The lack of annotated medical images limits the performance of deep learning models, which usually need large-scale labelled datasets. Few-shot learning techniques can reduce data scarcity issues and enhance medical image analysis, especially with meta-learning. This systematic review gives a comprehensive overview of few-shot learning in medical imaging. We searched the literature systematically and selected 80 relevant articles published from 2018 to 2023. We clustered the articles based on medical outcomes, such as tumour segmentation, disease classification, and image registration; anatomical structure investigated (i.e. heart, lung, etc.); and the meta-learning method used. For each cluster, we examined the papers' distributions and the results provided by the state-of-the-art. In addition, we identified a generic pipeline shared among all the studies. The review shows that few-shot learning can overcome data scarcity in most outcomes and that meta-learning is a popular choice to perform few-shot learning because it can adapt to new tasks with few labelled samples. In addition, following meta-learning, supervised learning and semi-supervised learning stand out as the predominant techniques employed to tackle few-shot learning challenges in medical imaging and also best performing. Lastly, we observed that the primary application areas predominantly encompass cardiac, pulmonary, and abdominal domains. This systematic review aims to inspire further research to improve medical image analysis and patient care.

A systematic review of experimental studies investigating genotoxic effects induced by RF-EMF in in vitro cellular models was carried out based on a structured protocol, defined and validated a priori. Bibliographic search was conducted in three databases (Pubmed, Web of Science, EMF-Portal), and 151 studies were included in the review after the assessment of compliance with the inclusion/exclusion criteria. Relevant data regarding bibliographic information, experiment features and results were extracted from each study, and the quality of studies was rated based on the outcome of the risk of bias assessment. The experiments extracted from the included studies were characterized by a high variability of the parameters considered (cell types, endpoint analyzed, etc.), which precluded the possibility to perform a meta-analysis. Despite that, it was possible to aggregate data and develop descriptive statistics. The results showed that 80% of experiments did not report effects of RF exposures, whereas in 20% statistically significant differences were found between exposed and unexposed cultures. It also emerged that only a few studies reporting significant effects were at low risk of bias, and a dose-response relationship between the onset of effects and exposure conditions was ruled out. From this analysis, it is possible to infer about absence of elements in favor of an association between RF exposure and genotoxicity in mammalian cells. Furthermore, although the number of publications on this subject has considerably increased, the quality of the experimental methodologies still needs to be improved.

A major public health challenge facing local administrations is reducing the preventable burden of non-communicable diseases making cities more resilient against environmental threats. The objective of this work was to conduct a synthesis of scientific evidence relating to the local context and implement a translational process to support the Department of the Environment in order to improve integration with concurrent policy sectors to urban health and sustainability goals. The first phase reviewed the studies on the association between environmental risk factors and human health and on the contamination levels of the environmental matrices; the second phase synthesised the data in key messages according to the concerns formulated with the collaboration of the Environmental Department. A total of 31 studies were assessed: 21 investigated environmental risk factors, and 9 measured the presence of pollutants in the environmental matrices. The findings identified air and noise pollution as the most important threats associated with respiratory and cardiovascular diseases, together with significant contamination levels of the urban environment from microplastics and hydrocarbons. Based on the review findings, a layman's report for the City Council and the citizens, explicitly addressing emerging issues, was made publicly accessible. A lack of specific, updated and exchangeable data for city health profiling in a deteriorated environmental context represented the main barrier to a resilient community. The suggested recommendation for the local administration was to adopt an environmental policy integration framework to strengthen the monitoring of the impact on citizens' health.

Technology-Assisted Review (TAR) refers to the human-in-the-loop machine learning process whose goal is that of maximizing the cost-effectiveness of a review (i.e., the task of labeling items to satisfy an information need). This thesis explores and thoroughly analyzes: the applicability of the SLD algorithm to TAR scenarios; the usage of active learning combined with the MINECORE framework, effectively improving the framework performance; the portability of machine/deep learning models for the production of systematic reviews in empirical medicine. Finally, the thesis proposes a new algorithm, based on SLD, called SALt, which improves the class prevalence estimates on active learning scenarios, with respect to the current state-of-the-art.

Over the last years there has been significant research on the presence and effects of plastics in terrestrial systems. Here we summarize current research findings on the effects of nano- and microplastics (NMPs) on terrestrial plants, with the aim to determine patterns of response and sensitive endpoints. We conducted a systematic review (based on 78 studies) on the effects of NMPs on germination, plant growth and biochemical biomarkers. The majority of studies to date have used pristine polystyrene or polyethene particles, either in a hydroponic or pot-plant setup. Our results show that effects on plants are widespread. We noted similar responses among plant species, and between monocots and dicots to NMPs, except for consistent lower germination in dicots due to NMPs. Our results also highlight variation in sensitivity of endpoints to NMPs. During early development, germination and root growth are more strongly affected compared to shoot growth. NMPs induced similar adverse growth effects on plant biomass and length in the most tested plant species (lettuce, wheat, corn, and rice) irrespective of the polymer type and size used. Moreover, biomarker responses were consistent across species; chlorophyll levels were commonly negatively affected, while stress indicators (e.g., ROS or free radicals) and stress respondents (e.g., antioxidant enzymes) were consistently upregulated. Importantly, effects were commonly observed at environmentally relevant concentrations for most endpoints. These findings clearly indicate that NMPs have a wide ranging and ubiquitous impacts affecting plant performance. Importantly, most studies have been conducted under highly controlled conditions and with pristine plastics, raising the urgent need to test under more environmentally realistic condition to ensure the lab-based studies can be extrapolated to the field.

The use of social media in higher education has been demonstrated in a number of studies to be an attractive and contemporary method of teaching and learning. However, further research and investigation are required in order to align social media's pedagogical benefits with the theoretical perspectives that inform educational practices. It is the objective of this study to provide a systematic literature review using bibliometric analysis techniques and content analysis to provide a map of research produced between 2009 and 2021. This study aims to identify theoretical frameworks, current research trends, and patterns in this field. A total of 772 publications were analysed using bibliometric methodology, while a subset of 55 publications were analysed using content analysis. As indicated by the results, there is still a growing interest in this area of research, with recent studies still focusing on attitudes towards the use of social media in teaching and learning. According to the content analysis, technology acceptance theories and learning theories are the most commonly used reference theories. This field has yet to elaborate on pedagogical theory, and there is a tendency to rely primarily on technology acceptance models rather than pedagogical models. A discussion of future practice and research implications is also provided.

Over the last years there has been significant research on the presence and effects of plastics in terrestrial systems. Here we summarize current research findings on the effects of nano- and microplastics (NMPs) on terrestrial plants, with the aim to determine patterns of response and sensitive endpoints. We conducted a systematic review (based on 78 studies) on the effects of NMPs on germination, plant growth and biochemical biomarkers. This review highlights that the majority of studies to date have used pristine polystyrene or polyethylene particles, either in a hydroponic or pot-plant setup. Based on these studies we found that effects on plants are widespread. We noted similar responses between and within monocots and dicots to NMPs, except for consistent lower germination seen in dicots exposed to NMPs. During early development, germination and root growth are more strongly affected compared to shoot growth. NMPs induced similar adverse growth effects on plant biomass and length in the most tested plant species (lettuce, wheat, corn, and rice) irrespective of the polymer type and size used. Moreover, biomarker responses were consistent across species; chlorophyll levels were commonly negatively affected, while stress indicators (e.g., ROS or free radicals) and stress respondents (e.g., antioxidant enzymes) were consistently upregulated. In addition, effects were commonly observed at environmentally relevant levels. These findings provide clear evidence that NMPs have wide-ranging impacts on plant performance. However, as most studies have been conducted under highly controlled conditions and with pristine plastics, there is an urgent need to test under more environmentally realistic conditions to ensure the lab-based studies can be extrapolated to the field.

Anorexia Nervosa (AN) patients exhibit distorted body representation. The purpose of this study was to explore studies that analyze virtual reality (VR) applications, related to body image issues, to propose a new tool in this field. We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Scopus, and Web of Science databases were explored; the review included 25 studies. Research has increased over the last five years. The selected studies, clinical observational studies (n = 16), mostly concerning patients' population with AN (n = 14) or eating disorders (EDs) diagnosis, presented multiple designs, populations involved, and procedures. Some of these studies included healthy control groups (n = 7). Studies on community sample populations were also selected if oriented toward clinical applications (n = 9). The VR technologies in the examined period (about 20 years) have evolved significantly, going from very complex and bulky systems, requiring very powerful computers, to agile systems. The advent of low-cost VR devices has given a big boost to research works. Moreover, the operational proposal that emerges from this work supports the use of biofeedback techniques aimed at evaluating the results of therapeutic interventions in the treatment of adolescent patients diagnosed with AN.

The assessment of students' performances is one of the essential components of teaching activities, and it poses different challenges to teachers and instructors, especially when considering the grading of responses to open-ended questions (i.e., short-answers or essays). Open-ended tasks allow a more in-depth assessment of students' learning levels, but their evaluation and grading are time-consuming and prone to subjective bias. For these reasons, automatic grading techniques have been studied for a long time, focusing mainly on short-answers rather than long essays. Given the growing popularity of Massive Online Open Courses and the shifting from physical to virtual classrooms environments due to the Covid-19 pandemic, the adoption of questionnaires for evaluating learning performances has rapidly increased. Hence, it is of particular interest to analyze the recent effort of researchers in the development of techniques designed to grade students' responses to open-ended questions. In our work, we consider a systematic literature review focusing on automatic grading of open-ended written assignments. The study encompasses 488 articles published from 1984 to 2021 and aims at understanding the research trends and the techniques to tackle essay automatic grading. Lastly, inferences and recommendations are given for future works in the Learning Analytics field.

Natural Language Processing for Requirements Engineering (NLP4RE) is an area of research and development that seeks to apply natural language processing (NLP) techniques, tools, and resources to the requirements engineering (RE) process, to support human analysts to carry out various linguistic analysis tasks on textual requirements documents, such as detecting language issues, identifying key domain concepts, and establishing requirements traceability links. This article reports on a mapping study that surveys the landscape of NLP4RE research to provide a holistic understanding of the field. Following the guidance of systematic review, the mapping study is directed by five research questions, cutting across five aspects of NLP4RE research, concerning the state of the literature, the state of empirical research, the research focus, the state of tool development, and the usage of NLP technologies. Our main results are as follows: (i) we identify a total of 404 primary studies relevant to NLP4RE, which were published over the past 36 years and from 170 different venues; (ii) most of these studies (67.08%) are solution proposals, assessed by a laboratory experiment or an example application, while only a small percentage (7%) are assessed in industrial settings; (iii) a large proportion of the studies (42.70%) focus on the requirements analysis phase, with quality defect detection as their central task and requirements specification as their commonly processed document type; (iv) 130 NLP4RE tools (i.e., RE specific NLP tools) are extracted from these studies, but only 17 of them (13.08%) are available for download; (v) 231 different NLP technologies are also identified, comprising 140 NLP techniques, 66 NLP tools, and 25 NLP resources, but most of them-particularly those novel NLP techniques and specialized tools-are used infrequently; by contrast, commonly used NLP technologies are traditional analysis techniques (e.g., POS tagging and tokenization), general-purpose tools (e.g., Stanford CoreNLP and GATE) and generic language lexicons (WordNet and British National Corpus). The mapping study not only provides a collection of the literature in NLP4RE but also, more importantly, establishes a structure to frame the existing literature through categorization, synthesis and conceptualization of the main theoretical concepts and relationships that encompass both RE and NLP aspects. Our work thus produces a conceptual framework of NLP4RE. The framework is used to identify research gaps and directions, highlight technology transfer needs, and encourage more synergies between the RE community, the NLP one, and the software and systems practitioners. Our results can be used as a starting point to frame future studies according to a well-defined terminology and can be expanded as new technologies and novel solutions emerge.

Climate change (CC) is a key, global driver of change of marine ecosystems. At local and regional scales, other local human stressors (LS) can interact with CC and modify its effects on marine ecosystems. Understanding the response of the marine environment to the combined effects of CC and LS is crucial to inform marine ecosystem-based management and planning, yet our knowledge of the potential effects of such interactions is fragmented. At a global scale, we explored how cumulative effect assessments (CEAs) have addressed CC in the marine realm and discuss progress and shortcomings of current approaches. For this we conducted a systematic review on how CEAs investigated at different levels of biological organization ecological responses, functional aspects, and the combined effect of CC and HS. Globally, the effects of 52 LS and of 27 CC-related stressors on the marine environment have been studied in combination, such as industrial fisheries with change in temperature, or sea level rise with artisanal fisheries, marine litter, change in sediment load and introduced alien species. CC generally intensified the effects of LS at species level. At trophic groups and ecosystem levels, the effects of CC either intensified or mitigated the effects of other HS depending on the trophic groups or the environmental conditions involved, thus suggesting that the combined effects of CC and LS are context-dependent and vary among and within ecosystems. Our results highlight that large-scale assessments on the spatial interaction and combined effects of CC and LS remain limited. More importantly, our results strengthen the urgent need of CEAs to capture local-scale effects of stressors that can exacerbate climate-induced changes. Ultimately, this will allow identifying management measures that aid counteracting CC effects at relevant scales.

Quinoa (Chenopodium quinoa Willd.) is one of the most popular emerging food crops in the Andean region. It is tolerant to environmental stresses and characterized by interesting nutritional traits. Thus, it has the potential to contribute to food and nutrition security in marginal environments. In this study, we conducted a systematic review integrated with a bibliometric analysis of cropping practices of quinoa under field conditions. The analysis is based on published data from the literature relating to the period 2000-2020. A total of 33 publications were identified, revealing that scientific research on the agronomic practices and performances of quinoa under field conditions is still limited. Africa, Asia, and Europe were the leading research production sites in this field and together provided over 81% of the total scientific production. There were no papers from the Australian continent. The number of papers screened dealing with tillage and weed control management was very limited. The keyword co-occurrence network analyses revealed that the main topics addressed in the scientific literature related to the effect of "variety" and "deficit irrigation", followed by "water quality", "fertilization", and "sowing date" on seed yield. Results from this study will permit us to identify knowledge gaps and limited collaboration among authors and institutions from different countries. Salinity, sowing density, and sowing date were the agronomic interventions affecting productive response the most.

Exposure to radiofrequency (RF) electromagnetic fields (EMF) (frequencies of 100 kHz to 300 GHz) has been steadily increasing. In addition to heat-related effects of RF EMF, other yet-unspecified biological effects, might exist which could possibly lead to health effects. Given the large number of health endpoints that have been studied, we wanted to prioritize those that would merit systematic reviews.

With the increasing number of older adults in today's population, it is important to promote active ageing in order to offer them better life conditions, and enable them to be autonomous as long as possible despite the problems arising from aging. To guarantee active aging, physical, social and mental conditions must be considered. In this research we mainly focus on the cognitive functions implicated in aging. To cope with the cognitive impairments, many proposals have been put forward that exploit digital interactive technologies in interdisciplinary projects. An area that has high potential is the use of serious games supported by some interactive technology because of their potential attractiveness and engagement. We report on a systematic literature review that has been carried out in order to explore and analyse the various proposals in this field and, on the basis of the results, identify the interactive devices that have been considered, the results achieved in terms of cognitive support, and current trends in this area.

Regular physical activity is strongly recommended to prevent chronic respiratory diseases, including asthma. On the other hand, vigorous physical training may trigger airway symptoms and bronchoconstriction. The transient airway narrowing occurring because of exercise is named exercise-induced bronchoconstriction (EIB). Despite management according to guidelines, a significant proportion of patients experiences uncontrolled EIB, which thus represents a relevant unmet medical need. In particular, although prevention and treatment of EIB are effectively based on the use of beta-2 bronchodilator drugs, high heterogeneity in individual responses has been reported. Furthermore, even though beta-2 adrenergic drugs remain the mainstay of EIB management, occurrence of tolerance and side effects, as well as doping concerns have been reported with their use. In regard to this, inhaled antimuscarinics could represent an alternative or additional effective and safe bronchodilator therapeutic option for achieving optimal EIB control and minimize adverse events. The present systematic review aims to collect and provide the most updated and evidence-based literature findings on the efficacy and safety of short- and long-acting inhaled anti-muscarinic drugs for the preventive treatment of EIB in both children and adults. Take-Home Message: Anti-muscarinic drugs are effective and safe in preventing EIB, despite response variability is reported. Further studies should focus on long-acting molecules, chronic administration and phenotype-driven effects.

Background The growing "process" of burnout impair performance and quality of professional services, with consequences for physicians, healthcare care organization, and patient's outcomes. Aims We aim to evaluate which strategy of intervention, individual or organization directed, is more effective to reduce physician burnout and to provide management suggestions in terms of actual organizational strategies and intensity leading to reductions in physician burnout. Methods The meta analysis was conducted according to the PRISMA guidelines. We included physicians of any specialty in the primary, secondary, or intensive care setting, including residents and fellows. Eligible interventions were any intervention designed to relieve stress and/or improve the performance of physicians and reported burnout outcomes, including physician-directed interventions and organization-directed interventions. The electronic search strategy applied standard filters for identification of the different studies. Databases searched were the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (from inception to September 2018), and EMBASE (from beginning to September 2018). Meta analysis was performed with mixed random effect using DerSimonian and Laird method. The standardized mean difference (SMD) and 95% CI for each outcome were separately calculated for each trial pooling data when needed, according to an intention-to-treat principle. Results Pooled interventions were associated with small significant reductions in burnout (SMD = - 0.289; 95% CI, - 0.419 to - 0.159; I2 = 29%) (Fig.2). Organization-directed interventions were associated with a medium reduction in burnout score (SMD = - 0.446; 95% CI, - 0.619 to - 0.274; I2 = 8%) while physician-directed interventions were associated with a moderate reduction in burnout score (SMD = - 0.178; 95% CI, - 0.322 to - 0.035; I2 = 11%). Discussion This systematic review and meta-analysis showed that (1) organization-directed interventions were associated with moderate reduction in burnout score, (2) physician-directed interventions were associated with small reduction in burnout score, (3) organization-directed interventions reduced more the depersonalization than physician-directed interventions, (4) organization-directed interventions were related to a more improvement of the personal accomplishment than physician-directed interventions. Conclusions This meta analysis found that physicians could gain important benefits from interventions to reduce burnout, especially from organizational strategies, by viewing burnout rooted in issues related to the working environment and organizational culture.

Background and aims: To systematically review the latest evidence on established and emerging nutrition-related risk factors for incidence of and mortality from total, ischemic and haemorrhagic strokes.

Purpose: The purpose of this study is to provide a synthesis of the state of research on collaborative innovation in tourism and hospitality. It presents a systematic review of the academic literature, and provides insights into the specific issues addressed by studies in this area. Design/methodology/approach: A search of major research databases with multiple keywords was performed to identify relevant articles up to 2017. A total of 79 articles were identified and analyzed according to the following criteria: location of the study, perspective of analysis, methodology, level of analysis and specific themes addressed. Findings: Based on a qualitative thematic analysis, five groups of articles were identified: cooperative behavior of innovating firms, co-creation, collaborative networks for innovation, knowledge transfer and innovation policies. Research limitations/implications: This study contributes to making the current body of knowledge on collaborative innovation in tourism and hospitality more organized. The analysis of the different issues addressed by the literature could build the foundation for future research. Originality/value: This study presents a comprehensive review of literature on collaborative innovation in tourism and hospitality. It can serve as a roadmap of literature for both academicians and practitioners, and help stimulate further interest.

Falls are a leading cause of morbidity, healthcare use and mortality. Dance is a popular form of physical activity among older people and previous research has suggested that it may improve various health outcomes in this population, including balance, gait and muscle performance. A systematic review of the potential benefits of dance on falls and fear of falling is lacking. Thus, we conducted a systematic review considering all randomized controls trials (RCTs) investigating if dance can reduce falls and improve fear of falling in older adults. Major databases were searched from inception until 1 March 2017 and a total of 10 RCTs were identified, which included a total of 680 people (n = 356 dance, n = 324 control). Overall, the mean age of the samples was 69.4 years, and 75.2% were female. Across four RCTs, dance therapy reduced falls versus usual care in only one study. Dance therapy improved fear of falling in two out of three included RCTs. There were no serious adverse events reported in the RCTs. In summary, we found a paucity of studies investigating the effect of dance on falls and fear of falling and the evidence base is preliminary and equivocal. Given the heterogeneity of the included samples and interventions, in addition to the short-term follow-up, no firm conclusions can be drawn. However, dance appears to be safe and, given its popularity and demonstrated benefits on other health/wellbeing outcomes in older adults, it is important that future research considers its potential benefits on falls/fear of falling in older age.

To evaluate if advanced neuroimaging research is mainly conducted by imaging specialists, we investigated the number of first authorships by radiologists and non-radiologist scientists in articles published in the field of advanced neuroimaging in the past 10 years.