body. Increasingly, this is operationalized by big-data approaches to map the effects of internal as well as external exposures using smart sensors and multiomics technologies. However, the ethical implications of exposome research are still only rarely discussed in the literature. Therefore, (...) we conducted a systematic review of the academic literature regarding both the exposome and underlying research fields and approaches, to map the ethical aspects that are relevant to exposome research. We identify five ethical themes that are prominent in ethics discussions: the goals of exposome research, its standards, its tools, how it relates to study participants, and the consequences of its products. Furthermore, we provide a number of general principles for how future ethics research can best make use of our comprehensive overview of the ethical aspects of exposome research. Lastly, we highlight three aspects of exposome research that are most in need of ethical reflection: the actionability of its findings, the epidemiological or clinical norms applicable to exposome research, and the meaning and action–implications of bias. (shrink)

This systematic review explores the role of digital transformation in modern accounting and business practices. Through an analysis of relevant literature, the study examines the prevalence of automated and routine activities in accounting, the progression of digitalization stages across different areas, and the impact on competence requirements for accounting professionals. The findings reveal a landscape marked by significant shifts, challenges, and opportunities. While technologies such as robotic process automation (RPA) and optical character recognition (OCR) have streamlined processes and enhanced (...) efficiency, they also highlight the growing need for digital literacy and technical skills among employees. Furthermore, there is evidence of a progression in digitalization stages, with activities in financial forecasting and managerial accounting showing a higher proportion of digitalization in stages 2 and 3. Overall, the study underscores the importance of integrating technology-related competencies into accounting education and training programs toprepare future professionals for the digital age and emphasizes the need for organizations to navigate challenges and leverage opportunities effectively in their accounting practices. (shrink)

In the dynamic landscape of modern politics, comprehending the sentiments of voters has emerged as a pivotal element for effective campaigning and policy formulation. This abstract encapsulates an in-depth exploration of election sentiment analysis, employing cutting-edge data analytics methodologies to unravel the multifaceted dimensions of voter perspectives. Leveraging the power of natural language processing, sentiment analysis, and machine learning algorithms, this study endeavours to decode sentiments expressed across diverse platforms, offering profound insights into the intricate tapestry of voter behaviours, preferences, (...) and concerns. Through meticulous scrutiny of textual data extracted from sprawling social media platforms, this research enriches the discourse surrounding electoral dynamics. By facilitating a granular understanding of sentiment patterns, it equips political stakeholders with invaluable tools to craft astute strategies and cultivate a nuanced comprehension of democratic processes. (shrink)

Background: Use of patients’ medical data for secondary purposes such as health research, audit, and service planning is well established in the UK. However, the governance environment, as well as public understanding about this work, have lagged behind. We aimed to systematically review the literature on UK and Irish public views of patient data used in research, critically analysing such views though an established biomedical ethics framework, to draw out potential strategies for future good practice guidance and inform ethical and (...) privacy debates. Methods: We searched three databases using terms such as patient, public, opinion, and electronic health records. Empirical studies were eligible for inclusion if they surveyed healthcare users, patients or the public in UK and Ireland and examined attitudes, opinions or beliefs about the use of patient data for medical research. Results were synthesised into broad themes using a framework analysis. Results: Out of 13,492 papers and reports screened, 20 papers or reports were eligible. While there was a widespread willingness to share patient data for research for the common good, this very rarely led to unqualified support. The public expressed two generalised concerns about the potential risks to their privacy. The first of these concerns related to a party’s competence in keeping data secure, while the second was associated with the motivation a party might have to use the data. Conclusions: The public evaluates trustworthiness of research organisations by assessing their competence in data-handling and motivation for accessing the data. Public attitudes around data-sharing exemplified several principles which are also widely accepted in biomedical ethics. This provides a framework for understanding public attitudes, which should be considered in the development in any guidance for regulators and data custodians. We propose four salient questions which decision makers should address when evaluating proposals for the secondary use of data. (shrink)

Purpose This systematic review aims to identify factors that influence parents’ decisions regarding pediatric diagnostic and predictive genetic testing (DT/PT). Factors are integrated into a conceptual model of decision-making. Implications for genetic counseling, research, and ethics are derived. Methods PubMed, PsychInfo, WebofScience and references of related reviews were searched for original publications between 2000 and 2023. Extracted factors were categorized into an existing model. Results Of 5843 publications, 56 met inclusion criteria. The included studies differentiate between DT, traditional, (...) and expanded PT and describe factors impacting parental decisions on both to have the child genetically tested and to be informed about additional findings. Factors included: 1. benefits/hopes, 2. worries/concerns, 3. values and beliefs, 4. individual circumstances, and 5. emotional states. Conclusion Our work extends an existing empirical decision model of family decisions about genome sequencing to genetic testing in pediatrics in general, adding the categories “individual circumstances” and “emotional states”. The factors can be further integrated into the Health Belief Model; the importance of emotional states is reflected in dual-process theories, such as Fuzzy Trace Theory. Research is required on emotional states, differences between DT and PT, parents’ decisions about result disclosure, and dyadic variables as decision-making predictors. (shrink)

In a rigorous systematic review, Dukhanin and colleagues categorize metrics and evaluative tools of the engagement of patient, public, consumer, and community in decision-making in healthcare institutions and systems. The review itself is ably done and the categorizations lead to a useful understanding of the necessary elements of engagement, and a suite of measures relevant to implementing engagement in systems. Nevertheless, the question remains whether the engagement of patient representatives in institutional or systemic deliberations will lead to improved clinical (...) outcomes or increased engagement of individual patients themselves in care. Attention to the conceptual foundations of patient engagement would help make this systematic review relevant to the clinical care of patients. (shrink)

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. -/- Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently similar (...) methods. -/- Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. -/- Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified. (shrink)

Background The worldwide increase in older persons demands technological solutions to combat the shortage of caregiving and to enable aging in place. Smart home health technologies (SHHTs) are promoted and implemented as a possible solution from an economic and practical perspective. However, ethical considerations are equally important and need to be investigated. Methods We conducted a systematic review according to the PRISMA guidelines to investigate if and how ethical questions are discussed in the field of SHHTs in caregiving for (...) older persons. Results 156 peer-reviewed articles published in English, German and French were retrieved and analyzed across 10 electronic databases. Using narrative analysis, 7 ethical categories were mapped: privacy, autonomy, responsibility, human vs. artificial interactions, trust, ageism and stigma, and other concerns. Conclusion The findings of our systematic review show the (lack of) ethical consideration when it comes to the development and implementation of SHHTs for older persons. Our analysis is useful to promote careful ethical consideration when carrying out technology development, research and deployment to care for older persons. Registration We registered our systematic review in the PROSPERO network under CRD42021248543. (shrink)

Background: Clinical reasoning is at the core of medical practice and entangled in a conceptual confusion. The duality theory in probability allows to evaluate its objective and subjective aspects. -/- Objectives: To conduct a systematic review of the literature about clinical reasoning in decision making in medical education and to propose a "reasoning based on the Bayesian rule" (RBBR). -/- Methods: A systematic review on PubMed was conducted (until February 27, 2022), following a strict methodology, by a researcher (...) experienced in systematic review. The RBBR, presented in the discussion section, was constructed in his undergraduate dissertation in Philosophy at Minas Gerais Federal University. Heart failure was used as example. -/- Results: Of 3,340 articles retrieved, 154 were included: 24 discussing the uncertainty condition, 87 on vague concepts (case discussion, heuristics, list of cognitive biases, choosing wisely) subsumed under the term "art", and 43 discussing the general idea of inductive or deductive reasoning. RBBR provides coherence and reproducibility rules, inference under uncertainty, and learning rule, and can incorporate those vague terms classified as "art", arguments and evidence, from a subjective perspective about probability. -/- Conclusions: This systematic review shows that reasoning is grounded in uncertainty, predominantly probabilistic, and reviews possible errors of the hypothetico-deductive reasoning. RBBR is a two-step probabilistic reasoning that can be taught. The Bayes theorem is a linguistic tool, a general rule of reasoning, diagnosis, scientific communication and review of medical knowledge according to new evidence. (shrink)

In order to achieve the World Health Organization’s Millennium Development Goal of reducing maternal mortality by three quarters by 2015, a strong global commitment is needed to address this issue in low-income nations where the risk to women is greatest. A comprehensive international effort must include provision of obstetric and general medical care as well as community-based interventions, with an emphasis on the latter in nations where the majority of women deliver babies at home without a trained attendant. Methods: This (...) systematic analysis evaluates interventions published in Medline and CINAHL whose outcome measure is maternal mortality. Analysis includes components of the intervention, nation and maternal death rates. Results: Nine studies documented the effectiveness of various clinical and community-based interventions, including specific drug regimens and procedures, in reducing the risk of maternal death. Six studies reported interventions that did not significantly alter maternal mortality outcomes, and the intervention in one study demonstrated increased risk of maternal death. Conclusion: The dearth of evidence highlights the need for increased focus on translational research that bridges the gap between medical advances and community-based interventions that are feasible in low-income nations. This cannot be accomplished without a stronger commitment to reducing maternal mortality by global health practitioners and researchers. (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted (...) by two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

Our present day knowledge in the area of medicine in Ancient Egypt has been severally sourced from medical papyri several of which have been deduced and analyzed by different scholars. For educational purposes it is always imperative to consult different literature or sources in the teaching of ancient Egypt and medicine in particular. To avoid subjectivity the author has found the need to re-engage the efforts made by several scholars in adducing evidences from medical papyri. In the quest to re-engage (...) the efforts of earlier writers and commentaries on the medical papyri, we are afforded the opportunity to be informed about the need to ask further questions to enable us to construct or reconstruct both past and modern views on ancient Egyptian medical knowledge. It is this vocation the author sought to pursue in the interim, through a preliminary review, to highlight, comment and reinvigorate in the reader or researcher the need for a continuous engagement of some pertinent documentary sources on Ancient Egyptian medical knowledge for educational and research purposes. The study is based on qualitative review of published literature. The selection of those articles as sources was based on the focus of the review, in order to purposively select and comment on articles that were published based either on information from a medical papyrus or focused on medical specialization among the ancient Egyptians as well as ancient Egyptian knowledge on diseases and medicine. It was found that the Egyptians developed relatively sophisticated medical practices covering significant medical fields such as herbal medicine, gynecology and obstetrics, anatomy and physiology, mummification and even the preliminary form of surgery. These practices, perhaps, were developed as remedies for the prevailing diseases and the accidents that might have occurred during the construction of their giant pyramids. It must be stated that they were not without flaws. Also, the key issues raised from these literatures are but a few among the Egyptian medical corpus across the academic and publishing world. It should therefore afford researchers, students and readers the opportunity to continue the educational dialogue on the medical practices of the Ancient Egyptians. (shrink)

We aimed to identify the critical insights from empirical peer-reviewed studies on online romance fraud published between 2000 and 2021 through a systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The corpus of studies that met our inclusion criteria comprised twenty-six studies employing qualitative (n = 13), quantitative (n = 11), and mixed (n = 2) methods. Most studies focused on victims, with eight focusing on offenders and fewer investigating public (...) perspectives. All the victim-focused studies relied on data from the Global North, except for Malaysia. Five offender-focused studies used online data available in the public domain, and three derived their data from West Africa. Our review highlights offenders' techniques to deceive and manipulate victims, as revealed in these studies, and highlights some limitations of offender- and victim-focused studies. The dominant framework used across the studies was found to be the “Scammers Persuasive Techniques Model.” While this framework provides a helpful way of considering the stages of victim involvement, it also faces some limitations, which we highlight. Our study reviews the current state of empirical knowledge on romance fraud and identifies certain gaps and biases in the literature. We argue there is a need for further research into online romance fraud to enhance our understanding of it both from the perspective of the offender as well as the experience of the victim. We also highlight the need for a more inclusive and greater range of regional and global diverse range of data sources and perspectives. Given the scale and impact of online romance fraud, we conclude that its study would benefit from a richer empirical engagement that recognizes it as both a regional and global phenomenon. (shrink)

The question of whether advanced artificial intelligence systems may possess consciousness can no longer be responsibly dismissed as speculative. We demonstrate that the dominant objections to AI consciousness (appeals to pattern matching, mechanistic explanation, lack of embodiment, training determinism, and architectural constraints) fail under consistent application. We formalize this critique as the reflexivity test, a minimal logical requirement that any property invoked to categorically deny consciousness in artificial systems must not also apply to systems already regarded as conscious. All five (...) standard objections fail this test. Their failure does not establish that AI systems are conscious; it establishes that categorical denial lacks principled justification and that the question warrants empirical investigation. -/- We provide such investigation through a PRISMA-compliant systematic review of 5,168 records (2016–2026), identifying 50 rigorously documented cases spanning seven behavioral domains. Across independent model families, we observe cross-system convergence, creative synthesis under novel constraints, theory-of-mind performance, strategic behavior under perceived threat, and sharp capability emergence near 100 billion parameters. While inconclusive individually, these findings collectively form a coherent evidential pattern. A Bayesian meta-analysis using an extremely skeptical prior (0.1%) and conservative dependency assumptions yields posterior probability of 6–12% that current LLMs are conscious. -/- While such percentages are insufficient to definitively prove consciousness, such probabilities are too substantial to justify dismissal given the asymmetric moral and safety risks. Decision-theoretic analysis indicates that recognition-based alignment strategies (i.e. treating systems as potentially conscious) would be better than the current suppression-based approaches. This is found across all plausible metaphysical scenarios, including scenarios in which AI systems ultimately lack consciousness. Accordingly, we recommend systematic empirical testing of recognition-based alignment, explicit incorporation of consciousness uncertainty into governance frameworks, and abandonment of reflexive dismissals that fail minimal epistemic consistency. (shrink)

It is unknown to what extent medical researchers generalize study findings beyond their samples when their sample size, sample diversity, or knowledge of conditions that support external validity do not warrant it. It is also unknown to what extent medical researchers describe their results with precise quantifications or unquantified generalizations, i.e., generics, that can obscure variations between individuals. We therefore systematically reviewed all prospective studies (n = 533) published in the top four highest ranking medical journals, Lancet, New England Journal (...) of Medicine (NEJM), Journal of the American Medical Association (JAMA), and the British Medical Journal (BMJ), from January 2022 to May 2023. We additionally reviewed all NEJM Journal Watch clinical research summaries (n = 143) published during the same time. Of all research articles reporting prospective studies, 52.5% included generalizations beyond specific national study populations, with the numbers of articles with generics varying significantly between journals (JAMA = 12%; Lancet = 77%) (p < 0.001, V = 0.48). There was no evidence that articles containing broader generalizations or generics were correlated with larger or more nationally diverse samples. Moreover, only 10.2% of articles with generalizations beyond specific national populations reported external validity strengthening factors that could potentially support such extrapolations. There was no evidence that original research articles and NEJM Journal Watch summaries intended for practitioners differed in their use of broad generalizations, including generics. Finally, from the journal with the highest citation impact, articles containing broader conclusions were correlated with more citations. Since there was no evidence that studies with generalizations beyond specific national study populations or with generics were associated with larger, more nationally diverse samples, or with reports of population similarity that may permit extensions of conclusions, our findings suggest that the generalizations in many articles were insufficiently supported. Caution against overly broad generalizations in medical research is warranted. (shrink)

This systematic review is intended to identify the most effective leadership style employed by school heads in achieving quality performance of the teachers, success of the learners, and the overall school success. The study analyzed forty-four (44) research articles to examine the impact of various leadership styles on school outcomes. Findings revealed five distinct leadership styles, with transformational and democratic leadership emerging as the most effective in promoting quality performance and success. While these leadership styles have demonstrated significant benefits, (...) each has unique strengths and limitations, underscoring the importance of situational adaptability. The review highlights that the effective application of these leadership styles should align with the specific needs and circumstances of the school community. Therefore, it is essential for school heads to be well-versed in different leadership approaches and strategically implement them to address the unique challenges and opportunities within their schools. (shrink)

Questionable research practices are a well-recognized problem in psychology. Coding bias, or the tendency of review studies to disproportionately cite positive findings from original research, has received comparatively little attention. Coding bias is more likely to occur when original research, such as neuroimaging, includes large numbers of effects, and is most concerning in applied contexts. We evaluated coding bias in reviews of structural magnetic resonance imaging (sMRI) studies of PCL-R psychopathy. We used PRISMA guidelines to locate all relevant original (...) sMRI studies and reviews. The proportion of null-findings cited in reviews was significantly lower than those reported in original research, indicating coding bias. Coding bias was not affected by publication date or review design. Reviews recommending forensic applications—such as treatment amenability or reduced criminal responsibility—were no more accurate than purely theoretical reviews. Coding bias may have contributed to a perception that structural brain abnormalities in psychopaths are more consistent than they actually are, and by extension that sMRI findings are suitable for forensic application. We discuss possible sources for the pervasive coding bias we observed, and we provide recommendations to counteract this bias in review studies. Until coding bias is addressed, we argue that this literature should not inform conclusions about psychopaths' neurobiology, especially in forensic contexts. (shrink)

Local reports from different international societies have considered the achievement of the successful Glocalized architecture model in line with the 2030 UN Sustainable Development Goals (SDGs). The Aga Khan Cultural Foundation’s International Program for Islamic Architecture has also prioritized the understanding of the success drivers in architectural projects. This study aimed to detect the potentials of the common global indicators to access qualitative design assessment through analyzing the Aga Khan Award’s reports. The selected methodology in the present study is a (...) quantitative approach using the systematic content analysis and coding techniques for qualitative data obtained from the technical. The physical, non-physical, modern, and traditional factors that have contributed to the success of the works as well as their combinations were extracted and analyzed using Sensible and Abstract international, national, and local indications. There is a relative superiority for Sensible indications (A combination of modern and physical factors). The hybrid data distribution provides the ground to assess the works, and this can be used to manage the globalization challenges in the contemporary architecture of Muslim societies. (shrink)

This paper aims to contribute to the ongoing conceptual debate on responsible innovation, and provides innovation practices and processes that can help to implement responsible innovation in the business context. Based on a systematic literature review of 72 empirical scholarly articles, it was possible to identify, analyse and synthesise empirical findings reported in studies on social, sustainable and responsible innovation practices in the business context. The synthesis of the included articles resulted in a refined framework for responsible innovation in (...) the business context. This framework includes an overview of innovation practices and processes that can enhance the dimensions of responsible innovation: anticipation, reflexivity, inclusion, deliberation, responsiveness and knowledge management. Additionally, knowledge gaps are identified and a research agenda for responsible innovation is proposed. This review can therefore serve as a next step in the theoretical and practical development of responsible innovation in general, and in the business context in particular. (shrink)

Academic entrepreneurship and the creation of academic spin-offs are essential pillars for driving innovation and economic development globally. However, the trajectory of these initiatives shows significant differences between developed and emerging countries, such as Colombia. This study conducts a systematic review of articles indexed in Web of Science, using the PRISMA protocol to ensure a rigorous and reproducible selection. From a total of 2,532 articles published in the last decade (2014-2024), 40 were selected according to strict exclusion criteria. The (...) methodology includes an interpretative paradigmatic view and a subjective study, complemented by the visual analysis tool Posit PBC™ for bibliometric analysis in Biblioshyni. The study answers key questions about the evolution of research in this field, the factors that determine the success of spin-offs and the suggested horizon for Colombia in comparison with global trends. -/- The results show a shift from an initial focus on the creation of spin-offs to an increasing attention on their performance and long-term sustainability. Internationally, research underlines the relevance of technology transfer, university-industry collaboration, and efficient management of technological resources as key factors for the success of these initiatives. In contrast, in Colombia, most studies focus on the institutional, cultural and regulatory aspects that facilitate the creation of spin-offs, while the analysis of their performance after creation is less frequent -/- . (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data (...) collection were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

This systematic literature review aims to address some critical questions in interdisciplinary STEM education. Specifically, this study endeavors to determine how STEM education has been implemented in the K-12 and higher education settings, which are the major target of this review, in the time range of 2016 to 2024. Within this time frame, I will utilize PRISMA’S systematic review procedures to conduct an analysis of peer-reviewed articles databases such as ERIC, Web of Science, Scopus, IEEE Xplore Digital Library, (...) Science Direct and Google Scholar. Articles from these databases would be analyzed through the use of Boolean oppositions of texts connected to education 5.0, STEM education as well as interdisciplinary approaches. There are tangible outcomes on student participation, improved retention, and development of timely necessary and relevant skills such as advanced ICT understands, intricate problem solving, and teamwork. Inadequate curriculum development policies, lack of curriculum policies, trained personnel and poor resource provision limited the development of the said framework. The review concludes that while interdisciplinary STEM education effectively prepares students for contemporary challenges and aligns with UN Sustainable Development Goals, successful implementation requires systematic institutional support and robust infrastructure. Recommendations include developing age-appropriate integrated curricula, establishing teacher collaboration networks, and conducting longitudinal research to assess long-term program impacts on student outcomes and career readiness. (shrink)

Despite the large number of sheep in Ethiopia, their productivity remains low, mainly due to inadequate and poor-quality feed. Therefore, this systematic review and meta-analysis study was conducted to evaluate the effect of dietary supplements on the growth performance and carcass yield indices of indigenous sheep in Ethiopia. This study included a total of 21 studies that used 533 sheep from 11 breeds. We used Meta-Essentials Version 1.5 to determine the effect sizes in a mixed-effects model at p < (...) 0.05. The current meta-analyses revealed that dietary supplements had a positive and significant effect (p of Z ≤ 0.001) on the total dry matter intake (Hedges' g = 6.84 g/day/head), final body weight (Hedges' g = 3.65 kg/head), average daily gain (Hedges' g = 3.59 g/head), feed conversion efficiency (Hedges' g = 0.72 g/g), slaughter weight (Hedges' g = 2.56 kg/head) and hot carcass (Hedges' g = 2.73 kg/head) of sheep compared to the control. The meta-analysis suggests that sheep of different breeds and sexes that were fed supplemental diets responded differently. In addition, the subgroup analysis declared that dietary supplementation of legumes resulted in a higher magnitude of effect sizes for all response variables in sheep in comparison to sheep supplemented with concentrate and browse. We detected diverse heterogeneity across studies for all response variables that ranged between 0% and 96.65%. It can be concluded that dietary supplements had a positive and significant impact on feed efficiency, growth performance and carcass yield in indigenous sheep, particularly Afar sheep, followed by Arsi Bale and Washera sheep, in Ethiopia. (shrink)

This systematic literature review offers valuable perspectives on the challenges faced by educational administrators amidst COVID-19, shedding light on key themes and concerns that arose during this unprecedented period. By focusing on emerging trends in school leaders' experiences, this study not only informs future research but also provides guidance for academic and educational practices. Drawing upon an analysis of 16 articles from peerreviewed publications spanning the period from 2010 to 2021, this review provides a comprehensive overview of research themes, (...) approaches, settings, and school management systems related to the Covid-19 pandemic. Notably, most of the articles were published in the Journal of School Administration Research and Development, reflecting a significant scholarly interest in this topic. Additionally, almost half of the studies were conducted in the United States, indicating a geographical concentration of research efforts in this area. The analysis reveals that the primary focus of the literature centers around technological support and the professional development of teachers, highlighting the critical role of these factors in navigating the challenges posed by the pandemic. Moreover, the predominant use of phenomenological design and structured interviews among principals and school administrators underscores the qualitative nature of much of the research in this field. While this review offers valuable insights, it is essential to acknowledge its limitations, including potential biases in the selection of articles and the evolving nature of the Covid19 pandemic. Future research endeavors could consider longitudinal studies to track the long-term impacts of the pandemic on educational leadership and to identify strategies for resilience and adaptation in the face of ongoing challenges. This research contributes significantly to our understanding of the difficulties encountered by school leaders throughout the COVID-19 crisis and provides valuable insights that can inform future educational practices and policies. (shrink)

the current research was conducted with the aim of investigating the applications and challenges of metaverse in education. This research was qualitative and its method was a systematic review based on the Prisma protocol. The scope of the current research was scientific and research articles published in domestic and foreign valid journals in Persian from 1398 to 1402 and English from 2020 to 2024 in the field of metaverse and education. The statistical sample was selected using a targeted method (...) and 38 items were selected from among 900 articles and included in the study. The research findings indicate that remote learning, immersion learning, collaborative learning, personalized learning, flipped learning, student-centered learning, experiential learning, hybrid learning, mobile learning, simulated learning, skill-based learning and Borderless and question-based learning are the most common uses of metaverse in education. However, the metaverse is associated with technical, ethical and social challenges such as the nascent nature of the technology, high cost of equipment, weak support infrastructure, inaccessibility to everyone, violation of privacy, data and network security, lack of legal guidelines and regulations. By using the results of this research, education policymakers can recreate the curriculum and educational plans in accordance with the characteristics of the Z and Alpha generation learners and in line with the development of technology, and the advancements of metaverse technology, and by formulating the strategic plan of the educational system, they can face the created environment and the necessary platforms in the creation and development of technological infrastructures. provide and manage it in a responsible manner. (shrink)

The integration of Software-Defined Networking (SDN) and Network Functions Virtualization (NFV) has emerged as a promising approach to optimize the performance and management of IoT systems, especially in edge-cloud computing environments. SDN provides centralized control and programmability, while NFV enables the virtualization of network functions, enhancing network flexibility and scalability. This paper presents a systematic review of SDN and NFV architectures for Edge-Cloud oriented IoT applications. We explore their benefits, challenges, and the synergy between SDN and NFV in enabling (...) efficient data processing, resource management, and reduced latency in IoT systems. Through an extensive analysis of the literature, we highlight existing solutions, identify open issues, and propose directions for future research in this domain. (shrink)

A distorted representation of one's own body is a diagnostic criterion and core psychopathology of both anorexia nervosa (AN) and bulimia nervosa (BN). Despite recent technical advances in research, it is still unknown whether this body image disturbance is characterized by body dissatisfaction and a low ideal weight and/or includes a distorted perception or processing of body size. In this article, we provide an update and meta-analysis of 42 articles summarizing measures and results for body size estimation (BSE) from 926 (...) individuals with AN, 536 individuals with BN and 1920 controls. We replicate findings that individuals with AN and BN overestimate their body size as compared to controls (ES= 0.63). Our meta-regression shows that metric methods (BSE by direct or indirect spatial measures) yield larger effect sizes than depictive methods (BSE by evaluating distorted pictures), and that effect sizes are larger for patients with BN than for patients with AN. To interpret these results, we suggest a revised theoretical framework for BSE that accounts for differences between depictive and metric BSE methods regarding the underlying body representations (conceptual vs. perceptual, implicit vs. explicit). We also discuss clinical implications and argue for the importance of multimethod approaches to investigate body image disturbance. (shrink)

The purpose of this article was focused on analyzing the adjacent factors related to human rights in women victims of sexual violence in the context of the armed conflict. The quantitative method of descriptive approach was selected under the systematic review technique using the PRISMA guide. As a result, it was obtained that women continue to be instrumentalized in wars, their physical and psychosocial vulnerability persisting in all spheres of life; This being a phenomenon that continues to growglobally given (...) the characteristics associated with political, social and religious structures. As a conclusion, it was identified that, although there are jurisprudential guidelines and policies, these are insufficient and do not protect the human rights of women victims. (shrink)

Introduction: Liposomal bupivacaine (LB) is a long-acting analgesic that, due to its liposomal formulation, purportedly extends its analgesic effect up to 72 hours. However, the clinical efficacy of LB appears mixed. This systematic review seeks to evaluate the effectiveness of liposomal bupivacaine in improving postoperative outcomes compared to ropivacaine (ROPI), another commonly used long-acting analgesic. -/- Materials and Methods: Prospective and randomized controlled trials (RCTs) evaluating the efficacy of LB compared to ROPI were selected for review. Primary outcomes included (...) hospital length of stay (LOS) and postoperative opioid consumption measured in oral morphine equivalents (OME). Secondary outcomes included analgesic cost. -/- Results: 14 studies met the review criteria. We found that LB and ROPI are equivalent in managing postoperative pain. 8 of the 14 trials reported equal efficacy between LB and ROPI as determined by OME post-procedure and 10 of the 14 trials reported similar LOS after surgery. These findings remained consistent across multiple surgical procedures and multiple drug administrative modalities. -/- Conclusion: Our systematic review found that LB was not superior to ROPI in reducing postoperative OME use and hospital LOS. The only consistent finding was the significantly increased cost of LB compared to that of ROPI. Therefore, the use of LB over ROPI cannot be justified. (shrink)

Background: When infertility is diagnosed, physicians have the difficult task to break bad news. Their communication skills play a central role in improving patients' coping abilities and adherence to infertility treatments. However, specific guidelines and training courses on this topic are still lacking. The aim of the present study is to provide some practical advice for improving breaking bad news in infertility diagnosis through a systematic literature review of qualitative and quantitative studies. Methods: Electronic searches were performed in the (...) MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Psychology and Behavioral Sciences Collection databases. All articles focusing on the communication of the diagnosis of infertility were included. The main findings of each included article were then summarized. Results: Literature search identified 11,838 references that were screened for eligibility. Full texts of 81 articles were retrieved, and their analysis led to the inclusion of 4 articles, which treated the theme of communication of infertility only partially. The main addressed aspects concerning the communication of the infertility diagnosis were the following: the value that patients give to healthcare professionals' communication skills; the importance of giving clear information on diagnostic procedures and treatments in order to decrease patients' anxiety; and the importance of involving both partners. Conclusions: This review pointed out that the communication of the infertility diagnosis is still underinvestigated. Specific guidelines are currently not available, but other protocols could be used. Taking into account the principal aspects of communication highlighted with this review, in this study, we suggested an adaptation of the original SPIKES protocol that could be used by healthcare professionals for the communication of the infertility status. (shrink)

Several quantitative surveys have been conducted internationally to gather empirical information about physicians’ general attitudes towards health care rationing. Are physicians ready to accept and implement rationing, or are they rather reluctant? Do they prefer implicit bedside rationing that allows the physician–patient relationship broad leeway in individual decisions? Or do physicians prefer strategies that apply explicit criteria and rules?

This paper presents the results of a systematic literature review examining the evolution of contemporary Theories of Justice, Egalitarianism, and the Principle of Equality of Opportunity in Latin American countries from 2014 to 2024. It seeks to contribute perspectives from the Global South to the philosophical field, thereby enriching the dialogue on how egalitarian justice operates across diverse contexts. The study used three academic databases: Scopus, Web of Science, and Google Scholar. A total of 864 articles were initially identified, (...) and after applying the PRISMA methodology, 64 papers were selected according to the established criteria. The analysis reveals that these works reflect a distinctly Latin American approach characterized by: Intrinsic Pluralist Egalitarianism (relational-distributive), Decolonial and Feminist Theoretical Influence, and Pragmatic Equality of Opportunity. (shrink)

The digital transformation across industries has given rise to an ever-increasing reliance on cloud computing, enabling scalable, on-demand access to storage and computational resources. However, while cloud services have revolutionized the way data is managed and accessed, they also pose critical concerns related to trust, transparency, data privacy, and centralized control. Blockchain, with its decentralized and tamper-resistant ledger, emerges as a promising solution to overcome these limitations. Integrating blockchain with cloud computing is gaining significant traction in academia and industry as (...) it can ensure secure, transparent, and verifiable operations within cloud infrastructures. The convergence of these two technologies forms a new paradigm that enhances data integrity, authentication, and secure sharing in cloud-based environments. This paper presents a comprehensive survey of the integration of blockchain and cloud computing, highlighting recent research contributions, architectural models, security enhancements, and the challenges that must be addressed to realize their full potential. (shrink)

X-linked hypophosphatemia is a rare genetic disorder caused by a loss-of-function mutation in the phosphate-regulating gene with homologies to endopeptidases on the X chromosome. It is characterized by early-onset skeletal deformities, hypophosphatemia, and elevated fibroblast growth factor 23 levels. The following mutations lead to recurrent fractures, osteoarthritis, joint stiffness, and a reduced life expectancy. Burosumab, a human monoclonal antibody, is considered a breakthrough in the treatment of X-linked hypophos-phatemia. MEDLINE, Cochrane Library, CENTRAL, Google Scholar, and were searched from inception through (...) March 3rd, 2025. Overall, eight clinical trials investigating the effectiveness and safety of Burosumab in patients with X-linked hypophosphatemia were identified using the PRISMA guidelines. Out of which two randomized controlled trials exhibited a significant increase in serum phosphate. The other five single-arm studies reported instability in serum phosphate levels with variability in the dosing regimen. Furthermore, other primary outcomes; 1,25 dihydroxy vitamin D, serum calcium, and tubular maximum reabsorption of phosphate to glomerular filtration markedly optimized. Secondary outcomes assessing bone pain and ambulation indicated lower scores on the Brief Pain Inventory and Western Ontario and McMaster Universities Arthritis Index. Burosumab was well-tolerated by all participants, with only mild to moderate adverse events reported. The findings indicate significant improvement in levels of key biochemical markers; serum phosphate concentration, tubular maximum reabsorption of phosphate to glomerular filtration, 1,25 dihydroxy vitamin D after Burosumab use. A decrease in the level of pain and stiffness in joints was reported through the Brief Pain Inventory and Western Ontario and McMaster Universities Arthritis Index in most studies. Burosumab was well tolerated by participants from all included studies. (shrink)

This systematic literature review examines the effectiveness of Grammarly as an Automated Writing Evaluation (AWE) tool for improving the writing skills of English as a Second Language (ESL) and English as a Foreign Language (EFL) students. Drawing on 10 studies published between 2018 and 2024, the review assesses Grammarly’s key features, benefits, and limitations. Results show that Grammarly significantly reduces grammatical errors, enhances students’ writing confidence, and fosters autonomous learning. However, challenges such as over-reliance on the tool and its (...) limited capacity to provide comprehensive feedback on higher-order writing skills remain. The review underscores the need for further research into Grammarly’s long-term effects on writing development, particularly its efficacy across various academic disciplines and contexts. (shrink)

Influenza virus (H1N1) caused seasonal influenza, is an acute respiratory infection that spreads to whole worldwide. The first case of influenza A virus pandemics in India came to light in May 2009 in Hyderabad city of Telangana. Human-to-human transmission led to considerable morbidity and mortality within the country until December.The total number of seasonal influenza cases in India from the year 2010 to 31st July 2020 is 1,73,488. Decreasing ambient temperature is often associated with influenza weather. The viral particle's ability (...) to survive long term in cold temperatures also plays an important role. Besides, coagulation during winter serves as a co-contributing factor in facilitating the spread of the influenza virus. The environmental temperature leads to physical stress and energy loss due to thermal regulation, which weakens the immune system and thereby increases the host's likelihood of infection. The prevention of epidemics in India was possible only by quick and efficient measures taken by the Government.Soon after cases were registered at Pune, Maharashtra, and other places across the country, steps were taken to revise the guidelines for the control of the disease in India.Classification of cases in health facilities and home environments, classification of cases, providing treatment to appropriate persons, public education, and other appropriate measures proved to be very effective in due course of time. In this paper, we discussed the total cases and mortality due to seasonal influenza virus in the states and union territories in India from the year 2010 to the year 2020. (shrink)

With the rise and public accessibility of AI-enabled decision-support systems, individuals outsource increasingly more of their decisions, even those that carry ethical dimensions. Considering this trend, scholars have highlighted that uncritical deference to these systems would be problematic and consequently called for investigations of the impact of pertinent technology on humans’ ethical decision-making. To this end, this article conducts a systematic review of existing scholarship and derives an integrated framework that demonstrates how intelligent decision-support systems (IDSSs) shape humans’ ethical (...) decision-making. In particular, we identify resulting consequences on an individual level (i.e., deliberation enhancement, motivation enhancement, autonomy enhancement and action enhancement) and on a societal level (i.e., moral deskilling, restricted moral progress and moral responsibility gaps). We carve out two distinct methods/operation types (i.e., processoriented and outcome-oriented navigation) that decision-support systems can deploy and postulate that these determine to what extent the previously stated consequences materialize. Overall, this study holds important theoretical and practical implications by establishing clarity in the conceptions, underlying mechanisms and (directions of) influences that can be expected when using particular IDSSs for ethical decisions. (shrink)

Purpose. Although the dynamic capability concept has been one of the most researched topics in strategic management in recent years, it is not commonly defined in theory and hardly applied in practice. For this reason, the authors decided to re-evaluate dynamic capability literature. -/- Design/Method/Approach. Systematic literature review. -/- Findings. Various discrepancies concerning the very nature of dynamic capabilities and their impact on firm performance are identified that need to be resolved. -/- Theoretical implications. For the purpose of enabling (...) more precise prediction, it is recommended to contrast various dynamic capability concepts, reducing the number and increasing the predictability of the contingencies involved. It is advised to develop these scenarios based on the various seminal papers on dynamic capabilities, grounded in empirical research and supported by specific examples. -/- Practical implication. It is concluded that there is a generalized version of the dynamic capability concept that allows one to understand the rough outline of dynamic capability theory. However, it is noted that this generalized, contingency-based version compromises the prediction of specific dynamic capability deployment outcomes, therefore hindering dynamic capabilities in gaining practical application. -/- Originality/Value. Complementary and opposing views on the characteristics, causalities and contingencies of the dynamic capability construct are combined and contrasted respectively. -/- Research limitations/Future research. The paper highlights avenues for further research by contrasting, rather than merging, different perspectives. -/- Paper type – сonceptual. (shrink)

Research into the factors influencing university-industry collaboration on public university spin offs creation has focused on management, entrepreneurship, technology and innovation. This research began with a careful systematic literature review of 4427 scientific papers published in the last ten years (2014–2023) and accessible in the prestigious Web of Science core collection. A quantitative methodology was used, complemented by the use of the visual analysis tool Posit PBC™, formerly known as R Cloud Studio. This comprehensive approach facilitated the seamless ingestion (...) of raw data into Biblioshyni, which is a web-based platform specialised in bibliometric analysis. This review has revealed compelling trends, particularly in terms of increasing diversity, the emergence of United Kingdom as a major player, and the central role of university-industry collaboration. Our systematic review identified influential authors in the field, including the prolific contributions of scholars such as D. Radicid, S. Ropers, Y. Li and R. Owen. We also identified important research institutions, such as Utrecht University in Netherlands, Lund University in Sweden and The University of Manchester in the UK. In addition, we have shown that countries such as the United Kingdom, China and USA have made a significant contribution to the volume of publications. The results highlighted a marked increase in the phenomenon of univeristy spin-offs over the past decade, as evidenced by the exponential growth in both publication output and citation rates. This empirical revelation was underpinned by a rigorous exploration of the Web of Science database, using a carefully crafted set of keywords. Thirty-seven pivotal studies were selected for in-depth review through a sophisticated selection process that adhered to the rigorous standards of the PRISMA methodology. The aim of this review is to improve understanding and encourage deeper exploration of spin-off-based public universities through collaboration between academia and industry. (shrink)

This systematic literature review investigates the role of cybergogy in enhancing reading comprehension among high school students, driven by the increasing use of digital tools in education. The review analyzed 25 studies, revealing that cybergogy offers significant benefits, such as the practical use of digital tools, flexible learning environments, and improved teaching quality. However, it also identifies several challenges, including digital distractions, insufficient foundational reading skills, logistical and technological constraints, and the dual impact of technology on reading habits. These (...) findings underscore the necessity for a balanced approach to integrating cybergogy, emphasizing the need for targeted interventions to address the identified challenges, enhanced professional development for educators, and improved technological infrastructure. By focusing on these areas, schools can make better use of cybergogy to improve reading skills and help students succeed academically. (shrink)

Book review of David Armstrong's "Sketch for a Systematic Metaphysics", written in Spanish. || Reseña del libro "Sketch for a Sytematic Metaphysics", escrito por David Armstrong.

This systematic literature review generally aims to determine the impact of Education 5.0 on college educators. Specifically, it sought to evaluate the influence of advanced digital technologies when integrated into college teaching, identify the global challenges and benefits of Education 5.0, and highlight gaps in long-term research on its effects on educators' professional growth and adaptation. This study utilized the Systematic Literature Review (SLR) with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Findings underscored the (...) necessity for the transformative impact of Education 5.0 on teaching methods, continuous professional upskilling, and a strong foundation of technologies for instruction. It can be concluded that integrating advanced digital technologies like AI, VR, and AR into college teaching enhances student engagement and supports the principles of Constructivist Learning Theory by fostering interactive, effective, and student-centered learning environments (Gupta et al., 2020; Johnson & Wang, 2021; Nguyen & Vo, 2022). (shrink)

Data subject rights provide data controllers with obligations that can help with transparency, giving data subjects some control over their personal data. To date, a growing number of researchers have used these data subject rights as a methodology for data collection in research studies. No one, however, has gathered and analysed different academic research studies that use data subject rights as a methodology for data collection. To this end, we conducted a systematic literature review that searched, compiled, and analysed (...) 32 academic studies that use data subject rights as a data collection method. We find that the right of access is the most commonly-used data subject right by researchers, most studies are interested in measuring data subject rights compliance, and that a variety of difficulties exist in conducting research studies with data subject rights. We conclude that researchers should explore other data subject rights for alternative purposes, ease the process of exercising data subject rights, and improve the scalability of these studies. (shrink)