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Primacy of the research question, structure of the paper, writing a research article: advice to beginners.

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Thomas V. Perneger, Patricia M. Hudelson, Writing a research article: advice to beginners, International Journal for Quality in Health Care , Volume 16, Issue 3, June 2004, Pages 191–192, https://doi.org/10.1093/intqhc/mzh053

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Writing research papers does not come naturally to most of us. The typical research paper is a highly codified rhetorical form [ 1 , 2 ]. Knowledge of the rules—some explicit, others implied—goes a long way toward writing a paper that will get accepted in a peer-reviewed journal.

A good research paper addresses a specific research question. The research question—or study objective or main research hypothesis—is the central organizing principle of the paper. Whatever relates to the research question belongs in the paper; the rest doesn’t. This is perhaps obvious when the paper reports on a well planned research project. However, in applied domains such as quality improvement, some papers are written based on projects that were undertaken for operational reasons, and not with the primary aim of producing new knowledge. In such cases, authors should define the main research question a posteriori and design the paper around it.

Generally, only one main research question should be addressed in a paper (secondary but related questions are allowed). If a project allows you to explore several distinct research questions, write several papers. For instance, if you measured the impact of obtaining written consent on patient satisfaction at a specialized clinic using a newly developed questionnaire, you may want to write one paper on the questionnaire development and validation, and another on the impact of the intervention. The idea is not to split results into ‘least publishable units’, a practice that is rightly decried, but rather into ‘optimally publishable units’.

What is a good research question? The key attributes are: (i) specificity; (ii) originality or novelty; and (iii) general relevance to a broad scientific community. The research question should be precise and not merely identify a general area of inquiry. It can often (but not always) be expressed in terms of a possible association between X and Y in a population Z, for example ‘we examined whether providing patients about to be discharged from the hospital with written information about their medications would improve their compliance with the treatment 1 month later’. A study does not necessarily have to break completely new ground, but it should extend previous knowledge in a useful way, or alternatively refute existing knowledge. Finally, the question should be of interest to others who work in the same scientific area. The latter requirement is more challenging for those who work in applied science than for basic scientists. While it may safely be assumed that the human genome is the same worldwide, whether the results of a local quality improvement project have wider relevance requires careful consideration and argument.

Once the research question is clearly defined, writing the paper becomes considerably easier. The paper will ask the question, then answer it. The key to successful scientific writing is getting the structure of the paper right. The basic structure of a typical research paper is the sequence of Introduction, Methods, Results, and Discussion (sometimes abbreviated as IMRAD). Each section addresses a different objective. The authors state: (i) the problem they intend to address—in other terms, the research question—in the Introduction; (ii) what they did to answer the question in the Methods section; (iii) what they observed in the Results section; and (iv) what they think the results mean in the Discussion.

In turn, each basic section addresses several topics, and may be divided into subsections (Table 1 ). In the Introduction, the authors should explain the rationale and background to the study. What is the research question, and why is it important to ask it? While it is neither necessary nor desirable to provide a full-blown review of the literature as a prelude to the study, it is helpful to situate the study within some larger field of enquiry. The research question should always be spelled out, and not merely left for the reader to guess.

Typical structure of a research paper

The Methods section should provide the readers with sufficient detail about the study methods to be able to reproduce the study if so desired. Thus, this section should be specific, concrete, technical, and fairly detailed. The study setting, the sampling strategy used, instruments, data collection methods, and analysis strategies should be described. In the case of qualitative research studies, it is also useful to tell the reader which research tradition the study utilizes and to link the choice of methodological strategies with the research goals [ 3 ].

The Results section is typically fairly straightforward and factual. All results that relate to the research question should be given in detail, including simple counts and percentages. Resist the temptation to demonstrate analytic ability and the richness of the dataset by providing numerous tables of non-essential results.

The Discussion section allows the most freedom. This is why the Discussion is the most difficult to write, and is often the weakest part of a paper. Structured Discussion sections have been proposed by some journal editors [ 4 ]. While strict adherence to such rules may not be necessary, following a plan such as that proposed in Table 1 may help the novice writer stay on track.

References should be used wisely. Key assertions should be referenced, as well as the methods and instruments used. However, unless the paper is a comprehensive review of a topic, there is no need to be exhaustive. Also, references to unpublished work, to documents in the grey literature (technical reports), or to any source that the reader will have difficulty finding or understanding should be avoided.

Having the structure of the paper in place is a good start. However, there are many details that have to be attended to while writing. An obvious recommendation is to read, and follow, the instructions to authors published by the journal (typically found on the journal’s website). Another concerns non-native writers of English: do have a native speaker edit the manuscript. A paper usually goes through several drafts before it is submitted. When revising a paper, it is useful to keep an eye out for the most common mistakes (Table 2 ). If you avoid all those, your paper should be in good shape.

Common mistakes seen in manuscripts submitted to this journal

Huth EJ . How to Write and Publish Papers in the Medical Sciences , 2nd edition. Baltimore, MD: Williams & Wilkins, 1990 .

Browner WS . Publishing and Presenting Clinical Research . Baltimore, MD: Lippincott, Williams & Wilkins, 1999 .

Devers KJ , Frankel RM. Getting qualitative research published. Educ Health 2001 ; 14 : 109 –117.

Docherty M , Smith R. The case for structuring the discussion of scientific papers. Br Med J 1999 ; 318 : 1224 –1225.

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Writing a Scientific Review Article: Comprehensive Insights for Beginners

Ayodeji amobonye.

1 Department of Biotechnology and Food Science, Faculty of Applied Sciences, Durban University of Technology, P.O. Box 1334, KwaZulu-Natal, Durban 4000, South Africa

2 Writing Centre, Durban University of Technology, P.O. Box 1334 KwaZulu-Natal, Durban 4000, South Africa

Japareng Lalung

3 School of Industrial Technology, Universiti Sains Malaysia, Gelugor 11800, Pulau Pinang, Malaysia

Santhosh Pillai

Associated data.

The data and materials that support the findings of this study are available from the corresponding author upon reasonable request.

Review articles present comprehensive overview of relevant literature on specific themes and synthesise the studies related to these themes, with the aim of strengthening the foundation of knowledge and facilitating theory development. The significance of review articles in science is immeasurable as both students and researchers rely on these articles as the starting point for their research. Interestingly, many postgraduate students are expected to write review articles for journal publications as a way of demonstrating their ability to contribute to new knowledge in their respective fields. However, there is no comprehensive instructional framework to guide them on how to analyse and synthesise the literature in their niches into publishable review articles. The dearth of ample guidance or explicit training results in students having to learn all by themselves, usually by trial and error, which often leads to high rejection rates from publishing houses. Therefore, this article seeks to identify these challenges from a beginner's perspective and strives to plug the identified gaps and discrepancies. Thus, the purpose of this paper is to serve as a systematic guide for emerging scientists and to summarise the most important information on how to write and structure a publishable review article.

1. Introduction

Early scientists, spanning from the Ancient Egyptian civilization to the Scientific Revolution of the 16 th /17 th century, based their research on intuitions, personal observations, and personal insights. Thus, less time was spent on background reading as there was not much literature to refer to. This is well illustrated in the case of Sir Isaac Newton's apple tree and the theory of gravity, as well as Gregor Mendel's pea plants and the theory of inheritance. However, with the astronomical expansion in scientific knowledge and the emergence of the information age in the last century, new ideas are now being built on previously published works, thus the periodic need to appraise the huge amount of already published literature [ 1 ]. According to Birkle et al. [ 2 ], the Web of Science—an authoritative database of research publications and citations—covered more than 80 million scholarly materials. Hence, a critical review of prior and relevant literature is indispensable for any research endeavour as it provides the necessary framework needed for synthesising new knowledge and for highlighting new insights and perspectives [ 3 ].

Review papers are generally considered secondary research publications that sum up already existing works on a particular research topic or question and relate them to the current status of the topic. This makes review articles distinctly different from scientific research papers. While the primary aim of the latter is to develop new arguments by reporting original research, the former is focused on summarising and synthesising previous ideas, studies, and arguments, without adding new experimental contributions. Review articles basically describe the content and quality of knowledge that are currently available, with a special focus on the significance of the previous works. To this end, a review article cannot simply reiterate a subject matter, but it must contribute to the field of knowledge by synthesising available materials and offering a scholarly critique of theory [ 4 ]. Typically, these articles critically analyse both quantitative and qualitative studies by scrutinising experimental results, the discussion of the experimental data, and in some instances, previous review articles to propose new working theories. Thus, a review article is more than a mere exhaustive compilation of all that has been published on a topic; it must be a balanced, informative, perspective, and unbiased compendium of previous studies which may also include contrasting findings, inconsistencies, and conventional and current views on the subject [ 5 ].

Hence, the essence of a review article is measured by what is achieved, what is discovered, and how information is communicated to the reader [ 6 ]. According to Steward [ 7 ], a good literature review should be analytical, critical, comprehensive, selective, relevant, synthetic, and fully referenced. On the other hand, a review article is considered to be inadequate if it is lacking in focus or outcome, overgeneralised, opinionated, unbalanced, and uncritical [ 7 ]. Most review papers fail to meet these standards and thus can be viewed as mere summaries of previous works in a particular field of study. In one of the few studies that assessed the quality of review articles, none of the 50 papers that were analysed met the predefined criteria for a good review [ 8 ]. However, beginners must also realise that there is no bad writing in the true sense; there is only writing in evolution and under refinement. Literally, every piece of writing can be improved upon, right from the first draft until the final published manuscript. Hence, a paper can only be referred to as bad and unfixable when the author is not open to corrections or when the writer gives up on it.

According to Peat et al. [ 9 ], “everything is easy when you know how,” a maxim which applies to scientific writing in general and review writing in particular. In this regard, the authors emphasized that the writer should be open to learning and should also follow established rules instead of following a blind trial-and-error approach. In contrast to the popular belief that review articles should only be written by experienced scientists and researchers, recent trends have shown that many early-career scientists, especially postgraduate students, are currently expected to write review articles during the course of their studies. However, these scholars have little or no access to formal training on how to analyse and synthesise the research literature in their respective fields [ 10 ]. Consequently, students seeking guidance on how to write or improve their literature reviews are less likely to find published works on the subject, particularly in the science fields. Although various publications have dealt with the challenges of searching for literature, or writing literature reviews for dissertation/thesis purposes, there is little or no information on how to write a comprehensive review article for publication. In addition to the paucity of published information to guide the potential author, the lack of understanding of what constitutes a review paper compounds their challenges. Thus, the purpose of this paper is to serve as a guide for writing review papers for journal publishing. This work draws on the experience of the authors to assist early-career scientists/researchers in the “hard skill” of authoring review articles. Even though there is no single path to writing scientifically, or to writing reviews in particular, this paper attempts to simplify the process by looking at this subject from a beginner's perspective. Hence, this paper highlights the differences between the types of review articles in the sciences while also explaining the needs and purpose of writing review articles. Furthermore, it presents details on how to search for the literature as well as how to structure the manuscript to produce logical and coherent outputs. It is hoped that this work will ease prospective scientific writers into the challenging but rewarding art of writing review articles.

2. Benefits of Review Articles to the Author

Analysing literature gives an overview of the “WHs”: WHat has been reported in a particular field or topic, WHo the key writers are, WHat are the prevailing theories and hypotheses, WHat questions are being asked (and answered), and WHat methods and methodologies are appropriate and useful [ 11 ]. For new or aspiring researchers in a particular field, it can be quite challenging to get a comprehensive overview of their respective fields, especially the historical trends and what has been studied previously. As such, the importance of review articles to knowledge appraisal and contribution cannot be overemphasised, which is reflected in the constant demand for such articles in the research community. However, it is also important for the author, especially the first-time author, to recognise the importance of his/her investing time and effort into writing a quality review article.

Generally, literature reviews are undertaken for many reasons, mainly for publication and for dissertation purposes. The major purpose of literature reviews is to provide direction and information for the improvement of scientific knowledge. They also form a significant component in the research process and in academic assessment [ 12 ]. There may be, however, a thin line between a dissertation literature review and a published review article, given that with some modifications, a literature review can be transformed into a legitimate and publishable scholarly document. According to Gülpınar and Güçlü [ 6 ], the basic motivation for writing a review article is to make a comprehensive synthesis of the most appropriate literature on a specific research inquiry or topic. Thus, conducting a literature review assists in demonstrating the author's knowledge about a particular field of study, which may include but not be limited to its history, theories, key variables, vocabulary, phenomena, and methodologies [ 10 ]. Furthermore, publishing reviews is beneficial as it permits the researchers to examine different questions and, as a result, enhances the depth and diversity of their scientific reasoning [ 1 ]. In addition, writing review articles allows researchers to share insights with the scientific community while identifying knowledge gaps to be addressed in future research. The review writing process can also be a useful tool in training early-career scientists in leadership, coordination, project management, and other important soft skills necessary for success in the research world [ 13 ]. Another important reason for authoring reviews is that such publications have been observed to be remarkably influential, extending the reach of an author in multiple folds of what can be achieved by primary research papers [ 1 ]. The trend in science is for authors to receive more citations from their review articles than from their original research articles. According to Miranda and Garcia-Carpintero [ 14 ], review articles are, on average, three times more frequently cited than original research articles; they also asserted that a 20% increase in review authorship could result in a 40–80% increase in citations of the author. As a result, writing reviews can significantly impact a researcher's citation output and serve as a valuable channel to reach a wider scientific audience. In addition, the references cited in a review article also provide the reader with an opportunity to dig deeper into the topic of interest. Thus, review articles can serve as a valuable repository for consultation, increasing the visibility of the authors and resulting in more citations.

3. Types of Review Articles

The first step in writing a good literature review is to decide on the particular type of review to be written; hence, it is important to distinguish and understand the various types of review articles. Although scientific review articles have been classified according to various schemes, however, they are broadly categorised into narrative reviews, systematic reviews, and meta-analyses [ 15 ]. It was observed that more authors—as well as publishers—were leaning towards systematic reviews and meta-analysis while downplaying narrative reviews; however, the three serve different aims and should all be considered equally important in science [ 1 ]. Bibliometric reviews and patent reviews, which are closely related to meta-analysis, have also gained significant attention recently. However, from another angle, a review could also be of two types. In the first class, authors could deal with a widely studied topic where there is already an accumulated body of knowledge that requires analysis and synthesis [ 3 ]. At the other end of the spectrum, the authors may have to address an emerging issue that would benefit from exposure to potential theoretical foundations; hence, their contribution would arise from the fresh theoretical foundations proposed in developing a conceptual model [ 3 ].

3.1. Narrative Reviews

Narrative reviewers are mainly focused on providing clarification and critical analysis on a particular topic or body of literature through interpretative synthesis, creativity, and expert judgement. According to Green et al. [ 16 ], a narrative review can be in the form of editorials, commentaries, and narrative overviews. However, editorials and commentaries are usually expert opinions; hence, a beginner is more likely to write a narrative overview, which is more general and is also referred to as an unsystematic narrative review. Similarly, the literature review section of most dissertations and empirical papers is typically narrative in nature. Typically, narrative reviews combine results from studies that may have different methodologies to address different questions or to formulate a broad theoretical formulation [ 1 ]. They are largely integrative as strong focus is placed on the assimilation and synthesis of various aspects in the review, which may involve comparing and contrasting research findings or deriving structured implications [ 17 ]. In addition, they are also qualitative studies because they do not follow strict selection processes; hence, choosing publications is relatively more subjective and unsystematic [ 18 ]. However, despite their popularity, there are concerns about their inherent subjectivity. In many instances, when the supporting data for narrative reviews are examined more closely, the evaluations provided by the author(s) become quite questionable [ 19 ]. Nevertheless, if the goal of the author is to formulate a new theory that connects diverse strands of research, a narrative method is most appropriate.

3.2. Systematic Reviews

In contrast to narrative reviews, which are generally descriptive, systematic reviews employ a systematic approach to summarise evidence on research questions. Hence, systematic reviews make use of precise and rigorous criteria to identify, evaluate, and subsequently synthesise all relevant literature on a particular topic [ 12 , 20 ]. As a result, systematic reviews are more likely to inspire research ideas by identifying knowledge gaps or inconsistencies, thus helping the researcher to clearly define the research hypotheses or questions [ 21 ]. Furthermore, systematic reviews may serve as independent research projects in their own right, as they follow a defined methodology to search and combine reliable results to synthesise a new database that can be used for a variety of purposes [ 22 ]. Typically, the peculiarities of the individual reviewer, different search engines, and information databases used all ensure that no two searches will yield the same systematic results even if the searches are conducted simultaneously and under identical criteria [ 11 ]. Hence, attempts are made at standardising the exercise via specific methods that would limit bias and chance effects, prevent duplications, and provide more accurate results upon which conclusions and decisions can be made.

The most established of these methods is the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines which objectively defined statements, guidelines, reporting checklists, and flowcharts for undertaking systematic reviews as well as meta-analysis [ 23 ]. Though mainly designed for research in medical sciences, the PRISMA approach has gained wide acceptance in other fields of science and is based on eight fundamental propositions. These include the explicit definition of the review question, an unambiguous outline of the study protocol, an objective and exhaustive systematic review of reputable literature, and an unambiguous identification of included literature based on defined selection criteria [ 24 ]. Other considerations include an unbiased appraisal of the quality of the selected studies (literature), organic synthesis of the evidence of the study, preparation of the manuscript based on the reporting guidelines, and periodic update of the review as new data emerge [ 24 ]. Other methods such as PRISMA-P (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols), MOOSE (Meta-analysis Of Observational Studies in Epidemiology), and ROSES (Reporting Standards for Systematic Evidence Syntheses) have since been developed for systematic reviews (and meta-analysis), with most of them being derived from PRISMA.

Consequently, systematic reviews—unlike narrative reviews—must contain a methodology section which in addition to all that was highlighted above must fully describe the precise criteria used in formulating the research question and setting the inclusion or exclusion criteria used in selecting/accessing the literature. Similarly, the criteria for evaluating the quality of the literature included in the review as well as for analysing, synthesising, and disseminating the findings must be fully described in the methodology section.

3.3. Meta-Analysis

Meta-analyses are considered as more specialised forms of systematic reviews. Generally, they combine the results of many studies that use similar or closely related methods to address the same question or share a common quantitative evaluation method [ 25 ]. However, meta-analyses are also a step higher than other systematic reviews as they are focused on numerical data and involve the use of statistics in evaluating different studies and synthesising new knowledge. The major advantage of this type of review is the increased statistical power leading to more reliable results for inferring modest associations and a more comprehensive understanding of the true impact of a research study [ 26 ]. Unlike in traditional systematic reviews, research topics covered in meta-analyses must be mature enough to allow the inclusion of sufficient homogeneous empirical research in terms of subjects, interventions, and outcomes [ 27 , 28 ].

Being an advanced form of systematic review, meta-analyses must also have a distinct methodology section; hence, the standard procedures involved in the traditional systematic review (especially PRISMA) also apply in meta-analyses [ 23 ]. In addition to the common steps in formulating systematic reviews, meta-analyses are required to describe how nested and missing data are handled, the effect observed in each study, the confidence interval associated with each synthesised effect, and any potential for bias presented within the sample(s) [ 17 ]. According to Paul and Barari [ 28 ], a meta-analysis must also detail the final sample, the meta-analytic model, and the overall analysis, moderator analysis, and software employed. While the overall analysis involves the statistical characterization of the relationships between variables in the meta-analytic framework and their significance, the moderator analysis defines the different variables that may affect variations in the original studies [ 28 , 29 ]. It must also be noted that the accuracy and reliability of meta-analyses have both been significantly enhanced by the incorporation of statistical approaches such as Bayesian analysis [ 30 ], network analysis [ 31 ], and more recently, machine learning [ 32 ].

3.4. Bibliometric Review

A bibliometric review, commonly referred to as bibliometric analysis, is a systematic evaluation of published works within a specific field or discipline [ 33 ]. This bibliometric methodology involves the use of quantitative methods to analyse bibliometric data such as the characteristics and numbers of publications, units of citations, authorship, co-authorship, and journal impact factors [ 34 ]. Academics use bibliometric analysis with different objectives in mind, which includes uncovering emerging trends in article and journal performance, elaborating collaboration patterns and research constituents, evaluating the impact and influence of particular authors, publications, or research groups, and highlighting the intellectual framework of a certain field [ 35 ]. It is also used to inform policy and decision-making. Similarly to meta-analysis, bibliometric reviews rely upon quantitative techniques, thus avoiding the interpretation bias that could arise from the qualitative techniques of other types of reviews [ 36 ]. However, while bibliometric analysis synthesises the bibliometric and intellectual structure of a field by examining the social and structural linkages between various research parts, meta-analysis focuses on summarising empirical evidence by probing the direction and strength of effects and relationships among variables, especially in open research questions [ 37 , 38 ]. However, similarly to systematic review and meta-analysis, a bibliometric review also requires a well-detailed methodology section. The amount of data to be analysed in bibliometric analysis is quite massive, running to hundreds and tens of thousands in some cases. Although the data are objective in nature (e.g., number of citations and publications and occurrences of keywords and topics), the interpretation is usually carried out through both objective (e.g., performance analysis) and subjective (e.g., thematic analysis) evaluations [ 35 ]. However, the invention and availability of bibliometric software such as BibExcel, Gephi, Leximancer, and VOSviewer and scientific databases such as Dimensions, Web of Science, and Scopus have made this type of analysis more feasible.

3.5. Patent Review

Patent reviews provide a comprehensive analysis and critique of a specific patent or a group of related patents, thus presenting a concise understanding of the technology or innovation that is covered by the patent [ 39 ]. This type of article is useful for researchers as it also enhances their understanding of the legal, technical, and commercial aspects of an intellectual property/innovation; in addition, it is also important for stakeholders outside the research community including IP (intellectual property) specialists, legal professionals, and technology-transfer officers [ 40 ]. Typically, patent reviews encompass the scope, background, claims, legal implications, technical specifications, and potential commercial applications of the patent(s). The article may also include a discussion of the patent's strengths and weaknesses, as well as its potential impact on the industry or field in which it operates. Most times, reviews are time specified, they may be regionalised, and the data are usually retrieved via patent searches on databases such as that of the European Patent Office ( https://www.epo.org/searching.html ), United States Patent and Trademark Office ( https://patft.uspto.gov/ ), the World Intellectual Property Organization's PATENTSCOPE ( https://patentscope.wipo.int/search/en/structuredSearch.jsf ), Google Patent ( https://www.google.com/?tbm=pts ), and China National Intellectual Property Administration ( https://pss-system.cponline.cnipa.gov.cn/conventionalSearch ). According to Cerimi et al. [ 41 ], the retrieved data and analysed may include the patent number, patent status, filing date, application date, grant dates, inventor, assignee, and pending applications. While data analysis is usually carried out by general data software such as Microsoft Excel, an intelligence software solely dedicated to patent research and analysis, Orbit Intelligence has been found to be more efficient [ 39 ]. It is also mandatory to include a methodology section in a patent review, and this should be explicit, thorough, and precise to allow a clear understanding of how the analysis was carried out and how the conclusions were arrived at.

4. Searching Literature

One of the most challenging tasks in writing a review article on a subject is the search for relevant literature to populate the manuscript as the author is required to garner information from an endless number of sources. This is even more challenging as research outputs have been increasing astronomically, especially in the last decade, with thousands of new articles published annually in various fields. It is therefore imperative that the author must not only be aware of the overall trajectory in a field of investigation but must also be cognizant of recent studies so as not to publish outdated research or review articles. Basically, the search for the literature involves a coherent conceptual structuring of the topic itself and a thorough collation of evidence under the common themes which might reflect the histories, conflicts, standoffs, revolutions, and/or evolutions in the field [ 7 ]. To start the search process, the author must carefully identify and select broad keywords relevant to the subject; subsequently, the keywords should be developed to refine the search into specific subheadings that would facilitate the structure of the review.

Two main tactics have been identified for searching the literature, namely, systematic and snowballing [ 42 ]. The systematic approach involves searching literature with specific keywords (for example, cancer, antioxidant, and nanoparticles), which leads to an almost unmanageable and overwhelming list of possible sources [ 43 ]. The snowballing approach, however, involves the identification of a particular publication, followed by the compilation of a bibliography of articles based on the reference list of the identified publication [ 44 ]. Many times, it might be necessary to combine both approaches, but irrespective, the author must keep an accurate track and record of papers cited in the search. A simple and efficient strategy for populating the bibliography of review articles is to go through the abstract (and sometimes the conclusion) of a paper; if the abstract is related to the topic of discourse, the author might go ahead and read the entire article; otherwise, he/she is advised to move on [ 45 ]. Winchester and Salji [ 5 ] noted that to learn the background of the subject/topic to be reviewed, starting literature searches with academic textbooks or published review articles is imperative, especially for beginners. Furthermore, it would also assist in compiling the list of keywords, identifying areas of further exploration, and providing a glimpse of the current state of the research. However, past reviews ideally are not to serve as the foundation of a new review as they are written from someone else's viewpoint, which might have been tainted with some bias. Fortunately, the accessibility and search for the literature have been made relatively easier than they were a few decades ago as the current information age has placed an enormous volume of knowledge right at our fingertips [ 46 ]. Nevertheless, when gathering the literature from the Internet, authors should exercise utmost caution as much of the information may not be verified or peer-reviewed and thus may be unregulated and unreliable. For instance, Wikipedia, despite being a large repository of information with more than 6.7 million articles in the English language alone, is considered unreliable for scientific literature reviews, due to its openness to public editing [ 47 ]. However, in addition to peer-reviewed journal publications—which are most ideal—reviews can also be drawn from a wide range of other sources such as technical documents, in-house reports, conference abstracts, and conference proceedings. Similarly, “Google Scholar”—as against “Google” and other general search engines—is more appropriate as its searches are restricted to only academic articles produced by scholarly societies or/and publishers [ 48 ]. Furthermore, the various electronic databases, such as ScienceDirect, Web of Science, PubMed, and MEDLINE, many of which focus on specific fields of research, are also ideal options [ 49 ]. Advancement in computer indexing has remarkably expanded the ease and ability to search large databases for every potentially relevant article. In addition to searching by topic, literature search can be modified by time; however, there must be a balance between old papers and recent ones. The general consensus in science is that publications less than five years old are considered recent.

It is important, especially in systematic reviews and meta-analyses, that the specific method of running the computer searches be properly documented as there is the need to include this in the method (methodology) section of such papers. Typically, the method details the keywords, databases explored, search terms used, and the inclusion/exclusion criteria applied in the selection of data and any other specific decision/criteria. All of these will ensure the reproducibility and thoroughness of the search and the selection procedure. However, Randolph [ 10 ] noted that Internet searches might not give the exhaustive list of articles needed for a review article; hence, it is advised that authors search through the reference lists of articles that were obtained initially from the Internet search. After determining the relevant articles from the list, the author should read through the references of these articles and repeat the cycle until saturation is reached [ 10 ]. After populating the articles needed for the literature review, the next step is to analyse them individually and in their whole entirety. A systematic approach to this is to identify the key information within the papers, examine them in depth, and synthesise original perspectives by integrating the information and making inferences based on the findings. In this regard, it is imperative to link one source to the other in a logical manner, for instance, taking note of studies with similar methodologies, papers that agree, or results that are contradictory [ 42 ].

5. Structuring the Review Article

The title and abstract are the main selling points of a review article, as most readers will only peruse these two elements and usually go on to read the full paper if they are drawn in by either or both of the two. Tullu [ 50 ] recommends that the title of a scientific paper “should be descriptive, direct, accurate, appropriate, interesting, concise, precise, unique, and not be misleading.” In addition to providing “just enough details” to entice the reader, words in the titles are also used by electronic databases, journal websites, and search engines to index and retrieve a particular paper during a search [ 51 ]. Titles are of different types and must be chosen according to the topic under review. They are generally classified as descriptive, declarative, or interrogative and can also be grouped into compound, nominal, or full-sentence titles [ 50 ]. The subject of these categorisations has been extensively discussed in many articles; however, the reader must also be aware of the compound titles, which usually contain a main title and a subtitle. Typically, subtitles provide additional context—to the main title—and they may specify the geographic scope of the research, research methodology, or sample size [ 52 ].

Just like primary research articles, there are many debates about the optimum length of a review article's title. However, the general consensus is to keep the title as brief as possible while not being too general. A title length between 10 and 15 words is recommended, since longer titles can be more challenging to comprehend. Paiva et al. [ 53 ] observed that articles which contain 95 characters or less get more views and citations. However, emphasis must be placed on conciseness as the audience will be more satisfied if they can understand what exactly the review has contributed to the field, rather than just a hint about the general topic area. Authors should also endeavour to stick to the journal's specific requirements, especially regarding the length of the title and what they should or should not contain [ 9 ]. Thus, avoidance of filler words such as “a review on/of,” “an observation of,” or “a study of” is a very simple way to limit title length. In addition, abbreviations or acronyms should be avoided in the title, except the standard or commonly interpreted ones such as AIDS, DNA, HIV, and RNA. In summary, to write an effective title, the authors should consider the following points. What is the paper about? What was the methodology used? What were the highlights and major conclusions? Subsequently, the author should list all the keywords from these answers, construct a sentence from these keywords, and finally delete all redundant words from the sentence title. It is also possible to gain some ideas by scanning indices and article titles in major journals in the field. It is important to emphasise that a title is not chosen and set in stone, and the title is most likely to be continually revised and adjusted until the end of the writing process.

5.2. Abstract

The abstract, also referred to as the synopsis, is a summary of the full research paper; it is typically independent and can stand alone. For most readers, a publication does not exist beyond the abstract, partly because abstracts are often the only section of a paper that is made available to the readers at no cost, whereas the full paper may attract a payment or subscription [ 54 ]. Thus, the abstract is supposed to set the tone for the few readers who wish to read the rest of the paper. It has also been noted that the abstract gives the first impression of a research work to journal editors, conference scientific committees, or referees, who might outright reject the paper if the abstract is poorly written or inadequate [ 50 ]. Hence, it is imperative that the abstract succinctly represents the entire paper and projects it positively. Just like the title, abstracts have to be balanced, comprehensive, concise, functional, independent, precise, scholarly, and unbiased and not be misleading [ 55 ]. Basically, the abstract should be formulated using keywords from all the sections of the main manuscript. Thus, it is pertinent that the abstract conveys the focus, key message, rationale, and novelty of the paper without any compromise or exaggeration. Furthermore, the abstract must be consistent with the rest of the paper; as basic as this instruction might sound, it is not to be taken for granted. For example, a study by Vrijhoef and Steuten [ 56 ] revealed that 18–68% of 264 abstracts from some scientific journals contained information that was inconsistent with the main body of the publications.

Abstracts can either be structured or unstructured; in addition, they can further be classified as either descriptive or informative. Unstructured abstracts, which are used by many scientific journals, are free flowing with no predefined subheadings, while structured abstracts have specific subheadings/subsections under which the abstract needs to be composed. Structured abstracts have been noted to be more informative and are usually divided into subsections which include the study background/introduction, objectives, methodology design, results, and conclusions [ 57 ]. No matter the style chosen, the author must carefully conform to the instructions provided by the potential journal of submission, which may include but are not limited to the format, font size/style, word limit, and subheadings [ 58 ]. The word limit for abstracts in most scientific journals is typically between 150 and 300 words. It is also a general rule that abstracts do not contain any references whatsoever.

Typically, an abstract should be written in the active voice, and there is no such thing as a perfect abstract as it could always be improved on. It is advised that the author first makes an initial draft which would contain all the essential parts of the paper, which could then be polished subsequently. The draft should begin with a brief background which would lead to the research questions. It might also include a general overview of the methodology used (if applicable) and importantly, the major results/observations/highlights of the review paper. The abstract should end with one or few sentences about any implications, perspectives, or future research that may be developed from the review exercise. Finally, the authors should eliminate redundant words and edit the abstract to the correct word count permitted by the journal [ 59 ]. It is always beneficial to read previous abstracts published in the intended journal, related topics/subjects from other journals, and other reputable sources. Furthermore, the author should endeavour to get feedback on the abstract especially from peers and co-authors. As the abstract is the face of the whole paper, it is best that it is the last section to be finalised, as by this time, the author would have developed a clearer understanding of the findings and conclusions of the entire paper.

5.3. Graphical Abstracts

Since the mid-2000s, an increasing number of journals now require authors to provide a graphical abstract (GA) in addition to the traditional written abstract, to increase the accessibility of scientific publications to readers [ 60 ]. A study showed that publications with GA performed better than those without it, when the abstract views, total citations, and downloads were compared [ 61 ]. However, the GA should provide “a single, concise pictorial, and visual summary of the main findings of an article” [ 62 ]. Although they are meant to be a stand-alone summary of the whole paper, it has been noted that they are not so easily comprehensible without having read through the traditionally written abstract [ 63 ]. It is important to note that, like traditional abstracts, many reputable journals require GAs to adhere to certain specifications such as colour, dimension, quality, file size, and file format (usually JPEG/JPG, PDF, PNG, or TIFF). In addition, it is imperative to use engaging and accurate figures, all of which must be synthesised in order to accurately reflect the key message of the paper. Currently, there are various online or downloadable graphical tools that can be used for creating GAs, such as Microsoft Paint or PowerPoint, Mindthegraph, ChemDraw, CorelDraw, and BioRender.

5.4. Keywords

As a standard practice, journals require authors to select 4–8 keywords (or phrases), which are typically listed below the abstract. A good set of keywords will enable indexers and search engines to find relevant papers more easily and can be considered as a very concise abstract [ 64 ]. According to Dewan and Gupta [ 51 ], the selection of appropriate keywords will significantly enhance the retrieval, accession, and consequently, the citation of the review paper. Ideally, keywords can be variants of the terms/phrases used in the title, the abstract, and the main text, but they should ideally not be the exact words in the main title. Choosing the most appropriate keywords for a review article involves listing down the key terms and phrases in the article, including abbreviations. Subsequently, a quick review of the glossary/vocabulary/term list or indexing standard in the specific discipline will assist in selecting the best and most precise keywords that match those used in the databases from the list drawn. In addition, the keywords should not be broad or general terms (e.g., DNA, biology, and enzymes) but must be specific to the field or subfield of study as well as to the particular paper [ 65 ].

5.5. Introduction

The introduction of an article is the first major section of the manuscript, and it presents basic information to the reader without compelling them to study past publications. In addition, the introduction directs the reader to the main arguments and points developed in the main body of the article while clarifying the current state of knowledge in that particular area of research [ 12 ]. The introduction part of a review article is usually sectionalised into background information, a description of the main topic and finally a statement of the main purpose of the review [ 66 ]. Authors may begin the introduction with brief general statements—which provide background knowledge on the subject matter—that lead to more specific ones [ 67 ]. It is at this point that the reader's attention must be caught as the background knowledge must highlight the importance and justification for the subject being discussed, while also identifying the major problem to be addressed [ 68 ]. In addition, the background should be broad enough to attract even nonspecialists in the field to maximise the impact and widen the reach of the article. All of these should be done in the light of current literature; however, old references may also be used for historical purposes. A very important aspect of the introduction is clearly stating and establishing the research problem(s) and how a review of the particular topic contributes to those problem(s). Thus, the research gap which the paper intends to fill, the limitations of previous works and past reviews, if available, and the new knowledge to be contributed must all be highlighted. Inadequate information and the inability to clarify the problem will keep readers (who have the desire to obtain new information) from reading beyond the introduction [ 69 ]. It is also pertinent that the author establishes the purpose of reviewing the literature and defines the scope as well as the major synthesised point of view. Furthermore, a brief insight into the criteria used to select, evaluate, and analyse the literature, as well as the outline or sequence of the review, should be provided in the introduction. Subsequently, the specific objectives of the review article must be presented. The last part of the “introduction” section should focus on the solution, the way forward, the recommendations, and the further areas of research as deduced from the whole review process. According to DeMaria [ 70 ], clearly expressed or recommended solutions to an explicitly revealed problem are very important for the wholesomeness of the “introduction” section. It is believed that following these steps will give readers the opportunity to track the problems and the corresponding solution from their own perspective in the light of current literature. As against some suggestions that the introduction should be written only in present tenses, it is also believed that it could be done with other tenses in addition to the present tense. In this regard, general facts should be written in the present tense, specific research/work should be in the past tense, while the concluding statement should be in the past perfect or simple past. Furthermore, many of the abbreviations to be used in the rest of the manuscript and their explanations should be defined in this section.

5.6. Methodology

Writing a review article is equivalent to conducting a research study, with the information gathered by the author (reviewer) representing the data. Like all major studies, it involves conceptualisation, planning, implementation, and dissemination [ 71 ], all of which may be detailed in a methodology section, if necessary. Hence, the methodological section of a review paper (which can also be referred to as the review protocol) details how the relevant literature was selected and how it was analysed as well as summarised. The selection details may include, but are not limited to, the database consulted and the specific search terms used together with the inclusion/exclusion criteria. As earlier highlighted in Section 3 , a description of the methodology is required for all types of reviews except for narrative reviews. This is partly because unlike narrative reviews, all other review articles follow systematic approaches which must ensure significant reproducibility [ 72 ]. Therefore, where necessary, the methods of data extraction from the literature and data synthesis must also be highlighted as well. In some cases, it is important to show how data were combined by highlighting the statistical methods used, measures of effect, and tests performed, as well as demonstrating heterogeneity and publication bias [ 73 ].

The methodology should also detail the major databases consulted during the literature search, e.g., Dimensions, ScienceDirect, Web of Science, MEDLINE, and PubMed. For meta-analysis, it is imperative to highlight the software and/or package used, which could include Comprehensive Meta-Analysis, OpenMEE, Review Manager (RevMan), Stata, SAS, and R Studio. It is also necessary to state the mathematical methods used for the analysis; examples of these include the Bayesian analysis, the Mantel–Haenszel method, and the inverse variance method. The methodology should also state the number of authors that carried out the initial review stage of the study, as it has been recommended that at least two reviews should be done blindly and in parallel, especially when it comes to the acquisition and synthesis of data [ 74 ]. Finally, the quality and validity assessment of the publication used in the review must be stated and well clarified [ 73 ].

5.7. Main Body of the Review

Ideally, the main body of a publishable review should answer these questions: What is new (contribution)? Why so (logic)? So what (impact)? How well it is done (thoroughness)? The flow of the main body of a review article must be well organised to adequately maintain the attention of the readers as well as guide them through the section. It is recommended that the author should consider drawing a conceptual scheme of the main body first, using methods such as mind-mapping. This will help create a logical flow of thought and presentation, while also linking the various sections of the manuscript together. According to Moreira [ 75 ], “reports do not simply yield their findings, rather reviewers make them yield,” and thus, it is the author's responsibility to transform “resistant” texts into “docile” texts. Hence, after the search for the literature, the essential themes and key concepts of the review paper must be identified and synthesised together. This synthesis primarily involves creating hypotheses about the relationships between the concepts with the aim of increasing the understanding of the topic being reviewed. The important information from the various sources should not only be summarised, but the significance of studies must be related back to the initial question(s) posed by the review article. Furthermore, MacLure [ 76 ] stated that data are not just to be plainly “extracted intact” and “used exactly as extracted,” but must be modified, reconfigured, transformed, transposed, converted, tabulated, graphed, or manipulated to enable synthesis, combination, and comparison. Therefore, different pieces of information must be extracted from the reports in which they were previously deposited and then refined into the body of the new article [ 75 ]. To this end, adequate comparison and combination might require that “qualitative data be quantified” or/and “quantitative data may be qualitized” [ 77 ]. In order to accomplish all of these goals, the author may have to transform, paraphrase, generalize, specify, and reorder the text [ 78 ]. For comprehensiveness, the body paragraphs should be arranged in a similar order as it was initially stated in the abstract or/and introduction. Thus, the main body could be divided into thematic areas, each of which could be independently comprehensive and treated as a mini review. Similarly, the sections can also be arranged chronologically depending on the focus of the review. Furthermore, the abstractions should proceed from a wider general view of the literature being reviewed and then be narrowed down to the specifics. In the process, deep insights should also be provided between the topic of the review and the wider subject area, e.g., fungal enzymes and enzymes in general. The abstractions must also be discussed in more detail by presenting more specific information from the identified sources (with proper citations of course!). For example, it is important to identify and highlight contrary findings and rival interpretations as well as to point out areas of agreement or debate among different bodies of literature. Often, there are previous reviews on the same topic/concept; however, this does not prevent a new author from writing one on the same topic, especially if the previous reviews were written many years ago. However, it is important that the body of the new manuscript be written from a new angle that was not adequately covered in the past reviews and should also incorporate new studies that have accumulated since the last review(s). In addition, the new review might also highlight the approaches, limitations, and conclusions of the past studies. But the authors must not be excessively critical of the past reviews as this is regarded by many authors as a sign of poor professionalism [ 3 , 79 ]. Daft [ 79 ] emphasized that it is more important for a reviewer to state how their research builds on previous work instead of outright claiming that previous works are incompetent and inadequate. However, if a series of related papers on one topic have a common error or research flaw that needs rectification, the reviewer must point this out with the aim of moving the field forward [ 3 ]. Like every other scientific paper, the main body of a review article also needs to be consistent in style, for example, in the choice of passive vs. active voice and present vs. past tense. It is also important to note that tables and figures can serve as a powerful tool for highlighting key points in the body of the review, and they are now considered core elements of reviews. For more guidance and insights into what should make up the contents of a good review article, readers are also advised to get familiarised with the Boote and Beile [ 80 ] literature review scoring rubric as well as the review article checklist of Short [ 81 ].

5.8. Tables and Figures

An ideal review article should be logically structured and efficiently utilise illustrations, in the form of tables and figures, to convey the key findings and relationships in the study. According to Tay [ 13 ], illustrations often take a secondary role in review papers when compared to primary research papers which are focused on illustrations. However, illustrations are very important in review articles as they can serve as succinct means of communicating major findings and insights. Franzblau and Chung [ 82 ] pointed out that illustrations serve three major purposes in a scientific article: they simplify complex data and relationships for better understanding, they minimise reading time by summarising and bringing to focus on the key findings (or trends), and last, they help to reduce the overall word count. Hence, inserting and constructing illustrations in a review article is as meticulous as it is important. However, important decisions should be made on whether the charts, figures, or tables to be potentially inserted in the manuscript are indeed needed and how best to design them [ 83 ]. Illustrations should enhance the text while providing necessary information; thus, the information described in illustrations should not contradict that in the main text and should also not be a repetition of texts [ 84 ]. Furthermore, illustrations must be autonomous, meaning they ought to be intelligible without having to read the text portion of the manuscript; thus, the reader does not have to flip back and forth between the illustration and the main text in order to understand it [ 85 ]. It should be noted that tables or figures that directly reiterate the main text or contain extraneous information will only make a mess of the manuscript and discourage readers [ 86 ].

Kotz and Cals [ 87 ] recommend that the layout of tables and figures should be carefully designed in a clear manner with suitable layouts, which will allow them to be referred to logically and chronologically in the text. In addition, illustrations should only contain simple text, as lengthy details would contradict their initial objective, which was to provide simple examples or an overview. Furthermore, the use of abbreviations in illustrations, especially tables, should be avoided if possible. If not, the abbreviations should be defined explicitly in the footnotes or legends of the illustration [ 88 ]. Similarly, numerical values in tables and graphs should also be correctly approximated [ 84 ]. It is recommended that the number of tables and figures in the manuscript should not exceed the target journal's specification. According to Saver [ 89 ], they ideally should not account for more than one-third of the manuscript. Finally, the author(s) must seek permission and give credits for using an already published illustration when necessary. However, none of these are needed if the graphic is originally created by the author, but if it is a reproduced or an adapted illustration, the author must obtain permission from the copyright owner and include the necessary credit. One of the very important tools for designing illustrations is Creative Commons, a platform that provides a wide range of creative works which are available to the public for use and modification.

5.9. Conclusion/Future Perspectives

It has been observed that many reviews end abruptly with a short conclusion; however, a lot more can be included in this section in addition to what has been said in the major sections of the paper. Basically, the conclusion section of a review article should provide a summary of key findings from the main body of the manuscript. In this section, the author needs to revisit the critical points of the paper as well as highlight the accuracy, validity, and relevance of the inferences drawn in the article review. A good conclusion should highlight the relationship between the major points and the author's hypothesis as well as the relationship between the hypothesis and the broader discussion to demonstrate the significance of the review article in a larger context. In addition to giving a concise summary of the important findings that describe current knowledge, the conclusion must also offer a rationale for conducting future research [ 12 ]. Knowledge gaps should be identified, and themes should be logically developed in order to construct conceptual frameworks as well as present a way forward for future research in the field of study [ 11 ].

Furthermore, the author may have to justify the propositions made earlier in the manuscript, demonstrate how the paper extends past research works, and also suggest ways that the expounded theories can be empirically examined [ 3 ]. Unlike experimental studies which can only draw either a positive conclusion or ambiguous failure to reject the null hypothesis, four possible conclusions can be drawn from review articles [ 1 ]. First, the theory/hypothesis propounded may be correct after being proven from current evidence; second, the hypothesis may not be explicitly proven but is most probably the best guess. The third conclusion is that the currently available evidence does not permit a confident conclusion or a best guess, while the last conclusion is that the theory or hypothesis is false [ 1 ]. It is important not to present new information in the conclusion section which has link whatsoever with the rest of the manuscript. According to Harris et al. [ 90 ], the conclusions should, in essence, answer the question: if a reader were to remember one thing about the review, what would it be?

5.10. References

As it has been noted in different parts of this paper, authors must give the required credit to any work or source(s) of information that was included in the review article. This must include the in-text citations in the main body of the paper and the corresponding entries in the reference list. Ideally, this full bibliographical list is the last part of the review article, and it should contain all the books, book chapters, journal articles, reports, and other media, which were utilised in the manuscript. It has been noted that most journals and publishers have their own specific referencing styles which are all derived from the more popular styles such as the American Psychological Association (APA), Chicago, Harvard, Modern Language Association (MLA), and Vancouver styles. However, all these styles may be categorised into either the parenthetical or numerical referencing style. Although a few journals do not have strict referencing rules, it is the responsibility of the author to reference according to the style and instructions of the journal. Omissions and errors must be avoided at all costs, and this can be easily achieved by going over the references many times for due diligence [ 11 ]. According to Cronin et al. [ 12 ], a separate file for references can be created, and any work used in the manuscript can be added to this list immediately after being cited in the text [ 12 ]. In recent times, the emergence of various referencing management software applications such as Endnote, RefWorks, Mendeley, and Zotero has even made referencing easier. The majority of these software applications require little technical expertise, and many of them are free to use, while others may require a subscription. It is imperative, however, that even after using these software packages, the author must manually curate the references during the final draft, in order to avoid any errors, since these programs are not impervious to errors, particularly formatting errors.

6. Concluding Remarks

Writing a review article is a skill that needs to be learned; it is a rigorous but rewarding endeavour as it can provide a useful platform to project the emerging researcher or postgraduate student into the gratifying world of publishing. Thus, the reviewer must develop the ability to think critically, spot patterns in a large volume of information, and must be invested in writing without tiring. The prospective author must also be inspired and dedicated to the successful completion of the article while also ensuring that the review article is not just a mere list or summary of previous research. It is also important that the review process must be focused on the literature and not on the authors; thus, overt criticism of existing research and personal aspersions must be avoided at all costs. All ideas, sentences, words, and illustrations should be constructed in a way to avoid plagiarism; basically, this can be achieved by paraphrasing, summarising, and giving the necessary acknowledgments. Currently, there are many tools to track and detect plagiarism in manuscripts, ensuring that they fall within a reasonable similarity index (which is typically 15% or lower for most journals). Although the more popular of these tools, such as Turnitin and iThenticate, are subscription-based, there are many freely available web-based options as well. An ideal review article is supposed to motivate the research topic and describe its key concepts while delineating the boundaries of research. In this regard, experience-based information on how to methodologically develop acceptable and impactful review articles has been detailed in this paper. Furthermore, for a beginner, this guide has detailed “the why” and “the how” of authoring a good scientific review article. However, the information in this paper may as a whole or in parts be also applicable to other fields of research and to other writing endeavours such as writing literature review in theses, dissertations, and primary research articles. Finally, the intending authors must put all the basic rules of scientific writing and writing in general into cognizance. A comprehensive study of the articles cited within this paper and other related articles focused on scientific writing will further enhance the ability of the motivated beginner to deliver a good review article.

Acknowledgments

This work was supported by the National Research Foundation of South Africa under grant number UID 138097. The authors would like to thank the Durban University of Technology for funding the postdoctoral fellowship of the first author, Dr. Ayodeji Amobonye.

Data Availability

Conflicts of interest.

The authors declare that they have no conflicts of interest.

Finding Scholarly Articles: Home

What's a Scholarly Article?

Your professor has specified that you are to use scholarly (or primary research or peer-reviewed or refereed or academic) articles only in your paper. What does that mean?

Scholarly or primary research articles are peer-reviewed , which means that they have gone through the process of being read by reviewers or referees  before being accepted for publication. When a scholar submits an article to a scholarly journal, the manuscript is sent to experts in that field to read and decide if the research is valid and the article should be published. Typically the reviewers indicate to the journal editors whether they think the article should be accepted, sent back for revisions, or rejected.

To decide whether an article is a primary research article, look for the following:

• The author’s (or authors') credentials and academic affiliation(s) should be given;
• There should be an abstract summarizing the research;
• The methods and materials used should be given, often in a separate section;
• There are citations within the text or footnotes referencing sources used;
• Results of the research are given;
• There should be discussion   and  conclusion ;
• With a bibliography or list of references at the end.

Caution: even though a journal may be peer-reviewed, not all the items in it will be. For instance, there might be editorials, book reviews, news reports, etc. Check for the parts of the article to be sure.   

You can limit your search results to primary research, peer-reviewed or refereed articles in many databases. To search for scholarly articles in  HOLLIS , type your keywords in the box at the top, and select  Catalog&Articles  from the choices that appear next.   On the search results screen, look for the  Show Only section on the right and click on  Peer-reviewed articles . (Make sure to  login in with your HarvardKey to get full-text of the articles that Harvard has purchased.)

Many of the databases that Harvard offers have similar features to limit to peer-reviewed or scholarly articles.  For example in Academic Search Premier , click on the box for Scholarly (Peer Reviewed) Journals  on the search screen.

Review articles are another great way to find scholarly primary research articles.   Review articles are not considered "primary research", but they pull together primary research articles on a topic, summarize and analyze them.  In Google Scholar , click on Review Articles  at the left of the search results screen. Ask your professor whether review articles can be cited for an assignment.

A note about Google searching.  A regular Google search turns up a broad variety of results, which can include scholarly articles but Google results also contain commercial and popular sources which may be misleading, outdated, etc.  Use Google Scholar  through the Harvard Library instead.

About Wikipedia .  W ikipedia is not considered scholarly, and should not be cited, but it frequently includes references to scholarly articles. Before using those references for an assignment, double check by finding them in Hollis or a more specific subject  database .

Still not sure about a source? Consult the course syllabus for guidance, contact your professor or teaching fellow, or use the Ask A Librarian service.

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Types of journal articles

It is helpful to familiarise yourself with the different types of articles published by journals. Although it may appear there are a large number of types of articles published due to the wide variety of names they are published under, most articles published are one of the following types; Original Research, Review Articles, Short reports or Letters, Case Studies, Methodologies.

Original Research:

This is the most common type of journal manuscript used to publish full reports of data from research. It may be called an  Original Article, Research Article, Research, or just  Article, depending on the journal. The Original Research format is suitable for many different fields and different types of studies. It includes full Introduction, Methods, Results, and Discussion sections.

Short reports or Letters:

These papers communicate brief reports of data from original research that editors believe will be interesting to many researchers, and that will likely stimulate further research in the field. As they are relatively short the format is useful for scientists with results that are time sensitive (for example, those in highly competitive or quickly-changing disciplines). This format often has strict length limits, so some experimental details may not be published until the authors write a full Original Research manuscript. These papers are also sometimes called Brief communications .

Review Articles:

Review Articles provide a comprehensive summary of research on a certain topic, and a perspective on the state of the field and where it is heading. They are often written by leaders in a particular discipline after invitation from the editors of a journal. Reviews are often widely read (for example, by researchers looking for a full introduction to a field) and highly cited. Reviews commonly cite approximately 100 primary research articles.

TIP: If you would like to write a Review but have not been invited by a journal, be sure to check the journal website as some journals to not consider unsolicited Reviews. If the website does not mention whether Reviews are commissioned it is wise to send a pre-submission enquiry letter to the journal editor to propose your Review manuscript before you spend time writing it.  

Case Studies:

These articles report specific instances of interesting phenomena. A goal of Case Studies is to make other researchers aware of the possibility that a specific phenomenon might occur. This type of study is often used in medicine to report the occurrence of previously unknown or emerging pathologies.

Methodologies or Methods

These articles present a new experimental method, test or procedure. The method described may either be completely new, or may offer a better version of an existing method. The article should describe a demonstrable advance on what is currently available.

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Research Paper – Structure, Examples and Writing Guide

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Research Paper

Definition:

Research Paper is a written document that presents the author’s original research, analysis, and interpretation of a specific topic or issue.

It is typically based on Empirical Evidence, and may involve qualitative or quantitative research methods, or a combination of both. The purpose of a research paper is to contribute new knowledge or insights to a particular field of study, and to demonstrate the author’s understanding of the existing literature and theories related to the topic.

Structure of Research Paper

The structure of a research paper typically follows a standard format, consisting of several sections that convey specific information about the research study. The following is a detailed explanation of the structure of a research paper:

The title page contains the title of the paper, the name(s) of the author(s), and the affiliation(s) of the author(s). It also includes the date of submission and possibly, the name of the journal or conference where the paper is to be published.

The abstract is a brief summary of the research paper, typically ranging from 100 to 250 words. It should include the research question, the methods used, the key findings, and the implications of the results. The abstract should be written in a concise and clear manner to allow readers to quickly grasp the essence of the research.

Introduction

The introduction section of a research paper provides background information about the research problem, the research question, and the research objectives. It also outlines the significance of the research, the research gap that it aims to fill, and the approach taken to address the research question. Finally, the introduction section ends with a clear statement of the research hypothesis or research question.

Literature Review

The literature review section of a research paper provides an overview of the existing literature on the topic of study. It includes a critical analysis and synthesis of the literature, highlighting the key concepts, themes, and debates. The literature review should also demonstrate the research gap and how the current study seeks to address it.

The methods section of a research paper describes the research design, the sample selection, the data collection and analysis procedures, and the statistical methods used to analyze the data. This section should provide sufficient detail for other researchers to replicate the study.

The results section presents the findings of the research, using tables, graphs, and figures to illustrate the data. The findings should be presented in a clear and concise manner, with reference to the research question and hypothesis.

The discussion section of a research paper interprets the findings and discusses their implications for the research question, the literature review, and the field of study. It should also address the limitations of the study and suggest future research directions.

The conclusion section summarizes the main findings of the study, restates the research question and hypothesis, and provides a final reflection on the significance of the research.

The references section provides a list of all the sources cited in the paper, following a specific citation style such as APA, MLA or Chicago.

How to Write Research Paper

You can write Research Paper by the following guide:

• Choose a Topic: The first step is to select a topic that interests you and is relevant to your field of study. Brainstorm ideas and narrow down to a research question that is specific and researchable.
• Conduct a Literature Review: The literature review helps you identify the gap in the existing research and provides a basis for your research question. It also helps you to develop a theoretical framework and research hypothesis.
• Develop a Thesis Statement : The thesis statement is the main argument of your research paper. It should be clear, concise and specific to your research question.
• Plan your Research: Develop a research plan that outlines the methods, data sources, and data analysis procedures. This will help you to collect and analyze data effectively.
• Collect and Analyze Data: Collect data using various methods such as surveys, interviews, observations, or experiments. Analyze data using statistical tools or other qualitative methods.
• Organize your Paper : Organize your paper into sections such as Introduction, Literature Review, Methods, Results, Discussion, and Conclusion. Ensure that each section is coherent and follows a logical flow.
• Write your Paper : Start by writing the introduction, followed by the literature review, methods, results, discussion, and conclusion. Ensure that your writing is clear, concise, and follows the required formatting and citation styles.
• Edit and Proofread your Paper: Review your paper for grammar and spelling errors, and ensure that it is well-structured and easy to read. Ask someone else to review your paper to get feedback and suggestions for improvement.
• Cite your Sources: Ensure that you properly cite all sources used in your research paper. This is essential for giving credit to the original authors and avoiding plagiarism.

Research Paper Example

Note : The below example research paper is for illustrative purposes only and is not an actual research paper. Actual research papers may have different structures, contents, and formats depending on the field of study, research question, data collection and analysis methods, and other factors. Students should always consult with their professors or supervisors for specific guidelines and expectations for their research papers.

Research Paper Example sample for Students:

Title: The Impact of Social Media on Mental Health among Young Adults

Abstract: This study aims to investigate the impact of social media use on the mental health of young adults. A literature review was conducted to examine the existing research on the topic. A survey was then administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO (Fear of Missing Out) are significant predictors of mental health problems among young adults.

Introduction: Social media has become an integral part of modern life, particularly among young adults. While social media has many benefits, including increased communication and social connectivity, it has also been associated with negative outcomes, such as addiction, cyberbullying, and mental health problems. This study aims to investigate the impact of social media use on the mental health of young adults.

Literature Review: The literature review highlights the existing research on the impact of social media use on mental health. The review shows that social media use is associated with depression, anxiety, stress, and other mental health problems. The review also identifies the factors that contribute to the negative impact of social media, including social comparison, cyberbullying, and FOMO.

Methods : A survey was administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The survey included questions on social media use, mental health status (measured using the DASS-21), and perceived impact of social media on their mental health. Data were analyzed using descriptive statistics and regression analysis.

Results : The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO are significant predictors of mental health problems among young adults.

Discussion : The study’s findings suggest that social media use has a negative impact on the mental health of young adults. The study highlights the need for interventions that address the factors contributing to the negative impact of social media, such as social comparison, cyberbullying, and FOMO.

Conclusion : In conclusion, social media use has a significant impact on the mental health of young adults. The study’s findings underscore the need for interventions that promote healthy social media use and address the negative outcomes associated with social media use. Future research can explore the effectiveness of interventions aimed at reducing the negative impact of social media on mental health. Additionally, longitudinal studies can investigate the long-term effects of social media use on mental health.

Limitations : The study has some limitations, including the use of self-report measures and a cross-sectional design. The use of self-report measures may result in biased responses, and a cross-sectional design limits the ability to establish causality.

Implications: The study’s findings have implications for mental health professionals, educators, and policymakers. Mental health professionals can use the findings to develop interventions that address the negative impact of social media use on mental health. Educators can incorporate social media literacy into their curriculum to promote healthy social media use among young adults. Policymakers can use the findings to develop policies that protect young adults from the negative outcomes associated with social media use.

References :

• Twenge, J. M., & Campbell, W. K. (2019). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventive medicine reports, 15, 100918.
• Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., … & James, A. E. (2017). Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among US young adults. Computers in Human Behavior, 69, 1-9.
• Van der Meer, T. G., & Verhoeven, J. W. (2017). Social media and its impact on academic performance of students. Journal of Information Technology Education: Research, 16, 383-398.

Appendix : The survey used in this study is provided below.

Social Media and Mental Health Survey

• How often do you use social media per day?
• Less than 30 minutes
• 30 minutes to 1 hour
• 1 to 2 hours
• 2 to 4 hours
• More than 4 hours
• Which social media platforms do you use?
• Others (Please specify)
• How often do you experience the following on social media?
• Social comparison (comparing yourself to others)
• Cyberbullying
• Fear of Missing Out (FOMO)
• Have you ever experienced any of the following mental health problems in the past month?
• Do you think social media use has a positive or negative impact on your mental health?
• Very positive
• Somewhat positive
• Somewhat negative
• Very negative
• In your opinion, which factors contribute to the negative impact of social media on mental health?
• Social comparison
• In your opinion, what interventions could be effective in reducing the negative impact of social media on mental health?
• Education on healthy social media use
• Counseling for mental health problems caused by social media
• Social media detox programs
• Regulation of social media use

Thank you for your participation!

Applications of Research Paper

Research papers have several applications in various fields, including:

• Advancing knowledge: Research papers contribute to the advancement of knowledge by generating new insights, theories, and findings that can inform future research and practice. They help to answer important questions, clarify existing knowledge, and identify areas that require further investigation.
• Informing policy: Research papers can inform policy decisions by providing evidence-based recommendations for policymakers. They can help to identify gaps in current policies, evaluate the effectiveness of interventions, and inform the development of new policies and regulations.
• Improving practice: Research papers can improve practice by providing evidence-based guidance for professionals in various fields, including medicine, education, business, and psychology. They can inform the development of best practices, guidelines, and standards of care that can improve outcomes for individuals and organizations.
• Educating students : Research papers are often used as teaching tools in universities and colleges to educate students about research methods, data analysis, and academic writing. They help students to develop critical thinking skills, research skills, and communication skills that are essential for success in many careers.
• Fostering collaboration: Research papers can foster collaboration among researchers, practitioners, and policymakers by providing a platform for sharing knowledge and ideas. They can facilitate interdisciplinary collaborations and partnerships that can lead to innovative solutions to complex problems.

When to Write Research Paper

Research papers are typically written when a person has completed a research project or when they have conducted a study and have obtained data or findings that they want to share with the academic or professional community. Research papers are usually written in academic settings, such as universities, but they can also be written in professional settings, such as research organizations, government agencies, or private companies.

Here are some common situations where a person might need to write a research paper:

• For academic purposes: Students in universities and colleges are often required to write research papers as part of their coursework, particularly in the social sciences, natural sciences, and humanities. Writing research papers helps students to develop research skills, critical thinking skills, and academic writing skills.
• For publication: Researchers often write research papers to publish their findings in academic journals or to present their work at academic conferences. Publishing research papers is an important way to disseminate research findings to the academic community and to establish oneself as an expert in a particular field.
• To inform policy or practice : Researchers may write research papers to inform policy decisions or to improve practice in various fields. Research findings can be used to inform the development of policies, guidelines, and best practices that can improve outcomes for individuals and organizations.
• To share new insights or ideas: Researchers may write research papers to share new insights or ideas with the academic or professional community. They may present new theories, propose new research methods, or challenge existing paradigms in their field.

Purpose of Research Paper

The purpose of a research paper is to present the results of a study or investigation in a clear, concise, and structured manner. Research papers are written to communicate new knowledge, ideas, or findings to a specific audience, such as researchers, scholars, practitioners, or policymakers. The primary purposes of a research paper are:

• To contribute to the body of knowledge : Research papers aim to add new knowledge or insights to a particular field or discipline. They do this by reporting the results of empirical studies, reviewing and synthesizing existing literature, proposing new theories, or providing new perspectives on a topic.
• To inform or persuade: Research papers are written to inform or persuade the reader about a particular issue, topic, or phenomenon. They present evidence and arguments to support their claims and seek to persuade the reader of the validity of their findings or recommendations.
• To advance the field: Research papers seek to advance the field or discipline by identifying gaps in knowledge, proposing new research questions or approaches, or challenging existing assumptions or paradigms. They aim to contribute to ongoing debates and discussions within a field and to stimulate further research and inquiry.
• To demonstrate research skills: Research papers demonstrate the author’s research skills, including their ability to design and conduct a study, collect and analyze data, and interpret and communicate findings. They also demonstrate the author’s ability to critically evaluate existing literature, synthesize information from multiple sources, and write in a clear and structured manner.

Characteristics of Research Paper

Research papers have several characteristics that distinguish them from other forms of academic or professional writing. Here are some common characteristics of research papers:

• Evidence-based: Research papers are based on empirical evidence, which is collected through rigorous research methods such as experiments, surveys, observations, or interviews. They rely on objective data and facts to support their claims and conclusions.
• Structured and organized: Research papers have a clear and logical structure, with sections such as introduction, literature review, methods, results, discussion, and conclusion. They are organized in a way that helps the reader to follow the argument and understand the findings.
• Formal and objective: Research papers are written in a formal and objective tone, with an emphasis on clarity, precision, and accuracy. They avoid subjective language or personal opinions and instead rely on objective data and analysis to support their arguments.
• Citations and references: Research papers include citations and references to acknowledge the sources of information and ideas used in the paper. They use a specific citation style, such as APA, MLA, or Chicago, to ensure consistency and accuracy.
• Peer-reviewed: Research papers are often peer-reviewed, which means they are evaluated by other experts in the field before they are published. Peer-review ensures that the research is of high quality, meets ethical standards, and contributes to the advancement of knowledge in the field.
• Objective and unbiased: Research papers strive to be objective and unbiased in their presentation of the findings. They avoid personal biases or preconceptions and instead rely on the data and analysis to draw conclusions.

Advantages of Research Paper

Research papers have many advantages, both for the individual researcher and for the broader academic and professional community. Here are some advantages of research papers:

• Contribution to knowledge: Research papers contribute to the body of knowledge in a particular field or discipline. They add new information, insights, and perspectives to existing literature and help advance the understanding of a particular phenomenon or issue.
• Opportunity for intellectual growth: Research papers provide an opportunity for intellectual growth for the researcher. They require critical thinking, problem-solving, and creativity, which can help develop the researcher’s skills and knowledge.
• Career advancement: Research papers can help advance the researcher’s career by demonstrating their expertise and contributions to the field. They can also lead to new research opportunities, collaborations, and funding.
• Academic recognition: Research papers can lead to academic recognition in the form of awards, grants, or invitations to speak at conferences or events. They can also contribute to the researcher’s reputation and standing in the field.
• Impact on policy and practice: Research papers can have a significant impact on policy and practice. They can inform policy decisions, guide practice, and lead to changes in laws, regulations, or procedures.
• Advancement of society: Research papers can contribute to the advancement of society by addressing important issues, identifying solutions to problems, and promoting social justice and equality.

Limitations of Research Paper

Research papers also have some limitations that should be considered when interpreting their findings or implications. Here are some common limitations of research papers:

• Limited generalizability: Research findings may not be generalizable to other populations, settings, or contexts. Studies often use specific samples or conditions that may not reflect the broader population or real-world situations.
• Potential for bias : Research papers may be biased due to factors such as sample selection, measurement errors, or researcher biases. It is important to evaluate the quality of the research design and methods used to ensure that the findings are valid and reliable.
• Ethical concerns: Research papers may raise ethical concerns, such as the use of vulnerable populations or invasive procedures. Researchers must adhere to ethical guidelines and obtain informed consent from participants to ensure that the research is conducted in a responsible and respectful manner.
• Limitations of methodology: Research papers may be limited by the methodology used to collect and analyze data. For example, certain research methods may not capture the complexity or nuance of a particular phenomenon, or may not be appropriate for certain research questions.
• Publication bias: Research papers may be subject to publication bias, where positive or significant findings are more likely to be published than negative or non-significant findings. This can skew the overall findings of a particular area of research.
• Time and resource constraints: Research papers may be limited by time and resource constraints, which can affect the quality and scope of the research. Researchers may not have access to certain data or resources, or may be unable to conduct long-term studies due to practical limitations.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Speaking, writing and reading are integral to everyday life, where language is the primary tool for expression and communication. Studying how people use language – what words and phrases they unconsciously choose and combine – can help us better understand ourselves and why we behave the way we do.

Linguistics scholars seek to determine what is unique and universal about the language we use, how it is acquired and the ways it changes over time. They consider language as a cultural, social and psychological phenomenon.

“Understanding why and how languages differ tells about the range of what is human,” said Dan Jurafsky , the Jackson Eli Reynolds Professor in Humanities and chair of the Department of Linguistics in the School of Humanities and Sciences at Stanford . “Discovering what’s universal about languages can help us understand the core of our humanity.”

The stories below represent some of the ways linguists have investigated many aspects of language, including its semantics and syntax, phonetics and phonology, and its social, psychological and computational aspects.

Understanding stereotypes

Stanford linguists and psychologists study how language is interpreted by people. Even the slightest differences in language use can correspond with biased beliefs of the speakers, according to research.

One study showed that a relatively harmless sentence, such as “girls are as good as boys at math,” can subtly perpetuate sexist stereotypes. Because of the statement’s grammatical structure, it implies that being good at math is more common or natural for boys than girls, the researchers said.

Language can play a big role in how we and others perceive the world, and linguists work to discover what words and phrases can influence us, unknowingly.

How well-meaning statements can spread stereotypes unintentionally

New Stanford research shows that sentences that frame one gender as the standard for the other can unintentionally perpetuate biases.

Algorithms reveal changes in stereotypes

New Stanford research shows that, over the past century, linguistic changes in gender and ethnic stereotypes correlated with major social movements and demographic changes in the U.S. Census data.

Exploring what an interruption is in conversation

Stanford doctoral candidate Katherine Hilton found that people perceive interruptions in conversation differently, and those perceptions differ depending on the listener’s own conversational style as well as gender.

Cops speak less respectfully to black community members

Professors Jennifer Eberhardt and Dan Jurafsky, along with other Stanford researchers, detected racial disparities in police officers’ speech after analyzing more than 100 hours of body camera footage from Oakland Police.

How other languages inform our own

People speak roughly 7,000 languages worldwide. Although there is a lot in common among languages, each one is unique, both in its structure and in the way it reflects the culture of the people who speak it.

Jurafsky said it’s important to study languages other than our own and how they develop over time because it can help scholars understand what lies at the foundation of humans’ unique way of communicating with one another.

“All this research can help us discover what it means to be human,” Jurafsky said.

Stanford PhD student documents indigenous language of Papua New Guinea

Fifth-year PhD student Kate Lindsey recently returned to the United States after a year of documenting an obscure language indigenous to the South Pacific nation.

Students explore Esperanto across Europe

In a research project spanning eight countries, two Stanford students search for Esperanto, a constructed language, against the backdrop of European populism.

Chris Manning: How computers are learning to understand language​

A computer scientist discusses the evolution of computational linguistics and where it’s headed next.

Stanford research explores novel perspectives on the evolution of Spanish

Using digital tools and literature to explore the evolution of the Spanish language, Stanford researcher Cuauhtémoc García-García reveals a new historical perspective on linguistic changes in Latin America and Spain.

Language as a lens into behavior

Linguists analyze how certain speech patterns correspond to particular behaviors, including how language can impact people’s buying decisions or influence their social media use.

For example, in one research paper, a group of Stanford researchers examined the differences in how Republicans and Democrats express themselves online to better understand how a polarization of beliefs can occur on social media.

“We live in a very polarized time,” Jurafsky said. “Understanding what different groups of people say and why is the first step in determining how we can help bring people together.”

Analyzing the tweets of Republicans and Democrats

New research by Dora Demszky and colleagues examined how Republicans and Democrats express themselves online in an attempt to understand how polarization of beliefs occurs on social media.

Examining bilingual behavior of children at Texas preschool

A Stanford senior studied a group of bilingual children at a Spanish immersion preschool in Texas to understand how they distinguished between their two languages.

Predicting sales of online products from advertising language

Stanford linguist Dan Jurafsky and colleagues have found that products in Japan sell better if their advertising includes polite language and words that invoke cultural traditions or authority.

Language can help the elderly cope with the challenges of aging, says Stanford professor

By examining conversations of elderly Japanese women, linguist Yoshiko Matsumoto uncovers language techniques that help people move past traumatic events and regain a sense of normalcy.

ORIGINAL RESEARCH article

The causal effect of adipose tissue on hodgkin's lymphoma: two-sample mendelian randomization study and validation.

• Fujian Medical University Union Hospital, Fuzhou, China

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Background: Extensive research has been conducted on the correlation between adipose tissue and the risk of malignant lymphoma. Despite numerous observational studies exploring this connection, uncertainty remains regarding a causal relationship between adipose tissue and malignant lymphoma.Methods: The increase or decrease in adipose tissue was represented by the height of BMI. The BMI and malignant lymphoma genome-wide association studies (GWAS) used a summary dataset from the OPEN GWAS website. Single-nucleotide polymorphisms (SNPs) that met the criteria of P 0.8 were identified, while palindromic and outlier SNPs were excluded. Mendelian randomization (MR) analysis used five methods, including inverse-variance weighted (IVW) model, weighted median (WM), MR-Egger, simple mode, and weighted mode. Sensitivity assessments included Cochran's Q test, MR-Egger intercept test, and leave-one-out analysis. Participants randomly selected by the National Center for Health Statistics (NHANSE) and newly diagnosed HL patients at Fujian Medical University Union Hospital were used for external validation.Results: The results of the MR analysis strongly supported the causal link between BMI and Hodgkin's lymphoma (HL). The research demonstrated that individuals with lower BMI face a significantly increased risk of developing HL, with a 91.65% higher risk (ORIVW = 0.0835, 95% CI 0.0147 -0.4733, P = 0.005). No signs of horizontal or directional pleiotropy were observed in the MR studies. The validation results aligned with the results from the MR analysis (OR = 0.871, 95% CI 0.826 -0.918, P < 0.001). And there was no causal relationship between BMI and non-Hodgkin's lymphoma (NHL).Conclusions: The MR analysis study demonstrated a direct correlation between lower BMI and HL. This suggested that a decrease in adipose tissue increases the risk of developing HL. Nevertheless, further research is essential to grasp the underlying mechanism of this causal association comprehensively.

Keywords: Hodgkin's lymphoma (HL)1, non-Hodgkin's lymphoma (NHL)2, Adipose3, Body mass index (BMI)4, Mendelian randomization (MR)5

Received: 14 Mar 2024; Accepted: 16 May 2024.

Copyright: © 2024 Wu, 廖, Guo and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Nainong Li, Fujian Medical University Union Hospital, Fuzhou, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Cultural Relativity and Acceptance of Embryonic Stem Cell Research

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There is a debate about the ethical implications of using human embryos in stem cell research, which can be influenced by cultural, moral, and social values. This paper argues for an adaptable framework to accommodate diverse cultural and religious perspectives. By using an adaptive ethics model, research protections can reflect various populations and foster growth in stem cell research possibilities.

INTRODUCTION

Stem cell research combines biology, medicine, and technology, promising to alter health care and the understanding of human development. Yet, ethical contention exists because of individuals’ perceptions of using human embryos based on their various cultural, moral, and social values. While these disagreements concerning policy, use, and general acceptance have prompted the development of an international ethics policy, such a uniform approach can overlook the nuanced ethical landscapes between cultures. With diverse viewpoints in public health, a single global policy, especially one reflecting Western ethics or the ethics prevalent in high-income countries, is impractical. This paper argues for a culturally sensitive, adaptable framework for the use of embryonic stem cells. Stem cell policy should accommodate varying ethical viewpoints and promote an effective global dialogue. With an extension of an ethics model that can adapt to various cultures, we recommend localized guidelines that reflect the moral views of the people those guidelines serve.

Stem cells, characterized by their unique ability to differentiate into various cell types, enable the repair or replacement of damaged tissues. Two primary types of stem cells are somatic stem cells (adult stem cells) and embryonic stem cells. Adult stem cells exist in developed tissues and maintain the body’s repair processes. [1] Embryonic stem cells (ESC) are remarkably pluripotent or versatile, making them valuable in research. [2] However, the use of ESCs has sparked ethics debates. Considering the potential of embryonic stem cells, research guidelines are essential. The International Society for Stem Cell Research (ISSCR) provides international stem cell research guidelines. They call for “public conversations touching on the scientific significance as well as the societal and ethical issues raised by ESC research.” [3] The ISSCR also publishes updates about culturing human embryos 14 days post fertilization, suggesting local policies and regulations should continue to evolve as ESC research develops. [4]  Like the ISSCR, which calls for local law and policy to adapt to developing stem cell research given cultural acceptance, this paper highlights the importance of local social factors such as religion and culture.

I.     Global Cultural Perspective of Embryonic Stem Cells

Views on ESCs vary throughout the world. Some countries readily embrace stem cell research and therapies, while others have stricter regulations due to ethical concerns surrounding embryonic stem cells and when an embryo becomes entitled to moral consideration. The philosophical issue of when the “someone” begins to be a human after fertilization, in the morally relevant sense, [5] impacts when an embryo becomes not just worthy of protection but morally entitled to it. The process of creating embryonic stem cell lines involves the destruction of the embryos for research. [6] Consequently, global engagement in ESC research depends on social-cultural acceptability.

a.     US and Rights-Based Cultures

In the United States, attitudes toward stem cell therapies are diverse. The ethics and social approaches, which value individualism, [7] trigger debates regarding the destruction of human embryos, creating a complex regulatory environment. For example, the 1996 Dickey-Wicker Amendment prohibited federal funding for the creation of embryos for research and the destruction of embryos for “more than allowed for research on fetuses in utero.” [8] Following suit, in 2001, the Bush Administration heavily restricted stem cell lines for research. However, the Stem Cell Research Enhancement Act of 2005 was proposed to help develop ESC research but was ultimately vetoed. [9] Under the Obama administration, in 2009, an executive order lifted restrictions allowing for more development in this field. [10] The flux of research capacity and funding parallels the different cultural perceptions of human dignity of the embryo and how it is socially presented within the country’s research culture. [11]

b.     Ubuntu and Collective Cultures

African bioethics differs from Western individualism because of the different traditions and values. African traditions, as described by individuals from South Africa and supported by some studies in other African countries, including Ghana and Kenya, follow the African moral philosophies of Ubuntu or Botho and Ukama , which “advocates for a form of wholeness that comes through one’s relationship and connectedness with other people in the society,” [12] making autonomy a socially collective concept. In this context, for the community to act autonomously, individuals would come together to decide what is best for the collective. Thus, stem cell research would require examining the value of the research to society as a whole and the use of the embryos as a collective societal resource. If society views the source as part of the collective whole, and opposes using stem cells, compromising the cultural values to pursue research may cause social detachment and stunt research growth. [13] Based on local culture and moral philosophy, the permissibility of stem cell research depends on how embryo, stem cell, and cell line therapies relate to the community as a whole. Ubuntu is the expression of humanness, with the person’s identity drawn from the “’I am because we are’” value. [14] The decision in a collectivistic culture becomes one born of cultural context, and individual decisions give deference to others in the society.

Consent differs in cultures where thought and moral philosophy are based on a collective paradigm. So, applying Western bioethical concepts is unrealistic. For one, Africa is a diverse continent with many countries with different belief systems, access to health care, and reliance on traditional or Western medicines. Where traditional medicine is the primary treatment, the “’restrictive focus on biomedically-related bioethics’” [is] problematic in African contexts because it neglects bioethical issues raised by traditional systems.” [15] No single approach applies in all areas or contexts. Rather than evaluating the permissibility of ESC research according to Western concepts such as the four principles approach, different ethics approaches should prevail.

Another consideration is the socio-economic standing of countries. In parts of South Africa, researchers have not focused heavily on contributing to the stem cell discourse, either because it is not considered health care or a health science priority or because resources are unavailable. [16] Each country’s priorities differ given different social, political, and economic factors. In South Africa, for instance, areas such as maternal mortality, non-communicable diseases, telemedicine, and the strength of health systems need improvement and require more focus. [17] Stem cell research could benefit the population, but it also could divert resources from basic medical care. Researchers in South Africa adhere to the National Health Act and Medicines Control Act in South Africa and international guidelines; however, the Act is not strictly enforced, and there is no clear legislation for research conduct or ethical guidelines. [18]

Some parts of Africa condemn stem cell research. For example, 98.2 percent of the Tunisian population is Muslim. [19] Tunisia does not permit stem cell research because of moral conflict with a Fatwa. Religion heavily saturates the regulation and direction of research. [20] Stem cell use became permissible for reproductive purposes only recently, with tight restrictions preventing cells from being used in any research other than procedures concerning ART/IVF.  Their use is conditioned on consent, and available only to married couples. [21] The community's receptiveness to stem cell research depends on including communitarian African ethics.

c.     Asia

Some Asian countries also have a collective model of ethics and decision making. [22] In China, the ethics model promotes a sincere respect for life or human dignity, [23] based on protective medicine. This model, influenced by Traditional Chinese Medicine (TCM), [24] recognizes Qi as the vital energy delivered via the meridians of the body; it connects illness to body systems, the body’s entire constitution, and the universe for a holistic bond of nature, health, and quality of life. [25] Following a protective ethics model, and traditional customs of wholeness, investment in stem cell research is heavily desired for its applications in regenerative therapies, disease modeling, and protective medicines. In a survey of medical students and healthcare practitioners, 30.8 percent considered stem cell research morally unacceptable while 63.5 percent accepted medical research using human embryonic stem cells. Of these individuals, 89.9 percent supported increased funding for stem cell research. [26] The scientific community might not reflect the overall population. From 1997 to 2019, China spent a total of $576 million (USD) on stem cell research at 8,050 stem cell programs, increased published presence from 0.6 percent to 14.01 percent of total global stem cell publications as of 2014, and made significant strides in cell-based therapies for various medical conditions. [27] However, while China has made substantial investments in stem cell research and achieved notable progress in clinical applications, concerns linger regarding ethical oversight and transparency. [28] For example, the China Biosecurity Law, promoted by the National Health Commission and China Hospital Association, attempted to mitigate risks by introducing an institutional review board (IRB) in the regulatory bodies. 5800 IRBs registered with the Chinese Clinical Trial Registry since 2021. [29] However, issues still need to be addressed in implementing effective IRB review and approval procedures.

The substantial government funding and focus on scientific advancement have sometimes overshadowed considerations of regional cultures, ethnic minorities, and individual perspectives, particularly evident during the one-child policy era. As government policy adapts to promote public stability, such as the change from the one-child to the two-child policy, [30] research ethics should also adapt to ensure respect for the values of its represented peoples.

Japan is also relatively supportive of stem cell research and therapies. Japan has a more transparent regulatory framework, allowing for faster approval of regenerative medicine products, which has led to several advanced clinical trials and therapies. [31] South Korea is also actively engaged in stem cell research and has a history of breakthroughs in cloning and embryonic stem cells. [32] However, the field is controversial, and there are issues of scientific integrity. For example, the Korean FDA fast-tracked products for approval, [33] and in another instance, the oocyte source was unclear and possibly violated ethical standards. [34] Trust is important in research, as it builds collaborative foundations between colleagues, trial participant comfort, open-mindedness for complicated and sensitive discussions, and supports regulatory procedures for stakeholders. There is a need to respect the culture’s interest, engagement, and for research and clinical trials to be transparent and have ethical oversight to promote global research discourse and trust.

d.     Middle East

Countries in the Middle East have varying degrees of acceptance of or restrictions to policies related to using embryonic stem cells due to cultural and religious influences. Saudi Arabia has made significant contributions to stem cell research, and conducts research based on international guidelines for ethical conduct and under strict adherence to guidelines in accordance with Islamic principles. Specifically, the Saudi government and people require ESC research to adhere to Sharia law. In addition to umbilical and placental stem cells, [35] Saudi Arabia permits the use of embryonic stem cells as long as they come from miscarriages, therapeutic abortions permissible by Sharia law, or are left over from in vitro fertilization and donated to research. [36] Laws and ethical guidelines for stem cell research allow the development of research institutions such as the King Abdullah International Medical Research Center, which has a cord blood bank and a stem cell registry with nearly 10,000 donors. [37] Such volume and acceptance are due to the ethical ‘permissibility’ of the donor sources, which do not conflict with religious pillars. However, some researchers err on the side of caution, choosing not to use embryos or fetal tissue as they feel it is unethical to do so. [38]

Jordan has a positive research ethics culture. [39] However, there is a significant issue of lack of trust in researchers, with 45.23 percent (38.66 percent agreeing and 6.57 percent strongly agreeing) of Jordanians holding a low level of trust in researchers, compared to 81.34 percent of Jordanians agreeing that they feel safe to participate in a research trial. [40] Safety testifies to the feeling of confidence that adequate measures are in place to protect participants from harm, whereas trust in researchers could represent the confidence in researchers to act in the participants’ best interests, adhere to ethical guidelines, provide accurate information, and respect participants’ rights and dignity. One method to improve trust would be to address communication issues relevant to ESC. Legislation surrounding stem cell research has adopted specific language, especially concerning clarification “between ‘stem cells’ and ‘embryonic stem cells’” in translation. [41] Furthermore, legislation “mandates the creation of a national committee… laying out specific regulations for stem-cell banking in accordance with international standards.” [42] This broad regulation opens the door for future global engagement and maintains transparency. However, these regulations may also constrain the influence of research direction, pace, and accessibility of research outcomes.

e.     Europe

In the European Union (EU), ethics is also principle-based, but the principles of autonomy, dignity, integrity, and vulnerability are interconnected. [43] As such, the opportunity for cohesion and concessions between individuals’ thoughts and ideals allows for a more adaptable ethics model due to the flexible principles that relate to the human experience The EU has put forth a framework in its Convention for the Protection of Human Rights and Dignity of the Human Being allowing member states to take different approaches. Each European state applies these principles to its specific conventions, leading to or reflecting different acceptance levels of stem cell research. [44]

For example, in Germany, Lebenzusammenhang , or the coherence of life, references integrity in the unity of human culture. Namely, the personal sphere “should not be subject to external intervention.” [45]  Stem cell interventions could affect this concept of bodily completeness, leading to heavy restrictions. Under the Grundgesetz, human dignity and the right to life with physical integrity are paramount. [46] The Embryo Protection Act of 1991 made producing cell lines illegal. Cell lines can be imported if approved by the Central Ethics Commission for Stem Cell Research only if they were derived before May 2007. [47] Stem cell research respects the integrity of life for the embryo with heavy specifications and intense oversight. This is vastly different in Finland, where the regulatory bodies find research more permissible in IVF excess, but only up to 14 days after fertilization. [48] Spain’s approach differs still, with a comprehensive regulatory framework. [49] Thus, research regulation can be culture-specific due to variations in applied principles. Diverse cultures call for various approaches to ethical permissibility. [50] Only an adaptive-deliberative model can address the cultural constructions of self and achieve positive, culturally sensitive stem cell research practices. [51]

II.     Religious Perspectives on ESC

Embryonic stem cell sources are the main consideration within religious contexts. While individuals may not regard their own religious texts as authoritative or factual, religion can shape their foundations or perspectives.

The Qur'an states:

“And indeed We created man from a quintessence of clay. Then We placed within him a small quantity of nutfa (sperm to fertilize) in a safe place. Then We have fashioned the nutfa into an ‘alaqa (clinging clot or cell cluster), then We developed the ‘alaqa into mudgha (a lump of flesh), and We made mudgha into bones, and clothed the bones with flesh, then We brought it into being as a new creation. So Blessed is Allah, the Best of Creators.” [52]

Many scholars of Islam estimate the time of soul installment, marked by the angel breathing in the soul to bring the individual into creation, as 120 days from conception. [53] Personhood begins at this point, and the value of life would prohibit research or experimentation that could harm the individual. If the fetus is more than 120 days old, the time ensoulment is interpreted to occur according to Islamic law, abortion is no longer permissible. [54] There are a few opposing opinions about early embryos in Islamic traditions. According to some Islamic theologians, there is no ensoulment of the early embryo, which is the source of stem cells for ESC research. [55]

In Buddhism, the stance on stem cell research is not settled. The main tenets, the prohibition against harming or destroying others (ahimsa) and the pursuit of knowledge (prajña) and compassion (karuna), leave Buddhist scholars and communities divided. [56] Some scholars argue stem cell research is in accordance with the Buddhist tenet of seeking knowledge and ending human suffering. Others feel it violates the principle of not harming others. Finding the balance between these two points relies on the karmic burden of Buddhist morality. In trying to prevent ahimsa towards the embryo, Buddhist scholars suggest that to comply with Buddhist tenets, research cannot be done as the embryo has personhood at the moment of conception and would reincarnate immediately, harming the individual's ability to build their karmic burden. [57] On the other hand, the Bodhisattvas, those considered to be on the path to enlightenment or Nirvana, have given organs and flesh to others to help alleviate grieving and to benefit all. [58] Acceptance varies on applied beliefs and interpretations.

Catholicism does not support embryonic stem cell research, as it entails creation or destruction of human embryos. This destruction conflicts with the belief in the sanctity of life. For example, in the Old Testament, Genesis describes humanity as being created in God’s image and multiplying on the Earth, referencing the sacred rights to human conception and the purpose of development and life. In the Ten Commandments, the tenet that one should not kill has numerous interpretations where killing could mean murder or shedding of the sanctity of life, demonstrating the high value of human personhood. In other books, the theological conception of when life begins is interpreted as in utero, [59] highlighting the inviolability of life and its formation in vivo to make a religious point for accepting such research as relatively limited, if at all. [60] The Vatican has released ethical directives to help apply a theological basis to modern-day conflicts. The Magisterium of the Church states that “unless there is a moral certainty of not causing harm,” experimentation on fetuses, fertilized cells, stem cells, or embryos constitutes a crime. [61] Such procedures would not respect the human person who exists at these stages, according to Catholicism. Damages to the embryo are considered gravely immoral and illicit. [62] Although the Catholic Church officially opposes abortion, surveys demonstrate that many Catholic people hold pro-choice views, whether due to the context of conception, stage of pregnancy, threat to the mother’s life, or for other reasons, demonstrating that practicing members can also accept some but not all tenets. [63]

Some major Jewish denominations, such as the Reform, Conservative, and Reconstructionist movements, are open to supporting ESC use or research as long as it is for saving a life. [64] Within Judaism, the Talmud, or study, gives personhood to the child at birth and emphasizes that life does not begin at conception: [65]

“If she is found pregnant, until the fortieth day it is mere fluid,” [66]

Whereas most religions prioritize the status of human embryos, the Halakah (Jewish religious law) states that to save one life, most other religious laws can be ignored because it is in pursuit of preservation. [67] Stem cell research is accepted due to application of these religious laws.

We recognize that all religions contain subsets and sects. The variety of environmental and cultural differences within religious groups requires further analysis to respect the flexibility of religious thoughts and practices. We make no presumptions that all cultures require notions of autonomy or morality as under the common morality theory , which asserts a set of universal moral norms that all individuals share provides moral reasoning and guides ethical decisions. [68] We only wish to show that the interaction with morality varies between cultures and countries.

III.     A Flexible Ethical Approach

The plurality of different moral approaches described above demonstrates that there can be no universally acceptable uniform law for ESC on a global scale. Instead of developing one standard, flexible ethical applications must be continued. We recommend local guidelines that incorporate important cultural and ethical priorities.

While the Declaration of Helsinki is more relevant to people in clinical trials receiving ESC products, in keeping with the tradition of protections for research subjects, consent of the donor is an ethical requirement for ESC donation in many jurisdictions including the US, Canada, and Europe. [69] The Declaration of Helsinki provides a reference point for regulatory standards and could potentially be used as a universal baseline for obtaining consent prior to gamete or embryo donation.

For instance, in Columbia University’s egg donor program for stem cell research, donors followed standard screening protocols and “underwent counseling sessions that included information as to the purpose of oocyte donation for research, what the oocytes would be used for, the risks and benefits of donation, and process of oocyte stimulation” to ensure transparency for consent. [70] The program helped advance stem cell research and provided clear and safe research methods with paid participants. Though paid participation or covering costs of incidental expenses may not be socially acceptable in every culture or context, [71] and creating embryos for ESC research is illegal in many jurisdictions, Columbia’s program was effective because of the clear and honest communications with donors, IRBs, and related stakeholders.  This example demonstrates that cultural acceptance of scientific research and of the idea that an egg or embryo does not have personhood is likely behind societal acceptance of donating eggs for ESC research. As noted, many countries do not permit the creation of embryos for research.

Proper communication and education regarding the process and purpose of stem cell research may bolster comprehension and garner more acceptance. “Given the sensitive subject material, a complete consent process can support voluntary participation through trust, understanding, and ethical norms from the cultures and morals participants value. This can be hard for researchers entering countries of different socioeconomic stability, with different languages and different societal values. [72]

An adequate moral foundation in medical ethics is derived from the cultural and religious basis that informs knowledge and actions. [73] Understanding local cultural and religious values and their impact on research could help researchers develop humility and promote inclusion.

IV.     Concerns

Some may argue that if researchers all adhere to one ethics standard, protection will be satisfied across all borders, and the global public will trust researchers. However, defining what needs to be protected and how to define such research standards is very specific to the people to which standards are applied. We suggest that applying one uniform guide cannot accurately protect each individual because we all possess our own perceptions and interpretations of social values. [74] Therefore, the issue of not adjusting to the moral pluralism between peoples in applying one standard of ethics can be resolved by building out ethics models that can be adapted to different cultures and religions.

Other concerns include medical tourism, which may promote health inequities. [75] Some countries may develop and approve products derived from ESC research before others, compromising research ethics or drug approval processes. There are also concerns about the sale of unauthorized stem cell treatments, for example, those without FDA approval in the United States. Countries with robust research infrastructures may be tempted to attract medical tourists, and some customers will have false hopes based on aggressive publicity of unproven treatments. [76]

For example, in China, stem cell clinics can market to foreign clients who are not protected under the regulatory regimes. Companies employ a marketing strategy of “ethically friendly” therapies. Specifically, in the case of Beike, China’s leading stem cell tourism company and sprouting network, ethical oversight of administrators or health bureaus at one site has “the unintended consequence of shifting questionable activities to another node in Beike's diffuse network.” [77] In contrast, Jordan is aware of stem cell research’s potential abuse and its own status as a “health-care hub.” Jordan’s expanded regulations include preserving the interests of individuals in clinical trials and banning private companies from ESC research to preserve transparency and the integrity of research practices. [78]

The social priorities of the community are also a concern. The ISSCR explicitly states that guidelines “should be periodically revised to accommodate scientific advances, new challenges, and evolving social priorities.” [79] The adaptable ethics model extends this consideration further by addressing whether research is warranted given the varying degrees of socioeconomic conditions, political stability, and healthcare accessibilities and limitations. An ethical approach would require discussion about resource allocation and appropriate distribution of funds. [80]

While some religions emphasize the sanctity of life from conception, which may lead to public opposition to ESC research, others encourage ESC research due to its potential for healing and alleviating human pain. Many countries have special regulations that balance local views on embryonic personhood, the benefits of research as individual or societal goods, and the protection of human research subjects. To foster understanding and constructive dialogue, global policy frameworks should prioritize the protection of universal human rights, transparency, and informed consent. In addition to these foundational global policies, we recommend tailoring local guidelines to reflect the diverse cultural and religious perspectives of the populations they govern. Ethics models should be adapted to local populations to effectively establish research protections, growth, and possibilities of stem cell research.

For example, in countries with strong beliefs in the moral sanctity of embryos or heavy religious restrictions, an adaptive model can allow for discussion instead of immediate rejection. In countries with limited individual rights and voice in science policy, an adaptive model ensures cultural, moral, and religious views are taken into consideration, thereby building social inclusion. While this ethical consideration by the government may not give a complete voice to every individual, it will help balance policies and maintain the diverse perspectives of those it affects. Embracing an adaptive ethics model of ESC research promotes open-minded dialogue and respect for the importance of human belief and tradition. By actively engaging with cultural and religious values, researchers can better handle disagreements and promote ethical research practices that benefit each society.

This brief exploration of the religious and cultural differences that impact ESC research reveals the nuances of relative ethics and highlights a need for local policymakers to apply a more intense adaptive model.

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Culturally, autonomy practices follow a relational autonomy approach based on a paternalistic deontological health care model. The adherence to strict international research policies and religious pillars within the regulatory environment is a great foundation for research ethics. However, there is a need to develop locally targeted ethics approaches for research (as called for in Alahmad, G., Aljohani, S., & Najjar, M. F. (2020). Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia. BMC medical ethics, 21(1), 35. https://doi.org/10.1186/s12910-020-00482-6), this decision-making approach may help advise a research decision model. For more on the clinical cultural autonomy approaches, see: Alabdullah, Y. Y., Alzaid, E., Alsaad, S., Alamri, T., Alolayan, S. W., Bah, S., & Aljoudi, A. S. (2022). Autonomy and paternalism in Shared decision‐making in a Saudi Arabian tertiary hospital: A cross‐sectional study. Developing World Bioethics , 23 (3), 260–268. https://doi.org/10.1111/dewb.12355 ; Bukhari, A. A. (2017). Universal Principles of Bioethics and Patient Rights in Saudi Arabia (Doctoral dissertation, Duquesne University). https://dsc.duq.edu/etd/124; Ladha, S., Nakshawani, S. A., Alzaidy, A., & Tarab, B. (2023, October 26). Islam and Bioethics: What We All Need to Know . Columbia University School of Professional Studies. https://sps.columbia.edu/events/islam-and-bioethics-what-we-all-need-know

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[43] The EU’s definition of autonomy relates to the capacity for creating ideas, moral insight, decisions, and actions without constraint, personal responsibility, and informed consent. However, the EU views autonomy as not completely able to protect individuals and depends on other principles, such as dignity, which “expresses the intrinsic worth and fundamental equality of all human beings.” Rendtorff, J.D., Kemp, P. (2019). Four Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity and Vulnerability. In: Valdés, E., Lecaros, J. (eds) Biolaw and Policy in the Twenty-First Century. International Library of Ethics, Law, and the New Medicine, vol 78. Springer, Cham. https://doi.org/10.1007/978-3-030-05903-3_3

[44] Council of Europe. Convention for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (ETS No. 164) https://www.coe.int/en/web/conventions/full-list?module=treaty-detail&treatynum=164 (forbidding the creation of embryos for research purposes only, and suggests embryos in vitro have protections.); Also see Drabiak-Syed B. K. (2013). New President, New Human Embryonic Stem Cell Research Policy: Comparative International Perspectives and Embryonic Stem Cell Research Laws in France.  Biotechnology Law Report ,  32 (6), 349–356. https://doi.org/10.1089/blr.2013.9865

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[48] Regulation of Stem Cell Research in Finland . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-finland

[49] Regulation of Stem Cell Research in Spain . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-spain

[50] Some sources to consider regarding ethics models or regulatory oversights of other cultures not covered:

Kara MA. Applicability of the principle of respect for autonomy: the perspective of Turkey. J Med Ethics. 2007 Nov;33(11):627-30. doi: 10.1136/jme.2006.017400. PMID: 17971462; PMCID: PMC2598110.

Ugarte, O. N., & Acioly, M. A. (2014). The principle of autonomy in Brazil: one needs to discuss it ...  Revista do Colegio Brasileiro de Cirurgioes ,  41 (5), 374–377. https://doi.org/10.1590/0100-69912014005013

Bharadwaj, A., & Glasner, P. E. (2012). Local cells, global science: The rise of embryonic stem cell research in India . Routledge.

For further research on specific European countries regarding ethical and regulatory framework, we recommend this database: Regulation of Stem Cell Research in Europe . Eurostemcell. (2017, April 26). https://www.eurostemcell.org/regulation-stem-cell-research-europe   

[51] Klitzman, R. (2006). Complications of culture in obtaining informed consent. The American Journal of Bioethics, 6(1), 20–21. https://doi.org/10.1080/15265160500394671 see also: Ekmekci, P. E., & Arda, B. (2017). Interculturalism and Informed Consent: Respecting Cultural Differences without Breaching Human Rights.  Cultura (Iasi, Romania) ,  14 (2), 159–172.; For why trust is important in research, see also: Gray, B., Hilder, J., Macdonald, L., Tester, R., Dowell, A., & Stubbe, M. (2017). Are research ethics guidelines culturally competent?  Research Ethics ,  13 (1), 23-41.  https://doi.org/10.1177/1747016116650235

[52] The Qur'an  (M. Khattab, Trans.). (1965). Al-Mu’minun, 23: 12-14. https://quran.com/23

[53] Lenfest, Y. (2017, December 8). Islam and the beginning of human life . Bill of Health. https://blog.petrieflom.law.harvard.edu/2017/12/08/islam-and-the-beginning-of-human-life/

[54] Aksoy, S. (2005). Making regulations and drawing up legislation in Islamic countries under conditions of uncertainty, with special reference to embryonic stem cell research. Journal of Medical Ethics , 31: 399-403.; see also: Mahmoud, Azza. "Islamic Bioethics: National Regulations and Guidelines of Human Stem Cell Research in the Muslim World." Master's thesis, Chapman University, 2022. https://doi.org/10.36837/ chapman.000386

[55] Rashid, R. (2022). When does Ensoulment occur in the Human Foetus. Journal of the British Islamic Medical Association , 12 (4). ISSN 2634 8071. https://www.jbima.com/wp-content/uploads/2023/01/2-Ethics-3_-Ensoulment_Rafaqat.pdf.

[56] Sivaraman, M. & Noor, S. (2017). Ethics of embryonic stem cell research according to Buddhist, Hindu, Catholic, and Islamic religions: perspective from Malaysia. Asian Biomedicine,8(1) 43-52.  https://doi.org/10.5372/1905-7415.0801.260

[57] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[58] Lecso, P. A. (1991). The Bodhisattva Ideal and Organ Transplantation.  Journal of Religion and Health ,  30 (1), 35–41. http://www.jstor.org/stable/27510629 ; Bodhisattva, S. (n.d.). The Key of Becoming a Bodhisattva . A Guide to the Bodhisattva Way of Life. http://www.buddhism.org/Sutras/2/BodhisattvaWay.htm

[59] There is no explicit religious reference to when life begins or how to conduct research that interacts with the concept of life. However, these are relevant verses pertaining to how the fetus is viewed. (( King James Bible . (1999). Oxford University Press. (original work published 1769))

Jerimiah 1: 5 “Before I formed thee in the belly I knew thee; and before thou camest forth out of the womb I sanctified thee…”

In prophet Jerimiah’s insight, God set him apart as a person known before childbirth, a theme carried within the Psalm of David.

Psalm 139: 13-14 “…Thou hast covered me in my mother's womb. I will praise thee; for I am fearfully and wonderfully made…”

These verses demonstrate David’s respect for God as an entity that would know of all man’s thoughts and doings even before birth.

[60] It should be noted that abortion is not supported as well.

[61] The Vatican. (1987, February 22). Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation Replies to Certain Questions of the Day . Congregation For the Doctrine of the Faith. https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html

[62] The Vatican. (2000, August 25). Declaration On the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells . Pontifical Academy for Life. https://www.vatican.va/roman_curia/pontifical_academies/acdlife/documents/rc_pa_acdlife_doc_20000824_cellule-staminali_en.html ; Ohara, N. (2003). Ethical Consideration of Experimentation Using Living Human Embryos: The Catholic Church’s Position on Human Embryonic Stem Cell Research and Human Cloning. Department of Obstetrics and Gynecology . Retrieved from https://article.imrpress.com/journal/CEOG/30/2-3/pii/2003018/77-81.pdf.

[63] Smith, G. A. (2022, May 23). Like Americans overall, Catholics vary in their abortion views, with regular mass attenders most opposed . Pew Research Center. https://www.pewresearch.org/short-reads/2022/05/23/like-americans-overall-catholics-vary-in-their-abortion-views-with-regular-mass-attenders-most-opposed/

[64] Rosner, F., & Reichman, E. (2002). Embryonic stem cell research in Jewish law. Journal of halacha and contemporary society , (43), 49–68.; Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[65] Schenker J. G. (2008). The beginning of human life: status of embryo. Perspectives in Halakha (Jewish Religious Law).  Journal of assisted reproduction and genetics ,  25 (6), 271–276. https://doi.org/10.1007/s10815-008-9221-6

[66] Ruttenberg, D. (2020, May 5). The Torah of Abortion Justice (annotated source sheet) . Sefaria. https://www.sefaria.org/sheets/234926.7?lang=bi&with=all&lang2=en

[67] Jafari, M., Elahi, F., Ozyurt, S. & Wrigley, T. (2007). 4. Religious Perspectives on Embryonic Stem Cell Research. In K. Monroe, R. Miller & J. Tobis (Ed.),  Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical, and Political Issues  (pp. 79-94). Berkeley: University of California Press.  https://escholarship.org/content/qt9rj0k7s3/qt9rj0k7s3_noSplash_f9aca2e02c3777c7fb76ea768ba458f0.pdf https://doi.org/10.1525/9780520940994-005

[68] Gert, B. (2007). Common morality: Deciding what to do . Oxford Univ. Press.

[69] World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA , 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 Declaration of Helsinki – WMA – The World Medical Association .; see also: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979).  The Belmont report: Ethical principles and guidelines for the protection of human subjects of research . U.S. Department of Health and Human Services.  https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html

[70] Zakarin Safier, L., Gumer, A., Kline, M., Egli, D., & Sauer, M. V. (2018). Compensating human subjects providing oocytes for stem cell research: 9-year experience and outcomes.  Journal of assisted reproduction and genetics ,  35 (7), 1219–1225. https://doi.org/10.1007/s10815-018-1171-z https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063839/ see also: Riordan, N. H., & Paz Rodríguez, J. (2021). Addressing concerns regarding associated costs, transparency, and integrity of research in recent stem cell trial. Stem Cells Translational Medicine , 10 (12), 1715–1716. https://doi.org/10.1002/sctm.21-0234

[71] Klitzman, R., & Sauer, M. V. (2009). Payment of egg donors in stem cell research in the USA.  Reproductive biomedicine online ,  18 (5), 603–608. https://doi.org/10.1016/s1472-6483(10)60002-8

[72] Krosin, M. T., Klitzman, R., Levin, B., Cheng, J., & Ranney, M. L. (2006). Problems in comprehension of informed consent in rural and peri-urban Mali, West Africa.  Clinical trials (London, England) ,  3 (3), 306–313. https://doi.org/10.1191/1740774506cn150oa

[73] Veatch, Robert M.  Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict . Georgetown University Press, 2012.

[74] Msoroka, M. S., & Amundsen, D. (2018). One size fits not quite all: Universal research ethics with diversity.  Research Ethics ,  14 (3), 1-17.  https://doi.org/10.1177/1747016117739939

[75] Pirzada, N. (2022). The Expansion of Turkey’s Medical Tourism Industry.  Voices in Bioethics ,  8 . https://doi.org/10.52214/vib.v8i.9894

[76] Stem Cell Tourism: False Hope for Real Money . Harvard Stem Cell Institute (HSCI). (2023). https://hsci.harvard.edu/stem-cell-tourism , See also: Bissassar, M. (2017). Transnational Stem Cell Tourism: An ethical analysis.  Voices in Bioethics ,  3 . https://doi.org/10.7916/vib.v3i.6027

[77] Song, P. (2011) The proliferation of stem cell therapies in post-Mao China: problematizing ethical regulation,  New Genetics and Society , 30:2, 141-153, DOI:  10.1080/14636778.2011.574375

[78] Dajani, R. (2014). Jordan’s stem-cell law can guide the Middle East.  Nature  510, 189. https://doi.org/10.1038/510189a

[79] International Society for Stem Cell Research. (2024). Standards in stem cell research . International Society for Stem Cell Research. https://www.isscr.org/guidelines/5-standards-in-stem-cell-research

[80] Benjamin, R. (2013). People’s science bodies and rights on the Stem Cell Frontier . Stanford University Press.

Mifrah Hayath

SM Candidate Harvard Medical School, MS Biotechnology Johns Hopkins University

Olivia Bowers

MS Bioethics Columbia University (Disclosure: affiliated with Voices in Bioethics)

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• 09 May 2024

Cubic millimetre of brain mapped in spectacular detail

• Carissa Wong

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Rendering based on electron-microscope data, showing the positions of neurons in a fragment of the brain cortex. Neurons are coloured according to size. Credit: Google Research & Lichtman Lab (Harvard University). Renderings by D. Berger (Harvard University)

Researchers have mapped a tiny piece of the human brain in astonishing detail. The resulting cell atlas, which was described today in Science 1 and is available online , reveals new patterns of connections between brain cells called neurons, as well as cells that wrap around themselves to form knots, and pairs of neurons that are almost mirror images of each other.

The 3D map covers a volume of about one cubic millimetre, one-millionth of a whole brain, and contains roughly 57,000 cells and 150 million synapses — the connections between neurons. It incorporates a colossal 1.4 petabytes of data. “It’s a little bit humbling,” says Viren Jain, a neuroscientist at Google in Mountain View, California, and a co-author of the paper. “How are we ever going to really come to terms with all this complexity?”

Slivers of brain

The brain fragment was taken from a 45-year-old woman when she underwent surgery to treat her epilepsy. It came from the cortex, a part of the brain involved in learning, problem-solving and processing sensory signals. The sample was immersed in preservatives and stained with heavy metals to make the cells easier to see. Neuroscientist Jeff Lichtman at Harvard University in Cambridge, Massachusetts, and his colleagues then cut the sample into around 5,000 slices — each just 34 nanometres thick — that could be imaged using electron microscopes.

Jain’s team then built artificial-intelligence models that were able to stitch the microscope images together to reconstruct the whole sample in 3D. “I remember this moment, going into the map and looking at one individual synapse from this woman’s brain, and then zooming out into these other millions of pixels,” says Jain. “It felt sort of spiritual.”

A single neuron (white) shown with 5,600 of the axons (blue) that connect to it. The synapses that make these connections are shown in green. Credit: Google Research & Lichtman Lab (Harvard University). Renderings by D. Berger (Harvard University)

When examining the model in detail, the researchers discovered unconventional neurons, including some that made up to 50 connections with each other. “In general, you would find a couple of connections at most between two neurons,” says Jain. Elsewhere, the model showed neurons with tendrils that formed knots around themselves. “Nobody had seen anything like this before,” Jain adds.

The team also found pairs of neurons that were near-perfect mirror images of each other. “We found two groups that would send their dendrites in two different directions, and sometimes there was a kind of mirror symmetry,” Jain says. It is unclear what role these features have in the brain.

Proofreaders needed

The map is so large that most of it has yet to be manually checked, and it could still contain errors created by the process of stitching so many images together. “Hundreds of cells have been ‘proofread’, but that’s obviously a few per cent of the 50,000 cells in there,” says Jain. He hopes that others will help to proofread parts of the map they are interested in. The team plans to produce similar maps of brain samples from other people — but a map of the entire brain is unlikely in the next few decades, he says.

“This paper is really the tour de force creation of a human cortex data set,” says Hongkui Zeng, director of the Allen Institute for Brain Science in Seattle. The vast amount of data that has been made freely accessible will “allow the community to look deeper into the micro-circuitry in the human cortex”, she adds.

Gaining a deeper understanding of how the cortex works could offer clues about how to treat some psychiatric and neurodegenerative diseases. “This map provides unprecedented details that can unveil new rules of neural connections and help to decipher the inner working of the human brain,” says Yongsoo Kim, a neuroscientist at Pennsylvania State University in Hershey.

doi: https://doi.org/10.1038/d41586-024-01387-9

Shapson-Coe, A. et al. Science 384 , eadk4858 (2024).

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