Metacognition is the conscious knowledge individuals have about their own cognitive capacities and the regulation of these activities through self-monitoring. The aim of this review was to identify the definitions and assessment tools used to examine metacognition in relation to stroke studies. A computer database search was conducted using MEDLINE, CINAHL, PsycINFO, Cochrane Reviews, Scopus and Web of Science. A total of 1412 publications were retrieved from the initial database search. Following the removal of unrelated articles, 34 articles remained eligible. 5 studies examined metacognition in relation to cognitive and/or emotional functioning, 4 examined the concept in relation to memory, while others investigated its relationship to driving, employment or restrictions in daily living. 12 studies examined metacognitive function exclusively in stroke. Only 1 study examined metacognition in the acute phase of stroke. 7 studies adhered to the standard definition of metacognition in line with the neuropsychological literature. The main assessment tools utilised included the Self-Regulation and Skills Interview (SRSI), the Self-Awareness of Deficits Interview (SADI), the Awareness Questionnaire (AQ) and the Patient Competency Rating Scale (PCRS). Assessment of metacognition has tended to focus on traumatic and other acquired brain injury in comparison to stroke. The majority of the studies that examined metacognition in stroke did not assess patients in the acute phase. The heterogeneity of assessment tools was in keeping with the variation in the definition of metacognition. The emergence of a standard metacognitive assessment tool may have important implications for future rehabilitative programmes.

Objective: With growing interest in applying artificial intelligence (AI) to population breast cancer screening, the evidence base has expanded rapidly. This systematic review aims to systematically review and summarise the published evidence on the use of AI in breast cancer screening. Design: We conducted a systematic review of primary studies assessing AI for screening mammography, extracting test-accuracy metrics (sensitivity, specificity, recall and cancer detection rates) and workflow outcomes. Data sources: We searched the Cochrane Breast Cancer Group Specialised Register, Cochrane CENTRAL, PubMed, Embase (Elsevier), Scopus, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform from January 2012 to June 2025; we also screened reference lists of included studies and relevant reviews. No language restrictions were applied. Eligibility criteria: Primary studies evaluating AI for screening mammography (digital mammography or digital breast tomosynthesis) in asymptomatic women, assessing AI as a standalone reader or AI-assisted radiologist workflows versus radiologists alone. Eligible designs included randomised trials, prospective paired reader studies, real-world implementation/registry cohorts, retrospective cohorts and multireader-multicase reader studies conducted in population-based or opportunistic screening settings. Key outcomes included diagnostic accuracy metrics (eg, sensitivity, specificity, Area Under the Curve (AUC) and/or programme metrics (cancer detection rate (CDR), recall/abnormal interpretation rate, positive predictive value, arbitration/workload). We excluded protocols, pilot/feasibility studies, case reports, editorials and studies without relevant accuracy or screening outcomes. Data extraction and synthesis: Two independent reviewers extracted data and assessed risk of bias. Study quality was appraised with Quality Assessment of Diagnostic Accuracy Studies-2 and an AI-specific critical appraisal tool, and findings were synthesised narratively with stratification by study design and AI integration role. Results: 31 studies met the inclusion criteria, encompassing randomised controlled trials, prospective paired-reader studies, registry-based implementations and retrospective simulations, representing more than two million screening examinations across Europe, Asia, North America and Australia. When used as a second reader or within double-reading workflows, AI generally maintained or modestly increased sensitivity (up to +9 percentage points (PP)) while preserving or improving specificity. Triage and decision-referral configurations delivered the greatest operational benefit, reducing reading volumes by 40–90% while maintaining non-inferior cancer detection when thresholds were conservatively calibrated. Stand-alone AI achieved AUC values comparable to radiologists and similar cancer detection in real-world, non-enriched cohorts, although interval-cancer follow-up remains incomplete in several datasets. In prospective randomised evidence, including the Mammography Screening with Artificial Intelligence trial (MASAI) trial, AI-supported screening achieved higher CDRs (6.4 versus 5.0 per 1000; p=0.0021) with stable or reduced false-positive and recall rates. Across implementation and simulation settings, integration of AI reduced radiologist workload substantially, with triage and band-pass approaches reducing the number of reads by approximately 40–90%. Overall certainty is limited by heterogeneity across study designs, reliance on enriched datasets for some accuracy estimates and incomplete interval-cancer follow-up in several major studies. Conclusion: Contemporary AI systems show diagnostic performance that is broadly comparable to radiologists and can substantially reduce reading workload, particularly when used as a second reader or triage tool. Emerging prospective evidence supports their safe integration in these roles, although transparent reporting, standardised evaluation and long-term population studies are still required before considering AI as a stand-alone reader. AI may improve workflow efficiency and possibly cancer detection, but definitive evidence on safety, especially interval cancer outcomes, remains essential.

Since the World Health Organization (WHO) issued guidelines for developing a non-sputum test for active tuberculosis (TB) diagnosis that exhibits similar performance characteristics to sputum-based diagnosis, salivary diagnostic techniques have gained prominence as potential screening tools or adjuncts to existing diagnostics. We searched online databases for studies that looked at salivary diagnostic techniques. Afterwards, duplicates were removed, titles and abstracts were screened, and full-text studies were assessed for eligibility based on inclusion and exclusion criteria. The studies chosen for final analysis underwent a rigorous quality assessment following a QUADAS-2 template, and data were extracted. The primary outcome assessed the difference in mean levels of interleukins between TB+ patients and TB-controls (Hedges’ g). We then conducted two subgroup analyses: the first segregated the control group into healthy patients, and those with other respiratory diseases (ORD), and the second addressed three different interleukins separately (IL-6, IL-5, IL-17). The secondary outcome involved comparing salivary molecular diagnostic assays to WHO guidelines. This study is registered with PROSPERO, CRD42024536884. A total of 17 studies, out of an initial 1010, were chosen for the final analysis, but one was then excluded for being of poor quality. Our meta-analyses for the primary outcome revealed minimal diagnostic potential for interleukins. Our first subgroup analysis showed that interleukins were incapable of differentiating active TB patients from both healthy controls and ORD patients. Our second subgroup analysis showed that IL-17 was reduced in active TB patients. Assessment of the secondary outcome revealed that most studies relied on a GeneXpert MTB/RIF assay on saliva, but none fulfilled WHO guidelines for a non-sputum test. Individual biomarkers currently lack sufficient discriminatory power to definitively distinguish active tuberculosis from healthy individuals or those with other respiratory diseases (ORD), reinforcing the need for multi-biomarker panels. Interleukins may be alternatively used as markers for prognosis, severity, or treatment response. Our findings also suggest that assays are unable to meet WHO guidelines.

Information literacy is essential for evidence-based medical education, yet Gulf-region studies rarely examine student competencies and barriers. This study examines the information literacy skills, attitudes, and challenges faced by medical and nursing students at RCSI Bahrain. A mixed-methods design was employed, combining a quantitative survey (n = 343) with qualitative focus groups (n = 10). Students reported high self-perceived information literacy across domains. Time constraints and information overload were identified as the primary barriers to effective communication. Focus group findings highlighted the late introduction of curricula, technical access challenges, and inequities between medical and nursing programs. Library training attendance, academic year, and barrier count were significant predictors of perceived competence. Confidence in information literacy coexists with structural and curricular barriers that restrict practical application. Early integration of information literacy, improved access systems, and discipline-specific instruction are recommended to enhance the use of information in medical education.

Emerging roles and activities of health sciences librarians: a literature review, 2004: Change across the educational landscape has been greatly influenced by demographic shifts, economic instability and technological advances. As globalization gains momentum fueled by social media tools enabling ease of access to information source the immediate effect has impacted work environments around the world. As librarians are considered as guardians of information new trends like open source concepts, digital revolution and new knowledge sharing initiatives have impacted job roles greatly. The purpose of this review is to focus on the health science librarian to identify how jobs have been re-engineered to enhance the role of health science librarians. Studies show that Medical and Health Science programmes are taking initiatives to introduce health information literacy skills into the curriculum (Cooper & Crum, 2013) whereby the role of librarians has moved beyond routine orientation sessions to curriculum integrated literacy sessions throughout the academic year. Objective: In this paper we will establish emerging roles of the health science librarian. Understand how new re-cast job roles have changed visible work activities, tasks and responsibilities. Determine how librarians are developing the capacity to take on the blended roles in order to move from information disseminators to information creators. Method/Approach: A systematic review of literature was conducted using LISTA, SCOPUS, Emerald, Academic Search Complete and Medline. A definite time period from 2004 to 2014 was defined to determine how Health Science librarianship has transformed over the years. Conclusion: The roles of health sciences librarians continue to emerge as our practices change to support the needs of the clientele.