Search results for: Systematic Literature Review
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9916

Search results for: Systematic Literature Review

9016 'Explainable Artificial Intelligence' and Reasons for Judicial Decisions: Why Justifications and Not Just Explanations May Be Required

Authors: Jacquelyn Burkell, Jane Bailey

Abstract:

Artificial intelligence (AI) solutions deployed within the justice system face the critical task of providing acceptable explanations for decisions or actions. These explanations must satisfy the joint criteria of public and professional accountability, taking into account the perspectives and requirements of multiple stakeholders, including judges, lawyers, parties, witnesses, and the general public. This research project analyzes and integrates two existing literature on explanations in order to propose guidelines for explainable AI in the justice system. Specifically, we review three bodies of literature: (i) explanations of the purpose and function of 'explainable AI'; (ii) the relevant case law, judicial commentary and legal literature focused on the form and function of reasons for judicial decisions; and (iii) the literature focused on the psychological and sociological functions of these reasons for judicial decisions from the perspective of the public. Our research suggests that while judicial ‘reasons’ (arguably accurate descriptions of the decision-making process and factors) do serve similar explanatory functions as those identified in the literature on 'explainable AI', they also serve an important ‘justification’ function (post hoc constructions that justify the decision that was reached). Further, members of the public are also looking for both justification and explanation in reasons for judicial decisions, and that the absence of either feature is likely to contribute to diminished public confidence in the legal system. Therefore, artificially automated judicial decision-making systems that simply attempt to document the process of decision-making are unlikely in many cases to be useful to and accepted within the justice system. Instead, these systems should focus on the post-hoc articulation of principles and precedents that support the decision or action, especially in cases where legal subjects’ fundamental rights and liberties are at stake.

Keywords: explainable AI, judicial reasons, public accountability, explanation, justification

Procedia PDF Downloads 111
9015 Exploring Methods and Strategies for Sustainable Urban Development

Authors: Klio Monokrousou, Maria Giannopoulou

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Urban areas, as they have been developed and operate today, are areas of accumulation of a significant amount of people and a large number of activities that generate desires and reasons for traveling. The territorial expansion of the cities as well as the need to preserve the importance of the central city areas lead to the continuous increase of transportation needs which in the limited urban space results in creating serious traffic and operational problems. The modern perception of urban planning is directed towards more holistic approaches and integrated policies that make it economically competitive, socially just and more environmentally friendly. Over the last 25 years, the goal of sustainable transport development has been central to the agenda of any plan or policy for the city. The modern planning of urban space takes into account the economic and social aspects of the city and the importance of the environment to sustainable urban development. In this context, the European Union promotes direct or indirect related interventions according to the cohesion and environmental policies; many countries even had the chance to actually test them. This paper is part of a wider research still in progress and it explores the methods and processes that have been developed towards this direction and presents a review and systematic presentation of this work. The ultimate purpose of this research is to effectively use this review to create a decision making methodological framework which can be the basis of a useful operational tool for sustainable urban planning.

Keywords: methods, sustainable urban development, urban mobility, methodological framework

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9014 Design an Assessment Model of Research and Development Capabilities with the New Product Development Approach: A Case Study of Iran Khodro Company

Authors: Hamid Hanifi, Adel Azar, Alireza Booshehri

Abstract:

In order to know about the capability level of R & D units in automotive industry, it is essential that organizations always compare themselves with standard level and higher than themselves so that to be improved continuously. In this research, with respect to the importance of this issue, we have tried to present an assessment model for R & D capabilities having reviewed on new products development in automotive industry of Iran. Iran Khodro Company was selected for the case study. To this purpose, first, having a review on the literature, about 200 indicators effective in R & D capabilities and new products development were extracted. Then, of these numbers, 29 indicators which were more important were selected by industry and academia experts and the questionnaire was distributed among statistical population. Statistical population was consisted of 410 individuals in Iran Khodro Company. We used the 410 questionnaires for exploratory factor analysis and then used the data of 308 questionnaires from the same population randomly for confirmatory factor analysis. The results of exploratory factor analysis led to categorization of dimensions in 9 secondary dimensions. Naming the dimensions was done according to a literature review and the professors’ opinion. Using structural equation modeling and AMOS software, confirmatory factor analysis was conducted and ultimate model with 9 secondary dimensions was confirmed. Meanwhile, 9 secondary dimensions of this research are as follows: 1) Research and design capability, 2) Customer and market capability, 3) Technology capability, 4) Financial resources capability, 5) Organizational chart, 6) Intellectual capital capability, 7) NPD process capability, 8) Managerial capability and 9) Strategy capability.

Keywords: research and development, new products development, structural equations, exploratory factor analysis, confirmatory factor analysis

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9013 Review on Wear Behavior of Magnesium Matrix Composites

Authors: Amandeep Singh, Niraj Bala

Abstract:

In the last decades, light-weight materials such as magnesium matrix composites have become hot topic for material research due to their excellent mechanical and physical properties. However, relatively very less work has been done related to the wear behavior of these composites. Magnesium matrix composites have wide applications in automobile and aerospace sector. In this review, attempt has been done to collect the literature related to wear behavior of magnesium matrix composites fabricated through various processing techniques such as stir casting, powder metallurgy, friction stir processing etc. Effect of different reinforcements, reinforcement content, reinforcement size, wear load, sliding speed and time have been studied by different researchers in detail. Wear mechanism under different experimental condition has been reviewed in detail. The wear resistance of magnesium and its alloys can be enhanced with the addition of different reinforcements. Wear resistance can further be enhanced by increasing the percentage of added reinforcements. Increase in applied load during wear test leads to increase in wear rate of magnesium composites.

Keywords: hardness, magnesium matrix composites, reinforcement, wear

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9012 Inflation and Unemployment in South Africa: A Review of the Relationship 2000 - 2022

Authors: Chigozie Azunna

Abstract:

Various studies have been carried out in several countries to determine the relationship between inflation and unemployment. The study was carried out to review this relationship in South Africa. Secondary data was obtained from Statistics South Africa, Reserve bank, and other reliable secondary sources to review this relationship. The study incorporated yearly inflation and unemployment data in South Africa from 2000 to 2022 to explain the relationship between inflation and unemployment in South Africa. The study found the relationship to be nonlinear and lacking any significant association or relationship. Various economic schools of thought postulations were incorporated in the review as it is applied to South Africa. Essentially, the Phillips Curve was reviewed in-line with the study objective.

Keywords: inflation and unemployment in south africa, philips curve, monetarists, neo keynesian, new-classical

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9011 Oil Producing Wells Using a Technique of Gas Lift on Prosper Software

Authors: Nikhil Yadav, Shubham Verma

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Gas lift is a common technique used to optimize oil production in wells. Prosper software is a powerful tool for modeling and optimizing gas lift systems in oil wells. This review paper examines the effectiveness of Prosper software in optimizing gas lift systems in oil-producing wells. The literature review identified several studies that demonstrated the use of Prosper software to adjust injection rate, depth, and valve characteristics to optimize gas lift system performance. The results showed that Prosper software can significantly improve production rates and reduce operating costs in oil-producing wells. However, the accuracy of the model depends on the accuracy of the input data, and the cost of Prosper software can be high. Therefore, further research is needed to improve the accuracy of the model and evaluate the cost-effectiveness of using Prosper software in gas lift system optimization

Keywords: gas lift, prosper software, injection rate, operating costs, oil-producing wells

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9010 A Review of Data Visualization Best Practices: Lessons for Open Government Data Portals

Authors: Bahareh Ansari

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Background: The Open Government Data (OGD) movement in the last decade has encouraged many government organizations around the world to make their data publicly available to advance democratic processes. But current open data platforms have not yet reached to their full potential in supporting all interested parties. To make the data useful and understandable for everyone, scholars suggested that opening the data should be supplemented by visualization. However, different visualizations of the same information can dramatically change an individual’s cognitive and emotional experience in working with the data. This study reviews the data visualization literature to create a list of the methods empirically tested to enhance users’ performance and experience in working with a visualization tool. This list can be used in evaluating the OGD visualization practices and informing the future open data initiatives. Methods: Previous reviews of visualization literature categorized the visualization outcomes into four categories including recall/memorability, insight/comprehension, engagement, and enjoyment. To identify the papers, a search for these outcomes was conducted in the abstract of the publications of top-tier visualization venues including IEEE Transactions for Visualization and Computer Graphics, Computer Graphics, and proceedings of the CHI Conference on Human Factors in Computing Systems. The search results are complemented with a search in the references of the identified articles, and a search for 'open data visualization,' and 'visualization evaluation' keywords in the IEEE explore and ACM digital libraries. Articles are included if they provide empirical evidence through conducting controlled user experiments, or provide a review of these empirical studies. The qualitative synthesis of the studies focuses on identification and classifying the methods, and the conditions under which they are examined to positively affect the visualization outcomes. Findings: The keyword search yields 760 studies, of which 30 are included after the title/abstract review. The classification of the included articles shows five distinct methods: interactive design, aesthetic (artistic) style, storytelling, decorative elements that do not provide extra information including text, image, and embellishment on the graphs), and animation. Studies on decorative elements show consistency on the positive effects of these elements on user engagement and recall but are less consistent in their examination of the user performance. This inconsistency could be attributable to the particular data type or specific design method used in each study. The interactive design studies are consistent in their findings of the positive effect on the outcomes. Storytelling studies show some inconsistencies regarding the design effect on user engagement, enjoyment, recall, and performance, which could be indicative of the specific conditions required for the use of this method. Last two methods, aesthetics and animation, have been less frequent in the included articles, and provide consistent positive results on some of the outcomes. Implications for e-government: Review of the visualization best-practice methods show that each of these methods is beneficial under specific conditions. By using these methods in a potentially beneficial condition, OGD practices can promote a wide range of individuals to involve and work with the government data and ultimately engage in government policy-making procedures.

Keywords: best practices, data visualization, literature review, open government data

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9009 Executive Function in Youth With ADHD and ASD: A Systematic Review and Meta-analysis

Authors: Parker Townes, Prabdeep Panesar, Chunlin Liu, Soo Youn Lee, Dan Devoe, Paul D. Arnold, Jennifer Crosbie, Russell Schachar

Abstract:

Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are impairing childhood neurodevelopmental disorders with problems in executive functions. Executive functions are higher-level mental processes essential for daily functioning and goal attainment. There is genetic and neural overlap between ADHD and ASD. The aim of this meta-analysis was to evaluate if pediatric ASD and ADHD have distinct executive function profiles. This review was completed following Cochrane guidelines. Fifty-eight articles were identified through database searching, followed by a blinded screening in duplicate. A meta-analysis was performed for all task performance metrics evaluated by at least two articles. Forty-five metrics from 24 individual tasks underwent analysis. No differences were found between youth with ASD and ADHD in any domain under direct comparison. However, individuals with ASD and ADHD exhibited deficient attention, flexibility, visuospatial abilities, working memory, processing speed, and response inhibition compared to controls. No deficits in planning were noted in either disorder. Only 11 studies included a group with comorbid ASD+ADHD, making it difficult to determine whether common executive function deficits are a function of comorbidity. Further research is needed to determine if comorbidity accounts for the apparent commonality in executive function between ASD and ADHD.

Keywords: autism spectrum disorder, ADHD, neurocognition, executive function, youth

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9008 Woman: Her Identity and Strive for Existence Reflected English Literature

Authors: Diksha Kadam

Abstract:

The study of images of women in literature and women writers has been a significant area of concern for the last four decades because it is as ‘the study of signification and meaning production’ play a vital role in shaping the perceptions and consciousness of various segment of society in relation to the lives, roles, problems and experiences of different categories of women as women and as autonomous citizen of society. In the history of worlds English literature the status of women and representation of her in the writings is an issue of discussion always. The essence of her existence in the literature is felt; the ecstasy of her feelings is always seen. The literature is full of facts and figures. She is one of them. Her contribution to the literature is undoubtedly a beginning of a new era. Multiple challenges and multiple identities as represented in majority of the literary texts and in real provide much hope and assurance to the new generation of mothers and daughters in the direction of transformation of the individual and collective consciousness of society paving way for the emergence of an actually empowered new woman. This paper will focus on some of the prominent Indian and American women writers in English literature and the various dimensions of her image through some of the prominent works. This attempt of mine will be merely a salute to those women who have struggled to prove their identity as one of the members of society.

Keywords: role of women’s writing, new era, contribution to the literature, consciousness, existence

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9007 Review of Electronic Voting as a Panacea for Election Malpractices in Nigerian Political System: Challenges, Benefits, and Issues

Authors: Muhammad Muhammad Suleiman

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The Nigerian political system has witnessed rising occurrences of election malpractice in the last decade. This has been due to election rigging and other forms of electoral fraud. In order to find a sustainable solution to this malpractice, the introduction of electronic voting (e-voting) has been suggested. This paper reviews the challenges, benefits, and issues associated with e-voting as a panacea for election malpractice in Nigeria. The review of existing literature revealed that e-voting can reduce the cost of conducting elections and reduce the opportunity for electoral fraud. The review suggests that the introduction of e-voting in the Nigerian political system would require adequate cybersecurity measures, trust-building initiatives, and proper legal frameworks to ensure its successful implementation. It is recommended that there should be an effective policy that would ensure the security of the system as well as the credibility of the results. Furthermore, a comprehensive awareness campaign needs to be conducted to ensure that voters understand the process and are comfortable using the system. In conclusion, e-voting has the potential to reduce the occurrence of election malpractice in the Nigerian political system. However, the successful implementation of e-voting will require effective policy interventions and trust-building initiatives. Additionally, the costs of acquiring the necessary infrastructure and equipment and implementing proper legal frameworks need to be considered.

Keywords: electronic voting, general election, candidate, INEC, cyberattack

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9006 A Literature Review on the Effect of Financial Knowledge toward Corporate Growth: The Important Role of Financial Risk Attitude

Authors: Risna Wijayanti, Sumiati, Hanif Iswari

Abstract:

This study aims to analyze the role of financial risk attitude as a mediation between financial knowledge and business growth. The ability of human resources in managing capital (financial literacy) can be a major milestone for a company's business to grow and build its competitive advantage. This study analyzed the important role of financial risk attitude in bringing about financial knowledge on corporate growth. There have been many discussions arguing that financial knowledge is one of the main abilities of corporate managers in determining the success of managing a company. However, a contrary argument of other scholars also enlightened that financial knowledge did not have a significant influence on corporate growth. This study used literatures' review to analyze whether there is another variable that can mediate the effect of financial knowledge toward corporate growth. Research mapping was conducted to analyze the concept of risk tolerance. This concept was related to people's risk aversion effects when making a decision under risk and the role of financial knowledge on changes in financial income. Understanding and managing risks and investments are complicated, in particular for corporate managers, who are always demanded to maintain their corporate growth. Substantial financial knowledge is extremely needed to identify and take accurate information for corporate financial decision-making. By reviewing several literature, this study hypothesized that financial knowledge of corporate managers would be meaningless without manager's courage to bear risks for taking favorable business opportunities. Therefore, the level of risk aversion from corporate managers will determine corporate action, which is a reflection of corporate-level investment behavior leading to attain corporate success or failure for achieving the company's expected growth rate.

Keywords: financial knowledge, financial risk attitude, corporate growth, risk tolerance

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9005 The Role of a Specialized Diet for Management of Fibromyalgia Symptoms: A Systematic Review

Authors: Siddhant Yadav, Rylea Ranum, Hannah Alberts, Abdul Kalaiger, Brent Bauer, Ryan Hurt, Ann Vincent, Loren Toussaint, Sanjeev Nanda

Abstract:

Background and significance: Fibromyalgia (FM) is a chronic pain disorder also characterized by chronic fatigue, morning stiffness, sleep, and cognitive symptoms, psychological disturbances (anxiety, depression), and is comorbid with multiple medical and psychiatric conditions. It has an incidence of 2-4% in the general population and is reported more commonly in women. Oxidative stress and inflammation are thought to contribute to pain in patients with FM, and the adoption of an antioxidant/anti-inflammatory diet has been suggested as a modality to alleviate symptoms. The aim of this systematic review was to evaluate the efficacy of specialized diets (ketogenic, gluten free, Mediterranean, and low carbohydrate) in improving FM symptoms. Methodology: A comprehensive search of the following databases from inception to July 15th, 2021, was conducted: Ovid MEDLINE and Epub ahead of print, in-process and other non-indexed citations and daily, Ovid Embase, Ovid EBM reviews, Cochrane central register of controlled trials, EBSCO host CINAHL with full text, Elsevier Scopus, website and citation index, web of science emerging sources citation and clinicaltrials.gov. We included randomized controlled trials, non-randomized experimental studies, cross-sectional studies, cohort studies, case series, and case reports in adults with fibromyalgia. The risk of bias was assessed with the Agency for Health Care Research and Quality designed, specific recommended criteria (AHRQ). Results: Thirteen studies were eligible for inclusion. This included a total of 761 participants. Twelve out of the 13 studies reported improvement in widespread body pain, joint stiffness, sleeping pattern, mood, and gastrointestinal symptoms, and one study reported no changes in symptomatology in patients with FM on specialized diets. None of the studies showed the worsening of symptoms associated with a specific diet. Most of the patient population was female, with the mean age at which fibromyalgia was diagnosed being 48.12 years. Improvement in symptoms was reported by the patient's adhering to a gluten-free diet, raw vegan diet, tryptophan- and magnesium-enriched Mediterranean diet, aspartame- and msg- elimination diet, and specifically a Khorasan wheat diet. Risk of bias assessment noted that 6 studies had a low risk of bias (5 clinical trials and 1 case series), four studies had a moderate risk of bias, and 3 had a high risk of bias. In many of the studies, the allocation of treatment (diets) was not adequately concealed, and the researchers did not rule out any potential impact from a concurrent intervention or an unintended exposure that might have biased the results. On the other hand, there was a low risk of attrition bias in all the trials; all were conducted with an intention-to-treat, and the inclusion/exclusion criteria, exposures/interventions, and primary outcomes were valid, reliable, and implemented consistently across all study participants. Concluding statement: Patients with fibromyalgia who followed specialized diets experienced a variable degree of improvement in their widespread body pain. Improvement was also seen in stiffness, fatigue, moods, sleeping patterns, and gastrointestinal symptoms. Additionally, the majority of the patients also reported improvement in overall quality of life.

Keywords: fibromyalgia, specialized diet, vegan, gluten free, Mediterranean, systematic review

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9004 A Critical Review of the Success Model of Indian Pharmaceutical Industry

Authors: Ekta Pandey

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The Indian Pharmaceutical Industry is ranked third largest by volume and fourteenth by value. It thus accounts for 10% of world’s production by volume and 1.5% by value according to Department of Pharmaceuticals, Government of India. The industry has shown phenomenal growth over past few years, moving from US $ 1 billion turnover in 1990 to a turnover of around US $30 billion in 2015. The Indian pharmaceutical sector is ranked seventeenth in terms of export value of active pharmaceutical ingredients and dosage forms to more than 200 countries around the globe. It has shown tremendous changes especially after Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement. Recognizing the immense potential for growth and its direct impact on Indian economy, it is important to look up the industrial policies adopted since Indian independence which turnaround the Indian pharmaceutical industry. A systematic review of changes in market structure of Indian pharmaceutical industry due to shift in policy regimes is done from 1850 to 2015 using secondary peer reviewed published research work. The aim is to understand the impact of anti-trust laws, intellectual property rights, industry competition acts and regulations are quite crucial in determining effective economic policy and have overall lasting effects on international trade and ties. The proposed paper examines the position of Indian domestic firms relative to multinational pharmaceutical firms tries to throw some light on the growth curve of Indian pharmaceutical sector.

Keywords: active pharmaceutical ingredients, competition act, pharmaceutical industry, TRIPS

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9003 The Efficacy of Preoperative Thermal Pulsation Treatment in Reducing Post Cataract Surgery Dry Eye Disease: A Systematic Review and Meta-analysis

Authors: Lugean K. Alomari, Rahaf K. Sharif, Basil K. Alomari, Hind M. Aljabri, Faisal F. Aljahdali, Amal A. Alomari, Saeed A. Alghamdi

Abstract:

Background: The thermal pulsation system is a therapy that uses heat and massage to treat dry eye disease; thus, some trials have been published to compare it with the conventional treatment. The aim of this study is to conduct a systematic review and meta-analysis comparing the efficacy of thermal pulsation systems with conventional treatment in patients undergoing cataract surgery. Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for eligible trials. We included three randomized controlled trials (RCTs) that compared the thermal pulsation system with the conventional treatment in patients undergoing cataract surgery. A table of characteristics was plotted, and the Quality of the studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Forest plots were plotted using the Random-effect Inverse Variance method. χ2 test and the Higgins-I-squared (I2) model were used to assess heterogeneity. A total of 201 cataract surgery patients were included, with 105 undergoing preoperative pulsation therapy and 96 receiving conventional treatment. Demographic analysis revealed comparable distributions across groups. Results: All the studies in our analysis are of good quality with a low risk of bias. A total of 201 patients were included in the analysis, out of which 105 underwent pulsation therapy, and 95 were in the control group. Tear Break-up Time (TBUT) analysis revealed no significant baseline differences, except pulsation therapy being better at 1 month. (SMD 0.42 [95%CI 0.14 - 0.70] p=0.004). This positive trend continued at three months (SMD 0.52 [95% CI (0.20 – 0.84)] p=0.002). Corneal fluorescein staining scores and Meibomian gland-yielding secretion scores showed no significant differences at baseline. However, at one month, pulsation therapy significantly improved Meibomian gland function (SMD -0.86 [95% CI (-1.20 - -0.53)] p<0.00001), indicating a reduced risk of dry eye syndrome. Conclusion: Preoperative pulsation therapy appears to enhance post-cataract surgery outcomes, particularly in terms of tear film stability and Meibomian gland secretory function. The sustained positive effects observed at one and three months post-surgery suggest the potential for long-term benefits.

Keywords: lipiflow, cataract, thermal pulsation, dry eye

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9002 Designing the Maturity Model of Smart Digital Transformation through the Foundation Data Method

Authors: Mohammad Reza Fazeli

Abstract:

Nowadays, the fourth industry, known as the digital transformation of industries, is seen as one of the top subjects in the history of structural revolution, which has led to the high-tech and tactical dominance of the organization. In the face of these profits, the undefined and non-transparent nature of the after-effects of investing in digital transformation has hindered many organizations from attempting this area of this industry. One of the important frameworks in the field of understanding digital transformation in all organizations is the maturity model of digital transformation. This model includes two main parts of digital transformation maturity dimensions and digital transformation maturity stages. Mediating factors of digital maturity and organizational performance at the individual (e.g., motivations, attitudes) and at the organizational level (e.g., organizational culture) should be considered. For successful technology adoption processes, organizational development and human resources must go hand in hand and be supported by a sound communication strategy. Maturity models are developed to help organizations by providing broad guidance and a roadmap for improvement. However, as a result of a systematic review of the literature and its analysis, it was observed that none of the 18 maturity models in the field of digital transformation fully meet all the criteria of appropriateness, completeness, clarity, and objectivity. A maturity assessment framework potentially helps systematize assessment processes that create opportunities for change in processes and organizations enabled by digital initiatives and long-term improvements at the project portfolio level. Cultural characteristics reflecting digital culture are not systematically integrated, and specific digital maturity models for the service sector are less clearly presented. It is also clearly evident that research on the maturity of digital transformation as a holistic concept is scarce and needs more attention in future research.

Keywords: digital transformation, organizational performance, maturity models, maturity assessment

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9001 Tourism and Sport: The Acknowledgment of a Strong Relationship for the Environment Framed in a Literature Review

Authors: Rute Martins, Margarida Mascarenhas, Elsa Pereira

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The importance between sport and the natural environment was researched through a systematic literature in order to analyse the available scientific articles on the association of sport -angling also the physical activity, active leisure and recreation- and environmental behaviour. The collected data were gathered within the last five years (from 2013 to April 2018) in the Scopus, Web of Science, ScienceDirect, Sage, Green Leaf Online Library, GreenFile (EBSCO) and Wiley online Library databases. The content analysis based on the qualitative methods employed in this study was made with Nvivo software. Regarding only the inclusion of scientific articles, more than half of the collected papers highlighted tourism as the main area where sports is being researched with regard to the environmental theme. Thus, it is possible to extract a perspective of the orientations of the ecological concerns in the sports tourism industry. As such, in the winter sports, the climate change is already an identified issue, wondering about the impact of the environment on the sports practice. In this context, there is a focus on the possible adaptative strategies, researching the characteristics of the sports tourist and the winter sports industry. Regarding the natural parks and protected areas (such as reefs), most of the research is on the environmental impact of the sports tourism, choosing the conservation and the protection of nature as the core topics. The research of the sports tourist profile is addressed by many articles, where the motives for practice and the environmental values are being scanned, and relations to the recreation specialization, environmental responsibility, environmental education, and place-attachment concepts are being made. Regarding the sustainable management, the sports tourism study area is approaching the research in a more holistic way; exploring the stakeholder’s interconnection, focusing on landscape planning and environmentally sustainable practices of sport tourism organizations. The natural parks, protected areas, coral reefs, and snow areas serve as the preferred case-studies for investigating the environmental impact and the ecotourism, in particular, studied through hiking and diving in the great majority. The results of the study are a valuable resource to understand the importance of the sports tourism in the environmental and sustainable action along with the need of embracing all stakeholders within the relationship between the sport and the natural environment.

Keywords: ecotourism, environmental behaviour, outdoor recreation, sport tourism

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9000 Customer Involvement in the Development of New Sustainable Products: A Review of the Literature

Authors: Natalia Moreira, Trevor Wood-Harper

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The acceptance of sustainable products by the final consumer is still one of the challenges of the industry, which constantly seeks alternative approaches to successfully be accepted in the global market. A large set of methods and approaches have been discussed and analysed throughout the literature. Considering the current need for sustainable development and the current pace of consumption, the need for a combined solution towards the development of new products became clear, forcing researchers in product development to propose alternatives to the previous standard product development models. This paper presents, through a systemic analysis of the literature on product development, eco-design and consumer involvement, a set of alternatives regarding consumer involvement towards the development of sustainable products and how these approaches could help improve the sustainable industry’s establishment in the general market. The initial findings of the research show that the understanding of the benefits of sustainable behaviour lead to a more conscious acquisition and eventually to the implementation of sustainable change in the consumer. Thus this paper is the initial approach towards the development of new sustainable products using the fashion industry as an example of practical implementation and acceptance by the consumers. By comparing the existing literature and critically analysing it this paper concluded that the consumer involvement is strategic to improve the general understanding of sustainability and its features. The use of consumers and communities has been studied since the early 90s in order to exemplify uses and to guarantee a fast comprehension. The analysis done also includes the importance of this approach for the increase of innovation and ground breaking developments, thus requiring further research and practical implementation in order to better understand the implications and limitations of this methodology.

Keywords: consumer involvement, products development, sustainability, eco-design

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8999 A Literature Review on Bladder Management in Individuals with Spinal Cord Injury

Authors: Elif Ates, Naile Bilgili

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Background: One of the most important medical complications that individuals with spinal cord injury (SCI) face are the neurogenic bladder. Objectives: To review methods used for management of neurogenic bladder and their effects. Methods: The study was conducted by searching CINAHL, Ebscohost, MEDLINE, Science Direct, Ovid, ProQuest, Web of Science, and ULAKBİM National Databases for studies published between 2005 and 2015. Key words used during the search included ‘spinal cord injury’, ‘bladder injury’, ‘nursing care’, ‘catheterization’ and ‘intermittent urinary catheter’. After examination of 551 studies, 21 studies which met inclusion criteria were included in the review. Results: Mean age of individuals in all study samples was 42 years. The most commonly used bladder management method was clean intermittent catheterization (CIC). Compliance with CIC was found to be significantly related to spasticity, maximum cystometric capacity, and the person performing catheterization (p < .05). The main reason for changing the existing bladder management method was urinary tract infections (UTI). Individuals who performed CIC by themselves and who voided spontaneously had better life quality. Patient age, occupation status and whether they performed CIC by themselves or not were found to be significantly associated with depression level (p ≤ .05). Conclusion: As the most commonly used method for bladder management, CIC is a reliable and effective method, and reduces the risk of UTI development. Individuals with neurogenic bladder have a higher prevalence of depression symptoms than the normal population.

Keywords: bladder management, catheterization, nursing, spinal cord injury

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8998 Evaluation of Railway Network and Service Performance Based on Transportation Sustainability in DKI Jakarta

Authors: Nur Bella Octoria Bella, Ayomi Dita Rarasati

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DKI Jakarta is Indonesia's capital city with the 10th highest congestion rate in the world based on the 2019 traffic index. Other than that based on World Air Quality Report in 2019 showed DKI Jakarta's air pollutant concentrate 49.4 µg and the 5th highest air pollutant in the world. In the urban city nowadays, the mobility rate is high enough and the efficiency for sustainability assessment in transport infrastructure development is needed. This efficiency is the important key for sustainable infrastructure development. DKI Jakarta is nowadays in the process of constructing the railway infrastructure to support the transportation system. The problems appearing are the railway infrastructure networks and the service in DKI Jakarta already planned based on sustainability factors or not. Therefore, the aim of this research is to make the evaluation of railways infrastructure networks performance and services in DKI Jakarta regards on the railway sustainability key factors. Further, this evaluation will be used to make the railway sustainability assessment framework and to offer some of the alternative solutions to improve railway transportation sustainability in DKI Jakarta. Firstly a very detailed literature review of papers that have focused on railway sustainability factors and their improvements of railway sustainability, published in the scientific journal in the period 2011 until 2021. Regarding the sustainability factors from the literature review, further, it is used to assess the current condition of railway infrastructure in DKI Jakarta. The evaluation will be using a Likert rate questionnaire and directed to the transportation railway expert and the passenger. Furthermore, the mapping and evaluation rate based on the sustainability factors will be compared to the effect factors using the Analytical Hierarchical Process (AHP). This research offers the network's performance and service rate impact on the sustainability aspect and the passenger willingness for using the rail public transportation in DKI Jakarta.

Keywords: transportation sustainability, railway transportation, sustainability, DKI Jakarta

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8997 An Overview of Suicidality in American Indians and Alaska Natives

Authors: Christopher S. Perez, Kendal C. Boyd

Abstract:

global suicide rates have decreased in recent decades, rates in the United States have increased by 35.2 percent since 1999.American Indians and Alaska Natives (AI/AN) have the highest rates of suicide in the U.S., with approximately 22 suicides per 100,000 people as of 2019. AI/AN have experienced significant historical trauma resulting in disproportionate rates of substance abuse and mental disorders. This literature review aimed to identify the demographic and clinical risk and protective factors for American Indians and Alaska Natives and provide an overview of suicidality in this population. The literature reflected varying definitions of suicidality depending on region, with some AI/AN tribesconceptualizing suicide through a spiritual framework, while others defined suicide in the biomedical sense. Furthermore, AI/AN adults and adolescents experienced higher rates of suicidal ideation when compared to other racial groups. Religious preference, sexual orientation, prior suicidal behavior, psychiatric admission, history of abuse, substance abuse, family history of mental illness, family history of substance abuse, family history of suicidal behaviors, domestic violence, and trauma were discussed as factors related to suicidality. Recommendations included increasing access to and utilization of mental health and medical services, culturally adapting suicide prevention programs to AI/AN communities, increasing support for LGBTQ+ AI/AN, providing opportunities that reinforce ethnic identity, and post-hospitalization follow-up care. The following databases were utilized to obtain peer-reviewed articles for this literature review: Complementary Index, Academic Search Premier, Science Direct, PsycInfo, Social Sciences Citation Index, PsycArticles, PubMed, EbscoHost, and PsycBooks. Articles that examined Native populations outside of the United States did not cite a primary source and/or were published before 1990 were excluded.

Keywords: alaska native, american indian, protective factors, risk factors, suicidality, suicide

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8996 Multitasking Trends and Impact on Education: A Literature Review

Authors: Mohammed Alkahtani, Ali Ahmad, Saber Darmoul, Shatha Samman, Ayoub Al-zabidi, Khaled Ba Matraf

Abstract:

Education systems are complex and involve interactions between humans (teachers and students); media based technologies, lectures, classrooms, etc. to provide educational services. The education system performance is characterized by how well students learn, which is measured using student grades on exams and quizzes, achievements on standardized tests, among others. Advances in portable communications technologies, such as mobile phones, tablets, and laptops, created a different type of classroom, where students seem to engage in more than just the intended learning activities. The performance of more than one task in parallel or in rapid transition is commonly known as multitasking. Several operations in educational systems are performed simultaneously, resulting in a multitasking education environment. This paper surveys existing research on multitasking in educational settings, summarizes literature findings, provides a synthesis of the impact of multitasking on performance, and identifies directions of future research.

Keywords: multitasking, education, education environment, impact

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8995 A Critique of Kenya’s Obsession with Ngugi Winning Literature Nobel Prize

Authors: Alexander Ernesto Khamala Opicho

Abstract:

The month of October in Kenya is full of events and literary speculations. For the past five years it has all been about Ngugi wa Thiong’o a Kenyan novelist winning the Nobel Prize. This goes on with a dint of self senselessness among the people involved. This paper surveys why some Kenyans are keen on Ngugi winning Nobel Prize for literature, and it also shows where and why they are wrong. The paper will end up with a comment on the proper position of African or Kenyan literature in the global literary citizenship.

Keywords: literature, onamastics, cultural Darwinism, obsession, Nobel Prize, denotation

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8994 Virtual Marketing Team Leadership and Burnout: Literature Review, Implications for Managers, and Recommendations for Future Research

Authors: Chad A. Roberts

Abstract:

In the digitally connected world, global virtual teams are increasingly becoming the norm at large, multinational companies. Marketing managers see the positives of virtual teams. They also see the negatives. Employees who work from home may feel isolated, unorganized, and distracted by homelife. These complexities create a phenomenon that leaves virtual team members feeling burnout, a significant issue for marketing leaders and their team members. This paper examines remote worker burnout in global virtual marketing team settings. It provides an overview of the benefits and downsides to remote working marketing teams. The paper presents the literature on remote work stress and burnout, discusses ways marketing leaders can help prevent virtual employee burnout and suggests future research studies.

Keywords: burnout, COVID-19 pandemic, leadership, marketing, remote work, virtual team

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8993 Evaluating Multiple Diagnostic Tests: An Application to Cervical Intraepithelial Neoplasia

Authors: Areti Angeliki Veroniki, Sofia Tsokani, Evangelos Paraskevaidis, Dimitris Mavridis

Abstract:

The plethora of diagnostic test accuracy (DTA) studies has led to the increased use of systematic reviews and meta-analysis of DTA studies. Clinicians and healthcare professionals often consult DTA meta-analyses to make informed decisions regarding the optimum test to choose and use for a given setting. For example, the human papilloma virus (HPV) DNA, mRNA, and cytology can be used for the cervical intraepithelial neoplasia grade 2+ (CIN2+) diagnosis. But which test is the most accurate? Studies directly comparing test accuracy are not always available, and comparisons between multiple tests create a network of DTA studies that can be synthesized through a network meta-analysis of diagnostic tests (DTA-NMA). The aim is to summarize the DTA-NMA methods for at least three index tests presented in the methodological literature. We illustrate the application of the methods using a real data set for the comparative accuracy of HPV DNA, HPV mRNA, and cytology tests for cervical cancer. A search was conducted in PubMed, Web of Science, and Scopus from inception until the end of July 2019 to identify full-text research articles that describe a DTA-NMA method for three or more index tests. Since the joint classification of the results from one index against the results of another index test amongst those with the target condition and amongst those without the target condition are rarely reported in DTA studies, only methods requiring the 2x2 tables of the results of each index test against the reference standard were included. Studies of any design published in English were eligible for inclusion. Relevant unpublished material was also included. Ten relevant studies were finally included to evaluate their methodology. DTA-NMA methods that have been presented in the literature together with their advantages and disadvantages are described. In addition, using 37 studies for cervical cancer obtained from a published Cochrane review as a case study, an application of the identified DTA-NMA methods to determine the most promising test (in terms of sensitivity and specificity) for use as the best screening test to detect CIN2+ is presented. As a conclusion, different approaches for the comparative DTA meta-analysis of multiple tests may conclude to different results and hence may influence decision-making. Acknowledgment: This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014-2020» in the context of the project “Extension of Network Meta-Analysis for the Comparison of Diagnostic Tests ” (MIS 5047640).

Keywords: colposcopy, diagnostic test, HPV, network meta-analysis

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8992 The Efficacy of Lithium vs. Valporate on Bipolar Patients and Their Sexual Side Effect: A Meta-Analysis of 4159 Patients

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Obada Ahmad Al Jayyousi, Ihdaa Mahmoud Bani Khalaf, Eman E. Alshial

Abstract:

Background: Bipolar disorder, formerly known as manic depression, is a mental health status that leads to extreme mood swings that include emotional lows (depression) and highs (mania or hypomania). This systematic review and meta-analysis aimed to assess the safety and efficacy of lithium versus valproate among bipolar patients. Methods: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until June 2022. Studies comparing lithium versus valproate among bipolar patients were selected for the analysis, and all relevant outcomes were pooled in the meta-analysis using Review Manager Software. Results: 11 Randomized Clinical Trials were included in this meta-analysis with a total of 4159 patients. Our meta showed that lithium was superior to valproate in terms of Young Mania Rating Scale (YMRS) (MD = 0.00 with 95% CI, (-0.55 – 0.55; I2 = 0%), P = 1.00). The results of the Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored the valproate treated group (MD = 1.41 with 95% CI, (-0.15 – 2.67; I2 = 0%), P = 0.03). Concerning the results of the Montgomery-Asberg Depression Rating Scale (MADRS), the results showed that the lithium was superior to valproate (MD = 0.03 with 95% CI, (-0.80 to 0.87; I2 = 40%), P = 0.94). In terms of the sexual side effect, we found that the valproate was superior to lithium (RR 1.19 with 95% CI, (0.74 to 1.91; I2 = 0%), P = 0.47). The lithium-treated group was superior in comparison to valproate treated group in terms of Abnormal Involuntary Movement Scale (AIMS) (MD = -0.03 with 95% CI (-0.38 to 0.32; I2 = 0%), P = 0.87). The lithium was more favorable in terms of Simpson-Agnes scale (MD = -0.40 with 95% CI, (-0.86 to 0.06; I2 = 0%), P = 0.09). The results of the Barnes akathisia scale showed that the overall effect of the valproate was more favorable in comparison to lithium (MD = 0.05 with 95% CI, (-0.12 to 0.22; I2 = 0%), P = 0.57). Conclusion: Our study revealed that on the scales of efficacy Lithium treated group surpassed Valproate treated group in terms of Young Mania Rating Scale (YMRS), Abnormal Involuntary Movement Scale (AIMS) and Simpson-Agnes scale, but valproate surpassed it in Barnes Akathisia scale. Furthermore, on the scales of depression Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored Valproate treated group, but Lithium surpassed valproate in terms of Montgomery-Asberg Depression Rating Scale (MADRS). Valproate surpassed Lithium in terms of sexual side effects.

Keywords: bipolar, mania, bipolar-depression, sexual dysfunction, sexual side effects, treatment

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8991 The Use of Brachytherapy in the Treatment of Liver Metastases: A Systematic Review

Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska

Abstract:

Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.

Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT

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8990 Economic and Financial Crime, Forensic Accounting and Sustainable Developments Goals (SDGs). Bibliometric Analysis

Authors: Monica Violeta Achim, Sorin Nicolae Borlea

Abstract:

This aim of this work is to stress the needs for enhancing the role of forensic accounting in fighting economic and financial crime, in the context of the new international regulation movements in this area enhanced by the International Federation of Accountants (IFAC). Corruption, money laundering, tax evasion and other frauds significant hamper the economic growth and human development and, ultimately, the UN Sustainable Development Goals. The present paper also stresses the role of good governance in fighting the frauds, in order to achieve the most suitable sustainable development of the society. In this view, we made a bibliometric systematic review on forensic accounting and its contribution towards fraud detection and prevention and theirs relationship with good governance and Sustainable Developments Goals (SDGs). In this view, two powerful bibliometric visual software tools, VosViewer and CiteSpace are used in order to analyze published papers identifies in Scopus and Web of Science databases over the time. Our findings reveal the main red flags identified in literature as used tools by forensic accounting, the evolution in time of the interest of the topic, the distribution in space among world countries and connectivity with patterns of a good governance. Visual designs and scientific maps are useful to show these findings, in a visual way. Our findings are useful for managers and policy makers to provide important avenues that may help in reaching the 2030 Agenda for Sustainable Development, adopted by all United Nations Member States in 2015, in the area of using forensic accounting in preventing frauds.

Keywords: forensic accounting, frauds, red flags, SDGs

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8989 Screening Diversity: Artificial Intelligence and Virtual Reality Strategies for Elevating Endangered African Languages in the Film and Television Industry

Authors: Samuel Ntsanwisi

Abstract:

This study investigates the transformative role of Artificial Intelligence (AI) and Virtual Reality (VR) in the preservation of endangered African languages. The study is contextualized within the film and television industry, highlighting disparities in screen representation for certain languages in South Africa, underscoring the need for increased visibility and preservation efforts; with globalization and cultural shifts posing significant threats to linguistic diversity, this research explores approaches to language preservation. By leveraging AI technologies, such as speech recognition, translation, and adaptive learning applications, and integrating VR for immersive and interactive experiences, the study aims to create a framework for teaching and passing on endangered African languages. Through digital documentation, interactive language learning applications, storytelling, and community engagement, the research demonstrates how these technologies can empower communities to revitalize their linguistic heritage. This study employs a dual-method approach, combining a rigorous literature review to analyse existing research on the convergence of AI, VR, and language preservation with primary data collection through interviews and surveys with ten filmmakers. The literature review establishes a solid foundation for understanding the current landscape, while interviews with filmmakers provide crucial real-world insights, enriching the study's depth. This balanced methodology ensures a comprehensive exploration of the intersection between AI, VR, and language preservation, offering both theoretical insights and practical perspectives from industry professionals.

Keywords: language preservation, endangered languages, artificial intelligence, virtual reality, interactive learning

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8988 Measuring Quality of Participation Processes: A Literature Review and Case Study to Determine Criteria for the Influence of Digital Tools

Authors: Michaela Kaineder, Beate Bartlmae, Stefan Gaebler, Miriam Gutleder, Marlene Wuerfl

Abstract:

Digital tools and e-participation processes have seen a steady increase in popularity in recent years. While online trends come with the premise of new opportunities and easier participatory possibilities, there are still manifold challenges that smart city initiators and developers need to face. In this paper, innovative quality criteria of citizen participation processes was suggested by defining meaningful and measurable evaluation categories. Considering various developments, including the global megatrend of connectivity, a need for a fundamental examination of the basic structure of citizen participation processes was identified. To this end, the application of methods and tools through different points in the policy cycle is required. In order to provide an overview of the current challenges and problems in the field of participation, this paper analyzes those issues by carrying out a literature review that also focuses on disparities in the civic sector that might hinder residents in their desire for engagement. Additionally, a case study was chosen to demonstrate the potential that e-participation tools offer to planning experts and public authorities when integrating citizen’s creativity and experience at a large scale. This online co-creation process finally leads to offline events – such as local co-design workshops - with professional planners. The findings of this paper subsequently suggest a combination of e-participation and analogue forms to merge the benefits of both worlds, resulting in a broader audience and higher quality for participation processes.

Keywords: citizen participation, disparities, e-participation, integrated urban development, sustainable development goals, sustainable urban development

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8987 Effectiveness of N-Acetylcysteine in the Treatment of Adults with Trichotillomania: An Evidenced Based Review

Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

Abstract:

Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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