Congenital cytomegalovirus (CMV) is a major cause of neonatal morbidity, particularly sensorineural hearing loss, yet its early detection remains challenging. While urinary PCR is the current diagnostic gold standard, its implementation in neonatal settings is often limited by feasibility issues. Salivary PCR presents a more practical alternative, but its diagnostic accuracy has remained uncertain. This systematic review and meta-analysis aimed to evaluate the performance of salivary PCR compared to urinary PCR in detecting congenital CMV in neonates. Following PRISMA guidelines, 15 observational studies involving 29,617 neonates were analyzed using a random-effects model. Pooled sensitivity and specificity were 0.99 and 1.00, respectively, with a negative predictive value (NPV) of 1.00 and a positive predictive value (PPV) of 0.91, despite moderate heterogeneity. Subgroup analysis showed high diagnostic performance across general neonates, infants of seropositive mothers and high-risk neonates (referring to neonates that are small for their gestational age (SGA), neonates who failed hearing screening, and neonates with CMV-related congenital abnormalities). The general group had the highest specificity (0.999), while high-risk neonates showed the highest sensitivity (0.981). Across all groups, NPV remained consistently above 0.994, with PPV ranging from 0.848 to 0.981. These findings confirm that salivary PCR is a highly accurate and feasible tool for congenital CMV diagnosis.

Mammographic sensitivity is reduced in women with dense breasts, leading to missed cancers and a higher burden of interval cancers. Automated breast ultrasound (ABUS) and ultrasound tomography (UST) have been introduced as supplemental breast imaging modalities, but primary studies are heterogeneous, and previous reviews have not focused on screening settings or on head-to-head comparisons with handheld ultrasound (HHUS). We systematically searched PubMed, Embase, Web of Science and the Cochrane Library for studies from 1 January 2000 to 31 May 2025 evaluating ABUS or UST as adjuncts to mammographic screening. Two reviewers independently selected studies and assessed risk of bias. When at least two clinically comparable studies were available, we pooled sensitivity and specificity using random-effects bivariate meta-analysis. Eighteen studies (just over 20,000 screening or recall episodes) met the inclusion criteria; 16 evaluated ABUS/ABVS and 2 UST. Adding ABUS to mammography increased sensitivity by 6–35 percentage points and improved cancer detection by 2.4–4.3 per 1000 women with dense breasts, with higher recall rates and modest reductions in specificity. When ABUS was compared directly with HHUS, pooled sensitivity was 0.90 and specificity 0.89, with HHUS showing slightly lower sensitivity and slightly higher specificity. Only two studies had an overall low risk of bias, and heterogeneity (particularly for specificity) was substantial. ABUS is a practical and scalable adjunct to mammography that increases cancer detection in women with dense breasts, with an expected trade-off of higher recall and modest specificity loss. Its comparative diagnostic accuracy appears broadly non-inferior to HHUS. However, the predominance of high-risk-of-bias studies and between-study heterogeneity means that high-quality population-based trials and standardised reporting are still required before widespread implementation in organised screening programmes.

First-trimester screening for preterm preeclampsia (PE) is often performed using the Fetal Medicine Foundation (FMF) Bayes' theorem-based competing-risks model, which combines maternal factors with mean arterial pressure, uterine artery pulsatility index and placental growth factor, with pregnancy-associated plasma protein-A included in some models. Ophthalmic artery (OA) Doppler has been proposed as an additional marker of maternal vascular adaptation, but its clinical contribution remains uncertain. This review critically evaluates the predictive performance of first-trimester OA Doppler for early-onset and preterm PE, and assesses its incremental value beyond established screening models. A PRISMA-guided systematic review was conducted. Studies assessing first-trimester OA Doppler in singleton pregnancies for the prediction of early-onset or preterm PE were included. Risk of bias was assessed using PROBAST. Given heterogeneity in population risk, Doppler indices, outcome definitions, and model structure, results were synthesized narratively. Five prospective cohort reports, representing four unique cohorts, met the inclusion criteria. In large unselected cohorts, OA Doppler showed limited standalone predictive value. Its contribution within multivariable models was modest, with detection rates for preterm PE of approximately 56-59% at a 10% false-positive rate. Smaller selected or mixed-risk cohorts reported substantially higher discrimination, including AUROC values up to 0.98. However, these estimates were based on few outcome events, lacked validation, and were most consistent with overfitting. All reports had high risk of bias in the analysis domain; therefore, reported AUROC and detection-rate estimates should be interpreted as exploratory. Reported performance of first-trimester OA Doppler is strongly influenced by population risk and model structure. Current evidence suggests limited standalone value and uncertain incremental benefit beyond established screening. Future studies should use standardised acquisition and reporting, consistent PE definitions and prespecified validation to enable data pooling and determine whether OA Doppler has clinically meaningful incremental value. PROSPERO CRD420261289728.

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.