Background/Objectives: Excitotoxicity, primarily caused by excessive glutamate signaling, is a significant contributor to the aetiology of several neurological disorders. Docosahexaenoic acid (DHA), a long-chain omega-3 polyunsaturated fatty acid, is known for its neuroprotective properties, including antioxidants and anti-inflammatory effects. However, the existing literature has not sufficiently reviewed its specific role in glutamate-induced excitotoxicity. This systematic review aimed to provide comprehensive information from the literature on the neuroprotective effects of DHA in models of glutamate-induced neurotoxicity. Methods: A systematic search was conducted in the Cochrane Library, Scopus, Web of Science, PubMed, ScienceDirect, and Google Scholar, following PRISMA 2020 guidelines. The following keywords were used: DHA OR docosahexaenoic acid AND excitotoxicity OR glutamate-induced excitotoxicity OR glutamate-induced neurotoxicity. A total of 475 articles were screened, and 13 original articles published between 2003 and 2025 were included for data extraction. These studies included nine in vivo animal studies, three ex vivo studies, and one in vitro study. The risk of bias was assessed using SYRCLE’s methodology. Results: Our findings demonstrate that DHA provides substantial neuroprotection against excitotoxicity through antioxidative, anti-inflammatory, and anti-apoptotic mechanisms. Furthermore, DHA enhances neuronal function and cognitive performance by modulating neurotransmitter levels and glutamate-related signaling pathways. Despite these positive outcomes, heterogeneity across studies suggests that the neuroprotective properties of DHA may be affected by various parameters, such as the source of DHA, treatment dose and duration, age and experimental design. Conclusions: Although previous studies have demonstrated the benefits of DHA in preclinical and clinical settings of neurological disorders, further clinical studies focusing on the modulation of excitotoxicity by DHA are needed to validate its translational efficacy and therapeutic significance.

Background: Interactive digital textbooks (IDTs) combine multimedia, interactivity, embedded assessment, and immediate feedback within a unified learning resource. These features may support technology-enhanced, learner-centered nursing education. Objective: To determine whether IDTs improve nursing students’ knowledge, skills, learning motivation, and competence compared with traditional or noninteractive educational approaches. Methods: This was a systematic review and meta-analysis. PubMed, MEDLINE, the Cochrane Library, Ovid MEDLINE, databases accessed through EBSCOhost, Scopus, Web of Science Core Collection, ScienceDirect, China National Knowledge Infrastructure, Wanfang Data, and China VIP Journal Database were searched from inception through August 1, 2026; reference lists were also screened. Standardized mean differences (SMD) with 95% confidence intervals (CIs) were calculated using random-effects models. Risk of bias was assessed with RoB 2 for randomized controlled trials and RoBANS for nonrandomized studies. Subgroup analyses were conducted by study design, and sensitivity analyses were performed by excluding outliers. Results: Eight studies (4 randomized controlled trials and 4 quasi-experimental studies; 579 participants) were included. IDTs improved knowledge (5 studies; SMD, 0.59; 95% CI 0.23-0.95), skills (4 studies; SMD, 0.73; 95% CI 0.19-1.27), and learning motivation or competence (6 studies; SMD, 1.00; 95% CI 0.45-1.55). Knowledge and motivation findings remained robust in sensitivity analyses, whereas the effect on skills was nonsignificant in the randomized controlled trial (RCT)-only analysis. Heterogeneity was moderate to high. Conclusions: IDTs appear to improve knowledge acquisition and learning motivation in nursing education. Effects on skills and competence are promising but less certain because of heterogeneity, variation in outcome measures, and the limited number of randomized trials. Well-designed, adequately powered trials using standardized outcomes and longer follow-up are needed.