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As part of a perennial project, our team is actively engaged in developing new synthetic assistant (SA) technologies to assist in training combat medics and medical first responders. It is critical that medical first responders are well trained to deal with emergencies more effectively. This would require real-time monitoring and feedback for each trainee. Therefore, we introduced a voice-based SA to augment the training process of medical first responders and enhance their performance in the field. The potential benefits of SAs include a reduction in training costs and enhanced monitoring mechanisms. Despite the increased usage of voice-based personal assistants (PAs) in day-to-day life, the associated effects are commonly neglected for a study of human factors. Therefore, this paper focuses on performance analysis of the developed voice-based SA in emergency care provider training for a selected emergency treatment scenario. The research discussed in this paper follows design science in developing proposed technology; at length, we discussed architecture and development and presented working results of voice-based SA. The empirical testing was conducted on two groups as user studies using statistical analysis tools, one trained with conventional methods and the other with the help of SA. The statistical results demonstrated the amplification in training efficacy and performance of medical responders powered by SA. Furthermore, the paper also discusses the accuracy and time of task execution (t) and concludes with the guidelines for resolving the identified problems.

Objective: Saudi Arabian adults face high rates of depression, stress, and anxiety. Selfstigma complicates the situation, hindering timely treatment and resulting in adverse outcomes. This study examined the prevalence of these mental health conditions and selfstigma among adults and their association with sociodemographic factors in the Jazan region of Saudi Arabia. The findings will inform targeted interventions and support for better mental health understanding in the region. Methods: This cross-sectional study included 1056 participants aged ≥18 years. Convenient sampling was used, and participants completed a self-administered online questionnaire comprising 49 questions. The questionnaire covered demographics, mental illnesses (assessed through the depression, anxiety, and stress scale 21 [DASS-21] questionnaire), and self-stigmatizing attitudes toward the measured mental conditions (measured using the self-stigma of depression scale [SSDS] questionnaire). Results: The majority of the 1056 participants were Saudi nationals living in the Jazan region, with a mean age of 29 years. The participants' mental health data revealed a high prevalence of depression, anxiety, and stress symptoms (55%, 56%, and 39%, respectively). The DASS-21 questionnaire results revealed varying degrees of depression (normal: 45%, mild: 12%, moderate: 20%, severe: 8%, extremely severe: 15%), anxiety (normal: 44%, mild: 7%, moderate: 18%, severe: 8%, extremely severe: 23%), and stress (normal: 60%, mild: 11%, moderate: 11%, severe: 10%, extremely severe: 7%). The mean self-stigmatization score reported was 52 (Standard Deviation (SD) = 17), with 540 (51%) participants having stigma and 513 (49%) with low levels of stigma. The relationship assessment between stigma and depression, anxiety, and stress revealed that levels of stigma were higher in normal individuals than in those having depression, anxiety, or stress. Regression analysis was performed to investigate the association between mental health variables, self-stigmatization, and other factors. The analysis revealed that urban residence and the severity of depression, anxiety, and stress were associated with lower levels of self-stigmatization. Conclusion: This research highlighted the high prevalence of depression, anxiety, and stress, along with self-stigmatization in Jazan, Saudi Arabia. Recommendations include increasing awareness, improving access to services, promoting early intervention, enhancing community support, combating self-stigma, and conducting further research to confirm generalizability. Targeted interventions and public health strategies are needed to promote mental well-being and address this burden in Jazan. [ABSTRACT FROM AUTHOR]

The study aimed to know the role of divorce in generating divorce and causing disorders and abnormal behaviors among a divorced family in the city of Irbid, Jordan. The study sample consisted of (12) males and females. The results of the study showed that there were statistically significant differences in the level of obsessive-compulsive disorder, hostility, and psychosis according to the gender variable and in favor of males and that abnormal disorders and behaviors were repeated in both genders, with females outperforming males in many of them. And that divorce generated 100% new divorce cases for females, a continuous family quarrel with the daughter-in-law of 100%, and 67% reluctance to marry for males. The reasons for divorce and disagreement varied between gender. [ABSTRACT FROM AUTHOR]

The authentication of wireless devices through physical layer attributes has attracted a fair amount of attention recently. Recent work in this area has examined various features extracted from the wireless signal to either identify a uniqueness in the channel between the transmitter–receiver pair or more robustly identify certain transmitter behaviors unique to certain devices originating from imperfect hardware manufacturing processes. In particular, the carrier frequency offset (CFO), induced due to the local oscillator mismatch between the transmitter and receiver pair, has exhibited good detection capabilities in stationary and low-mobility transmission scenarios. It is still unclear, however, how the CFO detection capability would hold up in more dynamic time-varying channels where there is a higher mobility. This paper experimentally demonstrates the identification accuracy of CFO for wireless devices in time-varying channels. To this end, a software-defined radio (SDR) testbed is deployed to collect CFO values in real environments, where real transmission and reception are conducted in a vehicular setup. The collected CFO values are used to train machine-learning (ML) classifiers to be used for device identification. While CFO exhibits good detection performance (97% accuracy) for low-mobility scenarios, it is found that higher mobility (35 miles/h) degrades (72% accuracy) the effectiveness of CFO in distinguishing between legitimate and non-legitimate transmitters. This is due to the impact of the time-varying channel on the quality of the exchanged pilot signals used for CFO detection at the receivers. [ABSTRACT FROM AUTHOR]

Background: Lifestyle choices significantly affect health outcomes in Saudi Arabia, but the relationship between health behaviors and satisfaction is unclear. This study aimed to assess lifestyle choices and associated satisfaction levels among residents in the Jazan region of Saudi Arabia. Methods: A cross-sectional study was conducted in Jazan, Saudi Arabia, with 3411 participants. Sociodemographic, lifestyle, and satisfaction data were collected using a questionnaire that was completed during interviews. Logistic regression analyses were implemented to examine the relationships between the study variables and factors related to weight, physical activity, and eating satisfaction. Results: The study found that 38.3% of participants were inactive and 77% rarely ate fruits and vegetables. A total of 47.6% were overweight or obese. Weight (71.12%) and eating (71.59%) satisfaction were high despite these health concerns. The satisfaction-behavior paradox was especially evident in diet. Higher income, physical activity, and healthy eating habits were significantly associated with higher satisfaction (OR = 1.49, 95% CI: 1.15–1.93, p = 0.003 for weight satisfaction, OR = 34.74, 95% CI: 25.42–48.35, p < 0.001 for physical activity satisfaction, and OR = 2.08, 95% CI: 1.67–2.61, p < 0.001 for fruit and vegetable consumption). Conclusions: Lifestyle behaviors and satisfaction in Jazan, Saudi Arabia, are complex. The satisfaction-behavior paradox, especially in diet, reveals a major gap between perceived and actual health. These findings highlight the need for targeted, culturally sensitive interventions that address behavioral change and perception alignment to improve regional public health. [ABSTRACT FROM AUTHOR]

This study evaluated the level of knowledge among parents in Jazan, Saudi Arabia, regarding substances that can harm child development. The Prevention of Toxic Chemicals in the Environment for Children Tool (PRoTECT) was used for this assessment. A cross-sectional survey using a multi-stage cluster random sampling approach was undertaken among 424 parents who were enlisted from eight primary healthcare centers (PHCCs). The PRoTECT score's median value was 72 out of 90, suggesting a generally high level of awareness. The study found that individuals with higher education, particularly those with postgraduate degrees, had greater awareness of protecting their children's health. Interestingly, unemployed individuals and those residing in mountainous areas also demonstrated higher awareness, possibly due to having more time to focus on their children's health and well-being. Most participants (68.2%) acknowledged the correlation between exposure to toxic chemicals during pregnancy and early childhood, and the subsequent development of neurodevelopmental disorders. The study found a solid foundation of knowledge, with 85.1% of participants interested in learning more about reducing children's exposure, but it also stressed the need for specific actions to turn awareness into prevention. These findings would help policymakers develop effective strategies, such as targeted educational campaigns, collaboration with healthcare providers, utilization of media channels, and encouragement of community-led initiatives, to reduce children's exposure to developmental toxicants in line with national and global environmental health initiatives. Future research should focus on longitudinal consciousness and behavior evaluations and regional environmental contaminants. [ABSTRACT FROM AUTHOR]

Background: Patients with multiple myeloma (MM) are at risk of venous thromboembolism (VTE), worsened by immunomodulatory drugs. Although antithrombotics are recommended for prophylaxis, existing guidelines are suboptimal and treatment outcomes remain unclear. Objectives: This study aimed to investigate adverse events, antithrombotic utilization, and their associations with survival outcomes in patients with MM initiating multi-drug immunomodulatory combinations. Design: A posthoc analysis of individual-participant level data (IPD). Methods: IPD from three daratumumab clinical trials (MAIA, POLLUX, and CASTOR) were pooled. Adverse events incidence and antithrombotic utilization were assessed. Logistic and Cox regression were utilized to examine associations between antithrombotics use with adverse events and survival outcomes at the baseline and 6-month landmark. Results: Among 1804 patients, VTE occurred in 10%, bleeding in 14%, ischemic heart disease in 4%, and stroke in 2%. Patients with these adverse events demonstrated elevated rates of any grade ⩾3 events. Antiplatelet (primarily aspirin) and anticoagulant (primarily LMWH and direct oral anticoagulants) prescriptions have seen an increase from baseline (25% and 14%, respectively) to 6 months (35% and 31%). The primary indication for their use was prophylaxis. Anticoagulant use within 6 months was associated with reduced VTE (OR (95% CI) = 0.45 (0.26–0.77), p = 0.004), while antiplatelet use showed no associations with any evaluated adverse events. Antithrombotics and survival outcomes had no significant associations. Conclusion: This study underscores the complexities of antithrombotic therapy and adverse events in MM and highlights the need for vigilant and proactive management due to increased grade ⩾3 adverse events. While anticoagulant use was associated with reduced VTE risk, further research is needed to optimize thromboprophylaxis guidelines and explore antithrombotic efficacy and safety in patients with MM. Trial registration: MAIA (NCT02252172), POLLUX (NCT02076009), CASTOR (NCT02136134). Plain language summary: Blood clot prevention drugs in multiple myeloma: usage and impact on patient outcomes Aims and Purpose of the Research This study aimed to understand how blood-thinning medications are used by patients with multiple myeloma, a type of blood cancer. Specifically, we wanted to find out how often these medications are used, what side effects they might cause, and whether they are linked with how long the patients live. Background of the Research This study is important because patients with multiple myeloma often have a higher risk of blood clots, especially when they are taking certain anticancer treatments. Blood-thinning drugs are usually recommended to prevent these clots, but it's not always clear how well these drugs work or what side effects they might cause. Methods and Research Design This study looked at data from three clinical trials involving a multiple myeloma drug called daratumumab. We looked at how often side effects occurred and how often blood-thinning drugs were used. Two groups of blood thinning drugs were investigated: antiplatelets and anticoagulants. We used two types of statistical methods, called logistic and Cox regression, to see if there was a connection between the use of these blood-thinning drugs and the occurrence of side effects or survival rates at the start of the study and after six months. Results and Importance The study found that the use of blood-thinning drugs increased over time and that using anticoagulants within the first six months was linked to a lower risk of blood clots. However, blood-thinning drugs were not linked with how long the patients lived. These results are important because they can help doctors better manage the use of blood-thinning drugs in patients with multiple myeloma. The key message is that more research is needed to improve guidelines for preventing blood clots and to better understand the safety and effectiveness of blood-thinning drugs in these patients. [ABSTRACT FROM AUTHOR]

Background: The use of prophylactic drainage after laparoscopic cholecystectomy has been a routine practice for many years. However, the debate surrounding using it stems from conflicting evidence regarding its potential benefits and risks. Methods: Patients who underwent laparoscopic cholecystectomy from February 1, 2022, to November 30, 2022, at Aleppo University Hospital were enrolled according to our previously registered protocol (NCT05267860). Results: This study included 232 patients (117 in the drainage group [DG], and 115 in the non‐drainage group [NDG]). There was no statistical difference in the patients' main characteristics, comorbidities, and laboratory findings. The duration of the surgical operation in NDG (mean = 44.92, SD = 1.85) was shorter than in DG (mean 55.14, SD = 2.14), with (p = 0.039) statistically significant, which indicates that the use of the drainage led to a prolongation of the surgical operation. The total number of complicated cases reached 22 (9.48%) cases (DG = 9 vs. NDG = 13, p = 0.348) as follows: bleeding (n = 1) (DG = 1 vs. NDG = 0; p = 0.320), bile leak with no established bile duct injury (n = 1) (DG = 1 vs. NDG = 0; p = 0.320), wound infection (n = 12) (DG = 4 vs. NDG = 8; p = 0.443), urinary tract infection (n = 3) (DG = 0 vs. NDG = 3; p = 0.079), prolonged shoulder pain (n = 2) (DG = 0 vs. NDG = 2; p = 0.152), and acute pancreatitis (n = 1) (DG = 1 vs. NDG = 0; p = 0.144). Conclusion: Based on the results of our study, the use of prophylactic drainage was safe, but ineffective, as it did not improve the outcomes statistically significantly or worsen them, which is consistent with previous studies highlighting the need for personalized patient care in this setting. [ABSTRACT FROM AUTHOR]

Background and Objective: This study aimed to explore the impact of physical activity on depression, anxiety, and stress among pregnant women in the Jazan region of Saudi Arabia. Materials and Methods: A descriptive cross-sectional study was conducted among pregnant women attending randomly selected prenatal clinics in primary healthcare hospitals in Jazan, Saudi Arabia. The calculated sample size was 350. Data were collected conveniently through a semi-structured questionnaire covering demographic details, pregnancy-related characteristics, physical activity assessed using the Pregnancy Physical Activity Questionnaire (PPAQ), and mental health parameters evaluated by the Depression, Anxiety, and Stress Scale-21 (DASS-21). The statistical analyses included descriptive statistics and Wilcoxon and Kruskal–Wallis rank sum tests, with significance levels set at p < 0.05. Results: The study involved 406 pregnant females. Nearly a third (31%) had a family history of depression, anxiety, or distress. The prevalence of depression, anxiety, and stress was 62.6%, 68.7%, and 38.4%, respectively. The mean sedentary, light, moderate, vigorous, and total energy expenditures were 1.512, 24.35, 22.32, 4.84, and 53.02 metabolic equivalent tasks/day. Anxious females exhibited higher light activity (median 24, p = 0.033), while stressed ones showed higher light (median 25, p = 0.039), moderate (median 20, p < 0.001), and vigorous activity (median 3, p < 0.001). A significant association was observed between total energy expenditure and stress levels (p < 0.001). Conclusions: This study underscores the importance of physical activity in managing depression, anxiety, and stress among pregnant women in Jazan, Saudi Arabia. The findings suggest a need for tailored interventions to promote physical activity to improve mental well-being during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of this research is to examine the effects of digital marketing on consumer behavior in the healthcare and pharmaceutical sectors by demonstrating the mediating and moderating role of digital entrepreneurship. It is based on the Technology Acceptance Model (TAM), Diffusion of Innovations Theory, and Consumer Decision-Making Process Model, and describes the relationships between the digital market, consumer practices and values, and digital entrepreneurship. A survey of 250 professionals from the healthcare and pharmaceutical sector domains, structured questionnaires. The research was designed to apply advanced regression analysis techniques to test hypotheses on the influence of digital marketing and digital entrepreneurship on consumer behavior. Findings showed that digital marketing strategies could have a direct positive effect on increased consumer engagement through the partial mediating effect of digital entrepreneurship. It also recognizes irregularities as well as restrictions of particular marketing strategies. The results indicate that the healthcare and pharmaceutical sectors need to make investments in digital communication and drive digital entrepreneurship to adopt a growing digital economy. The paper contributes to the literature by investigating flagging the mediating role of digital entrepreneurship in the relationship between the use of digital marketing activities and consumer behavior, some practical approaches to raise more concern among consumers and accelerate business growth in both areas. [ABSTRACT FROM AUTHOR]

This study aims to investigate the Impact of digital marketing on consumer Confidence: with a special reference to Mediating of AI and information sharing in the telecommunication field in Jordan. This study is quantitative and analyzes data collected from telecommunications companies in Jordan. The results indicate that social media, online branding, online advertising and information sharing have a strong influence on consumer confidence towards telecommunication; On the other hand, AI-driven customer relation also has an edge significantly. By properly using these digital marketing strategies, telecommunications companies can earn the trust of their consumers as well as influence them to make a purchase. This paper contributes to the understanding of digital, online advertising and information sharing have a strong influence on consumer confidence towards telecommunication; the research is limited to the telecommunications industry in Jordan, and the findings provide valuable insights for future research in other sectors and geographic locations. The results offer practical information for marketers and policymakers on how to leverage digital marketing strategies, information sharing, and AI to build consumer confidence. The findings are relevant not only to the Jordanian telecommunications sector but also to other markets looking to enhance consumer trust through digital marketing efforts. [ABSTRACT FROM AUTHOR]

(1) Background: Obesity, a poor diet, and inactivity are major health issues among Saudi youth. However, satisfaction with unhealthy lifestyles could impede change. This study assessed lifestyle factors and related satisfaction among Saudi university students. (2) Methods: In this cross-sectional study, 1957 students at Jazan University completed surveys on demographics, physical activity, dietary habits, and 10-point satisfaction scales for weight, activity, and diet. Chi-squared tests and logistic regression were used to analyze the associations between behaviors and satisfaction. (3) Results: Overweight/obesity prevalence was 25.45%, and only 26.67% of the subjects met activity guidelines. Many of them exhibited poor dietary habits. Despite unhealthy behaviors, some expressed high satisfaction, especially regarding their diets. Subjects with a normal BMI had the highest weight satisfaction. Activity satisfaction increased with higher activity levels. Dietary satisfaction was minimally impacted by healthfulness. Males and higher incomes were correlated with greater satisfaction. (4) Conclusions: A concerning paradox exists between unhealthy lifestyles and satisfaction among Saudi university students, particularly regarding their diets. Multicomponent interventions informed by behavior change theories and employing motivational techniques are urgently needed to address this disconnect and facilitate positive behavior change. [ABSTRACT FROM AUTHOR]

(1) Background: The rising prevalence of e-cigarette use among university students necessitates a comprehensive understanding of dependence levels and associated factors. This study investigates e-cigarette dependence among Jazan University students in Saudi Arabia. (2) Methods: With the use of a cross-sectional design, data were collected from 1187 students through an online survey from January to April 2024. Dependence levels were assessed using the Penn State Electronic Cigarette Dependence Index (PS-ECDI), and the Arabic version of the questionnaire was validated through pilot testing. Multivariable logistic regression analysis was employed to identify factors associated with e-cigarette dependence. (3) Results: The results indicated that among current e-cigarette users, 37.4% had low dependence, 34.4% had medium dependence, and 13.8% had high dependence. A significant proportion of current and ever users regarded e-cigarettes to be less harmful (50.6% and 44.4%, respectively) and less addictive (37.9% and 32.3%, respectively) than cigarettes. Significant factors influencing dependence included gender, with males showing higher odds of medium (AOR = 12.8, 95% CI: 3.4–47.6) and low dependence (AOR = 9.7, 95% CI: 2.5–37.3) compared to females. Longer duration of e-cigarette use (>2 years) was strongly associated with high dependence (AOR = 50, 95% CI: 7.7–324). Daily use and multiple quit attempts were also significant predictors of higher dependence levels. (4) Conclusions: These findings highlight the substantial e-cigarette dependence among university students and underscore the need for targeted interventions to address this growing public health concern. [ABSTRACT FROM AUTHOR]

Abstract While many studies have evaluated the relationship between BMI and breast cancer outcomes, it is unclear whether this relationship is consistent between early breast cancer (BC) and advanced BC. The study included 5099 patients with HER2 positive early BC (EBC) and 3496 with HER2 positive advanced BC (ABC). In the EBC cohort, higher BMI was associated with worse overall survival (OS) (HR [95% CI]: overweight = 1.30 [1.13–1.51]; obese = 1.37 [1.14–1.64], P =

Background: Municipal solid waste management is a complex process involving many technological options. In this review, the effect of five different health systems was studied to assess the impacts of MSW landfilling and incineration according to three environmental health measures: global warming potential, acidification, and nutrient enrichment potentials. Further investigation was conducted to determine whether these differences changed our study approach regarding selecting the most appropriate management option. Content: Life cycle assessment was used to examine the environmental health impacts of all MSW management stages through four main phases: goal and scope, life cycle inventory, life cycle impact assessment, and interpretation. Results were similar for Brazil, China, Lebanon, and Iran where global warming potential, acidification, and nutrient enrichment potentials were higher for landfills than for incinerators. In Canada, landfills produced fewer emissions. Summary: Such work can be helpful to choose the best environmentally friendly municipal solid waste management option based on the standards in Saudi Arabia. These results indicate that national health standards and policies determine these technologies’ environmental health impacts.

BackgroundBurnout is a syndrome that results from stressors in the work environment that have not been successfully managed. The prevalence of burnout among schoolteachers was always controversial. COVID-19 pandemic added more stressors to teachers since they had to change their working styles in response to the pandemic lockdowns or curfews. In Saudi Arabia, the prevalence and determinants of burnout among school teachers were not measured by any other group during the COVID-19 pandemic stressors.MethodsA cross-sectional survey was conducted among 879 teachers in the Jazan region, Saudi Arabia, using the Maslach Burnout Inventory (MBI), during April 2021. Multistage cluster random sampling was used.ResultsThe mean age of the participants was 41.4 (±6.9) years. Male teachers represented 52.6% of the participants while females represented 47.4%. Most teachers showed burnout symptoms (69.6%). Consequences of burnout were observed, such as using psychotropic medications (4.6%), absenteeism (45.6%), lack of job satisfaction (7.7%), and changing schools (15.8%). Using the MBI scale, most teachers showed medium or high emotional exhaustion (57.6%), low depersonalization (62.2%), and low personal accomplishment (51.4%).ConclusionMost teachers showed symptoms of burnout during the COVID-19 pandemic. Being an expert and ability to adapt to technology during the COVID-19 pandemic proved to effectively reduce burnout symptoms. Increasing incentives, early detection, and improving the work environment is recommended to diminish burnout consequences.

The aim of this study was to measure anxiety levels and many co-factors that might influence the levels of anxiety during the COVID-19 outbreak in southern Saudi Arabia (KSA). A cross-sectional self-reporting survey was conducted to determine the level of generalized anxiety disorder (GAD) symptoms related to COVID-19 and quarantining. We selected a convenience sample of eligible participants who had been invited online through social media apps. The survey instrument was distributed, and 981 participants responded. Of the total sample, almost 90% were under the age of 40, 75% were women, and 77% had an educational level beyond high school. Just over half were single, with nearly all participants Saudi nationals. The overall prevalence of anxiety related to COVID-19 was 27%. Factors most strongly related to reporting anxiety included having a diagnosis of COVID-19, spending 1- ≥ 3 h focused on COVID-19, having a previous mental illness history, being a current or former smoker, being female, having a previous diagnosis of chronic or respiratory illness, being below age 40, having a limited standard of living, and being a student. Our study reveals how critical it is to emphasize preventive mental health care during pandemics and what factors may make some individuals most vulnerable to anxiety. Further research is recommended to examine GAD levels pre, during and post pandemic. Additional research to explore the long-term impact of the pandemic on mental health is also needed. being a student, and a limited standard of living.

Introduction The World Health Organization’s (WHO) scalable psychological interventions, such as Problem Management Plus (PM+) and Step-by-Step (SbS) are designed to be cost-effective non-specialist delivered interventions to reduce symptoms of common mental disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD). The STRENGTHS consortium aims to evaluate the effectiveness, cost-effectiveness and implementation of the individual format of PM+ and its group version (gPM+), as well as of the digital SbS intervention among Syrian refugees in seven countries in Europe and the Middle East. This is a study protocol for a prospective individual participant data (IPD) meta-analysis to evaluate (1) overall effectiveness and cost-effectiveness and (2) treatment moderators of PM+, gPM+ and SbS with Syrian refugees.Methods and analysis Five pilot randomised controlled trials (RCTs) and seven fully powered RCTs conducted within STRENGTHS will be combined into one IPD meta-analytic dataset. The RCTs include Syrian refugees of 18 years and above with elevated psychological distress (Kessler Psychological Distress Scale (K10>15)) and impaired daily functioning (WHO Disability Assessment Schedule 2.0 (WHODAS 2.0>16)). Participants are randomised into the intervention or care as usual control group, and complete follow-up assessments at 1-week, 3-month and 12-month follow-up. Primary outcomes are symptoms of depression and anxiety (25-item Hopkins Symptom Checklist). Secondary outcomes include daily functioning (WHODAS 2.0), PTSD symptoms (PTSD Checklist for DSM-5) and self-identified problems (PSYCHLOPS). We will conduct a one-stage IPD meta-analysis using linear mixed models. Quality of evidence will be assessed using the GRADE approach, and the economic evaluation approach will be assessed using the CHEC-list.Ethics and dissemination Local ethical approval has been obtained for each RCT. This IPD meta-analysis does not require ethical approval. The results of this study will be published in international peer-reviewed journals.